APEA 3P EXAM PREP4 HEALTH PROMOTION QUESTIONS WITH 100% GRADED A+ ANSWERS AND EXPLANATIONS

APEA 3P EXAM PREP4 HEALTH PROMOTION QUESTIONS WITH 100% GRADED A+ ANSWERS AND EXPLANATIONS A patient who has been treated for hypothyroidism presents for her annual exam. Her TSH is 4.1 (normal = 0.4- 3.8). She feels well. How should she be managed? Continue her current dosage of thyroid replacement. Increase her replacement. Decrease her replacement. Repeat the TSH in 2-3 weeks. When an abnormal TSH is received, especially when a patient is not symptomatic, it should be repeated. Sometimes there are periods of transient hypothyroidism, lab error, and missed doses that can cause changes in TSH levels. A 20-year-old student has an MMR titer that demonstrates an unprotective titer for rubella. She is HIV positive. Her CD4 cell count is unknown. Which statement is true? She should not receive the MMR immunization because she is at low risk for the disease. MMR is safe to give but she does not need this. She is at risk for MMR but should not be immunized. She should receive this. The immunization is not alive. This patient is at risk for rubella because she does not have a sufficient titer. The MMR immunization is an attenuated virus. Though an attenuated immunization is weakened, it is still considered live and so is contraindicated in anyone who may be immunocompromised. Since her CD4 cell count is unknown, she should not receive this immunization yet. She may be able to receive this immunization if her CD4 count is normal. What choice below would be beneficial to a 76-year-old who takes daily oral steroids for COPD and now takes a daily aspirin for primary prevention of myocardial infarction? Screen for infection with H. pylori Daily proton pump inhibitor (PPI) Antacids PRN heartburn Daily use of low dose famotidine Aspirin does increase the risk of gastrointestinal bleeding, especially if it is given in combination with oral steroids. Most learned authorities and ACOVE (Assessing Care of Vulnerable Elders) agree that when two or more risk factors for GI bleed are present, aspirin should not be added without some form of protection for the GI tract (misoprostol or a daily PPI). In considering all the risks for GI bleed, the most significant ones are age 75 years, history of GI bleeding, warfarin use, daily NSAID use, and chronic steroid use.