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Health Promotion & Maintenance Questions

Health Promotion and Maintenance is 6 to 12 percent of the exam. NCSBN puts in it the aging process, antepartum, intrapartum, postpartum and newborn care, developmental stages, health screening, immunizations, lifestyle and self-care teaching, and physical assessment techniques. On screen the stem gives an age, a week of gestation, or a postpartum day, lists findings that are mostly normal, and asks which one is expected or which one needs follow-up; nobody is crashing, and the danger is treating the normal.

Anchor on the age or stage, then judge every finding against that norm. The norm you apply depends on the number in the stem, so find it before the options. Worked: "A 4-month-old does not sit without support; the stem tells you sitting alone is expected by about eight months." → expected at four months; a milestone that is still ahead is not required yet.

Decide whether the stem wants the expected finding or the one deviation. The same four options answer both, so only the asker tells you which one you are hunting. Worked: "Postpartum day 2. Which finding requires follow-up: dark red lochia, a firm midline fundus, calf pain on one side, or breast fullness?" → requires follow-up hunts the one deviation; the calf pain.

Prevent it is primary, find it early is secondary, limit the damage is tertiary. Sort by what the action does to the disease, never by how healthy the client is. Worked: "Which action is secondary prevention: teaching sunscreen use, a colonoscopy at 50, or daily weights in heart failure?" → the colonoscopy; it finds disease early in someone who feels well.

Review: the Pediatrics 'Growth & Development' topics
Rule 1: the milestone norms every age-anchored stem is built on
Review: the Maternal & Newborn 'Antepartum', 'Postpartum' and 'Newborn Care' topics
Rule 1: what is expected by week of gestation, postpartum day, and newborn age
Review: Nutritional assessment
Rule 2: the normal ranges the expected-finding hunt leans on
Review: the Pediatrics 'Immunizations & Infectious Disease' topics
Rule 3: immunizations are primary, and the schedule itself is recall
Review: the Community 'Cancer Screening Guidelines' topics
Rule 3: screening is secondary; which one is due at which age

Clinical Pearl

Anchor on the age or stage, know whether you are hunting the normal or the deviation, and prevent, find, limit is primary, secondary, tertiary.

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