Health Promotion.

Health Promotion.A. Be given the vaccine The patient who reports recent exposure to an infectious disease should be vaccinated today unless something else contraindicates the immunization. Since he is 12 months old, he is old enough to receive varicella and MMR. Varicella should be given on the same day as MMR or the two vaccines must be separated by at least 4 weeks. - answerA 12-month-old is here today to receive the varicella immunization. A patient's mother reports that her 12-month-old child was exposed to chickenpox about a week ago. The NP should recommend that he: A. Be given the vaccine B. Wait 4 weeks to receive the vaccine C. Not receive varicella today b/c he is not old enough D. Receive MMR only today, not varicella B. 3 years If the child is not cooperative, attempt again in 6 months, then at 4 years old. The usual vision of a 3yo is 20/50 - answerWhat is the usual age for vision screening in young children? A. 2 years B. 3 years C. 4 years D. 5 years B. Yes, but not more than 1-2 drinks/day A good rule of thumb for alcohol consumption in older adults is no more than 1-2 drinks/day after age 65. If the patient is cognitively impaired, abstinence is recommended. The type of alcohol is not of great importance. Beer, wine, and hard liquor all contain alcohol, which has the potential to impair older adults. The reason alcohol should be limited or avoided is b/c of decreased lean body mass and decreased total body water in aging bodies. - answerAn octogenarian asks the NP if it is OK for him to have an alcoholic beverage in the evenings. There is no contraindication. How should the NP respond? A. Yes, but not more than 4 days/week B. Yes, but not more than 1-2 drinks/day C. No, you will increase your risk of falling and injury D. It depends on the type of alcohol you would like to consume B. Stage 1 An average 8 yo would be expected to be prepubertal, which is Tanner 1. Pubertal changes can occur as early as 9-10 yrs in males or females. If changes occur prior to this, precocious puberty should be considered. - answerWhat Tanner stage corresponds to an average 8yo male? A. Stage 0 B. Stage 1 C. Stage 2 D. Stage 3 A. Give to immunocompetent adults 60 and older The zoster vaccine is currently FDA approved in immunocompetent adults age 50 and older. It should never be used to treat shingles. - answerWhich recommendation below reflects CDC's recommendation for administration of the zoster vacine? A. Give to immunocompetent adults 60 and older B. Give to immunocompetent adults 65 and older C. Give regardless of immune status at age 50 D. Give regardless of immune status at age 60 C. 5 years Common developmental tasks for a 5yo include: ability to draw a person with a body, head, arms, and legs; recognize most letters and can print some; know his address and phone number; dress self without help; able to skip and tiptoe; and play cooperatively and enjoy a playmate's company - answerWhat is the earliest age that an average child would be able to copy a triangle, know his colors, and count on his fingers? A. 3 years B. 4 years C. 5 years D. 6 years D. Continue feeding every 2-4 hours Babies will lose about 10% of their birth weight in the first 3-4 days of life. This baby has lost about 8 ounces; this is about 10% of his birth weight. This is an appropriate weight loss in this time. He should rapidly gain this weight back. When children begin losing weight and growth slows, one consideration should be given to congenital cardiac anomalies. There is no need for the mother to return in 1 week, but should return for 2 month check. - answerA 3-day-old infant weighed 8 pounds at birth. Today, he weighs 7.5 lbs. How should this be managed? A. Assess the baby for cardiac anomaly B. Add an extra feeding in the AM and PM C. Have the mother return to reweigh the baby in 1 week D. Continue feeding every 2-4 hours D. Infants Newborns are less than 1 month, Toddlers are greater than 1 year up to 3 years - answerBabies up to one year of age are called: A. Newborns B. Toddlers C. Newbies D. Infants A. Screening starting at 50 years At age 50, average risk males should have PSA with or without DRE. If high risk due to family hx (1st degree relative with prostate CA before age 65) or race (African American), screening discussions should take place at age 40-45 years. If initial PSA is 2.5 ng/mL, annual testing should take place. If 2.5 ng/mL, test every 2 years - answerWhat is the recommendation from American Cancer Society for assessment of the prostate gland in a man who is 45 yo and of average risk for development of prostate cancer? He should have: A. Screening starting at 50 years B. PSA now C. PSA and DRE now D. DRE only B. Breastfeeding Exposure to cigarette smoke, sucking on pacifiers increases the risk, unknown about Vitamin D - answerWhich of the following will decrease the risk of AOM in a 6 month old A. Cigarette smoke exposure B. Breastfeeding C. Sucking on pacifiers D. Vitamin D supplementation D. You are eligible to receive it but you still may get shingles Patients must be at least 50. It is generally well tolerated but provides protection from shingles in 50-64% of patients. The incidence of postherpetic neuralgia is decreased up to 65% after immunization. The patient still may develop shingles after receiving the immunization. The vaccine may be offered regardless of whether the patient has a hx of shingles. However, since it is a live vaccine, it may be contraindicated b/c of steroid use or immune status. - answerA patient who is 62 yo asks if she can get the shingles vaccine. She has never had shingles but states that she wants to make sure she doesn't get it. What should the NP advise? A. The immunization will protect you from acquiring shingles B. You are not old enough to receive the immunization C. The immunization is offered onl