Health Promotion and Maintenance
Health Promotion and Maintenance
This domain tests health promotion, disease prevention, screening, immunization, growth and development, nutrition, and client teaching. Questions often ask what the nurse should teach or which screening is appropriate at a given age.
Levels of prevention
- Primary prevention prevents disease before it occurs: immunization, seat belts, helmet use, smoking prevention, folic acid 400 mcg before and during early pregnancy.
- Secondary prevention detects disease early: Pap tests, mammography, colorectal screening, blood pressure screening.
- Tertiary prevention limits disability and supports rehabilitation after disease.
Screening and health maintenance
- Provincial programs generally offer colorectal screening with FIT every 2 years from age 50 to 74; mammography every 2 years from age 50 to 74; cervical screening every 3 years from age 21 to 69 (confirm local intervals).
- Canada's food guide: half the plate vegetables and fruit, one quarter whole grains, one quarter protein; water as the drink of choice.
- Aim for 150 minutes of moderate-to-vigorous activity weekly plus muscle-strengthening activities.
- Harm reduction (e.g., supervised consumption, naloxone) is health promotion, not endorsement of substance use.
Teaching and behaviour change
- Use plain language and teach-back: "Tell me in your own words how you will take this medication."
- Assess readiness and use motivational interviewing rather than lecturing.
- Screen for social determinants of health: income, housing, food security, transportation, and cultural safety.
- Involve family and interpreters as the client wishes.
Worked example
A 52-year-old client with no family history asks about colorectal cancer screening. The PN explains that a FIT kit is recommended every 2 years for average-risk adults aged 50 to 74, demonstrates how to collect the sample, and asks the client to explain it back. The PN documents the teaching and reminds the client to return the kit.
Traps that cost marks
- Labelling a Pap test as primary prevention; it is secondary prevention.
- Giving a client a printed handout without checking literacy or understanding.
- Assuming older adults do not need sexual health or substance-use teaching.
- Confusing screening intervals between provinces.
- Ignoring cost, housing, or transportation barriers.