RN Community Health Online Practice 2023 A

A school nurse is conducting hearing screening procedures in an elementary school. Which of the following instructions should the nurse provide when performing the Rinne test?

"After I place this tuning fork behind your ear, tell me when you no longer hear the sound." This is the appropriate instruction for a Rinne test, a hearing evaluation that compares air conduction and bone conduction of sound.

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?

"Clean your bathroom fixtures with a chlorine bleach solution." 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 home health nurse is caring for a client who is immunocompromised due to chemotherapy. Which of the following statements should the nurse make regarding food safety?

"Frozen food should be cooked immediately after it is thawed." 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.

An adult child of a client who is terminally ill and at the end of life approaches a hospice nurse and asks, "What can I do to help relieve my father's pain?" Which of the following interventions should the nurse suggest?

"Give your father brief hand massages." Soft and brief hand massages can reduce pain and stress in palliative care settings.

A public health nurse is providing information to a client who has alcohol use disorder and is asking about treatment. Which of the following statements should the nurse identify as an indication that the client understands the information?

"I can expect to get help with other aspects of my life while in treatment." Successful 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.

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 client statements indicates that they are experiencing role conflict?

"I feel overwhelmed with not having enough time for my mom as well as my children." 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 teaching a client who is overweight about steps to take to begin an exercise program. The nurse should identify that which of the following statements is an indication that the client understands the teaching?

"I will see my doctor before beginning an exercise program." The client should see their provider before beginning an exercise program. The client should receive a complete physical exam and obtain approval for exercise.

A home health nurse is evaluating a caregiver's technique for providing care to a client who has a chronic tracheostomy. Which of the following statements by the caregiver indicates an understanding of the procedure?

"I will use tap water to clean the inner cannula." The caregiver can use tap water when performing tracheostomy care.

A home health nurse is reviewing several client requests regarding complementary strategies. For which of the following situations should the nurse plan to discuss alternative strategies with the client to prevent harm?

A client who has cirrhosis and reports using kava to promote muscle relaxation. Although clients have used kava to promote sleep, it can cause severe liver damage, leading to the need for a liver transplant. This could worsen the condition of the client who has cirrhosis; therefore, the nurse should plan to discuss safer alternatives with the client.

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?

Administer antiviral medication to clients at the facility. 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 is preparing an educational program about influenza for a group of community health nurses. Which of the following activities should the nurse include as an example of tertiary prevention?

Administer antiviral medications within 48 hr to clients who have manifestations of influenza. Tertiary prevention involves ways to reduce the complications of illness, which includes administering antiviral medications to clients who already have influenza.

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?

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

A nurse is giving a presentation about family violence at a local community center. Which of the following information should the nurse include?

Child maltreatment is more common in homes where partner violence is present. Child maltreatment is very common in homes where partner violence is present.

A community health nurse is working to meet the health care needs of residents in a rural community. Which of the following characteristics should the nurse identify as a barrier to health care resources for this population?

Unavailability of outreach services Lack of availability of outreach services is a barrier to health care for residents in rural areas.

A school nurse is discussing levels of prevention with a teacher. Which of the following activities should the nurse identify as a primary prevention strategy?

Demonstrate proper handwashing techniques. This is an example of primary prevention, the goal of which is to promote health and prevent diseases from developing.

A community health nurse is planning a presentation for adults who have a family history of Alzheimer's disease. Which of the following behaviors should the nurse include as an early manifestation of Alzheimer's disease?

Forgetting the location of common objects Forgetting the location of common objects is an early manifestation of Alzheimer's disease.

A public health agency has assigned a newly licensed nurse to assist with the task force that is responsible for the core function of assessment. Which of the following is a task that the public health agency could assign to the nurse that would be consistent with the focus of the task force?

Investigating local health hazards Investigating health hazards of the local community is a component of the public health core function of assessment.

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?

Make the hospice referral in accordance with the client's decision. The nurse should follow the ethical principle of respect for client autonomy and make the hospice referral for the client.

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 phase?

Perform triage and provide hands-on care as needed to victims. 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 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?

Provide environmental health information is correct. 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. Refer the client for a tuberculosis screening is correct. Rates of tuberculosis 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. Provide skin cancer information is correct. 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. Recommend a dental health screening is correct. 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.

A nurse is collecting demographic data as a part of a community assessment. Which of the following information should the nurse include?

Racial distribution Racial distribution is part of demographic data. Other types of demographic data include marital information, population density, and death and birth rates.

A community health nurse is creating a program to reduce violence in the community. Which of the following interventions should the nurse identify as secondary prevention?

Recognizing and reporting suspected maltreatment to the appropriate protective services 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.

