Exam 1: Questions from Powerpoints

Which of the following individuals has the highest priority for receiving seasonal influenza vaccination? A. A 60 year old man with a hiatal hernia. B. A 36 year old woman with three children. C. A 50 year old woman caring for a spouse with cancer. D. A 60 year old woman with osteoarthritis.

C

Describe one of the filth diseases discussed in the film. Who is Typhoid Mary?

- Irish born American cook who had typhoid - bacteria that can be spread through contaminated food and water - treated with antibiotics and fluids

In what ways are malaria and yellow fever similar?

- spread by mosquitoes -can cause fever and flu-like symptoms - can cause jaundice - can be fatal

On May 17, 2012, Francesca Marie McNally lost her life to pertussis. She was only 3 mo old. Francesca's mother, Veronica, believes she had pertussis and passed it onto Francesca and her 3 yo son. Because the disease can be difficult to diagnose, it went unrecognized in all of them by numerous healthcare providers. Francesca was sent home from the pediatrician's office and the ER- neither of which recognized she had pertussis. The McNally's weren't told to protect Francesca from pertussis by surrounding her with vaccinated adults and children, forming a cocoon of protection. By the time she was admitted to the PICU, it was too late. Francesca's life may have been saved if she had been surrounded by vaccinated individuals. 1. What were Francesca's risk factors? 2. Could it have been prevented? 3. Why is pertussis serious? 4. Who should get vaccinated and with what?

1. 3 months old, unvaccinated caregivers 2. Yes 3. b/c it can go unnoticed, and can lead to seizures and brain damage 4. Dtap for young children, Tdap starting at 11-12 every 10 years. Pregnant woman needs Tdap at 27-36 weeks for each pregnancy

A. Sporadic disease B. Endemic disease C. Pandemic disease D. Epidemic disease 1.__ 22 cases of legionellosis occurred within 3 weeks among residents of a particular neighborhood (usually 0 or 1 per year) 2.__ Over 20 million people worldwide died from influenza in 1918-1919 3.__ Single case of histoplasmosis was diagnosed in a community 4.__ About 60 cases of gonorrhea are usually reported in this region per week, slightly less than the national average

1. D 2. C 3. A 4. B

Trinity is 5 years old and has no known medical conditions. She is in the office in July for a well-child visit. She is on schedule with her vaccinations and is due for her DTaP, MMR, VAR, and IPV doses. Trinity is very upset since she knows she may get several injections today. Her mother is concerned about how to comfort her. 1. What are some ways you can decrease Trinity's pain and help with her fear? 2. What advice will you give Trinity's mother to help Trinity before, during, and after vaccine administration? 3. What are the age-appropriate sites for administering the vaccines she needs today?

1. Distract them (toys, have them tell story or sing song, tell them why they need the shot, answer questions, let parent hold them) 2. Education on vaccine and schedule, Tell her how to hold child, Give her praise (stickers, candy) 3. Dtap: IM deltoid MMR: subQ side of arm, VAR: subQ side of arm, IPV: IM and SubQ on other arm

Ashley McCormick was a 23 yo nanny. She came home from work on December 20, 2013, with a runny nose, sore throat, and headache. The next day, she had a high fever and went to urgent care. Her positive flu result came too late for Ashley to be treated. She started to feel better, but on Christmas, her fever was 103.8 F. The next day, she went to the ER with pneumonia. Ashley had H1N1 flu and quickly became very sick. On December 27, 2013, Ashley died from the flu. Ashley's life may have been saved if she had been vaccinated. 1. What were Ashley's risk factors? 2. Could it have been prevented? 3. Why is influenza serious? b/c you can 4.When and who should be vaccinated?

1. Nanny, unvaccinated 2. Yes 3. b/c you can get pneumonia and die 4. Everyone over 6 months annually

A goal of community nursing is to provide primary prevention from disease. Which of the following nursing actions reflect this goal? A. A nurse creates a pamphlet discussing heart-healthy foods and distributes it in the neighborhood community center. B. A nurse starts an intravenous (IV) line on a dehydrated baby who has been brought to the emergency department. C. A nurse performs range-of-motion exercises for a patient in traction. D. A nurse repositions an elderly patient confined to a wheelchair to avoid the formation of pressure ulcers.

A

A nurse is planning a program to teach cardiac health at the senior citizens center. Which of the following is an effectively written objective for the program? A. By the end of the program each participant will report walking at least 30 minutes a day at least 5 days each week. B. By the end of the program each participant will voice a commitment to walk at least 30 minutes a day. C. By the end of the program each participant will understand the need for physical exercise. D. Each participant will voice a commitment to engage in physical exercise each day.

A

Staff members have agreed to implement evidence-based practice; they have chosen a specific problem and searched the literature. The group has selected the interventions that seem the easiest to implement. Which of the following actions would the staff take next? A. Assess the quality of the evidence in the literature. B. Decide how best to orient the staff and community to the proposed changes. C. Eliminate all nursing interventions that are not evidence-based. D. Choose another specific problem for the next literature search.

