Community Health Final (Learning System RN) 2022

A community health nurse is caring for a client exposed to HIV 2 days ago. The client asks the nurse what she should do. Which response should the nurse make? a. "I will administer an HIV vaccine today, and it will ne ...

A community health nurse is caring for a client exposed to HIV 2 days ago. The client asks the nurse what she should do. Which response should the nurse make? a. "I will administer an HIV vaccine today, and it will need to be repeated in 3 months." b. "I will administer an HIV test today, and you will need to return in 48hrs for me to read the results." c. "You will need to have an HIV test every other week for 6 months." d. "You will need to take prophylactic medications for 4 weeks." - ANSWER d. "You will need to take prophylactic medications for 4 weeks." RATIONALE: The client will need to take prophylactic medications for 4 weeks to prevent the virus from replicating within the body. Home health nurse and assistive personnel are discussing care for a client. Which statement by the AP requires intervention by the nurse? a. "I will change the PICC line dressing on my next visit." b. "Bathing the client is something I can do without assistance." c. "I assist the client in ambulating outdoors every time I visit." d. "The next time I visit, I plan to clean up the clutter in the client's room." - ANSWER a. "I will change the PICC line dressing on my next visit." RATIONALE: Changing IV dressings is not within the AP's scope of practice. The nurse should investigate this statement. An occupational health nurse is providing teaching to a group of clients about the risks of the work environment. Which of the following actions is the nurse performing? a. Case Management b. Secondary Prevention c. Tertiary Prevention d. Primary Prevention - ANSWER d. Primary Prevention RATIONALE: This nursing action is an example of primary prevention of accidents in the workplace. The goal of tertiary prevention is to limit disability caused by disease in a population. An example of tertiary prevention is working with members of the population who have diabetes to decrease the number of work days lost due to complications. The goal of secondary prevention is to detect levels of disease in a population and refer people for treatment. An example of secondary prevention is a hearing screening program that is indicated due to the excessive noise in the work environment. Case management is the coordination of care in order to improve client outcomes. A home health nurse is providing teaching to the primary caregiver of a client with Alzheimer's about respite care. Which of the following information should be included? a. "It's a community support group for family caregivers." b. "It requires placing the client in an assisted living facility." c. "It provides family caregivers with temporary relief from caregiving." d. "It supplies daily assistance from a home health aid." - ANSWER c. "It provides family caregivers with temporary relief from caregiving." RATIONALE: Respite care services provide family caregivers with temporary relief from the tasks associated with caregiving for chronically ill family members, such as adults who have Alzheimer's disease or children who have complex medical or developmental needs. Caring for a client who has complex care needs in the home is a difficult and draining task. Respite care allows overwhelmed caregivers to shop, have some time away, or get an uninterrupted night of sleep. A nurse is conducting a screening class for hypertension. Which of the following should be the nurses goal for secondary prevention? a. Prevent onset of the condition b. Identify severity of the condition c. Identify the condition early d. Deter condition-related complications - ANSWER c. Identify the condition early RATIONALE: Secondary prevention measures are those that identify and treat asymptomatic people who have already developed risk factors or preclinical disease, but in whom the condition is not clinically apparent. The goal of secondary prevention is early identification of the target condition. A nurse is providing teaching to a client about healthy lifestyle changes. The client states, "I work long hours, and I never have time for exercise or anything but fast food." Which of the following goals should be included in the plan of care? a. Client will improve overall health by next visit b. Client will introduce 2 green vegetables into her diet by the end of the month c. Client will reduce daily stress and increase activity by exercising d. Client will reduce weight by 4.5kg (10lb) within 2 weeks - ANSWER b. Client will introduce 2 green vegetables into her diet by the end of the month RATIONALE: This goal is simple, measurable, and realistic. The nurse should work with the client to develop goals that are realistic and achievable in order to ensure client success. A home health nurse is prioritizing visits for 4 clients. Which of the following clients should be seen first? a. Client with heart failure reporting a weight loss of 2.2kg (1lb) over the past week b. Client with osteoarthritis of the knees reporting joint pain when ambulating c. Client with Alzheimer's that's unable to remember the current year d. Client with Type II Diabetes Mellitus reporting a new fissure between her toes - ANSWER