NU426 Final
A client has been diagnosed with small cell lung cancer. The client has met with the oncologist and is now weighing the relative risks and benefits of chemotherapy and radiotherapy. This client is demonstrating which ethical principle in making a final decision?
autonomy
The community health nurse is teaching a health care group levels of prevention. What is the nurse's foci with primary prevention? Select all that apply.
self-care promotion prevention of illness continuity of care collaboration with other healthcare providers
A nurse is giving an educational class to members of the local disaster team. What should the nurse instruct members of the disaster team to do in a chemical bioterrorist attack?
stand up- most chemicals are heavier than air
Which level of prevention focuses on minimizing deterioration and improving quality of life?
tertiary
Within the public health system there has been an increased demand for medical, nursing, and social services. The nurse should recognize what phenomenon as the basis for this increased demand?
the growing number of older adults in the population
The nurse has been notified that the ED is expecting terrorist attack victims and that level D personal protective equipment (PPE) is appropriate. What does level D PPE include?
the nurse's typical work uniform
A medical nurse is providing palliative care to a client with a diagnosis of end-stage chronic obstructive pulmonary disease (COPD). What is the primary goal of this nurse's care?
to improve the client and family's quality of life
Which specialty in nursing involves providing nursing care in the context of the client's culture?
transcultural nursing
A nurse working in an emergency department is responsible for determining the severity of the patients' problems and how fast each needs to be seen. The nurse is implementing which of the following?
triage
The nurse is triaging victims after an explosion at an oil refinery. One victim reports tinnitus, dizziness, and otorrhea. For what probable condition should the nurse prepare care?
tympanic rupture
A client presents to the acute care facility with several signs and symptoms. How will the nurse determine and prioritize the client's healthcare needs?
using a systematic method to plan and implement care to reach desired outcomes
You are part of a disaster response team. Your team has been activated, and you have just reported to your mobilization point. You are assigned to triage clients as they come in. What is the first act you should perform while assessing victims of a disaster?
wear protective clothes
A community health nurse is educating a group of community stakeholders on the importance of increased outpatient resources in the community. Which factors will the nurse explain directly impact the shift in care from inpatient to outpatient services? Select all that apply.
changes in population trends (aging population) changes to federal legislation decreasing hospital revenues tighter insurance regulations
The nurse is starting a new position with a home health agency. Which population most frequently uses home care services?
clients who are older adults
Nursing students are reviewing information about weapons of terror. The students demonstrate understanding of the information when they identify which of the following as examples of chemical weapons? Select all that apply.
cyanide phosgene sarin
The nurse walks into the client's room and finds a shaman "fluffing the aura" of the client. What is the best action of the nurse?
leave the room and provide privacy
A nurse is caring for clients exposed to a terrorist attack involving chemicals. The nurse has been advised that personal protective equipment must be worn in order to give the highest level of respiratory protection with a lesser level of skin and eye protection. What level protection is this considered?
level B
During a disaster, the nurse sees a victim with a green triage tag. The nurse knows that the person has which type of injury?
minor, treatment can wait for hours to days
The nurse understands that one of the characteristics of critical thinking is flexibility. What can the nurse do to achieve this characteristic?
modify priorities and adapt to change
A nurse working in an emergency department notes that several clients who have arrived at the emergency department within the past day are experiencing the same unusual signs and symptoms. All the clients have attended the same sporting event. Which of the following should the nurse do next?
obtain an extensive history from each client
The nursing instructor is talking with their students about botulism. The instructor tells the students that when caring for a client with botulism what condition is most likely to cause death?
paralysis of resp muscles
A nurse is providing care to clients who were involved in an explosion and have sustained secondary blast injuries. Which types of injuries would the nurse expect to find? Select all that apply.
penetrating trauma traumatic amputations
A nurse is participating in a vaccination clinic at the local public health clinic. The nurse is describing the public health benefits of vaccinations to participants. Vaccine programs addressing which of the following diseases have been deemed successful? Select all that apply
polio, diptheria, mumps
The nurse is providing a community education program about sexually transmitted infections for a group of 13- to 16-year-olds. What type of prevention is the nurse targeting?
primary
Which nursing action best demonstrates primary cancer prevention?
promoting and providing vaccines
A client in the clinic is diagnosed with diarrhea caused by a Campylobacter species. Which instruction should the nurse provide to prevent further episodes?
properly store and cook meat
A nurse is providing care to a client in the emergency department and walks into the hallway to get equipment. All of a sudden, gunshots are heard. Which of the following would be the nurse's priority?
protecting him or herself
Exposure to gamma radiation can be decreased by completing which action?
providing distance from radiation source
Several families arrive at the scene of a disaster and are asking for information about their family members. Which person would be most appropriate to provide them with any information?
public information officer
Clients involved in a mass casualty incident are triaged and assigned a color-coded tag. When prioritizing care, clients tagged with which color would be treated first?
red
During a mass casualty incident (hurricane), a triage nurse participated in separating patients according to the severity of their injuries. She tagged a patient with a sucking chest wound with the color:
red
The nurse is admitting a client who has been exposed to the botulinum toxin during a terrorist attack. What should the nurse include in the client's immediate interdisciplinary care? Select all that apply.
resp support admin antitoxin
A client with the diagnosis of ovarian cancer confides in the nurse that they practice holistic medicine. The client believes a cure exists through a macrobiotic diet, rather than what surgery or medical treatment can achieve. Which statement by the nurse is most appropriate?
