HESI community #2
The nurse is caring for four clients in a women's health clinic. Which client should the nurse assess for risk for pelvic inflammatory disease A 30 year old with endometriosis A 40 year old with leiomyoma A 50 year old perimenopause A 20 year old with gonorrhea
A 20 year old with gonorrhea
An adolescent tells the school nurse that she is pregnant. Her last menstrual period was 4 months ago, and she has not yet received any medical care. She smokes but denies any other substance use. Which interventions should the nurse implement? (Select all that apply) Refer for prenatal care Notify her parents. Arrange for childcare. Offer nutritional instruction. Teach breastfeeding methods. Encourage smoking cessation.
Refer for prenatal care Offer nutritional instruction Encourage smoking cessation
Due to a limited supply the local health department needs to prioritize the distribution of influenza vaccinations. In determining which individuals should receive the limited available vaccine, which person should the public health nurse ask to return to the clinic later when more vaccine is available? An 80 year old resident in an Alzheimer's unit A 65 year old aide working in a nursing home A 60 year old client with diabetes and agoraphobia An 8 year old girl with poorly controlled asthma
A 60 year old client with diabetes and agoraphobia
The school nurse who is reviewing immunization records of students who will start kindergarten within the next month notes that most of the students have only received on does of the measles mumps rubella vaccine. Which intervention should the nurse implement? Note in the student records that the second dose of the mmr vaccine should be administered prior to entering first grade Send notices home with the children on the first day of class advising that mmr vaccine series must be completed Contact kindergarten parents to remind them that the second dose of mmr is due at eh start of the school year Speak at the next parent teacher association meeting to teach parents the benefits of immunizing their children
Contact kindergarten parents to remind them that the second dose of mmr is due at eh start of the school year
After assessing the health care needs of an elementary school the nurse determines that an increased prevalence of pediculosis capitis is a priority problem. The nurse develops a 2 month program with the goal to eradicate the conditions in the school. The program includes educational pamphlets sent home to parents and regular assessment of children by the school nurse. What action should the nurse implement to evaluate the effectiveness of the program? Evaluate the teachers ability to identify pediculosis capitis 2 months after initiation of the program Conduct an initial examination of each child in the school to obtain baseline data Survey parents 3 weeks after pamphlets are sent home to assess their understanding of the condition Measure the prevalence of pediculosis capitis among the children after four months
Measure the prevalence of pediculosis capitis among the children after four months
School teachers notify the schools nurse that a group of children of the migrant farm workers often miss school or sleep during classes. The nurse learns that the children range in age from 12 to 14 years old and work in an orchard with their parents until 2200 every night. Which action should the nurse implement Notify child protective services and local law enforcement of truancy concerns Schedule classes to teach the children and parents about adolescent health concerns Arrange a meeting with the manager of the orchard to discuss child labor concerns Organize focus groups with the childrens parents regarding educations concerns
Organize focus groups with the childrens parents regarding educations concerns
Tuberculosis screening at a federal prison reveals that two male inmates have positive skin test. What action is most important for the nurse to take: Start the two men on anti-tubercular medications Screen the prison guards for tb Refer the two men for chest xrays Re-screen the entire prison population in 6 weeks
Refer the two men for chest xrays
A government office worker is seen in the emergency room after opening an envelope containing a powder like substance which is being tested for anthrax. Which discharge instruction should the nurse provide the client concerning inhalation anthrax? Return to the emergency room if flu like symptoms develop within 42 days Notify co-workers to get the anthrax vaccine at the public health department Isolation from friends and family members is recommended for 3 weeks Cleanse all surfaces touched with pre-moistened anti-bacterial wipes
Return to the emergency room if flu like symptoms develop within 42 days
The nurse is developing a program about the risk factors of acquiring human immunodeficiency virus for the group of young adults at a community health center. Which life style behavior should the nurse include in the presentation that poses a risk for hiv: Participation in blood donations for a local blood bank center A history of receiving autologous blood transfusion Travel to places where drinking water is contaminate Self report of illegal intravenous drug abuse
Self report of illegal intravenous drug abuse
A prescription for discharge is written for an elderly female client who has asked to be discharged to her home. The client lives alone and is able to walk 10-15 feet with assistance. Which action should the nurse implement first? Arrange for a bedside commode to be delivered to the home Meet with case manager to plan a home safety evaluation Provide the client with information about medical alert devices Review the home medication schedule with the client and family
Meet with case manager to plan a home safety evaluation
The community health nurse who works in a gulf coast town that caters to tourists is presenting a class to residents and business owner of the town on disaster management. Which content is most important for the nurse be included in this class? Hurricane preparedness for families and businesses Available evacuation routes from the town Methods used to treat water to ensure it is safe to drink Actions to be taken during a tornado
Methods used to treat water to ensure it is safe to drink
