Health Screening
A 60-year-old patient never received a varicella vaccine and does not remember ever having chickenpox. However, you notice several ulcerated scars that look like scars from chickenpox. What is the next best course of action?
Draw blood to test for chickenpox antibodies
Administer the chickenpox vaccine (varicella vaccine)
Administer the shingles vaccine (Zostavax)
Prepare for a skin biopsy of the scar tissue
Administer the shingles vaccine (Zostavax)
Rationale: People 60 years of age or older should get shingles vaccine, whether they recall having had chickenpox or not. About 99% of Americans over the age of 40 have had chickenpox. There is no need to test for chickenpox to provide the shingles vaccine.
The nurse is providing disease prevention education to a 63-year-old woman with a negative family history of breast cancer. The nurse recommends the patient schedule mammograms with which frequency?
Every 5 years
Every 10 years
Every other year
Once a year
Every other year
Rationale: Mammograms, along with breast self-examinations and other routine tests are key for the early diagnosis and treatment of breast cancer. All major societies (WHO, ACS, USPSTF) recommend a screening mammogram every two years in women of this age at average risk of breast cancer. Frequency may change if there are identified family history and significant risk factors. Yearly is too frequent. Every 5 or 10 years is not frequent enough and place the patient at risk for cancer.