community health ATI

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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?

a. provide nutritional counseling for students who have diabetes
b. conduct vision and hearing screening for kindergarten enrollment
c. demonstrate proper hand washing techniques
d. report suspected child neglect to the proper authorities

c. demonstrate proper hand washing techniques

a school nurse is conducting hearing screening procedures in an elementary school. which of the following instructions should the nurse provide when preforming the Rinne test?

a. after i place the tuning fork on your scalp, tell me if you hear the sound better in one ear or the same in both ears
b. you’ll wear headphones and press the button when you hear a sound
c. after i place this tuning fork behind your ear, tell me when you no longer hear the sound
d. use your finger to close one ear while i whisper some numbers into your other ear

c. after i place this tuning fork behind your ear, tell me when you no longer hear the sound

a palliative care nurse is teaching a client who has cancer about the services that are available for the client. which of the following statements should the nurse identify as an indication that the client understands the teaching?

a. I can begin palliative care when i have less than 6 months to live
b. this type of care can help me with pain control
c. my family will not be involved with this type of care program
d. if I begin palliative care, i will have to stop my chemotherapy

b. this type of care can help me with pain control

a nurse is assessing a new client. which of the following information should the nurse include in the cultural portion of the assessment?

a. employment status
b. history of illness
c. sexual orientation
d. food preferences

d. food preferences

a nurse is collecting demographic data as a part of a community assessment. which of the following info should the nurse include?

a. presence of condemned buildings
b. racial distribution
c. family genograms
d. number of open water sources

b. racial distribution

a nurse is caring for a client who has AIDS and is experiencing rapid weight loss. which of the following actions should the nurse take first?

a. recommend the client increase her daily calorie intake by 25%
b. teach the client about findings that should be reported to the provider
c. encourage the client to consume 1.2-2.0g/kg of protein daily
d. examine the client’s oral mucous membranes

d. examine the client’s oral mucous membranes

a home health nurse is caring for a client who has breast cancer. which of the following assessment findings should the nurse identify as an indication that the client is coping effectively?

a. excessive sleeping
b. makes eye contact
c. inability to concentrate
d. lack of interest in food

b. makes eye contact

a home health nurse is scheduling client visits for the day. which of the following clients should the nurse plan to visit first?

a. a client who is 10 days postoperative following a mastectomy and needs to have surgical staples removed
b. a client in a hip spica cast who reports pruritus under the cast
c. a client who has diabetes mellitus and reports new erythema to the left foot
d. a client who has COPD and needs a follow-up visit related to home oxygen therapy

c. a client who has diabetes mellitus and reports new erythema to the left foot

a community health nurse is assessing a group of clients for risk factors of abusive behaviors. which of the following findings should the nurse identify as a risk factor for developing violent behavior?

a. a client lives in the same neighborhood where he spent his childhood years
b. a client states he witnessed his mother physically mistreat his father
c. a client states that her mother-in-law provides childcare while she is working
d. a client participates in volunteer activities in the community

b. a client states he witnessed his mother physically mistreat his father

a school nurse is teaching health promotion to a group of staff members who sit at a desk and use a computer for 8 hr at a time. which of the following information is the priority for the nurse to include?

a. take a walk after work
b. have your visual acuity assessed regularly
c. adjust your chair so your elbows are at desk height
d. point and flex your toes periodically

d. point and flex your toes periodically

a case manager is planning an educational program for a client who has DM. which of the following activities should the nurse include when using the psychomotor domain of learning?

a. show the client a video about how to monitor blood glucose levels
b. give the client a pamphlet about foot care
c. observe the client’s technique for drawing up insulin
d. review the color diagram of the food pyramid with the client

c. observe the client’s technique for drawing up insulin

a nurse manager at a community health clinic is presenting an in-service for nurses about assessing clients for abuse. which of the following statements by a nurse indicates an understanding of the teaching?

a. I should not document the name of the person the client accuses of the abuse in the client’s medical record
b. i should wait until I see signs of physical abuse before I help the client develop a safety plan
c. once I determine that a client is not at risk for abuse, I do not need to ask about it at future visits
d. i should refer a client for a rape kit exam if she reports sexual assault within the previous 24 hours

d. i should refer a client for a rape kit exam if she reports sexual assault within the previous 24 hours

a nurse is teaching a client who has a new diagnosis of hepatitis A how to prevent the spread of the virus. which of the following instructions should the nurse include?

a. clean your bathroom fixtures with a chlorine bleach solution
b. rinse your toothbrush with hydrogen peroxide after each use
c. use condoms during sexual contact for 2 weeks
d. use shared hand towels to dry your hands after washing

a. clean your bathroom fixtures with a chlorine bleach solution

a community health nurse is developing a plan of care for a client who is hispanic. which of the following actions should the nurse include in the plan?

a. maintain direct eye contact when speaking with the client
b. avoid using hand gestures when working with the client
c. discourage the client from using a faith healer
d. use therapeutic touch during conversation

d. use therapeutic touch during conversation

a nurse is conducting an educational session at an assisted living facility for a group of clients who have osteoporosis. which of the following statements should the nurse include in the teaching?

a. decrease your dietary intake of folate
b. increase your daily intake of leafy green vegetables
c. it is important to avoid weight-bearing exercises
d. it is important to spend 30 min each day exposed to sunlight

b. increase your daily intake of leafy green vegetables

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 then use include?

