Examkin

Soru

Zorluk: ZorHealth Screening

A nurse in an outpatient primary care clinic is conducting health screenings and wellness assessments for several clients. Which action by the nurse demonstrates the correct application of evidence-based health screening guidelines and assessment principles?

  1. Recommending an immediate screening colonoscopy for an asymptomatic 42-year-old client whose father was diagnosed with colorectal cancer at age 50Cevap
  2. B
    Administering the recombinant zoster vaccine to a 65-year-old client and documenting the intervention as a completed secondary prevention screening
  3. C
    Bypassing cognitive and diagnostic screening for a 78-year-old client presenting with sudden-onset confusion after concluding it is a normal physiological age-related change
  4. D
    Initiating the abdominal portion of a routine physical screening by palpating all four quadrants for masses before auscultating for bowel sounds

Cevap

The correct action is recommending an immediate screening colonoscopy for the 42-year-old client, as familial risk guidelines dictate starting screening 10 years prior to the first-degree relative's age of diagnosis.
The correct answer demonstrates accurate application of familial risk screening guidelines. For colorectal cancer, individuals with a first-degree relative diagnosed with the disease should begin screening at age 40, or 10 years prior to the youngest age of diagnosis of a family member, whichever comes first. Since the father was diagnosed at 50, screening should begin at age 40.

Adım Adım Çözüm

1
Analyze the screening requirement for the client with a family history of colorectal cancer.
Identified that guidelines require screening to start at age 40, or 10 years before the relative's diagnosis (which would be 40 in this case). The client is 42 and overdue.
Evidence-based guidelines mandate earlier screening intervals for high-risk populations to ensure early detection.
2
Evaluate the classification of the zoster vaccine intervention.
Determined that administering a vaccine is primary prevention, not secondary prevention.
Secondary prevention involves screening for existing asymptomatic disease, whereas primary prevention prevents the disease from occurring.
3
Assess the clinical presentation of the 78-year-old client.
Recognized that sudden-onset confusion indicates acute pathology (delirium) requiring immediate diagnostic workup, not a normal age-related change.
Normal cognitive aging does not present as acute, sudden confusion; this presentation is a medical emergency in geriatrics.
4
Review the abdominal assessment technique.
Identified that the nurse used the wrong sequence by palpating before auscultating.
Abdominal assessment requires auscultation prior to percussion and palpation to avoid falsely altering bowel motility.

Anahtar Kavram

Evidence-Based Health Screening and Assessment Guidelines
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Konular

Health Screening

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