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APEA 3P EXAM PREP4-HEALTH PROMOTION WITH RATIONALE

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APEA 3P EXAM PREP4-HEALTH PROMOTION WITH RATIONALE A 58-year-old patient has an annual exam. A fecal occult blood test was used to screen for colon cancer. Three were ordered on separate days. The first test was positive; the last two were negative. How should the nurse practitioner proceed?...

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  • January 18, 2024
  • 13
  • 2023/2024
  • Exam (elaborations)
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  • APEA 3P PREP4-HEALTH PROMOTION
  • APEA 3P PREP4-HEALTH PROMOTION

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APEA 3P EXAM PREP4 -HEALTH PROMOTION WITH RATIONALE A 58-year-old patient has an annual exam. A fecal occult blood test was used to screen for colon cancer. Three were ordered on separate days. The first test was positive; the last two were negative. How should the nurse practitioner proceed? Rescreen in one year. Perform a fourth exam. Examine him for hemorrhoids. Refer him for a colonoscopy. A fecal occult blood test is performed multiple times on different days because tumors don’t consistently excrete blood. The reason multiple tests are performed is to increase the likelihood of identifying blood. The patient needs to have a colonoscopy performed for examination of the colon. The standard of practice is to ref er all positive colon cancer screens for colonoscopy. A criterion for medication choice in an older adult is: long half -life to prevent frequent dosing. dosing of 3 -4 times daily. pill color and shape for easy identification. half-life less than 24 hours. Many factors go into prescribing for older adults. Some important safety criteria include established efficacy, low adverse event profile, and half -life less than 24 hours with no active metabolites. Active metabolites would produce a longer effect of the drug in the patient. Dosing of a medication three to four times daily invites dosing and medication errors. Once - or twice -daily dosing is ideal. Pill color and shape is never a criterion for prescribing. Patients who are cognitively able will recognize t he color, shape, and size of pills they take on a regular basis. What is the recommendation from American Cancer Society for asses sment of the prostate gland in a man who is 45 years old and of average risk for development of prostate cancer? He should have: screening starting at 50 years of age. prostate -specific antigen (PSA) now. PSA and digital rectal exam now. digital rectal exam only. At age 50 years, males of average prostate cancer risk should have a PSA measurement with or without a digital rectal exam (DRE). If they are deemed to be of high risk because of a family history (first -degree relative with prostate canc er before age 65 years) or race (African American), screening discussions should take place at age 40 -45 years. If the initial PSA is > 2.5 ng/mL, annual testing should take place. If the initial PSA is < 2.5 ng/mL, test every 2 years. A 75-year-old adult asks for the pneumonia vaccine. His immunization record indicates that he had one at age 65 and another a year later. What is the recommendation of the CDC about how the NP should handle his request? Revaccination is recommended now Revaccination is recomm ended every 5 years after age 65 years Do not revaccinate this patient at this time He should have received one at age 70 years The recommendation of CDC is NOT to revaccinate this patient. After initial vaccination with PCV13 at age 65 years and subseque nt vaccination with PPSV23 1 year later, no revaccination is recommended in this patient. What should the nurse practitioner recommend to any elder taking medications? Have someone check your medications prior to taking them

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