The nurse notes that the influenza immunization rates are much lower for certain demographic groups than for others. Which intervention is likely to be most useful in increasing the rate of immunization in these under-served immunization groups? a. Reports describing influenza rates during times of greatest prevalence b. Radio announcements about the availability of the influenza vaccine c. Legislative proposals that mandate influenza vaccinations for all d. Designation of clinics conveniently located in target neighborhoods
d. Designation of clinics conveniently located in target neighborhoods
When developing a presentation on injury prevention for high school students enrolled in a health education class, which topic is most important for the nurse to include in the teaching plan? a. Pregnancy prevention b. Substance abuse c. Sports related injuries d. Seat belt safety
d. Seat belt safety
Which expected outcome statement is most relevant to the plan of care for an elderly female client who has a nursing problem of "altered nutrition less than body requirements related to social isolation" and lives alone in her own home Client will participate in daily meals at a senior nutrition center Client will describe a menu of well balanced meals Client understands the need for placement in a long-term care facility Client will receive well-balanced diet from meals on wheels
Client will participate in daily meals at a senior nutrition center
On a repeat home visit to see an 84 year old widow the nurse discovers that the client is unkempt, smells of stale urine and does not recognize her neighbors or the nurse. What action should the nurse take first? Complete a physical and mental exam of the client Call the clients pharmacy to determine what medications she is taking Seek the family's assistance in caring for the client Call adult protective services to obtain emergency nursing home placement
Complete a physical and mental exam of the client
Last year the nurse implemented a tertiary prevention program for osteoporosis in an adult long-term care facility. What annual statistic indicates that the program was effective? Reduce mortality from falls Lowered number of bone density exams conducted Decreased incidence of hip fractures Increased prevalence of osteoporosis
Decreased incidence of hip fractures
An older adult male who fractured his right hip is discharged to home one week following an arthroplasty. Which adjustment to the clients home environment is most important for the home health nurse to implement A. Lower the temperature on the clients water heater B. Encourage the client to wear rubber soled shoes C. Ensure that an elevated toilet seat is installed D. Leave motion activated light in the living room
Ensure that an elevated toilet seat is installed
A male client comes to the public health clinic requesting information about which immunizations he should receive prior to visiting a developing nation. Which immunization should the nurse recommend as a priority for this client? Tetanus toxoid vaccine Influenza vaccine Hepatitis b vaccine Hepatitis A vaccine
Hepatitis A vaccine
An older male client refuses a recommended annual influenza vaccination because it made him sick last year. He tells nurse the nurse that he will take his prescription for amantadine if he develops symptoms of the flu. Which response should the nurse provide? Since the client received the vaccine last year this plan should be supported It is best for the client to take the influenza vaccine and avoid using amantadine It is unlikely the vaccine will make the client sick in two consecutive years If symptoms of the flu develop the client should obtain the influenza vaccination
It is best for the client to take the influenza vaccine and avoid using amantadine
The occupational health nurse who works in a mobile clinic is developing an exposure control plan for blood-borne pathogens. Which topics should the nurse include in this plan? (select all that apply) Areas with negative-pressure airflow Personal protective equipment (PPE). Vaccination schedule for Hepatitis B Puncture-resistant sharps containers. Needleless medication delivery systems.
Personal protective equipment (PPE). Vaccination schedule for Hepatitis B Puncture-resistant sharps containers. Needleless medication delivery systems.
The community health nurses is counseling a group of 14 year olds about safe sexual practices. Which health teaching strategy would be most effective for the nurse to use with this age group. A.Encourage group members to describe personal experiences in practicing safe sex B. Provide the group with statistical data about behaviors leading to venereal diseases C. Tell the group that for aids prevention abstinence is the best safe sex practice D. Role play situations in which the adolescent is rewarded for practicing safe sex
Role play situations in which the adolescent is rewarded for practicing safe sex
The nurse is planning a health education program for 10-year old. Which setting is most likely to increase the preadolescent's participation in the program? The school classroom Community center Home of one of the children A local place of worship
The school classroom
A male high school student is referred to the school nurse because he lost consciousness during gymnastics class. His neurological vital signs are with normal limits, and his blood pressure is 100/62. He is 6 ft 3 in tall wighs 135 pound and his body mass index is 16.9. which assessment data should the nurse obtain first? Serial bp reading every 30 minutes Twenty-four hour diet recall Use of performance enhancing drugs Recent exposure to allergens
Twenty-four hour diet recall
The home health nurse assesses an older adult woman and observes possible signs of abuse. Which resources best guide the nurse's decision regarding reporting these suspicions? a. State law b. Nurse practice act c. Nursing procedure manual d. ANA Code of Ethics
a. State law The nurse should report the suspicions to the state's Department of Child and Family Services, who will follow up on the report. The nurse should not report them to the older adult's doctor or any other parties. This is because it is against the law for a health care professional to disclose information about a patient without their consent.
