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Difficulty: MediumHealth Screening

A nursing care coordinator at a primary care clinic is auditing client charts to ensure adherence to national health maintenance guidelines. Which of the following planned actions indicates that the coordinator correctly applies evidence-based screening principles?

  1. Recommending an annual low-dose computed tomography (LDCT) scan to screen for lung cancer in a 62-year-old client with a 30-pack-year smoking history.Answer
  2. B
    Documenting the administration of the seasonal influenza and pneumococcal vaccines as essential secondary prevention screening measures.
  3. C
    Omitting cognitive and functional screenings for an 80-year-old client presenting with sudden, severe confusion, as this is an expected physiological change of aging.
  4. D
    Delegating the initial reading and clinical interpretation of a client's tuberculin skin test (TST) induration to the unlicensed assistive personnel (UAP).

Answer

The correct action is recommending an annual low-dose computed tomography (LDCT) scan to screen for lung cancer in a 62-year-old client with a 30-pack-year smoking history.
The correct answer demonstrates accurate knowledge of current national health screening guidelines. The United States Preventive Services Task Force (USPSTF) recommends annual screening for lung cancer with low-dose computed tomography (LDCT) in adults aged 50 to 80 years who have a 20 pack-year smoking history. The client in this scenario meets all criteria for this secondary prevention measure.

Step-by-Step Solution

1
Evaluate the lung cancer screening recommendation.
Identified as correct.
Current evidence-based guidelines recommend annual LDCT screening for adults aged 50 to 80 years who have a 20 pack-year or greater smoking history and currently smoke or have quit within the past 15 years.
2
Analyze the classification of vaccines as secondary prevention.
Identified as incorrect.
Immunizations are primary prevention strategies designed to prevent the onset of disease, whereas secondary prevention involves screenings for early disease detection.
3
Assess the approach to sudden confusion in an older adult.
Identified as incorrect.
Sudden cognitive decline (delirium) is always pathological and requires urgent screening to identify reversible causes like infection; it is never a normal age-related change.
4
Review the delegation of reading a tuberculin skin test (TST).
Identified as incorrect.
Interpreting the induration of a TST requires clinical judgment and assessment, which cannot be delegated to an unlicensed assistive personnel (UAP).

Key Concept

Evidence-Based Health Screening and Maintenance
Estimated Time:1m 15s
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Topics

Health Screening

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