FULL TEST
Nurse Practitioner BANK
Certification
Examination and Practice Preparation
Testbank by Margaret A. Fitzgerald
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,Health Promotion
and Disease Prevention 1
Primary Prevention 6. Active immunity is defined as:
A. resistance developed in response to an antigen.
Measures B. immunity conferred by an antibody produced in
another host.
1. An example of a primary prevention measure for a78- C. the resistance of a group to an infectious agent.
year-old man with chronic obstructive pulmonary D. defense against disease acquired naturally by the
disease is: infant from the mother.
A. reviewing the use of prescribed medications.
B. conducting a home survey to minimize fall risk. 7. Which of the following is usually viewed as the most
C. checking FEV1 (force expired volume at 1 second) to cost-effective form of healthcare?
FVC (forced vital capacity) ratio. A. primary prevention
D. ordering fecal occult blood test (FOBT). B. secondary prevention
C. tertiary prevention
2. Which of the following is an example of a primary preven- D. cancer-reduction measures
tion activity in a 76-year-old woman with osteoporosis?
A. bisphosphonate therapy 8. An 18-year-old woman with allergic rhinitis presents for
B. calcium supplementation primary care. She is sexually active with a male partner
C. ensuring adequate illumination in the home and is 1 year post-coitarche; during this time she had had
D. use of a back brace two sex partners. An example of a primary prevention
activity for this patient is:
3. Secondary prevention measures for a 78-year-old man A. screening for sexually transmitted infection.
with chronic obstructive pulmonary disease include: B. counseling about safer sexual practices.
A. screening for mood disorders. C. prescribing therapies for minimizing allergy.
B. administering influenza vaccine. D. obtaining a liquid-based Papanicolaou (Pap) test.
C. obtaining a serum theophylline level.
D. advising about appropriate use of car passenger 9. When a critical portion of a community is immunized
restraints. against a contagious disease, most members of the com-
munity, even the unimmunized, are protected against
4. Tertiary prevention measures for a 69-year-old woman that disease because there is little opportunity for an
with heart failure include: outbreak. This is known as immunity.
A. administering antipneumococcal vaccine. A. passive
B. adjusting therapy to minimize dyspnea. B. humoral
C. surveying skin for precancerous lesions. C. epidemiologic
D. reviewing safe handling of food. D. community
5. Which of the following products provides passive
immunity?
A. hepatitis B immune globulin (HBIG)
Answers
B. measles, mumps, and rubella (MMR) vaccine 1. B. 4. B. 7. A.
C. pneumococcal conjugate vaccine 2. C. 5. A. 8. B.
D. live attenuated influenza vaccine (LAIV) 3. A. 6. A. 9. D.
1
,2 CHAPTER 1 ■ Health Promotion and Disease Prevention
Primary prevention measures include activities provided
to individuals to prevent the onset or acquisition of a given
Influenza
disease. The goal of primary prevention measures is to spare Immunization
individuals the suffering, burden, and cost associated with the
clinical condition and is the first level of healthcare. An ex- 10. When advising a patient about injectable influenza im-
ample is health-protecting education and counseling, such as munization, the nurse practitioner (NP) considers the
encouraging the use of car restraints and bicycle helmets, following about the use of this vaccine:
counseling about safer sexual practices, and providing infor- A. Its use is not recommended in sickle cell anemia.
mation on accident and fall prevention. Given its focus on B. Its use is limited to children older than 2 years.
preventing illness or injury, primary prevention is usually C. Its use is limited due to containing live virus.
viewed as the most effective form of healthcare. D. Its use is recommended for virtually all members of
Immunizations and chemoprophylaxis are also exam- the population.
ples of primary prevention measures. Active immunization
through the use of vaccines provides long-term protection 11. A middle-aged man with chronic obstructive pul-
from disease. In herd or community immunity, a significant monary disease who is about to receive injectable in-
portion of a given population has immunity against an infec- fluenza vaccine should be advised that:
tious agent; the likelihood that the susceptible portion of the A. it is more than 90% effective in preventing influenza.
group would become infected is minimized (Fig. 1–1). Pas- B. its use is contraindicated in the presence of psoriasis
sive immunity is provided when a person receives select an- vulgaris.
tibodies, usually via the administration of immune globulin C. localized reactions such as soreness and redness at
(IG), after exposure to an infective agent. This immunity is the site of the immunization are fairly common.
