A school nurse is discussing level of prevention with a teacher. Which of the following activities should the nurse identify as primary prevention strategy?
Demonstrate proper hand washing- primary prevention is to promote health and prevent disease from developing.
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 this tuning fork behind your ear, tell me when you no longer hear the sound"- a hearing evaluation that compares air conduction and bone conduction of sound
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 a indication that the client understands the teaching?
"This type of care can help me with pain control"- clients who have cancer might require complicated tx 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
A nurse is assessing a new client. Which of the following information should the nurse include in the cultural portion of the assessment?
Food preference- part of cultural assessment
A nurse is collecting demographic data as part of a community assessment. Which of the following information should the nurse include?
Racial distribution-part of demographics
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- the first action that the nrse sould take when using the nursing proces is to assess the client. the nurse should examine the client's oral mucous membranes for painful lesions, such as candidiasis
A home health nurse is caring for a client who has a breast cancer. Which of the following assessment findings should the nurse identify as an indication that the client is coping effectively?
Makes eye contact- characterized as effective coping
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 has diabetes mellitus and reports new erythema to the left foot-risk for infection and required prompt evaluation and tx
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 mistreat his father-prior exposure increases the potential risk for continuing violent behaviors
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?
"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 their position of their feet and legs
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
Observe the client's technique for drawing up insulin- required coordination and use of motor skills
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?
"I should refer a client for a rape kit examination if she reports sexual assault within the previous 24 hours."
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 instruction should the nurse include?
" Clean your bathroom fixtures with a chlorine bleach solution."- the client should clean his bathroom with a 10:1 chlorine bleach solution. Hepatitis A virus is spread via FECES and survives human hands since it is resistant to soap and detergents.
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?
Use therapeutic touch during conversation- caring and compassion gesture
A nurse is conducting an education 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?
Increase your daily intake of leafy green vegetables- increase daily calcium intake. Recommend leafy green veggies, milk fortified w/ vitamin D, cheese, and yogurt. (Note: spend 10-15 mins in the sun daily for VitD; use weight bering exercises to strengthen and protect bones & prevent fx)
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?
"A component of healthy grieving is the ability to openly express your anger."- nurse should teach family that they will experience feeling anger, guilt, shame, and doubt while grieving. the ability to openly express their feelings of anger is expected grief reaction. fluctuation of emotions is normal. constant sadness & helplessness and self-esteem disturbances are signs of depression.
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?
Administer antiviral medication 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
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
- Choose an interpreter who speaks the workers' language and dialect
- Evaluate the interpreter's approach to clients prior to the educational session
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?
"Can you tell me more about your decision to stop your medicine?"-open ended question
A community health nurse is planning an education program for farmers about occupational health risks. Which of the following risks should the nurse include?
Respiratory disorders-farmers are at an increased risk for respiratory disorders d/t exposure to agricultural chemicals, such as herbicides and pesticides. Other health risks include accidents w. vehicles and machinery, dermatitis, dental problems, and stress and anxiety disorders
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?
Unavailability of outreach services-lack of availability of outreach services is a barrier to health care for residents in rural areas.
A community health nurse is teaching a client who is overweight about steps to take tot 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 see my doctor before beginning an exercise program."- client should receive a complete physical exam and obtain approval for exercise
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 areas within the community where residents speak English as a second language
A nurse is providing blood pressure screening 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?
African American race-greater risk of developing hypertension
A home health nurse is planning care for the day. Which of the following clients should the nurse visit first?
A school-age child who was treated in the emergency department last night for status asthmaticus- ABC!! Airway 1st.
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 has a new onset of confusion and slurred speech- when using the urgent vs non-urgent 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.
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?
Inject 0.1 ml of purified protein derivative.- equivalent to 5 tuberculin units interdermally at 5-15 degree angle in inner forearm and create a wheal approximately 6mm in diameter
A public health nurse is monitoring medication compliance for a group of migrant workers who are being treated for tuberculosis. The nurse should use information from which of the following resources to assist with this process?