The public health nurse is evaluating resources in a rural community. Which healthcare resource is most important to the community? a. Annual health fair b. Weather-related disaster plan c. Accessibility to trauma care d. Family planning center
c. Accessibility to trauma care
During a two-week postoperative follow-up home visit, a female client who had gastric bypass surgery exhibits abdominal tenderness, shoulder pain, and describes feelings of malaise. Her vital signs are: temperature 101.8°F, blood pressure 100/50, heart rate 104 beats/minute, and respirations 18 breaths/minute. Which action should the nurse take? a. Determine the client's current oxygen saturation rate. b. Instruct the client to drive to the hospital for admission c. Recheck the client's vital signs in 30 minutes d. Have the client transported via ambulance to the hospital
d. Have the client transported via ambulance to the hospital
A young adult man goes to an emergency treatment area after finishing a marathon run. He is weak dizzy and remains thirsty after drinking a pint of a flavored sports drink. What action should the nurse implement first A. Instruct the runner that a urine sample is needed B. Send for the automatic external defibrillator C. Determine if there are friends or family nearby D. Give the runner another pint of fluids to drink
Give the runner another pint of fluids to drink
The nurse is working with parent teacher organization to increase safety for children walking to and from a nearby elementary school. Which action should the nurse include to help achieve this goal? Advise the residents to keep their porch lights on during hours that children are walking to and from school Help the residents plan a campaign to remind people driving through the school zone to wear seatbelts at all times Lead a discussion about the benefits of designated safe houses located throughout the school neighborhood Encourage residents with older homes along the school route to get their homes inspected for excessive lead levels
Lead a discussion about the benefits of designated safe houses located throughout the school neighborhood
Several employees who have a 10 year or longer smoking history ask the occupational health nurse for assistance with smoking cessation. The nurse develops a 2 month program that includes weekly group sessions on lifestyle changes and use of wove the counter nicotine substitute products. Which measurement provides the best indication of the programs effectiveness? Survey employees to determine how many are smoking 2 months after the end of the program At the end of the program test the employees knowledge of OTC nicotine substitute products Ask the employees to inform the group if they stop smoking and if they start smoking again Design a questionnaire that identifies lifestyle changes that contribute to smoking cessation
Survey employees to determine how many are smoking 2 months after the end of the program
An established community has a history of being skilled in identifying and managing problems. What role should the community health nurse assume in program development for this community? Community leader or facilitator Data organizer Group gatekeeper Technical expert or advisor
Technical expert or advisor
The parish nurse notes that an elderly male client has had a 5 lbs weight loss since his check up one month ago. The client has good hygiene, still drives a car and lives alone. To which agency should the nurse refer this client? The adult day care center The social security administration office The women infant and children office The senior citizen center
The senior citizen center
The public health nurse is called to investigate a report of several cases of chickenpox at a day care center. The day care worker states that five children have been sent home over the past two weeks with fever and itchy blisters. Which intervention should the nurse implement first? Validate that the children sent home did develop chickenpox Report the presence of a viral endemic at the day care center Confirm the number of children with symptoms Determine how many people have been exposed
Validate that the children sent home did develop chickenpox
The epidemiological triad can be used to frame strategies for the prevention of farm machinery injuries. Which action should the nurse take to focus on the agent? Teach farm workers not to smoke around farm equipment Translate written vehicle instructions into picture format Provide rehabilitation services to injured farm hands Work with legislators to mandate safe tractor design
Work with legislators to mandate safe tractor design
A 93-year-old client with a number of co-morbidities is assessed by the home health nurse. What problem is most important for the nurse to investigate further? a. Social isolation b. Medication interactions c. Urinary incontinences d. Caregiver stress
b. Medication interactions
The home health nurse visits a young male client with AIDS who has Kaposi's sarcoma and peripheral neuropathies. His parents, who are the care-takers, tell the nurse that their son sleeps most of the times. The nurse assess that the client is semi-conscious with stable vital signs, cries out in pain when turned or moved, has a Duragesic pain patch in place, and skin lesions that are closed and dried. Which intervention should the nurse implement? a. Remove the Duragesic patch as directed by prescription b. Give a complete bed bath to further assess the client c. Discuss end-of-life decisions with the client's parents d. Call for ambulance transportation to the hospital immediately
c. Discuss end-of-life decisions with the client's parents
