Health Promotion Guidelines Across Lifespan

Notes

Intra-uterine
Oxygen
  • To meet the fetal demands for oxygen, the pregnant mother gradually increases her normal blood flow by about one-third, peaking at about 8 months.
  • Respiratory rate and cardiac output increase significantly during this period.
  • Feta circulation travels from the placenta through umbilical arteries, which caries deoxygenated blood away from the fetus.
Nutrition and Fluids
  • The fetus obtains nourishment from the placental circulation and by swallowing amniotic fluid.
  • Nutritional needs are met when the mother eats a well-balanced diet containing sufficient calories and nutrients to meet both her needs and those of the fetus.
  • Adequate folic acid, one of the B vitamins, is important in order to prevent neural tube defects
  • Folic rich foods are green leafy vegetables, oranges, dried beans and suggest she take a vitamin supplement that contain folic acid.
Rest and Activity
  • The fetus sleeps most of the time and develops a pattern of sleep and wakefulness that usually persist after birth.
  • Fetal activity can be felt by the mother at about the fifth lunar month of pregnancy
Elimination
  • Fetal feces are formed in the intestines from swallowed amniotic fluid throughout the pregnancy, but are normally not excreted until after birth.
  • Urine normally is excreted into the amniotic fluid when the kidneys mature (16 to 20 weeks).
Temperature Maintenance
  • Amniotic fluid usually provides a safe and comfortable temperature for the fetus.
  • Significant changes in the maternal temperature can alter the temperature of the amniotic fluid and the fetus.
  • Significant alter in temperature increases due to illness, hot whirlpool baths, or saunas may result in birth defects.
  • In the last weeks of gestation, the fetus develops subcutaneous fatty tissue stores that will help maintain body temperature at birth.
Safety
  • The body systems form during the embryonic period. As a result, the embryo is particularly vulnerable to damage from teratogen, which is anything that adversely affects normal cellular development in the embryo or fetus.
  • It is important for the nurse to inquire about possible pregnancy when giving medications that are known teratogens and also ask when the woman is scheduled for tests that involve radiography (x-ray).
  • Smoking, alcohol, and drugs can affect the environment for the fetus. Smoking has been associated with preterm labor, spontaneous abortion, low-birth weight infants, and sudden infant death syndrome and learning disorders.
  • Fetal alcohol syndrome (FAS), a result of impaired mitochondrial development, leads to microcephaly, mental retardation, learning disorders, and other central nervous system defects.
Infants
Health Examinations
  • Screening of newborns for hearing loss; follow-up at 3 months and early intervention by 6 months if appropriate
  • At 2 weeks and at 2,4,6, and 12 months
Protective Measures
  • Immunizations: diptheria,tetanus, acellular pertussis (DTaP), inactivated poliovirus vaccine (IVP), pneumococcal, measles-mumps-rubella (MMR), Haemophilus influenzae type B (HIB), hepatitis B (HepB), varicella and influenza vaccines as recommended
  • Fluoride supplements if there is adequate water fluoridation (less than 0.7 part per million)
  • Screening for tuberculosis
  • Screening for phenylketonuria (PKU) and other metabolic conditions
  • Prompt attention for illnesses
  • Appropriate skin hygiene and clothing
Infant Safety
  • Importance of supervision
  • Car seat, crib, playpen, bath, and home environment safety ,measures
  • Feeding measures (e.g., avoid propping bottle)
  • Provide toys with no small parts or sharp edges
  • Eliminate toxins in the environment (e.g., chemicals, radon, lead, mercury)
  • Use smoke and carbon monoxide (CO) detectors in home
Nutrition
  • Breast-feeding to age 12 months
  • Breast-feeding and bottle feeding techniques
  • Formula preparation
  • Feeding schedule
  • Introduction of solid foods
  • Need for iron supplements at 4 to 6 months
Elimination
  • Characteristics and frequency of stool and urine elimination
  • Diarrhea and its effects
Rest/ Sleep
  • Establish routine for sleep and rest patterns
Sensory Stimulation
  • Touch: holding, cuddling, rocking
  • Vision: colorful, moving toys
  • Hearing: soothing voice tones, music, singing
  • Play: toys appropriate for development
Toddlers
Health Examinations
  • At 15 and 18 months and then as recommended by the primary care provider
  • Dental visit starting at age of 3 or earlier
Protective Measures
  • Immunizations: continuing DTaP, IPV series, pneumococcal, MMR, Haemophilus influenzae type B, hepatitis, hepatitis A, and influenza vaccines as recommended
  • Screenings for tuberculosis and lead poisoning
  • Fluoride supplements if there is inadequate water fluoridation (less than 0.7 part per million)
Toddler Safety
  • Importance of constant supervision and teaching child to obey commands
  • Home environment safety measures (e.g., lock medicine cabinet)
