Adult-Gerontology Primary Care Nurse Practitioner Exam Health Promotion & Disease Prevention 1 — Questions and Answers
Question 1: According to current ACIP recommendations, which pneumococcal vaccination strategy is appropriate for a 65-year-old adult who has never received any pneumococcal vaccine?
- PPSV23 alone as a single dose
- PCV13 followed by PPSV23 one year later
- PCV20 alone OR PCV15 followed by PPSV23 at least one year later (Correct answer)
- PCV15 alone as a single dose
Correct answer: PCV20 alone OR PCV15 followed by PPSV23 at least one year later
Current ACIP guidelines recommend either PCV20 alone or PCV15 followed by PPSV23 (≥1 year later) for pneumococcal-naive adults aged 65 and older.
Question 2: The USPSTF recommends lung cancer screening with annual low-dose CT (LDCT) for which population?
- All adults aged 60 and older with any tobacco history
- Adults aged 50–80 with a ≥20 pack-year history who currently smoke or quit within the past 15 years (Correct answer)
- Adults aged 55–80 with a ≥30 pack-year history who currently smoke or quit within the past 10 years
- Adults aged 65 and older who currently smoke
Correct answer: Adults aged 50–80 with a ≥20 pack-year history who currently smoke or quit within the past 15 years
The 2021 USPSTF update expanded lung cancer screening to adults aged 50–80 years with a ≥20 pack-year smoking history who currently smoke or have quit within the past 15 years.
Question 3: Per USPSTF guidelines, how often should mammography be performed for average-risk women aged 50–74?
- Annually
- Every 2 years (Correct answer)
- Every 3 years
- Every 5 years
Correct answer: Every 2 years
USPSTF recommends biennial (every 2 years) mammography screening for average-risk women aged 50–74 years.
Question 4: A 65-year-old woman presents for a well visit. According to USPSTF guidelines, bone mineral density (DEXA) screening for osteoporosis should be recommended:
- Only after a low-impact fracture occurs
- At age 65 for all women regardless of risk factors (Correct answer)
- Only when the FRAX 10-year fracture risk exceeds 20%
- Only for women with a BMI below 18.5
Correct answer: At age 65 for all women regardless of risk factors
USPSTF recommends bone density screening with DEXA for all women aged 65 and older, regardless of additional risk factors.
Question 5: The 2017 ACC/AHA hypertension guidelines recommend a blood pressure target of less than how many mmHg for most adults aged 65 and older, including those with stable coronary artery disease?
- 120/80 mmHg
- 130/80 mmHg (Correct answer)
- 140/90 mmHg
- 150/90 mmHg
Correct answer: 130/80 mmHg
The 2017 ACC/AHA guidelines set a target of <130/80 mmHg for most adults, including older adults with stable cardiovascular conditions.
Question 6: Which of the following falls prevention interventions has the strongest evidence for reducing falls in community-dwelling older adults?
- Vitamin D supplementation alone
- Hip protectors
- Multifactorial assessment and individualized intervention including exercise programs (Correct answer)
- Home safety modifications alone
Correct answer: Multifactorial assessment and individualized intervention including exercise programs
Multifactorial falls prevention programs that include individualized risk assessment combined with exercise (particularly balance and strength training) have the strongest evidence for reducing falls in community-dwelling older adults.
Question 7: According to USPSTF recommendations, colorectal cancer screening for average-risk adults aged 50–75 years may be accomplished by which method?
- Annual digital rectal exam only
- CT colonography every 10 years only
- Colonoscopy every 10 years, annual high-sensitivity stool-based tests, or sigmoidoscopy every 5 years (Correct answer)
- Annual CEA tumor marker measurement
Correct answer: Colonoscopy every 10 years, annual high-sensitivity stool-based tests, or sigmoidoscopy every 5 years
USPSTF endorses multiple equivalent colorectal cancer screening strategies for average-risk adults 50–75, including colonoscopy every 10 years, annual stool-based tests, or sigmoidoscopy every 5 years.
Adult-Gerontology Primary Care Nurse Practitioner Exam Health Promotion & Disease Prevention 1
According to current ACIP recommendations, which pneumococcal vaccination strategy is appropriate for a 65-year-old adult who has never received any pneumococcal vaccine?