RN Community Health Online Practice 2016 A and B – Flashcards
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A public health nurse is developing a visual health program by using a community-oriented approach. Which of the following interventions should the nurse include? Teach a client who has a vision loss about safety in the home environment Provide genetic counseling to the family of a newborn who has congenital cataracts Consult with the local school nurse to schedule yearly vision screenings for students Develop a plan of care for a client who was newly diagnosed with glaucoma
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Consult with the local school nurse to schedule yearly vision screenings for students Consulting with the local school nurse to schedule yearly vision screenings for students focuses on the health care of a population rather than illness care for individuals. Therefore, this intervention is using a community-oriented approach. INCORRECT: Teaching a client who has vision loss about safety in the home environment focuses on illness care for individuals. Therefore, this intervention is using a community-based approach. Providing genetic counseling to the family of a newborn who has congenital cataracts focuses on illness care for families. Therefore, this intervention is using a community-based approach. Developing a plan of care for a client who was newly diagnosed with glaucoma focuses on illness care for individuals. Therefore, this intervention is using a community-based approach.
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A home health nurse is caring for a client who has breast cancer. Which of the following assessment findings should the nurse identify as an indication that the client is coping effectively? Inability to concentrate Makes eye contact Excessive sleeping Lack of interest in food
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Makes eye contact The nurse should recognize that making eye contact is a characteristic of effective coping. INCORRECT: An inability to concentrate is a characteristic of ineffective coping. Excessive sleeping is a characteristic of ineffective coping. A lack of interest in food is a characteristic of ineffective coping.
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A community health nurse is teaching a client who was newly diagnosed with active pulmonary tuberculosis about disease transmission. Which of the following information should the nurse include? Household members should be placed in respiratory isolation. The client should use disposable utensils during meals. Household members should take isoniazid for 6 to 12 months. The client should have a repeat purified protein derivative test in 3 months.
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Household members should take isoniazid for 6 to 12 months. Household members of a client who has active pulmonary tuberculosis are at risk for developing the disease. Therefore, taking isoniazid prophylactically for 6 to 12 months is recommended. INCORRECT: Respiratory isolation is not necessary for household members of a client who has active pulmonary tuberculosis. It is not necessary for a client who has active pulmonary tuberculosis to use disposable utensils during meals in the home setting. A client who has active pulmonary tuberculosis should receive a chest x-ray for future screenings.
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A case manager is developing a discharge plan for a client who has a spinal cord injury and is in a rehabilitation facility. Which of the following actions should the nurse take first? Hold a care conference with the client and his family to discuss treatment options. Contact service providers to determine the availability of services offered. Determine the client's ability to perform self-care. Evaluate the client's satisfaction with the case manager's services.
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Determine the client's ability to perform self-care. The first action the nurse should take when using the nursing process is to assess the client's needs. Determining a client's needs is the first step of the case management process. Therefore, the nurse should first determine the client's ability to perform self-care. INCORRECT: The nurse should hold a conference with the client and his family to discuss treatment options as part of the implementation step of the nursing process. However, the nurse should take another action first. The nurse should contact service providers to determine the availability of services for the client as part of the implementation step of the nursing process. However, the nurse should take another action first. The nurse should determine if the client is satisfied with the services he received as part of the evaluation step of the nursing process. However, the nurse should take another action first.
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A community health nurse is working in a mobile health care clinic. Which of the following clients should the nurse assess first? A client who requires removal of sutures from a laceration A client who has a temperature of 37.8° C (100.1° F) A client who has COPD and an oxygen saturation of 92% A client who has a new onset of confusion and slurred speech
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A client who has a new onset of confusion and slurred speech When using the urgent vs nonurgent approach to client care, the nurse should determine that the client is experiencing acute changes in mental status and speech that might indicate a neurological problem requiring immediate intervention. Therefore, the nurse should assess this client first. INCORRECT: The need for suture removal is nonurgent. Therefore, there is another client that the nurse should assess first. A temperature of 37.8° C (100.1° F), which is within the expected reference range, is nonurgent. Therefore, there is another client that the nurse should assess first. A client who has COPD and an oxygen saturation of 92% is nonurgent as this is an expected finding for a client who has a chronic lung disease. Therefore, there is another client that the nurse should assess first.
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A public health nurse is developing a presentation for local day care providers about infectious childhood diseases. Which of the following statements should the nurse include? "Respiratory syncytial virus is spread through contact with respiratory secretions from an infected person." "Rotavirus infections in children peak during the summer months." Children who have fifth disease will exhibit bloody diarrhea." "Antiviral medications shorten the duration of a shigella infection."
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"Respiratory syncytial virus is spread through contact with respiratory secretions from an infected person." The nurse should include this statement in the presentation, as respiratory syncytial virus (RSV) is spread by direct contact with respiratory secretions while within 3 feet of a person who is infected. Manifestations of RSV include dyspnea, tachypnea, coughing, and wheezing. INCORRECT: Rotavirus infections in children peak during the winter months of the year. Manifestations of rotavirus include fever and vomiting followed by watery diarrhea. The clinical manifestations of fifth disease (erythema infectiosum) do not include bloody diarrhea. Clinical manifestations include a rash that gives the client a slapped-face appearance that progresses from the face down to the body. Other manifestations include fever, myalgia, nausea, vomiting, and lethargy. Antibiotics shorten the length of a shigella infection and decrease mortality rates. Manifestations of shigella include fever and anorexia followed by watery or bloody diarrhea.
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A nurse in a rural community is planning education for a young adult client who is a migrant farm worker. Which of the following actions should the nurse include? (Select all that apply.) Provide environmental health information. Refer the client for a tuberculosis screening. Provide skin cancer information. Recommend a dental health screening. Provide forms to apply for Medicare.
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A,B,C,D Provide environmental health information is correct. Migrant farm workers are at risk for exposure to pesticides and other hazardous materials that could be harmful. Therefore, the nurse should include environmental health information in the client's education. Refer the client for a tuberculosis screening is correct. Rates of tuberculosis are estimated to be higher among migrant farm workers due to crowded living conditions and substandard housing. Therefore, the nurse should include a tuberculosis screening in the client's education. Provide skin cancer information is correct. Due to working outdoors, skin cancer is a health risk for migrant farm workers. Therefore, the nurse should include information about skin cancer in the client's education. Recommend a dental health screening is correct. Dental problems are a primary health risk for migrant farm workers. Therefore, the nurse should include information about dental health in the client's education. INCORRECT: Provide forms to apply for Medicare is incorrect. To be eligible for Medicare, individuals must meet an age requirement or be permanently disabled. Therefore, the nurse should not include Medicare information in the client's education.
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A public health nurse is working in a community that has a population of 24,096. There are 2,096 existing cases of heart disease within the population. The nurse can determine which of the following from this information? Mortality rate Attack rate Prevalence proportion Incidence proportion
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Prevalence proportion The prevalence proportion can be calculated by using the number of people who were affected at a given time and the total population. INCORRECT: The mortality rate cannot be determined because the number of affected people who died is unknown. The attack rate cannot be calculated because the population has not been exposed to a specific agent. The incidence proportion cannot be calculated because the number of people newly diagnosed with heart disease over a period of time is not known.
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A nurse is assessing the risks and benefits of meal delivery services for an older adult client who lives alone and has no transportation. Which of the following ethical principles is the nurse demonstrating? Distributive justice Respect for autonomy Fidelity Beneficence
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Beneficence The nurse is demonstrating the ethical principle of beneficence by determining if the client needs this service to maintain his health. INCORRECT: The nurse would demonstrate the ethical principle of distributive justice by fairly determining which clients should receive meal delivery when there are a limited amount of services available for clients. The nurse would demonstrate the ethical principle of respect for autonomy by asking the client if he wants this service and respecting his choice. The nurse would demonstrate the ethical principle of fidelity by determining that the client needs the meal service and following through with initiating a referral.
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A nurse on the scene following a mass casualty explosion is triaging a client who has a large, open occipital wound and the following findings: respiratory rate 6/min, agonal pattern; capillary refill time 4.5 seconds; nonresponsive to painful stimuli. Which of the following actions should the nurse take? Turn the client to left semi-Fowler's position and begin assessing the next client. Place a firm pressure dressing to the occiput and open the airway. Apply a cervical spine collar and perform a focused neurological exam. Request that the client be assessed immediately by the next available provider.
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Turn the client to left semi-Fowler's position and begin assessing the next client. Principles of triage indicate that clients who have extensive injuries and a low-probability of survival do not receive treatment. Therefore, the nurse should provide only comfort measures before moving on to assess the next client. INCORRECT: The nurse should not perform this action for the client because it does not meet prioritization guidelines following a mass casualty incident. The nurse should not perform this action for the client because it does not meet prioritization guidelines following a mass casualty incident. The nurse should not perform this action for the client because it does not meet prioritization guidelines following a mass casualty incident.
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A community health nurse is assigned to lead a county-level environmental task force. Which of the following activities should the nurse direct the task force to complete first? Review community-specific epidemiological data. Recommend updates to local environmental policies. Create program goals that align with Healthy People 2020 objectives. Distribute environmental health education materials to community members.
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Review community-specific epidemiological data. The first action the nurse should direct the task force to take when using the nursing process is to conduct a community assessment, which includes a review of community-specific epidemiological data. The community assessment will assist the task force in identifying environmental health concerns within the county. INCORRECT: The nurse should direct the task force to recommend updates to local policies if needed to ensure environmental standards are being met and to advocate for health promotion within the community. However, there is another action that the task force should complete first. The nurse should direct the task force to create program goals that align with Healthy People 2020 to assist in achieving national-level objectives by minimizing health issues caused by the interaction of community members with the environment. However, there is another action that the task force should complete first. The nurse should direct the task force to distribute environmental health education materials to community members in order to promote health and prevent diseases related to environmental concerns. However, there is another action that the task force should complete first.
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A case manager is planning an educational program for a client who has diabetes mellitus. Which of the following activities should the nurse include when using the psychomotor domain of learning? Review a color diagram of the food pyramid with the client. Show the client a video about how to monitor blood glucose levels. Observe the client's technique for drawing up insulin. Give the client a pamphlet about foot care.
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Observe the client's technique for drawing up insulin. The nurse should include this activity in order to use the psychomotor domain of learning because it requires coordination and the use of motor skills. INCORRECT: The nurse should include this activity in order to use the cognitive domain of learning because it involves the client understanding and applying information. The nurse should include this activity in order to use the cognitive domain of learning because it includes learning new information and applying it in a different way. The nurse should include this activity in order to use the cognitive domain of learning because it includes reading and learning new information.
