Health Promotion and Maintenance: Screening, Teaching, and Development
What you must understand
Expect questions on age-specific screening schedules, immunization timing, developmental milestones, and client teaching. Know that colorectal cancer screening begins around age 45, mammography is generally discussed from age 40 to 50 depending on risk, cervical screening starts at 21, and bone density screening is recommended for women around age 65. Know the childhood immunization schedule in broad strokes: hepatitis B at birth, the DTaP, IPV, Hib, and PCV series in infancy, MMR and varicella around 12 to 15 months, and HPV and Tdap boosters in adolescence. Understand Piaget and Erikson stages well enough to predict behavior.
Teaching questions ask you to select the method that matches the learner: teach-back for confirmation, demonstration and return demonstration for psychomotor skills, and written material at a low reading level for reinforcement. Health promotion also covers nutrition, exercise, smoking cessation, and injury prevention across the lifespan.
Traps to watch
- Screening vs. diagnostic. Screening is for asymptomatic people; diagnostic testing follows symptoms.
- Erikson mismatches. Adolescence is identity versus role confusion, not intimacy.
- Teach-back is the best evidence of understanding, not "the client nodded."
- Live vaccines are avoided in pregnancy and significant immunocompromise.
Rule of thumb
Match the intervention to the developmental stage first, then to the learning domain. If the question asks how to confirm learning, choose return demonstration or teach-back.
Worked example
A 68-year-old client newly diagnosed with hypertension says, "I don't need to change anything, I feel fine." The best response is to explore the client's beliefs about health and medication, then use teach-back to confirm understanding of the regimen, because the barrier is the health belief, not knowledge alone.