RN Community Health 2019
Total Questions : 57
Showing 25 questions, Sign in for moreA school nurse is planning safety education for a group of adolescents.
The nurse should give priority to which of the following topics as the leading cause of death for this age group?
Explanation
According to the World Health Organization, unintentional injuries, especially road traffic accidents, are the leading cause of death and disability among adolescents1. As a category of accidents, motor vehicle fatality is the leading cause of death among teenagers2.
Choice A is not the answer because sports injury prevention is not mentioned as a leading cause of death for adolescents.
Choice B is not the answer because substance abuse prevention is not mentioned as a leading cause of death for adolescents.
Choice C is not the answer because gun safety is not mentioned as a leading cause of death for adolescents.
Choice A is not the answer because sports injury prevention is not mentioned as a leading cause of death for adolescents.
Choice B is not the answer because substance abuse prevention is not mentioned as a leading cause of death for adolescents.
Choice C is not the answer because gun safety is not mentioned as a leading cause of death for adolescents.
The nurse is working with a case manager for a client who participates in a health maintenance organization.
The nurse should identify which of the following payment structures?
Explanation
The provider is paid a fixed sum for the client on a monthly or yearly basis. This payment structure is known as capitation. In a health maintenance organization (HMO), the provider is paid a fixed amount per enrolled member per month or year, regardless of the services provided.
Choice B is not the answer because it describes a fee-for-service healthcare insurance program, which is different from an HMO.
Choice C is not the answer because it describes a co-insurance payment structure, which is also different from an HMO.
Choice D is not the answer because it states that none of the above choices are correct.
A school nurse is assessing a child and discovers Koplik spots on the child's buccal mucosa.
Which of the following actions should the nurse take?
Explanation
Koplik spots are a prodromic viral enanthem of measles manifesting two to three days before the measles rash itself1. They are pathognomonic for measles1. The nurse should review the immunization records of the child’s classmates to ensure they are protected against measles.
Choice C is not the answer because increasing Vitamin B intake is not a treatment for measles.
Choice D is not the answer because using alcohol-based mouthwash is not related to Koplik spots or measles.
A nurse is developing a health-screening program for clients who are at risk for hypertension.
Which of the following actions should the nurse take first?
Explanation
Before developing a health-screening program for clients who are at risk for hypertension, the nurse should first assess the community’s need for such a program. Conducting a survey to identify the community’s need for hypertension screening is an important first step in this process.
Choice A is not the answer because determining the number of clients referred for treatment of hypertension is not the first step in developing a health screening program.
Choice B is not the answer because researching best practices for the treatment of hypertension is not the first step in developing a health-screening program.
Choice C is not the answer because applying for funding to conduct hypertension screening is not the first step in developing a health-screening program.
A home health nurse is assessing a client with AIDS.
Which of the following responses by the client indicates a risk for suicide?
Explanation
People living with HIV/AIDS have a much higher risk of suicide than the general population1.Some of the risk factors for suicidal ideation, suicide attempts and suicide deaths in this group are depression, advanced disease, neurological changes, stigma, poor social support, negative life events, physical pain and fear of rejection.
Based on these risk factors, the response by the client that indicates a higher risk for suicide isd. “I am afraid of experiencing pain near the end.”This response suggests that the client has a low perception of their physical health, a fear of losing control and a pessimistic outlook on their future.These are signs of hopelessness, which is a strong predictor of suicide.
The other responses do not necessarily indicate a high risk for suicide, although they may reflect some challenges that the client is facing. For example, response a. may indicate a desire for autonomy and dignity, response b. may indicate a coping strategy or denial, and response c. may indicate a source of emotional support or dependency. However, these responses do not imply that the client is thinking about harming themselves or ending their life.
Therefore, the home health nurse should assess the client’s level of hopelessness, suicidal ideation and suicide plan, and provide appropriate interventions and referrals to prevent a possible suicide attempt. The nurse should also monitor the client’s mood, pain, medication adherence and social support, and offer education, counseling and resources to improve the client’s quality of life.
A nurse at a community mental health centre is caring for a client with antisocial personality disorder.
Which of the following actions should the nurse include in the plan of care?
Explanation
This action can help the client learn how to manage their emotions in a healthy way.
Choice B is not an answer because assertiveness training may not address the underlying issues of antisocial personality disorder.
