community health ATI

A nurse is developing an educational program about bioterrorism and smallpox. The nurse should include the teaching that the smallpox rash is expected to first appear in which of the following locations? a. face b. posterior shoulders c. abdomen d. lower extremities

answer: A

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? a. biological b. behavioral c. social d. economic

answer: A A family genogram tracks the incidence of disease over multiple generations of a family and will identify biological risk factors.

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? a. Administer antiviral medication to clients at the facility. b. Schedule immunizations for clients at the facility. c. Recommend that the day care center close for 2 weeks. d. Give immune globulin to clients at the facility who have early manifestations of influenza.

answer: A Antiviral medications are administered to individuals who have been exposed to influenza type A to provide immediate protection and to help prevent an outbreak.

A nurse in a clinic is caring for a client who reports taking ginkgo biloba for several weeks after seeing a naturopathic healer. The nurse should instruct the client that ginkgo biloba can alter the effects of which of the following medications? a. warfarin b. metoprolol c. digoxin d. diltiazem

answer: A Ginkgo biloba can hinder coagulation. Therefore, the nurse should instruct the client that ginkgo biloba can alter the effects of warfarin.

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? a. Turn the client to left semi-Fowler's position and begin assessing the next client. b. Place a firm pressure dressing to the occiput and open the airway. c. Apply a cervical spine collar and perform a focused neurological exam. d. Request that the client be assessed immediately by the next available provider.

answer: A 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.

A nurse at a county health clinic is caring for a client who has recently assumed the role of primary caregiver for their parent. Which of the following statements by the client indicates that she is experiencing role conflict? a. "I feel overwhelmed with not having enough time for my mom as well as my children." b. "I hope my siblings will be able to visit and help care for mom for a few days." c. "I am glad that my job is flexible, so I can accommodate my mom's needs." d. "I don't think my partner likes having to help more with the household chores."

answer: A 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.

A community health nurse is planning to establish a community garden to introduce nutritious food options in the area. Which of the following actions should the nurse take first to initiate the plan? a. Identify community members who demonstrate an interest in the project. b. Hold a community information session to inform the residents of the plan. c. Select residents to take on leadership roles in the project. d. Monitor the progress of the project to keep the project on course.

answer: A 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.

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? a. Ask the child to pretend to blow up a balloon during the injection b. Reassure the child that the injection is not going to hurt c. Ask the child's parent to leave the room during the injection. d. Request that the child count backwards from the number 10 during the injection

answer: A 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.

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? a. Make the hospice referral in accordance with the client's decision b. Verify that the client's health insurance pays for hospice services. c. Recommend a second opinion from another provider. d. Assess whether or not the family agrees with the client's decision

answer: A The nurse should follow the ethical principle of respect for client autonomy and make the hospice referral for the client.

A school nurse is conducting visual acuity testing for a school-aged child using a Snellen letter chart. Which of the following actions should the nurse take? a. Allow the child to keep her glasses on during the testing. b. Have the child stand 5 feet away from the Snellen letter chart. c. Progress to the next line once the child reads two symbols correctly. d. Begin the test by instructing the child to use both eyes to read the chart.

answer: A 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.

An occupational health nurse is planning to use an interpreter during an educational session with a group of workers who speak a different language than the nurse. Which of the following actions should the nurse take? a. Instruct the interpreter to guide the nurse in providing information in a culturally-sensitive manner. b. Ask the interpreter to add information she feels might be necessary. c. Choose an interpreter who speaks the workers' language and dialect. d. Evaluate the interpreter's approach to clients prior to the educational session. e. Encourage the interpreter to paraphrase the workers' questions and responses.

answer: A, C, D

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.) a. Provide environmental health information. b. Refer the client for a tuberculosis screening. c. Provide skin cancer information. d. Recommend a dental health screening. e. Provide forms to apply for Medicare.

answer: A,B,C,D

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? a. "Respiratory syncytial virus is spread through contact with respiratory secretions from an infected person." b. "Rotavirus infections in children peak during the summer months." c. "Children who have fifth disease will exhibit bloody diarrhea." d. "Antiviral medications shorten the duration of a shigella infection."

answer: A\The nurse should include this statement in the presentation because 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.

A public health nurse is conducting an educational session about Lyme disease for a group of older adult clients. Which of the following statements should the nurse identify as an indication that the clients understand the teaching? a. "I should get an annual immunization to prevent Lyme disease." b. "I can take penicillin for 10 to 14 days to manage Lyme disease." c. "I can get Lyme disease from a mosquito bite." d. "I will have abdominal pain and diarrhea if I get Lyme disease."

answer: B 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. A client who has Lyme disease can have a lesion from a tick bite with mild influenza-like manifestations, such as fever, fatigue, and malaise. A client who has Escherichia coli is more likely to have abdominal pain and diarrhea.

