Final- Health Promo
A lab value that is commonly decreased in older adults is A. creatinine clearance B. serum cholesterol. C. serum triglyceride D. blood urea nitrogen (Ch. 3 Winland-Brown)
A
According to the Joint National Committee (JNC) on Prevention, Detection, Evaluation and Treatment of High Blood Pressure guidElines, Jesse, who has stage I hypertension, should be placed on which treatment plan for control of his hypertension? A. Thiazide diuretic B. Diet and exercise C. One drug from one of the following classes: ACE inhibitor, calcium channel blocker, or angiotensin receptor blocker (ARB) D. Thiazide diuretic and either ACE inhibitor, calcium channel blocker or and ARB. (Ch. 3 Winland-Brown)
A
Bone density studies to screen for osteoporosis should be performed on which of the following? A. Perimenopausal women who used to smoke but no longer do B. Only on women after menopause C. All women who have had hysterectomies D. Women with drinking problems (Ch. 3 Winland-Brown)
A
Dennis, age 62, has benign prostatic hyperplasia (BPH). He tells you that he voids at least four times per night and that he has read about a preventive drug called terazosin hydrochloride (Hytrin) that might help him. What do you tell him? A. "Its not a preventive drug but it relaxes smooth muscle in the prostate and bladder neck." B. "It changes the pH of the urine and prevents infections caused by urinary stasis." C. "It relaxes the urethra." D. It shrinks the prostate tissue." (Ch. 3 Winland-Brown)
A
Eileen, a 42 year old woman, comes to your office with the chief complaint of fatigue, weight loss, and blurred vision. Eileen has a negative past medical history for any chronic medical problems. You obtain a fasting chemistry panel, lipid profile, CBC, and HgbA1c. The results of the blood work show Eileen's blood sugar to be elevated at 356 mg/dL, total cholesterol elevated at 255, HDL is 28, LDL is elevated at 167, triglycerides 333, and HgbA1c 12. On questioning Eileen further, you discover that both her grandmothers had adult-onset diabetes mellitus. You diagnose type 2 diabetes mellitus. Your treatment plan should include a cholesterol-lowering agent, an agent that lowers blood sugar, and which other class of medication? A. ACE inhibitor B. Diuretic C. Weight loss medication D. Beta Blocker (Ch. 3 Winland-Brown)
A
For primary prevention of skin cancer, you would recommend a sunscreen with how much ultraviolet (UV) wave protection? A. 15 B. 25 C. 30 D. 45 (Ch. 3 Winland-Brown)
A
How do you respond when Mattie, who is taking levothyroxine (Levothroid, Synthroid), says she has read that she should not eat brussels sprouts? A. "Burssels sprouts contain a high amount of iodine, and therefore you should not eat them." B. "Brussels sprouts interfere with the absorption of the medication." C. "There is no reason why you should not eat brussels sprouts.." D. "It is safe if you take the medication in the morning and don't eat brussels sprouts until the evening." (Ch. 3 Winland-Brown)
A
If a screening test used on 100 individuals known to be free of breast cancer identified 80 individuals who did not have breast cancer while missing 20 of the individuals, the specificity would be A. 80% B. 60% C. 40% D. 20% (Ch. 3 Winland-Brown)
A
Margo, age 50, is perimenopausal. She tells you she is taking dehydroepiandrosterone (DHEA) and wants to start on hormone replacement therapy (HRT). When she asks for your opinion, you tell her that A. taking both DHEA and HRT is not recommended because it is like "doulbe dosing." B. DHEA is safe and will not affect prescribed medications C. she will be safe as long as she takes the minimum dose of both therapies D. DHEA has the same pharmacotherapeutic effects as HRT (Ch. 3 Winland-Brown)
A
Marie, a Russian Jew, married Endo, a Filipino, and is adapting to his culture. This is referred to as A. acculturation. B. biculturalism C. cultural relativity. D. enculturation. (Ch. 3 Winland-Brown)
A
Mary, a 70 year old woman with diabetes, is at your office for her 3 month diabetic checkup. Mary's list of medications includes Glucophage XR 1000mg daily, an angiotensin-coverting enzyme (ACE) inhibitor daily, and one baby aspirin (ASA) daily. Mary's blood work showed a fasting blood sugar of 112 and glycosylated hemoglobin (GhbA1c) of 6.5. You tell Mary that her blood work shows A. that her diabetes is under good control and she should remain on the same medications. B. that her diabetes is controlled and she needs to have her medications decreased. C. that her diabetes is not controlled and her medications need to be increased. D. that her diabetes has resolved and she no longer needs any medication. (Ch. 3 Winland-Brown)
A
Most anal cancers are potentially preventable. Which of the following is a cause of anal cancer? A. Sexually transmitted diseases (STDs) B. a low-fiber diet C. Hemorrhoids D. Foreign bodies used as sexual stimulants (Ch. 3 Winland-Brown)
A
One of the most common causes of involuntary weight loss is A. malignancy B. pulmonary disease. C. endocrine disturbances D. substance abuse (Ch. 3 Winland-Brown)
A
Providers understand the effects of stress on the body. These effects go beyound the skin and can impair hair follicles. Which of the following conditions in a female can be described as hair "coming out in handfuls?" A. Telogen effluvium B. Alopecia areata C. Female pattern hair loss D. Androgenic baldness (Ch. 3 Winland-Brown)
A
Sam, age 30 has a total cholesterol level of 186 mg/dL. How often should he be screened for hypercholesterolemia? A. every 5 years B. every 2 years C. every year D. Whenever blood work is done (Ch. 3 Winland-Brown)
A
Susan is traveling to South America and wonders if she should get a tetanus and diphtheria (Td) vaccination. You tell her that A. she needs one if she has not had a Td shot within the past 10 years B. she should have tetanus immune globulin administered before departure. C. she should receive a tetanus shot now D. tetanus and diphtheria are not longer a serious problem in South America (Ch. 3 Winland-Brown)
A
The U.S. government report, Healthy People 2020, National Health Promotion and Disease Prevention Objectives, lists which of the following as leading health indicators? A. Obesity, substance abuse, and immunizations B. Obesity, responsible sexual behavior, and driver education C. Obesity, substance abuse, and driver education D. Obesity, immunizations, and driver education (Ch. 3 Winland-Brown)
A
The best strategy to promote personal health is to A. instill a sense of responsibility in persons for their own health. B. provide complete health information in many languages. C. encourage health-promoting habits D. teach clients about appropriate risk factors. (Ch. 3 Winland-Brown)
A
Tuberculin skin testing using the Mantoux test should be considered for A. high-risk adolescents, recent immigrants, and homeless individuals. B. all clients every 2 years C. all clients at their annual physical D. all children before entrance into first-grade (Ch. 3 Winland-Brown)
A
What is the ultimate goal of crisis intervention? A. To help persons function at a higher level than in their precrisis state. B. To help persons eliminate the crisis and get back to where they were. C. To prevent further crises D. To eliminate stress altogether (Ch. 3 Winland-Brown)
A
When does the National Cholesterol Education Program recommend cholesterol sreening for persons with no family history of coronary heart disease before age 55? A. Starting at age 20 and then at least every 5 years if the cholesterol level remains normal B. Whenever any other blood test is ordered C. At the annual routine physical D. Starting at age 20 and then annually (Ch. 3 Winland-Brown)
A