temporary and requires the patient to present post-exposure; D. a short, intense, flulike syndrome typically occurs
the protection provided by IG usually starts within hours of after immunization.
receiving the doses and lasts a number of months. The use of 12. A 44-year-old woman with asthma presents asking for
vaccines to produce lasting disease protection is preferred to a “flu shot.” She is seen today for an urgent care visit, is
passive immunization through the use of IG. Another exam- diagnosed with a lower urinary tract infection, and is
ple of passive immunity is the acquisition of disease protec- prescribed trimethoprim-sulfamethoxazole. She is
tion provided from mother to unborn child via the placenta. without fever or gastrointestinal upset with stable
Secondary prevention measures include activities provided respiratory status. You inform her that she:
to identify and treat asymptomatic persons who have risk fac- A. should return for the immunization after complet-
tors for a given disease or in preclinical disease. Examples in- ing her antibiotic therapy.
clude screening examinations for preclinical evidence of B. would likely develop a significant reaction if immu-
cancer, such as mammography and cervical examination with nized today.
a Papanicolaou test. Other examples of secondary prevention C. can receive the immunization today.
activities include screening for clinical conditions with a pro- D. is not a candidate for any form of influenza vaccine.
tracted asymptomatic period, such as a blood pressure meas-
urement to detect hypertension and a lipid profile to detect 13. Which of the following statements best describes
hyperlipidemia (Table 1–1). amantadine or rimantadine use in the care of patients
with or at risk for influenza?
See full color images of this topic A. Significant resistance to select strains of influenza
on DavisPlus at limits the usefulness of these medications.
http://davisplus.fadavis.com | B. The primary action of these therapies is in prevent-
Keyword: Fitzgerald
ing influenza A during outbreaks.
Tertiary prevention measures are part of the management C. These therapies are active against influenza A and B.
of an established disease. The goal is to minimize disease- D. The use of these products is an acceptable alternative
associated complications and the negative health effects of to influenza vaccine.
the conditions to the patient. Examples include medications 14. Which of the following statements best describes
and lifestyle modification to normalize blood glucose levels zanamivir (Relenza) or oseltamivir (Tamiflu) use in the
in individuals with diabetes mellitus and in conjunction with care of patients with or at risk for influenza?
the treatment of heart failure, aimed at improving or mini- A. Initiation of therapy early in acute influenza illness
mizing disease-related symptoms. can help minimize the severity of disease when the
DISCUSSION SOURCES illness is caused by a nonresistant viral strain.
http://www.cdc.gov/excite/skincancer/mod13.htm, Centers for B. The primary indication is in preventing influenza A
Disease Control and Prevention: Levels of Prevention during outbreaks.
http://www.niaid.nih.gov/topics/pages/communityimmunity.aspx, C. The drugs are active only against influenza B.
National Institute of Allergy and Infectious Disease: Community D. The use of these medications is an acceptable alter-
Immunity native to influenza vaccine.
, Section 1: Preventive Services Recommended by the USPSTF
The U.S. Preventive Services Task Force (USPSTF) recommends that clinicians discuss these preventive services with eligible patients and offer them as a
priority. All these services have been given “A” or a “B” (recommended) grade from the Task Force.
Adults Special Populations
Recommendation
Men Women Pregnant Women Children
Abdominal Aortic Aneurysm, Screening
Alcohol Misuse Screening and Behavioral Counseling
Interventions
CHAPTER 1
Asymptomatic Bacteriuria in Adults, Screening
Breast and Ovarian Cancer Susceptibility, Genetic Risk
Assessment and BRCA Mutation Testing
Breast Cancer, Screening
Breastfeeding, Primary Care Interventions to Promote
■
Cervical Cancer, Screening
Health Promotion and Disease Prevention
Chlamydial Infection, Screening
Colorectal Cancer, Screening
Congenital Hypothyroidism, Screening
Depression in Adults, Screening
Diabetes Mellitus (Type 2) in Adults, Screening
Folic Acid to Prevent Neural Tube Defects
Gonococcal Ophthalmia Neonatorum, Preventive
Medication
Figure 1-1 Preventive services recommended by the U.S. Preventive Services Task Force (USPSTF). Available at http://www.ahrq.gov/clinic/
pocketgd2012/gcp12s1.htm.
Continued
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