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A home health nurse is planning care for the day. Which of the following clients should the nurse visit first? An older adult client who was treated in the emergency department last night for a stage III pressure ulcer A school-age child who was treated in the emergency department last night with status asthmaticus An older adult client who has a newly prescribed antihypertensive medication and needs a BP check A school-age child whose percutaneous endoscopic gastrostomy (PEG) tube needs changing
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A school-age child who was treated in the emergency department last night with status asthmaticus When using the airway, breathing, circulation approach to client care, the nurse should determine that the client who recently experienced status asthmaticus is the priority. Therefore, the nurse should visit this client first. INCORRECT: The nurse should assess the client who has a stage III pressure ulcer to determine if further intervention is needed. However, there is another client that the nurse should visit first. The nurse should assess the client who has a newly prescribed antihypertensive medication to determine if the medication is effective. However, there is another client that the nurse should visit first. The nurse should assess the client whose PEG tube needs to be changed. However, there is another client that the nurse should visit first.
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A nurse in a rural health clinic is caring for a client who has heart failure. The client states, "I'm not going to take any more heart medicine." Which of the following responses should the nurse make? "Why did you decide to stop your heart medicine?" "Can you tell me more about your decision to stop your medicine?" "Don't you know what stopping your medicine will do to your heart?" "Don't you think your doctor knows what's best for your heart?"
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"Can you tell me more about your decision to stop your medicine?" The nurse is asking an open-ended question, which encourages continued communication and allows the nurse to investigate the reasons why the client has decided to stop taking the medicine. INCORRECT: "Why did you decide to stop your heart medicine?" The nurse is asking a "why" question, which can sound accusatory and make the client defensive. "Don't you know what stopping your medicine will do to your heart?" The nurse is showing disapproval of the client's decision, which can make the client defensive and discourage continued communication. "Don't you think your doctor knows what's best for your heart?" The nurse is showing disapproval of the client's decision, which can make the client defensive and discourage continued communication.
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A public health nurse is planning care for four clients. Which of the following interventions should the nurse recognize as tertiary prevention? Providing chemoprophylaxis for malaria to a client who is traveling to mosquito-infested countries Performing a serological screening for HIV for a client who is pregnant Participating in partner notification for a client who has an STI Administering antibiotics to a client who has AIDS and was diagnosed with Pneumocystis jiroveci
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Administering antibiotics to a client who has AIDS and was diagnosed with Pneumocystis jiroveci Administering antibiotics to a client who has AIDS and was diagnosed with Pneumocystis jiroveci is an example of tertiary prevention. INCORRECT: Providing chemoprophylaxis for malaria to a client who is traveling to mosquito-infested countries is an example of primary prevention. Performing a serological screening for HIV for a client who is pregnant is an example of secondary prevention. Participating in partner notification for a client who has an STI is an example of secondary prevention.
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An occupational health nurse is planning to use an interpreter during an educational session with a group of migrant workers who do not speak the same language as the nurse. Which of the following actions should the nurse take? (Select all that apply.) Instruct the interpreter to guide the nurse in providing information in a culturally-sensitive manner. Ask the interpreter to add information she feels may be necessary. Choose an interpreter who speaks the workers' language and dialect. Evaluate the interpreter's approach to clients prior to the educational session. Encourage the interpreter to paraphrase the workers' questions and responses.
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a,c,d Instruct the interpreter to guide the nurse in providing information in a culturally-sensitive manner is correct. The nurse should rely on the interpreter to inform him how he should deliver information that workers might find culturally sensitive because the interpreter will have more knowledge about these issues. Choose an interpreter who speaks the workers' language and dialect is correct. The nurse should choose an interpreter who can speak the clients' native language, including the specific dialect, in order to facilitate accurate communication. Evaluate the interpreter's approach to clients prior to the educational session is correct. The nurse should evaluate the style of the interpreter prior to the educational session to determine if she is able to develop a trusting relationship with the migrant workers in order to promote effective communication. INCORRECT: The nurse should ask the interpreter to not add or omit any information because it can interfere with the accuracy of the content. The nurse should ask the interpreter to translate the workers' comments and questions using their own words to increase the accuracy of the communication.
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A community health nurse is discussing the concept of epidemiology with a coworker. Which of the following interventions should the nurse provide as an example of the use of the principles of epidemiology? Conducting screenings for dental caries in the local school system Reviewing county health records for data on cases of chickenpox Providing a client with information about preventing STIs Documenting medication compliance for clients who have tuberculosis
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Reviewing county health records for data on cases of chickenpox Reviewing health records is an example of using epidemiological principles to analyze incidence and track outcomes of interventions for a particular disease or condition. INCORRECT: Screening individual clients for dental caries is a secondary prevention activity that does not address epidemiological principles. Providing a client with information about preventing STIs is a primary prevention activity that does not address epidemiological principles. Documenting medication compliance is a tertiary prevention activity that does not address epidemiological principles.
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A public health nurse is providing information to a client who has alcohol use disorder and is asking about treatment. Which of the following statements should the nurse identify as an indication that the client understands the information? "I will not have to completely stop drinking alcohol if I go into an inpatient treatment program." "Once I make it through detoxification, I will be free of my addiction." "I am not eligible for an outpatient program until I have completed an inpatient program first." "I can expect to get help with other aspects of my life while in treatment."
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"I can expect to get help with other aspects of my life while in treatment." Successful treatment of alcohol use disorder is more likely if the client receives help in other areas of his life, such as his physical health, psychological well-being, and family interactions. INCORRECT: Treatment for alcohol use disorder requires complete abstinence. The nurse should inform the client that medical detoxification to manage the acute physical withdrawal manifestations is the first step in treating alcohol use disorder. There is no cure for alcohol use disorder and the client must have a commitment to life-long sobriety. There is no requirement for a client to complete an inpatient program before entering an outpatient program. There are outpatient programs available, but clients should have a strong support system to facilitate success.
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A nurse is assessing a new client. Which of the following information should the nurse include in the cultural portion of the assessment? Food preferences Employment status History of illnesses Sexual orientation
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Food preferences Food preferences are a part of cultural assessment. INCORRECT: Employment status is not a part of cultural assessment. History of illnesses is not a part of cultural assessment. Sexual orientation is not a part of cultural assessment.
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A nurse is conducting an educational session at an assisted living facility for a group of clients who have osteoporosis. Which of the following statements should the nurse include in the teaching? "It is important to avoid weight-bearing exercises." "Decrease your dietary intake of folate." "Increase your daily intake of leafy green vegetables." "It is important to spend 30 minutes each day exposed to sunlight."
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"Increase your daily intake of leafy green vegetables." The nurse should instruct clients who have osteoporosis to increase their daily calcium intake. Food recommendations include leafy green vegetables, milk fortified with vitamin D, cheese, and yogurt. INCORRECT: Clients who have osteoporosis should use weight-bearing exercises to strengthen and protect their bones. This can help to prevent injury and fractures. Clients who have osteoporosis should increase their daily dietary intake of folate. Food recommendations should include legumes, seeds, liver, and orange juice. Clients who have osteoporosis should spend 10 to 15 min exposed to sunlight three times each week to stimulate the production of vitamin D. Vitamin D is necessary for calcium uptake in the bones.
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A community health nurse is planning an educational program for farmers about occupational health risks. Which of the following risks should the nurse include? Respiratory disorders Diabetes mellitus Sickle cell anemia Hypertension
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Respiratory disorders Farmers are at an increased risk for respiratory disorders due to exposure to agricultural chemicals, such as herbicides and pesticides. Other health risks for farmers include accidents with vehicles and machinery, dermatitis, dental problems, and stress and anxiety disorders. INCORRECT: Diabetes mellitus is not an occupational health risk for farmers. Sickle cell anemia is not an occupational health risk for farmers. Hypertension is not an occupational health risk for farmers.
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A palliative care nurse is teaching a client who has cancer about the services that are available for the client. Which of the following statements should the nurse identify as an indication that the client understands the teaching? "If I begin palliative care, I will have to stop my chemotherapy." "I can begin palliative care when I have less than 6 months to live." "This type of care can help me with pain control." "My family will not be involved with this type of care program."
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"This type of care can help me with pain control." Clients who have cancer might require complicated treatments that can cause pain, disfigurement, and emotional and psychological distress. Palliative care provides support and management of the disease process regardless of the prognosis, including pain management. INCORRECT: A client who is experiencing an illness, such as cancer, can still receive palliative care even if the client is undergoing treatment for the disease. Clients who have a life-limiting and progressive illness, such as cancer, can receive long-term palliative care. Once the prognosis is short-term, the client can receive hospice care. The nurse should instruct the client that palliative care provides support to all members of the client's family and support system.
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A hospice nurse is teaching about expected grief reactions with the family of a client who has end-stage pancreatic cancer. Which of the following information should the nurse include? "It is common to experience a persistent state of sadness while grieving." "Disturbances in your self-esteem is an expected grief reaction." "You will feel a sense of hopelessness throughout the grieving process." "A component of healthy grieving is the ability to openly express your anger."
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"A component of healthy grieving is the ability to openly express your anger." The nurse should teach the family that they will experience feelings of anger, guilt, shame, and doubt while grieving. The ability to openly express their feelings of anger is an expected grief reaction. INCORRECT: The nurse should teach the family that they should expect emotions to fluctuate frequently while grieving. A persistent state of sadness is an indication of clinical depression. The nurse should teach the family that their self-esteem is not altered while grieving. Disturbances in self-esteem are an indication of clinical depression. The nurse should teach the family that they should continue experiencing feelings of hope while grieving. A sense of hopelessness is an indication of clinical depression.
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A nurse is providing blood pressure screenings for older adult clients at a local community center. Which of the following should the nurse identify as increasing a client's risk for developing hypertension? BMI of less than 30 Daily walking routine African American race HDL level greater than 70 mg/dL
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African American race The nurse should identify that clients who are African American have a greater risk of developing hypertension. She should instruct these clients to participate in regular blood pressure screenings to aid in early detection. INCORRECT: The nurse should identify that individuals who are obese with a BMI of greater than 30 have an increased risk of developing hypertension. The nurse should identify that individuals who do not engage in regular physical activity have an increased risk of developing hypertension. The nurse should identify that an HDL level greater than 60 mg/dL for men and greater than 70 mg/dL for women indicates a low risk for developing hypertension.
