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 C

Explanation

A) A young person with diabetes mellitus:
While diabetes mellitus is a significant health condition that requires management, especially in cold weather, it does not necessarily indicate an immediate or heightened risk compared to other conditions. Diabetes requires proper care and monitoring, but the urgency related to exposure to freezing temperatures may not be as critical as other conditions.

B) A middle-aged person who has hypertension:
Hypertension is an important condition that requires management, but in the context of a cold weather emergency, it does not represent an immediate risk related to exposure. The middle-aged person with hypertension may need stable conditions for managing their health, but their situation is less critical in terms of immediate exposure to freezing temperatures.

C) An older person who is malnourished:
An older person who is malnourished is at a higher risk when exposed to freezing temperatures. Malnutrition can impair the body’s ability to regulate temperature and increase susceptibility to cold-related illnesses such as hypothermia. Therefore, this individual is at greater risk and most in need of shelter to protect against the dangers of extreme cold.

D) An adult who was hit by a car 3 weeks ago:
An individual who was injured in a car accident 3 weeks ago may have ongoing medical needs, but unless there are specific complications or issues directly related to cold exposure, their immediate need for shelter due to freezing temperatures is less critical compared to a malnourished older person. Ensuring warmth and protection from the cold is the primary concern for those most vulnerable to the weather conditions.

A. Contact kindergarten parents to remind them that the second dose of MMR is due at the start of the school year. B. Send notices home with the children on the first day of class advising that MMR vaccine series must be completed. C. Note in student records that the second dose of the MMR vaccine should be administered prior to entering first grade. D. Speak at the next parent-teacher association meeting to teach parents the benefits of immunizing their children.

Correct Answer is A

Explanation

A) Contact kindergarten parents to remind them that the second dose of MMR is due at the start of the school year:
Directly contacting parents before the school year begins is the most effective intervention for ensuring that students receive the necessary immunizations. By reminding parents ahead of time, the school nurse can help ensure that the second dose of the MMR vaccine is administered before the start of kindergarten, which is crucial for meeting school entry requirements and protecting public health.

B) Send notices home with the children on the first day of class advising that MMR vaccine series must be completed:
Sending notices on the first day of class might be too late for many parents to act on promptly. Ensuring that children have received the second dose of the MMR vaccine before the school year starts is important for compliance and preventing potential outbreaks.

C) Note in student records that the second dose of the MMR vaccine should be administered prior to entering first grade:
While noting the requirement in student records is important for long-term tracking, it does not address the immediate need to ensure that students are up-to-date with their vaccinations before starting kindergarten. Immediate action is necessary to ensure compliance at the beginning of the school year.

D) Speak at the next parent-teacher association meeting to teach parents the benefits of immunizing their children:
While educating parents about the benefits of immunization is valuable, it does not directly address the immediate need for the second dose of the MMR vaccine. Direct reminders and actions to ensure vaccinations are up-to-date are more effective in achieving timely compliance.

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Naxlex Comprehensive Predictor Exams

On a day when the temperature is expected to drop to below freezing during the night, the nurse is asked to determine which homeless adults are most in need of the limited spaces that are available in a shelter. It is most important for which person to be admitted for the night?

Correct Answer is C

Explanation

The school nurse who is reviewing immunization records of students who will start kindergarten within the next month notes that most of the students have only received one dose of the measles, mumps, rubella (MMR) vaccine. Which intervention should the nurse implement?

Correct Answer is A

Explanation

The community health nurse determines that the average family income of a certain community is $67,000 per year with a range of $27,000 to $102,000. Based on this demographic information, which additional information is important for the nurse to assess?

The nurse notes that the influenza immunization rates are much lower for certain demographic groups than for others. Which intervention is likely to be most useful in increasing the rates of immunization in these under-served immunization groups?

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?

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?

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?

The epidemiological triad can be used to frame strategies for the prevention of farm machinery injuries. Which action should the nurse take to focus on the agent?