NCSBN - National Council of State Boards of Nursing Health Promotion and Maintenance Questions and Answers — Questions and Answers
Question 1: A nurse is providing community education on primary prevention strategies for cardiovascular disease. Which of the following activities should the nurse emphasize as the BEST example of primary prevention?
- Completing a health risk assessment at a community fair.
- Starting a low-dose aspirin regimen after a transient ischemic attack (TIA).
- Participating in a cardiac rehabilitation program after a myocardial infarction.
- Initiating a regular walking program and smoking cessation. (Correct answer)
Correct answer: Initiating a regular walking program and smoking cessation.
Primary prevention involves measures to prevent the onset of a disease or injury before the disease process begins. Initiating a walking program and stopping smoking are lifestyle modifications aimed at preventing the development of cardiovascular disease. A health risk assessment is secondary prevention (early detection). Aspirin after a TIA and cardiac rehabilitation are examples of tertiary prevention (managing existing disease).
Question 2: A public health nurse is assessing a 2-year-old child during a home visit. Which developmental finding would be a cause for concern and require further evaluation?
- The child can build a tower of six blocks.
- The child has a vocabulary of 20 words. (Correct answer)
- The child can walk up and down stairs with assistance.
- The child engages in parallel play with other toddlers.
Correct answer: The child has a vocabulary of 20 words.
By age 2, a child is expected to have a vocabulary of 50 or more words and be able to speak in two-to-three-word sentences. A vocabulary of only 20 words is a significant delay and warrants further investigation for potential speech or developmental issues. Building a six-block tower, navigating stairs with help, and parallel play are all expected findings for a 2-year-old.
Question 3: A nurse is providing prenatal education to a client in her first trimester. Which of the following topics is most crucial to include to prevent congenital neural tube defects?
- The importance of avoiding unpasteurized dairy products.
- The need for adequate daily intake of folic acid. (Correct answer)
- Strategies for managing morning sickness effectively.
- The schedule for glucose tolerance testing during pregnancy.
Correct answer: The need for adequate daily intake of folic acid.
Adequate intake of folic acid (at least 400 mcg per day) before and during the early weeks of pregnancy is proven to significantly reduce the risk of neural tube defects like spina bifida. While the other topics are important aspects of prenatal care, folic acid supplementation is directly linked to the prevention of this specific birth defect.
Question 4: A 55-year-old male client with no significant past medical history asks the nurse what health screenings are recommended for him. Based on current guidelines, which screening should the nurse recommend?
- A baseline electrocardiogram (ECG) to screen for heart disease.
- A testicular self-exam to be performed monthly.
- A colonoscopy to screen for colorectal cancer. (Correct answer)
- A yearly chest X-ray to screen for lung cancer.
Correct answer: A colonoscopy to screen for colorectal cancer.
Standard guidelines from organizations like the U.S. Preventive Services Task Force (USPSTF) recommend colorectal cancer screening for average-risk individuals beginning at age 45 or 50. A colonoscopy is a primary screening modality. Baseline ECGs and yearly chest X-rays are not recommended for asymptomatic, average-risk individuals. While testicular self-exams are sometimes discussed, their routine recommendation is less emphasized than colorectal cancer screening.
Question 5: A nurse is planning a health promotion program for a group of older adults at a senior center. To promote musculoskeletal health and reduce the risk of falls, which activity would be most appropriate to include?
- High-impact aerobic exercises.
- Detailed instruction on a low-fat, low-sodium diet.
- Balance and weight-bearing exercises. (Correct answer)
- Annual cognitive screening tests.
Correct answer: Balance and weight-bearing exercises.
Balance and weight-bearing exercises, such as tai chi or light weight training, are most effective for improving stability, strengthening bones (reducing osteoporosis risk), and maintaining muscle mass in older adults. This directly addresses the risk of falls, a major health concern in this population. High-impact aerobics can be unsafe, and while diet and cognitive screening are important, they do not directly target musculoskeletal strength and balance.
Question 6: A nurse is educating a newly diagnosed diabetic client on self-management. The client seems overwhelmed and states, 'I don't think I can do all of this.' Which of the following actions by the nurse best demonstrates an understanding of adult learning principles?
- Providing the client with several detailed pamphlets to read at home.
- Arranging for a family member to manage the client's care.
- Setting mutual goals and prioritizing the most critical learning needs first. (Correct answer)
- Advising the client to schedule a follow-up appointment once they feel ready to learn.
Correct answer: Setting mutual goals and prioritizing the most critical learning needs first.
Adult learning is most effective when the learner is involved in the process and the content is perceived as relevant and manageable. By setting mutual goals and prioritizing (e.g., focusing on blood glucose monitoring and hypoglycemia signs first), the nurse breaks down the information into manageable steps and respects the client's autonomy. This approach reduces feelings of being overwhelmed and empowers the client.
NCSBN - National Council of State Boards of Nursing Health Promotion and Maintenance Questions and Answers
A nurse is providing community education on primary prevention strategies for cardiovascular disease.
Which of the following activities should the nurse emphasize as the BEST example of primary prevention?