When performing a sports physical exam on Kevin, a 16 year old healthy boy, which question in the history is important to ask Kevin or his guardian? A. Did anyone in your family ever have sudden cardiac death? B. Does anyone in your family have elevated cholesterol levels? C. Did you ever have any injury requiring stitches? D. Does anyone in your family have a history of asthma? (Ch. 3 Winland-Brown)
A
Which federal insurance program went into effect in 1966 to provide funds for medical costs for persons age 65 and older, as well as disabled persons of any age? A. Medicare B. Title XIX of the Social Security Act C. Medicaid D. Omnibus Reconciliation Act (Ch. 3 Winland-Brown)
A
Which health-care system delivers comprehensive health maintenance and treatment services to members of an enrolled group who pay a prenegotiated and fixed payment? A. Health maintenance organizations (HMOs) B. Preferred provider organizations (PPOs) C. Fee-for-service (FFS) independent practices D. Exclusive provider organizations (EPOs) (Ch. 3 Winland-Brown)
A
Which is the leading cause of cancer deaths? A. Lung cancer B. Prostate cancer C. Colon cancer D. Breast cancer (Ch. 3 Winland-Brown)
A
Which of the following is a major risk factor associated with osteoporosis and fragility fractures? A. Body wight less than 127 lb B. Alcohol intake greater than 2 drinks/day C. Estrogen deficiency occurring before 45 years of age D. Low physical activity (Ch. 3 Winland-Brown)
A
Which of the following statements is true about the older adult? A. Older adults are at an increased risk for depression. B. Depression is a normal part of aging. C. Depression may just be the emotion felt when a spouse is grieving the loss of a loved one. D. Most antidepressive drugs do not work without psychotherapy on older adults. (Ch. 3 Winland-Brown)
A
Which part of Medicare is basic hospital insurance? A. Medicare Part A B. Medicare Part B C. Medicare Part C D. Medicare Part D (Ch. 3 Winland-Brown)
A
Which statement is true regarding testicular cancer? A. White men are at higher risk. B. All races are equally susceptible C. Although testicular self-examination (TSE) alerts the person to the presence of a tumor, it has not been shown to decrease mortality. D. TSE should be taught to all middle-aged men. (Ch. 3 Winland-Brown)
A
Who is the most important source of social support for an adult? A. Spouse (if applicable) B. Parents C. Close friends D. Children (Ch. 3 Winland-Brown)
A
What is the goal of a sports physical? A. To clear all athletes for full participation in their sport activity. B. To limit the number of athletes participating in a sport activity C. To identify health risks that may be minimized or cured in order to allow participation D. To identify students at risk for health problems and limit their sports participation (Ch. 3 Winland-Brown)
C
What is the most common type of occupational (nonfatal) illness in the United States? A. Poisoning B. Respiratory conditions caused by toxic agents C. Repetitive stress injury D. Skin disorders (Ch. 3 Winland-Brown)
C
When is routine screening for hypothyroidism performed? A. When a client reaches age 65 B. Whenever a client exhibits symptoms C. Never; it is not routinely recommended D. When a client has a family history of thyroid problems (Ch. 3 Winland-Brown)
C
Which class of drugs causes the most adverse reactions? A. Chemotherapeutic agents B. Anticovulsants C. Antibiotics D. Antidepressants (Ch. 3 Winland-Brown)
C
Which individuals does the U.S. Preventive Services Task Force (USPSTF) recommend screening for depression? A. Adults who are experiencing gender issues B. Adults who has already tried unsuccessfully to commit suicide C. All adults D. If a provider suspects depression, the individual should be referred to a specialist rather than screening in the primary care office. (Ch. 3 Winland-Brown)
C
Which of the following criteria is not diagnostic for a child with attention deficit-hyperactivity disorder (ADHD)? A. The child frequently blurts out the answer to a question before the question is finished. B. The child has difficulty following directions. C. The child talks very little but is very restless. D. The child often engages in physically dangerous activities. (Ch. 3 Winland-Brown)
C
Which of the following definitions refers to the epidemiologic term of endemic? A. Outbreaks of an illness/disease that occur occasionally and are unrelated in space and time B. Presence of an event (illness or disease) at a much higher than expected rate based on past history. C. Presence of an illness/disease constantly present or present at a rate that is expected based on history. D. Presence of an event in epidemic proportions affecting many communities and countries in a short period of time. (Ch. 3 Winland-Brown)
C
Which of the following is a true contraindication to immunizations? A. Mild-to-moderate local reaction to a previous immunization B. Mild acute illness with a low-grade fever C. Moderate or severe illness with or without a fever D. Recent exposure to an infectious disease (Ch. 3 Winland-Brown)
C
Which statement about gender diparities and suicide is true? A. Women take their own lives more often than men. B. Men attempt suicide more often than women C. Suicide rates for males are highest among those aged 75 and older. D. Poisoning is the most common method of suicide for both sexes. (Ch. 3 Winland-Brown)
C
Women tend to outlive men by an average of A. 3-4 years B. 5-6 years C. 6-7 years D. 7 or more years (Ch. 3 Winland-Brown)
C
You see a 48-year-old patient who started taking varenicline (Chantix) 4 weeks ago to aid in smoking cessation. Which of the following is the most important question to ask during today's visit? A. "How many cigarettes a day are you currently smoking?" B. "On a scale of 0 to 10, how strong is your desire to smoke?" C. "Have you noticed any changes in your mood?" D. "Are you having any trouble sleeping?
C. "Have you noticed any changes in your mood?"
In the United States, universal childhood HBV began in what year? A. 1962 B. 1972 C. 1982 D. 1992
C. 1982
In the United States, what proportion of all reported hepatitis A cases have no specific risk factor identified? A. Approximately 25% B. Approximately 50% C. Approximately 75% D. Nearly 100%
C. Approximately 75%
A 44-year-old woman with asthma presents asking for a "flu shot." She is seen today for an urgent care visit, is diagnosed with a lower urinary tract infection, and is prescribed trimethoprim-sulfamethoxazole. She is without fever or gastrointestinal upset with stable respiratory status. You inform her that she: A. should return for the immunization after completing her antibiotic therapy. B. would likely develop a significant reaction if immunized today. C. can receive the immunization today. D. is not a candidate for any form of influenza vaccine.
C. can receive the immunization today.
Which of the following types of cancer screening is not routinely recommended in a 55-year-old woman? A. breast B. skin C. endometrial D. colorectal
C. endometrial
Which of the following is an example of a primary prevention activity in a 76-year-old woman with osteoporosis? A. bisphosphonate therapy B. calcium supplementation C. ensuring adequate illumination in the home D. use of a back brace
C. ensuring adequate illumination in the home
A 50-year-old man with hypertension and dyslipidemia presents for a primary care visit. He states, "It has been at least 10 years since my last tetanus shot." He should be immunized with: A. Td. B. Tetanus IG. C. Tdap. D. None of the above, owing to his concomitant health problems.
C. Tdap.
Of the following, the most common route of hepatitis A virus (HAV) transmission is: A. needle sharing. B. raw shellfish ingestion. C. ingestion of contaminated food or water. D. exposure to blood and body fluids.