a. you will feel a sense of hopelessness throughout the grieving process
b. it is common to experience a persistent state of sadness while grieving
c. disturbances in your self esteem is an expected grief reaction
d. a component of healthy grieving is the ability to openly express your anger

d. a component of healthy grieving is the ability to openly express your anger

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 for tertiary prevention?

a. provide immunizations at long-term care facilities
b. offer classes to elementary school teachers about hand washing
c. provide info to occupational nurses about the reasons for employees to not come to work
d. administer antiviral meds within 48 hr to client who have manifestations fo influenza

d. administer antiviral meds within 48 hr to client who have manifestations fo influenza

an occupational health nurse is planning to use an interpreter during an educational session with a group of migrant workers who do not speak the same language as the nurse. which of the following actions should then use take? (select all that apply)

a. evaluate the interpreter’s approach to clients prior to the educational session
b. instruct the interpreter to guide the nurse in providing info in a culturally sensitive manner
c. ask the interpreter to add info she feels may be necessary
d. encourage the interpreter to paraphrase the workers’ questions and responses
d. choose an interpreter who speaks the workers language and dialect

a. evaluate the interpreter’s approach to clients prior to the educational session b. instruct the interpreter to guide the nurse in providing info in a culturally sensitive manner d. choose an interpreter who speaks the workers language and dialect

a nurse in a rural health clinic is caring for a client who has heart failure. the client states "I’m not going to take any more heart medicine." which of the following responses should the nurse make?

a. why did you decide to stop your heart medicine?
b. don’t you know what stopping your medicine will do to your heart?
c. don’t you think your doctor knows what’s best for your heart?
d. can you tell me more about your decision to stop your medicine?

d. can you tell me more about your decision to stop your medicine?

a community health nurse is planning an educational program for farmers about occupational health risks. which of the following risks should the nurse include?

a. respiratory disorders
b. hypertension
c. sickle cell anemia
d. diabetes mellitus

a. respiratory disorders

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 this population?

a. unavailability of outreach services
b. less autonomy in providing client care
c. lack of cohesiveness among community members
d. disinterest by members of population in providing input for community health programs

a. unavailability of outreach services

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?

a. I will need to purchase exercise equipment before I can start"
b. I will see my doctor before beginning an exercise program
c. i should try to perform aerobic exercise for an hour a day, 5 days a week
d. I should avoid participating in weight-lifting exercises

b. I will see my doctor before beginning an exercise program

a public health nurse is participating in a community planning committee for disaster preparedness for a local community that is at risk for hurricanes. which of the following information should the nurse contribute to the plan?

a. how to activate the local medical facility’s emergency-management plan
b. a list of residents who have experienced a hurricane in the past and will not need evacuation
c. the name of the individual who is necessary to implement the plan
d. a list of areas within the community where residents speak english as a second language

d. a list of areas within the community where residents speak english as a second language

a nurse s providing blood pressure screenings for older adult clients at a local community center. which of the following should the nurse identify as increasing a client’s risk for developing hypertension

a. HDL level greater than 70 mg/dL
b. african american race
c. daily walking routine
d. BMI of less than 30

b. african american race

a home health nurse is planning care for the day. which of the following clients should the nurse visit first?

a. an older adult client who has a newly prescribed antihypertensive medication and needs a BP check
b. an older adult client who was treated in the ED last night for a stage III pressure ulcer
c. a school-age child who was treated in the ED last night with status asthmaticus
d. a school-age child whose percutaneous endoscopic gastrostomy (PEG) tube needs changing

c. a school-age child who was treated in the ED last night with status asthmaticus

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

a. a client who has a new onset of confusion and slurred speech
b. a client who has a temperature of 37.8C (100.1 F)
c. a client who has COPD and an oxygen saturation of 92%
d. a client who requires removal of sutures from a laceration

a. a client who has a new onset of confusion and slurred speech

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

a. insert the needle at a 45 degree angle
b. create a wheal that measures about 15 mm in diameter
c. preparing the outer aspect of the upper arm for the injection
d. inject 0.1 mL of purified protein derivative

d. inject 0.1 mL of purified protein derivative

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

a. migrant clinicians network (MCN)
b. U.S. preventive services task force (USPSTF)
c. agency for healthcare quality and research (AHRQ)
d. centers for disease control and prevent

a. migrant clinicians network (MCN)

a school nurse is conducting visual acuity testing for a school-age child. which of the following actions should the nurse take?

a. progress to the next line once the child reads two symbols correctly
b. have the child stand 5 feet away from the snellen letter chart
c. allow the child to keep her glasses on during the testing
d. begin the test by instructing the child to use both eyes to read the chart

c. allow the child to keep her glasses on during the testing

a public health nurse is developing a visual health program by using a community-oriented approach. which of the following interventions should the nurse include?

a. provide genetic counseling to the family of a newborn who has congenital cataracts
b. develop a plan of care for a client who is newly diagnosed with glaucoma
c. teach a client who has a vision loss about safety in the home environment
d. consult the local school nurse to schedule yearly vision screenings for students

d. consult the local school nurse to schedule yearly vision screenings for students

a public health nurse is planning care for four clients. which of the following interventions should the nurse recognize as tertiary prevention?

a. providing chemoprophylaxis for malaria to a client who is traveling to mosquito-infested countries
b. administering antibiotics to a client who has AIDS and was diagnosed with pneumocystis jiroveci
c. performing a serological screening for HIV for a client who is pregnant
d. participating in partner notification for a client who has an STI

b. administering antibiotics to a client who has AIDS and was diagnosed with pneumocystis jiroveci

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 mom died last year." which of the following responses should the nurse make?

