NUR 601 Exam 2: Health Promotion and Disease
Prevention - St. Thomas University Updated and
Latest Questions and Correct Answers with
Rationale
1. A 52-year-old female patient asks about the appropriate frequency for screening
mammography based on the USPSTF guidelines. What is the correct recommendation?
A. Every year starting at age 40
B. Biennially for women aged 50 to 74 years
C. Every 3 years starting at age 45
D. Only if the patient has a first-degree relative with breast cancer
Correct Answer: B
Rationale: The USPSTF currently recommends biennial screening mammography for
women aged 50 to 74 years. Screening before age 50 should be an individual decision
based on patient values and risk factors. This approach balances the benefits of early
detection against the potential harms of overdiagnosis and false positives. For women aged
75 and older, the evidence is insufficient to recommend for or against screening. The goal is
to maximize mortality reduction while minimizing unnecessary procedures.
2. Which of the following is considered an example of primary prevention?
A. Administering the Influenza vaccine to a pregnant woman
B. Performing a colonoscopy on a 50-year-old male
C. Prescribing metformin for a patient with prediabetes
D. Referral to cardiac rehabilitation after a myocardial infarction
Correct Answer: A
Rationale: Primary prevention focuses on preventing the initial onset of disease or injury
by eliminating causes or increasing resistance. Immunizations are classic examples because
they protect individuals before any disease occurs. In contrast, screenings like
colonoscopies are secondary prevention because they detect existing asymptomatic
conditions. Tertiary prevention involves managing established diseases to prevent further
complications or disability. Understanding these levels is crucial for implementing effective
public health strategies.
3. The USPSTF recommends screening for colorectal cancer in adults starting at what age?
A. 45 years old
B. 40 years old
,C. 50 years old
D. 55 years old
Correct Answer: A
Rationale: Recent updates to screening guidelines have lowered the starting age for
colorectal cancer screening from 50 to 45 years. This change reflects the increasing
incidence of early-onset colorectal cancer observed in recent years. Screening should
continue until age 75 for most asymptomatic adults at average risk. Methods can include
stool-based tests or direct visualization such as colonoscopy. Early detection significantly
reduces mortality by identifying and removing precancerous polyps.
4. According to the 5 As model for smoking cessation, what is the first step a provider should
take?
A. Assist the patient in a quit plan
B. Arrange for follow-up contact
C. Ask the patient about tobacco use at every visit
D. Assess the patient’s willingness to quit
Correct Answer: C
Rationale: The 5 As model begins with ‘Ask’ to identify all tobacco users at every clinical
encounter. This systematic approach ensures that the provider is aware of the patient’s risk
profile regarding nicotine. Once tobacco use is identified, the provider proceeds to Advise,
Assess, Assist, and Arrange. Consistently asking establishes tobacco use as a clinical
priority in the health record. This initial step is vital for triggering the subsequent
intervention phases.
5. A 66-year-old male smoker with a 30 pack-year history asks about lung cancer screening.
Which test is recommended?
A. Annual Chest X-ray
B. Sputum cytology every 6 months
C. Annual low-dose computed tomography (LDCT)
D. High-resolution CT every 3 years
Correct Answer: C
Rationale: The USPSTF recommends annual screening for lung cancer with low-dose
computed tomography (LDCT) for high-risk adults. Eligible patients are those aged 50 to 80
who have a 20 pack-year smoking history and currently smoke or quit within 15 years.
LDCT has been proven to reduce lung cancer mortality through earlier detection compared
to standard imaging. Chest X-rays and sputum cytology are not recommended for screening
, as they do not show mortality benefit. Screening should stop once a person has not smoked
for 15 years or develops a limiting health condition.
6. When screening for cervical cancer, what is the recommended guideline for a 25-year-old
woman with average risk?
A. Primary HPV testing every 5 years
B. Co-testing with cytology and HPV every 5 years
C. Cervical cytology (Pap test) every 3 years
D. Annual Pap test
Correct Answer: C
Rationale: For women aged 21 to 29 years, the USPSTF recommends screening for cervical
cancer every 3 years with cervical cytology alone. HPV testing is generally not
recommended in this age group due to the high prevalence of transient HPV infections.
Once women reach age 30, they may choose to continue cytology alone every 3 years or
move to HPV testing every 5 years. Screening should not begin before age 21 regardless of
sexual activity. This strategy aims to prevent cervical cancer while avoiding over-treatment
of lesions that might regress spontaneously.
7. An asymptomatic 55-year-old male with a blood pressure of 145/92 mmHg should be
managed how?
A. Confirm the diagnosis with out-of-office blood pressure monitoring
B. Start immediate pharmacotherapy with a beta-blocker
C. Order an EKG and recheck in one year
D. Advise the patient to reduce salt and return in 6 months
Correct Answer: A
Rationale: Current guidelines emphasize confirming a diagnosis of hypertension with out-
of-office measurements before starting treatment. This helps identify ‘white coat
hypertension’ and ensures that medications are only prescribed when necessary. Home
blood pressure monitoring or ambulatory monitoring are the preferred methods for
confirmation. If the blood pressure remains elevated outside the clinic, lifestyle
modifications and potential medication should be discussed. Accurate diagnosis is the
cornerstone of preventing cardiovascular complications associated with chronic
hypertension.
8. The USPSTF recommends screening for Abdominal Aortic Aneurysm (AAA) in which
population?
