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Difficulty: MediumHealth Screening

A clinic nurse is developing a health maintenance plan for a 50-year-old female client who has a body mass index (BMI) of 31 kg/m231 \text{ kg/m}^2 and a family history of type 2 diabetes. The client currently reports feeling healthy and has no physical complaints. Which of the following secondary prevention screenings should the nurse include in the client's plan of care? (Select all that apply.)

  1. Hemoglobin A1c testingAnswer
  2. Screening mammographyAnswer
  3. C
    Administration of the recombinant zoster vaccine
  4. D
    Dual-energy x-ray absorptiometry (DEXA) scan
  5. Screening colonoscopyAnswer
  6. F
    Education on a low-glycemic, calorie-restricted diet

Answer

The indicated secondary prevention screenings for this client are hemoglobin A1c testing, screening mammography, and a screening colonoscopy.
Secondary prevention focuses on early disease detection and screening. For a 50-year-old female who is asymptomatic and has a BMI of 31 kg/m231 \text{ kg/m}^2, evidence-based guidelines recommend screening for type 2 diabetes (due to age and obesity), breast cancer (routine screening mammography), and colorectal cancer (routine screening begins at age 45).

Step-by-Step Solution

1
Identify the exact goal of the question.
The nurse must select interventions that qualify as 'secondary prevention screenings' and are age- and risk-appropriate for this specific client.
Differentiating between primary, secondary, and tertiary prevention is necessary to eliminate incorrect options.
2
Evaluate the client's demographic and clinical data.
The client is a 50-year-old female, is classified as obese (BMI 31 kg/m231 \text{ kg/m}^2), and has a family history of type 2 diabetes.
Client age, biological sex, and specific risk factors dictate which evidence-based screenings are indicated.
3
Match the client data to secondary prevention (screening) guidelines.
Mammography and colonoscopy are indicated based on her age. Hemoglobin A1c is indicated due to her age, elevated BMI, and family history.
To select the necessary screenings required for this particular patient profile.
4
Eliminate primary prevention measures and age-inappropriate screenings.
The zoster vaccine and diet education are primary prevention interventions. The DEXA scan is age-inappropriate as it is typically initiated at age 65 for average-risk women.
To ensure only the correctly indicated secondary prevention screenings are selected.

Key Concept

Secondary prevention focuses on early disease detection through screening. Evidence-based guidelines dictate specific screening timelines based on age, sex, and risk factors.
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Health Screening

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