community module 2 exam
a major goal for home health care nurses is to
restore maximum health function
A new employee asks the occupational health nurse about measures to prevent inhalation exposure to toxic substances. What should the nurse recommend?
"Wear protective attire and devices when working with a toxic substance." Explanation: When working with toxic substances, the employee must wear or use protective devices such as face masks, hoods, or industrial respirators. Immunizations do not confer protection from toxins and a paper mask is normally insufficient protection. Never position a fan directly blowing on the toxic substance as it will disperse the fumes throughout the area.
A school nurse is caring for a child who appears to be having an allergic response. What should be the initial action of the school nurse?
Assess for signs and symptoms of anaphylaxis.
The nurse is caring for a client who is interested in learning about hospice care. Which of the eligibility criteria would the nurse stress?
Choice of palliative care over cure focused Explanation: An important focus of hospice care is that care is palliative in nature. No further aggressive treatment to find a cure for the illness is administered. The client must accept this philosophy of care. The other options are factual and agreed on.
The home health nurse and the parish nurse have separate roles in health care. What best describes the common factor all community-based nurses share?
Community health nurses focus on community needs as well as the needs of individual patients.
The school nurse at a local elementary school is administering a medication to a student. What additional role may the school nurse perform? Select all that apply.
Education of staff members regarding various illnesses or diseases Assist in development of health education curriculum Education of students regarding various illness or diseases Explanation: The school nurse will perform all of the duties stated with exception of assessment of various conditions. Assessment is for the nurse only and cannot be performed by someone other than the nurse.
You are an occupational health nurse in a large ceramic manufacturing company. How would you intervene to prevent occupational lung disease in the employees of the company?
Fit all employees with protective masks. Explanation: The primary focus is prevention, with frequent examination of those who work in areas of highly concentrated dust or gases. Laws require work areas to be safe in terms of dust control, ventilation, protective masks, hoods, industrial respirators, and other protection. Workers are encouraged to practice healthy behaviors, such as quitting smoking. Adequate breaks, giving workshops, and providing smoking cessation materials do not prevent occupational lung diseases.
A patient with a "Do Not Resuscitate" (DNR) order requires large doses of a narcotic for pain that rates a 10 on a 0-10 scale. After the patient requests pain medication, the nurse assesses a respiratory rate of 12 breaths per minute. What intervention by the nurse would be considered ethical?
Give the pain medication without fear of respiratory depression. Explanation: End-of-life issues shift the focus from curative care to palliative and end-of-life care. Focusing on the caring as well as the curing role may help nurses deal with these difficult moral situations. Needs of patients and families require holistic and interdisciplinary approaches. End-of-life issues that often involve ethical dilemmas include pain control, "do not resuscitate" orders, life support measures, and administration of food and fluids. However, because the patient has a legal order to not be resuscitated, the nurse should respect the patient's autonomy and preference of pain relief over possible lethal complications.
Occupational Health Nurse's Roles and Responsibilities- Secondary Prevention
Identifying workplace hazards, early detection through health surveillance and screening, prompt treatment, counseling and referral, and prevention of further limitations.
A nurse employed in a school suspects an outbreak of pediculosis. Which of the following nursing actions should be taken to prevent and control the outbreak?
Insist that everyone who is infested with lice follows the prescribed treatment. Explanation: If everyone who is infested with lice follows the prescribed treatment, the outbreak can be controlled and eliminated. The nurse performs hair inspection whenever there is an outbreak, but this cannot prevent or control the outbreak. Washing clothes and vacuuming furniture, bedding, and carpets are the aspects to be included in client teaching. They cannot prevent or control the outbreak. Anyone can become infected, and the infestation has no reflection on hygiene or living conditions.
At the beginning of a day that will involve several home visits, the nurse has ensured that the health care agency has a copy of the nurse's daily schedule. What is the rationale for this action?
It supports safety precautions for the nurse when making a home care visit.