A nurse is conducting a home visit with a client who reports a history of partner violence. The nurse should identify that which of the following finings places the client at greatest risk for partner violence? a. client is 13 weeks gestation b. client states they are leaving their partner c. client recently started a job d. client visits friends without the partner's knowledge

answer: B A client's decision to leave their partner places them at greatest risk for partner violence because the perpetrator can view the client 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.

A community health nurse is teaching a group of clients about environmental health hazards. Which of the following examples should the nurse include as a possible source of carbon monoxide exposure? a. washing machines b. gas ranges c. air conditioners d. electric space heaters

answer: B Carbon monoxide is an odorless, colorless, tasteless gas that is emitted into the air. Gas ranges, motor vehicles, and fire places are potential sources for carbon monoxide exposure.

A community health nurse is working with a community where the incidence of violence has increased. Which of the following actions should the nurse take as a tertiary prevention strategy? a. Provide open education sessions to teach parenting skills. b. Provide victims of violence with referral information to crisis lines. c. Identify potential community risk factors for violence. d. Assess for evidence of violence during routine encounters.

answer: B Referring victims of violence to available community resources is a tertiary prevention strategy. The community health nurse should be aware of all available community resources.

A community health nurse is planning a health education program for adults. The nurse should plan to take which of the following actions during the program? a. Use medical terminology throughout the presentation. b. Provide take-home materials written at a 6th-grade level. c. Extend the presentation to include as much information as possible. d. Avoid the use of technology to display images and videos.

answer: B The American Medical Association and the National Institutes of Health recommend that take-home documents are written at a 6th- to 8th-grade level or lower to promote client understanding of the provided material.

A nurse is teaching a client who has a new diagnosis of hepatitis A about how to prevent the spread of the virus. Which of the following instructions should the nurse include? a. "Double-bag tissues used for coughing or blowing the nose." b. "Clean your bathroom fixtures with a chlorine bleach solution." c. "Use shared hand towels to dry your hands after washing." d. "Use barrier contraceptives during sexual contact for 2 weeks after beginning treatment."

answer: B The client should clean 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.

A school nurse is teaching health promotion to a group of staff members who sit at a desk and use a computer for 8 hours at a time. Which of the following information is a porosity for the nurse to induced? a. take a walk after work b. point and flex your toes periodically c. have your visual acuity assessed regularly d. adjust your chair so that your elbows are at desk height

answer: B 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. All others are correct but not a priority

A nurse in an emergency department is caring for a client who is homeless and has hypothermia. Which of the following actions should the nurse take? a. Notify the local law enforcement agency of the client's situation. b. Initiate a referral to the facility's social worker. c. Ask the client why they did not seek shelter sooner. d. Tell the client everything will work out now that they are in the hospital.

answer: B The nurse should refer the client to the facility's social worker or to an agency that can assist the client with finding housing.

A nurse is performing a home visit for a client who has TB. As the nurse is leaving the client's house, a neighbor asks, "Is it true my neighbor has TB?" Which of the following responses should the nurse make? a. "You should ask the public health department." b. "Do you have questions about tuberculosis?" c. "Have you ever been tested for tuberculosis?" d. "You should take precautions against this infection."

answer: B This response addresses the neighbor's concerns while protecting the client's confidentiality.

A case manager at a home health agency is obtaining equipment for a client's home use. Which of the following actions is a violation of client confidentiality? a. The case manager used a computer at the agency with an automatic sign-off mechanism. b. The case manager left a clipboard with the client's prescription information face up on the office desk. c. The case manager sent a fax to the equipment company on a machine using programmed speed dial. d. The case manager shared the client's name with the equipment company.

answer: B When using a clipboard, the case manager should place the clipboard on the desk face down so that a client's personal health information is not visible to other individuals.

A school nurse is conducting health screening procedures in an elementary school. Which of the following instructions should she prcvide when performing the Rinne test? a. "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." b. "Use your finger to close one ear while I whisper some numbers into your other ear." c. "After I place this tuning fork behind your ear, tell me when you no longer hear the sound." d. "You'll wear headphones and press the button when you hear a sound."

answer: C A is a weber test, B is a whisper test, D is a audiometry test.

