FNP CERT EXAM PREP - Health Promotion and Disease Prevention QUETIONS AND VERIFIED ANSWERS

FNP CERT EXAM PREP - Health Promotion and Disease Prevention QUETIONS AND VERIFIED ANSWERS An example of a primary prevention measure for a 78-year-old man with chronic obstructive pulmonary disease (COPD) 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 a faecal occult blood test (FOBT) - ANSWER B - Primary prevention is the first level of health care and includes activities provided to individuals to prevent the onset or acquisition of a given disease or injury. Though this often involves immunization against infectious diseases, primary prevention can also include education and counseling on disease prevention and conducting home surveys to minimize the risk of accidents. Incorrect: Secondary prevention measures include activities provided to identify and treat asymptomatic persons who have risk factors for a given disease or are in preclinical disease. This can involve screening for cancer, such as ordering FOBT to screen for colorectal cancer (D). Tertiary prevention measures are part of the management of an established disease. For a patient with COPD, this can include assessing respiratory function (C) and reviewing current medications (A) 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 home D. use of a back brace - ANSWER C - Adequate illumination is important in reducing the risk of falls and injury, improper administration of medicines, and so on, and is considered a primary prevention measure. This is particularly important in the elderly population as they are at higher risk of fractures and more likely to be taking multiple medications. Incorrect: Tertiary prevention measures are part of the management of an established disease. Bisphosphonate therapy (A), calcium supplementation (B), and the use of a back brace (D) are all part of the management of this patient's osteoporosis and are thus considered tertiary prevention measures. Secondary prevention measures for a 78-year-old man with COPD whose medications include inhaled corticosteroid, long-acting beta-2 agonist, and theophylline, 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 - ANSWER A - Secondary prevention measures include activities provided to identify and treat asymptomatic persons who have risk factors for a given disease or are in preclinical disease. These measures typically involve screening tests, such as screening for mood disorders (A) and cancer Incorrect: Immunizations (B) and advising about the appropriate use of car passenger restrains (D) are aimed to prevent disease or injury and are considered primary prevention measure. Obtaining a serum theophylline level (C) is part of the management plan for the patient's COPD diagnosis and thus is a tertiary prevention measure. Tertiary prevention measures for a 69-year-old woman with heart failure include: A. administering pneumococcal vaccine B. adjusting therapy to minimize dyspnea C. surveying skin for precancerous lesions D. reviewing safe handling of food - ANSWER B - Tertiary prevention measures are part of the management of an established disease. A tertiary prevention measure for this patient with heart failure can include evaluating and adjusting therapy to minimize dyspnea. Incorrect: Immunization (A) and reviewing the safe handling of food (D) are both aimed to prevent disease and illness and are considered primary prevention measures. Screening for cancer, such as surveying skin for precancerous lesions (C), is a secondary prevention measure Which of the following products provides passive immunity? A. hepatitis B immune globulin (HBIG) B. measles, mumps, and rubella (MMR) vaccine C. pneumococcal conjugate vaccine D. influenza vaccine - ANSWER A - Passive immunity is provided when a person receives select antibodies produced in another host, usually via the administration of IG, after exposure to an infective agent. This type of immunity is not preferred as passive immunity is only temporary and requires the patient to present following exposure to an infecting agent. Incorrect: Active immunity can be acquired through vaccination (B, C, D) or following an active infection. Active immunity via vaccination is preferred over passive immunity as active immunity provides long-term protection from the disease. 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. defence against disease acquired naturally by the infant from the mother - ANSWER A - Active immunity is defined as resistance developed through exposure to an antigen. Active immunity can be acquired through vaccination or following an active infection Incorrect: Passive immunity is acquired when a person receives select antibodies produced in another host. This can be through administration of antibodies (i.e., IG) (B) or naturally by a foetus or infant from the mother (D). The resistance of a group to an infectious agent describes an aspect of herd immunity (C), which can be accomplished when a certain percentage of the population has active immunity (either through vaccination or following infection) against an infecting agent. 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 - ANSWER A - The goal of primary prevention is to prevent a disease or injury before it happens. In this manner, it is the most cost-effective approach to health care as it eliminates all the costs associated with treating the disease. Incorrect: Though not as cost-effective as primary prevention measures, secondary prevention measures are also cost-effective in health care, particularly if screening is performed to identify disease at early stages where treatment and recovery are possible (B). Tertiary prevention is often considered a failure of primary prevention measures and is the costliest approach to care (C). "Cancer-reduction measures" is a non defined term, though any management approaches for an established disease can be considered part of tertiary prevention measures (D) 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 had two sex partners. An example of a primary prevention activity for this patient is: A. screening for sexually transmitted infection (STI) B. counseling about safer sexual practices C. prescribing therapies for minimizing allergy D. obtaining a liquid-based Papanicolaou (Pap) test - ANSWER B - The goal of primary prevention is to prevent a disease or injury before it happens. Educating the patient about safer sexual practices is important in reducing the risk for sexually transmitted diseases Incorrect: Screening for STIs (A) and performing a Pap test (D) are both part of secondary prevention measures to potentially detect/identify already established diseases. Prescribing medication to minimize allergy (C) can be part of the patient management plan for allergic rhinitis and is considered a tertiary prevention measure When a critical portion of a population is immunized against a contagious disease, most members of the group, 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. epidemiological D. community - ANSWER D - In herd or community immunity, a significant portion of a given population has immunity against an infectious agent; the likelihood that the susceptible portion of the group would become infected is minimized. Incorrect: