FULL TEST BANK
,Health Promotion
1
n
and Disease Prevention
n n
Primary Prevention M
n n
Activenimmunitynisndefinednas:
resistancendevelopedninnresponsentonannantigen.
easures immunitynconferrednbynannantibodynprodu
cedninnanothernhost.
Annexamplenofnanprimarynpreventionnmeasurenf thenresistancenofnangroupntonanninfectiousnagent.
ornan78-year- defensenagainstndiseasenacquirednnaturallyn
oldnmannwithnchronicnobstructivenpulmonaryndi byntheninfantnfromnthenmother.
seasenis:
A.nreviewingnthenusenofnprescribednmedications. Whichnofnthenfollowingnisnusuallynviewednasnt
conductingnanhomensurveyntonminimizenfallnrisk. henmostncost-effectivenformnofnhealthcare?
checkingnFEV1n(forcenexpirednvolumenatn1nsecon primarynprevention
d)ntonFVCn(forcednvitalncapacity)nratio. secondarynprevention
D.norderingnfecalnoccultnbloodntestn(FOBT). tertiarynprevention
D.ncancer-reductionnmeasures
Whichnofnthenfollowingnisnannexamplenofnanprimary
npreven-tionnactivityninnan76-year- Ann18-year-
oldnwomannwithnosteoporosis?nA.nbisphosphonaten oldnwomannwithnallergicnrhinitisnpresentsnfornprimar
therapy yncare.nShenisnsexuallynactivenwithnanmalenpartnernand
calciumnsupplementation nisn1nyearnpost-
ensuringnadequatenilluminationninnthenhome coitarche;nduringnthisntimenshenhadnhadntwonsexnpart
D.nusenofnanbacknbrace ners.nAnnexamplenofnanprimarynpreventionnactivitynfo
rnthisnpatientnis:
Secondarynpreventionnmeasuresnfornan78-year- A.nscreeningnfornsexuallyntransmittedninfection.
oldnmannwithnchronicnobstructivenpulmonaryndise counselingnaboutnsafernsexualnpractices.
aseninclude:nA.nscreeningnfornmoodndisorders. prescribingntherapiesnfornminimizingnallergy.
administeringninfluenzanvaccine. D.nobtainingnanliquid-basednPapanicolaoun(Pap)ntest.
obtainingnanserumntheophyllinenlevel.
D.nadvisingnaboutnappropriatenusenofncarnpas Whennancriticalnportionnofnancommunitynisnimmunizedn
sengernrestraints. againstnancontagiousndisease,nmostnmembersnofnthenco
m-
Tertiarynpreventionnmeasuresnfornan69-year- munity,nevennthenunimmunized,narenprotectednagainst
oldnwomannwithnheartnfailureninclude: thatndiseasenbecausentherenisnlittlenopportunitynfornan
A.nadministeringnantipneumococcalnvaccine. outbreak.nThisnisnknownnas immunity.
adjustingntherapyntonminimizendyspnea. passive
surveyingnskinnfornprecancerousnlesions. humoral
D.nreviewingnsafenhandlingnofnfood. epidemiologic
nD.ncommunity
Whichnofnthenfollowingnproductsnprovidesnp
assivenimmunity?
A.nhepatitisnBnimmunenglobulinn(HBIG)
measles,nmumps,nandnrubellan(MMR)nvaccine
n Answers
pneumococcalnconjugatenvaccine 1. B. 4. B. 7. A.
D.nlivenattenuatedninfluenzanvaccinen(LAIV) 2. C. 5. A. 8. B.
3. A. 6. A. 9. D.
,2 CnHnAnPnTnEnR 1 ■ HealthnPromotionnandnDiseasenPrevention
http://www.cdc.gov/excite/skincancer/mod13.htm,nCentersn
fornDiseasenControlnandnPrevention:nLevelsnofnPreventio
Primarynpreventionnmeasuresnincludenactivitiesnprovidedntonin
n
dividualsntonpreventnthenonsetnornacquisitionnofnangivenndiseas
http://www.niaid.nih.gov/topics/pages/communityimmunity.aspx,
e.nThengoalnofnprimarynpreventionnmeasuresnisntonsparenindivi nNationalnInstitutenofnAllergynandnInfectiousnDisease:nCommu
dualsnthensuffering,nburden,nandncostnassociatednwithnthenclini nitynImmunity
calnconditionnandnisnthenfirstnlevelnofnhealthcare.nAnnex-
amplenisnhealth-
protectingneducationnandncounseling,nsuchnasnencouragingnthe
nusenofncarnrestraintsnandnbicyclenhelmets,ncounselingnaboutnsa
fernsexualnpractices,nandnprovidingninfor-
mationnonnaccidentnandnfallnprevention.nGivennitsnfocusnonnpre
ventingnillnessnorninjury,nprimarynpreventionnisnusuallynviewe
dnasnthenmostneffectivenformnofnhealthcare.
Immunizationsnandnchemoprophylaxisnarenalsonexam-
plesnofnprimarynpreventionnmeasures.nActivenimmunizationnth
roughnthenusenofnvaccinesnprovidesnlong-
termnprotectionnfromndisease.nInnherdnorncommunitynimmunit
y,nansignificantnportionnofnangivennpopulationnhasnimmunityna
gainstnanninfec-
tiousnagent;nthenlikelihoodnthatnthensusceptiblenportionnofntheng
roupnwouldnbecomeninfectednisnminimizedn(Fig.n1–1).nPas-
sivenimmunitynisnprovidednwhennanpersonnreceivesnselectnan-
tibodies,nusuallynvianthenadministrationnofnimmunenglobulinn(I
G),nafternexposurentonanninfectivenagent.nThisnimmunitynisntem
porarynandnrequiresnthenpatientntonpresentnpost-
exposure;nthenprotectionnprovidednbynIGnusuallynstartsnwithinn
hoursnofnreceivingnthendosesnandnlastsnannumbernofnmonths.nT
henusenofnvaccinesntonproducenlastingndiseasenprotectionnisnpre
ferredntonpassivenimmunizationnthroughnthenusenofnIG.nAnothe
rnexam-
plenofnpassivenimmunitynisnthenacquisitionnofndiseasenprotec-
tionnprovidednfromnmotherntonunbornnchildnvianthenplacenta.nS
econdarynpreventionnmeasuresnincludenactivitiesnprovidedntoni
dentifynandntreatnasymptomaticnpersonsnwhonhavenrisknfac-
torsnfornangivenndiseasenorninnpreclinicalndisease.nExamplesnin-
cludenscreeningnexaminationsnfornpreclinicalnevidencenofncance
r,nsuchnasnmammographynandncervicalnexaminationnwithnanPa
panicolaountest.nOthernexamplesnofnsecondarynpreventionnactiv
itiesnincludenscreeningnfornclinicalnconditionsnwithnanpro-
tractednasymptomaticnperiod,nsuchnasnanbloodnpressurenmeas-
urementntondetectnhypertensionnandnanlipidnprofilentondetectnh
yperlipidemian(Tablen1–1).
Seenfullncolornimagesnofnthisnto
picnonnDavisPlusnatnhttp://davi
splus.fadavis.comn|nKeywor
d:nFitzgerald
Tertiarynpreventionnmeasuresnarenpartnofnthenmanagementn
ofnannestablishedndisease.nThengoalnisntonminimizendisease-
associatedncomplicationsnandnthennegativenhealthneffectsnofnthe
nconditionsntonthenpatient.nExamplesnincludenmedicationsnandn
lifestylenmodificationntonnormalizenbloodnglucosenlevelsninnind
ividualsnwithndiabetesnmellitusnandninnconjunctionnwithnthentr
eatmentnofnheartnfailure,naimednatnimprovingnornmini-
mizingndisease-relatednsymptoms.
DISCUSSIONnSOURCES
, Thenprimarynindicationnisninnpreventingninflue
nzanAnduringnoutbreaks.
Influenza ThendrugsnarenactivenonlynagainstninfluenzanB.
Immunization D.nThenusenofnthesenmedicationsnisnannacceptable
nalter-nativentoninfluenzanvaccine.
Whennadvisingnanpatientnaboutninjectableninfluenzanim
-
munization,nthennursenpractitionern(NP)nconsidersnthen
followingnaboutnthenusenofnthisnvaccine:
A.nItsnusenisnnotnrecommendedninnsicklencellnanemia.
Ȁ ⸀Ā ̀Ā ĀĀȀ ̀Ā ȀȀ⸀Ā ᜀ Ā ᜀ
tsnusenisnlimitedntonchildrennoldernthann2nyears.
Ȁ ⸀Ā ̀Ā ĀĀȀ ̀Ā ȀȀ⸀Ā ᜀ Ā ᜀ
tsnusenisnlimitednduentoncontainingnlivenvirus.
D.nItsnusenisnrecommendednfornvirtuallynallnmem
bersnofnthenpopulation.