Migrant Clinicians Network (MCN)-migrant workers frequently change locations and move from job to job. This can interfere with the client adhering to the 6-12 month TB tx plan. MCN is a tracking program developed so that health care providers can access prior provider information and maintain TB tx continuity for migrant population
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- snellen letter chart assessment, keep glasses on, sit or stand 10 ft at eye level, progress to next line after reading 4 letters/symbols correctly, cover R eye first - then L - then both
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?
Consult with the local school nurse to schedule yearly vision screenings for students- focused on population care rather than individual care.
A public health nurse is planning care for four clients. Which of the following interventions should the nurse recognize as tertiary prevention?
Administering antibiotics to a clients who has AIDS and was diagnoses with Pneumocystis jiroveci- ex of tertiary
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?
"Can I give you some information about Alcoholics Anonymous?"
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?
"RSV is spread through contact with respiratory secretions from an infected person."- RSV is spread by direct contact with respiratory secretion within 3 feet of a person who is infected. Manifestations of RSV include dyspnea, tachypnea, coughing, and wheezing.....
A community health nurse suspects an outbreak of scabies in the local area. Which of the following actions should the nurse take first?
Determine incidence rate-1st action when using the nursing process (determine new cases of scabies in the community)
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 principles of epidemiology?
Reviewing county health records for data on cases of chickenpox-reviewing health records is an ex of using epidemiological principles to analyze incidence and track outcomes of interventions for a particular disease or condition.
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- 1st action to conduct a community assessment, which includes reviewing community-specific epidemiological data. The community assessment will assist the task force in identifying environmental health concerns within the county.
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 take isoniziad for 6-12 months- b/c at risk for developing the disease. Therefore, taking isoniazid prophylactically for 6-12 months is recommended.
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- can reduce pain and stress in palliative care settings
A community health nurse has been contracted 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 outbreaks?
Administer antiviral medication to clients at the facility- antiviral med is given to those exposed to influenza type A to provide immediate protection and help prevent an outbreak. immunizations don't provide immediate protection (so won't prevent an outbreak), single client diagnosis doesn't warrant closing the facility, no immune globulin
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 (b/c at risk for exposure to pesticides and other hazardous materials that can be harmful)
- Refer client for TB screening (b/c rates estimated higher for migrant farm workers d/t crowded living conditions and substandard housing)
- Provide skin cancer information (d/t working outdoors skin cancer is a health risk)
- Recommend a dental health screening (dental problems primary risk for migrant farm workers)
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?
Prevalence proportion- can be calculated by using the number of people who were affected at a given time and the total population.
A home health nurse is assessing an older adult who is taking captopril to treat heart failure. Which of the following findings should the nurse identify as an adverse effect of this medication?
Dry cough- captopril prevents the conversion of angiotensin I and angiotensin II, causing bradykinin to accumulate. The client may experience coughing as a result of bradykinin accumulation
A nurse is developing an education 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-first appearance
A nurse is assessing the risks and benefits of meal delivery services for older an older adult who lives alone and has no transportation. Which of the following ethical principles is the nurse demonstrating?
Benefience- determining if the client needs this service to maintain his health (justice would consider two people)
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 states she is leaving her partner- the clients decision to leave her partner places her at greater risk for intimate partner abuse b.c 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 greater risk for violence during this time.
A case manager is developing a discharge plan for a client who has a spinal cord injury and is in rehabilitation facility. Which of the following actions should the nurse take first?
Determine the client's ability to perform self-care- nursing process is 1st assess the client'e needs. Determine a clients needs is the 1st step in the case management process. therefore, the nurse should first determine the client's ability to perform self-care.
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"- two or more roles that are in opposition of each other
A nurse is planning to teach a community group about the meningococcal vaccine. The nurse should identify that which of the following clients should receive the vaccine?
A client who is moving into a college dorm- individuals living in crowded areas, such as dormitories, should receive the meningococcal vaccine
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 can expect to get help with other aspects of my life while in treatment."-successful tx 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.
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; cap 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- 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. TRIAGE is the assignment of degrees of urgency to wounded or illnesses to decide the order of treatment of a large number of pts
