NR 443/ATI RN Community Health Online Practice 2016 B,100% CORRECT

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NR 443/ATI RN Community Health Online Practice 2016 B 1. A public health nurse is developing a visual health program by using a community-oriented approach. Which of the following interventions shoul... d the nurse include? Teach a client who has vision loss about safety in the home environment. Provide genetic counseling to the family of a newborn who has congenital cataracts. Consult with the local school nurse to schedule yearly vision screenings for students- Develop a plan of care for a client who was newly diagnosed with glaucoma. Consulting with the local school nurse to schedule yearly vision screenings for students focuses on the health care of a population rather than illness care for individuals. Therefore, this intervention Is using a community-oriented approach. The other answers options are community based approach. 2. A home health nurse is caring for a client who has a breast cancer. Which of the following assessment findings should the nurse identify as an indication that the client is coping effectively? Inability to concentrate Makes eye contact Excessive sleeping Lack of interest in food 3. 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? Household members should be places in respiratory isolation. The client should use disposable utensils during meals. Household members should take isoniazid for 6-12 months The client should have a repeat purified protein derivative test in 3 months. Resp. isolation is not necessary for household memebers of a client who has active pulmonary tuberculosis. IT is not necessary for a client who has active pulmonary TB to use disposable utensils during meals in the home setting. Household memebers of a client who has active pulmonary TB are at risk for developing the disease. Therefore, taking isoniazid prophylactically for 6-12 months is recommended. A client who has active pulmonary tuberculosis should receive a chest x ray for future screenings. 4. A case manager is developing a discharge plan for a client who has a spinal cord injury and is in rehabilitation facility. Which of the following actions should the nurse take first? Hold a care conference w/ the client and his family to discuss tx options. Contact service providers to determine the availability of services offered. Determine the client's ability to perform self-care Evaluate the client satisfaction with the case managers services. First two options are implementation step of the nursing process. The 3rd options is to assess the client needs. Evaluate option is the evaluation step of the nursing process. 5. A community health nurse is working in a mobile health care clinic. Which of the following clients should the nurse assess first? A client who has a new onset of confusion and slurred speech 6. 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? "RSV is spread through contact with respiratory secretions from an infected person." “rotavirus infections in children peal during the summer months.” “Children who have 5th disease will exhibit bloody diarrhea.” Antiviral medications shorten the duration of a shigella infection.” The nurse should include this statement in the presentation, as RSV is spread by direct contact w/ respiratory secretions while within 3 feet of a person who is infected. Manifestations of RSV include dyspnea, tachypnea, coughing, and wheezing. Rotavirus infection in children peak during winter months of the year. Manifestations of rotavirus include fever and vomiting followed by watery diarrhea. The clinical manifestation of 5th disease (erythema infectiosum) do not inclue bloody diarrhea. Clinical manifestations include rash that gives the client a slapped-faced appearance that progresses from the face down to the body. Other manifestations include fever, myalgia, N/V, and lethargy. Antibiotics shorten the length of a shigella infection and decrease mortality rates. Manifestation of shigella include fever and anorexia followed by watery or bloody diarrhea. 7. A nurse in a rural community is planning education for a young adult client who is a migrant farm worker. Which of the following actions should the nurse include? (Select all that apply) - Provide environmental health - Refer client for TB screening - Provide skin cancer information - Recommend a dental health screening -Provide forms to apply for medicare Medicare are individuals must meet age requirement or be permanently disabled. Migrant FW are at risk exposure to pesticides and other hazardous materials that could be harmful. Thereofre should include environmental health information in the client’s education. Rate of TB are estimated higher amoing migrant workers due to crowded living conditions and substandard housing. Therefore, the nurse should include a tuberculosis screening in the clients education. Dental problems are primary health risk for migrant FW. 8. 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? Mortality rate attack rate Prevalence proportion Incidence proportion The mortality rate cannot be determined because the # of affected people who died is unknown. The attack rate cannot be calculated because the population has not been exposed to a specific agent. The prevalence proportion can be calculated by using the # of people who were affected at a given time and the total population. The incidence proportion cannot be calculated because the # of people newly diagnosed w/ heart disease over a period is time is not known. 9. A nurse is assessing the risks and benefits of meal delivery services for older an older adult who lives alone and has no transportation. Which of the following ethical principles is the nurse demonstrating? Benefience Distributive justice Respect for autonomy Fidelity The nurse would demonstrate the ethical principle of distributive justice by fairly determining which clients should receive meal delivery when there are a limited amount of services available for clients. The nurse would demonstrate the ethical principle of respect for autonomy by asking the client if he wants this service and respecting his choice. The nurse would demonstrate the ethical principle of fidelity by determining that the client needs the meal service and following through with initiating a referral. 