AGACNP REVIEW RISK ASSESSMENT Questions and Answers

AGACNP REVIEW RISK ASSESSMENT Questions and Answers When should adolescents receive complete physical exams? starting age 11-14, every 3 years 11-14 15-17 18-21 When should HPV vaccine, Gardasil 9, be administered, and to who? Ages 9-14 should receive 2 injections, 6 months apart ages 15-26 should receive 3 injections at 0, 2, and 6 months Ages 27 - 45 should receive 3 injections at 0, 2, and 6 months after shared clinical decision making When should syphilis screening occur and how? When sexually active, PRN or with Pap smear When should someone be screened for HIV? At least once, ages 13-64, or depending on level of sexual activity or iV drug use When should Hep C screening begin? At least once after age 18 When should someone receive Tdap? as early as age 7, and every 10 years When should someone receive meningococcal vaccine? All adolescents aged 11-18 Revaccinate 1 time for high risk (college freshman living in dorms) 5 years after initial vaccine When should someone receive the influenza vaccine? Annually Who and when should someone receive the pneumococcal vaccine? ages 19-64 with certain underlying conditions PCV 15 followed by PCV 23 1 year (minimum 8 weeks for immunocompromised) When should someone receive PPD screening? Once during adolescence and every two years if at risk or with any exposure to TB How often should young adults ages 20 - 39 receive complete physical exams Beginning age 20 every 5-6 years When and how often should females receive pap smears with cytology? Beginning age 21 every 3 years D/C at age 65 with 3 consecutive normal cytology tests and no abnormal tests in the past 10 yeaers When should females begin receiving clinical breast exams and how often? Every 3 years, then annually starting at age 40 How often should BP be assessed? Every health care visit or every 2 years How often should total cholesterol be assessed? Beginning age 20, every 5 years unless cholesterol 200 How often should individuals receive dental cleanings and checkups? every 6-12 months What are the recommended intervals for receiving mammograms? ACS: annually ages 45 - 54, every 2 years after age 55, continue as long as in good health and expected to live 10+years USPSTF: every 2 years ages 50 - 74, not recommended ages 75 ACOG: annually ages 50 - 74, no recommendations to discontinue When should males receive prostate screening? Digital exam and PSA annually at age 40 for men with a family history of prostate cancer or if African American All males annually beginning age 50 When should adults receive a baseline ECG? Age 40 and every 2 years if pt. has cardiac risk factors? What age should colorectal cancer screening begin for average-risk adults in good health with life expectancy 10 years? Age 45 - 75 What are the current CRC screening methods and intervals? stool based (annual FIT, annual Guaiac, every 3 years DNA test) OR Structural: Colonoscopy q10 years, CT colonography Q5 years, flex sig q5years All positive non-colonoscopy screening should be followed up with colonoscopy Ages 76 - 85 based on pt preferences, life expectancy, health status, and prior screening history Ages 80 & , discourage screening When and how often should glaucoma screening occur? Beginning at age 40, annually When and how should herpes zoster (Shringrix) vaccine be given? age 50 series of 2, second dose 2-6 months later What ages are considered "elderly" 60-64 What ages are considered "geriatric? 65 When and how often should older adults receive complete physical exams? Every 2 years starting age 60 When/who should receive abdominal aortic aneurysm screen with ultrasonography? Age 65 - 75 for individuals who have ever smoked, one time What is the top 3 causes of death ages 12 - 19 Accidents Homicide Suicide What is the top causes of deat ages 40 - 59 heart disease accidents malignancy (lung, breast, CRC Liver disease Suicide DM What are the major casues of death in elderly adults 60? Heart disease CVA COPD Alzheimer's Malignancy What are the top killers of adults in the US? Heart disease Cancer Accidents Loer resp disease CVA What cancer is responsible for the highest mortality in women? Lung What is the leading GYN-associated cancer killer in women? ovarian What cancer has the highest incidence other than skin cancer in women? Breast What cancer is responsible for the highest mortality in men? Lung Other than skin cancer, what is the 2nd most common cancer in men and #2 cancer "killer"? Prostate When combining cancer in men and women, what is the leading cancer "killer"? Lung When combining cancer in men and women, what is the second leading cancer "killer"? Colorectal What is the recommended carbohydrate intake in the diet? 55-60% What is the recommended fat intake? 