Choice D is not an answer because minimizing feelings of guilt may not be helpful in managing the behavior of someone with antisocial personality disorder.
Several nurses are developing a parish nurse group to help address the primary and secondary healthcare needs of the congregation.
Which of the following services should the nurses plan to provide to the congregation?
Explanation
Organize an influenza immunization clinic with the American Red Cross.
This action can help address the primary healthcare needs of the congregation by providing preventative care.
Choice A is not an answer because facilitating discharge from a facility to the home is not a service typically provided by a parish nurse group.
Choice B is not an answer because performing wound care in the home of members is not a service typically provided by a parish nurse group.
Choice D is not an answer because providing end-of-life care for members who are terminal is not a service typically provided by a parish nurse group.
A nurse case manager is providing discharge planning for a client.
The nurse is functioning in which of the following roles when arranging for the delivery of medical equipment to the client's home?
Explanation
When arranging for the delivery of medical equipment to the client’s home, the nurse case manager is functioning in the role of a coordinator by organizing and facilitating the necessary resources for the client’s care.
Choice A is not an answer because advocating for the client’s rights and needs is not the primary focus in this situation.
Choice C is not an answer because allocating resources within a healthcare system is not the primary focus in this situation.
Choice D is not an answer because providing expert advice or consultation is not the primary focus in this situation.
A community health nurse is planning strategies to address childhood obesity in the area.
Which of the following actions should the nurse take first?
Explanation
Before taking any action to address childhood obesity in the area, the community health nurse should first assess the current situation by examining the prevalence of childhood obesity in the community.
Choice A is not an answer because providing nutritional education to children and their families is an intervention that should be implemented after assessing the current situation.
Choice B is not an answer because establishing goals for the community to decrease childhood obesity should be done after assessing the current situation.
Choice D is not an answer because promoting the placement of healthy food choices in the community is an intervention that should be implemented after assessing the current situation.
A nurse at a shelter is assisting with client triage after a tornado destroyed a community.
Which of the following clients should receive priority care?
Explanation
An adult client who is short of breath should receive priority care because shortness of breath can be a sign of a life-threatening condition such as respiratory distress.
Choice B is incorrect because while an infant crying may indicate discomfort or distress, it is not necessarily a sign of a life-threatening condition.
Choice C is incorrect because while a head abrasion may require medical attention, it is not necessarily a life-threatening condition.
Choice D is incorrect because while a fractured arm may require medical attention, it is not necessarily a life-threatening condition.
A community health nurse encounters a client who has a suspected bioterrorism-related illness.
Which of the following actions should the nurse take?
Explanation
In a suspected or confirmed bioterrorism event, the nurse should don personal protective equipment to protect themselves from potential exposure 1.
Choice B is incorrect because disinfecting contaminated areas of skin with isopropyl alcohol may not be sufficient to protect against a bioterrorism-related illness.
Choice C is incorrect because while reporting the client’s condition to the appropriate authorities is important, the Federal Bureau of Investigation may not be the appropriate agency to report to in this situation.
The nurse should report the client’s condition to local and state health departments 1.
Choice D is incorrect because while moving the client to a quarantine area may be necessary in some situations, it is not necessarily the first action that should be taken.
A school nurse is implementing health screenings.
Which of the following assessment findings should the nurse recognize as the highest priority?
Explanation
An adolescent who has scoliosis should be recognized as the highest priority because scoliosis can progress rapidly during growth spurts and can lead to long-term health problems if left untreated.
Choice A is incorrect because while psoriasis may require medical attention, it is not necessarily a high-priority condition.
Choice B is incorrect because a BMI of 18 falls within the normal range for children and adolescents and does not necessarily indicate a health concern.
Choice D is incorrect because while nits may indicate a lice infestation, it is not necessarily a high-priority condition.
A home health nurse is visiting a client who has right-sided weakness following a recent stroke.
The client states, "I'm not sure how I will buy my groceries since I can't go back to work." Which of the following actions should the nurse take?
Explanation
A social worker can help the client to identify and access resources that can assist with grocery shopping and other needs. This is the most appropriate action for the nurse to take because it addresses the client’s long-term needs and helps to promote independence.
Choice A is not the best answer because it is not sustainable for the nurse to bring groceries to the client on a regular basis.
Choice B is not the best answer because it is not the nurse’s role to contact friends and neighbours to shop for the client.