d. Client with Type II Diabetes Mellitus reporting a new fissure between her toes RATIONALE: The home health nurse should apply the acute versus chronic priority-setting framework when prioritizing home visits. Using this framework, acute needs are typically the priority need because they pose more of a threat to the client. Because chronic needs usually develop over a period of time, the client has more of an opportunity to adapt to the alteration in health. The nurse should also attend to alterations when they are in the acute phase, so they don't escalate into a life-threatening event or evolve into a chronic alteration in health. Clients who have type 2 diabetes mellitus are at risk for neurovascular compromise; therefore, the home health nurse should visit this client first to determine needed treatment and prevent further complications due to impaired skin integrity. A community health nurse is teaching a group of adult clients about factors that influence health behaviors. Which of the following is a modifiable risk factor that should be included? a. Family history of Diabetes b. Immunization status c. Mental illness d. Air pollution - ANSWER b. Immunization status RATIONALE: The client can modify his immunization status. A client can receive immunizations at any stage throughout his lifespan. A nurse is planning a health fair for a local community. Which of the following should be the nurse's priority consideration when deciding what screening programs will benefit the population the most? a. Identify prevalent health problems in the community b. Identify health care resources available for clients in the community c. Identify cost of screening programs d. Identify availability of transportation to the health fair - ANSWER a. Identify prevalent health problems in the community RATIONALE: In order to best meet the needs of the local community, the nurse should identify prevalent health problems within the local area; therefore, this should be the nurse's priority consideration when deciding what screening programs to have available at the health fair. A nurse is teaching a group of older clients about complementary and alternative therapies. Which of the following interventions should the nurse recommend to restore balance? a. Naturopathic Medicine b. Magnet Therapy c. Tai Chi d. Progressive Relaxation Therapy - ANSWER c. Tai Chi RATIONALE: Tai chi is an ancient Chinese martial art program consisting of a series of slow, gentle, continuous movements. Older adult clients who take part in structured tai chi programs improve their balance and physical strength, which reduces the risk for falls. A nurse is planning a teaching session at a community center about preventing suicide. Which of the following groups is most at risk for suicide? a. Older adult males, 75-90yrs old b. School-age children, 6-12yrs old c. Adolescent females, 12-20yrs old d. Middle adults, 25-44yrs old - ANSWER a. Older adult males, 75-90yrs old RATIONALE: The nurse should target older adult male clients, whose risk for committing suicide is about 36.1 per 100,000 clients. A school nurse is called to the scene of a large fight that just ended. The school security officers have called the police. Which of the following actions should the nurse take first? a. Teach coping skills to children who witnessed the fight b. Triage injured students c. Provide support to help staff deal with the traumatic situation d. Compare response to the incident with school policies - ANSWER b. Triage injured students RATIONALE: The school nurse should apply the nursing process priority-setting framework. The nurse can use the nursing process to plan client care and prioritize nursing actions. Each step of the nursing process builds on the previous step, beginning with assessment or data collection. Before the nurse can formulate a plan of action, implement a nursing intervention, or notify a provider of a change in the client's status, she must first collect adequate data from the client. Assessing or collecting additional data will provide the nurse with knowledge to make an appropriate decision. The school nurse will likely be the first medical responder to the site and should begin triaging the injured clients to assist medical personnel as they arrive. A nurse on a bioterrorism committee is developing a brochure to increase public awareness about the threat of inhalation anthrax. The nurse should plan to include which of the following information in the brochure? a. Vaccination for inhalation anthrax is recommended to be administered to children b. Clients with symptoms of inhalation anthrax will need antibiotic treatment for 60 days c. The initial symptoms of inhalation anthrax include itchy skin lesion that blisters and scabs d. Clients exposed to housemates who have inhalation anthrax must receive prophylactic treatment - ANSWER b. Clients with symptoms of inhalation anthrax will need antibiotic treatment for 60 days RATIONALE: Anthrax is an infectious disease caused by a spore-forming bacteria called Bacillus anthracis. Infection in humans most often involves the skin (cutaneous anthrax), the gastrointestinal tract, or the lungs (inhalation anthrax). After infection, anthrax is treated with antibiotics for 60 days. Success of the treatment is dependent on how long the client has had the infection