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Nursing Questions & Rationales
A Comprehensive Review for Community and Public Health Nursing
Generated on: 2025-11-21
1. Health Teaching for Adolescents
The community health nurses is counseling a group of 14 year olds about safe sexual
practices. Which health teaching strategy would be most effective for the nurse to use
with this age group?
a. Encourage group members to describe personal experiences in practicing safe
sex
b. Provide the group with statistical data about behaviors leading to venereal
diseases
c. Tell the group that for aids prevention abstinence is the best safe sex practice
D. Role play situations in which the adolescent is rewarded for practicing
safe sex
Rationale
The correct answer is D. Adolescents, particularly in the 14-year-old age range,
are in a developmental stage (Piaget's formal operational stage) where they can
think abstractly but are heavily influenced by peer pressure and the need for social
acceptance. They learn best through active, engaging, and relevant methods.
Role-playing (Option D) is highly effective because it provides a safe, simulated
environment to practice communication and decision-making skills. It allows
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adolescents to rehearse how they would handle peer pressure or navigate a
difficult conversation about safe sex. The "reward" aspect reinforces positive
behavior and builds self-efficacy, making them more confident in their ability to
make safe choices in real-life situations.
Encouraging personal experiences (Option A) is inappropriate and potentially
harmful. It can cause embarrassment, breach confidentiality, and put
individuals on the spot. Many may not have personal experiences to share, and
forcing such a discussion can create anxiety and shut down communication.
Providing statistical data (Option B), while informative, is often too abstract and
impersonal for this age group to be the *most* effective strategy. Adolescents
may not connect with statistics and can feel that "it won't happen to me." While
data can supplement teaching, it should not be the primary method.
Telling them abstinence is the best practice (Option C) is an incomplete and
potentially ineffective message. While abstinence is 100% effective in
preventing pregnancy and STIs, a significant number of adolescents will
become sexually active. An abstinence-only approach fails to provide them with
the necessary information and skills to protect themselves if they choose to
have sex. A comprehensive approach that includes information on both
abstinence and contraception/safe sex practices is the recommended standard
of care.
2. Post-Marathon Care
A young adult man goes to an emergency treatment area after finishing a marathon run.
He is weak dizzy and remains thirsty after drinking a pint of a flavored sports drink. What
action should the nurse implement first?
a. Instruct the runner that a urine sample is needed
b. Send for the automatic external defibrillator
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c. Determine if there are friends or family nearby
d. Give the runner another pint of fluids to drink
Rationale
The correct answer is d. The client's symptoms—weakness, dizziness, and
persistent thirst after a marathon—are classic signs of significant fluid volume
deficit (dehydration). The immediate priority is to address this physiological
imbalance.
Giving more fluids (Option D) is the most direct and immediate intervention to
treat the underlying cause of his symptoms. A single pint of fluid is often
insufficient to correct the profound dehydration that can occur after a marathon.
Continuing oral rehydration is the first and most crucial step, assuming the
client is conscious and able to swallow.
Requesting a urine sample (Option A) is a useful assessment to evaluate
hydration status (e.g., specific gravity) and kidney function, but it is not the
priority intervention. Rehydration must come first. The client may not even be
able to produce a urine sample until he is better hydrated.
Sending for an AED (Option B) is not indicated at this time. While severe
electrolyte imbalances from dehydration can lead to cardiac arrhythmias, the
client is not described as being in cardiac arrest, pulseless, or having chest
pain. This would be an overreaction based on the current assessment findings.
Determining if friends or family are nearby (Option C) is part of a holistic
assessment and can be helpful for gathering more history or providing support,
but it does not address the immediate physiological need. The priority is
medical stabilization.
3. Post-Arthroplasty Home Safety
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An older adult male who fractured his right hip is discharged to home one week following
an arthroplasty. Which adjustment to the clients home environment is most important for
the home health nurse to implement?
a. Lower the temperature on the clients water heater
b. Encourage the client to wear rubber soled shoes
c. Ensure that an elevated toilet seat is installed
d. Leave motion activated light in the living room
Rationale
The correct answer is c. The most important priority for a client post-hip
arthroplasty is to prevent hip dislocation by adhering to hip precautions. These
precautions typically include avoiding hip flexion greater than 90 degrees, avoiding
adduction (crossing the legs), and avoiding internal rotation.
