NU 629 FINAL EXAM (NEW 2024/ 2025 UPDATE) ADVANCED HEALTH PROMOTION | QS & AS| GRADE A|, Exams of Nursing

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NU 629 FINAL EXAM (NEW 2024/ 2025 UPDATE)

ADVANCED HEALTH PROMOTION | QS & AS| GRADE

A| 100% CORRECT (VERIFIED ANSWERS) – REGIS

Hepatitis B - ANS ✓-The USPSTF recommends screening for Hepatitis B virus infections in persons at high risk for infection.

• Risk groups for HBV that should be screened are persons with high prevalence of HBV, US born whose parents were born in high prevalence of HBV, HIV positive persons, injection drug users, men who have sex with men, household contacts or sexual partners of persons with HBV
• Approved Hep B surface antigen followed by a neutralizing confirmatory test for reactive results should be used to screen for HBV infection
• Diagnosis of HBV infection is characterized by persistence of HBsAg for at least six months or longer
• HBV treatment consists of antiviral regimens. First line are pegylated interferon a2a, entecavir, and tenofovir. sexually transmitted infections (STIs) - ANS ✓-The USPSTF recommends intensive behavioural counseling for all sexually active adolescents and for adults who are at increased with for sexually transmitted infections (STI)
• All sexually active adolescents are at increased risk for STI and should be counselled, other risk group such as those with other infections in the past year or

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current STI, those who have had multiple sex partners, and those who do not use condoms.

• Obtain a sexual history from all patients and encourage risk reduction through counseling, including HIV counseling
• Physical examination inspecting skin, pharynx, lymph nodes, anogenital area, neurologic system
• Screening is available for gonorrhea, chlamydia, syphilis, Hep B, Hep C, and HIV. Trichomoniasis and cervical and anal cancer are also to be tested for those at risk for STDs.
• Treatment of partners prevents reinfection and is essential to interrupting transmission of STD colorectal cancer - ANS ✓-The USPSTF recommends screening for colorectal cancer starting at age 50 years and continuing until age 75 years.
• For vast majority of adults, the most important risk factor for colorectal cancer is older age. Other associated risk factors include family history, male sex, and black race
• Screening to early-detect colorectal cancer, stool-based tests, direct visualization, and serology tests.
• Treatment of early-stage colorectal cancer is local excision or simple polypectomy for tumors limited to colonic mucosa or surgical resection for larger localized lesions

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• When a vaccine is not administered at the recommended age, administer at a subsequent visit
• Can receive influenza vaccine at 6 months old and if egg allergies are present that result in hives, given any influenza vaccine that is appropriate for age and health status annually cervical cancer - ANS ✓-The USPSTF recommends screening for cervical cancer every 3 years with cervical cytology alone in women aged 21 to 29 years old.
• Women 30-65 recommend screening every 3 years with cervical cytology along and every 5 years with HPV testing alone, or every 5 years with combination
• Recommends against screening for cervical cancer in women who have had a hysterectomy with removal of cervix and do not have history of high-grade precancerous lesion or cervical cancer
• Not recommended to screening women that are younger than 21 years old
• Risk factors include HIV, compromised immune system, utero exposure to diethylstilbestrol, previous treatment of cancerous lesion or cervical cancer Fall prevention - ANS ✓-Screen patients over 65 years and older and routinely ask: Have you fallen in the past year? Do you feel unsteady when standing or walking? Do you worry about falling?
• STEADI: Stopping elderly accidents, deaths, and injuries. Screen patients for fall risk, assess modifiable risk factors, and intervene to reduce risk by using effective clinical and community strategies

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• Recommended to utilize exercise interventions to prevent falls in community- dwelling adults 65 years or older who are at increased risk for falls
• Risk factors that contribute to falls are muscle weakness, gait disturbances, and imbalance
• History of falls is fundamental to a fall reduction program and recommended to ask elderly about falls at least once a year and assess gait and balance through evaluation if history of fall smoking/vaping - ANS ✓-The USPSTF recommends that clinicians ask about adults tobacco use and advise them to stop using tobacco, provide behavior interventions through FDA approved pharmacotherapy
• Pharmacotherapy interventions including NRT, bupropion SR, and varenicline with or without behavioural counseling interventions improves achievement of tobacco cessation
• Recommend counseling through in persons, telephone, or over the phone to successfully quit cmoking
• The USPSTF recommends that primary care clinicians provide interventions including education or counseling to prevent initiation of tobacco use among school-aged children and adolescents
• All youth are considered at risk for tobacco use regardless or absence of other risk factors. Risk factors include male, white race, not college-bound, rural area, parents with lower levels of education, parental smoking, childhood friends that smoke, older adolescent, and stressful events

