MSNCB Health Promotion & Disease Prevention 3 — Questions and Answers
Question 1: A nurse is assessing a patient's readiness to quit smoking. The patient states, 'I know I should quit, but I'm not planning to do anything about it yet.' Which stage of change does this represent?
- Precontemplation
- Contemplation (Correct answer)
- Preparation
- Action
Correct answer: Contemplation
Contemplation is characterized by awareness of a problem and consideration of change but no commitment to action within the next 30 days.
Question 2: Which immunization is recommended annually for all adults, including those with medical-surgical conditions such as COPD or heart failure?
- Pneumococcal vaccine (PPSV23)
- Influenza vaccine (Correct answer)
- Hepatitis B vaccine
- Tdap booster
Correct answer: Influenza vaccine
Annual influenza vaccination is recommended for all adults, and is especially critical for those with chronic conditions who are at higher risk of complications.
Question 3: A nurse is teaching a patient about breast self-exam (BSE). According to current evidence-based guidelines, what is the most accurate statement about BSE?
- BSE is recommended monthly and replaces clinical breast exams
- BSE alone is insufficient for early detection but increases breast health awareness (Correct answer)
- BSE is no longer relevant since mammography was introduced
- BSE should be performed weekly for women over 40
Correct answer: BSE alone is insufficient for early detection but increases breast health awareness
Current guidelines do not endorse BSE as a standalone screening tool, but it promotes awareness and encourages women to report changes promptly.
Question 4: A nurse counsels a post-MI patient on cardiac rehabilitation. Which component is essential to tertiary prevention in this context?
- Administering statins as prophylaxis in healthy adults
- Supervised exercise and lifestyle modification to prevent recurrence (Correct answer)
- Annual cholesterol screening in all adults over 40
- Providing influenza vaccine to reduce cardiovascular risk
Correct answer: Supervised exercise and lifestyle modification to prevent recurrence
Tertiary prevention focuses on reducing complications and recurrence of existing disease; cardiac rehab achieves this through supervised exercise and lifestyle changes.
Question 5: A nurse is reviewing a patient's BMI of 31 kg/m². How should the nurse classify this finding and what health promotion action is most appropriate?
- Overweight; recommend dietary counseling only
- Obese Class I; counsel on weight loss through diet, exercise, and behavioral strategies (Correct answer)
- Normal; no intervention needed
- Obese Class II; immediately refer for bariatric surgery
Correct answer: Obese Class I; counsel on weight loss through diet, exercise, and behavioral strategies
A BMI of 30–34.9 kg/m² is classified as Obese Class I, and first-line management includes lifestyle interventions: diet, exercise, and behavioral therapy.
Question 6: Which laboratory value best supports screening for prediabetes or diabetes in an asymptomatic adult?
- Random blood glucose above 100 mg/dL
- Fasting plasma glucose ≥126 mg/dL on two separate occasions (Correct answer)
- HbA1c above 5.0% on a single test
- Postprandial glucose above 140 mg/dL
Correct answer: Fasting plasma glucose ≥126 mg/dL on two separate occasions
Diabetes is diagnosed when fasting plasma glucose is ≥126 mg/dL on two separate occasions, or when HbA1c is ≥6.5% on two tests.
Question 7: A nurse is planning health education for a group of men aged 55–69. Which cancer screening should the nurse include based on USPSTF recommendations?
- Annual digital rectal exam for prostate cancer
- One-time PSA screening with informed decision-making (Correct answer)
- Annual PSA testing regardless of risk factors
- Prostate MRI every 3 years
Correct answer: One-time PSA screening with informed decision-making
USPSTF recommends that men aged 55–69 engage in shared decision-making about PSA-based prostate cancer screening rather than routine universal testing.
MSNCB Health Promotion & Disease Prevention 3
A nurse is assessing a patient's readiness to quit smoking.
The patient states, 'I know I should quit, but I'm not planning to do anything about it yet.' Which stage of change does this represent?