prior to beginning treatment and the type of anthrax. A community health nurse at a family planning clinic is developing a program about adolescent sexuality. Which of the following is a developmental task of adolescence according to Erikson's Theory of Psychosocial Development? a. Adjusting to dramatic changes in body image b. Developing hypothetical reasoning skills c. Establishing the capacity for an intimate love relationship d. Learning to make good choices and avoid risk-taking behaviors - ANSWER a. Adjusting to dramatic changes in body image RATIONALE: According to Erikson, the major developmental task in adolescent clients (12 to 18 years of age) is identity vs. role confusion. In this stage, adolescent clients are preoccupied with their changing bodies and how their bodies appear to others. A public health nurse is assisting community leaders to develop a disaster response plan in the event of an outbreak of a serious communicable disease. When teaching the leaders about infectious disease, the nurse should explain that a vector is which of the following? a. Mode of transmission for the disease b. Microorganism causing infection c. Environment where pathogen can survive d. Client who is susceptible to the infection - ANSWER a. Mode of transmission for the disease RATIONALE: In the chain of infection, the vector is the mode of transmission for the disease, or the method of transfer by which the organism moves or is carried from one place to another. A community health nurse who works in a refugee center is evaluating children who are new arrivals to the US. Assessment of a listless, 20-month-old toddler indicates that the child is in the 6th percentile for weight and the 40th percentile for height. The toddler has thin limbs, a protuberant abdomen, and dull, dry hair. The nurse should suspect that the child might have which of the following conditions? a. Chronic Hypoxemia b. Anemia c. Protein Deficit d. Fluid Overload - ANSWER c. Protein Deficit RATIONALE: Growth failure, thin limbs, protuberant abdomen, and dry, dull hair characterize a protein deficit. A public health nurse is responsible for several activities in the community. The nurse is implementing tertiary prevention when he takes which of the following actions? a. Teaching stress reduction to parents of children with developmental delays b. Advocating for expansion of mental health rehabilitation facilities with community leaders c. Performing screenings for depression for older adult clients d. Coordinating a drive-through clinic for influenza immunizations - ANSWER b. Advocating for expansion of mental health rehabilitation facilities with community leaders RATIONALE: The nurse is implementing tertiary prevention when advocating for expansion of mental health rehabilitation facilities with community leaders. These services will assist with limiting negative outcomes related to a mental health diagnosis. A nurse is planning a smoking cessation program for women of childbearing age. Which of the following is an increased risk associated with smoking during pregnancy that should be included? a. Infant developmental delays b. Maternal osteoporosis c. Maternal ulcers d. Infant lung cancer - ANSWER a. Infant developmental delays RATIONALE: Smoking during pregnancy is associated with an increased risk for developmental delays, premature birth, low birth weight, sudden infant death syndrome, bronchitis, and pneumonia. A home hospice nurse is caring for a client who is dying. A family member of the client is talking to the nurse. Which of the following statements by the family member requires further clarification by the nurse? a. "Although my father can't get around much, at least he's alert." b. "My siblings and I have a schedule for when we can care for our father." c. "My biggest concern is that I don't want my father to be in any pain." d. "I'm glad professionals will be here incase my father stops breathing." - ANSWER d. "I'm glad professionals will be here incase my father stops breathing." RATIONALE: This statement will require clarification for two reasons. The first is that, when a client is admitted to hospice, the care changes from curative to palliative. Hospice clients do not receive major medical interventions or resuscitative measures, such as CPR, to prolong life. The nurse needs to determine if the family member understands and accepts the goals of hospice care. Secondly, home hospice care is provided primarily by family and volunteers. The nurse makes frequent visits to evaluate the client and provide support and education to the client's primary caregivers, and assistive personnel might assist with the client's ADL needs; however, a professional health care provider is not always in the client's home. A nurse is caring for a client who has a positive Mantoux skin test following screening for TB. The nurse should inform the client that the positive reaction indicates which of the following findings? a. Client has never been exposed to TB b. Client had infectious TB at one time, but it's not active c. Client has active TB d. Further evaluation is required - ANSWER d. Further evaluation is required RATIONALE: A positive Mantoux skin test indicates only that the client has been exposed to TB and further evaluation will be needed through the use of sputum cultures and chest x-rays.