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A nurse is teaching a client who has a new diagnosis of hepatitis A how to prevent the spread of the virus. Which of the following instructions should the nurse include? "Rinse your toothbrush with hydrogen peroxide after each use." "Clean your bathroom fixtures with a chlorine bleach solution." "Use shared hand towels to dry your hands after washing." "Use condoms during sexual contact for 2 weeks."
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"Clean your bathroom fixtures with a chlorine bleach solution." The client should clean his bathroom fixtures with a 10:1 chlorine bleach solution. The hepatitis A virus spreads via feces and survives on human hands since it is resistant to soap and detergents. INCORRECT: Hydrogen peroxide does not kill the hepatitis A virus. The nurse should instruct the client to avoid sharing a toothbrush with others to prevent the transmission of the virus. The client should not share bath or hand towels with other members of the household. The hepatitis A virus spreads via feces and survives on human hands since it is resistant to soap and detergents. The client should avoid sexual contact until the provider confirms that the hepatitis A antibody test is negative, which could be as long as 4 to 6 weeks. If the client engages in sexual contact, he should use a condom for at least 4 to 6 weeks.
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A nurse is planning to teach a community group about the meningococcal vaccine. The nurse should identity that which of the following clients should receive the vaccine? A client who is traveling to northern Europe An infant who has bronchiolitis An infant who is 4 weeks old A client who is moving into a college dormitory
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A client who is moving into a college dormitory Individuals living in crowded areas, such as dormitories, should receive the meningococcal vaccine. INCORRECT: Individuals traveling to northern Europe are not at an increased risk for meningococcal meningitis. The meningococcal vaccine is not recommended for an infant who has bronchiolitis. The minimum age for immunization with the meningococcal vaccine is 6 weeks.
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A nurse at a county health clinic is caring for a client who has recently assumed the role of primary caregiver for her mother. Which of the following statements by the client indicates that she is experiencing role conflict? "I feel overwhelmed with not having enough time for my mom as well as my children." "I hope my siblings will be able to visit and help care for mom for a few days." "I am glad that my job is flexible, so I can accommodate my mom's needs." "I don't think my partner likes having to help more with the household chores."
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"I feel overwhelmed with not having enough time for my mom as well as my children." Role conflict occurs when a client performs two or more roles that are in opposition of each other. Caring for children and a parent can cause feelings of stress for the client and lead to conflict within the family. INCORRECT: "I hope my siblings will be able to visit and help care for mom for a few days." The client is exploring potential ways in which her siblings might be able to relieve her from her role of caregiver temporarily. This statement might be an indication that the client is experiencing role strain. "I am glad that my job is flexible, so I can accommodate my mom's needs." The client is identifying a positive aspect of how her role as an employee fits with her role as a caregiver. By assimilating the caregiver role with other responsibilities, the client has enhanced her self-esteem and ability to perform various roles successfully. "I don't think my partner likes having to help more with the household chores." This statement indicates that the client and her partner might be experiencing difficulties assimilating her role as a caregiver with her role in their partnership. This might be an indication that the client and her partner are experiencing role ambiguity.
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A community health nurse is teaching a client who is overweight about steps to take to begin an exercise program. The nurse should identify that which of the following statements is an indication that the client understands the teaching? "I will need to purchase exercise equipment before I can start." "I should try to perform aerobic exercise for an hour a day, 5 days a week." "I will see my doctor before beginning an exercise program." "I should avoid participating in weight-lifting exercises."
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"I will see my doctor before beginning an exercise program." The client should see his provider before beginning an exercise program. The client should receive a complete physical exam and obtain approval for exercise. INCORRECT: Walking, jogging, lifting half-gallon jugs filled with sand, or doing sit-ups and push-ups are all types of exercise that do not require special equipment. When beginning a new exercise program, the client should aim to perform aerobic exercise three to five times a week or every other day for about 30 min. The client should balance a routine of strength training exercises with aerobic activities. Performing different types of exercise can help the client increase activity tolerance.
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A school nurse is discussing levels of prevention with a teacher. Which of the following activities should the nurse identify as a primary prevention strategy? Provide nutritional counseling for students who have diabetes. Report suspected child neglect to the proper authorities. Conduct vision and hearing screening for kindergarten enrollment. Demonstrate proper handwashing techniques.
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Demonstrate proper handwashing techniques. This is an example of primary prevention, the goal of which is to promote health and prevent diseases from developing. INCORRECT: Provide nutritional counseling for students who have diabetes. This is an example of tertiary prevention, which begins once a disease becomes apparent and includes attempts to limit the progression of the disease and subsequent disability. Report suspected child neglect to the proper authorities. This is an example of secondary prevention, the goal of which is to detect and treat a condition in its early stages, often before manifestations become apparent. Conduct vision and hearing screening for kindergarten enrollment. This is an example of secondary prevention, the goal of which is to detect and treat a condition in its early stages, often before manifestations become apparent.
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A nurse is collecting demographic data as a part of a community assessment. Which of the following information should the nurse include? Racial distribution Family genograms Number of open water sources Presence of condemned buildings
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Racial distribution Racial distribution is part of demographic data. INCORRECT: Family genograms are not part of demographic data. The number of open water sources is not demographic data. The presence of condemned buildings is not demographic data.
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A community health nurse is assessing a group of clients for risk factors of abusive behaviors. Which of the following findings should the nurse identify as a risk factor for developing violent behavior? A client states he witnessed his mother physically mistreat his father. A client states that her mother-in-law provides childcare while she is working. A client participates in volunteer activities in the community. A client lives in the same neighborhood where he spent his childhood years.
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A client states he witnessed his mother physically mistreat his father. Clients who have prior exposure to violence have a greater potential for continuing the violent and abusive behavior. INCORRECT: Having employment and social support protects the client against developing violent behavior. Participating in community activities allows the client to interact with others and have support outside the home. This protects the client against developing violent behavior. Living in the same area over time allows clients to develop and maintain consistent relationships that can provide ongoing support and protect against developing violent behavior.
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A community health nurse is working to meet the health care needs of residents in a rural community. Which of the following characteristics should the nurse identify as a barrier to health care resources for this population? Less autonomy in providing client care Disinterest by members of the population in providing input for community health programs Lack of cohesiveness among community members Unavailability of outreach services
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Unavailability of outreach services Lack of availability of outreach services is a barrier to health care for residents in rural areas. INCORRECT: Health care providers have greater independence and work more autonomously in providing client care in rural areas. Residents of rural communities are no less likely to be interested in health promotion than members of urban communities. Community cohesiveness is generally not a barrier to providing health care in rural areas. Rural residents often rely on community networks for support.
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A home health nurse is scheduling client visits for the day. Which of the following clients should the nurse plan to visit first? A client who is 10 days postoperative following a mastectomy and needs to have surgical staples removed A client who has diabetes mellitus and reports new erythema to the left foot A client who has COPD and needs a follow-up visit related to home oxygen therapy A client in a hip spica cast who reports pruritus under the cast
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A client who has diabetes mellitus and reports new erythema to the left foot When using the urgent vs nonurgent approach to client care, the nurse should determine that the client who has diabetes mellitus and a new onset of erythema to the left foot should be seen first. This client is at risk for infection and requires prompt evaluation and treatment. INCORRECT: The client who is 10 days postoperative following a mastectomy and needs to have surgical staples removed is considered nonurgent. Therefore, there is another client that the nurse should see first. The client who has COPD and needs a follow-up visit related to home oxygen therapy is considered nonurgent. Therefore, there is another client that the nurse should see first. The client in a hip spica cast who reports pruritus under the cast is considered nonurgent. Therefore, there is another client that the nurse should see first.
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A nurse is conducting a home visit with a female client who reports a history of intimate partner abuse. The nurse should identify that which of the following findings places the client at greatest risk for domestic violence? The client is at 13 weeks of gestation. The client states she is leaving her partner. The client recently started a new job. The client visits friends without her partner's knowledge.
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The client states she is leaving her partner. A client's decision to leave her partner places her at greatest risk for intimate partner abuse because the perpetrator can view her as a possession and fear loss of control. Whether the client actually leaves the relationship or just threatens to leave, the client is at greatest risk for violence during this time. INCORRECT: A pregnancy increases the client's risk for intimate partner abuse due to increased responsibility and feelings of jealousy by the perpetrator. However, there is another finding that places the client at greater risk for abuse. Starting a new job increases the client's risk for intimate partner abuse as this is an act of independence by the client. However, there is another finding that places the client at greater risk for abuse. Visiting friends without her partner's knowledge increases the client's risk for intimate partner abuse as this is an act of independence by the client. However, there is another finding that places the client at greater risk for abuse.
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A nurse in a county health department is caring for a client who states, "I've been drinking too much in the evenings since my mom died last year." Which of the following responses should the nurse make? "It sounds like you are probably an alcoholic." "Don't you think your family is being affected by your drinking?" "Can I give you some information about Alcoholics Anonymous?" "I don't think your mom would have approved of your drinking."
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"Can I give you some information about Alcoholics Anonymous?" The nurse is giving information to the client, which conveys a sense of caring. This also allows the nurse to provide additional information on resources that can help the client. INCORRECT: The nurse is making a judgmental statement, which can make the client feel defensive. This statement will not encourage further communication with the client. The nurse is making a judgmental statement, which can make the client feel guilty. This statement will not encourage further communication with the client. The nurse is making a judgmental statement, which can make the client feel guilty. This statement will not encourage further communication with the client.
