CH Focused Review
A nurse in an oncology clinic is caring for a client who is undergoing treatment for cancer and reports difficulty eating due to inability to taste food. Which of the following interventions should the nurse recommend? 1 avoid citrus juices 2 use plastic utensils to eat 3 eat foods that are warm 4 increase foods high in pectin
2 plastic utensils when eating can enhance taste sensations for the client undergoing cancer treatment and reduce the occurrence of a metallic taste NOT 1 add tart to foods, such as citrus, to the diet to increase food taste and reduce the occurrence of metallic taste 3 eating cold or room temp foods improve taste sensations 4 adding pectin rich foods the increase bulk of the store in lengthen transition time in the colon
You are teaching a client who was recently diagnosed with active pulmonary TB about disease transmission. Which of the following information should you include? 1 Household members should be placed in respiratory isolation. 2 Wear a mask in the home. 3 Household members should take isoniazid for at least 6 months. 4 Have a repeat Mantoux test in 3 months.
3 The household members of a client who has active pulmonary TB are at risk for developing the disease. Therefore, taking isoniazid prophylactically for at least 6 months is recommended. NOT 1 Respiratory isolation is not necessary for the household members of a client who has active pulmonary TB. 2 It is not necessary for a client who has active pulmonary TB to wear a mask in the home setting. 4 A client who has active pulmonary TB should receive a chest x-ray for future screenings (NOT Mantoux test).
Tasks nurses can delegate to assistive personnel (AP)
ADLs Bathing Grooming Dressing Toileting Ambulating Feeding (without swallowing precautions) Positioning Routine tasks Specimen collection I & Os Vital signs (for stable clients)
Clonidine MOA, nursing consideration, and side effects
Alpha 2 agonist - Reduce sympathetic outflow from CNS Take baseline vitals before administration When using for substance abuse withdrawal, they can help with the withdrawal effects related to autonomic hyperactivity (increased BP, HR, diarrhea, etc.) Dry mouth, sedation, hypotension, constipation
You are preparing to assess an infant. Which of the following is an expected findings of shaken baby syndrome? (sata) 1 sunken fontanelles 2 respiratory distress 3 retinal hemorrhage 4 altered LOC 5 increase in head circumference
Answer: 2,3,4,5 Incorrect: 1 - bulging, rather than sunken, fontanelles are an expected findings
Acamprosate
Decreases unpleasant effects resulting from abstinence like dysphoria, anxiety, restlessness
Naltrexone is administered to ...
To assist the client in maintaining abstinence from ETOH or opioid withdrawal
Vehicle-borne transmission
Transport of an infectious agent into a susceptible host via any intermediate substance (e.g., fomites or food)
Amantidine, rimantidine, and ribivarin
Tx for influenza
Which of the following findings are considered atypical indications of infection when assessing an older client? (Select all that apply) 1 urinary incontinence 2 malaise 3 acute confusion 4 fever 5 agitation
answer: 1, 3, 5 incorrect: 2, 4 (typical)
Erythema infectiosum: Transmission
Erythema infectiosum (aka 5th disease) is a contagious illness that is transmitted via respiratory secretions and blood. Clinical manifestations include a rash that gives the client a slapped-face appearance that progresses from the face down to the body. Other manifestations include fever, myalgia, nausea, vomiting, and lethargy
MRSA mode of transmission
MRSA is usually spread in the community by contact with infected people or things that are carrying the bacteria. This includes through contact with a contaminated wound or by sharing personal items, such as towels or razors, that have touched infected skin. Prophylactic treatment is NOT available for MRSA.
TB expected findings
Persistent cough lasting > 3 weeks Purulent sputum, possibly blood-streaked Weight loss and anorexia Night sweats and low-grade fever in the afternoon Fatigue & lethargy
Inflammitory response (Nonspecific Innate)
Phagocytic cells, (neutrophile, eosinophils, macrophages), the complement system,
Direct factor Xa inhibitors
Rivaroxaban, Apixaban, and fondaparinux and directly with the active center of factor XA, which inhibits the production of thrombin.
