Promoting Health & Preventing Ill Health

What are the UK Chief Medical Officers' low-risk drinking guidelines for adults?

• ANo more than 21 units a week, taken on any 2 days
• BNo more than 7 units a week, taken on a single day
• CNo more than 28 units a week, spread over 7 days
• DNo more than 14 units a week, spread over 3 or more days✓

Answer: The UK CMOs advise that, to keep health risks low, adults should not regularly drink more than 14 units a week, spread over three or more days, with some drink-free days.

How much moderate-intensity physical activity do UK guidelines recommend for adults each week?

• AAt least 300 minutes
• BAt least 150 minutes✓
• CAt least 90 minutes
• DAt least 60 minutes

Answer: The UK CMOs' guidelines recommend at least 150 minutes of moderate-intensity activity a week, or 75 minutes of vigorous activity, plus strength activities on two days.

What is the healthy BMI range for most adults?

• A25 to 29.9
• B16 to 22.9
• C20 to 29.9
• D18.5 to 24.9✓

Answer: For most adults a BMI of 18.5 to 24.9 is in the healthy range; 25 to 29.9 is overweight and 30 or above is obese. Lower thresholds are used for some ethnic groups.

A patient weighs 80 kg and is 1.6 m tall. Which BMI category are they in?

• AObese (BMI about 31)✓
• BObese (BMI about 50)
• CHealthy weight (BMI about 24)
• DOverweight (BMI about 27)

Answer: BMI = weight in kg / (height in m) squared = 80 / (1.6 x 1.6) = 80 / 2.56 = 31.25, which is in the obese range of 30 or above.

What are the three steps of 'very brief advice' on smoking?

• AAsk, Advise, Act✓
• BAsk, Assess, Assist
• CAdvise, Arrange, Audit
• DAssess, Agree, Arrange

Answer: Very brief advice, promoted by the NCSCT, involves asking about smoking, advising that the best way to stop is with support, and acting on the response by offering referral or treatment.

What does 'Making Every Contact Count' (MECC) encourage health professionals to do?

• AUse everyday contacts to support healthier lifestyle choices✓
• BRefer every patient to a specialist health promotion team
• CLimit the time spent with each patient to save money
• DRecord every patient contact in a national database

Answer: MECC encourages staff to use the many everyday conversations they have with people to encourage and support positive changes in health and wellbeing.

According to NICE, what clinic blood pressure indicates stage 1 hypertension?

• A130/85 mmHg or higher
• B120/80 mmHg or higher
• C140/90 mmHg or higher✓
• D160/100 mmHg or higher

Answer: NICE NG136 defines stage 1 hypertension as a clinic blood pressure of 140/90 mmHg or higher, confirmed by ambulatory or home readings of 135/85 mmHg or higher.

Which of these is an example of secondary prevention?

• ACampaigns to stop people starting smoking
• BScreening to find disease early✓
• CRehabilitation after a stroke
• DVaccinating children against measles

Answer: Secondary prevention detects disease early, before symptoms, so it can be treated sooner, as in screening programmes. Vaccination is primary prevention and rehabilitation is tertiary.

What is meant by herd immunity?

• AWhen a hospital ward isolates patients to stop infections from spreading
• BWhen one vaccine gives lifelong protection against every strain of a virus
• CWhen a person becomes immune after catching the disease from a farm animal
• DWhen enough people are immune, the disease spreads less and others are protected✓

Answer: Herd (community) immunity occurs when a high enough proportion of the population is immune, reducing spread so that people who cannot be vaccinated are also protected.

The Dahlgren and Whitehead 'rainbow' model is used to show what?

• AThe stages of change a person goes through when quitting
• BThe steps of the nursing process from assessment onwards
• CThe order in which to remove personal protective equipment
• DThe wider determinants of health, such as housing and income✓

Answer: The model shows layers of influences on health, from individual factors and lifestyle to social networks, living and working conditions, and wider socio-economic conditions.

How many portions of fruit and vegetables a day does NHS advice recommend for adults?

• AAt least 3
• BAt least 5✓
• CAt least 10
• DAt least 2

Answer: The NHS Eatwell guidance recommends eating at least five portions of a variety of fruit and vegetables every day.

What does the 'T' in the FAST stroke campaign stand for?

• ATalk to a pharmacist
• BTime to call 999✓
• CTake an aspirin
• DTest blood sugar

Answer: FAST stands for Face, Arms, Speech, Time: if you see any of these signs it is time to call 999, because rapid treatment improves outcomes.