a. it sounds like you are probably an alcoholic
b. i don’t think your mom would have approved of your drinking
c. don’t you think your family is being affected by your drinking?
d. can i give you some information about alcoholic anonymous?

d. can i give you some information about alcoholic anonymous?

a public health nurse is developing a presentation for local day care providers about infectious childhood diseases. which of the following statements should the nurse include?

a. "children who have fifth disease will exhibit bloody diarrhea"
b. "rotavirus infections in children peak during the summer months"
c. "antiviral medications shorten the duration of shigella infection"
d. "respiratory syncytial virus is spread through contact with respiratory secretions from an infected person"

d. "respiratory syncytial virus is spread through contact with respiratory secretions from an infected person"

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

a. determine the incidence rate
b. institute prophylactic treatment
c. educate the community about disease transmission
d. discuss treatment plans with clients’ families

a. determine the incidence rate

a community health nurse is discussing the concept of epidemiology with a coworker. which of the following interventions should the nurse provide as an example of the use of the principles of epidemiology?

a. providing a client with info about preventing STIs
b. reviewing county health records for data on cases of chickenpox
c. conducting screenings for dental caries in the local school system
d. documenting medication compliance for clients who have TB

b. reviewing county health records for data on cases of chickenpox

a community health nurse is assigned to lead a county-level environmental task force. which of the following activities should the nurse direct the task force to complete first?

a. review community-specific epidemiological data
b. recommend updates to local environmental policies
c. distribute environmental health education materials to community members
d. create program goals that align with healthy people 2020 objectives

a. review community-specific epidemiological data

a community health nurse is teaching a client who was newly diagnosed with active pulmonary tuberculosis about disease transmission. which of the following information should the nurse include?

a. household members should be placed in respiratory isolation
b. the client should have a repeat purified protein derivative test in 3 months
c. the client should use disposable utensils during meals
d. household members should take isoniazid for 6-12 months

d. household members should take isoniazid for 6-12 months

The daughter of the client who has had a stroke asks the nurse for additional resources. What is the nurse’s best response?

a. increase the illumination in the room
b. administer citalopram when the client is agitated
c. give the client brief hand massages
d. place a warm cloth on the clients forehead

c. give the client brief hand massages

a community health nurse has been contacted regarding a client diagnosis of influenza type A in an adult day care. which fo the following actions should the nurse take to assist in the prevention of an outbreak?

a. administer antiviral medication to clients at the facility
b. recommend that the day care center close for 2 weeks
c. schedule immunizations for clients at the facility
d. give immune globulin to clients at the facility who have early manifestations of influenza

a. administer antiviral medication to clients at the facility

a nurse in a rural community is planning education for a young adult client who is a migrant farm worker. which fo the following actions should the nurse include? (select all that apply)

a. recommend a dental health screening
b. provide skin cancer information
c. provide forms to apply for medicare
d. provide environmental health information
e. refer the client for a tuberculosis screening

a. recommend a dental health screening b. provide skin cancer information d. provide environmental health information e. refer the client for a tuberculosis screening

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

a. attack rate
b. mortality rate
c. incidence proportion
d. prevalence proportion

d. prevalence proportion

a home health nurse is assessing an older adult client who is taking captopril to treat heart failure. which of the following findings should the nurse identify as an adverse effect of this medication?

a. dry cough
b. weight gain
c. ataxia
d. photophobia

a. dry cough

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?

a. lower extremities
b. posterior shoulders
c. face
d. abdomen

c. face

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?

a. distributive justice
b. fidelity
c. beneficence
d. respect for autonomy

c. beneficence

a nurse is conducting a home visit with a female client who reports a history of intimate partner abuse. the nurse should identify that which of the following findings places the client at greatest risk for domestic violence?

a. the client visits friends without her partner’s knowledge
b. the client states she is leaving her partner
c. the client is at 13 weeks of gestation
d. the client recently started a new job

b. the client states she is leaving her partner

a case manager is delivering a discharge plan for a client who has a spinal cord injury and is in a rehabilitation facility. which of the following actions should the nurse take first?

a. contact service providers to determine the availability of services offered
b. determine the client’s ability to perform self-care
c. hold a care conference with the client and his family to discuss treatment options
d. evaluate the client’s satisfaction with the case managers services

b. determine the client’s ability to perform self-care

a nurse at a county health clinic is caring for a client who has recently assumed the role of primary caregiver for her mother. which of the following statements by the client indicates that she is experiencing role conflict?

a. i feel overwhelmed with not having enough time for my mom as well as my children
b. i hope my siblings will be able to visit and help care form y mom for a few days
c. i don’t think my partner likes having to help more with the household chores
d. i am glad that my job is flexible, so i can accommodate to my moms needs

a. i feel overwhelmed with not having enough time for my mom as well as my children

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. an infant who has bronchiolitis
b. an infant who is 4 weeks old
c. a client who is traveling to northern Europe
d. a client who is moving into a college dormitory

d. a client who is moving into a college dormitory

a public health nurse is providing information to a client who has alcohol use disorder and is asking about treatment. which of the following statements should the nurse identify as an indication that the client understands the information?

a. i am not eligible for an outpatient program until i have completed an inpatient program first
b. i can expect to get help with other aspects of my life while in treatment
c. once i make it through detoxification, i will be free of my addiction
d. i will not have to completely stop drinking alcohol if i go into an inpatient treatment program

b. i can expect to get help with other aspects of my life while in treatment

a nurse on the scene following a mass casualty explosion is triaging a client who has a large, open occipital wound and the following findings: respiratory rate 6/min, atonal pattern; capillary refill time 4.5 seconds; non responsive to painful stimuli. which of the following actions should the nurse take?