Anmiddle-
agednmannwithnchronicnobstructivenpul-
monaryndiseasenwhonisnaboutntonreceiveninjectable
nin-fluenzanvaccinenshouldnbenadvisednthat:
A.nitnisnmorenthann90%neffectiveninnpreventingninfluenza
.
itsnusenisncontraindicatedninnthenpresencenofnpsori
asisnvulgaris.
localizednreactionsnsuchnasnsorenessnandnrednessnatnt
hensitenofnthenimmunizationnarenfairlyncommon.
D.nanshort,nintense,nflulikensyndromentypicallyn
occursnafternimmunization.
An44-year-
oldnwomannwithnasthmanpresentsnaskingnfornan“flunsh
ot.”nShenisnseenntodaynfornannurgentncarenvisit,nisndiagn
osednwithnanlowernurinaryntractninfection,nandnisnpresc
ribedntrimethoprim-
sulfamethoxazole.nShenisnwithoutnfevernorngastrointesti
nalnupsetnwithnstablenrespiratorynstatus.nYouninformnh
ernthatnshe:
shouldnreturnnfornthenimmunizationnafternco
mplet-ingnhernantibioticntherapy.
wouldnlikelyndevelopnansignificantnreactionnifni
mmu-nizedntoday.
cannreceiventhenimmunizationntoday.
D.nisnnotnancandidatenfornanynformnofninfluenzanvaccine.
Whichnofnthenfollowingnstatementsnbestndescribe
snamantadinenornrimantadinenuseninnthencarenofn
patientsnwithnornatnrisknforninfluenza?
Significantnresistancentonselectnstrainsnofninfluenzanli
mitsnthenusefulnessnofnthesenmedications.
Thenprimarynactionnofnthesentherapiesnisninnprev
ent-ingninfluenzanAnduringnoutbreaks.
ThesentherapiesnarenactivenagainstninfluenzanAnandnB.
Thenusenofnthesenproductsnisnannacceptablenalter
nativentoninfluenzanvaccine.
Whichnofnthenfollowingnstatementsnbestndescribesnza
namivirn(Relenza)nornoseltamivirn(Tamiflu)nuseninnth
encarenofnpatientsnwithnornatnrisknforninfluenza?
Initiationnofntherapynearlyninnacuteninfluenzanillnes
sncannhelpnminimizenthenseveritynofndiseasenwhennt
henillnessnisncausednbynannonresistantnviralnstrain.
,Health Promotion
1
n
and Disease Prevention
n n
Primary Prevention M
n n
Activenimmunitynisndefinednas:
resistancendevelopedninnresponsentonannantigen.
easures immunitynconferrednbynannantibodynprodu
cedninnanothernhost.
Annexamplenofnanprimarynpreventionnmeasurenf thenresistancenofnangroupntonanninfectiousnagent.
ornan78-year- defensenagainstndiseasenacquirednnaturallyn
oldnmannwithnchronicnobstructivenpulmonaryndi byntheninfantnfromnthenmother.
seasenis:
A.nreviewingnthenusenofnprescribednmedications. Whichnofnthenfollowingnisnusuallynviewednasnt
conductingnanhomensurveyntonminimizenfallnrisk. henmostncost-effectivenformnofnhealthcare?
checkingnFEV1n(forcenexpirednvolumenatn1nsecon primarynprevention
d)ntonFVCn(forcednvitalncapacity)nratio. secondarynprevention
D.norderingnfecalnoccultnbloodntestn(FOBT). tertiarynprevention
D.ncancer-reductionnmeasures
Whichnofnthenfollowingnisnannexamplenofnanprimary
npreven-tionnactivityninnan76-year- Ann18-year-
oldnwomannwithnosteoporosis?nA.nbisphosphonaten oldnwomannwithnallergicnrhinitisnpresentsnfornprimar
therapy yncare.nShenisnsexuallynactivenwithnanmalenpartnernand
calciumnsupplementation nisn1nyearnpost-
ensuringnadequatenilluminationninnthenhome coitarche;nduringnthisntimenshenhadnhadntwonsexnpart
D.nusenofnanbacknbrace ners.nAnnexamplenofnanprimarynpreventionnactivitynfo
rnthisnpatientnis:
Secondarynpreventionnmeasuresnfornan78-year- A.nscreeningnfornsexuallyntransmittedninfection.
oldnmannwithnchronicnobstructivenpulmonaryndise counselingnaboutnsafernsexualnpractices.
aseninclude:nA.nscreeningnfornmoodndisorders. prescribingntherapiesnfornminimizingnallergy.
administeringninfluenzanvaccine. D.nobtainingnanliquid-basednPapanicolaoun(Pap)ntest.
obtainingnanserumntheophyllinenlevel.
