Adolescent Health Screening and Prevention, Exams of Nursing

Download Adolescent Health Screening and Prevention and more Exams Nursing in PDF only on Docsity! CMN 571- Unit 2 Exam How far back should you ask adolescent (greater than 11) patients if they've drank? - Answer- one year At what age should you ask about friend's drinking habits BEFORE the patients? - Answer- ages 9-14 (elementary and middle school patients) How far back do you ask about alcohol use in elementary students (9-11 y/o)? - Answer- ever What are the estimated binge drinking levels for youth? - Answer- Boys: ages 9-13=3 drinks, 14-15 = 4 drinks, 16 and >= 5 drinks. Girls of all ages= 3 drinks What are 2 short tools that can be used to identify alcohol abuse among adolescents? - Answer- The AUDIT tool, and the CRAFFT tool What causes the majority of melanomas? What are some other risk factors? - Answer- UV radiation; fair skin and family hx. What is considered the most preventable cause of skin cancer? - Answer- UV radiation At what age do lipid levels reach similar levels of that of adults? - Answer- 2 What is an acceptable cholesterol and LDL level in adolescence? - Answer- <170 and <110 What is considered borderline cholesterol and LDL levels in adolescence? - Answer- 170-199 and 110-129 what is considered an elevated cholesterol and LDL level in adolescence? - Answer- >200 and >130 What are some primary prevention factors in the prevention of dental caries? - Answer- fluoride, oral hygiene, diet management, and sealants Name two secondary prevention interventions used in the prevention of dental caries. - Answer- 1. Professional preventative care 2. restorative dentistry What important component should always be incorporated into the physical exam of an adolescent? - Answer- growth indices What should the focus of a developmental surveillance be? - Answer- growth and self- efficacy What are the main vaccines that are given during adolescence? - Answer- HPV, Tdap, meningicoccal, flu What type of pap technology involves using a wooden spatula and a cytobrush to collect cervical cells, and then placing the cells immediately on a slide and sprayed with fixative to preserve? - Answer- conventional slide pap What type of pap does not require the clinician to prepare the slide? - Answer- liquid- based cervical cytology test What are the advantages and disadvantages of using a liquid-based cervical cytology test? - Answer- improved specimen adequacy, improved sensitivity, and the ability to retain a sample for follow-up HPV dna testing; expensive What percentage of normal cervical cytology tests are required to be re-screened by cytologists? - Answer- 10% What are cervical cancer screening failures mainly due to? - Answer- women who have never been screened, or haven't been screened within the last 5 years For women, what is the second most common cause of cancer and is the leading cause of cancer death? - Answer- cervical cancer What ethnicity has the highest rates of cervical cancer? - Answer- hispanic What ethnicity has the highest mortality rates from cervical cancer? - Answer- African- Americans What 4 common practices are associated with hpv transmission and cervical cancer? - Answer- early initiation of sex, multiple partners, smoking, and unprotected sex What type of rare cancer are women who were exposed to DES in utero at risk for? - Answer- Clear cell adenocarcinoma What are the risk factors for cervical cancer? - Answer- smoking, chlamydia infection, grand multiparity, DES exposure, and long-term use of oral contraceptives What are the 2 most common types of HPV that cause cervical cancer? - Answer- 16 & 18 At what age are changes caused by drugs more likely to 'stick' and become hardwired as addiction? - Answer- 20 What is the single biggest contributing factor to drug abuse among teens? - Answer- friends who engage in the problem behavior What is the drug of choice among teens? - Answer- alcohol When can you start screening adolescents regarding alcohol use? - Answer- You can begin screening as soon as you start seeing the youth alone, without a parent What is the uspstf recommendations on screening for testicular cancer in adolescent or adult men? - Answer- The USPSTF recommends against screening for testicular cancer in adolescent or adult men What genetic factors contribute to a person's risk of developing skin cancer? - Answer- fair-skinned, family hx. What are the most common types of skin cancer closely associated with, and what is the most preventable cause of cancer? - Answer- UV exposure T/F The concentration of serum lipids and lipoproteins has been shown to increase to childhood - Answer- True