Platform 2: Promoting Health & Preventing Ill Health

What is the maximum weekly alcohol intake recommended by the UK Chief Medical Officers for adults?

• ANo more than 28 units a week, with two alcohol-free days
• BNo more than 14 units a week, spread over three or more days✓
• CNo more than 7 units a week for anyone over the age of 65
• DNo more than 21 units a week for men and 14 for women

Answer: Since 2016 the UK guidance has been the same for men and women: to keep health risks low, drink no more than 14 units a week, spread evenly over three or more days. The older 21/14 split has been withdrawn.

How much moderate-intensity physical activity does UK guidance recommend for adults each week?

• AAt least 60 minutes
• BAt least 150 minutes✓
• CAt least 300 minutes
• DAt least 30 minutes

Answer: The UK Chief Medical Officers' guidelines recommend at least 150 minutes of moderate activity (or 75 minutes of vigorous activity) a week for adults, plus strength activities on two days. 60 minutes a day is the recommendation for children and young people.

A patient's BMI is calculated as 31. Which category does this fall into?

• AHealthy weight
• BOverweight
• CObese✓
• DUnderweight

Answer: For adults, a BMI below 18.5 is underweight, 18.5 to 24.9 is the healthy range, 25 to 29.9 is overweight, and 30 or above is obese. Lower thresholds are used for people of some ethnic backgrounds.

What does 'Making Every Contact Count' ask health and care staff to do?

• AGive every patient a leaflet about smoking regardless of whether they smoke
• BRefer every patient they see to a specialist health-promotion service
• CUse routine interactions to offer brief, appropriate advice on healthier choices✓
• DRecord every contact with a patient on the electronic record within an hour

Answer: MECC is the approach of using everyday contacts to have brief conversations that support people to make healthier choices, such as stopping smoking or being more active, where it is appropriate to do so.

Which statement about hand hygiene and Clostridioides difficile is correct?

• AGloves make hand hygiene unnecessary when caring for a patient with C. difficile
• BAlcohol hand rub is the most effective way to remove C. difficile spores from the hands
• CC. difficile is spread through the air, so hand hygiene makes little difference to transmission
• DAlcohol hand rub does not kill C. difficile spores, so hands must be washed with soap and water✓

Answer: C. difficile forms spores that alcohol does not destroy; only physical washing with soap and water removes them. Gloves reduce contamination but hands must still be washed after they are removed, and the organism spreads by contact, not through the air.

At what age does the NHS childhood schedule give the first dose of the MMRV vaccine (measles, mumps, rubella and varicella, which has replaced MMR)?

• AAt 12 months✓
• BAt 6 months
• CAt 8 weeks
• DAt 3 years and 4 months

Answer: The first dose of MMRV — the combined measles, mumps, rubella and varicella vaccine that has replaced MMR in the NHS schedule — is given at 12 months, with the second dose at 18 months for children born on or after 1 July 2024 (children born between 1 September 2022 and 31 December 2024 still receive their second dose at 3 years 4 months). Eight weeks is when the primary course of infant vaccinations begins.

A patient who smokes says they would like to stop. What is the most effective support a nursing associate can point them to?

• AAdvice to cut down gradually over several months without any additional support or medication
• BA leaflet about the risks of smoking to read at home
• CA suggestion to switch to a lower-tar brand of cigarette
• DReferral to a stop-smoking service offering behavioural support and medication✓

Answer: Combining behavioural support with stop-smoking medication or nicotine replacement gives the best chance of quitting, and NHS stop-smoking services provide both. Cutting down alone, leaflets alone, and switching brands are much less effective.

Which of these is a modifiable risk factor for type 2 diabetes?

• AAge over 40
• BExcess body weight✓
• CFamily history of diabetes
• DSouth Asian ethnicity

Answer: Weight is something a person can change through diet and activity, which is why it is called modifiable. Family history, age and ethnicity all raise the risk but cannot be altered.

A patient asks how much salt they should eat to help their blood pressure. What is the maximum daily intake recommended for UK adults?

• A12 g of salt a day
• B6 g of salt a day✓
• C20 g of salt a day
• D2 g of salt a day

Answer: UK guidance recommends adults eat no more than 6 g of salt (about a teaspoon) a day, since higher intakes raise blood pressure. Most people eat more than this, largely from processed food.

Which statement about the 'Eatwell Guide' is correct?

• AIt is a weight-loss programme prescribed through GP surgeries
• BIt lists the calorie content of common foods for people trying to lose weight
• CIt shows the proportions of the five food groups that make up a healthy, balanced diet✓
• DIt sets out the nutritional needs of hospital patients on special diets

Answer: The Eatwell Guide is the UK's visual guide to a balanced diet, showing the proportions of fruit and vegetables, starchy foods, proteins, dairy and fats and oils. It is not a calorie table or a prescribed programme.

A patient tells a nursing associate that they smoke 20 cigarettes a day and are not interested in stopping. What is the most appropriate response?

• ALecture the patient on the dangers of smoking until they agree to consider stopping
• BOffer brief advice on the benefits of stopping and the support available, respect their choice, and leave the door open for later✓
• CSay nothing about smoking at all, since the patient has made their choice and it is not the nursing associate's place to comment on it
• DRefer the patient to the stop-smoking service without their agreement so that they are contacted anyway

Answer: Very brief advice is effective and appropriate even when a person is not ready; respecting their autonomy while making support visible keeps the relationship open. Lecturing, silence and unwanted referral all fail either the person or the opportunity.

Which vaccine is offered every year to adults aged 65 and over in the UK?

• AThe BCG vaccine
• BThe seasonal influenza vaccine✓
• CThe MMR vaccine
• DThe HPV vaccine

Answer: Adults aged 65 and over are offered the flu vaccine every autumn because they are at higher risk of complications. MMR and HPV are given in childhood and adolescence, and BCG is offered only to babies and others at higher risk of TB.

A nursing associate is teaching a patient with a new stoma how to care for it at home. Which principle of health education is most important?

• AExplain the procedure once, clearly and slowly, and record in the notes that stoma-care teaching has been given
• BAsk the patient's partner to attend so that they can take over the care
• CGive the patient the printed leaflet to take home and confirm at the next visit that they have read it through
• DCheck the patient's understanding by asking them to demonstrate and explain the care back to you✓

Answer: Teach-back — having the person show or explain what they have learned — is the most reliable way to confirm understanding. A leaflet, a single explanation, or shifting the task to a partner do not show the patient can do it themselves.