The nurse provides teaching to a group of evacuees in a mass casualty center after a natural flooding disaster. Which information should the nurse include in the teaching plan? (Select all that apply.) a. Wash all fruits and vegetables thoroughly in running tap water. b. Identify all sexual contacts since the evacuation process c. Take all doses of prophylactic prescriptions for diarrhea d. Clean hands using soap, clean water, or waterless antibacterial solutions E. Drink only boiled water or bottled oral rehydration solutions
c. Take all doses of prophylactic prescriptions for diarrhea d. Clean hands using soap, clean water, or waterless antibacterial solutions E. Drink only boiled water or bottled oral rehydration solutions
Which annual screening should the nurse include when planning an eye health program at a preschool? a. Conjunctivitis b. Red light reflex c. Visual acuity d. glaucoma
c. Visual acuity
On a day when the temperature is expected to drop to below freezing during the night, the nurse is asked to determine which homeless adults are most in need of the limited spaces that are available in a shelter. It is most important for which person to be admitted at night? a. An adult who was hit by a car 3 weeks ago. b. A young person with diabetes mellitus. c. A middle-aged person who has hypertension. d. An older person who is malnourished.
d. An older person who is malnourished.
A client with Type 2 diabetes has a hemoglobin A1c value of 1.1% (0.91). Which action should the nurse take? a. Ask the client why his lab value is so out of control b. Explore the diabetes self-care regimen with the client c. Report the lab value to the healthcare provider immediately d. Congratulate the client on his excellent glycemic
d. Congratulate the client on his excellent glycemic
The nurse is preparing a community outreach program on primary disease prevention. Which topic should the nurse plan to include in this event? a. Blood pressure screening. b. Domestic violence assistance c. Outreach for support group information. d. Immunizations that are available
d. Immunizations that are available
An older client requiring total care resides with a family consisting of two daughters who take shifts providing care around-the-clock. During a home visit, the daughters ask the nurse about resources that are available for client care while they attend a scheduled family reunion. Which information is best for the nurse to provide? a. Propose the family seek assistance for care int the area of the reunion's location b. Tell the caregivers to consider hiring a private duty nurse during the time away c. Advise to have a case management evaluation of the client's home environment d. Suggest social services be contacted to find a respite care facility for the client
d. Suggest social services be contacted to find a respite care facility for the client
A community hit by a hurricane has suffered mass destruction and flooding. Sewage facilities are non functioning and the area is contaminated with human excreta. The nurse is developing a plan of care for clients diagnosed with cholera after an outbreak. Which intervention has the highest priority? Administer prophylactic antibiotics as prescribed Provide fluid and electrolyte replacement Isolate all infectious diarrhea victims Administer cholera vaccine
Provide fluid and electrolyte replacement
The nurse is planning to implement a health education program on breast screening for Hispanic women at a community center. Which component of the teaching plan best provides culturally competent care? Provide handouts and brochures in the English and Spanish languages Ask a Hispanic breast cancer survivor to present the educational class Include treatment modalities with survival statistics for Hispanic women Design flyers that target Hispanic women encouraging their attendance
Provide handouts and brochures in the English and Spanish
A male construction worker presents at the industrial clinic with a fever and a cough. He states I think I have that sudden acute respiratory syndrome that's been in the news. What is important for the nurse to do first Take the clients temperature and a pulse rate Place a surgical mask on the client and nurse Ask the client about recent travel or exposure Obtain a description of his sputum and cough
Ask the client about recent travel or exposure
An adult male client with recurrent ascites from cirrhosis tells the home health nurse that he has no appetite or energy. The nurse should provide what diet suggestions for this client. Select all that apply Eat concentrated sweets for a quick energy boost Avoid adding salt to foods when cooking or at the table Try to eat at least six small meals daily Limit helpings of fresh fruits and vegetables Choose small helping of lean protein such as legumes
Avoid adding salt to foods when cooking or at the table Try to eat at least six small meals daily Choose small helping of lean protein such as legumes
A middle aged male client presents for his annual health visit at a community clinic. He is 5 ft 10 in tall weighs 250 pounds, and works as an accountant. He smokes at least one pack of cigarettes every day for the last 15 years. Which secondary prevention measure should the nurse recommend the client to follow? Compliance with antihypertensive and lipid lowering agents. Increase physical activity and diet low in saturated fat Smoking cessation Blood pressure and lipid screening
Blood pressure and lipid screening
An older female client tells the home health nurse that she has no money, and since she does not deserve to eat, she has not asked anyone to bring her food. What information is most important for nurse to obtain? Client thoughts about wanting to hurt herself Medication history for antipsychotic agents Availability of family members to provide meals Community resources to provide financial aid
Client thoughts about wanting to hurt herself