C. ingestion of contaminated food or water.
A middle-aged man with chronic obstructive pulmonary disease who is about to receive injectable influenza vaccine should be advised that: A. it is more than 90% effective in preventing influenza. B. its use is contraindicated in the presence of psoriasis vulgaris. C. localized reactions such as soreness and redness at the site of the immunization are fairly common. D. a short, intense, flu like syndrome typically occurs after immunization
C. localized reactions such as soreness and redness at the site of the immunization are fairly common.
In which of the following groups is routine HBsAg screening recommended? A. hospital laboratory workers B. recipients of hepatitis B vaccine series C. pregnant women D. college students
C. pregnant women
An 18-year-old man has no primary tetanus immunization series documented. Which of the following represents the immunization needed? A. three doses of diphtheria, tetanus, and acellular pertussis (DTaP) vaccine 2 months apart B. tetanus IG now and two doses of tetanus-diphtheria(Td) vaccine 1 month apart C. tetanus, diphtheria, and acellular pertussis (Tdap) vaccine now with a dose of Td vaccine in 1 and 6 months D. Td vaccine as a single dose
C. tetanus, diphtheria, and acellular pertussis (Tdap) vaccine now with a dose of Td vaccine in 1 and 6 months
Influenza protection options for a 62-year-old manwith hypertension, dyslipidemia, and type 2 diabetesmellitus include receiving: A. live attenuated influenza vaccine via nasal spray. B. high-dose trivalent inactivated vaccine (TIV) via intramuscular injection C. trivalent inactivated vaccine (TIV) in standard dose via intramuscular injection. D. appropriate antiviral medication as the initial onset of influenza-like illness.
C. trivalent inactivated vaccine (TIV) in standard dose via intramuscular injection.
When advising a patient about the influenza nasal sprayvaccine, the NP considers the following: A. Its use is acceptable during pregnancy. B. Its use is limited to children younger than 6 years. C. It contains live, attenuated virus. D. This is the preferred method of influenza protection in the presence of airway disease
C.It contains live, attenuated virus.
When considering an adult's risk for measles, mumps,and rubella (MMR), the NP considers the following: A. Patients born before 1957 have a high likelihood of immunity against these diseases because of a history of natural infection. B. Considerable mortality and morbidity occur with all three diseases. C. Most cases in the United States occur in infants. D. The use of the MMR vaccine is often associated with protracted arthralgia
A. Patients born before 1957 have a high likelihood of immunity against these diseases because of a history of natural infection.
Identify whether the item has the characteristics of 23-valent pneumococcal polysaccharide vaccine (PPSV23)or 13-valent pneumococcal conjugate vaccine (PCV13). A. Routinely used in early childhood ________ B. Use is associated with greater immunogenicity________ C. Routinely used in all well adults age 65 years orolder________ D. Not licensed for use in children younger than 2 years of age________
A. Routinely used in early childhood- PSV13 B. Use is associated with greater immunogenicity-PSV13 C. Routinely used in all well adults age 65 years or older- PSV23 D. Not licensed for use in children younger than 2 years of age- PSV23
Which of the following statements best describes amantadine or rimantadine use in the care of patients with or at risk for influenza? A. Significant resistance to select strains of influenza limits the usefulness of these medications. B. The primary action of these therapies is in preventing influenza A during outbreaks. C. These therapies are active against influenza A and B. D. The use of these products is an acceptable alternative to influenza vaccine
A. Significant resistance to select strains of influenza limits the usefulness of these medications.
Which wound presents the greatest risk for tetanus infection? A. a puncture wound obtained while gardening B. a laceration obtained while trimming beef C. a human bite D. an abrasion obtained by falling on a sidewalk
A. a puncture wound obtained while gardening
Peak infectivity of persons with hepatitis A usually occurs: A. before onset of jaundice. B. at the time of maximum elevation of liver enzymes. C. during the recovery period. D. at the time of maximum disease-associated symptoms.
A. before onset of jaundice.
Which of the following best describes how the variola virus that causes smallpox is transmitted? A. direct deposit of infective droplets B. surface contact C. blood and body fluids D. vertical transmission
A. direct deposit of infective droplets
How is the varicella virus most commonly transmitted? A. droplet transmission B. contact with inanimate reservoirs C. contact transmission D. waterborne transmission
A. droplet transmission
Which of the following products provides passive immunity? A. hepatitis B immune globulin (HBIG) B. measles, mumps, and rubella (MMR) vaccine C. pneumococcal conjugate vaccine D. live attenuated influenza vaccine
A. hepatitis B immune globulin (HBIG)
Smallpox vaccine contains: A. live vaccinia virus. B. a virus fragment. C. dead smallpox virus. D. an antigenic protein
A. live vaccinia virus.
During an office visit, a 48-year-old man who smokes two packs of cigarettes per day states, "My kids are begging me to quit. My dad smoked and died when he was 80. I am not sure what all the fuss is about." According to the Stages of Change Transtheoretical Model, his statement is most consistent with a person at the stage of: A. precontemplation. B. contemplation. C. preparation. D. action.
A. precontemplation.
Which of the following is usually viewed as the most cost-effective form of healthcare? A. primary prevention B. secondary prevention C. tertiary prevention D. cancer-reduction measures
A. primary prevention
Active immunity is defined as: A. resistance developed in response to an antigen. B. immunity conferred by an antibody produced in another host. C. the resistance of a group to an infectious agent. D. defense against disease acquired naturally by the infant from the mother
A. resistance developed in response to an antigen.
Secondary prevention measures for a 78-year-old man with chronic obstructive pulmonary disease include: A. screening for mood disorders. B. administering influenza vaccine. C. obtaining a serum theophylline level. D. advising about appropriate use of car passenger restraints
A. screening for mood disorders
Brief intervention that provides motivation to quit tobacco use should be: A. used at every clinical visit that the tobacco user has,regardless of reason for the visit. B. offered when the tobacco user voices concern about the health effects of smoking. C. applied primarily during visits for conditions that are clearly related to or exacerbated by tobacco use,such as respiratory tract disease. D. when the clinician is conducting a comprehensive health assessment, such as with the annual physical examination.
A. used at every clinical visit that the tobacco user has,regardless of reason for the visit.
You are sharing with your client the idea that he needs to get some counseling to deal with his severe stress because it is affecting his physiological condition. Which of the following hormonal changes occurs during severe stress? A. A decrease in catecholamines B. An increase in cortisol C. A decrease in antidiuretic hormone D. A decrease in aldosterone (Ch. 3 Winland-Brown)
B
A sedentary, obese 52-year-old woman is diagnosed with hypertension and states, "It is going to be too hard to diet, exercise, and take these pills." What is the least helpful response to her statement? A. "Try taking your medication when you brush your teeth." B. "You really need to try to improve your health." C. "Tell me what you feel will get in your way of improving your health." D. "Could you start with reducing the amount of salty foods in your diet?
B. "You really need to try to improve your health."
An example of a primary prevention measure for a 78-year-old man with chronic obstructive pulmonary disease is: A. reviewing the use of prescribed medications. B. conducting a home survey to minimize fall risk. C. checking FEV1/FVC ratio. D. ordering fecal occult blood test (FOBT).