Choice C is not the best answer because respite care provides temporary relief for caregivers, but it does not address the client’s need for assistance with grocery shopping.
A nurse manager in a community health clinic is reviewing secondary prevention activities with a group of nurses during orientation.
Which of the following activities should the nurse manager include as an example of secondary prevention?
Explanation
Testing a client who has a family history for diabetes mellitus is an example of secondary prevention. Secondary prevention involves screening and early detection of diseases in individuals who are at risk but do not yet have symptoms.
Choice A is not the best answer because educating a client who has hypertension about exercises to reduce blood pressure is an example of tertiary prevention, which involves managing and treating existing diseases.
Choice B is not the best answer because providing nutrition counselling for an adolescent who is underweight is an example of primary prevention, which involves preventing diseases before they occur.
Choice C is not the best answer because teaching a group of school-age children about hand hygiene is also an example of primary prevention.
A nurse at a health department is discussing regulations regarding STIs during a staff education session.
Which of the following statements by a staff member indicates an understanding of the information?
Explanation
Nurses should withhold the name of the client who has an STI during partner notification. This statement indicates an understanding of the importance of maintaining client confidentiality while also ensuring that partners are notified of their potential exposure to an STI.
Choice B is not the best answer because it is not Congress that mandates the requirements for STI reporting, but rather the Centers for Disease Control and Prevention (CDC).
Choice C is not the best answer because state health departments report selected STIs to the CDC, not to the National Institutes of Health.
Choice D is not the best answer because clients who have STIs are not legally required to provide a list of sexual partners, although they may be encouraged to do so voluntarily.
A nurse manager is reviewing the disaster plan at a long-term care facility.
Which of the following is the most comprehensive method for the nurse to use to determine the effectiveness of the plan?
Explanation
Reviewing how the staff implements the plan during a hands-on practice drill is the most comprehensive method for the nurse to use to determine the effectiveness of the disaster plan. This allows the nurse to observe how well the staff understands and follows the plan in a simulated disaster situation.
Choice B is not the best answer because using inservices to have the staff discuss various disaster scenarios does not provide a comprehensive evaluation of the effectiveness of the plan.
Choice C is not the best answer because testing staff to determine their knowledge of the principles of the plan only assesses their theoretical understanding and does not evaluate their ability to implement the plan in practice.
Choice D is not the best answer because analyzing findings from a facility tabletop disaster simulation only provides a limited evaluation of the effectiveness of the plan.
A nurse in a community clinic is assessing a client who reports injecting heroin 1 hr ago.
Which of the following findings should the nurse expect?
Explanation
The nurse should expect the client to exhibit euphoria after injecting heroin 1 hr ago. Euphoria is a common effect of heroin use and is characterized by intense feelings of happiness and well-being.
Choice A is not the best answer because tachypnea, or rapid breathing, is not a common effect of heroin use.
Choice B is not the best answer because heroin use typically causes pupils to constrict, not dilate.
Choice D is not the best answer because nystagmus, or involuntary eye movement, is not a common effect of heroin use.
A community health nurse is teaching a group of clients about available resources to assist with recovery following a stroke.
Which of the following resources should the nurse recommend for clients who are experiencing dysphagia?
Explanation
Speech-language pathologists are professionals who specialize in treating communication and swallowing disorders. Dysphagia is a term that means “difficulty swallowing” and can result in aspiration which occurs when food or liquids go into the windpipe and lungs 1. A speech-language pathologist can help clients with dysphagia by evaluating their swallowing function and developing a treatment plan to improve their ability to swallow safely.
Choice A is not the correct answer because physical therapists specialize in helping people improve their movement and manage pain.
Choice C is not the correct answer because occupational therapists help people develop, recover, or maintain daily living skills.
Choice D is not the correct answer because restorative aides assist with rehabilitation and maintenance of physical function but do not specialize in treating dysphagia.
A home health nurse is preparing to teach the family of a client who has a new diagnosis of HIV about infection control.
Which of the following factors should the nurse identify as an educator-related barrier to learning?
Explanation
Reliance on written notes during the teaching session can be an educator-related barrier to learning. This is because the nurse may focus too much on their notes and not engage with the family or adapt their teaching style to meet the family’s needs.
Choice A is not the correct answer because using educational materials in written and video formats can actually enhance learning by providing information in multiple formats.
