NRSG 316 Wellness & Health Promotion Final Exam Flashcards

NRSG 316 Wellness & Health Promotion: Final Exam Guidelines (Spring, 2025)

Week 1: Clinical Preventive Services/Lifestyle and Chronic Diseases (~6-8 questions)

Levels of Prevention

• Primary: Preventing disease/injury before it occurs.

  • Examples: Immunization, walkable communities, seatbelts, legislation for safe practices.

• Secondary: Early detection and intervention.

  • Examples: Regular exams and screening tests.

• Tertiary: Managing disease to slow or stop progression, reduce complications, and improve quality of life.

  • Examples: Case management, diabetes management classes, support groups, therapy.

Screening vs. Diagnostic Tests

• Screening Test:

  • Identifies asymptomatic people possibly having a disease.

• Diagnostic Test:

  • Determines presence/absence of disease when patient shows signs/symptoms.

Good Screening Criteria (SSAAIR)

• Simple, Safe, Available, Acceptable, Inexpensive, Rapid.

• Examples: Pap smears, fasting blood sugar (FBS), mammograms, blood pressure screening.

• Early detection leads to early treatment, breaking transmission chains and is often cost-effective.

• Screenings start BEFORE diagnosis via:

  • History questions.

  • Physical exam findings.

  • Lab tests.

  • Pre-test probability.

Key Numbers/Ranges

• **BMI/Weight Status Categories

  • < 18.5: Underweight

  • 18.5-24.9: Normal

  • 25.0-29.9: Overweight

• Waist Circumference & Risk:

  • Women:

    • \le 31.5\text{in}: Low risk

    • 31.5-34.5\text{in}: Increased risk

    • > 34.5\text{in}: Greatly Increased risk

  • Men:

    • \le 37\text{in}: Low risk

    • 37-40\text{in}: Increased risk

    • > 40\text{in}: Greatly Increased risk

  • Waist measurements correlating to obesity: women > 34.5in, men > 40in.

• Blood Pressure (mmHg):

  • Normal: < 120/80

  • Elevated: 120-129/< 80

  • Hypertension Stage 1: 130-139/80-89

  • Hypertension Stage 2: > 140/90

  • Hypertensive Crisis: > 180/120

• Glucose:

  • Fasting Blood Sugar (FBS) (mg/dL) / HgbA1C (%):

    • Normal: < 100 / < 5.7

    • Prediabetes: 100-125 / 5.7-6.4

    • Diabetes: > 126 / > 6.5

    • Diabetes Target: Individuals w/diabetes, target HgbA1C <7

• Lipid Profile (mg/dL):

  • Total Cholesterol: < 200

  • HDL: > 60

  • LDL: < 100

  • Triglycerides: < 150

• Metabolic Syndrome: Having 3+ of the following:

  • Increased Waist Circumference:

    • Men: >40\text{in}

    • Women: >35\text{in}

  • Low HDL:

    • Men: <40\text{mg/dL}

    • Women: <50\text{mg/dL}

  • High Triglycerides: >150\text{mg/dL}

  • High Blood Pressure: >130/ >85\text{mmHg}

  • Elevated Fasting Glucose: >100\text{mg/dL} (prediabetes)

  • Increases risk for heart disease and diabetes.

Reliability and Validity in Screening

• Reliability: Consistency of a test.

  • Types:

    • Intra-Subject: consistency within the same subject across occasions.

    • Intra-Rater: consistency by the same tester.

    • Inter-Rater: consistency between different testers (most important for screening tools).

    • Instrument: internal consistency of the measurement tool.

• Validity: How well the test distinguishes between those with and without the disease.

Affordable Care Act (ACA)

• Focus on protection and improved access to clinical preventative services.

• Promotes wellness in the workplace.

• Strengthens the role of communities in promoting prevention.

• Invests in primary care workforce for prevention via the Prevention and Public Health Fund.

• Evaluated prevention as a national priority through National Prevention Strategies.

• Three Main Goals:

  • Expand health insurance.

  • Shift focus towards prevention.

  • Reduce costs and improve healthcare efficiency.

US Preventive Services Task Force (USPSTF)

• Assesses benefits/harms of preventative services in asymptomatic individuals based on age, gender, and risk factors.

• Recommends which preventative services should be routine in primary care.

• Reviews existing peer-reviewed evidence to make recommendations.

• Considered the gold standard for evidence-based preventative service recommendations.

• Grade A & Grade B services fully covered by ACA.

  • Routine immunizations.

  • Preventative care & screening for infants, children, & adolescents.

  • Preventative services for women identified in guidelines.

Modifiable and Non-Modifiable Risks

• Modifiable: High LDL, smoking, hypertension (HTN), obesity, inactivity, stress.

• Non-Modifiable: Genetics, race, age.

Lifestyle and Chronic Disease

• Key lifestyle interventions (Lifestyle Medicine Pillars):

  • Wholefood, Plant-Based Eating Patterns.

  • Restorative Sleep.

  • Regular Physical Activity.

  • Avoidance of Risky Substances.

  • Stress Management.

  • Positive Social Connections.

Week 2: Health Behavior Change/Motivational Interviewing (~8-10 questions)

Transtheoretical Model of Change (Stages of Change Model): PCPAM

• Focus on individual motivation and readiness to change a problem behavior.

  • Precontemplation: Not ready for change (