HESI - Management of Care

Therapeutic expectations after administering ibuprofen

- Pain relief - Temperature reduction - Reduced inflammation Remember it does cause anticoagulation but this is typically an adverse effect, not therapeutic

Medicare

Health insurance program is designed for clients 65 years of age and older.

Medicaid

A federal and state assistance program that provides long-term care to low-income families and disabled older clients.

A senior high school student asks the school nurse which immunizations will be included in the precollege physical. Which vaccine would the nurse tell the student to expect to receive? - Hepatitis C (HepC) - Influenza type B (HIB) - Measles, mumps, rubella (MMR) - Diphtheria, tetanus, pertussis (DTaP)

- Measles, mumps, rubella (MMR) Individuals born after 1956 should receive one additional dose of MMR vaccine if they are students in postsecondary educational institutions. Currently there is no vaccine for hepatitis C. The HIB immunization is unnecessary. If the student received an additional DTaP at age 12, it is not necessary. A booster dose of tetanus toxoid (Td) should be received every 10 years.

The nurse advises a client to refrain from adding salt to food as a way to prevent high blood pressure. Which health care service is this? - Tertiary care - Primary care - Preventive care - Restorative care

- Primary care When the nurse provides nutrition counseling to the client, it qualifies as primary care. In the given scenario, the nurse advises the client to refrain from adding salt in the diet to prevent high blood pressure. Tertiary care includes intensive care and subacute care. Preventive care includes blood pressure and cancer screenings, immunizations, mental health counseling and crisis prevention, and community legislation. Restorative care includes cardiovascular and pulmonary rehabilitation, sports medicine, spinal cord injury programs, and home care.

Which color tag is assigned the lowest priority for care in a mass casualty event? A.) Red B.) Black C.) Green D.) Yellow

B.) Black Clients with black tags are expected to die or are already dead; therefore, these clients are the lowest priority. The first priority should be given for clients with a red tag because the client's life may be saved with immediate treatment. A client with a yellow tag should be given second priority because she or he can wait for the treatment for some time. A client with a green tag can be given care after some time, because her or his condition would be stable.

Information decay

When patient's health status changes rapidly and specific information is no longer relevant to the patients condition.

The nurse in the family planning clinic reviews the health history of a sexually active 16-year-old girl whose chief concern is a thick, burning vaginal discharge accompanied by low abdominal pain. After her examination, the girl is informed that she may have a sexually transmitted infection (STI) that requires treatment. The adolescent is concerned that her parents will discover that she is sexually active. She asks the nurse whether her parents will be contacted. How would the nurse respond? - "Your parents will not be contacted because treatment at the clinic is confidential." - "Your parents need to be informed to sign a consent form for testing and treatment." - "Your parents will be notified when the insurance company is billed for testing and treatment." - "Your parents will not be told if you promise to have your sexual contacts tested."

- "Your parents will not be contacted because treatment at the clinic is confidential." To prevent disclosure, family planning clinics treat these adolescents as emancipated minors who can sign their own consent forms. Federal law allows family planning clinics to maintain minors' confidentiality, although individual states may have different regulations. There is a concern that teenagers will not seek or continue treatment if they fear disclosure. Most family planning clinics receive funding and charge on a sliding scale based on income, thereby encouraging adolescents to seek treatment. Not telling the parents in exchange for the client having her sexual contacts tested could be viewed as coercion; if the STI is reportable, follow-up of sexual partners is indicated, but the adolescent will not be held responsible for ensuring that they report for testing.

Which activity by the community nurse is an illness prevention strategy? - Encouraging the client to exercise daily - Arranging an immunization program for chicken pox - Teaching the community about stress management - Teaching the client about maintaining a nutritious diet

- Arranging an immunization program for chicken pox An illness prevention program protects people from actual or potential threats to health. A chickenpox immunization program is an illness prevention program. It motivates the community to prevent a decline in health or functional levels. A health promotion program encourages the client to maintain his or her present levels of health. The nurse promotes the health of the client by encouraging the client to exercise daily. Wellness education teaches people how to care for themselves in a healthy manner. The nurse provides wellness education by teaching about stress management. The nurse promotes the health of the client by teaching the client to maintain a nutritious diet.

Which skills are essential for the nurse who is setting priorities for client care?

- Assessment - Critical thinking - Clinical-decision making Essential skills for the nurse who is setting priorities for client care include assessment, critical thinking, and clinical decision-making. Evaluation and case management are nursing skills; however, these are not essential for setting priorities.

Which type of therapy is suitable for a client who has unresolved residual feelings after being seen and treated for a physical attack by an unknown assailant? A.) Psychotherapy that emphasizes desensitization B.) Short-term therapy emphasizing crisis intervention C.) Long-term therapy with a psychoanalytical emphasis D.) Group therapy with a behavior modification component

B.) Short-term therapy emphasizing crisis intervention Crisis intervention helps the client put the event in perspective and resolve feelings so the individual can resume life within a short time. Desensitization is effective if the victim develops phobias as a result of the physical attack. Unless there are complicating factors, long-term therapy is not indicated. Behavior modification could be used if the client has provocative or aggressive behaviors that precipitated the attack.

When a client who has peripheral arterial disease of the lower extremities tells the nurse, "I walk so slowly that no one wants to walk with me," which response by the nurse is best? A.) "Many people enjoy walking alone." B.) "You will be able to walk faster eventually." C.) "It is important that you keep walking to improve circulation." D.) "Perhaps you might consider a supervised exercise training program."

D.) "Perhaps you might consider a supervised exercise training program." Supervised exercise training programs for peripheral arterial disease include exercise and walking programs that encourage new growth of vessels around the obstructed artery; this may improve peripheral perfusion and the ability to walk. These programs also involve interaction with a therapist and other clients, which may improve motivation. Although many people may enjoy walking alone, this client's statement indicates a preference for walking with others. An assurance that walking speed will improve does not address the client's current concern.

A client from China is referred to the National Cancer Institute in the United States for the treatment of a brain tumor. Which type of health information technology oversees the exchange of the client's health information among the client's health care providers and between the two countries? A.) Personal health record (PHR) B.) Electronic medical record (EMR) C.) The Decade of Health Information Technology D.) Regional Health Information Organization (RHIO)

D.) Regional Health Information Organization (RHIO) An RHIO is an essential element of the health information technology infrastructure. It supervises the exchange of a client's information among health care providers and across geographic areas. A PHR helps a client maintain her or his health records. The EMR is an individual's health record within a health care provider's facility. The Decade of Health Information Technology is a report presented by Dr. Brailer. It does not oversee the exchange of client information.

Which is the subset of clinical health care informatics?

Nursing Informatics NI is the subset of clinical health care informatics. This is a specialty that integrates nursing science, computer science, and information science to manage and communicate data, information, knowledge, and wisdom in nursing practice.