"We can talk to your provider about adding this diet as a complementary therapy."
A client tells the nurse that she will be researching an alternative method of treatment for her disease. What is the most appropriate response by the nurse?
"You are within your right to search for other methods of treatment. Just be sure to inform your physician what treatments you are using."
Therapeutic communication techniques between client and nurse facilitate continuity of care. Which of the following identifies the value of therapeutic communication? Select all that apply.
Allows the nurse to display interest in the client and the communication Helps the nurse to assist the client to explore and understand his or her problems
A gerontologic nurse is making an effort to address some of the misconceptions about older adults that exist among health care providers. The nurse has made the point that most people aged 75 years and over remain functionally independent. The nurse should attribute this trend to what factor?
Application of health-promotion and disease-prevention activities
An infectious outbreak of unknown origin has occurred in a long-term care facility. The nurse who oversees care at the facility should report the outbreak to what organization?
CDC
The home health nurse receives a referral from the hospital for a client who needs a home visit for wound care. After obtaining the referral, what action should the nurse first take?
Call the client to obtain permission to visit.
A nurse is reviewing the medical record of a client to determine his eligibility for home care services. Which of the following would alert the nurse to a potential problem in this area?
Client attends social groups at a senior center three times a week.
A home care nurse is looking at ways that home care nurses can promote holistic care of the client. What action will the nurse implement in order to accomplish this task?
Collaboration with an interdisciplinary team
A public health nurse describes the role of the nurse in public health to a group of community stakeholders during a budget meeting. Which category of care will the nurse place public health nursing?
Community-oriented nursing
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
A client is declared to have a terminal illness. What intervention will a nurse perform related to the final decision of a dying client?
respect the client and family member's choices
A major goal for home care nurses is to
restore maximum health function.
A group of nurses have attended an in-service on the prevention of occupationally acquired diseases that affect health care providers. What action has the greatest potential to reduce a nurse's risk of acquiring hepatitis C in the workplace?
Disposing of sharps appropriately and not recapping needles
The family members of a dying client are finding it difficult to verbalize their feelings for and show tenderness to the client. Which intervention should a nurse perform in such a situation?
Encourage the family members to express their feelings and listen to them in their frank communication
A gerontologic nurse is overseeing the care in a large, long-term care facility. The nurse is educating staff about the significant threat posed by influenza in older, frail adults. What action should the nurse prioritize to reduce the incidence and prevalence of influenza in the facility?
Ensure that residents receive influenza vaccinations in the fall of each year.
A 42-year-old man has come to the clinic for an annual physical. The nurse notes in the client's history that his father was treated for breast cancer. What should the nurse provide to the client before he leaves the clinic?
Instructions about breast self-examination (BSE)
An elderly client, while being seen in an urgent care facility for a possible respiratory infection, asks the nurse if Medicare is going to cover the cost of the visit. What information can the nurse give the client?
Medicare has a copayment for many of the services it covers. This requires the client to pay a part of the bill.
A novice nurse is learning the difference between community-based nursing and community-oriented nursing. Which scenario does the nurse recognize as a role of the community-oriented nurse?
Nurse working a booth at a health fair performing blood pressure and glucose screenings
The RN is obtaining a health history and performing a physical assessment for a client who is admitted to the hospital with complaints of chest pain. What part of the nursing process is the RN performing?
assessment
When the nurse attempts to obtain vital signs, the client pulls away, gathers the bed covers to their chin, and speaks in a language unfamiliar to the nurse. What is the best action for the nurse to take?
attempt to find an interpreter
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
A nurse is collaborating with a team of community nurses to identify the vision and mission for community care. What is the central focus of community-based nursing?
Promoting and maintaining the health of individuals and families
When describing the Emergency Operations Plan (EOP) to a group of nurses working as part of a disaster response team, which of the following would be identified as its primary goal?
Protection of the community
What nursing interventions are performed by the school nurse? Select all that apply.
Provide first aid care for a laceration Perform health screenings for hearing deficits Teach sexuality in a health class Administer glucagon for hypoglycemia
A hospital nurse is transitioning to a home health nurse position. The nurse has learned that the client smokes while at home. What will the nurse need to do to work therapeutically with the client in the home setting?
Resolve to convey respect for the client's beliefs and choices.
The home care nurse is finishing a visit with a client. What teaching points should the nurse cover with the client and client's family member prior to leaving? Select all that apply.
Teach back instruction on new procedures or medication administration A review of the teaching plan with written instructions Positive findings during the visit in order to provide encouragement
In which situation is the nurse providing tertiary prevention?
Teaching rehabilitation exercises to a client after a mastectomy
A nurse is caring for an older adult with emphysema. Which nursing action demonstrates primary prevention?
