A middle-aged client presents for an annual health visit at a community clinic. The client is 5 feet 10 inches (177.8 cm) tall, weighs 250 pounds (113.4 kg), and works as an accountant. The client has smoked at least one pack of cigarettes every day for the last 15 years. Which secondary prevention measure should the nurse recommend the client to follow?

Smoking cessation.

Compliance with antihypertensive and lipid lowering agents.

Blood pressure and lipid screening.

Increase physical activity and diet low in saturated fat.

Answer and Explanation

The Correct Answer is C

A) Smoking cessation:
Smoking cessation is a crucial preventive measure and is considered a primary prevention strategy to reduce the risk of developing smoking-related diseases. However, for a middle-aged client who already has health issues such as obesity or hypertension, secondary prevention focuses on early detection and management of conditions that have already developed or are at high risk of developing.

B) Compliance with antihypertensive and lipid-lowering agents:
While compliance with medication is essential for managing existing conditions such as hypertension or dyslipidemia, it is not a secondary prevention measure in itself. Secondary prevention is focused on screening and early detection of health issues before they progress further.

C) Blood pressure and lipid screening:
Blood pressure and lipid screening are appropriate secondary prevention measures for this client. Secondary prevention involves identifying and managing health conditions early to prevent progression or complications. Given the client’s smoking history, weight, and potential risk for cardiovascular issues, regular screening for blood pressure and lipid levels helps detect any developing issues early, allowing for timely intervention.

D) Increase physical activity and diet low in saturated fat:
Increasing physical activity and adopting a diet low in saturated fat are important lifestyle changes for overall health and primary prevention of chronic diseases. However, in the context of secondary prevention, where the focus is on monitoring and managing existing risk factors or health conditions, screening measures like blood pressure and lipid testing are more directly relevant.

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Correct Answer is A

Explanation

A. Diabetes mellitus:
Given that a large percentage of Hispanic children in the elementary school are overweight, diabetes mellitus is a significant health concern. Overweight and obesity are major risk factors for type 2 diabetes, which is increasingly prevalent in children with these conditions. Screening for diabetes mellitus is crucial for early identification and management to prevent complications associated with this condition.

B. Hypothyroidism:
While hypothyroidism can contribute to weight gain, it is less directly linked to the prevalence of overweight in the general population compared to diabetes mellitus. Screening for hypothyroidism would be less prioritized unless there are specific indications or symptoms related to thyroid dysfunction.

C. English proficiency:
Although English proficiency is important for academic success and communication, it is not directly related to the health concerns associated with overweight and obesity. Addressing health issues like diabetes is more urgent for managing the overweight problem.

D. Iron deficiency anemia:
Iron deficiency anemia is a concern in some populations, but it is less directly associated with overweight and obesity compared to diabetes mellitus. Screening for iron deficiency anemia would be relevant in different contexts but is not the highest priority in addressing the immediate health impact of obesity-related conditions.

A. Hepatitis B vaccine. B. Influenza vaccine. C. Tetanus toxoid vaccine. D. Hepatitis A vaccine.

Correct Answer is D

Explanation

A) Hepatitis B vaccine:
While Hepatitis B is a significant vaccine for many travelers, especially those at risk of bloodborne pathogen exposure or those planning extended stays, Hepatitis A is more commonly prioritized for short-term travel to developing nations where sanitation and food safety may be compromised.

B) Influenza vaccine:
The influenza vaccine is important for seasonal protection against flu, but it is not specifically targeted at the types of health risks commonly encountered in developing nations. It's generally recommended for annual protection but is not the primary concern for travel to developing countries.

C) Tetanus toxoid vaccine:
Tetanus is a concern for wound management and prevention of tetanus infection, but it is not specific to travel to developing nations. This vaccine is typically part of routine immunizations and might be updated based on injury or specific risk factors, rather than travel alone.

D) Hepatitis A vaccine:
Hepatitis A is crucial for travelers to developing nations because it is transmitted through contaminated food and water. In areas with poor sanitation and hygiene, the risk of Hepatitis A is high. Therefore, the Hepatitis A vaccine should be prioritized to prevent infection in these conditions.

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Naxlex Comprehensive Predictor Exams

The school health nurse observes that a large percentage of Hispanic children in the elementary school are overweight. Which screening program should the nurse choose to target the highest priority health concern for this population?

Correct Answer is A

Explanation

A client comes to the public health clinic requesting information about which immunizations to receive prior to visiting a developing nation. Which immunization should the nurse recommend as a priority for this client?

Correct Answer is D

Explanation

While assessing a child at the community health clinic, the nurse notes that the toddler has multiple bruises on his legs and buttocks. After reporting suspected child abuse to the supervisor, which action should the nurse take next?

Several clients who have recently come to the local health clinic in a rural county are diagnosed with tuberculosis (TB). After reporting the occurrence to the health department, which community focused action should the nurse implement first?

A 66-year-old client is retiring and will no longer have health insurance through a place of employment. Which agency should the client be referred to by the employee health nurse for health insurance needs?

Community health nurses are particularly concerned with the spread of communicable diseases such as hepatitis A. Which group of Individuals should the nurse identify as being at greatest risk for contracting this type of hepatitis?

A nurse is planning a nutrition class for a group of older adults at a community center and wants to emphasize the amount and types of fat in some foods versus others. Which teaching method is best for the nurse to use?

Two years ago, the nurse assessed the health needs of high school students and determined that student pregnancy was a priority problem. The nurse then developed a pregnancy prevention program for the entire school district. Which finding is the best indicator of the program's effectiveness?