Medicare is a federal program that finances many Americans' home health care expenses. The Medicare program facilitates what aspect of home health care?
Managing and evaluating client care for seriously ill clients Explanation: Many home health care expenditures are financed by Medicare, which allows nurses to manage and evaluate client care for seriously ill clients who have complex, labile conditions and are at high risk for rehospitalization. Home health nurses, despite who funds their visits, do not provide care without the oversight of a physician; they do not normally write medication orders; nor do they order the services of ancillary specialists such as physical, occupational, or speech therapists.
Which is a role of a school nurse?
Monitoring immunization status Explanation: School nurses perform health screenings, provide basic care for minor injuries, administer medications, monitor the immunization status of students and families, and identify children with health problems.
What is the primary basis for growth in home care nursing?
The discharge of patients who are more critically ill Explanation: With shorter hospital stays and increased use of outpatient health care services, more nursing care is provided in the home and community setting. The other answers are incorrect because they are not the basis for the growth in nursing care delivered in the home setting.
what is pastoral care that is provided by a parish nurse?
Pastoral care by a parish nurse implies providing care by stressing the spiritual dimension of nursing, lending support during times of joy and sorrow, guiding the person through health and illness throughout life, and helping identify the spiritual strengths that assist in coping with particular events. The parish nurse is able to provide pastoral care; she or he does not have to involve the pastor
A client with long-term breast cancer who was recently enrolled in a hospice program demonstrates signs and symptoms of clinical depression. Which action by the hospice nurse is appropriate?
Perform a thorough pain assessment. Explanation: An effective combined approach to clinical depression includes relief of physical symptoms such as pain. Clinical depression should not be accepted as an inevitable consequence of dying. Researchers have linked the psychological effects of cancer pain to suicidal thought and, less frequently, to carrying out a planned suicide. An effective combined approach to clinical depression includes relief of physical symptoms and pharmacologic intervention with tricyclic antidepressants.
The community health nurse is preparing to conduct a home visit. When performing the home visit, how should the nurse best implement the principles of infection control?
Perform hand hygiene before and after giving direct client care.
The nurse is working in an ambulatory health clinic. What is the focus of community-based nursing practice?
Promoting and maintaining population health and preventing and minimizing disease progress Explanation: Although nursing interventions used by public health nurses might involve individuals, families, or small groups, the central focus remains promoting health and preventing disease in the entire community.
Which occupational nursing action supports the primary goal of the Occupational Safety & Health Administration (OSHA)?
Providing CPR certification to shift supervisors Explanation: OSHA has had a major impact on health conditions in the workplace. Its goal is to ensure safe and healthy work conditions. OSHA does not affect cost-effective health insurance, achievement in school, or nursing interventions aimed at evaluating health promotion needs.
A newly hired elementary*** school health nurse is reviewing the job description. Which activities can the school nurse expect to perform in this new role? Select all that apply.
Providing minor first aid Educating teachers about HIV Organizing a visit from the mobile dentist Writing curriculum related to effects of chemotherapy Explanation: The leading health problems of elementary school children are injuries, infections, malnutrition, dental disease, and cancer. Alcohol and drug abuse, mental/emotional problems, and suicide are leading health problems for high school students.
Occupational Health Nurse's Roles and Responsibilities- Tertiary Prevention
Restoration of health through rehabilitation strategies and limited-duty programs.
Which order of activities is accurate when making a home visit?
Review agency policies regarding visits, ask permission to enter home, perform hand hygiene, and document care provided. Explanation: A review of agency policies provides agency philosophy, procedures, and services provided. The nurse should ask permission before entering a home. Infection control is as important in the home as the hospital, and therefore hand hygiene is indicated and should be performed after entering the home. Documenting the client's needs and nursing care provided is an essential part of the visit. To increase safety, the nurse should park close to the home. It is proper to bring only required equipment into the home setting. Leaving a detailed message may compromise patient
A nursing student has taught a colleague that nursing practice is not limited to hospital settings, explaining that nurses are now working in ambulatory health clinics, hospice settings, and homeless shelters and clinics. What factor has most influenced this increased diversity in practice settings for nurses?