Rotavirus: Transmission
Rotavirus is a contagious illness that is transmitted via the fecal-oral route or by the person-to-person route. It causes a gastrointestinal infection and is the number one cause of diarrhea-associated hospital admissions in children. Manifestations of rotavirus include fever and vomiting followed by watery diarrhea.
Scarlet fever: Transmission
Scarlet fever is a contagious illness that is transmitted via direct contact with an individual who is infected or indirect contact with contaminated objects. (not included on the Nationally Notifiable Infectious Conditions list)
Categories of triage during mass casualty events: Class II
Second highest priority is given to clients who have major injuries that are not yet life-threatening and can usually wait 30 min to 2 hours for treatment
Agonal respirations are:
Slow, shallow, irregular respirations or occasional gasping breaths; sometimes seen in dying patients. Can indicate a minimal chance of survival.
TMV
TB Measles Varicella Airborne precautions
Collecting TB samples
obtain 3 early morning samples obtained in negative air pressured room wear PPE
PE Nursing Care
- Administer oxygen therapy to relieve hypoxemia and dyspnea - High Fowler's = 90 degrees (maximizes ventilation) - initiate and maintain IV access - administer medication as prescribed - assess respiratory status at least every 30 minutes (Aspartame lungs, measure rate/rhythm/ease of respirations, inspect skin color and cap refill, examined for a position of trachea) - assess cardiac status (compare BP in both arms, palpate pulse quality, check for dysrhythmias on ECG, examined for distended neck veins, inspect the thorax for petechiae) - right emotional support and comfort to control client anxiety - Monitor changes in LOC and mental status
Nursing care for Influenza (precautions & monotoring)
- Maintain droplet and contact precautions for hospitalized clients who have pandemic influenza - Provide saline gargles - Administer fluid therapy as prescribed - Monitor hydration status, intake, and output - Monitor respiratory status
To obtain information regarding behavioral risks, including personal and family health habits, the nurse should conduct a ...
... a lifestyle risk assessment.
To obtain information regarding economic risks, including the relationship between family resources and the demand for those resources, the nurse should conduct an ...
... environmental risk assessment.
To obtain information regarding social risks, including living in a high-stress environment like a high-crime neighborhood, the nurse should conduct an ...
... environmental risk assessment.
1 "Respiratory syncytial virus is spread through contact with respiratory secretions from an infected person." 2 "Rotavirus infections in children peak during the summer months." 3 "Children who have fifth disease will exhibit bloody diarrhea." 4 "Antiviral medications shorten the duration of a shigella infection."
1 (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. NOT 2 Rotavirus infections in children peak during the WINTER months of the year. Manifestations of rotavirus include fever and vomiting followed by watery diarrhea. 3 Diarrhea is NOT an expected manifestation of fifth disease, also called erythema infectiosum. Clinical manifestations include a rash that gives the client a slapped-face appearance that progresses from the face down to the body. Other manifestations include fever, myalgia, nausea, vomiting, and lethargy. 4 ATB shorten the length of a shigella infection and decrease mortality rates. Manifestations of shigella include fever and anorexia followed by watery or bloody diarrhea.
A community health nurse has been contacted regarding a client diagnosis of influenza type A in an adult take care. Which of the following actions should you take to assist in the prevention of an outbreak? 1 Administer antiviral medication to clients at the facility. 2 Schedule immunizations for clients at the facility. 3 Recommend that the day care center close for 2 weeks. 4 Give immune globulin to clients at the facility who have early manifestations of influenza.
1 Antiviral medications are administered to individuals who have been exposed to influenza type A to provide immediate protection and to help prevent an outbreak. NOT 2 Immunizations do not provide IMMEDIATE protection and, therefore, will NOT be effective in preventing an outbreak. The efficacy of the vaccine is also dependent on the strain of influenza used to produce it. 3 A single client Dx of influenza does not warrant closing the facility. Quarantine and isolation are indicated for pandemic influenza. 4 Immune globulin does NOT prevent or treat influenza and, therefore, will not be effective in preventing an outbreak.