B. conducting a home survey to minimize fall risk.
During an office visit, a 38-year-old woman states, "I drink way too much but do not know what to do to stop." According to the Stages of Change Transtheoretical Model, her statement is most consistent with a person at the stage of: A. precontemplation. B. contemplation. C. preparation. D. action
B. contemplation.
An 18-year-old woman with allergic rhinitis presents for primary care. She is sexually active with a male partner and is 1 year post-coitarche; during this time she had had two sex partners. An example of a primary prevention activity for this patient is: A. screening for sexually transmitted infection. B. counseling about safer sexual practices. C. prescribing therapies for minimizing allergy. D. obtaining a liquid-based Papanicolaou (Pap) test
B. counseling about safer sexual practices.
A 22-year-old man is starting a job in a college health center and needs proof of German measles, measles,and mumps immunity. He received childhood immunizations and supplies documentation of MMR vacci-nation at age 1.5 years. Your best response is to: A. obtain rubella, measles (rubeola), and mumps titers. B. give MMR immunization now. C. advise him to obtain IG if he has been exposed to measles or rubella. D. advise him to avoid individuals with skin rashes
B. give MMR immunization now.
You see Harold, a 25-year-old man who recently had multiple sexual encounters without condom use with a male partner who has chronic hepatitis B. Harold provides documentation of receiving a properly timed hepatitis B immunization series. In addition to counseling about safer sexual practices, you also advise that Harold: A. needs to repeat his hepatitis B immunization series. B. receive a single dose of HBV vaccine. C. be tested for hepatitis B surface antibody (HBsAb). D. should receive hepatitis B immune globulin (HBIG)and a single dose of the hepatitis B immunization series
B. receive a single dose of HBV vaccine.
Anorexia nervosa is a steady, intentional loss of weight with maintenance of that weight at an extremely unhealthy low level. Which statement is true regarding anorexia nervosa? A. The poor eating habits result in diarrhea. B. It may cause tachycardia. C. It may occur from prepubescence into the early 30s D. It may cause excessive bleeding during menses. (Ch. 3 Winland-Brown)
C
By 2030, the number of U.S. adults aged 65 or older will more than double to about 71 million. What percentage of older adults have one chronic condition? A. 30% B. 50% C. 80% D. almost 100% (Ch. 3 Winland-Brown)
C
Concerning hepatitis B virus (HBV) vaccine, which ofthe following is true? A. The vaccine contains live, whole HBV. B. Adults should routinely have anti-hepatitis B surface antibody titers measured after three doses of vaccine. C. The vaccine should be offered during treatment for sexually transmitted diseases in unimmunized adults. D. Serologic testing for hepatitis B surface antigen(HBsAg) should be done before hepatitis B vaccination is initiated in adults.
C. The vaccine should be offered during treatment for sexually transmitted diseases in unimmunized adults
Carol, a nursing student, is at your office for her nursing school admittance physical exam and immunizations. On reviewing carol's allergies, you find that she is allergic to baker's yeast. What would you tell Carol regarding the hepatitis B vaccine? A. You recommend that she receive the first hepatitis B vaccine today B. You advise her to wait until she is starting her clinical rotations to get the first hepatitis B injection C. You advise her that she cannot receive the hepatitis B vaccine because of her allergy to baker's yeast. D. You instruct her to receive the first hepatitis B vaccine today, the second injection in 6 months, and the third injection in 1 year. (Ch. 3 Winland-Brown)
C
Ethnocentrism is A. being concerned about the health needs of all Americans. B. putting the group being studied at the center of dialogue. C. thinking that the ethnic groups other than one's own are inferior. D. keeping a central focus on commonalities, not differences. (Ch. 3 Winland-Brown)
C
Which of the following should not receive vaccination against influenza? A. a 19 year-old with a history of hive-form reaction to eating eggs B. a 24-year-old woman who is 8 weeks pregnant C. a 4-month-old infant who was born at 32 weeks of gestation D. a 28-year-old woman who is breastfeeding a 2 week old.
C. a 4-month-old infant who was born at 32 weeks of gestation
Which of the following is a recommended method of annual colorectal cancer screening for a 62-year-old man?A. digital rectal examination B. in-office fecal occult blood test (FOBT) C. at-home FOBT D. sigmoidoscopy
C. at-home FOBT
Harry is taking his entire family to Central America and is wondering about protection against mosquito bites causing malaria. What advise do you give him? A. Use an insect repellent with diethyltoluamide (DEET) for the entire family, applying it sparingly to small children B. Make sure the family is in a well-screened or indoor areas from dusk to dawn. C. Use an insect repellent with DEET for adults and permethrin for children, and stay inside from dusk to dawn. D. Stay inside from dusk to dawn, and use an insect repellent with permethrin. (Ch. 3 Winland-Brown)
C
Herbert, a 69 year old man, comes to your office complaining of nocturia. On questioning Herbert, you find that for the past 3 months he has been getting up at least five times a night to void. He came in to seek help today because of his wife's insistence that he be checked out. When you perform the digital rectal exam, you find that his prostate protrudes 3-4 cm into the rectum. What grade would you assign to Herbert's prostate enlargement? A. Grade 1 B. Grade 2 C. Grade 3 D. Grade 4 (Ch. 3 Winland-Brown)
C
How do you respond when Jill, age 42, asks you what constitutes a good minimum cardiovascular workout? A. Exercising for at least 30 minutes every day B. Exercising a total of 2 hours per week C. Exercising for at least 20 minutes 3 or more days per week D. Exercising for at least 30 minutes, 5 days per week. (Ch. 3 Winland-Brown)
C
In women with HIV infection, there is a high prevalence of additional infection from A. Chlamydia B. syphilis C. human papillomavirus (HPV) D. Candida (Ch. 3 Winland-Brown)
C
Jan's mother has Alzheimer's disease. She tells you that her mother's recent memory is poor and that she is easily disoriented, incorrectly identifies people, and is lethargic. Jan asks you, "Is this as bad as it gets?" You tell her that her mother is in which stage of the disease? A. Stage 1 B. Stage 2 C. Stage 3 D. Stage 4 (Ch. 3 Winland-Brown)
C
Josephine, a 60 year old woman, presents to your office with a history of elevated total cholesterol, triglycerides, and low-density lipoprotein (LDL) cholesterol. She was started on a statin medication 4 weeks ago and is concerned about some muscle pains she has been experiencing. On questioning Josephine, you discover that she has had pain in both her thighs for the past 2 weeks. What possible complication of statin therapy are you concerned that Josephine might be experiencing? A. Liver failure B. Renal failure C. Rhabdomyolysis D. Rheumatoid arthritis (Ch. 3 Winland-Brown)
C
Julia, age 18 asks you how many calories of fat she is eating when one serving has 3 g of fat. You tell her A. 12 calories B. 18 calories C. 27 calories D. 30 calories (Ch. 3 Winland-Brown)
C
Many of the 78 million baby boomers have a hearing loss. In a survey, all of the following statements were reported by baby boomers. Which statement was shared by the greatest percentage? A. Hearing loss is affecting the home life of baby boomers B. Baby boomers have problems hearing on cell phones C. Baby boomers are reluctant to admit the impact of their hearing loss D. Hearing loss is affecting the work/jobs of baby boomers (Ch. 3 Winland-Brown)
C
Margaret, age 29, is of medium build and 5ft 4 in. tall. You estimate that she should weigh about A. 105 lb B. 110 lb C. 120 lb D. 130 lb (Ch. 3 Winland-Brown)
C
Marvin is a gay man who is ready to "come out." What is the last step in the process of coming out? A. Testing and exploration B. Identity acceptance C. Identity integration and self-disclosure D. Awareness of homosexual feelings. (Ch. 3 Winland-Brown)
C