Choice C is not the correct answer because using humour to deal with disruptive behaviour can help defuse tension and keep the learning environment positive.
Choice D is not the correct answer because previous experience teaching can actually be an asset, as it can help the nurse draw on past successes to improve their teaching.
A nurse is developing health promotion strategies for older adult clients at an assisted living facility.
Which of the following strategies is the priority for the nurse to include?
Explanation
Immunizing the clients against influenza is the priority for the nurse to include in health promotion strategies for older adult clients at an assisted living facility. Influenza can be particularly dangerous for older adults, who are at higher risk for complications such as pneumonia. Immunization is an effective way to prevent influenza and its complications.
Choice A is not the correct answer because while providing a low-fat diet can be beneficial for overall health, it is not the priority in this situation.
Choice B is not the correct answer because while scheduling annual dental examinations is important for maintaining oral health, it is not the priority in this situation.
Choice D is not the correct answer because while encouraging regular exercise can improve overall health and well-being, it is not the priority in this situation.
An occupational health nurse is preparing for an initial meeting with a committee that is planning a health fair for an industrial work site.
The nurse should instruct the committee members to take which of the following actions first?
Explanation
The first action the committee members should take when planning a health fair for an industrial work site is to determine the health concerns of the employees. This will help the committee tailor the health fair to address the specific needs and interests of the employees.
Choice A is not the correct answer because while making a list of expected outcomes for the health fair is important, it should be done after determining the health concerns of the employees.
Choice C is not the correct answer because marketing the health fair to the employees should be done after determining their health concerns and planning the fair accordingly.
Choice D is not the correct answer because obtaining the necessary supplies and equipment should be done after determining the health concerns of the employees and planning the fair accordingly.
A home health nurse is reviewing messages from a group of clients. Which of the following clients should the nurse contact first?
Explanation
A stoma that turns dark red, purple, or even black in color can be a sign of a problem with blood supply to the stoma 1. This can be a serious issue that requires immediate medical attention.
Choice B is not the correct answer because an oxygen saturation of 90 for a client with COPD is within an acceptable range.
Choice C is not the correct answer because feeling a vibration in a new internal arteriovenous graft for dialysis is not necessarily a cause for immediate concern.
Choice D is not the correct answer because vomiting after a dose of methylphenidate may be a side effect of the medication and may not require immediate attention.
A school nurse is implementing health screenings.
Which of the following assessment findings should the nurse recognize as the highest priority?
Explanation
Nits are the eggs of head lice and their presence indicates an infestation. Head lice can spread quickly among school children through close contact and shared items such as hats and combs. It is important for the school nurse to address this issue promptly to prevent further spread.
Choice A, an adolescent who has psoriasis, is not the highest priority because psoriasis is a chronic skin condition that is not contagious.
Choice B, a child who has a BMI of 18, is also not the highest priority because a BMI of 18 falls within the normal range for children.
Choice C, an adolescent who has scoliosis, is not the highest priority because scoliosis is a curvature of the spine that typically develops slowly over time and requires monitoring rather than immediate intervention.
A nurse is caring for a client who is homeless.
Which of the following actions should the nurse take first?
Explanation
The first step a nurse should take when caring for a client who is homeless is to assess their understanding of their living situation. This will help the nurse to understand the client’s perspective and needs, and to tailor their care accordingly.
Choice B, assisting the client to develop goals for obtaining shelter, is important but should come after the initial assessment.
Choice C, discussing the risks of being homeless with the client, is also important but should come after the initial assessment.
Choice D, developing client teaching using a variety of strategies, is also important but should come after the initial assessment and after determining the client’s needs and goals.
A hospice nurse is concerned that the partner of a client is experiencing caregiver burden.
Which of the following actions should the nurse take first?
Explanation
The first action the hospice nurse should take is to explore possible solutions with partner 1. This can help the nurse understand the partner’s needs and concerns and work together to find ways to alleviate caregiver's burden. It is important for the nurse to address concerns about finances, daily schedule changes, and family support and screen for preparedness for caregiving 2.
Choice A is not the correct answer because inviting family members to assist with client care may not be a feasible solution for everyone.
Choice B is not the correct answer because teaching the partner about getting enough rest is important but may not be the first action to take.
Choice D is not the correct answer because suggesting an assistive personnel visit daily to provide client care may not be a feasible solution for everyone.
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