a. apply a cervical spine collar and perform a focus neurological exam
b. turn the client to left semi-fowler’s position and begin assessing the next client
c. place a firm pressure dressing on the occiput and open the airway
d. request that the client be assessed immediately by the next available provider

b. turn the client to left semi-fowler’s position and begin assessing the next client

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 alzheimers disease?

a. experiencing incontinence
b. withdrawal from social activities
c. forgetting the location of common objects
d. neglecting personal hygiene

c. forgetting the location of common objects

a community health nurse identifies an increase in the occurrence of osteoporosis related fractures in women experiencing menopause. which of the following primary prevention strategies should the nurse implement?

a. encourage the women to participate in weight-bearing activities
b. advise the women to keep their immunization updated
c. educate the women about the importance of limiting sun exposure
d. instruct at-risk women to increase there intake fo foods high in vitamin E

a. encourage the women to participate in weight-bearing activities

a nurse is caring for a client who has terminal lung cancer and is receiving hospice care. which of the following statements should the nurse identify as an indication that the client is in the denial stage of the grief process?

a. I’m going to plan my memorial service next week
b. I don’t deserve to die. this just isn’t fair
c. If I could just make it through this, I’d never smoke again
d. I’m looking forward to my daughter’s wedding next year

d. I’m looking forward to my daughter’s wedding next year

a home care 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 he is socially isolated?

a. have you considered moving to an assisted living facility?
b. do you need help completing you’re housework?
c. how often do you have visitors come to see you?
d. why haven’t you brought in your newspapers?

c. how often do you have visitors come to see you?

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?

a. the faith community nurse can facilitate substance abuse support groups
b. the faith community nurse can provide pharmacological pain management for clients who have a terminal illness
c. the faith community nurse can plan workplace safety training for employees in a local factory
d. the faith community nurse can provide wound care for clients in their home

a. the faith community nurse can facilitate substance abuse support groups

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?

a. health surveys
b. morbidity/mortality statistics
c. medical records
d. informant interviews

d. informant interviews

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 client statements indicates an understanding of the teaching?

a. i will increase the amount of red meat and milk in my child’s diet
b. i will use hot tap water to prepare my baby’s formula
c. i will vacuum our wood floors every week
d. i will use a dry-sanding technique when preparing to repair my front door

a. i will increase the amount of red meat and milk in my child’s diet

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)

a. written audits
b. interviews
c. values self-study
d. satisfaction survey
e. focus groups

a. written audits b. interviews d. satisfaction survey e. focus groups

a community health nurse is planning an in-service about STIs for a group of adolescents. which of the following clinical findings should the nurse include as a manifestation of primary syphilis?

a. lymphadenopathy
b. maculopapular rash on palms
c. chancre
d. malaise

c. chancre

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?

a. provide information on parenting classes so the client can learn about caring for a newborn
b. help the client obtain a provider for prenatal care
c. request permission to interview the father of the child to obtain a medical history
d. recommend that the adolescent meet with the school guidance counselor to discuss educational options

b. help the client obtain a provider for prenatal care

a community health nurse is planning to establish a community garden to address the lack of nutritious food options in the area. which of the following actions should the nurse take first to initiate the plan?

a. monitor the progress of the project to keep the project on course
b. select residents to take on leadership roles in the project
c. identify community members who demonstrate an interest in the project
d. hold a community information session to inform the residents of the plan

c. identify community members who demonstrate an interest in the project

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?

a. lives alone
b. taking outdated prescriptions
c. has a BMI of 25
d. presence of alcohol in the home

b. taking outdated prescriptions

a nurse is caring for a 16 year old client who has a new diagnosis of human papilloma virus. which of the following actions should the nurse take?

a. instruct the client to return for a blood test in 1 month
b. report the infection to the state health department
c. teach the client how to apply imiquimod 5% cream to the lesions
d. administer ceftriaxone 250 mg IM

c. teach the client how to apply imiquimod 5% cream to the lesions

a school nurse is reviewing the records of four students who are returning to school after being diagnosed with methicillin-resistant staphylococcus aureus (MRSA). which of the following actions should the nurse take?

a. recommend prophylactic treatment of classmates
b. provide education about MRSA throughout the school system
c. report the cases of MRSA to child protective services
d. coordinate an immunization clinic at the school

b. provide education about MRSA throughout the school system

a public health nurse is conducting an educational session about lyme disease for a group of older adult clients at a senior center. which of the following statements should the nurse identify as an indication that the client understands the teaching?

a. i can get lyme disease from a mosquito bite
b. i will have abdominal pain and diarrhea if i get lyme disease
c. i should get an annual immunization to prevent lyme disease.
d. i can take penicillin for 10-14 days to manage lyme disease

d. i can take penicillin for 10-14 days to manage lyme disease

a school nurse is educating a group of high school students about recommended dietary guidelines. which of the following statements by a student indicates an understanding of the teaching?

a. i should consume less than 300 mg per day of dietary cholesterol
b. i should consume 800 mg per day of dietary calcium
c. i can increase my daily consumption of foods that contain refined grains
d. i can consume up to 25% of my daily calories from saturated fatty acids

a. i should consume less than 300 mg per day of dietary cholesterol

a community health nurse is creating a program to reduce domestic violence in the community. which of the following interventions should the nurse identify as secondary prevention?