At what age do serum lipids and lipoproteins reach adult levels? - Answer- 2 Children with what disease are at the highest risk of cardiovascular disease in adulthood? - Answer- progressive atherosclerosis What does the process of "generational forgetting" involve? - Answer- As the perception of danger decreases, old drugs may reappear in common use What s/e are associated with anabolic-androgenic steroids? - Answer- acne, liver tumors, htn, premature closure of the epiphysis, ligamentous injury, and precocious puberty. In females, they can cause hirutism, male pattern baldness, and virilization. In males, they can cause gynecomastia and testicular atrophy What comorbidities are associated with marijuana use? - Answer- tachycardia, mild htn, bronchodilation, decreased fertility, What substance is associated with amotivational syndrome, and what is it? - Answer- Marijuana; inattention to environmental stimuli, and impaired goal-directed thinking and behavior. What screening tool can be used to screen adolescents for substance abuse? - Answer- CAGE What score on the CAGE questionnaire is suggestive of substance abuse? - Answer- 2 or more How long does it take for adolescents to become nicotine dependent? - Answer- 4 weeks What behavior denotes nicotine dependency? - Answer- smoke a pack a day or feels the urge to smoke within 30 min. of waking What is an example of a primary prevention program aimed at preventing substance abuse among adolescents? - Answer- DARE Who are secondary level prevention programs, related to substance abuse, aimed at? What is an example? - Answer- target populations at an increased risk for substance use to prevent progression from initiation to continuance and maintenance; Alateen ( a program that supports the children of alcoholic parents) Systemic fluoride intake via optimal fluoridation of drinking water or professionally prescribed supplements is recommended until what age? - Answer- 16 What test can be used to screen for scoliosis? - Answer- The Adam's forward bend test If a spinal curve measures greater than ______ degrees, it is considered scoliosis - Answer- 10 What evaluation is based on external body contour when screening for scoliosis? - Answer- surface topography What are the screening recommendations for school-based screening for scoliosis according to the AAP? - Answer- girls 10-12 and boys 13-14 What are 2 important determinants in the progression of idiopathic scoliosis? - Answer- future growth potential and magnitude of the curve What instrument is used to measuring quality of life in adolescents with scoliosis who are being treated conservatively with a corrective brace? - Answer- Brace questionaire What do higher scores on the Brace questionnaire indicate? - Answer- A better quality of life What 2 questionnaires were created to assess the self-image of patients with scoliosis? - Answer- The Trunk Appearance Perception Scale and Spinal Appearance Questionnaire What adolescent population is especially at a high risk for IPV - Answer- high school females What 2 screening tools are commonly used to screen adolescents for depression? - Answer- PHQ-2 and PHQ-9 What 2 treatments have been shown to decrease depression symptoms in adolescents? - Answer- SSRIs and psychotherapy What instrument is used to measure the spinal curve? - Answer- scoliometer Which type of scoliosis in adolescence may have a milder clinical course? - Answer- idiopathic At what age do most teenagers complete puberty? - Answer- 16-18 How often should adolescents aged 11-21 have routine health visits? - Answer- Annually When should adolescent patients be seen alone? - Answer- By age 11 or 12 At the onset of puberty, what allows pulsatilla production and release of LH and FSH? - Answer- Inhibition of gonadotropin releasing hormone is removed in the hypothalamus What stimulates the interstitial cells of the testes to produce testosterone? - Answer- LH What stimulates the production of spermatocytes in the presence of testosterone? - Answer- FSH How long does pubertal growth last? - Answer- 2-4 years and lasts longer in boys What is considered the "gold standard" for scoliosis dx.? - Answer- x-ray At what spinal curvature do you refer? - Answer- >7-10 At what spinal curvature do you wear brace? - Answer- >20 At what spinal curvature do you refer for surgery? - Answer- >40 What are the DSM-IV criteria for depression? - Answer- depressed mood and anhedonia for most days in a 2 week period during most of the day If hx. of severe Arthus (local vasculitis ass. w/ deposition of immune complexes) reaction after previous TD vaccine, how long should the vaccine be deffered? - Answer- 10 years