Week 14
Question 1For which of the following is START the acronym?
a.Screening tool of pharmacy prevention
b.Screening tool to accommodate right treatment
c.Screening tool to ask for recommended treatment
d.Screening tool to alert to right treatment
Question 2For which of the following is STOPP the acronym?
a.Screening tool of pharmacodynamic prevention
b.Screening tool of pharmacy prevention
c.Screening tool of older people's prescriptions
d.Screening tool to alert to right treatment
Question 3Haden just delivered her 3rd child at home. She and the baby are both doing well. The midwife who was present for the birth should ________. Choose all that apply.
a.not treat the newborn with prophylactic ocular topical medication to prevent gonococcal ophthalmia neonatorum because this is a hospital acquired infection and not needed as Haden had a home delivery.
b.discuss the option to do the newborn PKU screening, as this is an optional screening in the state where Haden lives
c.order the PKU screening test that needs to be completed within one to two days of birth
d.treat the newborn with prophylactic ocular topical medication to prevent gonococcal ophthalmia neonatorum
Question 4How can developmental milestones be noted in children? Choose all that apply.
a.Play
b.Learn
c.Speak
d.Act
Question 5How do vaccinations help individuals fight off disease?
a.Vaccines contain antibodies to fight infection.
b.Vaccines are weakened germs that are genetically modified to be safe in humans.
c.Vaccines fight off disease by helping the body create antigens to the disease.
d.Vaccines introduce a small number of antigens into the individualâ??s body.
Question 6If alcohol is consumed, it should be in moderation " ________ " and only by adults of legal drinking age.
a.up to four drinks per day for women and up to five drinks per day for men
b.up to one drink per day for women and up to two drinks per day for men
d.no more than five to seven drinks in one setting for women and no more than eight to ten drinks in one setting for men
Question 7Intimate partner violence (IPV) is common in the United States but often remains undetected. Although estimates vary, IPV (including sexual violence, physical violence, and stalking) is experienced by approximately 36 percent of U.S. women and 33 percent of U.S. men during their lifetime. Severe physical violence is experienced by 21 percent of U.S. women and 15 percent of U.S. men during their lifetime. Which of the following is the best definition of IPV according to the USPSTF?
a.The term "intimate partner violence" refers to acts whereby a trusted person causes or creates risk of harm to an adult.
b.The term "intimate partner violence" refers to acts whereby a trusted person (for example, a caregiver) causes or creates risk of harm to an older adult.
c.The term "intimate partner violence" refers to physical violence, sexual violence, psychological aggression (including coercive tactics, such as limiting access to financial resources), or stalking by a romantic or sexual partner, including spouses, boyfriends, girlfriends, dates, and casual hookups. Severe physical violence includes being hit with a fist or something hard, kicked, hurt by pulling hair, slammed against something, hurt by choking or suffocating, beaten, burned on purpose, or threatened with a knife or gun.
d."Intimate partner violence" is usually associated with situations of power imbalance and may include bullying, gaslighting, and abuse in the workplace.
Question 8Listening may appear passive, but it is a very active experience. Choose the reason(s) providers should hone their listening skills.
a.Listening helps providers gather important information they might otherwise miss.
b.Listening will promote the provider-client relationship.
c.Patients whose providers listen to them are more comfortable and satisfied with their care, making the patients more willing to open up and be honest.
d.Listening can save providers time, because they develop an ability to quickly grasp the essence of the patients' concerns. This allows providers to move from topic to topic.
Question 9Read the following scenarios and choose the correct exchange based on the USPSTF Guidelines.
a.Lois is 83 years old and is here for her annual physical. Lois is in good health and states she does not believe she needs to be screened for osteoporosis because she eats three to four Tums a day. You agree. At Lois's age, she no longer falls within the required age guidelines for screening.
b.Kathy is a 66-year-old female who presents to your office to establish care, and you recommend a bone density screen since Kathy is over 65.
c.Susan is a 58-year-old female who states she has a hx of a fractured hip related to a MVA when she was 45. You discuss her increased risk for osteoporosis and recommend she have a bone density test to evaluate the strength of her bones.
d.Kim is 48 years old and has a history of a total hysterectomy when she was 36 years old. She is unable to take hormone replacement and is concerned about her bones. Kim is active and maintains a diet rich in healthy foods. You reassure Kim that she does not need to worry about osteoporosis and that, per the guidelines, she does not need a bone density scan.
Question 10Read the following scenarios and choose the one that implements the correct preventive guideline recommendations.
a.MaryAnn is 18 and presents to your office for her yearly well woman exam. She states that she is sexually active and has had three partners in the past nine months. You will screen MaryAnn for chlamydia and gonorrhea during her pelvic exam.
b.Brian is a 22-year-old heterosexual male who presents for an annual exam and medication refill visit. Brian indicates that he is sexually active, asymptomatic, and has had two partners in the past 18 months. You will screen Brian for chlamydia and gonorrhea during his visit with the use of a urine screening test.
c.Elizabeth is a 58-year-old female who is widowed and presents for your annual exam. She is considering dating again. You will screen Elizabeth for chlamydia and gonorrhea during her pelvic exam.
d.Micah is a 27-year-old male who presents to your office with questions about STD screening. He states that he has been the recipient of anal penetration once in the past six months but denies receiving or performing oral sex. He denies any other sexual contact â?" male or female. He denies any symptoms and wants the least invasive screening. You recommend an oral swab for chlamydia and gonorrhea just to â??be safe.â?