10. 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, agonal pattern; cap refill time 4.5 seconds; nonresponsive to painful stimuli. Which of the following actions should the nurse take? Turn the client to left semi-Fowler's position and begin assessing the next client Place a frim pressure dressing to the occiput and open the airway Apply a cervical spine collar and perform a focused neurological exam Request that the client be assess immediately by the next available provider. Principles of triage indicate that clients who have extensive injuries and a low-probability of survival do not receive tx. Therefore, the nurse should provide only comfort measure before moving on to assess the next client. 11. 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? Review community-specific epidemiological data- Recommend updates to local environment policies. Create program goals that align with Healthy People 2020 objectives. Distribute health education material to community members. -The 1st action the nurse should direct the task to take when using the nursing process is to conduct a community assessment, which includes a review of specific edimioligical data. Tge community assessment will assist the task force in identifying environmental health concerns within the county. -The nurse should direct the task force to recommend update to local policies if neede to ensure environmental standards are bing met and to advocate for health promotion withing the communitu. Hoevere another action is t complete first. -The nurse should direct task force to create program goals that align with Healthy People 202 to assist in achieving national level objectives by ionizing health issues cause by intereaction of community memebers with the environment. However another action task firt. -Task force distributice environmental health education materials to community members in order to promotoe health and prevent diseases related to environemntla concerns. 12. A case manager is planning an educational program for a client who has diabetes mellitus. Which of the following activities should the nurse include when using the psychomotor domain of learning? Review a color diagram of the food pyramid with the client. Show the client a video about how to monitor blood glucose levels. Observe the client's technique for drawing up insulin Give the client a pamphlet about foot care. The nurse should include this activity in order to use the psychomotor domain of learning because it requires coordination and the use of motor skills. The other options are cognitive domain of learning because it involves the client understanding and applying information; learning new information and applying it in a different way; reading and learning new information. 13. A home health nurse is planning care for the day. Which of the following clients should the nurse visit first? An older adult who has treated in the ED last night for a stage 3 pressure ulcer A school-age child who was treated in the emergency department last night for status asthmaticus An older adult client who has newly prescribed antihypertensive medication and needs a BP check A school age child whose percutaneous endoscopic gastrostomy (PEG) tube needs changing. 14. 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? “Why did you decide to stop your heart medicine?” "Can you tell me more about your decision to stop your medicine?" “Don’t you know what stopping your medicine will do to your heart?” “Don’t you think your doctor knows what’s best for your heart?” 15.A public health nurse is planning care for four clients. Which of the following interventions should the nurse recognize as tertiary prevention? Providing chemoprophylaxis for malaria to a client who is traveling to mosquito-infested countries- primary Administering antibiotics to a clients who has AIDS and was diagnoses with Pneumocystis jiroveci Participating in partner notification for a client who has an STI- 2ndary Performing a serological screening for HIV for a client who is pregnant.- 2ndary 16. 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 the nurse take? (Select all that apply) - Instruct the interpreter to guide the nurse in providing information in a culturally-sensitive manner - ask the interpreter to add information she feels may be necessary - Choose an interpreter who speaks the workers' language and dialect - Evaluate the interpreter's approach to clients prior to the educational session - encourage the interpreter to paraphrase the workers questions and responses. The nurse should rely on the interpreter to inform him how he should deliver information that workers might find culturally sensitive because the interpreter will have more knowledge about theses issues. The nurse should ask the interpreter to not ass or omit any information because it can interfere with the accuracy of the content. The nurse should choose an interpreter who can speak the clients native language, including the specific dialect, in order to facilitate accurate communication. The nurse should evaluate the style of the interpreter prior to the educational session to determining if she is able to develop a trusting relationship with the migrant workers in order to promote effective communication. The nurse should ask the interpreter to translate the workers comments and questions using their own words to increase the accuracy of the communication. 17. 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 principles of epidemiology? Conducting screening for dental caries in the local school system Reviewing county health records for data on cases of chickenpox Providing a client with information about preventing STIs Documenting medication compliance for clients who have tuberculosis Screening individual clients for dental caries is a 2ndary prevention activity that does not address epidemiological principles. Reviewing health records is an example of using epidemiological principles to analyze incidence and track outcomes of interventions for a particular disease or condition Providing a client with information about preventing STIs is a primary prevention activity that does not address epidemiological principles. Documenting medication compliance is a tertiary prevention activity that does not address epidemiological principles. 