  • Outdoor safety measures (e.g., close supervision near water)
  • Appropriate toys
  • Eliminate toxins in environment (e.g., pesticides, herbicides, mercury, lead, arsenic in playground materials)
  • Use smoke and carbon monoxide (CO) detectors in home
Nutrition
  • Importance of nutritious meals and snacks
  • Teaching simple mealtime manners
  • Dental care
Elimination
  • Toilet training techniques
Rest/Sleep
  • Dealing with sleep disturbances
Play
  • Providing adequate space and variety of activities
  • Toys that allow “acting on” behaviors and provide motor and sensory stimulation
Preschoolers
Health Examinations
  • Every 1 to 2 years
Protective Measures
  • Immunizations: continuing DTaP, IPV series, MMR, hepatitis, pneumococcal, influenza, and other immunizations as recommended
  • Screenings for tuberculosis
  • Vision and hearing screening
  • Regular dental screenings and fluoride treatment
Preschooler Safety
  • Educating child about simple safety rules (e.g., crossing the street)
  • Teaching child to play safely (e.g., bicycle and playground safety)
  • Educating to prevent poisoning; exposure to toxic materials
Nutrition
  • Importance of nutritious meals and snacks
Elimination
  • Teaching proper hygiene (e.g., washing hands after using bathroom)
Rest/ Sleep
  • Dealing with sleep disturbances (e.g., night terrors, sleepwalking)
Play
  • Providing times for group play activities
  • Teaching child simple games that require cooperation and interaction
  • Providing toys and dress-ups for role-playing
School-Age Children
Health Examinations
  • Annual physical examination or as recommended
Protective Measures
  • Immunizations as recommended (e.g., MMR, meningococcal, tetanus-diphtheria, adult preparation [Td])
  • Screening for tuberculosis
  • Periodic vision, speech, and hearing screenings
  • Regular dental screenings and fluoride treatment
  • Providing accurate information about sexual issues (e.g., reproduction, AIDS)
School-Age Child Safety
  • Using proper equipment when participating in sports and other physical activities (e.g., helmets, pads)
  • Encouraging child to take responsibility for own safety (e.g., participating in bicycle and water safety courses)
Nutrition
  • Importance of child not skipping meals and eating balance diet
  • Experiences with food that may lead to obesity
Elimination
  • Utilizing positive approaches for elimination problems (e.g., enuresis)
Play and Social Interactions
  • Providing opportunities for a variety of organized group activities
  • Accepting realistic expectations of child’s abilities
  • Acting as role models in acceptance of other persons who may be different
  • Providing a home environment that limits TV viewing and video games and encourages completion of homework and healthy exercise
Adolescents
Health Examinations
  • As recommended by the primary care provider
Protective Measures
  • Immunizations as recommended, such as adult tetanus –diphtheria vaccine, MMR, pneumococcal, and hepatitis B vaccine
  • Screening for tuberculosis
  • Periodic vision and hearing screenings
  • Regular dental assessments
  • Obtaining and providing accurate information about sexual issues
Adolescent Safety
  • Adolescent’s taking responsibility for using motor vehicles safely (e.g., completing a driver’s education course, wearing seat belt and helmet)
  • Making certain that proper precautions are taken during all athletic activities (e.g., medical supervision, proper equipment)
  • Parent’s keeping lines of communication open and being alert to signs of substance abuse and emotional disturbances in the adolescent
Nutrition and Exercise
  • Importance of healthy snacks and appropriate patterns of food intake and exercise
  • Factors that may lead to nutritional problems (e.g., obesity , anorexia nervosa, bulimia)
  • Balancing sedentary activities with regular exercise
Social Interactions
  • Encouraging and facilitating adolescent success in school
  • Encouraging adolescent to establish relationships that promote discussion of feelings, concerns, and fears.
  • Parents’ encouraging adolescent peer group activities that promote appropriate moral and spiritual values
  • Parents’ acting as role models for appropriate social interactions
  • Parents’ providing a comfortable home environment for appropriate adolescent peer group activities
  • Parents’ expecting adolescents to participate in and contribute to family activities
Young Adults
Health Test and Screenings
  • Routine physical examination (every 1 to 3 years for females; every 5 years for males)
  • Immunizations as recommended, such as tetanus-diphtheria boosters every 0 years, meningococcal vaccine if not given in early adolescence, and hepatitis B vaccine
  • Regular dental assessments (every 6 months)
  • Periodic vision and hearing screenings
  • Professional breast examination every 1 to 3 years
  • Papanicolaou smear annually within 3 years of onset of sexual activity
  • Testicular examination every year
  • Screening for cardiovascular disease (e.g., cholesterol test every 5 years if results are normal; blood pressure to detect hypertension; baseline electrocardiogram at age 35)