a. collaborating with support agencies to ensure the ongoing treatment for abuse
b. recognizing and reporting suspected abuse to the appropriate protective services
c. educating individuals and groups about preventing domestic and community abuse
d. creating a public service announcement about the warning signs of intimate partner abuse

b. recognizing and reporting suspected abuse to the appropriate protective services

a nurse in a clinic is planning teaching for a client who is newly diagnosed with hepatitis C. which of the following instructions should the nurse include in the teaching?

a. schedule an appointment for an immunoglobulin injection
b. wear a mask in public places while receiving treatment
c. abstain from sexual intercourse until antibody tests are negative
d. consume a low-carbohydrate diet until symptoms resolve

c. abstain from sexual intercourse until antibody tests are negative

a nurse at a country 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 for potential future abuse of the newborn?

a. the client recently married the father of her unborn baby
b. the client has changed providers three times during her pregnancy
c. the client works part-time at a local resturant
d. the client has recurring nightmares about her unborn baby

b. the client has changed providers three times during her pregnancy

a public health nurse is planning and educational program for a group of nurses at a community health department about pertussis infection. which of the following information should the nurse include?

a. individuals who have had pertussis do not require immunization
b. newborns should receive the first dose of the diphtheria, tetanus, and acellular pertussis (DTaP) vaccine prior to discharge from the hospital
c. individuals should receive an annual influenza vaccine to minimize the risk fo infection with pertussis
d. individuals transmit the pertussis bacteria through airborne droplets

d. individuals transmit the pertussis bacteria through airborne droplets

a clinic nurse is caring for a client who reports taking ginkgo biloba for several weeks since seeing a naturopathic healer. the nurse should instruct the client that ginkgo biloba may alter the effects of which fo the following medications?

a. diltiazem
b. warfarin
c. digoxin
d. metoprolol

b. warfarin

a faith community nurse is teaching the daughter of a client who has a terminal illness about her role as a member of the client’s health care team. which of the following statements by the daughter indicates an understanding of the teaching?

a. you will be able to access my mother’s hospital medical records for us to review
b. you can submit invoices to medicare to reimburse you for your services
c. you will be able to give my mother pain medication
d. you will coordinate with volunteers who will come to help my mother

d. you will coordinate with volunteers who will come to help my mother

a home health care nurse is teaching a client’s family about preventing the transmission of Clostridium difficile. which of the following transmission-based precaution should the nurse include in the teaching?

a. protective environment
b. airborne precautions
c. droplet precautions
d. contact precautions

d. contact precautions

a nurse is performing a home visit for a client who has TB. as the nurse is leaving the client’s house, a neighbor asks, "is it true that my neighbor has TB?" which of the following responses should the nurse make?

a. you should take precautions against this infection
b. have you ever been tested for TB?
c. you should ask the public health department
d. do you have questions about TB

d. do you have questions about TB

a nurse is developing a venogram for a client to determine education needs. which of the following health risks information should the nurse expect to obtain with this tool?

a. economic
b. social
c. behavioral
d. biological

d. biological

an occupational health nurse is assessing a client who reports taking ibuprofen daily. the nurse should counsel the client about the risk for which of the following adverse effects?

a. hyperglycemia
b. gastric ulcerations
c. urinary retention
d. orthostatic hypotension

b. gastric ulcerations

a nurse is giving a presentation about family violence at a local community center. which of the following information should the nurse include?

a. child abuse is more common in homes where intimate partner abuse is present
b. child who are abused are less likely to become abusers
c. minority populations may be at greater risk for abuse
d. intimate partner abuse occurs more frequently in lower socioeconomic households

a. child abuse is more common in homes where intimate partner abuse is present

a nurse in an emergency department is triaging clients following an explosion at a local factory. which of the following clients should the nurse identify as a priority?

a. a client who has agonal respirations and an open head injury
b. a client who has tracheal deviation and shortness of breath
c. a client who has a fracture of the humerus and a bleeding foot laceration
d. a client who has superficial burns to 10% of the abdomen

b. a client who has tracheal deviation and shortness of breath

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?

a. implement an exercise program for clients who have hypertension
b. teach clients who have family history of hypertension how to monitor blood pressure
c. conduct a hypertension screening clinic for the community
d. provide education about risk factors for hypertension

a. implement an exercise program for clients who have hypertension

a home health nurse is conducting a follow-up visit for a client who was recently discharged from an acute rehabilitation program for alcohol use disorder. which of the following actions should the nurse take?

a. schedule transcranial magnetic stimulation (TMS) biweekly
b. tell the client to take naltrexone daily
c. teach the client to avoid foods that contain tyramine
d. instruct the client to take buprenophine for the next 9 to 12 months

b. tell the client to take naltrexone daily

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?

a. food allergies
b. illness practices
c. sexual activity
d. immunization status

b. illness practices

a school nurse is notified that a school-age child has been newly diagnosed with pertussis. which of the following actions should the nurse take? (select all that apply)

a. instruct the parent to keep the client at home until the coughing stage has passed
b. encourage the family members to obtain prophylactic treatment
c. check the immunization status of the child’s classmates
d. recommend that the child receive a pneumococcal vaccine in 28 days
e. quarantine the children in the child’s class

a. instruct the parent to keep the client at home until the coughing stage has passed b. encourage the family members to obtain prophylactic treatment c. check the immunization status of the child’s classmates

a nurse is caring for a client who has stage IV pancreatic cancer and has received information regarding available treatment options. which of the following is the responsibility of the nurse if the client chooses to forgo treatment and enter hospice care?