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A school nurse is conducting hearing screening procedures in an elementary school. Which of the following instructions should the nurse provide when performing the Rinne test? "After I place the tuning fork on your scalp, tell me if you hear the sound better in one ear or the same in both ears." "Use your finger to close one ear while I whisper some numbers into your other ear." "After I place this tuning fork behind your ear, tell me when you no longer hear the sound." "You'll wear headphones and press the button when you hear a sound."
answer
"After I place this tuning fork behind your ear, tell me when you no longer hear the sound." This is the appropriate instruction for a Rinne test, a hearing evaluation that compares air conduction and bone conduction of sound. INCORRECT: "After I place the tuning fork on your scalp, tell me if you hear the sound better in one ear or the same in both ears." This instruction is for a Weber test, a test that evaluates lateralization of sound. "Use your finger to close one ear while I whisper some numbers into your other ear." This instruction is for a whispered voice test, an initial screening to determine the need for further testing of a client's hearing. "You'll wear headphones and press the button when you hear a sound." This instruction is for audiometry, which provides a precise measurement of hearing ability. A client wears earphones or headphones and gives a specific signal, such as pressing a button or raising a finger, to indicate when tones of various intensities are heard.
question
A nurse is preparing an educational program about influenza for a group of community health nurses. Which of the following activities should the nurse include as an example of tertiary prevention? Offer classes to elementary school teachers about handwashing. Provide information to occupational nurses about the reasons for employees to not come to work. Administer antiviral medications within 48 hr to clients who have manifestations of influenza. Provide immunizations at long-term care facilities.
answer
Administer antiviral medications within 48 hr to clients who have manifestations of influenza. Tertiary prevention involves ways to reduce the complications of illness, which includes administering antiviral medications to clients who already have influenza. INCORRECT: Offer classes to elementary school teachers about handwashing. Secondary prevention involves ways to prevent the spread of infection, which includes frequent handwashing. Provide information to occupational nurses about the reasons for employees to not come to work. Secondary prevention involves ways to prevent the spread of infection, which includes isolating individuals who have manifestations of illness. Provide immunizations at long-term care facilities. Primary prevention involves ways to prevent the occurrence of illness, which includes providing immunizations to susceptible populations.
question
A community health nurse has been contacted regarding a client diagnosis of influenza type A in an adult day care. Which of the following actions should the nurse take to assist in the prevention of an outbreak? Administer antiviral medication to clients at the facility. Schedule immunizations for clients at the facility. Recommend that the day care center close for 2 weeks. Give immune globulin to clients at the facility who have early manifestations of influenza.
answer
Administer antiviral medication to clients at the facility. Antiviral medications are administered to individuals who have been exposed to influenza type A to provide immediate protection and to help prevent an outbreak. INCORRECT: Immunizations do not provide immediate protection and, therefore, will not be effective in preventing an outbreak. A single client diagnosis of influenza does not warrant closing the facility. Immune globulin does not prevent or treat influenza and, therefore, will not be effective in preventing an outbreak.
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A nurse is developing an educational program about bioterrorism and smallpox. The nurse should include in the teaching that the smallpox rash is expected to first appear in which of the following locations? Face Posterior shoulders Abdomen Lower extremities
answer
Face The nurse should teach that the smallpox rash is expected to first appear on the face. INCORRECT: The nurse should teach that the smallpox rash is expected to first appear on the face, not the posterior shoulders. The nurse should teach that the smallpox rash is expected to first appear on the face, not the abdomen. The nurse should teach that the smallpox rash is expected to first appear on the face, not the lower extremities.
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The daughter of a client who is terminally ill and at the end of life approaches a hospice nurse and asks what she can do to help relieve her father's pain. Which of the following interventions should the nurse suggest? Give the client brief hand massages. Increase the illumination in the room. Place a warm cloth on the client's forehead. Administer citalopram when the client is agitated.
answer
Give the client brief hand massages. Soft massage and brief hand massages can reduce pain and stress in palliative care settings. INCORRECT: Dimming the environmental light has a calming effect and can reduce pain and anxiety. The nurse should suggest a cool cloth because body temperature rises with pain and stress. The nurse should suggest nonpharmacological comfort measures that have pain-relieving benefits. Citalopram is an antidepressant that is not effective for acute pain.
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A public health nurse is monitoring medication compliance for a group of migrant workers who are being treated for tuberculosis (TB). The nurse should use information from which of the following resources to assist with this process? Agency for Healthcare Quality and Research (AHRQ) Migrant Clinicians Network (MCN) Centers for Disease Control and Prevention (CDC) U. S. Preventive Services Task Force (USPSTF)
answer
Migrant Clinicians Network (MCN) Migrant workers frequently change locations and move from job to job. This can interfere with the client adhering to the 6 to 12 month TB treatment plan. The MCN is a tracking program developed so that health care providers can access prior provider information and maintain TB treatment continuity for the migrant population. INCORRECT: The AHRQ provides evidence-based clinical guidelines for client care, such as pain management, cancer screening, and diabetes mellitus treatment. The CDC provides information about STIs and immunization guidelines. The USPSTF is an organization that reviews preventative services and suggests appropriate services for primary medical care and topics for research.
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A nurse in a community center is preparing to administer a tuberculin skin test to multiple clients to screen for tuberculosis. Which of the following actions should the nurse take? Prepare the outer aspect of the upper arm for the injection. Insert the needle at a 45° angle. Inject 0.1 mL of purified protein derivative. Create a wheal that measures about 15 mm in diameter.
answer
Inject 0.1 mL of purified protein derivative. The nurse should inject 0.1 mL of purified protein derivative, which is equivalent to 5 tuberculin units. INCORRECT: The nurse should prepare the inner aspect of the forearm for the injection. The nurse should inject purified protein derivative intradermally, which requires a 5 to 15° angle. The nurse should create a wheal that is approximately 6 mm in diameter.
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A school nurse is teaching health promotion to a group of staff members who sit at a desk and use a computer for 8 hr at a time. Which of the following information is the priority for the nurse to include? "Take a walk after work." "Point and flex your toes periodically." "Have your visual acuity assessed regularly." "Adjust your chair so that your elbows are at desk height."
answer
"Point and flex your toes periodically." The greatest risk to staff members who are immobile for long periods of time is a venous thromboembolism. Therefore, the nurse should encourage the staff members to frequently change the position of their feet and legs. INCORRECT: "Take a walk after work." The nurse should encourage the staff members to exercise to reduce the risks associated with a sedentary lifestyle. However, another option is the priority. "Have your visual acuity assessed regularly." The nurse should encourage the staff members to have annual eye exams. However, another option is the priority. "Adjust your chair so that your elbows are at desk height." The nurse should encourage the staff members to sit in an ergonomically correct position to prevent injury. However, another option is the priority.
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A school nurse is conducting visual acuity testing for a school-age child. Which of the following actions should the nurse take? Allow the child to keep her glasses on during the testing. Have the child stand 5 feet away from the Snellen letter chart. Progress to the next line once the child reads two symbols correctly. Begin the test by instructing the child to use both eyes to read the chart.
answer
Allow the child to keep her glasses on during the testing. When using the Snellen letter chart to assess a school-age child's visual acuity, the nurse should allow the child to keep her glasses on during the test. INCORRECT: When using the Snellen letter chart to assess a school-age child's visual acuity, the child should stand or sit at least 10 feet away from the chart. The chart should be placed at the child's eye level. When using the Snellen letter chart to assess a school-age child's visual acuity, the child should progress to the next line once she is able to read at least four symbols on the current line. When using the Snellen letter chart to assess a school-age child's visual acuity, the nurse should instruct the child to cover the right eye first, and then move to the left eye. The final step is to have the child read the chart using both eyes.
question
A community health nurse is developing a plan of care for a client who is Hispanic. Which of the following actions should the nurse include in the plan? Avoid using hand gestures when working with the client. Use therapeutic touch during conversation. Discourage the client from using a faith healer. Maintain direct eye contact when speaking with the client.
answer
Use therapeutic touch during conversation. A client who is Hispanic might view touch as a gesture of caring and compassion. INCORRECT: A client who is Hispanic might express himself with face, hand, and body gestures and consider touch a show of caring and compassion. A client who is Hispanic might seek care from a faith healer, a Santero priest, or a yerbero. The nurse should respect the client's decision to follow traditional Hispanic health care practices. A client who is Hispanic might view direct eye contact as a sign of disrespect. The nurse should avoid direct eye contact to convey respect and attentiveness to the client.
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A nurse manager at a community health clinic is presenting an in-service for nurses about assessing clients for abuse. Which of the following statements by a nurse indicates an understanding of the teaching? "Once I determine that a client is not at risk for abuse, I do not need to ask about it at future visits." "I should not document the name of the person the client accuses of the abuse in the client's medical record." "I should wait until I see signs of physical abuse before I help the client develop a safety plan." "I should refer a client for a rape kit examination if she reports sexual assault within the previous 24 hours."
answer
"I should refer a client for a rape kit examination if she reports sexual assault within the previous 24 hours." Clients should undergo a rape kit examination if they report sexual assault within the last 24 hr. Evidence-based practice indicates that a health care provider should collect a rape kit if a client reports sexual assault within the previous 48 hr to ensure accurate collection of evidence. Current research is ongoing regarding this time frame. The nurse should also provide information regarding support groups and resources for clients who were sexually assaulted. INCORRECT: The nurse should assess clients for abuse at every visit because the risk for abuse can change. The nurse should document the name of the person the client accuses of the abuse in the medical record for future reference in a possible legal case. Developing a safety plan is a priority for a client who is a recipient of abuse regardless of the type, such as physical or psychological. The nurse should provide the client with information about resources that can help, such as shelters and support groups.
question
A nurse is caring for a client who has AIDS and is experiencing rapid weight loss. Which of the following actions should the nurse take first? Examine the client's oral mucous membranes. Encourage the client to consume 1.2 to 2.0 g/kg of protein daily. Recommend the client increase her daily calorie intake by 25%. Teach the client about findings that should be reported to the provider.
answer
Examine the client's oral mucous membranes. The first action that the nurse should take when using the nursing process is to assess the client. The nurse should examine the client's oral mucous membranes for painful lesions, such as candidiasis. INCORRECT: The nurse should encourage the client to consume 1.2 to 2.0 g/kg of protein daily to help prevent wasting syndrome. However, there is another action that the nurse should take first. The nurse should recommend a 25% increase in the client's daily calorie intake to help prevent wasting syndrome. However, there is another action that the nurse should take first. The nurse should teach the client about findings that should be reported to the provider. However, there is another action that the nurse should take first.
question
A public health nurse is participating in a community planning committee for disaster preparedness for a local community that is at risk for hurricanes. Which of the following information should the nurse contribute to the plan? A list of residents who have experienced a hurricane in the past and will not need evacuation A list of areas within the community where residents speak English as a second language How to activate the local medical facility's emergency-management plan The name of the individual who is necessary to implement the plan
answer
A list of areas within the community where residents speak English as a second language The public health nurse, who is most familiar with the community, should contribute this information to the disaster plan to assist in aiding and evacuating residents who are at risk. INCORRECT: The nurse should include a plan to assist in evacuating all residents. Prior experience with hurricane survival does not indicate that the residents are prepared to withstand a new disaster. The Joint Commission mandates that all medical facilities have a response plan that includes the actions that facility staff can take in the event of a local disaster. The community plan may include notifying the facility, but the staff within the facility must activate this plan. A disaster plan requires readiness regardless of who is present at the time of the disaster.
