Community Health Online Practice B

A school nurse is serving 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

A community health nurse suspects an outbreak of scabies in the local area. Which of the following actions should the nurse take first?

Determine the incidence rate

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 b 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 nurse is providing education regarding lead exposure to a group of clients who live in a housing development built in 1968. Which of the following statements indicates and understanding of the teaching?

"I will increase the amount of red meant and milk in my child's diet."; Children should receive adequate amounts of iron and calcium in their diets to prevent lead absorption from their environment.

A hospice nurse is teaching about expected grief reactions with the family of a client who has end-stage pancreatic cancer. Which of the following information should the nurse include?

"A component of healthy grieving is the ability to openly express your anger."; in addition to teaching to expect emotions to fluctuate, disturbances in self-esteem is an indication of clinical depression, a sense of hopelessness is an indication of clinical depression.

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 make?

"Can I give you some information about Alcoholics Anonymous?"

An adult child of a client who is terminally ill and at the end of life approached 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"

A home health nurse is visiting an older adult client and notes that unwashed dishes are piled up and newspapers cover the front steps. Which of the following questions should the nurse ask the client to determine if the client is socially isolated?

"How often do you have visitors come to see you?"; addresses the issue of social isolation by determining the frequency of contact between the client and others.

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."

A nurse manager at a community health clinic is presenting an in-service for nurses about assessing clients who have experienced violence. Which of the following statements by a nurse indicates an understanding of the teaching?

"I should determine whether a client who has been sexually assaulted requires a rape kit examination."; Clients who report sexual assault within a certain time frame should undergo a rape kit examination. In some cases, collection must be obtained within 24 hr of the occurrence. However, the time frame can vary based on the type of assault. The nurse should also provide information regarding support groups and resources for clients who were sexually assaulted.

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?

"I should remove the identification tag that is on my key ring."

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 should see me doctor before beginning an exercise program."- The client should receive a complete physical exam and obtain approval for exercise.

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

A school nurse is notified that a shcool-age child has pertussis. Which of the following actions should the nurse take? (Select all that apply)

*Instruct the parent to keep the child at home for 2 weeks after the initial symptoms first present *Encourage family members to obtain prophylactic treatment *Check the immunization status of the child's classmates

A community health nurse is working in a mobile health care clinic. Which of the following clients should the nurse assess first?

A client who has a new onset of confusion and slurred speech (indicates neurological problem and requires immediate intervention)

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 client who is moving into a college dormitory; individuals living in crowded areas

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 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

A public health nurse is lobbying Congress to increase funding for health screening provided to migrant farm workers. Which of the following concepts is the nurse demonstrating?

Advocacy; Advocacy is supporting or seeking a specific course of action for the benefit and on behalf of a person, group, or community.

A school nurse is conducting visual acuity testing for a school-age child using a Snellen letter chart. Which of the following actions should the nurse take?

Allow the child to keep her glasses on during testing

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

A community health nurse is providing care to a client who has stopped taking their prescribed blood pressure medication. Which of the following actions should the nurse take first?

Determine the client's reason for discontinuing the medication

A home health nurse is teaching a client's family about preventing the transmission of Clostridium difficile. Which of the following transmission-based precautions should the nurse include in the teaching?

Contact precautions

A nurse is assessing the risks and benefits of meal delivery services for an older adult client who lives alone and has no transportation. Which of the following ethical principles is the nurse demonstrating?

Correct: Beneficence-The nurse is demonstrating the ethical principle of beneficence by determining if the client needs this service to maintain their health; The nurse would demonstrate the ethical principle of distributive justice by fairly determining which clients should receive meal delivery when there are a limited amount of services available for clients.

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 hand washing techniques (primary is prevention)

A nurse is developing an educational program about bioterrorism and smallpox. The nurse should include in the teaching that the smallpox rash is expected to first appear in which of the following locations?

Face; first appear on face and then spread down

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: later manifestations are: withdrawal from social activities, experiencing incontinence, and neglecting personal hygiene

A community health nurse is caring for an adolescent who is seeking help for an unplanned pregnancy. Which of the following actions should the nurse take first?

Help the client obtain a provider for prenatal care

A nurse is assessing a new client at a public health clinic. Which of the following areas should the nurse address as part of the cultural assessment?

Illness practices

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?

Implement an exercise program for clients who have hypertension

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 in a community center is preparing to administer a tuberculin skin test to multiple clients to screen for tuberculosis. Which of the following actions should the nurse take?

Inject 0.1 mL of purified protein derivative; wheal should be 6mm in diameter, 5-15 degree needle insertion, administered on inner arm

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- instruct the client that sexual partners from the past 60 days should be referred for evaluation and treatment of gonorrhea.

An occupational health nurse in a factory is performing a routine tuberculosis screening and identifies an employee who has a positive Mantoux tuberculin test. Which of the following actions should the nurse plan to take?

Instruct the employee that they will need to obtain a chest x-ray; The presence of a positive Mantoux skin test can indicate the client has been exposed to the tuberculosis organism. A chest x-ray will determine if the disease is active or dormant.

A public health nurse is monitoring medication compliance for a group of migrant workers who are being treated for tuberculosis (TB). The nurse should use information from which of the following resources to assist with this process?

Migrant Clinicians Network (MCN); Migrant workers frequently change locations and move from job to job. This can interfere with the client adhering to the 6 to 12 month TB treatment plan. The MCN is a tracking program developed so that health care providers can access prior provider information and maintain TB treatment continuity for these clients.

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- number of people who were affected at a given time and the total population; The incidence proportion cannot be calculated because the number of people newly diagnosed with heart disease over a period of time is not known.

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?

Provide victims of violence with referral information to crisis lines (tertiary- already happened this is how to mitigate it)

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

Review community-specific epidemiological data

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; sign of inadequate medical care

A nurse is preparing a community education program about health care needs during pregnancy. The nurse should include that which of the following vaccines is safe to administer to a client who is pregnant?

Tetanus, diphtheria, pertussis (Tdap); between 27 and 36 weeks of gestation

A case manager at a home agency is obtaining equipment for a client's home use. Which of the following actions is a violation of client confidentiality?

The case manager left a clipboard with the client's prescription information face up on the office desk; 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 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.

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?

The faith community nurse can facilitate substance abuse support for groups

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

A nurse on the scene following a mass casualty explosion is triaging a client who has a large, open occipital wounds 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 the left semi-Fowler's position and begin assessing the next client

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 thie population?

Unavailability of outreach services

A hospice nurse is caring for a client who is at the end of life and has developed dyspnea and noisy breathing. Which of the following actions should the nurse take?

Use a fan in the client's room- A fan moves the air, which stimulates the client's trigeminal nerve and can minimize the sensation of dyspnea.

A nurse is preparing to administer medication to a client who has active tuberculosis. Which of the following precautionary measures should the nurse take?

Use an N95 respirator