A

The most effective measure the nurse can use to prevent wound infections when changing a client's dressing after coronary artery bypass surgery is to: A. Observe careful handwashing procedures B. Clean the incisional area with an antiseptic C. Use prepackaged sterile dressings to cover the incision D. Place soiled dressings in a waterproof bag before disposing of them

A

Which of the following instructions about activities during menstruation would the nurse include when counseling an adolescent who has just begun to menstruate? A. Take a mild analgesic if needed for menstrual pain B. Avoid cold foods if menstrual pain persists C. Stop exercise while menstruating D. Avoid sexual intercourse while menstruating

A

The nurse is planning a program about women's health and cancer prevention for a community health fair. Which information should the nurse include? Select all that apply. A. Regular self-exams of the breast and vulva are important self-care activities. B. Cancer can be prevented by removing precancerous lesions of the vulva, cervix, or endometrium. C. Girls, age 11 to 12, should receive immunization for human papillomavirus (HPV) to prevent cervical cancer. D. Smoking cessation reduces the risk of cervical cancer. E. There is limited evidence that cancer in women is inherited.

A, B, C, D

A patient is ordered a clear liquid diet. The nurse can offer the patient which of the following on the food tray? A. orange juice B. lime Jell-O C. skim milk D. tomato soup

B

Cancer prevalence is defined as: A. The likelihood cancer will occur in a lifetime. B. The number of persons with cancer at a given point in time. C. The number of new cancers in a year. D. All cancer cases more than 5 years old.

B

The nurse reviewing a patient's lab values realizes that the normal range for serum potassium measured in mEq/L is: A. 0.5-2.5 B. 3.5-5.5 C. 6.0-8.0 D. 10.0-12.0

B

A community health nurse is implementing health programs with several populations in the local area. In which of the following situations is the nurse using primary prevention? A. Performing a home safety check at a client's home B. Teaching healthy nutrition to clients who have hypertension C. Providing influenza immunizations to employees at a local preschool D. Implementing a program to notify individuals exposed to a communicable disease

C

The clinic nurse prepares to administer a measles, mumps, rubella (MMR) vaccine to a 5-year-old child. The nurse should administer this vaccine by which best route and in which best site? A. Subcutaneously in the gluteal muscle. B. Intramuscularly in the deltoid muscle. C. Subcutaneously in the outer aspect of the upper arm. D. Intramuscularly in the anterolateral aspect of the thigh.

C

The mother of a 6-month-old states that she started her infant on 2% milk. The nurse should first ask the mother: A. "Do you think your baby will be fine with this milk?" B. "Is it possible for you to switch your baby to whole milk?" C. "Can you tell me more about the reason you switched your baby to 2% milk?" D. "You cannot switch to 2% milk right now. Did your pediatrician tell you to do this?"

C

The nurse is instructing the unlicensed assistive personnel about the correct technique for obtaining a clean-catch urine culture from a female client. Which of the following statements indicates that the assistant has understood the instructions? A. "I will have the client completely empty her bladder into the specimen cup." B. "I will need to catheterize the client to get the urine specimen." C. "I will ask the client to clean her labia, void into the toilet, and then void into the specimen cup." D. "I will obtain the specimen in the afternoon after the client has had plenty of fluids."

C

The nurse is preparing a group of Cub Scouts for an overnight camping trip and instructs the scouts about the methods to prevent Lyme disease. Which statement by one of the Cub Scouts indicates a need for further instructions? A. "I need to bring a hat to wear during the trip." B. "I should wear long-sleeved tops and long pants." C. "I should not use insect repellents because it will attract the ticks." D. "I need to wear closed shoes and socks that can be pulled up over my pants."

C

When the community health nurse visits a client at home, the client states, "I haven't slept at all the last couple of nights." Which response by the nurse illustrates a therapeutic communication response to this client? A. "I see." B. "Really?" C. "You're having difficulty sleeping?" D. "Sometimes, I have trouble sleeping, too."

C

A client is to be discharged from an alcohol rehabilitation program. Which of the following should the nurse emphasize in the discharge plan as a priority? A. Supportive friends B. A list of goals C. Family forgiveness D. Follow-up care

D

A parent brings her 6-month-old infant to a well-baby clinic for immunizations. The child is up-to-date with the immunization schedule. The nurse should prepare to administer which immunizations to this infant? A. Varicella, hepatitis B vaccine (Hep B) B. Diphtheria, tetanus, acellular pertussis (DTaP); measles, mumps, rubella (MMR); inactivated poliovirus vaccine (IPV) C. MMR, Haemophilus influenzae type b (Hib), DTaP D. DTaP, Hib, IPV, pneumococcal vaccine (PCV), rotavirus (RV)

D

What is generally considered the beginning of the modern era of Tuberculosis control?

In 1944, treated with streptomycin

Before Trinity received her vaccines today (DTaP, MMR, VAR, and IPV doses), her mother expressed concern that Trinity would be getting so many vaccines during the same visit. Worried about "overwhelming" her daughter's immune system, Trinity's mother felt it was best to space the vaccines out over multiple visits. 1. How do you respond to this mother's concerns about the number of vaccines Trinity will receive today?

Recommended for her age group, easier to not have to come for multiple visits, delay can make child more vulnerable

What was Edward Jenner's contribution to public health?

Smallpox vaccine