MSNCB Health Promotion & Disease Prevention 5 — Questions and Answers
Question 1: A nurse is assessing a patient's alcohol consumption. The patient reports drinking 5 or more standard drinks on a single occasion at least once per week. How should the nurse classify this behavior?
- Moderate drinking
- Binge drinking (Correct answer)
- Heavy alcohol use disorder
- Social drinking within safe limits
Correct answer: Binge drinking
Binge drinking is defined by NIAAA as consuming 4+ drinks (women) or 5+ drinks (men) on a single occasion, bringing blood alcohol to ≥0.08 g/dL.
Question 2: A nurse is reviewing a patient's dietary recall and notes high intake of trans fats. Which patient education point about trans fats is most accurate?
- Trans fats raise HDL and have no effect on LDL
- Trans fats raise LDL and lower HDL, increasing cardiovascular risk (Correct answer)
- Trans fats are safe when consumed in moderation
- Only naturally occurring trans fats are harmful
Correct answer: Trans fats raise LDL and lower HDL, increasing cardiovascular risk
Artificial trans fats raise LDL (bad cholesterol) and lower HDL (good cholesterol), significantly increasing the risk of cardiovascular disease.
Question 3: A nurse is teaching a patient about osteoporosis prevention. Which combination of measures provides the strongest evidence-based primary prevention?
- Vitamin C supplementation and bed rest
- Adequate calcium and vitamin D intake combined with weight-bearing exercise (Correct answer)
- Hormone replacement therapy initiated at menopause for all women
- Bisphosphonate therapy starting at age 50 for all women
Correct answer: Adequate calcium and vitamin D intake combined with weight-bearing exercise
Weight-bearing exercise and adequate calcium (1000–1200 mg/day) with vitamin D (600–800 IU/day) are the cornerstone of evidence-based osteoporosis primary prevention.
Question 4: A med-surg nurse is using motivational interviewing (MI) with a patient reluctant to change their diet. Which technique is most consistent with MI principles?
- Telling the patient the health consequences of poor diet until they agree to change
- Asking open-ended questions and reflecting the patient's own reasons for change (Correct answer)
- Providing a detailed meal plan and asking the patient to follow it exactly
- Expressing disapproval of the patient's current food choices
Correct answer: Asking open-ended questions and reflecting the patient's own reasons for change
Motivational interviewing uses open-ended questions, affirmations, reflective listening, and summarizing to explore the patient's intrinsic motivation for change.
Question 5: A patient asks whether taking aspirin daily will prevent a first heart attack. Based on current USPSTF guidance, which response is most appropriate?
- All adults over 40 should take low-dose aspirin daily for cardiovascular prevention
- Low-dose aspirin for primary prevention is not recommended for adults 60 and older due to bleeding risk outweighing benefit (Correct answer)
- Aspirin 325 mg daily is the recommended dose for primary prevention
- Aspirin is only indicated after a documented MI
Correct answer: Low-dose aspirin for primary prevention is not recommended for adults 60 and older due to bleeding risk outweighing benefit
The 2022 USPSTF guideline recommends against initiating low-dose aspirin for primary CVD prevention in adults 60 and older due to increased bleeding risk.
Question 6: A nurse is providing discharge teaching to a patient recovering from pneumonia. Which pneumococcal vaccination schedule is recommended for an immunocompetent adult aged 67 with no prior pneumococcal vaccine?
- PPSV23 only, administered once
- PCV15 followed by PPSV23 at least 1 year later, or PCV20 alone (Correct answer)
- PCV13 followed by PPSV23 at 8 weeks
- No pneumococcal vaccine needed after age 65 if previously healthy
Correct answer: PCV15 followed by PPSV23 at least 1 year later, or PCV20 alone
Current ACIP guidelines recommend either PCV15 followed by PPSV23 ≥1 year later, or a single dose of PCV20 for pneumococcal-naive adults aged ≥65.
Question 7: A nurse is screening a 45-year-old female patient for depression in the outpatient med-surg setting. Which tool is the most widely validated and recommended for adult depression screening?
- Hamilton Depression Rating Scale (HAM-D)
- Patient Health Questionnaire-9 (PHQ-9) (Correct answer)
- Beck Depression Inventory (BDI-II) clinician version
- Center for Epidemiologic Studies Depression Scale (CES-D)
Correct answer: Patient Health Questionnaire-9 (PHQ-9)
The PHQ-9 is the most widely validated, brief, and recommended screening tool for depression in adult primary and outpatient care settings.
MSNCB Health Promotion & Disease Prevention 5
A nurse is assessing a patient's alcohol consumption.
The patient reports drinking 5 or more standard drinks on a single occasion at least once per week.
How should the nurse classify this behavior?