A community health nurse is reviewing the levels of disease prevention. Which of the following activities is an example of tertiary prevention?

Choice A reason: Free T4

In primary hypothyroidism, the thyroid gland is underactive and does not produce enough thyroid hormones. As a result, free T4 levels are typically low, not elevated. Free T4 is a direct measure of the active thyroid hormone available in the blood. Therefore, an elevation in free T4 is not expected in primary hypothyroidism.

Choice B reason: Thyroid-stimulating hormone (TSH)

Thyroid-stimulating hormone (TSH) is elevated in primary hypothyroidism due to the lack of negative feedback from low thyroid hormone levels. The pituitary gland produces more TSH in an attempt to stimulate the thyroid gland to produce more hormones. This is a hallmark finding in primary hypothyroidism and is used as a key diagnostic indicator.

Choice C reason: Serum T3

Serum T3 levels can be variable in primary hypothyroidism. While they may be low, they are often maintained within the normal range until the condition becomes severe. This is because T3 is produced in smaller quantities and has a shorter half-life compared to T4. Therefore, an elevation in serum T3 is not typically seen in primary hypothyroidism.

Choice D reason: Serum T4

Similar to free T4, serum T4 levels are usually low in primary hypothyroidism. The thyroid gland’s reduced ability to produce thyroid hormones results in decreased levels of both free and total T4. Thus, an elevation in serum T4 is not expected in primary hypothyroidism.

Choice A reason:

The statement “Long attention span” is generally not associated with autism spectrum disorder (ASD). Children with ASD often have difficulty maintaining attention on tasks or activities, especially those that do not interest them. They may exhibit hyperfocus on specific interests but typically struggle with sustained attention in other areas.

Choice B reason:

The statement “Delayed language development” is a common characteristic of ASD. Many children with autism experience delays in speech and language skills. They may have difficulty with verbal communication, understanding language, and using language in social contexts. This delay can vary widely among individuals with ASD.

Choice C reason:

The statement “Speaking with direct eye contact” is not typically associated with ASD. Children with autism often avoid direct eye contact and may find it uncomfortable or overwhelming. They might look away or use peripheral vision instead of making direct eye contact during conversations.

Choice D reason:

The statement “Repetitive behavior” is a hallmark of ASD. Children with autism often engage in repetitive behaviors, such as hand-flapping, rocking, or repeating certain actions or phrases. These behaviors can be a way to self-soothe or cope with sensory overload.

Choice E reason:

The statement “Playing with toys repetitively” is also characteristic of ASD. Children with autism may play with toys in a repetitive manner, such as lining them up, spinning them, or focusing on specific parts of the toy rather than using them in imaginative play. This repetitive play is part of the broader pattern of repetitive behaviors seen in ASD.