  • Tuberculosis skin test every 2 years
  • Smoking: history and counseling if needed
Safety
  • Motor vehicle safety reinforcement (e.g., using designated drivers when drinking, maintaining brakes and tires) and making sure the vehicle is insured from a company such as Money Expert.
  • Sun protection measures
  • Workplace safety measures
  • Water safety reinforcement (e.g., no diving in shallow water)
Nutrition and Exercise
  • Importance of adequate iron intake in diet
  • Nutritional and exercise factors that may lead to cardiovascular disease (e.g., obesity, cholesterol, and fat intake, lack of vigorous exercise)
Social Interactions
  • Encouraging personal relationship that promote discussion of feelings, concerns, and fears
  • Setting short-and long- term goals for work and career choices
Middle-Aged Adults
Health Test and Screening
  • Physical examination (every 3 to 5 years until age 40, then annually)
  • Immunizations as recommended, such as a tetanus booster every 10 years, and current recommendations for influenza vaccine.
  • Regular dental assessments (e.g., every 6 months)
  • Tonometry for signs of glaucoma and other eye diseases every 2 to 3 years or annually if indicated
  • Breast examination annually by primary care provider
  • Testicular examination annually by primary care provider
  • Screenings for cardiovascular disease (e.g., blood pressure measurement; electrocardiogram and cholesterol test as directed by the primary care provider)
  • Screenings for colorectal, breast, cervical, uterine, and prostate cancer
  • Screening for tuberculosis every 2 years
  • Smoking: history and counseling, if needed
Safety
  • Motor vehicle safety reinforcement, especially when driving at night
  • Workplace safety measures
  • Home safety measures: keeping hallways and stairways lighted and uncluttered, using smoke detector, using nonskid mats and handrails in the bathrooms
Nutrition and Exercise
  • Importance of adequate protein, calcium, and vitamin D in diet
  • Nutritional and exercise factors that may lead to cardiovascular disease (e.g., obesity, cholesterol and fat intake, lack of vigorous exercise)
  • An exercise program that emphasizes skill and coordination
Social Interactions
  • The possibility of a middle crisis: encourage discussion of feelings, concerns, and fears
  • Providing time to expand and review previous interests
  • Retirement planning (financial and possible diversional activities), with partner if appropriate
Elders
Health Test and Screening
  • Total cholesterol and high density lipid protein measurement every 3 to 5 years until age 75
  • Aspirin, 81 mg daily, if in high- risk group
  • Diabetes mellitus screen every 3 years, if in high-risk group
  • Smoking cessation
  • Screening mammogram every 1 to 2 years (women)
  • Clinical breast exam annually (women)
  • Pap smear annually if there is a history of abnormal smears or previous hysterectomy of malignancy (United States Preventive Services Task Force, 2003)
    • Older women who have regular, normal Pap smear or hysterectomy for nonmalignant causes do NOT need Pap smear beyond the age of 65
  • Annual digital rectal exam
  • Annual prostate-specific antigen (PSA)
  • Annual fecal occult blood test (FOBT)
  • Sigmoidoscopy every 5 years; colonoscopy every 10 years
  • Visual acuity screen annually
  • Hearing screen annually
  • Depression screen periodically
  • Family violence screen periodically
  • Height and weight measurements annually
  • Sexually transmitted disease testing, if high- risk group
  • Annual flu vaccine if over 65 or in high-risk group
  • Pneumococcal vaccine at 65 and every 10 years thereafter
  • Td vaccine every 10 years
Safety
  • Home safety measures to prevent falls, fire, burns, scalds, and electrocution
  • Working smoke detectors and carbon monoxide detectors in the home
  • Motor vehicle safety reinforcement, especially when driving at night
  • Elder driver skills evaluation (some states require for license renewal)
  • Precautions to prevent pedestrian accidents
Nutrition and Exercise
  • Importance of a well-balanced diet with fewer calories to accommodate lower metabolic rate and decreased physical activity
  • Importance of sufficient amounts of vitamin D and calcium to prevent osteoporosis
  • Nutritional and exercise factors that may lead to cardiovascular disease (e.g., obesity, cholesterol and fat intake, lack of exercise)
  • Importance of 30 minutes of moderate physical activity daily; 20 minutes of vigorous physical activity 3 times per week
Elimination
  • Importance of adequate roughage in the diet, adequate exercise, and at least six 8-once glasses of fluid daily to prevent constipation
Social Interaction
  • Encouraging intellectual and recreational pursuits
  • Encouraging personal relationships that promote discussion of feelings, concerns, and fears
  • Assessment of risk factors for maltreatment
  • Availability of social community centers and programs for seniors