Nurse is caring for a group of clients. Which of the following clients are at risk for PE? 1 client who has a BMI of 30 2 female client who is post menopausal 3 client who has fractured femur 4 a marathon runner 5 client who has chronic atrial fibrillation
1 BMI of 30 is considered obese and has at increased risk for a blood clot 3 a fractured bone, particularly in a long bone such as the femur, increases the risk of fat emboli 5 tribute blood flow in the heart, such as with atrial defibrillation, is an increased risk for a blood clot NOT 2 female who is post menopausal has a decreased estrogen levels. Increased estrogen levels are a risk factor for developing a PE 4 Marathon runners have increased blood flow and circulation of the body, which decreases the risk for developing a PE
You're conducting a follow up visit for a client who was recently discharged from an acute rehabilitation program for alcohol use disorder. Which of the following actions should you take? 1 Tell the client to take naltrexone daily. 2 Instruct the client to take buprenorphine for the next 9 to 12 months. 3 Teach the client to avoid foods that contain tyramine. 4 Schedule transcranial magnetic stimulation (TMS) biweekly.
1 Instruct the client to take naltrexone daily to decrease cravings for alcohol. Naltrexone is prescribed to assist the client with alcohol withdrawal and prevent relapse. NOT 2 Buprenorphine is prescribed for clients who are withdrawing from OPIATES. It is not used for the treatment of alcohol use disorder. 3 Clients who are prescribed MAOIs (for depression) are instructed to avoid foods that contain tyramine. 4 TMS is used for the treatment of depression for clients who did not respond to other treatment interventions.
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 you include? (SATA) 1 Provide environmental health information. 2 Refer the client for a tuberculosis screening. 3 Provide skin cancer information. 4 Recommend a dental health screening. 5 Provide forms to apply for Medicare.
1 Migrant farm workers are at risk for exposure to pesticides and other hazardous materials that could be harmful. Therefore, the nurse should include environmental health information in the client's education. 2 Rates of TB are estimated to be higher among migrant farm workers due to crowded living conditions and substandard housing. Therefore, the nurse should include a tuberculosis screening in the client's education. 3 Due to working outdoors, skin cancer is a health risk for migrant farm workers. Therefore, the nurse should include information about skin cancer in the client's education. 4 Dental problems are a primary health risk for migrant farm workers. Therefore, the nurse should include information about dental health in the client's education. NOT 5 To be eligible for Medicare, individuals must meet an age requirement (> 65) or be permanently disabled (ALS, ESRD). DO NOT not include Medicare information in the client's education.
After doing a vision screening, which of the following statements should you identify as an indication that the client, who has age related macular degeneration, is adapting to the changes? 1 "I have a prescription bottle magnifier to help me read my pill bottle labels." 2 "I canceled all of my magazine subscriptions since I can't read them." 3 "I purchased green towels to use in my bathroom." 4 "I have learned that I cannot to go outside when the sun is bright."
1 The client can obtain a prescription bottle magnifier, or other low-vision optical devices, to assist with reading the labels on prescriptions, which helps the client to remain independent NOT 2 client should obtain large print magazines and other reading materials that have large, dark, and evenly-spaced printing 3 client should obtain brightly colored towels with primary colors at the upper end of the spectrum, such as red and orange, because these are easier for a client who has age-related macular degeneration to see. 4 client should obtain sunglasses that have yellow or amber lenses because they will decrease the glare and allow the client to go outside even when the sun is bright.