Mimi, age 52, asks why she should perform a monthly breast self-examination (BSE) when she has an annual exam by the physician, as well as a yearly mammogram. You respond, A. "If you are faithful about your annual exams and mammograms, that is enough." B. "More breast abnormalities are picked up by mammograms than by clinical exams or BSE." C. "More than 90% of all breast abnormalities are first detected by self-examination." D. "Self-examinations need to be performed only every other month." (Ch. 3 Winland-Brown)
C
Molly, age 48, is health and has well-controlled asthma. She asks if she should get an annual flu vaccination. You tell her that she should A. get it only after she reaches age 65 B. get it only during the fall season when her asthma is bothering her C. get it on an annual basis D. not get it because she has a respiratory problem (asthma) (Ch. 3 Winland-Brown)
C
Postmenopausal women who are not on hormone replacement therapy need how much calcium per day to help prevent osteoporosis? A. 1,000 mg B 1,200 mg C. 1,500 mg D. 1,800 mg (Ch. 3 Winland-Brown)
C
Sal is traveling out of the country and asks for a prescription to prevent traveler's diarrhea. What do you give him? A. Trimethoprim with sulfamethoxazole (TMP-SMX) double strength daily B. Bismuth subsalicylate, 2 tabs qid C. Nothing, but tell him to "cook it, boil it, peel it, or forget it" D. Nothing but tell him to use bottled drinking water (Ch. 3 Winland-Brown)
C
Sally, age 25, is of normal weight. She follows a diet of 70% carbohydrates, 10% fat, and 20% proteins. How do you respond when she asks you if this is a good diet? A. "Yes, this is a good diet." B. "No, you should eat more proteins." C. "You should be eating only about 55% carbohydrates." D. "Make sure your fats are divided among saturated, polyunsaturated, and monounsaturated fats." (Ch. 3 Winland-Brown)
C
Sandra, a 27 year old nurse, states that she does not want to get the hepatitis B virus vaccine because of its adverse effects. You tell her that the most common adverse effect s A. fatigue B. headache C. pain at the injection site. D. elevated temperature (Ch. 3 Winland-Brown)
C
Screening is considered a form of A. health counseling. B. Primary prevention C. Secondary prevention D. tertiary intervention (Ch. 3 Winland-Brown)
C
The National Cancer Institute (NCI) recommends that mammography, as a method of screeing for breast cancer, should be performed A. every year after 40 B. only after a woman finds a lump when performing monthly breast self-examinations C. every 1-2 years after the age of 40 D. After a clinical breast exam every 2 years (Ch. 3 Winland-Brown)
C
The first step in alleviating the problem of homelessness is to A. increase available housing for low-income individuals. B. make public assistance more readily available. C. correct the public's perception of homeless persons D. provide community support for deinstitutionalized persons. (Ch. 3 Winland-Brown)
C
Utilization review refers to a system A. of reviewing access to and utilization of healthcare services. B. that uses retrospective review of client records to reveal problems that may be addressed in the future. C. to monitor diagnosis, treatment, and billing practices to assist in lowering costs. D. that has client use an identification card to be able to use healthcare services. (Ch. 3 Winland-Brown)
C
What is an example of an active strategy of health promotion? A. Maintaining clean water B. Introducing fluoride into the water C. Enacting a stress management program D. Maintaining a sanitary sewage system (Ch. 3 Winland-Brown)
C
A child's head circumference should be measured until the child reaches what age? A. 6 months B. 12 months C. 18 months D. 24 months (Ch. 3 Winland-Brown)
D
A diagram that depicts each member of a family, shows connections between the generations, and includes genetically related diseases is called a A. family assessment diagram B. family generation illustration. C. generations diagram D. genogram (Ch. 3 Winland-Brown)
D
A heart-healthy diet should be recommended to clients A. with a LDL level greater than 160 mg/dL B. with a total cholesterol level greater than 200 mg/dL C. with a HDL cholesterol level below 35 mg/dL D. regardless of age or risk. (Ch. 3 Winland-Brown)
D
A high sodium intake contributes to the risk of A. cancer B. heart disease C. osteoporosis D. hypertension (Ch. 3 Winland-Brown)
D
Andrea, a 20 year old nursing student, never had her second measles, mumps, rubella (MMR) immunization. What test must you do before giving Andrea her second MMR? A. Complete blood count B. Complete metabolic panel C. Lipid profile D. Urine pregnancy test (Ch. 3 Winland-Brown)
D
Emily, a health 26 year old woman, asks you how she can preent bone loss as she ages. She is concerned because both her maternal grandmother and now her mother have severe osteoporosis. What guidance would you give to Emily? A. Drink all the soda you lik- it has no effect on you bone density. B. It has not been proved that smoking affects bone loss C. Replace estrogen when you reach menopause. D. Perform aerobic exercise at least three times a week (Ch. 3 Winland-Brown)
D
Harey, age 55, comes to the office with a blood pressure of 144/96 mm Hg. He states that he did not know if it was ever elevated before. When you retake his blood pressure at the end of the examination, it remains at 144/96. What should your next action be? A. Start him on an ACE inhibitor. B. Start him on a diuretic. C. Have him monitor his blood pressure at home. D. Try nonpharmacological methods and have him monitor his blood pressure at home. (Ch. 3 Winland-Brown)
D
How can health-care providers help prevent the spread of antibiotic resistance? A. By ordering medication empirically B. by ordering an antibiotic that is not commonly given C. By ordering an antibiotic that the patient has not received before D. By ordering an agent targeting the likely pathogens (Ch. 3 Winland-Brown)
D
In discussing sexuality with the mother of a 4 year old, you should be concerned with which of the following? A. Has your child asked questions about anatomical differences between sexes? B. Does you child touch his or her own genitals? C. Does you child play "doctor" with children of the opposite sex? D. A yes answer to any of these questions is of no concern (Ch. 3 Winland-Brown)
D
Joseph, a 55 year old man with diabetes, is at your office for his diabetes follow-up. On examining his feet with monofilament, you discover that he has developed decreased sensation in both feet. There are no open areas or signs of infection on his feet. What health teaching should Joseph receive today regarding the care of his feet? A. Wash your feet with cold water only. B. See a podiatrist every 2 years, inspect your own feet monthly, and apply lotion to your feet daily. C. Go to a spa and have a pedicure monthly. D. See a podiatrist yearly; wash your feet daily with warm, soapy water and towel dry between the toes; inspect your feet daily for any lesions; and apply lotion to any dry areas. (Ch. 3 Winland-Brown)
D
Marian's husband, Stu, age 72, has temporal arteritis. She tells you that his physician wants to perform a biopsy of the temporal artery. She asks if there is a less invasive diagnostic test. What test do you tell her is less invasive? A. Computed tomography (CT) scan B. Magnetic resonance imaging (MRI) C. Electroencephalogram (EEG) D. Color duplex ultrasonography (Ch. 3 Winland-Brown)
D
Martha, age 82, has an asymptomatic carotid bruit on the left side. What do you recommend? A. ASA therapy B. Coumadin therapy C. Surgery D. No treatment at this time (Ch. 3 Winland-Brown)
D
Mildred, a 92 year old independent woman, is moving into her daughter's home. Her daughter comes to see you seeking information to help keep her mother from falling. Which of the following interventions would you suggest she do to help prevent Mildred from falling? A. Install an intercom system in Mildred's bedroom B. Limit the time Mildred is home alone. C. Hire an aide to assist Mildred 24 hours a day. D. Remove all loose rugs from floors and install hand grasps in bathtubs and near toilets. (Ch. 3 Winland-Brown)
D
One of the major criteria for diagnosing chronic fatigue syndrome is A. generalized headaches B. unexplained, generalized muscle weakness C. sleep disturbance D. fatigue for more than 6 months (Ch. 3 Winland-Brown)