After assessing the health needs of an elementary school, the nurse determines that an increased incidence of bicycle injuries is a priority problem. The nurse develops a 2 month program with the goal to eliminate bicycle injuries in the school. The program includes educational pamphlets sent home to parents and two educations sessions by the school nurse. Which action should the nurse implement to evaluate the effectiveness of the program? Compare the incidence of bicycle injuries at the beginning and end of the program Determine the type of bicycle injuries each child sustained before conducting the sessions Conduct an initial survey of the children to determine their knowledge of bicycle safety Survey parents after one month to assess their understanding of the educational pamphlet
Compare the incidence of bicycle injuries at the beginning and end of the program
The nurse is teaching a group of adults at a health fair about healthy life style choices. Which information is most important for the nurse to emphasize Completely stop the use of cigarette and tobacco products Eat a diet high in fruits vegetables and whole grains Avoid the midday sun and use sunscreen Perform monthly self examination of breasts and testes
Completely stop the use of cigarette and tobacco products
A nurse is planning a nutrition class for a group of senior citizens at a community center and wants to emphasize the amount and types of fat is some foods versus others. What is the best teaching method for the nurse to use? Ask each senior to bring a food for others to taste, then estimate the fat contained in these foods Display posters with foods and tell the seniors about the fat content Determine foods most often eaten by this group and discuss the nutritional panel of each product Show a movie about cooking with foods that are low in fat but delicious
Determine foods most often eaten by this group and discuss the nutritional panel of each product
A community health nurse is applying for a federal grant to support a smoking cessation educational program. In which order should the nurse prioritize these nursing activities? Arrange in order top to bottom Determine the target aggregate that will be served by the program Consider pros and cons of different methods of data gathering Select and train the data collection personnel Review and analyze the data
Determine the target aggregate that will be served by the program Consider pros and cons of different methods of data gathering Select and train the data collection personnel Review and analyze the data
Which intervention should the nurse implement to help prevent client from getting a vector born infectious disease? Demonstrate the correct way to remove ticks imbedded in the skin Discuss the importance of wearing insect repellent when camping Instruct the client to drink only bottled water when traveling abroad Encourage the client to get immunizations prior to international travel
Discuss the importance of wearing insect repellent when camping
The public health nurse receives grant funding to implement primary prevention strategies for migrant farm workers and their families. Which action should the nurse plan to include? Teach a class in providing first aid for heat exhaustion Organize free community wide tuberculosis screenings Distribute brochures on measures to avoid pesticide exposure Ask a physical therapist to speak about managing low back pain
Distribute brochures on measures to avoid pesticide exposure
An older adult client visits the community health clinic and reports the onset of pain, redness and swelling of the right eye. Which question is most important for the clinic nurse to ask the client? Do you have any discharge from the eye Have you started any new prescriptions Are all of your immunizations current How often do you wash your hands
Do you have any discharge from the eye
The school nurse is conducting an audit of incident reports for adolescent students. Which finding is the best indication that the healthy people 2020 objectives are being addressed? The absenteeism rate has increased greatly over the past two years During the last year fewer firearms were retrieved on school property The number of requests for pregnancy testing is higher than last year Decline in the number of the students enrolled in school during the year
During the last year fewer firearms were retrieved on school property
The nurse is working with the family of a child with cerebral palsy. In order to help the nurse understand the connections among family members, resources and agencies in the community with assessment data gathering tool is best for the nurse to use? Genogram Ecomap Medical record Family tree
Ecomap
A male migrant farm worker who lives in a mobile home with several other workers visits the migrant health care center. He reports increasing episodes of dizziness headaches abdominal cramps and difficulty breathing what nursing action has the highest priority? Gather information about clients recent exposure to pesticides Obtain a blood sample to assess for lead paint exposure Determine the number and age of persons living in the mobile home Ask about the length of his workday and frequency of rest breaks
Gather information about clients recent exposure to pesticides
The nurse is documenting the medical history of a young adult male client who was recently diagnosed with type 1 diabetes mellitus. He smokes 2 packs of cigarettes daily and his father died of a heart attack at the age of 45. Which annual screening is most important for the nurse include? Peripheral neuropathy Retinopathy Renal insufficiency Hyperlipidemia
Hyperlipidemia