Exam

Welcome to your NCLEX Practice Exam for Health Promotion and Maintenance! This exam is carefully curated to help you consolidate your knowledge and gain deeper understanding on the topic.

 

Exam Details

  • Number of Questions: 25 items
  • Mode: Practice Mode

Exam Instructions

  1. Practice Mode: This mode aims to facilitate effective learning and review.
  2. Instant Feedback: After each question, the correct answer along with an explanation will be revealed. This is to help you understand the reasoning behind the correct answer, helping to reinforce your learning.
  3. Time Limit: There is no time limit for this exam. Take your time to understand each question and the corresponding choices.

Remember, this exam is not just a test of your knowledge, but also an opportunity to enhance your understanding and skills. Enjoy the learning journey!

 

Click 'Start Exam' when you're ready to begin. Best of luck!

💡 Hint

Consider how preschoolers typically interact with peers at this stage of development when playing together.

1 / 25

1. Nurse Megan is observing a group of 4-year-old children in the hospital playroom. Based on their developmental stage, what type of play would Nurse Megan most likely expect to see?

💡 Hint

Consider which condition is a well-known risk factor specifically associated with testicular cancer development.

2 / 25

2. Nurse Alex is taking the health history of Ryan, a 21-year-old male. During the interview, Ryan mentions certain past medical conditions. Which piece of information would suggest Ryan is at increased risk for developing testicular cancer?

💡 Hint

These cranial nerves are involved in the gag reflex and swallowing, so think about the tools needed to visualize the throat.

3 / 25

3. Nurse Parker is performing a physical assessment on a client and needs to evaluate cranial nerves IX and X. Which equipment should Nurse Parker gather to complete this assessment?

💡 Hint

Think about infant safety during oral medication administration, especially to prevent choking or spitting out the medication. The placement and positioning are key.

4 / 25

4. Nurse Maria is preparing to give an oral medication to baby Liam, a 4-month-old infant. To ensure the medication is administered safely and effectively, which approach should Nurse Maria take?

💡 Hint

The most effective statement clearly states the client's location and the nurse's role, which helps ground the client in reality.

5 / 25

5. Nurse Jenna is caring for a client who is admitted with confusion, difficulty remembering recent events, and disorientation when away from home. Which statement would best help to provide reality orientation for this client?

💡 Hint

Post-surgical care for infants often emphasizes comfort and emotional bonding, which can enhance healing and reduce stress. Consider interventions that soothe the infant both physically and emotionally.

6 / 25

6. Nurse Clara is caring for baby Noah, a 2-month-old infant who is recovering from surgery. To promote optimal recovery, which nursing intervention should Nurse Clara prioritize?

💡 Hint

Consider which approach uses simple language and encourages the child to express themselves in a way they can easily understand.

7 / 25

7. Nurse Rachel is preparing to communicate with a 4-year-old patient during an assessment. Which statement would be the most effective way for Nurse Rachel to engage the child?

💡 Hint

To calculate the EDD using Naegele's rule, subtract 3 months from the date of the last menstrual period (March 17), and then add 7 days to get the estimated due date.

8 / 25

8. Nurse Jenna is assessing a client who reports her last menstrual period was on March 17 and has since missed one period. After confirming the pregnancy with a urine test, Nurse Jenna needs to calculate the estimated date of delivery (EDD). What is the correct EDD?

💡 Hint

Focus on the measurement that may be outside the normal range for a newborn's head circumference.

9 / 25

9. Nurse Jenny is conducting a routine physical examination on a newborn baby. During the assessment, she identifies several findings. Which of the following should Nurse Jenny report to the physician?

💡 Hint

Focus on the facial features and developmental abnormalities most commonly associated with fetal alcohol exposure during pregnancy.

10 / 25

10. Nurse Leah is assessing a newborn whose mother drank alcohol during pregnancy. Which clinical signs would Nurse Leah expect to observe that are characteristic of fetal alcohol syndrome?

💡 Hint

Consider lifestyle changes that can lower cardiovascular risk, especially those related to diet and physical activity. Avoiding exercise is rarely recommended.