D
Performing range-of-motion exercises on a client who has had a cerebrovascular accident (CVA) is an example of which level of prevention? A. Primary prevention B. Secondary prevention C. Complications prevention D. Rehabilitation prevention (Ch. 3 Winland-Brown)
D
Screening test recommendations for HIV infection include A. all clients B. persons getting married C. teenagers who have been sexually active for 1 year D. intravenous drug users and clients with high-risk behaviors. (Ch. 3 Winland-Brown)
D
Susie, age 5, comes to the clinic for a well child visit. She has not been in since she was 2. Her immunizations are up to date. What immunizations would you give her today? A. None; wait until she is 6 years old to give her booster shots B. Diphtheria, tetanus, and pertussis (DTaP); Haemophilus influenzae type B (HiB); and measles, mumps, and rubella (MMR) C. DTaP and IPV D. DTap, IPV, and MMR (Ch. 3 Winland-Brown)
D
The U.S. Department of Health and Human Services recommends which of the following exercise guidelines for Americans to reduce the risk of chronic disease in adulthood? A. Participate in 45 minutes of cardiovascular exercise at least three times per week B. Walk 1 hour every day C. Engage in vigorous intense activity 60 minutes most days of the week D. Engage in 30 minutes or more of moderately intense physical activity at least 5 days per week. (Ch. 3 Winland-Brown)
D
The major public health and safety focus in the United States has shifted to A. cardiovascular risk reduction B. domestic abuse and violence D. unintended pregnancies. D. the threat of bioterrorism (Ch. 3 Winland-Brown)
D
The two main causes of death among U.S. adults aged 65 years or older are A. heart disease and stroke B. stroke and suicide C. heart disease and Alzheimer's disease. D. heart disease and cancer (Ch. 3 Winland-Brown)
D
Twenty percent of colorectal cancers can be attributed to which dietary cause? A. High-fat diet B. High-carbohydrate diet C. Use of alcohol D. Lack of fiber in the diet (Ch. 3 Winland-Brown)
D
When should children have their first visual acuity testing? A. When they are able to read B. When they enter kindergarten C. At age 2 D. At age 3 (Ch. 3 Winland-Brown)
D
When should glaucoma screening be instituted? A. When the client is 65 B. When the client exhibits vision problems C. At the client's annual exam D. Starting at age 40 (Ch. 3 Winland-Brown)
D
Which of the following individuals should get the shingles (herpes zoster) vaccine? A. Jerry, who has a mild upper respiratory tract infection and is allergic to neomycin B. Timmy, who has been on prolonged use of high-dose steroids for his COPD C. Joan, whose husband recently had shingles, and who is trying to get pregnant D. Joe, who has a stressful job. (Ch. 3 Winland-Brown)
D
Which tumor marker is specifically elevated in prostate cancer? A. Prostate cancer tumor marker (PCTM) B. Cancer antigen (CA) 125 C. Carinoembryonic antigen (CEA) D. Prostate-specific antigen (PSA) (Ch. 3 Winland-Brown)
D
Who should get the annual flu vaccination? A. Patients who have asthma and COPD B. Residents in a nursing home C. All individuals, including infants D. All persons aged 6 months and older (Ch. 3 Winland-Brown)
D
The best defense against colds, flu, and respiratory syncytial virus is A. the flue shot B. prevention. C. increased dosage of vitamin C D. rimantadine HCL (Flumadine) (Ch. 3 Winland-Brown)
B
What are the two leading causes of death in the United States for all ages? A. Cancer and stroke. B. Heart disease and cancer C. AIDS and heart disease D. Accidents and heart disease (Ch. 3 Winland-Brown)
B
What is the term used to describe a disorder characterized by excessive sleep? A. Insomnia B. Norcolepsy C. Nocturnal myoclonus D. Cataplexy (Ch. 3 Winland-Brown)
B
When can Pap smears be safely discontinued? A. At age 80 B. At age 65 if the previous three Pap smears have been normal C. Never; they should be continued throughout life D. After menopause or hysterectomy (Ch. 3 Winland-Brown)
B
When should a woman start getting Pap tests? A. When she becomes sexually active B. At age 21 C. During her first pregnancy D. Before birth control is prescribed (Ch. 3 Winland-Brown)
B
When should an African American man start to be screened for prostate enlargement by a digital rectal exam? A. age 60 and then yearly B. age 40 and then yearly C. age 40 and then every 2 years D. age 55 and then yearly (Ch. 3 Winland-Brown)
B
When should children be screened for lead A. Only if they are in high-risk groups B. At age 12 months C. At age 3 years D. Only if they live in or regularly visit a house built before 1960 (Ch. 3 Winland-Brown)
B
Which immunization may prevent meningitis? A. Hepatitis B B. Haemophilus influenzae type B (Hib) C. Measles, mumps, and rubella (MMR) D. Varicella (Ch. 3 Winland-Brown)
B
Which industry is responsible for the most injuries? A. Mining B. Construction C. Transportation and utilities D. Manufacturing (Ch. 3 Winland-Brown)
B
Which program aims to remove racial and ethnic disparities in health by addressing the screening and intervention needs of midlife uninsured women? A. Public health screening programs B. WISEWOMAN projects C. American Heart Association screening protocols D. Centers for Disease Control and Prevention (Ch. 3 Winland-Brown)
B
Risks associated with chronic hepatitis B include all of the following except: A. hepatocellular carcinoma. B. cirrhosis. C. continued infectivity. D. systemic hypertension
D. systemic hypertension
Approximately ____ of healthcare providers receive influenza immunization annually. A. one-quarter B. one-half C. two-thirds D. three-quarters or more
D. three-quarters or more
The broad-based initiative led by the U.S. Public Health Service (PHS) to improve the health of all Americans through emphasis on prevention, rather than just treatment, of health problems throughout the next decade is A. the National Health Objectives Report. B. Healthy People 2020 C. the Surgeon General's Report. D. the PHS Initiative. (Ch. 3 Winland-Brown)
B
The primary objective of screening is to A. prevent a disease B. detect a disease C. determine the treatment options D. promote genetic testing to prevent passing on the disease. (Ch. 3 Winland-Brown)
B
The components of brief intervention for treating tobacco use include: A. Ask, Advise, Assess, Assist, Arrange. B. Advise, Intervene, Counsel, Follow up, Prescribe. C. Document, Counsel, Caution, Describe, Demonstrate. D. Advise, Describe, Confer, Prescribe, Document
A. Ask, Advise, Assess, Assist, Arrange.
Jason is a healthy 18-year-old who presents for primary care. According to his immunization record, he received two dose of HBV vaccine 1 month apart at age 14 years. Which of the following best describes his HBV vaccination needs? A. He should receive a single dose of HBV vaccine now. B. A three-dose HBV vaccine series should be started during today's visit. C. He has completed the recommended HBV vaccine series. D. He should be tested for HBs Ab and further immunization recommendations should be made according to the test results.
A. He should receive a single dose of HBV vaccine now.
A 30-year-old man with HIV lives with his two preschool-aged children. Which of the following statements best represents advice you should give him about immunizing his children? A. Immunizations should take place without regard for his health status. B. The children should not receive influenza vaccine. C. MMR vaccine should not be given. D. The children should not receive poliovirus immunization
A. Immunizations should take place without regard for his health status.
Which of the following statements best describes zanamivir (Relenza) or oseltamivir (Tamiflu) use in the care of patients with or at risk for influenza? A. Initiation of therapy early in acute influenza illness can help minimize the severity of disease when the illness is caused by a non resistant viral strain. B. The primary indication is in preventing influenza A during outbreaks. C. The drugs are active only against influenza B. D. The use of these medications is an acceptable alternative to influenza vaccine
A. Initiation of therapy early in acute influenza illness can help minimize the severity of disease when the illness is caused by a non resistant viral strain.