question
A community health nurse suspects an outbreak of scabies in the local area. Which of the following actions should the nurse take first? Educate the community about disease transmission. Determine the incidence rate. Institute prophylactic treatment. Discuss treatment plans with the clients' families.
answer
Determine the incidence rate. The first action that the nurse should take when using the nursing process is to determine the number of new cases of scabies in the community. INCORRECT: While it is important to educate the community about disease transmission, this is not the first action that the nurse should take. While it is important to institute prophylactic treatment, this is not the first action that the nurse should take. While it is important to discuss treatment plans with the clients' families, this is not the first action that the nurse should take.
question
A home health nurse is assessing an older adult client who is taking captopril to treat heart failure. Which of the following findings should the nurse identify as an adverse effect of this medication? Weight gain Ataxia Photophobia Dry cough
answer
Dry cough Captopril prevents the conversion of angiotensin I to angiotensin II, causing bradykinin to accumulate. The client may experience coughing as a result of bradykinin accumulation. INCORRECT: Weight loss is an adverse effect of captopril. Ataxia is not an adverse effect of captopril. Photosensitivity is an adverse effect of captopril.
question
A community health nurse is planning a presentation for adults who have a family history of Alzheimer's disease. Which of the following behaviors should the nurse include as an early manifestation of Alzheimer's disease? Withdrawal from social activities Forgetting the location of common objects Experiencing incontinence Neglecting personal hygiene
answer
Forgetting the location of common objects Forgetting the location of common objects is an early manifestation of Alzheimer's disease. INCORRECT: Withdrawal from social activities is a later manifestation of Alzheimer's disease. Incontinence is a later manifestation of Alzheimer's disease. Neglecting personal hygiene is a later manifestation of Alzheimer's disease.
question
A community health nurse identifies an increase in the occurrence of osteoporosis-related fractures in women experiencing menopause. Which of the following primary prevention strategies should the nurse implement? Advise the women to keep their immunizations updated. Encourage the women to participate in weight-bearing activities. Educate the women about the importance of limiting sun exposure. Instruct at-risk women to increase their intake of foods high in vitamin E.
answer
Encourage the women to participate in weight-bearing activities. Weight-bearing exercises, such as weight lifting, walking, and running, have been found to be beneficial in preventing osteoporosis. INCORRECT: Currently, there is no immunization to prevent osteoporosis. Sun exposure with appropriate precautions is encouraged to increase the exposure to and absorption of vitamin D. Vitamin D is a necessary factor in the absorption of calcium, which helps prevent osteoporosis. Vitamin E has no relationship to bone density and the prevention of osteoporosis.
question
A nurse is caring for a client who has terminal lung cancer and is receiving hospice care. Which of the following statements should the nurse identify as an indication that the client is in the denial stage of the grief process? "I'm looking forward to my daughter's wedding next year." "I don't deserve to die. This just isn't fair." "If I could just make it through this, I'd never smoke again." "I'm going to plan my memorial service next week."
answer
"I'm looking forward to my daughter's wedding next year." During the denial stage of the grief process, the client rejects the reality of the impending loss. INCORRECT: "I don't deserve to die. This just isn't fair." During the anger stage of the grief process, the client exhibits increased anxiety and may project anger toward herself and others. "If I could just make it through this, I'd never smoke again." During the bargaining stage of the grief process, the client acknowledges the impending loss while remaining hopeful. "I'm going to plan my memorial service next week." During the acceptance stage of the grief process, the client establishes coping strategies and accepts the impending loss.
question
A home care nurse is visiting an older adult client and notes that unwashed dishes are piled up and newspapers cover the front steps. Which of the following questions should the nurse to ask the client to determine if he is socially isolated? "Why haven't you brought in your newspapers?" "Do you need help completing your housework?" "How often do you have visitors come to see you?" "Have you considered moving to an assisted living facility?"
answer
"How often do you have visitors come to see you?" The nurse should ask this question because it addresses the issue of social isolation by determining the frequency of contact between the client and others. INCORRECT: "Why haven't you brought in your newspapers?" This question does not determine the frequency of contact between the client and others. "Do you need help completing your housework?" This question does not determine the frequency of contact between the client and others. "Have you considered moving to an assisted living facility?" This question does not determine the frequency of contact between the client and others.
question
A community health nurse is discussing the role of a faith community nurse with a chaplain. Which of the following information should the nurse include in the discussion? The faith community nurse can provide pharmacologic pain management for clients who have a terminal illness. The faith community nurse can plan workplace safety training for employees in a local factory. The faith community nurse can provide wound care for clients in their homes. The faith community nurse can facilitate substance abuse support groups.
answer
The faith community nurse can facilitate substance abuse support groups. This is one of the roles of a faith community nurse. INCORRECT: The faith community nurse can provide pharmacologic pain management for clients who have a terminal illness. This is the role of a home health or hospice nurse. The faith community nurse can plan workplace safety training for employees in a local factory. This is the role of an occupational health nurse. The faith community nurse can provide wound care for clients in their homes. This is the role of a home health or wound care nurse.
question
A community health nurse is conducting a needs assessment of a community. The nurse should identify that which of the following methods will yield direct data? Health surveys Medical records Informant interviews Morbidity/mortality statistics
answer
Informant interviews The nurse should identify that informant interviews of the community's leaders will provide direct data. This information can help the nurse identify services needed by the community. INCORRECT: Health surveys will yield secondary data. Medical records will yield secondary data. Vital statistics will yield secondary data.
question
A nurse is providing education regarding lead exposure to a group of clients who live in a housing development built in 1968. Which of the following client statements indicates an understanding of the teaching? "I will use a dry-sanding technique when preparing to repaint my front door." "I will vacuum our wood floors every week." "I will increase the amount of red meat and milk in my child's diet." "I will use hot tap water to prepare my baby's formula."
answer
"I will increase the amount of red meat and milk in my child's diet." Children should receive adequate amounts of iron and calcium in their diets to prevent lead absorption from their environment. INCORRECT: The client should use a wet-sanding technique to prevent aerosolizing lead particles. The client should wet mop wood floors to prevent aerosolizing lead particles. The client should use cold tap water to prepare infant formula because hot water dissolves lead more quickly from the pipe than cold water.
question
A community health nurse is participating in a quality improvement plan for a local health department. Which of the following techniques should the nurse use for process evaluation of the facility? (Select all that apply) -focus groups -written audits -satisfaction survey -interviews -values self study
answer
A,B,C,D Focus groups is correct. The nurse should include focus groups, which are small groups of individuals who use the health department services, for process evaluation of the facility. This information allows for review of the facility's strengths and weaknesses in the quality of client care delivery. Written audits is correct. The nurse should include written audits, which are written evaluations of the quality of care provided by the health department, for process evaluation of the facility. This information allows for review of the facility's strengths and weaknesses in the quality of client care delivery. Satisfaction survey is correct. The nurse should include satisfaction surveys, which are assessments of clients' perception of their care made via telephone or written questionnaires, for process evaluation of the facility. Interviews is correct. The nurse should include interviews of clients who use the health department's services for process evaluation of the facility. Values self-study is incorrect. A values self-study is performed as the first step in quality assurance when the health department determines the needs of the community, the services to offer, and develops a philosophy and overall objectives for the facility.
question
A community health nurse is planning an in-service about STIs for a group of adolescents. Which of the following clinical findings should the nurse include as a manifestation of primary syphilis? Malaise Maculopapular rash on palms Chancre Lymphadenopathy
answer
Chancre Chancre is a clinical manifestation of primary syphilis. INCORRECT: Malaise is a clinical manifestation of secondary syphilis. Maculopapular rashes on the palms and soles of the feet are clinical manifestations of secondary syphilis. Lymphadenopathy is a clinical manifestation of secondary syphilis.
question
A community health nurse is caring for an adolescent who is seeking help for an unplanned pregnancy. Which of the following actions should the nurse take first? Recommend that the adolescent meet with the school guidance counselor to discuss educational options. Request permission to interview the father of the child to obtain a medical history. Help the client obtain a provider for prenatal care. Provide information on parenting classes so the client can learn about caring for a newborn.
answer
Help the client obtain a provider for prenatal care. The client is an adolescent and experiencing an unplanned pregnancy, which are factors that place the client at risk for complications. Therefore, the first action the nurse should take is to assist the client in obtaining prenatal care. INCORRECT: The nurse should encourage the client to meet with her guidance counselor regarding her educational plans. However, another action is the priority. The nurse should obtain the medical history of the father of the child if possible. However, another action is the priority. The nurse should provide information about parenting classes to the client. However, another action is the priority.
question
A community health nurse is planning to establish a community garden to address the lack of nutritious food options in the area. Which of the following actions should the nurse take first to initiate the plan? Identify community members who demonstrate an interest in the project. Hold a community information session to inform the residents of the plan. Select residents to take on leadership roles in the project. Monitor the progress of the project to keep the project on course.
answer
Identify community members who demonstrate an interest in the project. The first action the nurse should take when using the nursing process is to assess the community. By identifying those community members who demonstrate an interest in the project, the nurse can establish a local support group who will assist in engaging other community residents with establishing the garden. INCORRECT: The nurse should hold a community information session to inform the residents of the plan. This will encourage dialogue amongst the residents and enlist the help of others. However, there is another action the nurse should take first. The nurse should select residents to take on leadership roles in the project so the community can take ownership of the project, letting the nurse relinquish that control. However, there is another action the nurse should take first. The nurse should monitor the progress of the project to keep the project on course and to assist the residents in making changes and adjustments as necessary. However, there is another action the nurse should take first.
question
A nurse is conducting a home visit for an older adult client. The nurse should identify which of the following findings as an indicator of possible neglect? Lives alone Taking outdated prescriptions Has a BMI of 25 Presence of alcohol in the home
answer
Taking outdated prescriptions The client taking outdated prescriptions is an example of inadequate medical care and is an indicator of possible neglect. INCORRECT: The fact that the client lives alone is not an indicator of possible neglect. However, if the client has a lack of access to basic necessities, such as food and water, then these findings would require further assessment. A BMI of 25 to 30 indicates that the client is overweight. Weight loss and malnourishment are indicators of possible neglect. The presence of alcohol in the home is not an indicator of neglect. However, the nurse should assess the type and amount of alcohol that the client consumes to determine if further intervention is needed.