11 / 25

11. A 45-year-old male patient comes to the clinic for a routine check-up. He has a family history of hypertension and heart disease. Which health promotion strategy should the nurse prioritize to help reduce the patient’s risk of cardiovascular disease?

💡 Hint

Consider the fine motor skills typically developed in infants around 4 months of age.

12 / 25

12. Nurse Olivia is assessing a 4-month-old infant during a routine checkup. Based on the infant's age, which motor skill would Nurse Olivia expect to observe?

💡 Hint

Think about an approach that encourages communication and understanding of the client's concerns.

13 / 25

13. Nurse Jordan is administering medications to a client when the client says, "I don't want to take that medicine today." How should Nurse Jordan respond?

💡 Hint

Safety during surgery is crucial, especially regarding the airway. Consider why dentures pose a risk during general anesthesia and how to address the client's concerns before the procedure.

14 / 25

14. Nurse Emma is preparing a 65-year-old client for surgery under general anesthesia, but the client refuses to remove their dentures before being transported to the operating room. What is the most appropriate action for Nurse Emma to take?

💡 Hint

Consider which assessment method would provide important information without risking harm to the patient.

15 / 25

15. Nurse Sarah is caring for a client when she observes a pulsating mass in the client's periumbilical area during her assessment. What should Nurse Sarah do next?

💡 Hint

Think about which intervention directly addresses the cause of uterine overstimulation affecting fetal oxygenation.

16 / 25

16. Nurse Kelly is monitoring a laboring client who is receiving oxytocin (Pitocin) IV to enhance contractions. During the assessment, Nurse Kelly observes a prolonged late deceleration in the fetal heart rate. What should be Nurse Kelly's first action to ensure the safety of both the mother and baby?

💡 Hint

Consider which surgical procedure is specifically aimed at enhancing the appearance around the eyes by addressing excess skin.

17 / 25

17. Nurse Sarah is providing preoperative education to a client who wants to improve the appearance of their eyes by removing excess skin from the eyelids. Which procedure should Nurse Sarah discuss with the client?

💡 Hint

Think about whether certain body parts continue to grow or shrink with age, particularly the nose and ears.

18 / 25

18. Nurse Dana is assessing an elderly client and notes several physical changes in the head and face. Which of the following changes is NOT typically associated with aging?

💡 Hint

When dealing with a life-altering diagnosis, providing factual and relevant information helps empower the client to make informed decisions.

19 / 25

19. Nurse Rachel is caring for Mr. Greene, who has just been diagnosed with a stage IV brain tumor. She needs to choose the most appropriate approach to support him during this difficult time. What should Nurse Rachel do?

💡 Hint

Consider which question best assesses symptoms commonly associated with prostate issues.

20 / 25

20. Nurse Sam is preparing to assess Mr. Johnson, a 55-year-old male who is scheduled for a digital rectal examination. As part of the assessment, Nurse Sam wants to gather information that may indicate issues related to the prostate. What question should Nurse Sam prioritize during the interview?

💡 Hint

Consider the common metabolic issue in infants born to diabetic mothers, which can cause symptoms like jitteriness and lethargy.

21 / 25

21. Nurse Laura is monitoring a newborn weighing 8.5 lb, 6 oz, born to a mother with diabetes. When the infant shows signs of jitteriness and lethargy, Nurse Laura knows which intervention should be implemented.

💡 Hint

Consider which option refers to a physiological change that tends to decrease with age rather than increase.

22 / 25

22. Nurse Kayla is reviewing the medication profile of an elderly client to assess for potential adverse effects. Which of the following factors would NOT typically contribute to undesirable medication effects in this population?

💡 Hint

Consider which part of the bone is crucial for growth in children and can be affected by certain types of fractures.

23 / 25

23. Nurse Clara is speaking with the family of a 6-year-old child who has suffered a fractured femur. The family is concerned about the potential impact of the injury on the child's growth. Which statement is accurate regarding long bone fractures in children?

💡 Hint

Look for the action that reflects an inappropriate or potentially harmful way of managing the child's behavior.

24 / 25

24. Nurse Lily is observing a mother interacting with her preschool-aged child during a medical visit. Which behavior by the mother would suggest a potential issue with family interaction?

💡 Hint

Think about the recommended primary nutrition and hydration sources for infants during their first year of life.

25 / 25

25. Nurse Emma is educating the parents of a 3-month-old baby about proper nutrition and hydration. What should Nurse Emma emphasize as the primary source of fluids for their infant up until around 12 months of age?