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• Treatment consists of antidepressants or specific psychotherapy approaches either alone or in combination then with dialectical behavioral therapy, problem solving therapy, and developmental group there.
• Use evidence based counseling interventions when managing depression in pregnant or breastfeeding women. Hepatitis C (HCV) - ANS ✓-The USPSTF recommends screening for HCV infection in adults ages 18-79 years old who are at high risk for the infection
  • Adults that have positive screening test result are usually followed up with a diagnostic evaluation using 1 or various noninvasive tests.
• Treatment typically consists of oral direct acting antiviral regimens for 8- 12 weeks
• Risk factors include those that have past or current drug injection use
• Screening with anti-HCV antibody testing followed by polymerase chain reaction testing for HCV RNA is accurate to identify those with chronic HCV infection. Those with abnormal LFT and AST/LST/bilirubin levels are often screened Lung Cancer - ANS ✓-Asymptomatic adults aged 55-80 years who have a 30- pack year smoking history and currently smoking or have quit smoking within the past 15 years
• The appropriate screening for lung cancer is with low-dose computer tomography (LDCT)

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• Screening should be discontinued once a person has not smoked for 15 years or develops a health problem that substantially limits life expectancy or ability to have curative lung surgery
• Age, total exposure to tobacco smoke, and years since quitting smoking are important risk factors for lung cancer and are used to determine eligibility for screening
• Surgical resection is the current standard for localized NSCLC. This cancer is treated with surgical resection and with radiation and chemotherapy. prostate cancer - ANS ✓-Men 55-69 years PSA based screening is individual decision
• Do not screen for prostate cancer for men 70 years old and older
• Risk factors for prostate cancer include older age, African American race, family history or prostate cancer
• Screening tools are PSA (prostate-specific antigen) and if elevated and patient experiencing symptoms patient may undergo a transrectal ultrasound guided core-needle biopsy of prostate to diagnose prostate cancer
• Treatment options are removal of the prostate, radiation therapy, and active surveillance Adult Immunizations - ANS ✓-Adults that are at risk for heart disease or stroke should receive influenza vaccine, Tdap vaccine, pneumococcal vaccine, zoster

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• Risk factors include a family member that has had a history of breast cancer, race and ethnicity (white women).
• Treatment for breast cancer is surgery, chemotherapy, hormonal therapy, biological therapy, and radiation therapy. - Often a multidisciplinary approach from surgeons, medical oncologists and radiation oncologists. Human Papillomavirus (HPV) - ANS ✓-The USPSTF recommends screening for cervical cancer every 3 years with cervical cytology alone in women aged 21- 29 years.
• Women 30 to 65 years screening is recommended every 3 years with cervical cytology alone, every 5 years with high risk HPV testing alone, or every 5 years with testing in combination with cytology
• The USPSTF recommends against screening for cervical cancer in women who have had a hysterectomy with removal of the cervix and do not have a history of high-grade precancerous lesion or cervical cancer
• High-grade cervical lesions may be treated with excisional and ablative therapies. Early-stage cervical cancer may be treated with surgery (hysterectomy) or chemotherapy.
• Screening with cervical cytology alone, primary testing for hrHPV alone, or both at the same time (cotesting) can detect high-grade precancerous cervical lesions and cervical cancer. ----Clinicians should focus on ensuring that women receive adequate screening, appropriate evaluation of abnormal results, and indicated treatment, regardless of which screening strategy is used.

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• HPV can cause cervical cancer, vaginal cancer, and vulval cancer, anal cancer, penile cancer, and back of throat cancer, and the CDC recommends HPV vaccination at ages 11-12 years old to protect against these six potentiall types of cancer. Cardiovascular Disease - ANS ✓-Risk factors for CVD include older age, male, high blood pressure, smoker, elevated lipid labs, diabetes, obesity, and physical inactivity.
• Resting ECG records cardiac electrical activity while patient is at rest and exercise ECG records electrical activity during physical exertion.
• USPSTF recommends screening for high blood pressure, statins, counseling on smoking cessation, counseling on healthful diet and physical inactivity. Low dose aspirin recommended in those at increased risk of CVD events
• Asymptomatic adults at increased risk of CVD are treated with a combination of diet and exercise modifications, lipid lowering medications, aspirin, hypertension management, and encourage tobacco cessation through intervention.
• Assessment for those 20-39 years old it is reasonable to measure risk factors every 4-6 years and adults. Hypertension - ANS ✓-Person's aged 60 or older, initiate pharmacological treatment to lower BP at 150/90 or higher to achieve a BP lower than 150/90.
• In the general nonblack population, including those with diabetes, initial antihypertensive treatment should include a thiazide diuretic, CCB, ACEI, or ARB.

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