Teaching the client various methods to help prevent pneumonia
The nurse is caring for a patient who is to be discharged from the acute care facility to a rehabilitation unit after having a stroke. What type of prevention is this considered to be?
Tertiary
There are specific legal guidelines and regulations for the documentation related to home care. When providing care for a client who is a Medicaid recipient, what is most important for the nurse to document?
The client's homebound status and the specific need for skilled nursing care
A community health nurse is creating a task force to improve access of quality healthcare for the homeless population. What statements regarding the homeless population will guide the nurse when creating the program? Select all that apply.
The homeless population seeks healthcare later than individuals who are not homeless. The homeless population has lower life expectancies than those who are not homeless. The homeless population deteriorates more quickly than individuals who are not homeless.
A home care nurse is planning to visit a client newly diagnosed with diabetes. Further review of the chart reveals the client is of Japanese heritage. Upon arriving at the home, the home care nurse observes several pairs of shoes on a mat next to the door. Which of the following actions by the nurse demonstrates cultural competence?
The nurse removes her shoes and announces her arrival.
A public health nurse administers influenza vaccines to a group of individuals during a community vaccination clinic. The nurse understands that this action is considered primary prevention due to which statement?
The vaccination focuses on health promotion and prevention of illness.
The nurse educator is discussing emerging diseases with a group of nurses. The educator should cite what causes of emerging diseases? Select all that apply.
Use of extended-spectrum antibiotics population movements increased global travel globalization of food supplies
A community health nurse understands the importance and impact of cultural competence when caring for clients in the community. In what situation will the nurse find that cultural competence is particularly important?
When members of the community share a heritage that is unfamiliar to the nurse
A nurse is caring for a recently immigrated client who is in end-stage kidney disease. The physician offers to discharge the client home to hospice care, but the client and family refuse. After the physician leaves, the client's daughter approaches the nurse and asks what hospice care is. What would this lack of knowledge about hospice care be perceived as?
a barrier to hospice care for this client
The nurse is caring for three clients who have been diagnosed with anthrax. They were exposed after boarding a flight where a white powdery substance was found in one of the restrooms. The nurse knows that these clients would be classed as being victims of which of the following?
a biologic disaster
How can the nurse best provide culturally sensitive care?
accept each client as a unique individual
To prepare the community for the possible threat of anthrax, a nurse must teach that:
anthrax can infect the integumentary, GI, and respiratory systems.
Which of the following interventions should the nurse perform while providing spiritual care for a dying client?
ask the family members about spiritual care
During a mass casualty event, a person whose injuries are extensive and whose chances of survival are unlikely even with definitive care would receive which color tag?
black
When describing the use of smallpox as a biologic agent, which of the following would the nurse include as the primary means of infection?
direct contact
The nurse has just taken report on a newly admitted client who is a 15-year-old girl who is a recent immigrant. When planning interventions for this client, the nurse knows the interventions must be which of the following? Select all that apply.
ethical appropriate to clients culture appropriate to clients age
During an interview for a position at an ambulatory clinic, the nurse notices that family planning counseling is included in the job description. As a devout Catholic, how should the nurse best proceed with the interview?
excuse herself from the interview, stating she is catholic
A nurse working in the community is involved in secondary prevention. Which activity would most likely apply?
health screening for diabetes risk
According to the U.S. Department of Homeland Security, what are indications of bioterrorism? Select all that apply.
higher numbers of people seeking healthcare clusters of sick people from a shared location atypical incidence of illness for time of year
A patient who is Asian practices the yin/yang theory of harmony and illness. What paradigm of health and illness is this practice rooted in?
holistic
Which type of care is used for clients with terminal illness who have a life expectancy of less than 6 months?
hospice care
The nurse assisting at the scene of a terrorist bombing is assessing bystanders for quinary effects from the blast. The nurse assesses for which signs and symptoms? Select all that apply.
hyperpyrexia and diaphoresis
The nurse is monitoring a client's status following an angioplasty procedure. Which step of the nursing process this nurse engaged in?
implementation
A community health nurse is helping develop teaching on the role of the community health nurse and how this discipline can help the community. What does the nurse describe as a key component of community-based care?
improving quality of life
Which capability corresponds with home health care?
improvises when providing care
Which title refers to a management tool for organizing personnel, facilities, equipment, and communication for any emergency situation?
incident command system
A pipe bomb detonated on a city bus, causing numerous casualties. This would be an example of which type of disaster?
intentional human
The nurse is instructing volunteers at an emergency bioterrorism drill about the management and medications required to combat various viruses, bacteria, and toxins. The nurse knows that the volunteers understand the instruction when they state that managing clients who exhibit symptoms of the variola virus (smallpox) includes
isolation
The nurse is conducting a community education class on cultural diversity. The nurse explains that cultural sensitivity includes which of the following?
knowledge of cultural preferences
The nurse is meeting a homeless client for wound care. What groups represent growing proportions of those who are chronically homeless? Select all that apply.
women who experience abuse veterans