question
A nurse is caring for a 16-year-old client who has a new diagnosis of human papillomavirus. Which of the following actions should the nurse take? Report the infection to the state health department. Instruct the client to return for a blood test in 1 month. Administer ceftriaxone 250 mg IM. Teach the client how to apply imiquimod 5% cream to the lesions.
answer
Teach the client how to apply imiquimod 5% cream to the lesions. The client can self-treat the lesions using topical imiquimod 5% cream to the lesions at bedtime for up to 16 weeks. INCORRECT: The nurse should not report the infection to the state health department because human papillomavirus is not a reportable communicable disease. The client will undergo a physical examination, PAP test, and assessment of manifestations for initial diagnosis. The nurse should administer ceftriaxone for a client who has gonorrhea.
question
A school nurse is reviewing the records of four students who are returning to school after being diagnosed with methicillin-resistant Staphylococcus aureus (MRSA). Which of the following actions should the nurse take? Coordinate an immunization clinic at the school. Recommend prophylactic treatment for classmates. Report the cases of MRSA to child protective services. Provide education about MRSA throughout the school system.
answer
Provide education about MRSA throughout the school system. Appropriate hand hygiene and self-care will help prevent the spread of MRSA. INCORRECT: An immunization is not available to reduce the spread of MRSA. A prophylactic treatment is not available for MRSA. A diagnosis of MRSA is not an indicator of child abuse.
question
A public health nurse is conducting an educational session about Lyme disease for a group of older adult clients at a senior center. Which of the following statements should the nurse identify as an indication that the client understands the teaching? "I should get an annual immunization to prevent Lyme disease." "I can take penicillin for 10 to 14 days to manage Lyme disease." "I can get Lyme disease from a mosquito bite." "I will have abdominal pain and diarrhea if I get Lyme disease."
answer
"I can take penicillin for 10 to 14 days to manage Lyme disease." A client who receives a diagnosis of Lyme disease in the early stages should respond to 10 to 14 days of penicillin or tetracycline therapy. INCORRECT: Currently, there is no immunization to prevent Lyme disease. An older adult client should get an annual influenza immunization. The nurse should instruct the clients that the mode of transmission for Lyme disease is from the bite of an infective ixodid tick. The client who has Lyme disease can have a lesion from a tick bite with mild-flu like manifestations, such as fever, fatigue, and malaise. A client who has Escherichia coli is more likely to have abdominal pain and diarrhea.
question
A school nurse is educating a group of high school students about recommended dietary guidelines. Which of the following statements by a student indicates an understanding of the teaching? "I can consume up to 25 percent of my daily calories from saturated fatty acids." "I should consume less than 300 milligrams per day of dietary cholesterol." "I can increase my daily consumption of foods that contain refined grains." "I should consume 800 milligrams per day of dietary calcium."
answer
"I should consume less than 300 milligrams per day of dietary cholesterol." The nurse should instruct the students to consume less than 300 mg/day of dietary cholesterol. High levels of dietary cholesterol in a diet can be a risk factor for cardiovascular disease. INCORRECT: High school students should consume less than 10% of their daily calories from saturated fatty acids. High school students should decrease their consumption of foods that contain refined grains. Refined grains often contain solid fats, added amounts of sugar, and are high in sodium. Examples of foods that contain refined grains are white flour, white bread, and white rice. High school students should consume 1,300 mg/day of dietary calcium. Calcium promotes skeletal growth and bone mineralization, which is necessary during adolescence.
question
A community health nurse is creating a program to reduce domestic violence in the community. Which of the following interventions should the nurse identify as secondary prevention? Creating a public service announcement about the warning signs of intimate partner abuse Recognizing and reporting suspected abuse to the appropriate protective services Collaborating with support agencies to ensure the ongoing treatment for abuse Educating individuals and groups about preventing domestic and community abuse
answer
Recognizing and reporting suspected abuse to the appropriate protective services Secondary prevention is an intervention that focuses on early detection of a health problem to facilitate early diagnosis and treatment. Recognizing and reporting suspected abuse facilitates diagnosis and intervention, helping to prevent further abuse. INCORRECT: Public service announcements and other types of information sharing are examples of primary prevention, which includes interventions that are aimed at promoting health and preventing injury or illness. Collaborating with support agencies to ensure the ongoing treatment for abuse is an example of tertiary prevention, which includes interventions that are aimed at interrupting the course of a known disorder, reducing ensuing disability, and promoting rehabilitation. Providing education about abuse is an example of primary prevention, which includes interventions that are aimed at promoting health and preventing injury or illness.
question
A nurse in a clinic is planning teaching for a client who was newly diagnosed with hepatitis C. Which of the following instructions should the nurse include in the teaching? Consume a low-carbohydrate diet until symptoms resolve. Schedule an appointment for an immunoglobulin injection. Abstain from sexual intercourse until antibody tests are negative. Wear a mask in public places while receiving treatment.
answer
Abstain from sexual intercourse until antibody tests are negative. Hepatitis C is transmitted through sexual intercourse. Therefore, the nurse should instruct the client to abstain from sexual intercourse until antibody tests are negative. INCORRECT: The nurse should instruct the client to consume a diet high in carbohydrates and calories as part of the management of viral hepatitis. Postexposure prophylaxis is available for hepatitis A, not hepatitis C. Hepatitis C is transmitted through blood and body fluids. Therefore, it is not necessary for the client to follow airborne precautions.
question
A nurse at a county health department is caring for a client who is at 28 weeks of gestation. The nurse should identify which of the following characteristics as a risk for potential future abuse of the newborn? The client recently married the father of her unborn baby. The client works part-time at a local restaurant. The client has changed providers three times during her pregnancy. The client has recurring nightmares about her unborn baby.
answer
The client has changed providers three times during her pregnancy. Frequently changing health care providers is a warning sign for potential future child abuse because it can indicate that the client is in an abusive relationship and is attempting to hide it from her provider. Clients who experience abuse are at a higher risk for abusing their own children. INCORRECT: A new marriage between the client and the father of her baby reflects a commitment between the client and her partner. Rejection of a pregnant client by her partner is a warning sign for potential future abuse of a child. Employment outside of the home can contribute to economic stability, which decreases the risk for potential future abuse of a child. Emotional responses to pregnancy can include dreams about the unborn baby. Anxieties about the pregnancy, the developing baby, and parenthood can manifest as nightmares. However, these nightmares are not warning signs for potential future abuse of a child.
question
A public health nurse is planning an educational program for a group of nurses at a community health department about pertussis infection. Which of the following information should the nurse include? Individuals should receive an annual influenza vaccine to minimize the risk of infection with pertussis. Newborns should receive the first dose of the diphtheria, tetanus, and acellular pertussis (DTaP) vaccine prior to discharge from the hospital. Individuals who have had pertussis do not require immunization. Individuals transmit the pertussis bacteria through airborne droplets.
answer
Individuals transmit the pertussis bacteria through airborne droplets. Transmission occurs when an individual who has an infection with Bordetella pertussis coughs and expels droplets smaller than 5 microns. INCORRECT: The annual influenza vaccine does not protect individuals from infection with Bordetella pertussis. Individuals should still receive immunization against pertussis. Infants receive an immunization against diphtheria, tetanus, and pertussis in the form of the DTaP vaccine. Infants should receive the first dose of the DTaP vaccine at no earlier than 6 weeks of age. Infants should receive a series of five vaccines by the age of 6 years. Individuals who have a history of infection with Bordetella pertussis do not maintain permanent immunity against reinfection and should still receive the vaccine.
question
A clinic nurse is caring for a client who reports taking ginkgo biloba for several weeks since seeing a naturopathic healer. The nurse should instruct the client that ginkgo biloba may alter the effects of which of the following medications? Warfarin Metoprolol Digoxin Diltiazem
answer
Warfarin Ginkgo biloba can hinder coagulation. Therefore, the nurse should instruct the client that ginkgo biloba may alter the effects of warfarin. INCORRECT: Ginkgo biloba does not alter the effects of metoprolol. Ginkgo biloba does not alter the effects of digoxin. Ginkgo biloba does not alter the effects of diltiazem.
question
A faith community nurse is teaching the daughter of a client who has a terminal illness about her role as a member of the client's health care team. Which of the following statements by the daughter indicates an understanding of the teaching? "You will be able to access my mother's hospital medical records for us to review." "You will be able to give my mother pain medication." "You can submit invoices to Medicare to reimburse you for your services." "You will coordinate with volunteers who will come to help my mother."
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"You will coordinate with volunteers who will come to help my mother." A faith community nurse can assist with receiving services from various volunteers within the client's spiritual community to provide additional support and comfort to the client during the dying process. INCORRECT: "You will be able to access my mother's hospital medical records for us to review." Faith community nurses work within a specific spiritual agency to combine health and spiritual healing. They do not have access to hospital medical records. "You will be able to give my mother pain medication." The client will require assistance from a hospice nurse to receive pain medication during the dying process. "You can submit invoices to Medicare to reimburse you for your services." The services that a faith community nurse provides are either on a volunteer basis or financially supported through the faith agency.
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A home health care nurse is teaching a client's family about preventing the transmission of Clostridium difficile. Which of the following transmission-based precautions should the nurse include in the teaching? Contact precautions Droplet precautions Airborne precautions Protective environment
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Contact precautions The nurse should instruct the family to implement contact precautions while providing care for a client who has C. difficile. Contact precautions eliminate the exposure to contaminated body fluids and items. INCORRECT: The nurse should implement droplet precautions when providing care for a client who has diphtheria or mumps. Droplet precautions require the use of appropriate hand hygiene, the wearing of a surgical mask when within 3 feet of the client, and the use of dedicated care equipment. The nurse should implement airborne precautions when providing care for a client who has varicella, pulmonary tuberculosis, or measles. This type of precaution requires a negative airflow room and the wearing of an N95 mask. The nurse should implement protective environment precautions for clients who are highly susceptible to infections, such as clients who have severe dermatitis, major burns, leukemia, or who are undergoing chemotherapy.
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A nurse is performing a home visit for a client who has tuberculosis (TB). As the nurse is leaving the client's house, a neighbor asks, "Is it true that my neighbor has TB?" Which of the following responses should the nurse make? "You should ask the public health department." "Do you have questions about tuberculosis?" "Have you ever been tested for tuberculosis?" "You should take precautions against this infection."
