A middle-aged client presents for an annual health visit at a community clinic. The client is 5 feet 10 inches (177.8 cm) tall, weighs 250 pounds (113.4 kg), and works as an accountant. The client has smoked at least one pack of cigarettes every day for the last 15 years. Which secondary prevention measure should the nurse recommend the client to follow?
- A. Smoking cessation.
- B. Compliance with antihypertensive and lipid lowering agents.
- C. Blood pressure and lipid screening.
- D. Increase physical activity and diet low in saturated fat.
Correct Answer: C
Rationale: Blood pressure and lipid screening are secondary prevention measures to detect cardiovascular issues early, critical for a smoker with obesity and high cardiovascular risk.
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The elementary school nurse has identified a problem requiring a secondary intervention. Which intervention should the nurse implement?
- A. Instruct on technique of 'stop, drop & roll' at assembly.
- B. Involve the parent teacher association (PTA) in a fund raising event for the new gym.
- C. Invite 1st grade parents to a 'Meet the Teachers' event.
- D. Send letters to parents regarding a recent lice infestation.
Correct Answer: D
Rationale: Sending letters about a lice infestation is a secondary prevention intervention, addressing an identified problem to control its spread.
The epidemiological triad can be used to frame strategies for the prevention of farm machinery injuries. Which action should the nurse take to focus on the agent?
- A. Provide rehabilitation services to injured farm hands.
- B. Work with legislators to mandate safe tractor design.
- C. Teach farm workers not to smoke around farm equipment.
- D. Translate written vehicle instructions into picture format.
Correct Answer: B
Rationale: Mandating safe tractor design targets the agent (machinery) in the epidemiological triad, reducing injury risk by improving equipment safety features.
The school nurse who is reviewing immunization records of students who will start kindergarten within the next month notes that most of the students have only received one dose of the measles, mumps, rubella (MMR) vaccine. Which intervention should the nurse implement?
- A. Contact kindergarten parents to remind them that the second dose of MMR is due at the start of the school year.
- B. Send notices home with the children on the first day of class advising that MMR vaccine series must be completed.
- C. Note in student records that the second dose of the MMR vaccine should be administered prior to entering first grade.
- D. Speak at the next parent-teacher association meeting to teach parents the benefits of immunizing their children.
Correct Answer: A
Rationale: Contacting parents before the school year ensures timely MMR second-dose administration, meeting school entry requirements.
The school health nurse observes that a large percentage of Hispanic children in the elementary school are overweight. Which screening program should the nurse choose to target the highest priority health concern for this population?
- A. Diabetes mellitus.
- B. Hypothyroidism.
- C. English proficiency.
- D. Iron deficiency anemia.
Correct Answer: A
Rationale: Overweight Hispanic children are at high risk for type 2 diabetes, making diabetes screening a priority to detect and manage this condition early, given its increasing prevalence in this population.
According to the Centers for Disease Control and Prevention, which diseases are reportable infectious diseases? Select all that apply.
- A. Pediculosis.
- B. Bacterial conjunctivitis.
- C. Anthrax.
- D. Diphtheria.
- E. Tuberculosis.
Correct Answer: C,D,E
Rationale: Anthrax, Diphtheria, and Tuberculosis are reportable due to their severe public health implications, potential for outbreaks, and, in the case of anthrax, bioterrorism concerns. Pediculosis and bacterial conjunctivitis, while public health concerns, are not typically mandated for reporting to the CDC.
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