The public health nurse is working in an agriculture based community near the united states mexico border. Which aggregate should the nurse identify as the highest need for local public health services Migrant workers who plant and harvest field crops School aged children who are not bilingual Elderly population in the community who are on fixed incomes Adolescents who are exposed to intense sun and hot environments
Migrant workers who plant and harvest field crops
The home health nurse is evaluating client who is receiving enteral feedings by nasogastric NG tube. Which assessment finding indicates to the nurse that a change to the clients nutrition may be warranted for this client? Ulceration of .5 cm at left nares ng tube insertion site Intestinal migration of ng tube verified by aspirate ph of 7.1 Residual volume of 25 ml after each scheduled feeding Nausea occurs after each instillation of ng feeding
Nausea occurs after each instillation of ng feeding
when visiting a community health clinic a clients blood pressure is measured at 146/94. What information should the nurse provide the client: Participate in an exercise program for six weeks Obtain a blood pressure daily for two weeks Increase dietary intake of omega 3 Begin a low sodium diet immediately
Obtain a blood pressure daily for two weeks
The nurse is screening for hypertension at a local health fair. One of the community residents has a blood pressure reading of 138/80. Which interventions should the nurse implement for this client? Select all that apply Obtain another blood pressure to verify the first reading Ask the client about any current antihypertensive medications Recommend further evaluation for possible pre-hypertension Encourage the client to keep doing whatever you are doing Assess clients life style and other risk factors for hypertension
Obtain another blood pressure to verify the first reading Ask the client about any current antihypertensive medications Recommend further evaluation for possible pre-hypertension
A graduate nursing student requests information, including laboratory findings and chest x-ray results, about all clients with symptoms of h1n1 who have been seen during the last month in a community health clinic. Which action should the charge nurse take? Ask if permission has been obtained from the research committee Ask the student to sign a standard waiver form Obtain written authorization from clients to release the information Provide the information for research purposes only
Obtain written authorization from clients to release the information
A 4-year old near drowning victim who is severely disabled due to anoxia that occurred during the incident is being transferred to a long term care facility. When helping the parents select a treatment center for their child, which factor should the nurse encourage the parents to consider? Proximity of the facility to their home How many children are residents of the facility What type of home schooling is available at the facility Availability of medical care for emergencies
Proximity of the facility to their home
During a home health visit the nurse notices that an older male client with type 2 diabetes mellitus is wearing loose cloth slippers. The client reports that he cannot comfortably wear other shoes because his toenails get in the way. The nurse inspects the clients feet and finds long thick nails that curl down under some of the toes. Which action should the nurse take? Demonstrate proper foot care to the client and his family Have a home health aide assist client with hygiene weekly Schedule an appointment for the client with podiatrist Trim the clients toenails gradually over several visits
Schedule an appointment for the client with podiatrist
A young, divorced mother is attempting to get a job to support her two children. The children's father is unreliable with child support. She is using a program to help her with educational preparation for a job and providing a monthly stipend. This program is most likely which one of the following? TANF Medicaid SCHIP WIC
TANF
A teenage boy with a history of recurring atopic dermatitis tells the school nurse that he wants to play high school football. Which action should the nurse take Encourage the teenager to join the swim team instead of the football team Notify the parents of the problems associated with perspiration for those with eczema Tell the teenager to shower with a non perfumed soaps immediately after practice Inform the football coach of the teenagers skin condition and its manifestations
Tell the teenager to shower with a non perfumed soaps immediately after practice
The community health nurse determines that the average family income of a certain community is 67k per a year with a range of 27k to 102k based on this demographic information what additional information is important for the nurse to assess? Interventions focused on college educated individuals Characteristics of families in the upper middle class The frequency of incomes about and below the average The reliability of such a high average family income
The frequency of incomes about and below the average
In reviewing the objectives for Healthy people 2020 the nurse determines that the community has a significant problem in preventing dental caries among children to bring about change that addresses this identified community health problem. Where is the best place to initiate a prevention program Community youth center Hospital emergency departments The local shopping mall Women infant and children office
Women infant and children office
During a home visit, the nurse observes an elderly client with diabetes. Which action should the nurse take first? a. Check the client for lacerations or fractures b. Assess the client's blood sugar level c. Give the client 4 ounces of orange juice d. Call 911 to summon emergency assistance
a. Check the client for lacerations or fractures Question may have more info....
