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Difficulty: MediumHealth Screening

A community health nurse is evaluating a 45-year-old client who presents for an initial wellness examination. The client's vital signs are within normal limits, and the client has a body mass index (BMI) of 28 kg/m228 \text{ kg/m}^2. Although currently asymptomatic, the client expresses anxiety regarding a paternal history of premature myocardial infarction. When implementing the care plan, which action by the nurse represents the most appropriate secondary prevention health screening measure?

  1. Facilitating laboratory orders for a fasting lipid profile and basic metabolic panel to identify early metabolic dysregulation.Answer
  2. B
    Educating the client on the benefits of a low-sodium diet and a daily 30-minute aerobic exercise regimen.
  3. C
    Reassuring the client that developing a consistently elevated resting blood pressure is a harmless, expected physiological change associated with aging.
  4. D
    Delegating the initial assessment of the client's cardiovascular risk factors and the formulation of a screening plan to the unlicensed assistive personnel (UAP).

Answer

The correct action is to facilitate laboratory orders for a fasting lipid profile and basic metabolic panel, as this represents secondary prevention.
Secondary prevention focuses on the early detection and prompt treatment of asymptomatic disease. Facilitating laboratory screening, such as a lipid profile and metabolic panel, directly aligns with secondary prevention by identifying early cardiovascular or metabolic risks before clinical symptoms develop.

Step-by-Step Solution

1
Analyze the client's presentation and the specific requirement of the question.
The client is asymptomatic with a family history of heart disease, and the question specifically asks for a 'secondary prevention' measure.
Identifying the exact type of intervention requested (secondary prevention) is crucial to filtering the options.
2
Differentiate between the levels of prevention.
Primary prevention prevents disease onset (e.g., education, vaccines). Secondary prevention detects early, asymptomatic disease (e.g., lab screenings, mammograms). Tertiary prevention manages existing chronic disease.
Applying the correct definition of prevention levels prevents selecting an otherwise healthy intervention that does not answer the specific prompt.
3
Evaluate each option against the principles of secondary prevention and safe nursing practice.
Laboratory screening is secondary prevention. Dietary education is primary prevention. Reassuring about high blood pressure is clinically unsafe (confuses pathology with normal aging). Delegating initial assessment to a UAP is outside the scope of practice.
Systematic evaluation ensures the selected answer is both contextually correct and clinically safe.

Key Concept

Secondary Prevention and Health Screening
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Topics

Health Screening

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