When teaching a client who has tobacco use disorder about nicotine replacement therapy, which of the following statements by the client indicates an understanding of the teaching? 1 I should avoid eating right before I chew a piece of nicotine gum 2 I will need to stop using nicotine gum after one year 3 I know that nicotine gum is a safe alternative to smoking if I become pregnant 4 I must to nicotine gum quickly for about 15 minutes
1 client should avoid eating or drinking 15 minutes prior to and while chewing the nicotine gum NOT 2 the client should not use nicotine gum for longer than six months 3 client should avoid all nicotine products, including nicotine gum, while pregnant or during lactation 4 the client should chew the nicotine gum slowly and intermittently for over 30 minutes
You are teaching a community program a nutritional guidelines for cancer prevention. Which of the following instructions free include? (SATA) 1 Foods high in vitamin a 2 add cruciferous vegetables 3 increase intake of red meats 4 use oil high in saturated fat 5 consume refined grains
1 consuming foods high in vitamin a (apricots, carrots, leafy greens) reduces the risk of cancer 2 consuming cruciferous vegetables (broccoli, Brussels sprouts, cabbage, cauliflower, collard greens, kale) reduces the risk of cancer NOT 3 can increase the risk for cancer 4 can increase the risk for cancer 5 Refined grains, in contrast to whole grains, refers to grain products consisting of grains or grain flours that have been significantly modified from their natural composition. can increase the risk for cancer
A nurse at an urban community health agency is developing an education program for city leaders about homelessness. Which of the following groups for the nurse include as the fastest growing segment of the homeless population? 1 families with children 2 adolescent runaways 3 individuals who have experienced spouse or partner violence 4 older adults
1 families with children or the fastest growing segment of the homeless population NOT 2 not the fastest 3 not the fastest 4 not the fastest
Nurse is monitoring a group of clients for increased risk for developing pneumonia. Which of the following client should the nurse expect to be at risk? 1 client with dysphasia 2 client with aids 3 client who is vaccinated for pneumococcus and influenza six months ago 4 client who is post-op and has received local anesthesia 5 client who has a closed head injury and is receiving mechanical ventilation 6 client who has myasthenia gravis
1 find who has difficulty swallowing is at increased risk for pneumonia due to aspiration 2 immunocompromised patients are at increased risk of opportunistic infections, such as pneumonia 5 can you go ventilation is invasive and places the client at risk for VAP 6 client with MG has generalized weakness and can have difficulty clearing airway secretions, which increases the risk of pneumonia NOT 3 client who was recently vaccinated in the past few months has decreased risk to acquire an ammonia 4 postop client who has received LOCAL anesthesia has a decreased risk to acquire an ammonia
The nurse is discussing direct and indirect contact modes of transmission of infection at a staff education session. Which of the following incidents should the nurse include as examples of direct mode of transmission? (Select all that apply) 1 blood spurting from an arterial wound splashes into a nurse is I 2 needlestick injury 3 mosquito bites a hiker gets from the woods 4 you find a hole in your gloves while handling soiled dressing 5 someone fails to wash their hands after using the bathroom and touch as a client
1 transmission from blood to the nurses eyes, nose, or mouth is person to person or direct transmission 5 transmission from contaminated hands to a client is person to person or direct transmission NOT 2 transmission from a needle or other in animate object is INDIRECT transmission 3 transmission from an insect is vector borne (indirect) transmission 4 transmission from a soiled dressing or other in animate object is a vehicle-borne transmission
A nurse is caring for a client who is to receive thrombolytic therapy. Which of the following factors to the nurse recognize as a contraindication of the therapy? 1 hip arthroplasty two weeks ago 2 elevated sedimentation rate 3 incident of exercise induced asthma 1 week ago 4 elevated platelet count
1 undergoing a major surgical procedure within the last three weeks should not receive thrombolytic therapy because of the risk of hemorrhage from a surgical site NOT 2 Not a contraindication 3 Not a contraindication 4 Not a contraindication
You are caring for a client who has cervical cancer and is scheduled for brachytherapy. Which of the following actions should you take? (SATA) 1 permit visitors to stay with the client 30 minutes at a time 2 warn pregnant individuals to visit the room only once daily 3 wear a dosimeter went in the clients room 4 place soiled dressing in a biohazard bag before discarding in the regular trash 5 dispose soiled linens in the hamper outside the clients room