A community health nurse is made aware that several children, who are from the same family and did not receive immunizations, have contracted measles. Which of the following actions should the nurse take?

Report this information to the state health department. The CDC lists measles as a nationally notifiable disease. Requirements for reporting diseases are state mandated, rather than federally mandated. Therefore, the nurse should report this occurrence to the state health department, which then determines if it will report to the CDC.

A community health nurse is planning an educational program for farmers about occupational health risks. Which of the following risks should the nurse include?

Respiratory disorders Farmers are at an increased risk for respiratory disorders 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 in a pediatric clinic is providing care to several clients. The nurse should recognize that which of the following conditions is included on the Nationally Notifiable Infectious Conditions list?

Varicella The nurse should recognize that varicella is included on the Nationally Notifiable Infectious Conditions list. States voluntarily conduct surveillance and report instances of certain diseases to the Centers for Disease Control and Prevention so the data can be compiled and released each year.

Client reports fever, fatigue, lack of appetite, and headache that started 2 days ago. Today, client woke up with blister-like rash all over their face, chest, and back. Client states, "It is beginning to itch and spread." Lung sounds clear to auscultation. S1, S2, heard no murmur detected. Bowel sounds normoactive in all quadrants. Notified provider of findings.

When generating solutions, the nurse should anticipate the client has varicella (chicken pox); therefore, the nurse should place the client in a negative-pressure airflow room, wear an N95 mask when caring for the client, designate a stethoscope to be used only on the client, and request a prescription for an antipyretic. Varicella is transmitted by the air; therefore, airborne isolation precautions need to be taken while caring for this client.

Nurse is caring for a client who has Parkinson's disease and fell at home. Client has tremors of hands and voice trembles when speaking. Client states, "I lost my balance and fell." Client has skin tears on left forearm with bruising. No fracture detected upon x-ray results. Skin dressing on left forearm is dry and intact. Denies pain at this time.

gait how the client holds eating utensils how the client dresses self hand findings When analyzing cues, the nurse should identify that difficulty holding eating utensils, gait, hand findings and dressing self are all part of ADLs; therefore, the nurse should request a referral for an occupational therapist. An occupational therapist assists clients with their ADLs by improving their range of motion and muscle strength, as well as providing them adaptive devices to assist them with eating, dressing, and walking.

a home health nurse is planning care for the day. Which of the following clients should the nurse visit first?

A school-age child who was treated in the emergency department last night for status asthmaticus 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.

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?

Ask the child to pretend to blow up a balloon during the injection. 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 community health nurse is teaching a client who was newly diagnosed with active pulmonary tuberculosis about disease transmission. Which of the following information should the nurse include?

Household members should take isoniazid for at least 6 months. 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 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?

Individuals transmit the pertussis bacteria through airborne droplets. Transmission occurs when an individual who has an infection with Bordetella pertussis coughs.

A community health nurse is assigned to lead a county-level environmental task force. Which of the following activities should the nurse direct the task force to complete first?

Review community-specific epidemiological data. The first action the nurse should direct the task force to take when using the nursing process is to conduct a community assessment, which includes a review of community-specific epidemiological data. The community assessment will assist the task force in identifying environmental health concerns within the county.

A nurse in an emergency department is triaging clients following an explosion at a local factory. Which of the following clients should the nurse identify as the priority?

A client who has tracheal deviation and shortness of breath A client who has tracheal deviation and shortness of breath most likely has a pneumothorax and requires immediate intervention for survival. Therefore, when using the survival approach to client care, the nurse should give priority to this client.

A nurse is planning to teach a community group about the meningococcal vaccine. The nurse should identity that which of the following clients should receive the vaccine?

A client who is moving into a college dormitory Individuals living in crowded areas, such as dormitories, should receive the meningococcal vaccine.

A public health nurse is participating in a disaster preparedness planning committee for a local community that is at risk for hurricanes. Which of the following information should the nurse contribute to the plan?

A list of areas within the community where residents speak multiple languages The public health nurse, who is most familiar with the community, should contribute this information to the disaster plan to assist in aiding and evacuating residents who are at high-risk.

A public health nurse is planning care for four clients. Which of the following interventions should the nurse recognize as tertiary prevention?

Administering antibiotics to a client who has AIDS and was diagnosed with Pneumocystis jirovecii Administering antibiotics to a client who has AIDS and was diagnosed with Pneumocystis jirovecii is an example of tertiary prevention.

A community health nurse is participating in a group session for clients who have alcohol and substance use disorders. Which of the following information should the nurse provide regarding support programs for these individuals?