Question 11Read the following scenarios. Choose the scenario that best depicts the role of the provider in relation to health planning and the USPSTF Guidelines.
a.Jacob is a 22-year-old male who smokes two ppd and comes to your office to discuss his cough. As the provider, you discuss the health risk of smoking. You provide Jacob with information related to e-cigarettes and a pamphlet with tips to help him quit smoking. He is to schedule a follow-up visit to discuss his success with quitting smoking in two weeks.
b.Judith is 68 and presents to your office for an annual exam. She is asking about having an ultrasound done to screen for ovarian cancer. She states that she has a friend who went to the ER with abdominal pain and they found ovarian cancer, so she wants to be screened. As the provider, you discuss that the USPSTF does not recommend routine screening for women who are asymptomatic or not known to have high-risk hereditary cancer syndrome
c.Alice is a 24-year-old female who is homeless and lives in a tent camp in downtown Seattle. You are seeing Alice today in the free clinic and you approach the subject of birth control. Alice tells you that doesn't like putting anything foreign in her body so she uses the "rhythm method". Alice last had intercourse about two weeks ago. You explain to Alice that you want to help make sure she doesnâ??t become pregnant and that you are going to place a Nexplanon â?" implantable birth control. The clinic just received a grant for these devices. You step out to go get the device for Alice.
d.Martine is 8 years old and is here with his mother for his school physical. He is 51 inches tall and weighs 88 pounds. Martine is obese, and during the visit you take time to discuss diet, exercise, and your concerns for his overall health. Per the USPSTF Guidelines, you have fulfilled all the requirements of preventative services for this scenario.
Question 12Screening for obesity in children and adolescents should occur at what age?
a.Eight years of age and older
b.When the child starts kindergarten
c.With first menstrual cycle for females and age 12 for males
d.Six years of age and older
Question 13Screening is not right for everyone or every health problem. Screenings uncover health problems in an efficient and economically feasible manner when certain factor(s) are present. Read the following scenarios and choose the one(s) most consistent with the requirements of preventative screening.
a.Jacob is a 74-year-old male who smoked for 30+ years, but he quit smoking when he was 50. After his annual exam, you write orders for lab work and a CT of his lungs.
b.MaryAnn is a 43-year-old female who presents to your office with complaints of a lump in her right breast. You do not have the same finding on exam and schedule her for a mammogram.
c.Brittany is an 18-year-old pregnant female. During each of her OB visits, you run a urinalysis to screen for preeclampsia.
d.Susan is a 26-year-old female who presents to your office for her annual well woman exam. She is married with two children under the age of four. As part of her annual screening, you test for GC and chlamydia, trichomonas, and bacterial vaginosis.
Question 14Stacey is 26 years old and is 12 weeks pregnant. Today, she has no protein in her urine and her BP is 104/62; however, with her last pregnancy she developed proteinuria with hypertension and had to be placed on bedrest for the last trimester of her pregnancy.
a.Per the USPSTF Guidelines, you will recommend that Stacey start a low dose aspirin daily due to her risk of preeclampsia when she reaches 16 weeks.
b.Per the USPSTF Guidelines, you will recommend that Stacey start a low dose aspirin daily immediately as she is 12 weeks pregnant and high risk for preeclampsia.
c.Per the USPSTF Guidelines, you will have Stacey return to the office for weekly protein urine dips, and when or if she develops proteinuria you will initiate low dose aspirin therapy.
d.Per the USPSTF Guidelines, you will order a bleeding time and PTT test today while she is in the office and initiate Lovenox therapy at 1mg /kg/day.
Question 15The CDC and USPSTF recommend screening all high-risk individuals for hepatitis C and tuberculosis. Read the following scenarios and choose the best option.
a.Jose is a 38-year-old male who has lived in Mexico for the past 25 years. He is returning to the United States because his mother is ill. Jose is covered in tattoos; his arms, chest, and back are full, and he is working on his legs, with several new drawings having been started. He denies any IV drug use and states that he is heterosexual and has had one partner for the past 15 years. Jose has come to your office to establish care and prescription refills. After talking with Jose, you feel that he is at risk for Hep C and TB.
b.Maria is a 24-year-old female who is in your office today with her baby. The baby is happy, smiling, and appears well cared for. Maria admits to using heroin and has shared needles in the past. She states that she had her baby a year ago. You verify that her Hep C screen was negative when she delivered. She denies using now, stating that she quit when she found out she was pregnant. Maria is at risk for having hepatitis C, and you order a screening test.
c.Mike is a 38-year-old male who just finished a 10-year sentence for multiple armed robberies. You volunteer at the local health clinic and are seeing Mike for the first time. Due to his history of being incarcerated, Mike is at risk for TB and Hep C.
d.Karen is a 16-year-old female who states she had sex for the first time two weeks ago with Manuel. They have gone to school together since kindergarten, but she is worried she could have contracted an STD because they didnâ??t use protection. Since they didn't use protection, you perform a pelvic exam and do â??regular STDâ? screening test, but you also order a Hep C and TB test as well.