During a home visit, the nurse observes an older client who is attempting to ambulate to the bathroom and notes that the client is unsteady and holds on to furniture while refusing any assistance. Which action should the nurse implement? a. Determine home navigational safety hazards. b. Maintain the client's privacy while in the bathroom. c. Recommend that the client obtain a walker. d. Encourage the client to obtain a medical alert device.
a. Determine home navigational safety hazards.
When planning a scoliosis screening clinic, it is most important for the nurse to include which age group? a. Early adolescent girls b. Preschoolers of both genders c. Late adolescent boys d. Seven to ten-year-old boys
a. Early adolescent girls The nurse should include screening for scoliosis during the pre-adolescence/adolescence age group: for girls in grades 5 through 7 and for boys in grade 8 or 9.
A homeless client with alcohol dependency will be dismissed from the emergency department in 24 hours. The nurse notes that a tuberculin skin test was prescribed by the healthcare provider. What intervention is most important for the nurse to implement prior to discharge? a. Identify how the client will follow-up to have the results read. b. Give the client written information about the tuberculosis test c. Determine if the client understands the purpose of the tuberculin test d. Explain to the client results should be read between 48 and 72 hours
a. Identify how the client will follow-up to have the results read.
A client arrives to the clinic for an annual physical exam and the nurse inquires about the client's influenza status. The client responds, " I never get the vaccine because I don't get the flu." Which construct of the health belief model should the nurse identify the client is demonstrating? a. Perceived susceptibility b. Perceived barriers c. Perceived severity d. Perceived benefits
a. Perceived susceptibility
The community health nurse notes that a mother who frequently brings her children to the clinic for immunization has facial bruising, particularly around her eyes. What action should the nurse take first? a. Question the mother about the bruises without her children present b. Report the physical findings of suspected abuse to the local police c. Provide mother with information related to domestic violence d. Document possible spousal abuse in children's medical record
a. Question the mother about the bruises without her children present
The city health department director asks the community health nurse to make a presentation describing the greatest health concern facing the city. How should the nurse begin to collect the data needed for this presentation? a. Review morbidity data for the city's population compiled by the Bureau of Vital Statistics. b. Conduct a random telephone survey to determine the public's perception about health problems. c. Survey major hospitals in the area to determine the most common reasons for admissions. d. Call American Medical Association members to determine the most frequently treated diagnoses.
a. Review morbidity data for the city's population compiled by the Bureau of Vital Statistics. The nurse should begin to collect the data needed for this presentation by reviewing morbidity data for the city's population compiled by the Bureau of Vital Statistics. This will give the nurse an overview of the most common health concerns in the city. The nurse can then use this information to develop a presentation that will address the most pressing health concerns facing the city.
The nurse must delegate some aspects of a homebound client's care to a home health aide. Which intervention should the nurse delegate to the home health aide? a. Evaluate a pressure sore b. Apply a prosthetic device c. Perform a sterile dressing change d. Assess the client's need for an elevated toilet seat
b. Apply a prosthetic device
A home health nurse is reviewing the laboratory results for several clients with a history of heart failure (HF). Which client finding should the nurse report to the healthcare provider immediately? a. Total cholesterol 190 mg/dl. b. B-type natriuretic peptide 550 pg/ml. c. Glycosylated Hemoglobin of 7% d. Potassium 3.7 mEq/L
b. B-type natriuretic peptide 550 pg/ml.
Because of an increased number of falls among clients in a long term care facility, the nurse develops a six month falls prevention program. The program includes a mandatory continuing education class for staff on falls prevention and client education about the proper use of walkers. Which measurement provides the best indication of the program's effectiveness? a. Correlate the client's use of walkers with their age, gender, and condition. b. Compare the incidence of falls at the beginning and at the end of the program. c. Assess staff knowledge of fall prevention strategies during continuing education classes d. Determine difference in walking ability between clients who fall and those who do not fall.
b. Compare the incidence of falls at the beginning and at the end of the program.