a. assess whether or not the family agree with the clients decision
b. verify that the clients health insurance pays for hospice services
c. make the hospice referral in accordance with the clients decision
d. recommend a second opinion for another provider

c. make the hospice referral in accordance with the clients decision

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 client who is pregnant?

a. tetanus, diphtheria, pertussis (TDaP)
b. measles, mumps, rubella
c. varicella
d. herpes zoster

a. tetanus, diphtheria, pertussis (TDaP)

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

a. inform the provider of the client’s decision
b. provide the client with an educational pamphlet about the medication
c. determine the client’s reason for discontinuing the medication
d. discuss the consequences of discontinuing the medication with the client

c. determine the client’s reason for discontinuing the medication

community leaders have requested a meeting with a community health nurse to discuss creating a mobile meals program. which of the following should the community health nurse assess first?

a. the need for the program
b. the availability of volunteers
c. the leadership support of the community
d. the accessibility of residences

a. the need for the program

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

a. use an N95 respiratory
b. wear gloves
c. use disposable equipment
d. wear a gown

a. use an N95 respiratory

a community health nurse is reviewing plans for a health education program. the nurse should identify that which of the following components of the plan needs to be changed?

a. the presentation is delivered via a computer slide presentation
b. pamphlets are written at a 12th grade level
c. program content is organized topically
d. attendance at the program is voluntary

b. pamphlets are written at a 12th grade level

a nurse is planning health promotion activities for the local community. which of the following activities should the nurse include as an example of primary prevention?

a. teaching foot care to adults who have diabetes mellitus
b. providing tuberculosis screenings for day care providers
c. testing school-age children for lead exposure
d. teaching meal planning classes to older adults

d. teaching meal planning classes to older adults

a home health nurse is providing nutritional instructions to a client who has COPD and is malnourished. which of the following instructions should the nurse include?

a. avoid foods that contain eggs
b. lie flat for 15 to 30 min after eating
c. use milk instead of water when making canned soup
d. drink at least 480 mL (16 oz) of liquid with each meal

c. use milk instead of water when making canned soup

a nurse in a pediatric clinic is providing care to several clients. the nurse should recognize that which of the following conditions is included in the Nationally Notifiable Infectious Conditions list?

a. varicella
b. scarlet fever
c. erythema infectious
d. molluscum contagiosa

a. varicella

a nurse is caring for a client who has recently emigrated from another country and states, "the health care system in my country was better and should be used everywhere." the nurse should recognize that the client is demonstrating which of the following behaviors?

a. ethnocentrism
b. social organization
c. stereotyping
d. cultural imposition

a. ethnocentrism

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?

a. safer sex practices
b. heart-healthy diet
c. underage smoking
d. safety belt use

d. safety belt use

A nurse in an emergency department is planning care for a client who has a flail chest on the right side following a motor vehicle crash which of the following actions should the nurse plan to take?

a. ask the client why he did not seek shelter sooner
b. initiate a referral to the facility’s social worker
c. notify the local law enforcement agency of the client’s situation
d. tell the client everything will work out now that he is in the hospital

b. initiate a referral to the facility’s social worker

a nurse in a community health clinic is preparing to administer an immunization to a 5 year old child. which fo the following actions should the nurse take?

a. request that the child count backwards from the number 10 during the injection
b. ask the child to pretend to blow up a balloon during the injection
c. reassure the child that the injection is not going to hurt
d. ask the child’s parent to leave the room during the injection

b. ask the child to pretend to blow up a balloon during the injection

a nurse is developing a community education program about risk factors for family violence. the nurse should include which of the following circumstances as a risk factor for intimate partner abuse?

a. attempting to end the relationship
b. lacking supportive friends outside of the relationship
c. having health issues that limit independence
d. taking anti anxiety or sedative medications

a. attempting to end the relationship

a home health nurse is planning care for a client who reports practicing traditional Asian health beliefs. the nurse should recognize that the client participates in which of the following actions?

a. visits a shaman to seek healing from illness
b. applies cool compresses across the body to reduce fever
c. places a cup of steam against the skin to draw out toxins from the body
d. avoids eating dairy and meat products during the same meal

c. places a cup of steam against the skin to draw out toxins from the body

a community health nurse is conducting vision screenings at a health fair for an older adult client who has age-related macular degeneration . which of the following statements should the nurse identify as an indication that the client is adapting to the changes?

a. i have learned that i cannot go outside when the sun is bright
b. i canceled all my magazine prescriptions since I can’t read them
c. i purchased green towels to use in my bathroom
d. i have a prescription bottle magnifier to help me read my pill bottle labels

d. i have a prescription bottle magnifier to help me read my pill bottle labels

a community health nurse is participating in a group session for clients who have alcohol and substance use disorders. which of the following information should the nurse provide regarding support programs for these individuals?

a. alcoholics anonymous is a support group that requires disclosure of attendance to employers
b. AA assists a client who has an addiction to alcohol with developing a daily recovery program
c. narcotics anonymous will cure a client from her substance use disorder if she stays involved with the program
d. NA is one-on-one program that assists clients

b. AA assists a client who has an addiction to alcohol with developing a daily recovery program