D.nadvisingnaboutnappropriatenusenofncarnpas Whennancriticalnportionnofnancommunitynisnimmunizedn
sengernrestraints. againstnancontagiousndisease,nmostnmembersnofnthenco
m-
Tertiarynpreventionnmeasuresnfornan69-year- munity,nevennthenunimmunized,narenprotectednagainst
oldnwomannwithnheartnfailureninclude: thatndiseasenbecausentherenisnlittlenopportunitynfornan
A.nadministeringnantipneumococcalnvaccine. outbreak.nThisnisnknownnas immunity.
adjustingntherapyntonminimizendyspnea. passive
surveyingnskinnfornprecancerousnlesions. humoral
D.nreviewingnsafenhandlingnofnfood. epidemiologic
nD.ncommunity
Whichnofnthenfollowingnproductsnprovidesnp
assivenimmunity?
A.nhepatitisnBnimmunenglobulinn(HBIG)
measles,nmumps,nandnrubellan(MMR)nvaccine
n Answers
pneumococcalnconjugatenvaccine 1. B. 4. B. 7. A.
D.nlivenattenuatedninfluenzanvaccinen(LAIV) 2. C. 5. A. 8. B.
3. A. 6. A. 9. D.
,2 CnHnAnPnTnEnR 1 ■ HealthnPromotionnandnDiseasenPrevention
http://www.cdc.gov/excite/skincancer/mod13.htm,nCentersn
fornDiseasenControlnandnPrevention:nLevelsnofnPreventio
Primarynpreventionnmeasuresnincludenactivitiesnprovidedntonin
n
dividualsntonpreventnthenonsetnornacquisitionnofnangivenndiseas
http://www.niaid.nih.gov/topics/pages/communityimmunity.aspx,
e.nThengoalnofnprimarynpreventionnmeasuresnisntonsparenindivi nNationalnInstitutenofnAllergynandnInfectiousnDisease:nCommu
dualsnthensuffering,nburden,nandncostnassociatednwithnthenclini nitynImmunity
calnconditionnandnisnthenfirstnlevelnofnhealthcare.nAnnex-
amplenisnhealth-
protectingneducationnandncounseling,nsuchnasnencouragingnthe
nusenofncarnrestraintsnandnbicyclenhelmets,ncounselingnaboutnsa
fernsexualnpractices,nandnprovidingninfor-
mationnonnaccidentnandnfallnprevention.nGivennitsnfocusnonnpre
ventingnillnessnorninjury,nprimarynpreventionnisnusuallynviewe
dnasnthenmostneffectivenformnofnhealthcare.
Immunizationsnandnchemoprophylaxisnarenalsonexam-
plesnofnprimarynpreventionnmeasures.nActivenimmunizationnth
roughnthenusenofnvaccinesnprovidesnlong-
termnprotectionnfromndisease.nInnherdnorncommunitynimmunit
y,nansignificantnportionnofnangivennpopulationnhasnimmunityna
gainstnanninfec-
tiousnagent;nthenlikelihoodnthatnthensusceptiblenportionnofntheng
roupnwouldnbecomeninfectednisnminimizedn(Fig.n1–1).nPas-
sivenimmunitynisnprovidednwhennanpersonnreceivesnselectnan-
tibodies,nusuallynvianthenadministrationnofnimmunenglobulinn(I
G),nafternexposurentonanninfectivenagent.nThisnimmunitynisntem
porarynandnrequiresnthenpatientntonpresentnpost-
exposure;nthenprotectionnprovidednbynIGnusuallynstartsnwithinn
hoursnofnreceivingnthendosesnandnlastsnannumbernofnmonths.nT
henusenofnvaccinesntonproducenlastingndiseasenprotectionnisnpre
ferredntonpassivenimmunizationnthroughnthenusenofnIG.nAnothe
rnexam-
plenofnpassivenimmunitynisnthenacquisitionnofndiseasenprotec-
tionnprovidednfromnmotherntonunbornnchildnvianthenplacenta.nS
econdarynpreventionnmeasuresnincludenactivitiesnprovidedntoni
dentifynandntreatnasymptomaticnpersonsnwhonhavenrisknfac-
torsnfornangivenndiseasenorninnpreclinicalndisease.nExamplesnin-
cludenscreeningnexaminationsnfornpreclinicalnevidencenofncance
r,nsuchnasnmammographynandncervicalnexaminationnwithnanPa
panicolaountest.nOthernexamplesnofnsecondarynpreventionnactiv
itiesnincludenscreeningnfornclinicalnconditionsnwithnanpro-
tractednasymptomaticnperiod,nsuchnasnanbloodnpressurenmeas-
urementntondetectnhypertensionnandnanlipidnprofilentondetectnh
yperlipidemian(Tablen1–1).