18. 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? “I will not have to completely stop drinking alcohol if I go into an into tx program.” “Once I make it through detoxification, I will be free of my addiction.” “I am not eligible for an outpt program until I have completed an inpt program first.” "I can expect to get help with other aspects of my life while in treatment." Sucessful tx of alcohol use disorder is more likely if the client receives help in other areas of his life, such as his physical health, psychological well-being, and family interactions. 19. A nurse is assessing a new client. Which of the following information should the nurse include in the cultural portion of the assessment? Food preference Employment status hx of illnesses sexual orientation 20. A nurse is conducting an education 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? “It is important to avoid weight-bearing exercises.” “decrese your dietary intake of folate.” Increase your daily intake of leafy green vegetables “It is important to spend 30 minutes each day exposed to sunlight.” The nurse should instruct clients who have osteoporosis to increase their daily calcium intake. Food recommendations include leafy green vegetables, milk fortified with vitamin D, cheese, and yogurt. 21. A community health nurse is planning an education program for farmers about occupational health risks. Which of the following risks should the nurse include? Respiratory disorders Diabetes mellitus Sickle cell anemia Hypertension Farmers are at increased risk for resp disorders due to exposure to agricultural chemicals, such as herbicides and pesticides. Other health risks for farmers include accidents with vehicles and machinery, dermatitis, dental problems, and stress and anxiety disorders. 22. 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 a indication that the client understands the teaching? “IF I begin palliative care, I will have to stop my chemotherapy.” “I can begin palliative care when I have less than 6 mos to live” "This type of care can help me with pain control" “My family will not be involved with this type of care program.” A client who is experiencing an illness, such as cancer, can still receive palliative care even if the client is undergoing tx for the disease. Clients who have a life-limiting and progressive illness, such as cancer, can receive long-term palliative care. Once the prognosis is short term, the client can receive hospice care. Clients who has cancer might require complicated tx that can cause pain, disfigurement, and emotional and psychological distress. Palliative care provides support and mangemnt of the disease process regardless of the prognosis, including pain management. Insturct the client that palliative care provides support to all memebers of the clients familt and support system 23. A hospice nurse is teaching about expected grief reactions with the family of a client who has end-stage pancreatic cancer. Which of the following information should the nurse include? “It is common to experience a persistent state of sadness while grieving.” “Disturbances in your self-esteem is an expected grief reaction.” “You will feel a sense of hopelessness throughout the grieving process.” "A component of healthy grieving is the ability to openly express your anger." The nurse should teach the family that they will experience feelings of anger, guilt, shame, and doubt while grieving. The ability to openly express their feelings of anger is an expected grief reaction. Other options are indication of clinical depression. 24. A nurse is providing blood pressure screening 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? BMI of less than 30 Daily walking routine African American race- HDL level greater than 70 mg/dL 25. 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 instruction should the nurse include? “Rinse your toothbrush w/ hydrogen peroxide after each use.” " Clean your bathroom fixtures with a chlorine bleach solution." “Use shared hand towels to dry your hands after washing.” “Use condoms during sexual contact for 2 wks.” Hydrogen peroxide does not kills the hepatitis A virus. The nurse should instruct the client to avoid sharing a toothbrush with others to prevent the transmission of the virus. The client should clean his bbathroom fixtures with a 10:1 chlorine bleach solution. The hepatitis A virus spreads via feces and survives on human hands since it is resistant to soap and detergents. The client should not chasre bath or hand towels with other memebers of the household. The hepatitis A virus spreads vis feces and survives on human hands since it is resistant to soap and detergents. The cleitn should avoid sexual contat until provide confirms hep A antiodoby is negative which could last long 4-6 wks. 26. A nurse is planning to teach a community group about the meningococcal vaccine. The nurse should identify that which of the following clients should receive the vaccine? A client who is traveling to northern Europe An infant who has bronchiltits An infant who is 4 wks old A client who is moving into a college dorm Individuals traveling to northern Eurpoe are not an increased risk for meningococcal meningitis. Meningococcal vaccine is not recommened for an infant who has bronchilolits. Minimum age for vaccine is 6 wks Individual living in crowdee areas, such as dormitories, should receive the vaccine. 27. 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? "I feel overwhelmed with not having enough time for my mom as well as my children" “ I hope my siblings will be able to visit and help care for mom for a few days.”