Health Promotion and Maintenance
Health Promotion and Maintenance
This domain tests prevention, growth and development, screening, immunizations, and client teaching across the lifespan. The exam expects you to match the intervention to the client's age, readiness, and level of prevention.
Core rules
- Primary prevention prevents disease (immunization, seat belts, diet); secondary detects it early (Pap test, mammogram, colonoscopy); tertiary limits disability (cardiac rehab, support groups).
- Teach according to readiness, health literacy, and the learner's priorities. Use teach-back to confirm understanding.
- Developmental milestones guide expectations: at 4 months, an infant should hold the head steady, coo, and reach for objects; at 6 months, sit with support and babble.
- Immunizations follow age-based schedules; live vaccines are generally avoided in immunocompromised clients and pregnancy.
- Older adults benefit from fall prevention, medication review, and screening for depression and cognitive change.
Worked example
A 4-month-old is brought for a well-child visit. The parent reports the infant does not hold the head steady and does not coo. These are expected 4-month milestones; their absence warrants developmental referral and provider notification. By contrast, a 4-month-old is not expected to sit alone or use a pincer grasp. The mark-losing error is labeling a true delay as normal variation without acting on it.
Traps that cost marks
Calling a mammogram primary prevention; teaching a newly diagnosed client everything in one session; assuming an older adult cannot learn; skipping teach-back; mixing up normal developmental variation with delay.