Which of the following statements is true about poliovirus infection? A. It is transmitted via the fecal−oral route. B. Rates of infection among household contacts are about 30%. C. Sporadic outbreaks continue to occur in North America. D. It is transmitted via aerosol and droplets.
A. It is transmitted via the fecal−oral route
To quantify the margin of error in a screening instrument, the measure of validity is divided into two components: sensitivity and specificity. Sensitivity refers to a screening test's ability to A. recognize the negative reactions or non-diseased individuals. B. identify persons who actually have the disease. C. predict populations at risk D. give the same result regardless of who performs the test. (Ch. 3 Winland-Brown)
B
Alcohol, especially when used with tobacco, is a dietary factor in which type of cancer? A. Liver B. Esophagus C. Bladder D. Breast (Ch. 3 Winland-Brown)
B
An indicator of body fat measurement by dividing weight in kilograms by height in meters is the A. weight/height chart. B. body mass index C. body fat measurement. D. anthropometric measurement
B
For which patient would you administer the HPV vaccination? A. Susie, age 7 B. Janice, age 17, who had a baby 6 months ago and is breastfeeding C. Alice, age 18, who is allergic to yeast D. Jill, age 30, who is pregnant (Ch. 3 Winland-Brown)
B
Gerald, a 67 year old male retired maintenance worker, comes to your office for a physical. On reviewing Gerald's history, you discover that he has had pneumonia twice in the past 5 years. When you question Gerald about his immunization history, he reveals that his last tetanus and diphtheria (Td) immunization was 6 years ago, and his last flu shot was 8 months ago during the last flu season. He denies ever having had a pneumonia vaccination. Which immunizations should you offer to Gerald today. A. Td B. Pneumococcal vaccine C. Influenza D. Td and pneumococcal vaccine (Ch. 3 Winland-Brown)
B
Harriet, a 76 year old woman, comes to your office every 3 months for follow-up on her hypertension. Harriet's medications include one baby aspirin daily, lisinopril 5mg daily, and calcium 1500 mg daily. On today's visit, Harriet's blood pressure is 168/88. According to the Joint National Committee (JNC) VII guidelines, what should you do next to control Harriet's blood pressure? A. Increase her dose of lisinpril to 20mg daily. B. Add a thiazide diuretic to the lisinopril 5 mg daily. C. Discontinue the lisinopril and start a combination of ACE inhibitor and calcium channel blocker D. Discontinue the lisinopril and start a diuretic. (Ch. 3 Winland-Brown)
B
How much higher are health-care costs for smokers than for nonsmokers? A. 20% B. 40% C. 60% D. 80% (Ch. 3 Winland-Brown)
B
Lewin's change theory involves fundamental shifts in person's behaviors to evoke and successfully implement change. The final phase is referred to as A. implementation. B. refreezing. C. finalizing. D. change. (Ch. 3 Winland-Brown)
B
Mark, a 56 year old man, comes to your practice seeking help to quit smoking. You prescribe Chantix (varenicline), a prescription medication, to aid with his attempt. What instructions do you give Mark regarding how to stop smoking with Chantix? A. Start the Chantix today according to the dosing schedule and then quit smoking after the 12 week medication schedule B. Start the Chantix today according to the dosing schedule and then pick a date to stop smoking about 7 days after starting Chantix. C. Pick a date to stop smoking and start Chantix that day according to the dosing schedule. D. Start Chantix today, take it twice a day for 2 weeks, and then stop smoking (Ch. 3 Winland-Brown)
B
Martin, an 83 year old man, is at your office for his yearly physicial exam. He has a history of HTN, HLD, cigarette smoking and COPD. Martin states that he has been feeling increased fatigue with minimal activity but denies any chest pain or shortness of breath. Martin's list of medications includes the following: ASA qd, ACE QD, Diuretic QD, Statin QD. Martin's physical exam was normal. His blood pressure was 130/68, his heart rate was 88, and his respiratory rate was 22. Observing Martin during your examination, you detect that he utilizes pursed-lip breathing throughout the exam. What medication should he be started on for his COPD? A. Inhaled corticosteroid B. Inhaled anticholinergic and inhaled beta-2 agonists C. Oral steroids daily D. Inhales beta-2 agonists (Ch. 3 Winland-Brown)
B
Max states that he cannot give up drinking beer, but he will cut down. You suggest that his limit should be A. one can of beer a day B. two cans of beer a day C. three cans of beer a day D. four cans of beer a day. (Ch. 3 Winland-Brown)
B
Oral health problems are common and painful. Years ago, it was common to see almost all adults with complete dentures. Today, what percentage of U.S. adults aged 75 and older have lost all of their teeth? A. 10% B. 25% C. 50% D. 75% (Ch. 3 Winland-Brown)
B
The CAGE screening test for alcoholism is suggestive of the disease if two of the responses are positive. What does the E in CAGE stand for? A. Every day B. Eye opener C. Energy D. Ego (Ch. 3 Winland-Brown)
B
The National Cancer institute recommends that adults eat how may grams of fiber a day? A. 10-20 g B. 20-30 g C. 30-40 g D. 40-50 g (Ch. 3 Winland-Brown)
B
A healthy 6-year-old girl presents for care. Her parents request that she receive vaccination for influenza and report that she has not received this vaccine in the past. How many doses of influenza vaccine should she receive this flu season? A. 1 B. 2 C. 3 D. 4
B. 2
Which of the following is not recommended to receive the MMR vaccination? A. A 1-year-old boy with a history of hive-form reac-tion egg ingestion B. A 24-year-old woman who is 20 weeks pregnant C. A 4-year-old girl who was born at 32 weeks of gestation D. A 32-year-old woman who is breastfeeding a 2 week old
B. A 24-year-old woman who is 20 weeks pregnant
Linda is a 52-year-old woman who presents for a follow-up visit for hypertension, type 2 diabetes mellitus,and dyslipidemia. She has a 50-pack year cigarette smoking history, quit smoking 6 months ago, and now reports smoking about 10 cigarettes per day for the past 2 weeks while being particularly stressed during her 78-year-old mother's recent serious illness. Linda states, "I give up. I guess I cannot quit." Which of the following is the most appropriate response to Linda's statement? A. Do you think your mother's illness was a trigger for your smoking? B. Can we work on a plan to help you to get back to being smoking-free? C. Once your mom is well again, you should try quitting again. D. You sound really discouraged about this
B. Can we work on a plan to help you to get back to being smoking-free?
Maria is a 28-year-old healthy woman who is 6 weeks pregnant. Her routine prenatal laboratory testing reveals she is not immune to varicella. She voices her intent to breastfeed her infant for at least 6 months. Which of the following represents the best advice for Maria? A. She should receive VZV vaccine once she is in her second trimester of pregnancy. B. Maria should be advised to receive two doses of VZV vaccine after giving birth. C. Once Maria is no longer breastfeeding, she should receive one dose of VZV vaccine. D. A dose of VZIG should be administered now
B. Maria should be advised to receive two doses of VZV vaccine after giving birth.
Concerning the MMR vaccine, which of the following is true? A. The link between use of MMR vaccine and childhood autism has been firmly established. B. There is no credible scientific evidence that MMR use increases the risk of autism. C. The use of the combined vaccine is associated with increased autism risk, but giving the vaccine's three components as separate vaccines minimizes this risk. D. The vaccine contains thimerosal, a mercury derivative.