Shift of health care delivery into the community Explanation: As health care delivery shifts into the community, more nurses are working in a variety of community-based settings. These settings include public health departments, ambulatory health clinics, long-term care facilities, hospice settings, industrial settings (as occupational nurses), homeless shelters and clinics, nursing centers, home health agencies, urgent care centers, same-day surgical centers, short-stay facilities, and clients' homes.
Occupational Health Nurse's Roles and Responsibilities- Primary Prevention
Teaching good nutrition and knowledge of health hazards, and providing information on immunizations, and use of protective equipment.
The nurse is making an intial home visit for a client requiring wound care. What statement is true regarding safety during a home visit by a nurse?
The nurse should never walk into a patient's home uninvited. Explanation: A nurse should never walk into a client home uninvited. The nurse should take appropriate proactive safety measures, including keeping his or her cell phone and car in working order and having a plan of action in case of emergencies. The nurse should park his or her car close to the client's home. Home visits should only be scheduled during daylight hours.
The school nurse is preparing to work with an incoming kindergarten student who has a diagnosis of cerebral palsy. What is the reason the nurse will start a planning meeting at school with parents and teachers before school starts?
To provide anticipatory guidance to the family Explanation: Public health, parish, and school nurses may start communication to provide anticipatory guidance to high-risk families and follow-up care to clients with communicable diseases. The other nursing actions do not require a meeting before school starts. There is no indication that the child has made a clinic visit.
A nurse is comparing some of the similarities and differences between the care that is provided in community- and hospital-based settings. What type of care is provided in both of these settings?
ambulatory health care
When assessing for substances that are known to harm workers' lungs, the occupational health nurse should assess their potential exposure to which of the following?
asbestos
A nurse is working in a rural nurse-managed agency that provides immunizations, health assessments, and screening services. The nurse is most likely working in which of the following?
community nursing center Explanation: Community nursing centers are nurse-managed agencies that provide primary care services, such as ambulatory and outpatient care, immunizations, health assessments, and screening services. They typically provide such services to underserved populations who are rural, very young, very old, poor, or members of racial minorities.
The nurse is transitioning to a home health setting. What factor has resulted in a shift in the health care delivery setting?
growing number of elderly clients
In what area of nursing practice does the nurse provide palliative care in the patient's home?
hospice
A client has end-stage chronic obstructive pulmonary disease (COPD) and is terminally ill. The family wants the client to spend her last days in a facility that will be able to keep the patient comfortable and control her severe dyspnea. What facility will meet the needs of the client and family?
hospice care
Which type of care is used for clients with terminal illness who have a life expectancy of less than 6 months?
hospice care
What should the school nurse working in the elementary school setting be aware is one of the most frequent health care problems to affect this population?
infections
A nurse is working in a school health program that provides care to elementary school-aged children. The nurse would focus teaching on which area as being most problematic?
injuries
A client who is in end-stage renal failure has been moved to an inpatient hospice facility. The rationale for this move is that the client:
is terminally ill and needs symptom control. Explanation: Hospices allow terminally ill clients to live as fully as possible while managing pain, discomfort, and other symptoms. The client's lack of health insurance would not be criteria for admission to hospice. Hospice does involve skilled care. Hospice does not provide care related to regaining the ability to perform activities of daily living.
correctional nurse: common health concerns
mental health issues drug abuse communicable diseases--> HIV/AIDS, STI's, TB. Hep C
A nurse is based in an automotive assembly plant and works with the plant's employees in the areas of health promotion and basic primary care. What nursing role is this nurse performing?
occupational health nurse
A client with long-term breast cancer who was recently enrolled in a hospice program demonstrates signs and symptoms of clinical depression. Which action by the hospice nurse is appropriate?
perform a thorough pain assessment
The goal of OSHA is
to ensure safe work conditons
