Preventive Care and Education Flashcards

A community paramedic is conducting a fall risk assessment for a 78-year-old patient. Which standardized tool is MOST appropriate for evaluating fall risk in community-dwelling older adults?

Answer: Timed Up and Go (TUG) test

The Timed Up and Go (TUG) test is a validated, widely used tool for assessing fall risk and mobility in older community-dwelling adults.

When educating a patient with newly diagnosed hypertension on lifestyle modifications, which dietary approach has the strongest evidence for blood pressure reduction?

Answer: DASH diet

The DASH (Dietary Approaches to Stop Hypertension) diet is specifically designed and clinically proven to reduce blood pressure.

A community paramedic is teaching a diabetic patient about foot care. Which instruction is MOST important to include?

Answer: Inspect feet daily for cuts, blisters, and sores

Daily foot inspection allows early detection of wounds or infections that can rapidly worsen due to diabetic neuropathy and poor circulation.

Which vaccine is recommended annually for all adults, especially those with chronic respiratory conditions, as part of a community paramedic's preventive care plan?

Answer: Influenza vaccine

The annual influenza vaccine is recommended for all adults and is especially critical for those with chronic respiratory or cardiac conditions.

When using the teach-back method during patient education, the community paramedic asks the patient to:

Answer: Repeat back the information in their own words

The teach-back method asks patients to explain information back in their own words, confirming comprehension rather than just verbal acknowledgment.

A community paramedic identifies that a patient's A1C is 6.2%. How should the paramedic counsel this patient?

Answer: Counsel on prediabetes prevention strategies to avoid progression to type 2 diabetes

An A1C of 5.7–6.4% indicates prediabetes, and lifestyle interventions at this stage can significantly reduce or delay progression to type 2 diabetes.

Which social determinant of health is MOST directly associated with increased rates of preventable hospitalizations in urban communities?

Answer: Food insecurity and limited access to nutritious food

Food insecurity leads to poor nutrition management of chronic conditions like diabetes and hypertension, directly increasing preventable hospitalization rates.

A community paramedic is counseling a patient who smokes about cessation. Which pharmacotherapy has the HIGHEST rate of long-term abstinence when combined with behavioral counseling?

Answer: Varenicline (Chantix)

Varenicline (Chantix) combined with behavioral support has demonstrated the highest quit rates in clinical trials compared to other cessation medications.

When performing a pediatric well-child screening visit as part of a community paramedic program, at what age is developmental surveillance for autism spectrum disorder (ASD) specifically recommended by the AAP?

Answer: 18 and 24 months

The AAP recommends specific ASD screening at the 18- and 24-month well-child visits using validated tools such as the M-CHAT.

A community paramedic is educating a patient with COPD on pulmonary hygiene. Which technique is MOST effective for mobilizing secretions in this patient population?

Answer: Active Cycle of Breathing Technique (ACBT)

The Active Cycle of Breathing Technique (ACBT) combines breathing control, thoracic expansion exercises, and forced expiration to effectively clear secretions.

During a home visit, a community paramedic notices a patient hoards medications and takes higher doses than prescribed to manage pain. This behavior most likely represents:

Answer: Opioid use disorder requiring referral to addiction services

Hoarding medications and dose escalation without provider guidance are behavioral warning signs consistent with opioid use disorder requiring addiction assessment.

A community paramedic is screening a 50-year-old patient with a 25 pack-year smoking history. Which screening is NOW recommended by the USPSTF for this patient?

Answer: Annual low-dose CT (LDCT) scan of the chest

USPSTF recommends annual low-dose CT lung cancer screening for adults aged 50–80 with at least a 20 pack-year smoking history who currently smoke or quit within the past 15 years.

When educating a hypertensive patient on home blood pressure monitoring, the community paramedic should instruct the patient to:

Answer: Avoid caffeine for 30 minutes and rest 5 minutes before measurement

Avoiding caffeine and resting for at least 5 minutes before measurement eliminates variables that can artificially elevate blood pressure readings.

A community paramedic is reviewing immunization records for a 65-year-old patient who has never received a pneumococcal vaccine. Which vaccine(s) should be recommended?

Answer: PCV15 or PCV20 followed by PPSV23 if PCV15 was used

Current CDC guidance recommends PCV15 or PCV20 for pneumococcal-naive adults 65+; if PCV15 is used, PPSV23 should follow at least one year later.

A community paramedic is performing a mental health screen on a patient using the PHQ-9. A score of 15 indicates:

Answer: Moderately severe depression warranting active treatment or referral

A PHQ-9 score of 15–19 indicates moderately severe depression, which typically warrants initiation of treatment and/or mental health referral.

When counseling a pregnant patient on prenatal nutrition, which supplement is MOST critical to recommend in the first trimester to prevent neural tube defects?

Answer: Folic acid (400–800 mcg daily)

Folic acid taken before conception and during the first trimester significantly reduces the risk of neural tube defects such as spina bifida.

A community paramedic is implementing a medication reconciliation process for a high-risk patient. Which situation is the MOST common source of medication errors in this population?

Answer: Discrepancies between what patients report taking and what providers have prescribed

Discrepancies between patient-reported medications and prescribed medications are the leading source of errors, often due to adherence issues, discontinued meds, or miscommunication.

During a community health fair, a paramedic screens a 45-year-old male with BMI 31, sedentary lifestyle, and a father with type 2 diabetes. Using the ADA risk score, this patient should be:

Answer: Referred for a fasting glucose or A1C test to screen for prediabetes/diabetes

Multiple risk factors (overweight, sedentary, family history) indicate this patient should be screened with fasting glucose or A1C per ADA guidelines.

When performing a home safety assessment for a patient at risk for falls, which environmental modification has the STRONGEST evidence for fall reduction?

Answer: Removing trip hazards and installing grab bars in the bathroom

Removing trip hazards and installing grab bars are the most evidence-supported environmental interventions shown to reduce falls in older adults at home.

A community paramedic is using motivational interviewing (MI) with a patient resistant to making lifestyle changes. Which MI technique is used when the paramedic says, 'So on one hand you enjoy smoking with your coffee, but on the other hand you're worried about your lungs—is that right?'

Answer: Double-sided reflection

A double-sided reflection acknowledges both sides of ambivalence simultaneously, helping the patient explore the conflict between current behavior and desired health outcomes.