Seenfullncolornimagesnofnthisnto
picnonnDavisPlusnatnhttp://davi
splus.fadavis.comn|nKeywor
d:nFitzgerald
Tertiarynpreventionnmeasuresnarenpartnofnthenmanagementn
ofnannestablishedndisease.nThengoalnisntonminimizendisease-
associatedncomplicationsnandnthennegativenhealthneffectsnofnthe
nconditionsntonthenpatient.nExamplesnincludenmedicationsnandn
lifestylenmodificationntonnormalizenbloodnglucosenlevelsninnind
ividualsnwithndiabetesnmellitusnandninnconjunctionnwithnthentr
eatmentnofnheartnfailure,naimednatnimprovingnornmini-
mizingndisease-relatednsymptoms.
DISCUSSIONnSOURCES
, Thenprimarynindicationnisninnpreventingninflue
nzanAnduringnoutbreaks.
Influenza ThendrugsnarenactivenonlynagainstninfluenzanB.
Immunization D.nThenusenofnthesenmedicationsnisnannacceptable
nalter-nativentoninfluenzanvaccine.
Whennadvisingnanpatientnaboutninjectableninfluenzanim
-
munization,nthennursenpractitionern(NP)nconsidersnthen
followingnaboutnthenusenofnthisnvaccine:
A.nItsnusenisnnotnrecommendedninnsicklencellnanemia.
Ȁ ⸀Ā ̀Ā ĀĀȀ ̀Ā ȀȀ⸀Ā ᜀ Ā ᜀ
tsnusenisnlimitedntonchildrennoldernthann2nyears.
Ȁ ⸀Ā ̀Ā ĀĀȀ ̀Ā ȀȀ⸀Ā ᜀ Ā ᜀ
tsnusenisnlimitednduentoncontainingnlivenvirus.
D.nItsnusenisnrecommendednfornvirtuallynallnmem
bersnofnthenpopulation.
Anmiddle-
agednmannwithnchronicnobstructivenpul-
monaryndiseasenwhonisnaboutntonreceiveninjectable
nin-fluenzanvaccinenshouldnbenadvisednthat:
A.nitnisnmorenthann90%neffectiveninnpreventingninfluenza
.
itsnusenisncontraindicatedninnthenpresencenofnpsori
asisnvulgaris.
localizednreactionsnsuchnasnsorenessnandnrednessnatnt
hensitenofnthenimmunizationnarenfairlyncommon.
D.nanshort,nintense,nflulikensyndromentypicallyn
occursnafternimmunization.
An44-year-
oldnwomannwithnasthmanpresentsnaskingnfornan“flunsh
ot.”nShenisnseenntodaynfornannurgentncarenvisit,nisndiagn
osednwithnanlowernurinaryntractninfection,nandnisnpresc
ribedntrimethoprim-
sulfamethoxazole.nShenisnwithoutnfevernorngastrointesti
nalnupsetnwithnstablenrespiratorynstatus.nYouninformnh
ernthatnshe:
shouldnreturnnfornthenimmunizationnafternco
mplet-ingnhernantibioticntherapy.
wouldnlikelyndevelopnansignificantnreactionnifni
mmu-nizedntoday.
cannreceiventhenimmunizationntoday.
D.nisnnotnancandidatenfornanynformnofninfluenzanvaccine.
Whichnofnthenfollowingnstatementsnbestndescribe
snamantadinenornrimantadinenuseninnthencarenofn
patientsnwithnornatnrisknforninfluenza?
Significantnresistancentonselectnstrainsnofninfluenzanli
mitsnthenusefulnessnofnthesenmedications.
Thenprimarynactionnofnthesentherapiesnisninnprev
ent-ingninfluenzanAnduringnoutbreaks.
ThesentherapiesnarenactivenagainstninfluenzanAnandnB.
Thenusenofnthesenproductsnisnannacceptablenalter
nativentoninfluenzanvaccine.
Whichnofnthenfollowingnstatementsnbestndescribesnza
namivirn(Relenza)nornoseltamivirn(Tamiflu)nuseninnth
encarenofnpatientsnwithnornatnrisknforninfluenza?
Initiationnofntherapynearlyninnacuteninfluenzanillnes
sncannhelpnminimizenthenseveritynofndiseasenwhennt
henillnessnisncausednbynannonresistantnviralnstrain.