1 visitors should remain for no more than 30 minutes at a time and maintain a distance of at least 6 feet 3 healthcare personnel should wear a dosimeter when there is a potential exposure to radiation, such as in the radiology department or in the room of a client receiving brachytherapy NOT 2 pregnant individuals should not enter the room of a client receiving brachytherapy 4 don't discard the clients dressings in the regular trash, because the clients secretions are radioactive 5 no place objects from the clients room in the hallway because they are radioactive, but should dispose of them following facility policy
A nurse is caring for a client who has a new prescription for heparin therapy. Which of the following statements by the client should indicate an immediate concern for the nurse? 1 I'm allergic to morphine 2 I take anti-acid several times a day for my ulcer 3 I had a blood clot in my leg several years ago 4 it hurts to take deep breath's
2 greatest risk for the client is possibly pleading from the peptic ulcer. Priority intervention is to notify the provider of the findings NOT 1 you meant clients allergy to morphine to manage the clients discomfort due to a blood clot. However another action is priority 3 document the clients history of a blood clot to provide preventative measures. However another action is priority 4 but the client to report pain with breathing. However another action is priority
Which is a secondary prevention program aimed at reducing violence? 1 Creating a public service announcement about the warning signs of partner abuse 2 Recognizing and reporting suspected abuse to the appropriate protective services 3 Collaborating with support agencies to ensure the ongoing treatment for abuse 4 Educating individuals and groups about preventing domestic and community abuse
2 Secondary prevention is an intervention that focuses on early detection of a health problem to facilitate early diagnosis and treatment. Recognizing and reporting suspected abuse facilitates diagnosis and intervention, helping to prevent further abuse. NOT 1 Public service announcements and other types of information sharing are examples of primary prevention, which includes interventions that are aimed at promoting health and preventing injury or illness 3 Collaborating with support agencies to ensure the ongoing treatment for abuse is an example of tertiary prevention, which includes interventions that are aimed at interrupting the course of a known disorder, reducing ensuing disability, and promoting rehabilitation. 4 Providing education about abuse is an example of primary prevention, which includes interventions that are aimed at promoting health and preventing injury or illness.
You are 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 you include? 1 Double-bag tissues used for coughing or blowing the nose 2 Clean your bathroom fixtures with a chlorine bleach solution 3 Use shared hand towels to dry your hands after washing 4 Use barrier contraceptives during sexual contact for 2 weeks after beginning treatment
2 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. NOT 1 Hepatitis A is spread by oral-fecal contamination or by consuming contaminated food or water. Therefore, there is NO indication to double-bag tissues used for coughing or blowing the nose 3 The client should NOT share bath or hand towels with other members of the household. The hepatitis A virus spreads via feces and survives on human hands since it is resistant to soap and detergents. 4 The client should avoid sexual contact UNTIL the provider confirms that the hepatitis A antibody test is NEGATIVE. If the client engages in sexual contact AFTER the hepatitis A test is negative, USE BARRIER contraception should be used.
Nurse in an ED is caring for a client who is homeless and has hypo thermia. Which of the following actions should you make? 1 Notify the local law enforcement agency of the client's situation. 2 Initiate a referral to the facility's social worker. 3 Ask the client why they did not seek shelter sooner. 4 Tell the client everything will work out now that they are in the hospital.
2 The nurse should refer the client to the facility's social worker or to an agency that can assist the client with finding housing. NOT 1 The nurse should only involve the local law enforcement agency when there is a legal issue. 3 Asking a "why" question can make the client defensive and is a barrier to effective communication. 4 Telling the client everything will work out is giving the client false reassurance and does not address the client's immediate needs.
A nurse is assessing a client who has a PE. Which of the following manifestations should the nurse expect? 1 bradypnea 2 pleural friction rub 3 expect client to have a plural friction rub 4 petechiae 5 tachycardia
2 expect client to have a pleural friction rub 4 expect client to have petechiae 5 expect client to have tachycardia NOT 1 tachypnea is expected 3 hypotension is expected
A community health nurse is participating in a group session for clients who have alcohol and substance use disorder. Which of the following information should you provide regarding support programs for these individuals? 1 AA is a support group that requires disclosure of attendance to employers. 2 NA is a one-on-one program that assists clients. 3 AA assists a client who has an addiction to alcohol with developing a daily recovery program. 4 NA will cure a client from their substance use disorder if they stays involved with the program.