30% total calories with 10% total calories being saturated fats What is a "balanced plate" 1/2 fruit and vegetables Skim/1% milk 1/2 of grains should be whole vary proteins What should patients over 35 receive before initiating a program of exercise? a complete history and physical exam What is the recommended amount of exercise for adults? 30 minutes, most days of the week What are the positive effects of exercise? Decreased LDL Increased Basic metabolic rate Decreased stress Decreased signs of aging What are substances capable of inducing a specific immune response Antigens What are molecules synthesized in reaction to an antigen Antibodies What is conferred by antibody formation stimulated with a specific antigen such as typhoid fever immunization and toxoids? active immunity What is conferred by the introduction of antibody proteins such as gamma globulin injections or maternal immunity transferred to the fetus? Passive immunity Who should receive the pneumococcal vaccine? Those 65 or older Those age 19-64 who smoke or have asthma People with lung, hear, liver, or kidney disease Those with a chronic disease (diabetes, cirrhosis, sickle cell, alcoholism) People with a weakened immune system (hodgkin's disease, lymphoma, leukemia, multiple myeloma, HIV/AIDs, kidney failure, spleen damage) Pts. on chemo, long-term steroids, or receiving radiation Those living in a nursing home/LTC Who should receive the Hep A vaccine? military personnel travelers to endemic areas men who have sex with men Who should receive the Hep B vaccine? Healthcare workers and sexually active adults Who should receive the Mumps vaccine? Healthcare workers If born before 1957: 1 dose unless proven immunity If born after 1957: 2 doses unless proven immunity Who should receive the herpes zoster vaccine immunocompetent adults age 50 and older What vaccines should patients with asplenia receive? Both meningococcal vaccines Pneumococcal vaccine Hib vaccine Influenza vaccine annually Tdap vaccine Zoster vaccine HPV vaccine MMR Varicella What are the routine vaccines for adults ages 65 and older? Think "TIPS" Tdap Influenza Pneumococcal Shingles What is a tool for learning about different cultures and working to provide more balanced patient-provider power relationships? Cultural competence What is the lifelong process in which one is committed to reflecting on one's own culture and set of beliefs and how those two impact or fram interactions with each others? Cultural humility What ethnicities more commonly believe in voo-doo Haitians and Africans What ethnicity believes in mal de ojo and what is it? Hispanic/Latinx community "evil eye" Belief that illness may be caused by a "look" What are hispanic/Latinx populations commonly concerned about regarding medications? Potential for addiction and like injections What is commonly used by Asian ethnicities that may cause potential for drug-drug interactions? herbal remedies What are increasing numbers of Caucasians using? alternative sources of healthcare and herbal remedies What do most Caucasians typically expect when seeking care in a doctor or practitioner's office? a prescription What is a person's self-identified sense of being male of female (or neither or both). Gender What is the term for a person who does not identify with any gender, or intentionally doesn't follow expectations of gender? Agender What is the term referring to someone whose gender identity is the same as the biological sex they were assigned at birth? Cisgender What is the term referring to someone whose gender identity is different from the biological sex they wer assigned at birth? Transgender What is the term used to describe one's discomfort with the assigned gender and biological sex Gender dysphoria What is the term when someone uses the wrong pronoun or term to refer to a person, such as by calling a transgender boy "her" or a transgender girl "him" misgender What is a term referring to how a person identifies sexually; the physical and emotional ways we are attracted to persons of the same gender, another gender, or all genders? Sexual orientation What is an adjective used to describe people who do not experience romantic attraction? aromantic What is a person who has the capacity to form enduring physical, romantic, and/or emotional attractions to those of the same gender or to those of another gender? bisexual What is an adjective used to describe people whose enduring physical, romantic, and/or emotional attraction is to people of the opposite sex heterosexual (straight) What is a woman whose enduring physical, romantic, and/or emotional attraction is to other women? Lesbian