Health Promotion and Maintenance
What this domain tests
Growth, development, and prevention across the lifespan. Know the difference between primary prevention (immunization, seat belts, nutrition teaching, exercise), secondary prevention (screening - mammography, colonoscopy, cervical cytology, blood pressure and lipid checks, newborn metabolic screening), and tertiary prevention (rehabilitation, support groups, chronic disease self-management). Questions often hinge on matching the activity to the level.
Development
Erikson and Piaget supply most developmental items. Infancy is trust versus mistrust; toddlers need autonomy with safe limits; preschoolers initiate play and think magically; school-age children are industrious and understand cause and effect; adolescents wrestle with identity and value peer approval. Anticipatory guidance should match the stage - car seat safety and home childproofing for infants and toddlers, drowning and helmet safety for school-age children, driving and substance-use discussion for teens.
Lifespan care
Prenatal care includes folic acid, weight and blood pressure monitoring, and danger-sign teaching (bleeding, severe headache, decreased fetal movement, rupture of membranes). Older adults need fall prevention, polypharmacy review, and screening for depression and elder mistreatment. Sexual health, contraception counseling, and immunization schedules are common items.
Traps
Questions where the nurse gives facts instead of eliciting the client's readiness to change; 'teach-back' items where the nurse asks 'do you understand?' rather than asking the client to demonstrate; screening ages offered with one subtly wrong number; a health-promotion answer that is really treatment of existing disease.
Rule of thumb
Prevention is primary before disease, secondary at screening, tertiary after diagnosis. When teaching, confirm learning by having the client restate or demonstrate.