3 AA is a support group that will assist a client who has an addiction to ETOH and other substances with developing a daily recovery program using a 12-step approach. AA's primary purpose is to help the client obtain and maintain sobriety. NOT 1 The intent of the support group is confidentiality and anonymity. 2 NA is a support group that involves a group environment and social network for a client who is recovering from an addiction to opioids. 4 NA is a support group that helps clients understand the chronic nature of their addiction and learn to make changes in their life to stop using substances.
You are conducting a hearing screening procedure in an elementary school. Which of the following instructions should you provide when performing the Rinne Test? 1 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 2 Use your finger to close one ear while I whisper some numbers into your other ear 3 After I place this tuning fork behind your ear, tell me when you no longer hear the sound 4 You'll wear headphones and press the button when you hear a sound
3 This is the appropriate instruction for a RINNE TEST, a hearing evaluation that compares air conduction (AC) and bone conduction (BC) of sound. NOT 1 This instruction is for a WEBER test, a test that evaluates lateralization of sound 2 This instruction is for a whispered voice test, an initial screening to determine the need for further testing of a client's hearing. 4 This instruction is for audiometry, which provides a precise measurement of hearing ability. A client wears earphones or headphones and gives a specific signal, such as pressing a button or raising a finger, to indicate when tones of various intensities are heard.
You are caring for a client who is receiving chemotherapy and has mucositis. Which of the following actions should you take? 1 use a glycerin soaked swab to clean the clients teeth 2 encourage increased intake of citrus fruit juices 3 obtain a culture of the lesions 4 provide an alcohol-based mouthwash for oral hygiene
3 obtaining a culture of the oral lesions help identify pathogens and determine the appropriate treatment NOT 1 glycerin-based swabs should be avoided when providing oral hygiene to a client who has mucositis 2 Acidic foods are a no go 4 ETOH is a no go
You caring for a client who is undergoing chemotherapy and reports severe nausea. Which of the following statements should you make?(SATA) 1 your nausea will lessen with each course of chemo 2 how food is better tolerated due to the aroma 3 try eating several small meals throughout the day 4 increase your intake of read meat as tolerated
3 several small meals a day are usually better tolerated by the client who has nausea NOT 1 nausea usually occurs to the same extent with each session of chemo 2 cold foods are better tolerated than warm or hot foods because odors from heated foods can induce nausea 4 red meat is not tolerated well because the taste of me is frequently altered and unpalatable
A community health nurse is developing strategies to prevent or improve mental health issues in a local area. In which of the following situations is the nurse implementing a tertiary prevention strategy? 1 providing support programs for new partners 2 screening a client whose partner recently died for suicide 3 teaching a client who has schizophrenia about medication interactions 4 discussing stress reduction techniques with employees are in industrial site
3 teaching a client who has schizophrenia by medication interactions is a tertiary prevention strategy NOT 1 primary prevention strategy 2 secondary 4 discussing stress reduction techniques with employees at an industrial site is a primary prevention strategy
A nurse is reviewing prescriptions for a client who has a cute dyspnea and diaphoresis. The client states, "I am anxious and unable to get enough air. "Vital signs are HR 117/mon, RR 38/min, T 38.4 C (101.2F), and BP 100/54 mmHg. Which of the following nursing actions is the priority? 1 notify provider 2 administer heparin via IV infusion 3 administer oxygen therapy 4 obtain a CT scan
3 when using the ABCs priority approach to care, determine that the priority finding is related to the respiratory status. Meeting oxygen needs by administering oxygen therapy is the priority action. NOT 1 Notify the provider about the condition to obtain guidance on treatment. However another action is priority 2 Will prevent growth of existing clot and prevent additional class from forming. However another action is priority 4 Will detect the presence and location of blood clot. However another action is priority
If a client reports taking ibuprofen daily, you should counsel the client about the risk for which of the following adverse affects? 1 Urinary retention 2 Polycythemia 3 Hypokalemia 4 Gastric ulcerations
4 Daily use of NSAIDs, such as ibuprofen, increases the risk for gastric ulceration, perforation, and hemorrhage. NOT 1 Oliguria, dysuria, and hematuria are adverse effects of ibuprofen. 2 Polycythemia is NOT an adverse effect of ibuprofen. 3 HYPERrkalemia is an adverse effect of ibuprofen.