- experiencing role strain “I am glad that my job is flexible, so I can accommodate my mom’s needs”- Positive aspect by assimilating the caregiver role with other responsibilities the client has enhanced her self esteem and ability to perform various roles successfully “I don’t think my partner like having to help more with the household chores.” - Partner are experiencing role amibiguilty. 28. A community health nurse is teaching a client who is overweight about steps to take tot begin an exercise program. The nurse should identify that which of the following statements is an indication that the client understands the teaching? “ I will need to purchase exercise equipment before I can start.” “I should try to perform aerobic exercise for an hr a day, 5days a week.” "I will see my doctor before beginning an exercise program." “I should avoid participating in weight lifting exercises.” 29. A school nurse is discussing level of prevention with a teacher. Which of the following activities should the nurse identify as primary prevention strategy? Provide nutritional counseling for students who have diabetes.- tertiary Report suspected child neglect to the proper authorities.- 2ndary Conduct vision and hearing screening for kindergartedn enrollment.- 2ndary Demonstrate proper hand washing The client should see his provider before beginning an exercise program. The client should receive a complete physical exam and obtain approval for exercise. 30. A nurse is collecting demographic data as part of a community assessment. Which of the following information should the nurse include? Racial distribution Faimily genogram Numbe of open water sources Presence of condemned buildings 31. 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 client states he witnessed his mother mistreat his father A client states that her mother in law provide childcare while she is working A client participates in volunteer activities in the community A client lives in the same neighborhood where he spent his childhood yrs. Client who have prior exposure to violence have a greater potential for continuinf the violent and abusive behavior. 32. 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? -Less autonomy in providing client care- Health care provider have greater independence and work more autonomously in providing client care in rural areas. -Disinterest by members of the population in providing input for community health programs.- Residents of rural communities are no less likely to be interested in health promotion than memebers of urbam communities. -Lack of cohesiveness among community members.- Community cohesiveness is generally not a barrier to providing health care in rural areas. Rural residents often rely on community networks for support. -Unavailability of outreach services- Lack of availiability of outreach servicesis a barrier to health care for resident in rural area. 33. A home health nurse is scheduling client visits for the day. Which of the following clients should the nurse plan to visit first? A client who is 10days postoperative following a mastectomy and needs to have surgical staples removed A client who has diabetes mellitus and reports new erythema to the left foot- client is at risk for infection and requires prompt evaluation and tx. A client who has COPD and needs a f/u visit r/t home oxygen therapy A client in a hip spic cast who reports pruritus under the cast 34. 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 The client states she is leaving her partner 35. 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? "Can I give you some information about Alcoholics Anonymous?" 36. A school nurse is conducting hearing screening procedures in an elementary school. Which of the following instructions should the nurse provide when performing the Rinne test? “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.”= weber test- evulates lateralization of sound “Use your finger to close one ear while I whisper some numbers into your other ears.” – whiper voice test "After I place this tuning fork behind your ear, tell me when you no longer hear the sound"- “You’ll wear headphone and press the button when you hear a sound”- audiometry 37. A nurse is preparing an educational program about influenza for a group of community health nurses. Which of the following activities should the nurse include as an example of tertiary prevention? Offer clsses to elementary school about handwashing- 2ndary Provide information to occupational nurses about the reason for employees to not come to work- 2ndary, ways to prevent the spread of infection which includes isolating individual have manifestations of illness. Administer antiviral medication within 48 hr to clients who have manifestations of influenza- Provide immunizations at long term care facilities.- primry involves to prevent occurences of illness wihc includes provinf immunizations to susceptible populations. 38.A community health nurse has been contracted regarding a client diagnosis of influenza type A in an adult day care. Which of the following actions should the nurse take to assist in the prevention of an outbreaks? Administer antiviral medication to clients at the facility Schedule immunization for clients at the facility Recommened that the day care center close for 2 wks Give immune globin to clients at the facility who have early manifestation of influenza. -Antiviral meds are administer to individual who have been exposed to unfluenza type A to provide immediate porotection and to help prevent outbreak. Immunization doesn’t provide immediate protection and thereofe will not he effective in preventing an outbreak. A single client diagnosis of influenza doesn’t warrant closing the facility Immune globuling doesn’t prevent or treat infullenza and therefore will not be effective in preventing an outbreak. 39. A nurse is developing an education program about bioterrorism and smallpox. The nurse should include in the teaching that the smallpox rash is expected to first appear in which of the following locations? Face 40. The daughter of a client who is terminally ill and at the end of life approaches a hospice nurse and asks what she can do to help relieve her father's pain. Which of the following interventions should the nurse suggest? Give the client brief hand massages Increase the illumination in the room Place a warm cloth on the clients forehead- cool Administer citalopram when the client is agitated.