A. Men aged 65 to 75 who have ever smoked
B. All adults over age 65
Prevention - St. Thomas University Updated and
Latest Questions and Correct Answers with
Rationale
1. A 52-year-old female patient asks about the appropriate frequency for screening
mammography based on the USPSTF guidelines. What is the correct recommendation?
A. Every year starting at age 40
B. Biennially for women aged 50 to 74 years
C. Every 3 years starting at age 45
D. Only if the patient has a first-degree relative with breast cancer
Correct Answer: B
Rationale: The USPSTF currently recommends biennial screening mammography for
women aged 50 to 74 years. Screening before age 50 should be an individual decision
based on patient values and risk factors. This approach balances the benefits of early
detection against the potential harms of overdiagnosis and false positives. For women aged
75 and older, the evidence is insufficient to recommend for or against screening. The goal is
to maximize mortality reduction while minimizing unnecessary procedures.
2. Which of the following is considered an example of primary prevention?
A. Administering the Influenza vaccine to a pregnant woman
B. Performing a colonoscopy on a 50-year-old male
C. Prescribing metformin for a patient with prediabetes
D. Referral to cardiac rehabilitation after a myocardial infarction
Correct Answer: A
Rationale: Primary prevention focuses on preventing the initial onset of disease or injury
by eliminating causes or increasing resistance. Immunizations are classic examples because
they protect individuals before any disease occurs. In contrast, screenings like
colonoscopies are secondary prevention because they detect existing asymptomatic
conditions. Tertiary prevention involves managing established diseases to prevent further
complications or disability. Understanding these levels is crucial for implementing effective
public health strategies.
3. The USPSTF recommends screening for colorectal cancer in adults starting at what age?
A. 45 years old
B. 40 years old
,C. 50 years old
D. 55 years old
Correct Answer: A
Rationale: Recent updates to screening guidelines have lowered the starting age for
colorectal cancer screening from 50 to 45 years. This change reflects the increasing
incidence of early-onset colorectal cancer observed in recent years. Screening should
continue until age 75 for most asymptomatic adults at average risk. Methods can include
stool-based tests or direct visualization such as colonoscopy. Early detection significantly
reduces mortality by identifying and removing precancerous polyps.
4. According to the 5 As model for smoking cessation, what is the first step a provider should
take?
A. Assist the patient in a quit plan
B. Arrange for follow-up contact
C. Ask the patient about tobacco use at every visit
D. Assess the patient’s willingness to quit
Correct Answer: C
Rationale: The 5 As model begins with ‘Ask’ to identify all tobacco users at every clinical
encounter. This systematic approach ensures that the provider is aware of the patient’s risk
profile regarding nicotine. Once tobacco use is identified, the provider proceeds to Advise,
Assess, Assist, and Arrange. Consistently asking establishes tobacco use as a clinical
priority in the health record. This initial step is vital for triggering the subsequent
intervention phases.
5. A 66-year-old male smoker with a 30 pack-year history asks about lung cancer screening.
Which test is recommended?
A. Annual Chest X-ray
B. Sputum cytology every 6 months
C. Annual low-dose computed tomography (LDCT)
D. High-resolution CT every 3 years
Correct Answer: C
Rationale: The USPSTF recommends annual screening for lung cancer with low-dose
computed tomography (LDCT) for high-risk adults. Eligible patients are those aged 50 to 80
who have a 20 pack-year smoking history and currently smoke or quit within 15 years.
LDCT has been proven to reduce lung cancer mortality through earlier detection compared
to standard imaging. Chest X-rays and sputum cytology are not recommended for screening
, as they do not show mortality benefit. Screening should stop once a person has not smoked
for 15 years or develops a limiting health condition.
6. When screening for cervical cancer, what is the recommended guideline for a 25-year-old
woman with average risk?
A. Primary HPV testing every 5 years
B. Co-testing with cytology and HPV every 5 years
C. Cervical cytology (Pap test) every 3 years
D. Annual Pap test
Correct Answer: C
Rationale: For women aged 21 to 29 years, the USPSTF recommends screening for cervical
cancer every 3 years with cervical cytology alone. HPV testing is generally not
recommended in this age group due to the high prevalence of transient HPV infections.
Once women reach age 30, they may choose to continue cytology alone every 3 years or
move to HPV testing every 5 years. Screening should not begin before age 21 regardless of
sexual activity. This strategy aims to prevent cervical cancer while avoiding over-treatment
of lesions that might regress spontaneously.
7. An asymptomatic 55-year-old male with a blood pressure of 145/92 mmHg should be
managed how?
A. Confirm the diagnosis with out-of-office blood pressure monitoring
B. Start immediate pharmacotherapy with a beta-blocker
C. Order an EKG and recheck in one year
D. Advise the patient to reduce salt and return in 6 months
Correct Answer: A
Rationale: Current guidelines emphasize confirming a diagnosis of hypertension with out-
of-office measurements before starting treatment. This helps identify ‘white coat
hypertension’ and ensures that medications are only prescribed when necessary. Home
blood pressure monitoring or ambulatory monitoring are the preferred methods for
confirmation. If the blood pressure remains elevated outside the clinic, lifestyle
modifications and potential medication should be discussed. Accurate diagnosis is the
cornerstone of preventing cardiovascular complications associated with chronic
hypertension.
8. The USPSTF recommends screening for Abdominal Aortic Aneurysm (AAA) in which
population?
A. Men aged 65 to 75 who have ever smoked
B. All adults over age 65