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

a. instruct the employee to prepare a list of close personal contacts
b. initiate an employee immunization program
c. instruct the employee to wear an N95 respiratory mask
d. administer prophylactic penicillin to another employees

a. instruct the employee to prepare a list of close personal contacts

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A nurse manager at a community agency is developing an orientation program for newly hired nurses.
When discussing the differences between community-based and community-oriented nursing, the nurse
should include which of the following as examples of community-based nursing? (Select all that apply.)
A. A home health nurse performing wound care for a client who is immobile
B. An occupational health nurse providing classes on body mechanics at a local industrial plant
C. A school nurse teaching a student who has asthma about medications
D. A parish nurse teaching a class on low-sodium cooking techniques
E. A mental health nurse discussing stress management techniques with a support group

A. A home health nurse performing wound care for a client who is immobile C. A school nurse teaching a student who has asthma about medications

A nurse is advocating for local leaders to place a newly approved community health clinic in an area of
the city that has fewer resources than other areas. The nurse is advocating for the leaders to uphold which
of the following ethical principles?
A. Distributive justice
B. Fidelity
C. Respect for autonomy
D. Veracity

A. Distributive justice

a nurse is preparing an education program on disease transmission for employees at a local day care facility. when discussing the epidemiological triangle, the nurse should include which of the following factors as agents? (select all that apply)

a. resource availability
b. ethnicity
c. toxins
d. bacteria
e. altered immunity

c. toxins d. bacteria

A nurse is developing a community health education program for a group of clients who have a new diagnosis of diabetes mellitus. which of the following learning strategies should the nurse include for clients who are auditory learners?

a. showing informational videos
b. providing equipment to practice hands-on skills
c. supplying outlines for note-taking
d. facilitating small group discussions

d. facilitating small group discussions

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. providing influenza immunizations to employees at a local preschool

a nurse is preparing an educational program on cultural perspectives in nursing. the nurse should include that which of the following factors are influenced by an individual’s culture? (select all that apply)

a. nutritional practices
b. family structure
c. health care interactions
d. biological variations
e. views about illness

a. nutritional practices b. family structure c. health care interactions e. views about illness

a nurse is caring for a client who is from a different culture than himself. when beginning the cultural assessment, which of the following actions should the nurse take first?

a. determine the client’s perception fo his current health status
b. gather data about the client’s cultural belief
c. determine how the client’s culture can affect the effectiveness of nursing actions
d. gather information about previous client interactions with the health care system

b. gather data about the client’s cultural belief

a nurse is using the I PREPARE mnemonic to assess a client’s potential environmental exposures. which of the following questions should the nurse ask when assessing for "A" in the mnemonic?

a. "what do you like to do for fun?"
b. "what year was your residence built?"
c. "what jobs have you had in the past?"
d. "what industries are near where you live?"

a. "what do you like to do for fun?"

a nurse is reviewing information about the local health department to prepare for an interview. which fo the following services should the nurse expect the local health department to provide? (select all that apply)

a. managing the women, infants and children program
b. providing education to achieve community health goals
c. coordinating directives from state personnel
d. reporting communicable diseases to the CDC
e. licensing of registered nurses

b. providing education to achieve community health goals c. coordinating directives from state personnel

a nurse is conducting health screenings at a statewide health fair and identifies several clients who require referral to a provider. which of the following statements by a client indicates a barrier to accessing health care?

a. "I don’t drive, and my son is only available to take me places in the mornings"
b. "I can’t take off during the day and the local after-hours clinic is no longer in operation"
c. "Only one doctor in my town is a designated provider by my health maintenance organization"
d. "I would like to schedule an appointment with the local doctor in my town who speaks spanish and english"

b. "I can’t take off during the day and the local after-hours clinic is no longer in operation"

a nurse is preparing to conduct a windshield survey. which of the following data should the nurse collect as a component of this assessment? (select all that apply)

a. ethnicity of community members
b. individuals who hold power within the community
c. natural community boundaries
d. prevalence of disease
e. presence of public protection

a. ethnicity of community members c. natural community boundaries e. presence of public protection

a nurse is completing a needs assessment and beginning analysis of data. which of the following actions should the nurse take first?

a. determine health patterns within collected data
b. compile collected data into a database
c. ensure data collection is complete
d. identify health needs of the local community

b. compile collected data into a database

a nurse is planning a community health program. which of the following actions should the nurse include as part of the evaluation plan?

a. determine availability of resources to initiate the plan
b. gain approval for the program from local leaders
c. establish a timeline for implementation of interventions
d. compare program impact to similar programs

d. compare program impact to similar programs

a nurse is conducting a community assessment. which fo the following data collection methods is the nurse using when having direct conversations with individual members of the community?

a. key informant interviews
b. participant observation
c. focus groups
d. health surveys

a. key informant interviews

a nurse is collecting data to identify health needs in the local community. which of the following examples should the nurse identify as secondary data? (select all that apply)

a. birth statistics
b. previous health survey results
c. windshield survey
d. community forum
e. health records

a. birth statistics b. previous health survey results e. health records

a nurse is talking to a client who asks for additional information about hospice. which of the following statements should the nurse make?

a. "clients who require skilled nursing care at home qualify for hospice care"
b. "one function of hospice is to provide teaching to clients about life-sustaining measures"
c. "hospice assists clients to develop the skills needed to care for themselves independently"
d. "a component of hospice care is to control the client’s manifestations"

d. "a component of hospice care is to control the client’s manifestations"

a school nurse is scheduling visits with a physical therapist for a child who has cerebral palsy. in which of the following roles is the nurse functioning?