B. There is no credible scientific evidence that MMR use increases the risk of autism.
Of the following, who is at greatest risk for invasive pneumococcal infection? A. a 68-year-old man with chronic obstructive pulmonary disease B. a 34-year-old woman who underwent splenectomy after a motor vehicle accident C. a 50-year-old man with a 15-year history of type 2 diabetes D. a 75-year-old woman with decreased mobility as a result of severe osteoporosis
B. a 34-year-old woman who underwent splenectomy after a motor vehicle accident
All of the following patients received pneumococcal vaccine 5 years ago. Who is a candidate for receiving a second dose of antipneumococcal immunization at this time? A. a 45-year-old man who is a cigarette smoker B. a 66-year-old woman with COPD C. a 35-year-old man with moderate persistent asthma D. a 72-year-old woman with no chronic health problems
B. a 66-year-old woman with COPD
Which of the following represents the food or beverage that is least likely to be contaminated with the hepatitis A virus? A. a lettuce salad B. a bowl of hot soup C. a plate of peeled mango D. a glass of ice tea
B. a bowl of hot soup
For which of the following patients should an NP order varicella antibody titers? A. a 14 year old with an uncertain immunization history B. a healthcare worker who reports having had varicella as a child C. a 22-year-old woman who received two varicella immunizations 6 weeks apart D. a 72 year old with shingles
B. a healthcare worker who reports having had varicella as a child
When working with a middle-aged man with a body mass index of 33 kg/m2on weight reduction, an NP considers that one of the first actions should be to: A. add an exercise program while minimizing the need for dietary changes. B. ask the patient about what he believes contributes to his weight issues. C. refer the patient to a nutritionist for diet counseling. D. ask for a commitment to lose weight
B. ask the patient about what he believes contributes to his weight issues
Hepatitis B vaccine should not be given to a person with a history of anaphylactic reaction to: A. egg. B. baker's yeast. C. neomycin. D. streptomycin
B. baker's yeast.
The use of FDA-approved pharmacologic intervention in tobacco use: A. makes little difference in smoking cessation rates. B. reliably increases long-term smoking abstinence rates. C. is helpful but generally poorly tolerated. D. poses a greater risk to health than continued tobacco use.
B. reliably increases long-term smoking abstinence rates.
The most common mode of influenza virus transmission is via: A. contact with a contaminated surface. B. respiratory droplet. C. saliva contact. D. skin-to-skin contact
B. respiratory droplet.
When answering questions about HAV vaccine, the NPconsiders that it: A. contains live virus. B. should be offered to adults who frequently travel to developing countries. C. is contraindicated for use in children younger than age 6 years. D. usually confers lifelong protection after a single injection
B. should be offered to adults who frequently travel to developing countries.
In an immunocompetent adult, the length of incubation for the influenza virus is on average: A.less than 24 hours. B.1 to 4 days. C.4 to 7 days. D.more than 1 week
B.1 to 4 days.
Tertiary prevention measures for a 69-year-old woman with heart failure include: A. administering antipneumococcal vaccine. B. adjusting therapy to minimize dyspnea. C. surveying skin for precancerous lesions. D. reviewing safe handling of food
B.adjusting therapy to minimize dyspnea.
A 68 year old woman presents to your office for screening for osteoporosis. Sandy states that her grandmothter and mother both lost inches in their old age. Sandy has been postmenopausal for the past 15 years and never took any ormone replacement medications. She is Caucasian, weighs 108 lb, and is 5 ft 1 in. tall on today's measurement. When do women lose the greatest amount of bone density? A. during adolescence B. The first year of menopause C. The first 10 years after menopause D. Bone loss occurs continuously at the same rate from menopause to death. (Ch. 3 Winland-Brown)
C
A conservative, preventive health approach for healthy adults is to recommend limiting salt intake to how many grams per day? A. 2 g B. 4 g C. 6 g D. 8 g (Ch. 3 Winland-Brown)
C
Which of the following women should have screening for cervical cancer? A. An 18-year-old who has a history of genital warts B. A 17-year-old with coitarche 3 years ago and four male sexual partners C. An 80-year-old with heart failure and a remote history of normal Pap test results D. A 21-year-old who has had one male sexual partner and consistent condom use
D. A 21-year-old who has had one male sexual partner and consistent condom use
Which of the following statements is correct about the varicella vaccine? A. It contains killed varicella-zoster virus. B. The use of the vaccine is associated with an increase in reported cases of shingles. C. Varicella vaccine should be offered to adults who were U.S. born prior to 1980 and report a childhood history of chickenpox. D. Although highly protective against invasive varicella disease, mild cases of chickenpox have been reported in immunized individuals
D. Although highly protective against invasive varicella disease, mild cases of chickenpox have been reported in immunized individuals
When advising a patient about injectable influenza immunization, the nurse practitioner (NP) considers the following about the use of this vaccine: A. Its use is not recommended in sickle cell anemia. B. Its use is limited to children older than 2 years. C. Its use is limited due to containing live virus. D. Its use is recommended for virtually all members of the population
D. Its use is recommended for virtually all members of the population
When advising an adult patient about pneumococcal immunization, the NP considers the following about the vaccine: A. The vaccine contains inactivated bacteria. B. Its use is contraindicated in individuals with asthma. C. It protects against community-acquired pneumonia caused by atypical pathogens. D. Its use is seldom associated with significant adverse reactions
D. Its use is seldom associated with significant adverse reactions
Which of the following is true about the MMR vaccine? A. It contains inactivated virus. B. Its use is contraindicated in patients with a history of egg allergy. C. Revaccination of an immune person is associated with risk of significant systemic allergic reaction. D. Two doses at least 1 month apart are recommended for young adults who have not been previously immunized
D. Two doses at least 1 month apart are recommended for young adults who have not been previously immunized
All of the following individuals have not received vaccination against HBV. The vaccine should not be given in which of the following patients? A. a 35-year-old man with multiple sclerosis B. a 25-year-old woman with a past history of Guillain-Barré syndrome C. a 48-year-old woman with systemic lupus erythematosus D. a 28-year-old man who is acutely ill with bacterial meningitis
D. a 28-year-old man who is acutely ill with bacterial meningitis
When a critical portion of a community is immunized against a contagious disease, most members of the community, even the unimmunized, are protected against that disease because there is little opportunity for an outbreak. This is known as _________ immunity. A. passive B. humoral C. epidemiologic D. community
D. community
Smallpox disease includes which of the following characteristics? A. usually mild disease B. lesions that erupt over several days C. loss of contagiousness when vesicles form D. lesions all at the same stage during the eruptive phase of the illness
D. lesions all at the same stage during the eruptive phase of the illness
A woman who has been advised to receive varicella-zoster immune globulin (VZIG) asks about its risks. You respond that IG is a: A. synthetic product that is well tolerated. B. pooled blood product that often transmits infectious disease. C. blood product obtained from a single donor. D. pooled blood product with an excellent safety profile
D. pooled blood product with an excellent safety profile
You see a woman who has been sexually active with a man newly diagnosed with acute hepatitis B. She has not received hepatitis B vaccine in the past. You advise her that she should: A. start a hepatitis B immunization series. B. limit the number of sexual partners she has. C. be tested for hepatitis B surface antibody(HBsAb). D. receive hepatitis B immune globulin (HBIG) and hepatitis B immunization series.
D. receive hepatitis B immune globulin (HBIG) and hepatitis B immunization series.
Usual treatment for an adult with acute hepatitis A includes: A. interferon-alfa therapy. B. high-dose ribavirin. C. parenteral acyclovir. D. supportive care
D. supportive care