A community health nurse is working with a group of clients in a rural community who are unable to afford health insurance. Which of the following actions is the best for the nurse to take to advocate for these clients? a. Encourage the clients to form various exercise groups based on community interest. b. Perform weekly blood pressure screenings at the community center. c. Work with local health care practitioners to establish a free clinic. d. Provide for guaiac stool testing for clients who have a family history of colon cancer.

answer: C According to evidence-based practice, the nurse should work with local health care practitioners to establish a free clinic in the rural community. The nurse should advocate for comprehensive care for this client population to address the need for an affordable health care option, which will allow clients who do not have health insurance to access a variety of primary, secondary, and tertiary services in one location.

A home health nurse is reviewing several client requests regarding complementary strategies. The nurse should identify that which of the following alternative therapies is contraindicated for a client? a. Hippotherapy for a school-age child who has cerebral palsy b. Acupressure therapy for a client who has back pain c. Kava for a client who has cirrhosis d. Valerian for a client who has anxiety and insomnia

answer: C Although kava has been used to promote sleep, it can cause severe liver damage, which can lead to the need for a liver transplant. Using kava could worsen the condition of a client who has cirrhosis. Therefore, the nurse should plan to discuss safer alternatives with the client.

A nurse is giving a presentation about family violence at a local community center. Which of the following information should the nurse include? a. Socially active parents and guardians are at greater risk for becoming violent. b. Partner violence occurs more frequently in lower socioeconomic households. c. Child maltreatment is more common in homes where partner violence is present. d. Children who are abused are less likely to become abusers.

answer: C Child maltreatment is very common in homes where partner violence is present.

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? a. "If I begin palliative care, I will have to stop my chemotherapy." b. "I can begin palliative care when I have less than 6 months to live." c. "This type of care can help me with pain control." d. "My family will not be involved with this type of care program."

answer: C 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.

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? a. Consume a low-carbohydrate diet until symptoms resolve b. Schedule an appointment for an immunoglobulin injection. c. Abstain from sexual intercourse until antibody tests are negative. d. Wear a mask in public places while receiving treatment.

answer: C Hepatitis C is transmitted through sexual intercourse. Therefore, the nurse should instruct the client to abstain from sexual intercourse until antibody tests are negative. Postexposure prophylaxis is available for hepatitis A, not hepatitis C.

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? a. Household members should be placed in respiratory isolation. b. Wear a mask in the home. c. Household members should take isoniazid for at least 6 months. d. Have a repeat Mantoux test in 3 months.

answer: C The household members of a client who has active pulmonary tuberculosis are at risk for developing the disease. Therefore, taking isoniazid prophylactically for at least 6 months is recommended.

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 friend died last year." Which of the following responses should the nurse take? a. "It sounds like you are probably an alcoholic." b. "Don't you think your family is being affected by your drinking?" c. "Can I give you some information about Alcoholics Anonymous?" d. "I don't think your friend would have approved of your drinking."

answer: C 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.

A home care nurse is visiting an older adult 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? A. "Why haven't you brought in your newspapers?" B."Do you need help completing your housework?" C."How often do you have visitors come to see you?" D."Have you considered moving to an assisted living facility?"

answer: C 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.

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? a. Health surveys b. medical recorders c. informant interviews d. morbidity/mortality statistics

answer: C The nurse should identify that informant interviews with community members or leaders will provide direct data. This information can help the nurse identify services needed by the community.

A case manager is planning an educational program fora. client who has diabetes mellitus. Which of the following activities should the nurse include while using the psychomotor domain of learning? a. review a color diagram of the food pyramid with the client b. show the client a video about how to monitor blood glucose levels c. observe the client's technique for drawing up insulin d. encourage the client to discuss their feelings of self worth

answer: C 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. A is cognitive domain, B is cognitive domain, and D is affective domain

A school nurse is serving on a community disaster planning committee looking at school shooting scenarios.Which of the following actions should the nurse plan to take during the response please? a. Conduct ongoing assessments to identify potential hazards b. Provide disaster training to school personnel. c. Perform triage and provide hands-on care as needed to victims. d. Serve as a liaison between available community resources and those in need.

answer: C During the response phase of disaster planning, the school nurse's role can include triage, providing hands-on care, coordinating the first-aid response team, and serving as a counselor to those in need.

A case manager is developing a plan for a client who has a spinal cord injury and in a rehab facility. Which of the actions should the nurse take first? a. Hold a care conference with the client to discuss treatment options b. Contact service providers to determine the availability of services offered. c. Determine the client's ability to perform self-care d. Evaluate the client's satisfaction with the case manager's services.

answer: C 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 which allows the case manager to plan client-centered care.

