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Difficulty: Very hardHealth Promotion and Disease Prevention

The practical nurse (PN) in a community wellness clinic is implementing health promotion and disease prevention strategies for various clients. Which action by the PN demonstrates safe and effective care?

  1. Proceeding with routine immunization and wellness education for a 9-month-old infant who currently sits unsupported, uses a pincer grasp, and babbles.Answer
  2. B
    Reassuring the family of an 82-year-old client presenting for an annual wellness exam that the client's sudden-onset disorientation today is a normal age-related change.
  3. C
    Administering a scheduled subcutaneous measles, mumps, and rubella (MMR) vaccine to a 15-month-old toddler who has a documented anaphylactic allergy to neomycin.
  4. D
    Providing hypertension management education to an observant Jewish client by recommending the standard DASH diet, which includes drinking a glass of milk with every lunch and dinner meal that contains meat.

Answer

The correct action is to proceed with the wellness exam for the 9-month-old infant, as sitting unsupported, babbling, and using a pincer grasp are normal developmental milestones for this age.
The infant is demonstrating age-appropriate developmental milestones (sitting unsupported, babbling, utilizing a pincer grasp). Because the baseline assessment is normal, proceeding with routine health promotion and wellness education is safe, effective, and indicated.

Step-by-Step Solution

1
Evaluate the geriatric client's sudden confusion.
Recognize that sudden disorientation is a sign of acute delirium, not normal aging.
Acute confusion is a change in baseline that requires an immediate medical workup (e.g., for urinary tract infection or stroke), making routine reassurance unsafe.
2
Review the 15-month-old's immunization record and allergies.
Identify that a neomycin allergy is an absolute contraindication for the MMR vaccine.
Administering the vaccine to a client with a known anaphylactic allergy could cause a life-threatening systemic reaction.
3
Analyze the dietary recommendation for the observant Jewish client.
Determine that mixing meat and milk violates kosher dietary laws.
Health promotion and nutritional counseling must be culturally congruent to ensure client safety, respect, and adherence.
4
Assess the 9-month-old's developmental milestones.
Identify that sitting unsupported, using a pincer grasp, and babbling are expected, healthy findings.
Because the infant is developing normally, routine health promotion and scheduled interventions can safely proceed.

Key Concept

Applying evidence-based health promotion while maintaining safety across the lifespan, which requires evaluating vaccine contraindications, recognizing normal developmental milestones, accommodating cultural dietary needs, and identifying acute pathological changes.
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Topics

Health Promotion and Disease Prevention

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