Age-related macular degeneration (AMD)
A disease associated with aging that affects the macula. AMD gradually destroys sharp central vision, making it difficult to read, drive, and recognize faces. There are two forms of AMD: wet and dry. S/S Blurred or "fuzzy" vision Straight lines, such as sentences on a page, appearing wavy or distorted Blurry areas on a printed page Difficulty reading or seeing details in low light levels Extra sensitivity to glare
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 you identify as an indication that the client understands the information? 1 "I will not have to completely stop drinking alcohol if I go into an inpatient treatment program." 2 "Once I make it through detoxification, I will be free of my addiction." 3 "I am not eligible for an outpatient program until I have completed an inpatient program first." 4 "I can expect to get help with other aspects of my life while in treatment."
4 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. NOT 1 Treatment for alcohol use disorder requires complete abstinence. 2 Inform the client that medical detox to manage the acute physical withdrawal manifestations is the first step in treating alcohol use disorder. There is no cure for alcohol use disorder and the client must have a commitment to life-long sobriety. 3 There is NO REQUIREMENT for a client to complete an inpatient program before entering an outpatient program. There are outpatient programs available, but clients should have a strong support system to facilitate success.
A public health nurse is planning an educational program for a group of nurses at a community health department about pertussis infection. Which of the following information should the nurse include? 1 Individuals should receive an annual influenza vaccine to minimize the risk for infection with pertussis. 2 Newborns should receive the first dose of the diphtheria, tetanus, and acellular pertussis (DTaP) vaccine prior to discharge from the hospital. 3 Individuals who have had pertussis do not require immunization. 4 Individuals transmit the pertussis bacteria through airborne droplets.
4 Transmission occurs when an individual who has an infection with Bordetella pertussis coughs. NOT 1 annual influenza vaccine does not protect individuals from infection with Bordetella pertussis. Individuals should still receive immunization against pertussis. 2 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 (after discharge). Infants should receive a series of five vaccines by the age of 6 years. 3 Individuals who have a history of infection with Bordetella pertussis do not maintain permanent immunity against reinfection and should still receive the vaccine.
A community health nurse is developing an education program on substance use disorders for a group of adolescents. Which of the following information should the nurse include when discussing nicotine and smoking? 1 smoking is the fifth most preventable cause of death in the US 2 nicotine is a CNS depressant 3 withdrawal effects from smoking or minimal 4 tolerance to nicotine develops quickly
4 True statement NOT 1 smoking is the leading preventable cause of death in the US 2 nicotine is a CNS stimulant 3 withdrawal effects from smoking are substantial and increase physical dependence
A nurse in the clinic is assessing a client who has sinusitis. Which of the following techniques to the nurse use to identify manifestation of this disorder? 1 percussion of posterior lobes of the lungs 2 auscultation of the trachea 3 inspection of the conjunctiva 4 palpation of the orbital areas
4 climb with sinusitis will report tenderness when the orbital, frontal, and facial areas are palpated. NOT 1 lung percussion is used to assess a client who has pneumonia (dullness) 2 auscultation of trachea is used to assess a client who has bronchitis (Rhonchi: low-pitched wheezing sounds - like snoring and usually happen when you breathe out) 3 inspection of conjunctiva is used to assess client who has anemia (pale-little or no evidence of red color)
You're caring for a client who is immunocompromise due to chemotherapy. Which of the following statements should you make regarding food safety? 1 "Eat any leftovers within one week of preparation." 2 "Keep the inside of your refrigerator at 47 degrees Fahrenheit or below." 3 "Beef is the only meat that is acceptable to eat with a pink center." 4 "Frozen food should be cooked immediately after it is thawed."
