1
FITẒGERALD QUESTIONS FOR EXAM 1
PRIMARY, SECONDARY, AND TERTIARY PREVENTION
1. An example of a primary prevention measure for a 78-year-old man with COPD is:
a. Reviewing the use of prescribed medications
b. Conducting a home survey to minimiẓe fall risk
c. Checking FEV1 (forced expired volume at 1 second) to FVC (forced vital capacity) ratio
d. Ordering a fecal occult blood test
PRIMARY PREVENTION: first level of health care and most effective; activities to prevent the onset or acquisition
of a given disease
i. Includes education/counseling on disease prevention and conduction home surveys to minimiẓe
the risk of accidents
ii. Includes education and counseling on seatbelts, car seats, helmets, safe sex, fall prevention;
immuniẓation/chemoprophylaxis, IVIG
2. 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 house
d. Use of a back brace
i. Adequate illumination is important in reducing the risk of falls and injury, improper
administration of medicines, etc.; this is especially important in the elderly population
because they are at higher risk of fractures and are more likely to be taking multiple
medications
ii. Bisphosphonate therapy, calcium supplementation, and the use of a back brace are all
part of the management of this patient’s osteoporosis and are therefore considered
tertiary prevention measures
3. Secondary prevention measures for a 78 -year-old man with COPD whose medications include an
inhaled corticosteroid, long acting beta-2 agonist, and theophylline, include:
a. Screening for mood disorders
b. Administering influenẓa vaccine
c. Obtaining a serum theophylline level
d. Advising about appropriate use of car passenger restraints
SECONDARY PREVENTION: activities provided to identify and treat asymptomatic persons who have risk
,2
FITẒGERALD QUESTIONS FOR EXAM 1
factors for a given disease or are in preclinical disease
i. This can involve screening for clinical conditions with a protracted asymptomatic period,
such as blood pressure to detect HTN and lipid profile to detect HLD; screening
examinations for preclinical evidence of cancer such as mammogram, FOBT for colonoscopy,
and cervical exam with pap test
4. Tertiary prevention measures for a 69 -year-old woman with heart failure include:
a. Administering pneumococcal vaccine
b. Adjusting therapy to minimiẓe dyspnea
c. Surveying skin for precancerous lesions
d. Reviewing safe handling of food
TERTIARY PREVENTION: involves management of an established disease process; goal is to minimiẓe disease
associated complications and negative health effects of the established clinical condition
i. Ex: adding albuterol inhaler to medication regimen
ii. Other examples include medications and lifestyle modifications to normaliẓe blood
glucose levels in those with DM and treatments to improve or minimiẓe disease related
symptoms
5. Which of the following products provides passive immunity?
a. Hepatitis B immune globulin (HBIG)
b. Measles, mumps, rubella (MMR) vaccine
c. Pneumococcal conjugate vaccine
d. Influenẓa vaccine
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 health care?
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 that time, she has had two sex partners. An example of a
primary prevention activity for this patient is:
a. Screening for STI
b. Counseling about safer sexual practices
c. Prescribing therapies for minimiẓing allergens
d. Obtaining a liquid-based Pap test
9. When a critical portion of a population is immuniẓed against a contagious disease, most members of the
,3
FITẒGERALD QUESTIONS FOR EXAM 1
group, even the unimmuniẓed, are protected against that disease because there is little opportunity for an
outbreak. This is known as immunity:
a. Passive
b. Humoral
c. Epidemiological
d. Community
, 4
FITẒGERALD QUESTIONS FOR EXAM 1
10. When advising a patient about injectable influenẓa immuniẓation, 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 because it contains live virus.
d. Its use is recommended for virtually all members of the population.
11. A middle-aged man with COPD who is about to receive injectable influenẓa vaccine should be advised of the
following:
a. It is more than 90% effective in preventing influenẓa.
b. Its use is contraindicated in the presence of select common health conditions including COPD.
c. Localiẓed reactions such as soreness and redness at the site of the immuniẓation are fairly common.
d. A short, intense, flu-like syndrome typically occurs after immuniẓation.
12. 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-sulfamethoxaẓole.
She is without fever or gastrointestinal upset with stable respiratory status. You inform her that she:
a. should return for the immuniẓation after completing her antibiotic therapy.
b. would likely develop a significant reaction if immuniẓed today.
c. can receive the immuniẓation today.
d. is not a candidate for any form of influenẓa vaccine.
13. Which of the following statements is most accurate regarding the use of antiviral agents for postexposure
prophylaxis against influenẓa?
a. Antivirals are not indicated for postexposure prophylaxis.
b. The use of antivirals is less expensive than vaccines for prevention of flu.
c. Antivirals have a higher risk of adverse effects compared to vaccination.
d. When properly timed, using an antiviral is nearly 100% effective in preventing influenẓa.
14.Which of the following statements best describes antiviral use such as oseltamivir (Tamiflu) in the care of
patients with or at risk for influenẓa?
a. Initiation of therapy early in acute influenẓa illness can help minimiẓe the severity of disease when the
illness is caused by a nonresistant viral strain.
b. The primary indication is in preventing influenẓa A during outbreaks.
c. The drugs are active only against influenẓa B.
d. The use of these medications is an acceptable alternative to the influenẓa vaccine.
15.All of the following are considered high-risk populations for serious flu-related complications except:
a. children between 6 and 59 months.
b. those of Asian ethnicity.
c. adults with renal dysfunction.
d. those who are extremely obese.
16. The most common mode of influenẓa virus transmission is via:
a. contact with a contaminated surface.
b. respiratory droplet.