Alcoholics Anonymous (AA) assists a client who has an addiction to alcohol with developing a daily recovery program. AA is a support group that will assist a client who has an alcohol or substance use disorder with developing a daily recovery program using a 12-step approach. AA's primary purpose is to help the client obtain and maintain sobriety.

A community health nurse is participating in a quality improvement plan for a local health department. Which of the following techniques should the nurse use for process evaluation of the facility? Select all that apply. Focus groups Written audits Satisfaction survey Interviews Values self-study

Focus groups is correct. The nurse should include focus groups, which are small groups of individuals who use the health department services, for process evaluation of the facility. This information allows for review of the facility's strengths and weaknesses in the quality of client care delivery. Written audits is correct. The nurse should include written audits, which are written evaluations of the quality of care provided by the health department, for process evaluation of the facility. This information allows for review of the facility's strengths and weaknesses in the quality of client care delivery. Satisfaction survey is correct. The nurse should include satisfaction surveys, which are assessments of clients' perception of their care made via telephone or written questionnaires, for process evaluation of the facility. Interviews is correct. The nurse should include interviews of clients who use the health department's services for process evaluation of the facility.

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?

Informant interviews 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 nurse is caring for a client who has a positive gonorrhea culture. Which of the following actions should the nurse take?

Instruct the client that recent sexual partners will need to be treated. The nurse should instruct the client that sexual partners from the past 60 days should be referred for evaluation and treatment of gonorrhea.

A community health nurse is providing teaching about health promotion to a group of adolescents. Which of the following topics is the most important for the nurse to include in an attempt to lower adolescent mortality rates?

Safety belt use Automobile crashes are currently the leading cause of death among adolescents. Therefore, this topic is most important to discuss when attempting to reduce premature deaths in this age group.

A nurse is conducting a home visit for an older adult client. The nurse should identify which of the following findings as an indicator of possible neglect?

Taking outdated prescriptions The client taking outdated prescriptions is an example of inadequate medical care and is an indicator of possible neglect.

A home health nurse is 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 the nurse take?

Tell the client to take naltrexone daily. The nurse should 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.

A nurse at a county health department is caring for a client who is at 28 weeks of gestation. The nurse should identify which of the following characteristics as a risk factor for future child maltreatment?

The client has changed providers three times during their pregnancy. Frequently changing health care providers is a risk factor for future child maltreatment because it can indicate that the client is experiencing partner violence and is attempting to hide it from the provider. Clients who experience violence are at a higher risk for perpetuating violence against their own children.

Community leaders have requested a meeting with a community health nurse to discuss creating a mobile meals program. Which of the following information should the community health nurse assess first?

The need for the program When using the nursing process, the nurse should first assess the need for the mobile meals program. This action allows the nurse to collect data on the client, which is the community, and meets the first step of program planning. The needs of the community will determine all other steps of the planning process.

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?

Turn the client to left semi-Fowler's position and begin assessing the next client. Principles of triage indicate that clients who have extensive injuries and a low probability of survival do not receive treatment. Therefore, the nurse should provide only comfort measures before moving on to assess the next client.

A nurse is providing triage to clients who are transported by Emergency Medical Services (EMS) from a disaster scene. The nurse assigns the following 5 clients to the categories of delayed, immediate, or expectant. Which clients should the nurse assign to the immediate category?Select all that apply.

When prioritizing hypotheses, the nurse should determine that Client 1, Client 2, and Client 4 should be assigned to the immediate category because they have life threatening injuries but a high probability of survival. The nurse determines that Client 1 should be assigned to the immediate category because they are not able to walk, they do not respond to commands, and spontaneous respirations stop then resume after head is repositioned. The nurse determines that Client 2 should be assigned to the immediate category because they are not able to walk, they do not respond to commands, and capillary refill is greater than 2 seconds. The nurse determines that Client 4 should be assigned to the immediate category because they are not able to walk, and their respiratory rate is greater than 30/min.

Client presents to clinic for evaluation after working as a member of the disaster response team during a recent natural disaster. Medical history significant for type 1 diabetes mellitus. Client did not sustain any physical injuries during the disaster response. Client states, "I still haven't processed everything that happened." Client is alert and oriented, heart regular rate and rhythm, lungs clear to auscultation bilaterally. Blood glucose obtained. No concerns today. Client to return to clinic for 1 month follow-up visit.

When taking actions, Nurse 1 and Nurse 2 demonstrate the ethical principle of justice by ensuring that clients with limited access to seasonal flu immunizations have resources available to provide access to immunizations.

A public health nurse is working in a community that has a population of 24,096. There are 2,096 existing cases of heart disease within the population. The nurse can determine which of the following from this information?

prevalence proportion The prevalence proportion can be calculated by using the number of people who were affected at a given time and the total population.