A test that should be included in the yearly physical examination of men during the late middle and older adu… - BCCL kharkhanda Staff Nurse - 2015

BCCL kharkhanda Staff Nurse - 2015

Medical Surgical Nursing

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Appeared in: BCCL kharkhanda Staff Nurse - 2015

Explanation

The Prostate-Specific Antigen (PSA) test is a blood test used primarily to screen for prostate cancer.
The risk of developing prostate cancer increases with age, making it a key concern for men in their late middle and older adult years.
Benign and malignant changes in the prostate are very common in older men, with autopsies showing hyperplastic changes in over 90% of men in their eighth decade (SRC_12513).
Health organizations recommend that men aged 55 to 69 should make an individual decision about periodic PSA-based screening after discussing the potential benefits and harms with their clinician (SRC_12513).

Option B: ELISA (Enzyme-Linked Immunosorbent Assay) is a test used to detect antibodies in the blood, commonly for infectious diseases like HIV. It is not a routine screening test for all older men.
Option C: The Western blot test is a confirmatory test, not a screening tool. It is used to confirm the results of a positive ELISA test, particularly for HIV.
Option D: While monitoring serum triglycerides is an important part of assessing cardiovascular risk, it is a general health screening recommended for all adults, not one specifically targeted at the health risks that emerge uniquely for men in their older years.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Routine health screening for older adult males as background academic context rather than a clinical decision trigger.
A nurse's role is crucial in educating male patients about prostate health. This includes explaining the purpose of the PSA test, the meaning of the results, and the importance of shared decision-making with their provider regarding screening.
Nurses should inform patients that an elevated PSA does not automatically mean cancer, as other conditions like BPH and prostatitis can also raise levels (SRC_12515).
Patient counseling should cover the balance between the benefits of early detection and the potential harms of overdiagnosis and overtreatment of slow-growing cancers (SRC_12513).

How to Approach the Question

First, identify the key elements of the question: the population is 'men during the late middle and older adult years,' and the context is a 'yearly physical examination.'
The question asks for a test that is specifically relevant to this demographic's age-related health risks.
Evaluate each option: ELISA and Western blot are for infectious diseases and are based on risk, not routine annual screening for this entire age group.
Consider Serum Triglycerides. This is a general health test for all adults to check for cardiovascular risk.
Consider PSA. This test is for prostate cancer, a disease whose risk significantly increases with age in men. Therefore, it is a specific and relevant screening for this particular demographic.
Conclude that PSA is the most fitting answer as it directly addresses a major age-related health concern for older men.

Concept Tested & Keywords

Concept Tested: Routine health screening for older adult males
Stem keywords: yearly physical examination, men, late middle and older adult years
Lead-in keywords: is

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E6 textbook of Applied Biochemistry and Nutrition & DieteticsHarbans Lal (pp 26-464 of 479) p. 143-145