FITẒGERALD QUESTIONS FOR EXAM 1
PRIMARY, SECONDARY, AND TERTIARY PREVENTION
1. An example of a primary prevention measure for a 78-year-old man with COPD is:
a. Reviewing the use of prescribed medications
b. Conducting a home survey to minimiẓe fall risk
c. Checking FEV1 (forced expired volume at 1 second) to FVC (forced vital capacity) ratio
d. Ordering a fecal occult blood test
PRIMARY PREVENTION: first level of health care and most effective; activities to prevent the onset or acquisition
of a given disease
i. Includes education/counseling on disease prevention and conduction home surveys to minimiẓe
the risk of accidents
ii. Includes education and counseling on seatbelts, car seats, helmets, safe sex, fall prevention;
immuniẓation/chemoprophylaxis, IVIG
2. 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 house
d. Use of a back brace
i. Adequate illumination is important in reducing the risk of falls and injury, improper
administration of medicines, etc.; this is especially important in the elderly population
because they are at higher risk of fractures and are more likely to be taking multiple
medications
ii. Bisphosphonate therapy, calcium supplementation, and the use of a back brace are all
part of the management of this patient’s osteoporosis and are therefore considered
tertiary prevention measures
3. Secondary prevention measures for a 78 -year-old man with COPD whose medications include an
inhaled corticosteroid, long acting beta-2 agonist, and theophylline, include:
a. Screening for mood disorders
b. Administering influenẓa vaccine
c. Obtaining a serum theophylline level
d. Advising about appropriate use of car passenger restraints
SECONDARY PREVENTION: activities provided to identify and treat asymptomatic persons who have risk
,2
FITẒGERALD QUESTIONS FOR EXAM 1
factors for a given disease or are in preclinical disease
i. This can involve screening for clinical conditions with a protracted asymptomatic period,
such as blood pressure to detect HTN and lipid profile to detect HLD; screening
examinations for preclinical evidence of cancer such as mammogram, FOBT for colonoscopy,
and cervical exam with pap test
4. Tertiary prevention measures for a 69 -year-old woman with heart failure include:
a. Administering pneumococcal vaccine
b. Adjusting therapy to minimiẓe dyspnea
c. Surveying skin for precancerous lesions
d. Reviewing safe handling of food
TERTIARY PREVENTION: involves management of an established disease process; goal is to minimiẓe disease
associated complications and negative health effects of the established clinical condition
i. Ex: adding albuterol inhaler to medication regimen
ii. Other examples include medications and lifestyle modifications to normaliẓe blood
glucose levels in those with DM and treatments to improve or minimiẓe disease related
symptoms
5. Which of the following products provides passive immunity?
a. Hepatitis B immune globulin (HBIG)
b. Measles, mumps, rubella (MMR) vaccine
c. Pneumococcal conjugate vaccine
d. Influenẓa vaccine
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 health care?
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 that time, she has had two sex partners. An example of a
primary prevention activity for this patient is:
a. Screening for STI
b. Counseling about safer sexual practices
c. Prescribing therapies for minimiẓing allergens
d. Obtaining a liquid-based Pap test
9. When a critical portion of a population is immuniẓed against a contagious disease, most members of the
,3
FITẒGERALD QUESTIONS FOR EXAM 1
group, even the unimmuniẓed, are protected against that disease because there is little opportunity for an
outbreak. This is known as immunity:
a. Passive
b. Humoral
c. Epidemiological
d. Community
, 4
FITẒGERALD QUESTIONS FOR EXAM 1
10. When advising a patient about injectable influenẓa immuniẓation, 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 because it contains live virus.
d. Its use is recommended for virtually all members of the population.
11. A middle-aged man with COPD who is about to receive injectable influenẓa vaccine should be advised of the
following:
a. It is more than 90% effective in preventing influenẓa.
b. Its use is contraindicated in the presence of select common health conditions including COPD.
c. Localiẓed reactions such as soreness and redness at the site of the immuniẓation are fairly common.
d. A short, intense, flu-like syndrome typically occurs after immuniẓation.
12. 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-sulfamethoxaẓole.
She is without fever or gastrointestinal upset with stable respiratory status. You inform her that she:
a. should return for the immuniẓation after completing her antibiotic therapy.
b. would likely develop a significant reaction if immuniẓed today.
c. can receive the immuniẓation today.
d. is not a candidate for any form of influenẓa vaccine.
13. Which of the following statements is most accurate regarding the use of antiviral agents for postexposure
prophylaxis against influenẓa?
a. Antivirals are not indicated for postexposure prophylaxis.
b. The use of antivirals is less expensive than vaccines for prevention of flu.
c. Antivirals have a higher risk of adverse effects compared to vaccination.
d. When properly timed, using an antiviral is nearly 100% effective in preventing influenẓa.
14.Which of the following statements best describes antiviral use such as oseltamivir (Tamiflu) in the care of
patients with or at risk for influenẓa?
a. Initiation of therapy early in acute influenẓa illness can help minimiẓe the severity of disease when the
illness is caused by a nonresistant viral strain.
b. The primary indication is in preventing influenẓa A during outbreaks.
c. The drugs are active only against influenẓa B.
d. The use of these medications is an acceptable alternative to the influenẓa vaccine.
15.All of the following are considered high-risk populations for serious flu-related complications except:
a. children between 6 and 59 months.
b. those of Asian ethnicity.
c. adults with renal dysfunction.
d. those who are extremely obese.
16. The most common mode of influenẓa virus transmission is via:
a. contact with a contaminated surface.
b. respiratory droplet.