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? a. The faith community nurse can provide pharmacological pain management for clients who have a terminal illness. b. The faith community nurse can plan workplace safety training for employees in a local factory. c. The faith community nurse can provide wound care for clients in their homes. d. The faith community nurse can facilitate substance abuse support groups.

answer: D

A community health nurse is planning to develop a community health program. Which of the following actions should the nurse take first? a. review literature b. develop a budget c. obtain resources d. determine the need

answer: D

A community health nurse is planning an educational program for farmers about occupational health risks. Which of the following risks should the nurse include? a. HTN b. diabetes mellitus c. cardiomyopathy d. respiratory disorders

answer: D 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.

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. A client who is traveling to northern Europe B. An infant who has bronchiolitis C. An infant who is 4 weeks old D. A client who is moving into a college dormitory

answer: D 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? a. "I will not have to completely stop drinking alcohol if I go into an inpatient treatment program." b. "Once I make it through detoxification, I will be free of my addiction." c. "I am not eligible for an outpatient program until I have completed an inpatient program first." d. "I can expect to get help with other aspects of my life while in treatment."

answer: D Successful treatment of alcohol use disorder is more likely if the client receives help in other areas of their life, such as their physical health, psychological well-being, and family interactions. Treatment for alcohol use disorder requires complete abstinence.

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? a. Provide education about risk factors for hypertension. b. Conduct a hypertension screening clinic for the community. c. Teach clients who have a family history of hypertension how to monitor blood pressure. d. Implement an exercise program for clients who have hypertension.

answer: D 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.

A home health nurse is caring for a client who is immunocompromised due to chemotherapy. Which of the following statements should they make regarding food safety? a. "Eat any leftovers within one week of preparation." b. "Keep the inside of your refrigerator at 47 degrees Fahrenheit or below." c. "Beef is the only meat that is acceptable to eat with a pink center." d. "Frozen food should be cooked immediately after it is thawed."

answer: D The nurse should inform the client that frozen food should be thawed in a bowl in the refrigerator and should be cooked as soon as it is thawed.

A community health nurse is conducting a program regarding crime reduction strategies for older adult clients at the senior center. Which of the following statements indicates an understanding of the information a. "When I am in my car, I will keep my personal items on the seat beside me." b. "When I open my front door, I will ask for identification if the person is someone I do not know." c. "I should store my purchases in the back seat when I am out shopping." d. "I should remove the identification tag that is on my key ring."

answer: D The nurse should inform the clients to remove any identification tag on their key ring. If keys are lost along with identifying information, then the client is left vulnerable to home invasions.

A school nurse is revising the records of four students who are returning to school after being diagnosed with MRSA. Which of the following actions should the nurse take? a. Coordinate an immunization clinic at the school. b. Recommend prophylactic treatment for classmates. c. Report the cases of MRSA to child protective services. d. Provide education about MRSA throughout the school system.

answer: D The nurse should provide education about hand hygiene and self-care to help prevent the spread of MRSA throughout the school and community.

A school nurse is discussing levels of prevention with a teacher. Which of the following activities Sheila nurse identify as primary prevention strategy? a. Provide nutritional counseling for students who have diabetes. b. Report suspected child neglect to the proper authorities. c. Conduct vision and hearing screening for kindergarten enrollment. d. Demonstrate proper handwashing techniques.

answer: D This is an example of primary prevention, the goal of which is to promote health and prevent diseases from developing.

A public health nurse is planning an educational program for a group of nurses at a community health department about pertussis. Which of the following formation should the nurse include? a. Individuals should receive an annual influenza vaccine to minimize the risk for infection with pertussis. b. Newborns should receive the first dose of the diphtheria, tetanus, and acellular pertussis (DTaP) vaccine prior to discharge from the hospital. c. Individuals who have had pertussis do not require immunization. d. Individuals transmit the pertussis bacteria through airborne droplets

answer: D Transmission occurs when an individual who has an infection with Bordetella pertussis coughs. 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.

A home health nurse is planning care for the day. Which of the following clients should the nurse visit first? a. An older adult client who was treated in the emergency department last night for a stage 3 pressure injury b. A school-age child who was treated in the emergency department last night for status asthmaticus c. An older adult client who has a newly prescribed antihypertensive medication and needs a BP check d. A school-age child whose percutaneous endoscopic gastrostomy (PEG) tube needs changing

anwer: B 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. The client's status can change rapidly, and, at times, intensive care monitoring is required. Therefore, the nurse should visit this client first.