4 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. NOT 1 inform the client to eat leftovers within 3 to 4 days (NOT 1 weeek) 2 inform the client that, for safe food storage in the home, the inside of the refrigerator should be kept at 40° F or below. 3 inform the client that all meat and poultry should be cooked until there is NO pink coloring in the center.
Lyme disease
A client who receives a Dx of Lyme disease in the early stages should respond to 10 to 14 days of penicillin or tetracycline therapy. Client can have a lesion from an infective ixodid tick bite with mild influenza-like manifestations, such as fever, fatigue, and malaise. Not likely to have abdominal pain and diarrhea (client with E. coli is more likely to) No immunization to prevent Lyme disease
HibB, pertussis, mumps, rubella, plague, Strep PNA, meningococcal PNA
Contact precautions
Risk factor for violence: Rural or Urban?
Crowded living conditions or social isolation are risk factors for developing violent behavior. However, living in a rural community is not considered a risk factor.
Community-BASED approach
Focuses on illness care for individuals/a family unit
Community-OREIENTED approach
Focuses on the health care of a population rather than illness care for individuals.
Kava
Has been used to promote sleep Can cause liver damage Use caution if patient has liver problems
Categories of triage during mass casualty events: Class I
Highest priority is given to clients who have life-threatening injuries but also have a high possibility of survival once they are stabilized
Hippotherapy
Hippotherapy, or horse riding, has proven to be helpful for children who have cerebral palsy. Other methods helpful for children who have cerebral palsy include color-light therapy and pet therapy.
Vena cava filter
Insertion of a filter in the vena cava to prevent further emboli from reaching the pulmonary vasculature
Tasks nurses can delegate to practical nurses (PN)
Monitoring findings (as info to the RNs ongoing assessment) Reinforcing client teaching from the standard care plan Performing tracheostomy care Suctioning Checking NG tube patency Administering enteral feedings Inserting a urinary catheter Administering medication (excluding IV medication in some states)
Naltrexone
Opioid antagonist Presses the craving and pleasurable effects of alcohol (also used for opioid withdrawal) Nursing Actions: take accurate history to determine whether client it's also dependent on opioids, if using for alcohol (concurrent use of naltrexone and operates results in with drawl reactions) Client must abstain from alcohol before starting naltrexone Client Ed: take medication with meals to decrease G.I. distress Can utilize monthly IM injections of Depot naltrexone if having difficulty adhering to an oral treatment regimen
Power strips with breakers and extension
Power strips often include a circuit breaker to interrupt the electric current in case of an overload or a short circuit. Some power strips provide protection against electrical power surges Power strips with breakers and extension cords that are placed under sturdy furniture are examples of safety features that do not require modification.
PE Health promotion and disease prevention
Promote smoking cessation Encourage maintenance of a proper weight for height and body frame Encourage a healthy diet and physical activity Prevent DVT by encouraging clients to do leg exercises, wear compression stockings, and avoid sitting for long periods of time
Examples of demographic data
Racial distribution is part of demographic data. Other types of demographic data include marital information, population density, and death and birth rates.
Pandemic Influenza
Refers to a viral infection among animals that has mutated and became infectious to humans. Ex: H1N1 (Swine flu), H5N1 ("avian flu")
Categories of triage during mass casualty events: Class IV
The lowest priority is given to clients who are not expected to live and are allowed to die naturally. Comfort measures can be provided, but restoration of care is not
Categories of triage during mass casualty events: Class III
The next highest priority is given to clients who have minor injuries that are not life-threatening and do not need immediate attention
MRSA is resistant to most antibiotics except ...
Vancomycin
Weight-bearing exercises
Weight-bearing exercises can include weight lifting, walking, and running
brachytherapy
the use of radioactive materials in contact with or implanted into the tissues to be treated