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"Do you have questions about tuberculosis?" This response addresses the neighbor's concerns while protecting the client's confidentiality. INCORRECT: "You should ask the public health department." This statement leads the neighbor to believe that the information is obtainable. However, the public health department will not disclose this information. "Have you ever been tested for tuberculosis?" This response does not address the neighbor's concerns and may contribute to further anxiety about contracting TB. "You should take precautions against this infection." This response violates the client's confidentiality by indicating that the neighbor's suspicions are correct.
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A nurse is developing a genogram for a client to determine education needs. Which of the following health risk information should the nurse expect to obtain with this tool? Biological Behavioral Social Economic
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Biological A family genogram tracks the incidence of disease over multiple generations of a family and will identify biological risk factors. INCORRECT: To obtain information regarding behavioral risks, including personal and family health habits, the nurse should conduct a lifestyle risk assessment. To obtain information regarding social risks, including living in a high-stress environment like a high-crime neighborhood, the nurse should conduct an environmental risk assessment. To obtain information regarding economic risks, including the relationship between family resources and the demand for those resources, the nurse should conduct an environmental risk assessment.
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An occupational health nurse is assessing a client who reports taking ibuprofen daily. The nurse should counsel the client about the risk for which of the following adverse effects? Gastric ulcerations Orthostatic hypotension Hyperglycemia Urinary retention
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Gastric ulcerations Daily use of NSAIDs, such as ibuprofen, increases the risk of gastric ulceration, perforation, and hemorrhage. INCORRECT: Tachycardia and dysthymias are adverse effects of ibuprofen. Hypoglycemia is an adverse effect of ibuprofen. Oliguria, dysuria, and hematuria are adverse effects of ibuprofen.
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A nurse is giving a presentation about family violence at a local community center. Which of the following information should the nurse include? Minority populations may be at greater risk for abuse. Intimate partner abuse occurs more frequently in lower socioeconomic households. Child abuse is more common in homes where intimate partner abuse is present. Children who are abused are less likely to become abusers.
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Child abuse is more common in homes where intimate partner abuse is present. Child abuse is very common in homes where intimate partner abuse is present. INCORRECT: Studies show that there is no link between race and abuse. Studies show that there is no connection between socioeconomic level and abuse. Studies show that children who are abused are more likely to become abusers.
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A nurse in an emergency department is triaging clients following an explosion at a local factory. Which of the following clients should the nurse identify as the priority? A client who has superficial burns to 10% of the abdomen A client who has tracheal deviation and shortness of breath A client who has agonal respirations and an open head injury A client who has a fracture of the humerus and a bleeding foot laceration
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A client who has tracheal deviation and shortness of breath A client who has tracheal deviation and shortness of breath most likely has a pneumothorax and requires immediate intervention for survival. Therefore, when using the survival approach to client care, the nurse should give priority to this client. INCORRECT: A client who has superficial burns to 10% of the abdomen does not have an immediate threat to life and can wait for treatment. Therefore, the nurse should not identify this client as the priority. A client who has agonal respirations and an open head injury has a minimal chance of survival even with intervention. Therefore, the nurse should not identify this client as the priority. A client who has fracture of the humerus and a bleeding foot laceration does not have an immediate threat to life and can wait for treatment. Therefore, the nurse should not identify this client as the priority.
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A public health nurse is planning a community health promotion program for hypertension prevention. Which of the following interventions should the nurse include as a tertiary prevention strategy? Provide education about risk factors for hypertension. Conduct a hypertension screening clinic for the community. Teach clients who have a family history of hypertension how to monitor blood pressure. Implement an exercise program for clients who have hypertension.
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Implement an exercise program for clients who have hypertension. The nurse should implement tertiary prevention strategies for clients who have hypertension to promote the highest level of functioning possible, which can include regular exercise to maintain an active lifestyle. INCORRECT: The nurse should implement primary prevention strategies for a healthy population to prevent or delay hypertension, which can include providing community education about risk factors and early intervention. The nurse should implement secondary prevention strategies for early detection and treatment for clients who are at risk for developing hypertension, which can include conducting a hypertension screening clinic for the community. The nurse should implement secondary prevention strategies for early detection and treatment for clients who are at risk for developing hypertension, which can include teaching clients who have a family history of hypertension to monitor their blood pressure.
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A home health nurse is conducting a follow-up visit for a client who was recently discharged from an acute rehabilitation program for alcohol use disorder. Which of the following actions should the nurse take? Tell the client to take naltrexone daily. Instruct the client to take buprenorphine for the next 9 to 12 months. Teach the client to avoid foods that contain tyramine. Schedule transcranial magnetic stimulation (TMS) biweekly.
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Tell the client to take naltrexone daily. The nurse should instruct the client to take naltrexone daily to decrease her cravings for alcohol. Naltrexone is prescribed to assist the client with alcohol withdrawal and prevent relapse. INCORRECT: Buprenorphine is prescribed for clients who are withdrawing from opiates. It is not used for the treatment of alcohol use disorder. Clients who are prescribed monoamine oxidase inhibitors (MAOIs) are instructed to avoid foods that contain tyramine. MAOIs are prescribed for clients who have depression. TMS is used for the treatment of depression for clients who did not respond to other treatment interventions.
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A nurse is assessing a new client at a public health clinic. Which of the following areas should the nurse address as part of the cultural assessment? Immunization status Sexual activity Illness practices Food allergies
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Illness practices A cultural assessment focuses on beliefs, values, meanings, and behavior of people within a client's cultural, ethnic, or religious group. This includes culturally-based practices that relate to health and illness. INCORRECT: A client's immunization status is not part of a cultural assessment. A client's sexual activity is not part of a cultural assessment. Allergies are a result of a particular client's hypersensitivity to a substance, not of cultural beliefs or practices.
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A school nurse is notified that a school-age child has been newly diagnosed with pertussis. Which of the following actions should the school nurse take? (Select all that apply.) Instruct the parent to keep the child at home until the coughing stage has passed. Encourage family members to obtain prophylactic treatment. Quarantine the children in the child's class. Recommend that the child receive a pneumococcal vaccine in 28 days. Check the immunization status of the child's classmates.
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A,B,E Instruct the parent to keep the child at home until the coughing stage has passed is correct. The child should be kept at home until the coughing stage has passed because this is when the disease is most communicable. Encourage family members to obtain prophylactic treatment is correct. Individuals exposed to pertussis should be treated prophylactically with erythromycin, clarithromycin, or azithromycin. Quarantine the children in the child's class is incorrect. While the nurse should place the client on droplet precautions, it is not necessary to quarantine the children in the child's class. Recommend that the child receive a pneumococcal vaccine in 28 days is incorrect. A pneumococcal vaccine is not effective against pertussis. Check the immunization status of the child's classmates is correct. The immunization status of the child's classmates should be checked to identify the children who are most likely to acquire the infection.
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A nurse is caring for a client who has stage IV pancreatic cancer and has received information regarding available treatment options. Which of the following is the responsibility of the nurse if the client chooses to forgo treatment and enter hospice care? Make the hospice referral in accordance with the client's decision. Verify that the client's health insurance pays for hospice services. Recommend a second opinion from another provider. Assess whether or not the family agrees with the client's decision.
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Make the hospice referral in accordance with the client's decision. The nurse should follow the ethical principle of respect for client autonomy and make the hospice referral for the client. INCORRECT: The nurse's responsibility does not include verifying the insurance coverage of hospice services. Providing advice is nontherapeutic and is not congruent with the principle of respect for client autonomy. This action is a breach of client confidentiality and is not congruent with the principle of respect for client autonomy.
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A nurse is preparing a community education program about health care needs during pregnancy. The nurse should include that which of the following vaccines is safe to administer to a client who is pregnant? Herpes zoster Tetanus, diphtheria, pertussis (Tdap) Varicella Measles, mumps, rubella
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Tetanus, diphtheria, pertussis (Tdap) The nurse should include that a client who is pregnant should receive the Tdap vaccine between 27 and 36 weeks of gestation. INCORRECT: The herpes zoster vaccine is contraindicated during pregnancy. The varicella vaccine is contraindicated during pregnancy. The measles, mumps, rubella vaccine is contraindicated during pregnancy.
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A community health nurse is providing care to a client who has stopped taking his prescribed blood pressure medication. Which of the following actions should the nurse take first? Inform the provider of the client's decision. Determine the client's reason for discontinuing the medication. Discuss the consequences of discontinuing the medication with the client. Provide the client with an educational pamphlet about the medication.
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Determine the client's reason for discontinuing the medication. When using the nursing process, the first step the nurse should take is to assess the client. By determining the client's reason for discontinuing the medication, the nurse can promote adherence to treatment. INCORRECT: The nurse should notify the provider of the client's decision to stop taking prescribed medication. However, another action is the priority. The nurse should discuss the consequences of discontinuing the medication with the client. However, another action is the priority. The nurse should provide the client with information about the medication. However, another action is the priority.
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Community leaders have requested a meeting with a community health nurse to discuss creating a mobile meals program. Which of the following should the community health nurse assess first? The leadership support of the community The accessibility of residences The availability of volunteers The need for the program
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The need for the program Using the urgent vs. nonurgent approach to client care, the nurse should first assess the need for the mobile meals program. This action allows the nurse to collect data on the client, which is the community, and meets the first step of program planning. The needs of the community will determine all other steps of the planning process. INCORRECT: While the support afforded by the leaders of the community should be determined prior to implementing the program, it is not the first thing the nurse should assess. While the accessibility of residences will need to be determined prior to implementing the program, it is not the first thing the nurse should assess. While the availability of volunteers will need to be determined prior to implementing the program, it is not the first thing the nurse should assess.
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A nurse is preparing to administer medication to a client who has active tuberculosis. Which of the following precautionary measures should the nurse take? Wear gloves. Wear a gown. Use disposable equipment. Use an N95 respirator.
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Use an N95 respirator. A client who has active tuberculosis requires airborne precautions to prevent the spread of droplet nuclei smaller than 5 microns. The nurse should wear an N95 respirator when administering medication to prevent transmission of the infection. INCORRECT: The nurse should wear gloves when administering medication to a client who has an infection that requires contact precautions, such as shigella, herpes simplex, or scabies. The nurse should wear a gown when administering medication for a client who has an infection that requires contact precautions, such as shigella, herpes simplex, or scabies. The nurse should use disposable equipment when administering medication for a client who has an infection that requires contact precautions, such as shigella, herpes simplex, or scabies.
