Nurse Practitioner Certification Examination and Practice Preparation Exam Testbank by Margaret A. Fitzgerald

Nurse Practitioner Certification Examination and Practice Preparation Testbank by Margaret A. Fitzgerald-1. 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 (force expired volume at 1 second) to FVC (forced vital capacity) ratio. D. ordering fecal occult blood test (FOBT). 2. Which of the following is an example of a primary preven- tion 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 3. 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. 4. 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. 5. Which of the following products provides passive immunity? 6. 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. 7. 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 8. 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. 9. When a critical portion of a community is immunized against a contagious disease, most members of the com- munity, 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 A. hepatitis B immune globulin (HBIG) B. measles, mumps, and rubella (MMR) vaccine 1. B. 4. B. 7. A. C. pneumococcal conjugate vaccine 2. C. 5. A. 8. B. D. live attenuated influenza vaccine (LAIV) 3. A. 6. A. 9. D. 1 2 CHAPTER 1 ■ Health Promotion and Disease Prevention Primary prevention measures include activities provided to individuals to prevent the onset or acquisition of a given disease. The goal of primary prevention measures is to spare individuals the suffering, burden, and cost associated with the clinical condition and is the first level of healthcare. An ex- ample is health-protecting education and counseling, such as encouraging the use of car restraints and bicycle helmets, counseling about safer sexual practices, and providing infor- mation on accident and fall prevention. Given its focus on preventing illness or injury, primary prevention is usually viewed as the most effective form of healthcare. Immunizations and chemoprophylaxis are also exam- ples of primary prevention measures. Active immunization through the use of vaccines provides long-term protection from disease. In herd or community immunity, a significant portion of a given population has immunity against an infec- tious agent; the likelihood that the susceptible portion of the group would become infected is minimized (Fig. 1–1). Pas- sive immunity is provided when a person receives select an- tibodies, usually via the administration of immune globulin (IG), after exposure to an infective agent. This immunity is temporary and requires the patient to present post-exposure; the protection provided by IG usually starts within hours of receiving the doses and lasts a number of months. The use of vaccines to produce lasting disease protection is preferred to passive immunization through the use of IG. Another exam- ple of passive immunity is the acquisition of disease protec- tion provided from mother to unborn child via the placenta. Secondary prevention measures include activities provided to identify and treat asymptomatic persons who have risk fac- tors for a given disease or in preclinical disease. Examples in- clude screening examinations for preclinical evidence of cancer, such as mammography and cervical examination with a Papanicolaou test. Other examples of secondary prevention activities include screening for clinical conditions with a pro- tracted asymptomatic period, such as a blood pressure meas- urement to detect hypertension and a lipid profile to detect hyperlipidemia (Table 1–1). See full color images of this topic on DavisPlus at | Keyword: Fitzgerald Tertiary prevention measures are part of the management of an established disease. The goal is to minimize disease- associated complications and the negative health effects of the conditions to the patient. Examples include medications and lifestyle modification to normalize blood glucose levels in individuals with diabetes mellitus and in conjunction with the treatment of heart failure, aimed at improving or mini- mizing disease-related symptoms. DISCUSSION SOURCES