A community health nurse is helping a group of nursing students plan a tertiary prevention program for a local community clinic that serves a majority Hispanic population. Which service project meets the requirement of a tertiary prevention program and would best serve this population? a. Teach clients about recommended immunizations for children. b. Demonstrate foot care to a group of clients who have diabetes. c. Take blood pressures at a local shopping mall in the community. d. Instruct teens about prevention of sexually transmitted diseases
b. Demonstrate foot care to a group of clients who have diabetes.
The nurse is caring for a client with the sexually transmitted infection (STI) trichomoniasis. The client reports having unprotected sex. Which response should the nurse provide? a. Inform the client that complications will not result from the infection b. Explain that prolonged therapy and treatment may be needed c. Notify that persons with STIs are reported to local health departments d. Provide counseling that most contraceptive protect against infection
b. Explain that prolonged therapy and treatment may be needed
A nurse has started a group for senior citizens in a church setting. The group decides that their first project will be to begin a program for home-bound members. Which program outcome is the best measure of the project's effectiveness? a. Average annual income for the home bound members b. Number of home-bound seniors who are visited c. Calls received showing interest in the program d. Number of church members who are over 65
b. Number of home-bound seniors who are visited
1. The nurse is making a home visit to female client with end stage heart disease. She has a living will and states that she refuse to ever go back to a hospital. During the visit, the nurse notes that the client is pale and short of breath while speaking. The nurse discovers 3+ pitting edema in both ankles and bilateral pulmonary crackles. Which intervention should the nurse implement first? a. Explain the need for hospitalization b. Obtain a peripheral oxygen saturation level c. Elevate her feet above the level of her heart d. Apply 2L of oxygen per nasal cannula
b. Obtain a peripheral oxygen saturation level
Despite repeated instructions, an 80-year-old client with Parkinson's disease is unable to instill ophthalmic medication without assistance because of hand tremors. What action is best for the nurse to take? a. Document the client's inability to instill the medication without assistance b. Continue to reinforce the instructions to enhance the client's self-confidence c. Determine if a family member is available and willing to instill the medication d. Obtain a prescription for a visiting nurse to instill the medication twice a day
c. Determine if a family member is available and willing to instill the medication
A client with a history of chronic obstructive pulmonary disease (COPD) is being treated at home for pneumonia and is currently receiving oxygen at 2 L/nasal cannula. The spouse, who is the caregiver, reports that the client requires assistance when ambulating short distances including going to the bathroom. Which suggestion should the home health care nurse provide to the caregiver? a. Disconnect oxygen when assisting her to bathroom b. Ask for additional assistance to reduce risk of falls. c. Suggest obtaining a bedside commode for toileting. d. Administer a breathing treatment prior to ambulation
c. Suggest obtaining a bedside commode for toileting.
Following a blizzard that resulted in millions of dollars of damage, the community health nurse is planning to seek financial assistance for families affected by the disaster. Which contact is most important for the nurse to make? a. The governor's disaster relief program b. Local churches that can provide shelter c. The media to seek volunteer contributions d. Federal Emergency Management Agency
d. Federal Emergency Management Agency The Federal Emergency Management Agency (FEMA) is the best resources for financial assistance responsible for responding to and managing incidents of national significance, including natural disasters like blizzard. FEMA provides grants and low-interest loans to help individuals and families recover from disasters. The agency also provides resources and information on how to prepare for future disasters. The community health nurse should contact FEMA to learn more about what assistance is available to families affected by the blizzard. FEMA provides financial assistance to families who have been affected by natural disasters. The agency can provide financial assistance for repairs, temporary housing, and other needs. FEMA also provides information about disaster relief programs and can help connect families with resources.
The school nurse is facilitating a health care fair at an elementary school. A male student tells the nurse that he has itchy circles on his lower legs. Which Skin assessment finding warrants the most immediate intervention by the nurse? a. Patches of round lesions on both lower legs. b. Several limited circular bald, flaky scalp patches c. Red ring-shaped lesions with normal skin in the center d. Itchy red, scaly patches with blisters that are draining
d. Itchy red, scaly patches with blisters that are draining
The community health nurse notes that several clients with influenza characterized by unremitting vomiting and diarrhea has occurred over the past week among all age groups in a certain geographic area. Which action is most important for the nurse to take? a. Have the drinking water tested for Salmonella b. Review the food intake history of all those affected c. Determine how many people in each family are affected d. Report the incidence to the Center for Disease Control
d. Report the incidence to the Center for Disease Control