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A community health nurse is reviewing plans for a health education program. The nurse should identify that which of the following components of the plan needs to be changed? Program content is organized topically. Pamphlets are written at a 12th-grade level. The presentation is delivered via a computer slide presentation. Attendance at the program is voluntary.
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Pamphlets are written at a 12th-grade level. The nurse should identify that the pamphlets written at a 12th-grade reading level requires a change. The American Medical Association and the National Institutes of Health recommend written materials are written at a 6th-grade level or lower. INCORRECT: Appropriately organized content makes it easier for participants to comprehend and retain the material. The use of technology, such as a computer slide presentation, is an effective teaching method that addresses the needs of both visual and auditory learners. Participants are more likely to benefit from a program that they choose to attend rather than from one that is mandatory.
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A nurse is planning health promotion activities for the local community. Which of the following activities should the nurse include as an example of primary prevention? Teaching foot care to adults who have diabetes mellitus Testing school-age children for lead exposure Providing tuberculosis screenings for day care providers Teaching meal planning classes to older adults
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Teaching meal planning classes to older adults This is an example of primary prevention. INCORRECT: Teaching foot care to adults who have diabetes mellitus This is an example of tertiary prevention. Testing school-age children for lead exposure This is an example of secondary prevention. Providing tuberculosis screenings for day care providers This is an example of secondary prevention.
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A home health nurse is providing nutritional instructions to a client who has COPD and is malnourished. Which of the following instructions should the nurse include? Drink at least 480 mL (16 oz) of liquid with each meal. Avoid foods that contain eggs. Lie flat for 15 to 30 min after eating. Use milk instead of water when making canned soup.
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Use milk instead of water when making canned soup. The client should use milk when preparing canned soup to increase his intake of protein and calories. INCORRECT: The client should limit liquid intake at meal times. The client should consume foods that provide protein, such as eggs. The client should maintain an upright position, such as the high Fowler's position or the orthopneic position, to promote ventilation.
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A nurse in a pediatric clinic is providing care to several clients. The nurse should recognize that which of the following conditions is included on the Nationally Notifiable Infectious Conditions list? Varicella Erythema infectiosum Scarlet fever Molluscum contagiosum
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Varicella The nurse should recognize that varicella is included on the Nationally Notifiable Infectious Conditions list. States voluntarily conduct surveillance and report instances of certain diseases to the Centers for Disease Control and Prevention so the data can be compiled and released each year. INCORRECT: Erythema infectiosum is a contagious illness that is transmitted via respiratory secretions and blood, but it is not included on the Nationally Notifiable Infectious Conditions list. Scarlet fever is a contagious illness that is transmitted via direct contact with an individual who is infected or indirect contact with contaminated objects, but it is not included on the Nationally Notifiable Infectious Conditions list. Molluscum contagiosum is a contagious illness that is transmitted via skin-to-skin contact with an individual who is infected, but it is not included on the Nationally Notifiable Infectious Conditions list.
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A nurse is caring for a client who has recently emigrated from another country and states, "The health care system in my country was better and should be used everywhere." The nurse should recognize that the client is demonstrating which of the following behaviors? Social organization Cultural imposition Ethnocentrism Stereotyping
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Ethnocentrism Ethnocentrism occurs when people view the world from the perspective of their own cultural background and viewpoint. INCORRECT: Social organization is the pattern of relationships among a cultural group and how that group structures itself to carry out role functions. Cultural imposition is the process of forcing one group's cultural beliefs on others. Stereotyping occurs when members of a culture are viewed according to perceived characteristics without considering individual differences.
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A community health nurse is providing teaching about health promotion to a group of adolescents. Which of the following topics is the most important for the nurse to include in an attempt to lower adolescent mortality rates? Underage smoking Safer sex practices Safety belt use Heart-healthy diet
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Safety belt use Automobile crashes are currently the leading cause of death among adolescents. Therefore, this topic is most important to discuss when attempting to reduce premature deaths in this age group. INCORRECT: Underage smoking may lead to health complications later in life, but it is not the leading cause of death among adolescents. Safer sex practices will reduce the incidence of pregnancy and sexually transmitted infection, but they will not affect the leading cause of death among adolescents. An unhealthy diet may lead to health complications later in life, but it is not the leading cause of death among adolescents.
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A nurse in an emergency department is caring for client who is homeless and has hypothermia. Which of the following actions should the nurse take? Notify the local law enforcement agency of the client's situation. Initiate a referral to the facility's social worker. Ask the client why he did not seek shelter sooner. Tell the client everything will work out now that he is in the hospital.
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Initiate a referral to the facility's social worker. The nurse should refer the client to the facility's social worker or to an agency that can assist him with finding housing. INCORRECT: The nurse should only involve the local law enforcement agency when there a legal issue. Asking a "why" question can make the client defensive. Telling the client everything will work out is giving the client false reassurance and does not address his immediate needs.
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A nurse in a community health clinic is preparing to administer an immunization to a 5-year-old child. Which of the following actions should the nurse take? Ask the child to pretend to blow up a balloon during the injection. Reassure the child that the injection is not going to hurt. Ask the child's parent to leave the room during the injection. Request that the child count backwards from the number 10 during the injection.
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Ask the child to pretend to blow up a balloon during the injection. The nurse should ask the child to pretend to blow up a balloon during the injection. This serves as a distraction for the child, which decreases pain perception. INCORRECT: The nurse should explain to the child that the injection may feel like a sting or a poke for a short time. The nurse should then provide a distraction for the child during the injections. The child likely has anxiety and fear about receiving an injection and the presence of a parent can decrease this fear. The parent can talk to and reassure the child during the injection. A 5-year-old child does not have the cognitive development to perform this task. The nurse should have the child use a distraction during the injection, such as blowing bubbles or looking at a book.
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A nurse is developing a community education program about risk factors for family violence. The nurse should include which of the following circumstances as a risk factor for intimate partner abuse? Attempting to end the relationship Lacking supportive friends outside of the relationship Having health issues that limit independence Taking antianxiety or sedative medications
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Attempting to end the relationship Clients who are in a relationship with a potential or actual abuser heighten their risk for intimate partner abuse when they attempt to leave the relationship. INCORRECT: A lack of support outside of the intimate relationship can heighten an abuser's potential for violence. For the vulnerable person, social isolation is more likely a result of the abuse rather than a cause of it. Physical problems and cognitive decline typically heighten the risk for elder abuse, rather than abuse in an intimate partner relationship. Abusers typically thrive on dependence of and codependence with the vulnerable person. Substance use disorder, particularly of alcohol and drugs, can heighten an abuser's potential for violence. However, taking prescribed antianxiety or sedative medications is not typically a risk factor for the vulnerable person.
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A home health nurse is planning care for a client who reports practicing traditional Asian health beliefs. The nurse should recognize that the client participates in which of the following actions? Places a cup of steam against the skin to draw out toxins from the body Applies cool compresses across the body to reduce fever Avoids eating dairy and meat products during the same meal Visits a shaman to seek healing from illness
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Places a cup of steam against the skin to draw out toxins from the body The nurse should recognize that a health-related practice for clients who practice traditional Asian health beliefs includes cupping, which involves placing the open end of a cup of steam against the skin. A vacuum seal is created as the steam cools. When the cup is removed, it is believed that toxins are drawn out from the body. INCORRECT: The nurse should recognize that a health-related practice for clients who practice traditional Asian health beliefs includes covering the body with heated blankets during episodes of fever. This health belief is derived from the need to balance yin and yang during illness. The nurse should recognize that clients who follow the traditional religious beliefs of Orthodox Judaism avoid eating dairy and meat products during the same meal. The nurse should recognize that a health-related practice of clients who follow traditional American Indian beliefs includes visiting a shaman to seek healing from illness.
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A community health nurse is conducting vision screenings at a health fair for an older adult client who has age-related macular degeneration. Which of the following statements should the nurse identify as an indication that the client is adapting to the changes? "I have a prescription bottle magnifier to help me read my pill bottle labels." "I canceled all of my magazine prescriptions since I can't read them." "I purchased green towels to use in my bathroom." "I have learned that I cannot to go outside when the sun is bright."
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"I have a prescription bottle magnifier to help me read my pill bottle labels." The client can obtain a prescription bottle magnifier, or other low-vision optical devices, to assist him in his ability to read the labels on his prescriptions and remain independent. INCORRECT: The client should obtain large print magazines and other reading materials that have large, dark, evenly-spaced printing. The client should obtain brightly colored towels with primary colors at the upper end of the spectrum, such as red and orange, because these are easier for a client who has age-related macular degeneration to see. The client should obtain sunglasses that have yellow or amber lenses because they will decrease the glare and allow him to go outside even when the sun is bright.
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A community health nurse is participating in a group session for clients who have alcohol and substance use disorders. Which of the following information should the nurse provide regarding support programs for these individuals? Alcoholics Anonymous (AA) is a support group that requires disclosure of attendance to employers. Narcotics Anonymous (NA) is a one-on-one program that assists clients. Alcoholics Anonymous (AA) assists a client who has an addiction to alcohol with developing a daily recovery program. Narcotics Anonymous (NA) will cure a client from her substance use disorder if she stays involved with the program.
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Alcoholics Anonymous (AA) assists a client who has an addiction to alcohol with developing a daily recovery program. AA is a support group that will assist a client who has an addiction to alcohol and other substances with developing a daily recovery program using a 12-step approach. AA's primary purpose is to help the client obtain and maintain sobriety. INCORRECT: AA is a support group that can help clients who are addicted to alcohol and other substances. The intent of the support group is confidentiality and anonymity. NA is a support group that involves a group environment and social network for a client who is recovering from an addiction to opioids. NA is a support group that helps clients understand the chronic nature of their addiction and learn to make changes in their life to stop using substances.
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An occupational health nurse in a factory is performing a routine tuberculosis screening and identifies an employee who has a positive Mantoux tuberculin test. Which of the following actions should the nurse take? Instruct the employee to prepare a list of close personal contacts. Initiate an employee immunization program. Instruct the employee to wear an N95 respiratory mask. Administer prophylactic penicillin to other employees.
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Instruct the employee to prepare a list of close personal contacts. The nurse should report the name of an employee who has a positive Mantoux tuberculin test to the health department. The health department will follow up with the employee so that close personal contacts can be notified of the potential of exposure. INCORRECT: There are no immunizations for tuberculosis. Health care providers of clients who have tuberculosis should wear an N95 respiratory mask to prevent exposure to the infection. Prophylactic treatment for exposed individuals does not include penicillin.