- nonpharmacological comfort measure not citalopram is antidepressant 41. A public health nurse is monitoring medication compliance for a group of migrant workers who are being treated for tuberculosis. The nurse should use information from which of the following resources to assist with this process? Agency for Healthcare Quality and Research (AHRQ)- clinical guidelines for client care such as pain management, cancer screening, and DM Tx Migrant Clinicians Network (MCN)- is a tracking program developed so that healthcare providers can access prior provider information and maintain TB tx continuity for the migrant population. CDC- STIs and immunization guidleines. US preventive services task force (USPSTF)- organization that reviews preventative service and suggests appropriate services for primary medical care and topics for research 42. A nurse in a community center is preparing to administer a tuberculin skin test to multiple clients to screen for tuberculosis. Which of the following actions should the nurse take? Prepare the outer aspect of the upper arm for injection- inner aspect forearm Insert the needle at 45 degree angle- inject purified protein derivative intradermally 5-15 angle Inject 0.1 ml of purified protein derivative.- - 5 tub6mm in diamtererculin units Create a wheal that measures about 15mm in diameter- wheal approximately 43. 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? Take a walk after work "Point and flex your toes periodically Have your visual acuity asses regularly Adjust your chari so that your elbow are at desk height. Gratest rick to staff emember who are immobile for long periods of time is venous thromemboliam therefore the nurse should encourage the staff memener to frequently change the position of their feet and legs. Eye exam annual and prevent injury 44. A school nurse is conducting visual acuity testing for a school-age child. Which of the following actions should the nurse take? Allow the child to keep her glasses on during the testing Have the child stand 5 ft away from the Snellen letter chart. – 10 ft away Progress to the next line once the chil reads two symbols correctly- progress to the next line once she is able to read at least 4 symbolc on the current line Begin the test by instructing the child to use both eye to read the chart- cover right eye first then move the left eye.final step read both eyes. 45. 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? Avoid using hand gestures when working with the client- A vclient might exprss himself with face, hand, body gestures and consider touch a show os caring a compassion. Use therapeutic touch during conversation Discourage the client from using a faith healer- a Santero priest or a yerbro. Maintain direct eye contact when speaking with the client- direct eye cotatc a sign of disrespect. 46. 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? “Once I determine that a client is not at risk for abuse, I do not need to ask about it at future visits.” "I should refer a client for a rape kit examination if she reports sexual assault within the previous 24 hours." “I should wait until I see signs of physical abuse before I help the client develop a safety plan.” I Should refer a client for a rape kit examination is she reports sexual assault within the previous 24 hours. 47. 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? Examine the client's oral mucous membranes Encourage the client to consume 1.2 to 2.0 g/kg of protein daily Recommened the client increase her daily calorie intake by 25% Teach the cient about findings that should be reported to the provider. Examin oral for painful lesons such as candidiasis if the nurse first action . 48. 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 list of resident who have experience a hurricanr in the past and will not need evacuation. A list of areas within the community where residents speak English as a second language How to activate tge local medical facilitys emergency management plan- Joint commission mandates that all medical facilities have a response plan that includes the actions that facility staff can take in the event of a local disaster The name of the individual who is necessary to implement the plan. 49. A community health nurse suspects an outbreak of scabies in the local area. Which of the following actions should the nurse take first? Educate the community about disease transmission Determine incidence rate Institue prophylactic tx Discuss tx plans with the clients families. The FIRST action that the nurse should take when using the nursing process is to determine the number of new caes of scabies in the community. The public health nurse who is most familiar with the community should contribute this information to disaster plan to assit in aiding and evaculating resident who are at risk. 50. A home health nurse is assessing an older adult who is taking captopril to treat heart failure. Which of the following findings should the nurse identify as an adverse effect of this medication? Weight gain- Weight LOSS ADR catropril Ataxia- NOT an ADR catropril Photophobia- Photosensitivity is an ADR catropril Dry cough- Captopril prevents the conversion of angiotensin 1 to angiotensin 2 causing bradykinin to accumulate. The client may experience coughing as a result of bradykinin accumulation. A public health nurse is working in a community that has a population of 24,096. There are 2,096 existing cases of heart disease within the population. The nurse can determine which of the following from this information? Prevalence proportion The daughter of a client who is terminally ill and at the end of life approaches a hospice nurse and asks what she can do to help relieve her father's pain. Which of the following interventions should the nurse suggest? Give the client brief hand massages 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? "Can I give you some information about Alcoholics Anonymous?" [Show More]

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