Question 16 The CDC makes the following statements about chronic disease:
Six in 10 adults in the United States have a chronic disease.
Four in 10 adults in the United States have two or more chronic diseases.
Chronic diseases are the leading cause of death and disability in the United States.
Tobacco use, poor nutrition, lack of physical activity, and excessive alcohol use are key lifestyle risks for chronic disease
Now that you have reviewed these statements from the CDC, read the following scenarios and choose the one that most reflects the statistics on chronic disease.
a.Jason is a 34-year-old male who exercises five days a week, does not smoke, and drinks only on special occasions. He was just diagnosed with glaucoma.
b.Amelia is 18 months old and just stopped walking. She refuses to bear weight on her right leg, and the x-ray shows concerns for a bone tumor.
c.Kerri is a 78-year-old female who fell down four steps due to the ice and broke her left hip. She is concerned she may have osteoporosis.
d.Sandy is a 56-year-old female with frequent episodes of shingles. She is diabetic, has hypertension, and continues to smoke. Sandy's BMI is 38.
Question 17The most commonly reported STD in the United States is ________.
a.hepatitis C
b.trichomoniasis
c.herpes
d.chlamydia and gonorrhea
Question 18The USPSTF screening for hypertension in adults is best applied to which of these scenarios?
a.Mary is a 16-year-old Hispanic female. As her PCP, you would request that she check her BP and HR three times in the next two weeks and call the office with results.
b.John is a 32-year-old Caucasian male who is in your office with complaints of anxiety. His BP is 186/100. You recommend John check his BP outside of the office and call with those results before starting any medications.
The USPSTF recommends screening for hypertension in adults age 18 years or older. The USPSTF recommends obtaining measurements outside of the clinical setting for diagnostic confirmation before starting treatment.
c.Jack is a 46-year-old Native American male here to establish care. His BP is 160/82. You prescribe an ACE Inhibitor and a two-week follow-up appointment.
d.Calvin is a 52-year-old African American male who has documented BPs outside of your office of 152â?"174/76â?"102. You prescribe Calvin an ACE inhibitor.
Question 19The Women's Health Initiative studies caused controversy when trials were halted. The disinformation that came from the halting of the trials caused a panic. What are the current recommendations for healthful diet and exercise and the use of hormone replacement therapy in postmenopausal women?
a.The USPSTF recommends against the use of combined estrogen and progestin for the primary prevention of chronic conditions in postmenopausal women.
b.The UPSTF recommends the use of estrogen alone for the primary prevention of chronic conditions in postmenopausal women who have had a hysterectomy.
c.The USPSTF recommends that primary care professionals utilize behavioral counseling to help promote a healthful diet and physical activity for everyone.
d.The USPSTF recommends that all women follow a healthful diet and exercise plan; however, those on hormone replacement therapy tend to gain the most benefits.
Question 20To initiate change and adherence to treatment, motivational interviewing works by activating patients' own ________.
a.guilt
b.motivation
c.family
d.spouse
Question 21What are the four guiding principles of motivational interviewing?
a.Direct, guide, follow, and mix-n-match
b.Asking, listening, informing, collaborating
c.Resist, understand, listen, empower
d.Collaborative, evocative, autonomy, empower
Question 22What are: establishing oneself in a productive career, nourishing long-term relationships, childbearing, and child rearing?
a.Stressors frequently identified by adolescents
b.Stressors frequently identified by older adults
c.Stressors frequently identified by children
d.Stressors frequently identified by young and middle age adults
Question 23What are: feeling sick, having nothing to do, being along, family fighting, not having enough money to spend, being pressured to get good grades, feeling left out of a group, being compared to older siblings?
a.Stressors frequently identified by children
These are all stressors frequently identified by children.
b.Stressors frequently identified by adolescents
c.Stressors frequently identified by young and middle age adults
d.Stressors frequently identified by older adults
Question 24What is the main downfall of asking serial questions?
a.Providers find it difficult to recognize change talk when using this technique.
b.Serial questions do not allow the provider to shift between communication themes.
c.Serial questions make the practitioner appear to be really interested and taking a lot of time with the patient.
d.Serial questions tend to evoke defensiveness, often leading to answers that are half-truths as a means of protecting self-esteem.
Question 25When considering the aspect of communication, which of the following statement(s) is/are true? Choose all that apply.
a.The ability to ask questions thoughtfully and effectively is close to the heart of good quality patient care.
b.The tone, pacing, wording, and clarity of questioning are all building blocks to quality communication.
c.Demonstrating a sense of curiosity and good listening are solid components of quality communication.
d.Asking a question and getting a response are complicated when communicating with another human being.