a. direct caregiver
b. consultant
c. case manger
d. counselor

c. case manger

an occupational health nurse is consulting with senior management of a local industrial facility. when discussing work-related illness and injury, the nurse should include which of the following factors as physical agents? (select all that apply)

a. noise
b. age
c. lighting
d. viruses
e. stress

a. noise c. lighting

A newly hired occupational health nurse at an industrial facility is performing an initial workplace
assessment. Which of the following should the nurse determine when conducting a work site survey?
A. Work practices of employees
B. Past exposure to specific agents
C. Past jobs of individual employees
D. Length of time working in current role

A. Work practices of employees

a school nurse is planning health promotion and disease prevention activities for the upcoming school year. in which of the following situations is the nurse planning a secondary prevention strategy?

a. placing posters with images of appropriate hand hygiene near restrooms
b. routinely checking students for pediculosis throughout the school year
c. implementing age-appropriate injury prevention programs for each grade level
d. working with a dietitian to determine carbohydrate counts for students who have diabetes mellitus

b. routinely checking students for pediculosis throughout the school year

a nurse at a community clinic is conducting a well-child visit with a preschool-age child. the nurse should identify which fo the following manifestations as a possible indication of child neglect? (select all that apply)

a. underweight
b. healing spiral fracture of the arm
c. genital irritation
d. burns on the palms of the hands
e. poor hygiene

a. underweight e. poor hygiene

a nurse is caring for a client who is experiencing alcohol withdrawal. which of the following findings should the nurse identify as a manifestations of withdrawal?

a. decreased blood pressure
b. diaphoresis
c. pinpoint pupils
d. bradycardia

b. diaphoresis

a community health nurse is developing an education program on substance use disorders for a group of adolescents. which of the following information should the nurse include when discussing nicotine and smoking?

a. smoking is the fifth-most preventable cause of death in the US
b. nicotine is a central nervous system depressant
c. withdrawal effects from smoking are minimal
d. tolerance to nicotine develops quickly

d. tolerance to nicotine develops quickly

a community health nurse is developing strategies to prevent or improve mental health issues in the local area. in which of the following situations is the nurse implementing a tertiary prevention strategy?

a. providing support programs for new parents
b. screening a client whose partner recently died for suicide risk
c. teaching a client who has schizophrenia about medication interactions
d. discussing stress reduction techniques with employees at an industrial site

c. teaching a client who has schizophrenia about medication interactions

a nurse at an urban community health agency is developing an education program for city leaders about homelessness. which of the following groups should the nurse include as the fastest-growing segment of the homeless population?

a. families with children
b. adolescent runaways
c. intimate partner abuse survivors
d. older adults

a. families with children

a nurse is preparing a community health program on communicable diseases. when discussing modes of transmission, the nurse should include which of the following illness as airborne?

a. cholera
b. malaria
c. influenza
d. salmonellosis

c. influenza

a home health nurse is discussing portals of entry with a group of newly hired assistive personnel. which fo the following locations should then ruse include as a portal of entry? (select all that apply)

a. respiratory secretions
b. skin
c. genitourinary tract
d. saliva
e. mucous membranes

b. skin c. genitourinary tract e. mucous membranes

a newly hired public health nurse is familiarizing himself with the levels of disaster management. which of the following actions is a component of disaster prevention?

a. outlining specific roles of community agencies
b. identifying community vulnerabilities
c. prioritizing care of individuals
d. providing stress counseling

b. identifying community vulnerabilities

a community health nurse is educating the public on the agents of bioterrorism. which of the following agents should the nurse include as category A biological agents? (select all that apply)

a. hantavirus
b. typhus
c. plague
d. tularemia
e. botulism

c. plague d. tularemia e. botulism

a community health nurse is determining available and needed supplies in the event of a bioterrorism attack. the nurse should be aware that community members exposed to anthrax will need access to which of the following medications?

a. metronidazole
b. ciprofloxacin
c. zanamivir
d. fluconazole

b. ciprofloxacin

a nurse is creating partnerships to address health needs within the community. the nurse should be aware that which of the following characteristics must exist for partnerships to be successful? (select all that apply)

a. being a leading partner with decision-making authority.
b. flexibility among partners when considering new ideas
c. adherence of partners to ethical principles
d. varying goals for the different partners
e. willingness of partners to negotiate roles

b. flexibility among partners when considering new ideas c. adherence of partners to ethical principles e. willingness of partners to negotiate roles

a nurse is reviewing the various roles of a community health nurse. which of the following actions is an example of a nurse functioning as a consultant ?

a. advocating for federal funding of local health screening programs
b. updating state officials about health needs of the local community
c. facilitating discussion of a client’s ongoing needs with an inter professional team
d. performing health screenings for high blood pressure at a local health fair

b. updating state officials about health needs of the local community

a case management nurse at an acute care facility is conducting an initial visit with a client to identify needs prior to discharge home. after developing a working relationship with the client, the nurse is engaging in the referral process. which of the following actions should the nurse take first?

a. monitor the client’s satisfaction with the referral
b. provide the client information to referral agencies
c. review available resources with the client
d. identify referrals that the client needs

d. identify referrals that the client needs

a nurse developing a community health program is determining barriers to community resource referrals. which of the following factors should the nurse include as an example of a resource barrier?

a. costs associated with services
b. decreased motivation
c. inadequate knowledge of resources
d. lack of transportation

a. costs associated with services

a nurse is working with a client who has systemic lupus erythematous and recently lost her health insurance. which of the following actions should the nurse take in the implementation phase of the case management process?

a. coordinating services to meet the clients needs
b. comparing outcomes with original goals
c. determining the clients’ financial constraints
d. clarifying roles of inter professional team members

a. coordinating services to meet the clients needs

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