Installing an elevated toilet seat (Option C) directly addresses the risk of
excessive hip flexion. A standard-height toilet requires a person to bend their
hips well beyond 90 degrees to sit down, which could dislocate the new hip
prosthesis. An elevated seat reduces the amount of flexion needed, making
toileting safer and is therefore the most critical environmental modification.
Lowering the water heater temperature (Option A) is a general safety measure
to prevent burns, particularly for older adults who may have decreased
sensation, but it is not specific to the risks associated with hip arthroplasty.
Wearing rubber-soled shoes (Option B) is a good fall prevention strategy,
which is important, but it is secondary to preventing the specific, high-risk
complication of hip dislocation.
Using motion-activated lights (Option D) is also an excellent fall prevention
strategy, especially for nighttime mobility, but it does not address the
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Nursing Questions & Rationales
A Comprehensive Review for Community and Public Health Nursing
Generated on: 2025-11-21
1. Health Teaching for Adolescents
The community health nurses is counseling a group of 14 year olds about safe sexual
practices. Which health teaching strategy would be most effective for the nurse to use
with this age group?
a. Encourage group members to describe personal experiences in practicing safe
sex
b. Provide the group with statistical data about behaviors leading to venereal
diseases
c. Tell the group that for aids prevention abstinence is the best safe sex practice
D. Role play situations in which the adolescent is rewarded for practicing
safe sex
Rationale
The correct answer is D. Adolescents, particularly in the 14-year-old age range,
are in a developmental stage (Piaget's formal operational stage) where they can
think abstractly but are heavily influenced by peer pressure and the need for social
acceptance. They learn best through active, engaging, and relevant methods.
Role-playing (Option D) is highly effective because it provides a safe, simulated
environment to practice communication and decision-making skills. It allows
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adolescents to rehearse how they would handle peer pressure or navigate a
difficult conversation about safe sex. The "reward" aspect reinforces positive
behavior and builds self-efficacy, making them more confident in their ability to
make safe choices in real-life situations.
Encouraging personal experiences (Option A) is inappropriate and potentially
harmful. It can cause embarrassment, breach confidentiality, and put
individuals on the spot. Many may not have personal experiences to share, and
forcing such a discussion can create anxiety and shut down communication.
Providing statistical data (Option B), while informative, is often too abstract and
impersonal for this age group to be the *most* effective strategy. Adolescents
may not connect with statistics and can feel that "it won't happen to me." While
data can supplement teaching, it should not be the primary method.
Telling them abstinence is the best practice (Option C) is an incomplete and
potentially ineffective message. While abstinence is 100% effective in
preventing pregnancy and STIs, a significant number of adolescents will
become sexually active. An abstinence-only approach fails to provide them with
the necessary information and skills to protect themselves if they choose to
have sex. A comprehensive approach that includes information on both
abstinence and contraception/safe sex practices is the recommended standard
of care.
2. Post-Marathon Care
A young adult man goes to an emergency treatment area after finishing a marathon run.
He is weak dizzy and remains thirsty after drinking a pint of a flavored sports drink. What
action should the nurse implement first?
a. Instruct the runner that a urine sample is needed
b. Send for the automatic external defibrillator
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c. Determine if there are friends or family nearby
d. Give the runner another pint of fluids to drink
Rationale
The correct answer is d. The client's symptoms—weakness, dizziness, and
persistent thirst after a marathon—are classic signs of significant fluid volume
deficit (dehydration). The immediate priority is to address this physiological
imbalance.
Giving more fluids (Option D) is the most direct and immediate intervention to
treat the underlying cause of his symptoms. A single pint of fluid is often
insufficient to correct the profound dehydration that can occur after a marathon.
Continuing oral rehydration is the first and most crucial step, assuming the
client is conscious and able to swallow.
Requesting a urine sample (Option A) is a useful assessment to evaluate
hydration status (e.g., specific gravity) and kidney function, but it is not the
priority intervention. Rehydration must come first. The client may not even be
able to produce a urine sample until he is better hydrated.
Sending for an AED (Option B) is not indicated at this time. While severe
electrolyte imbalances from dehydration can lead to cardiac arrhythmias, the
client is not described as being in cardiac arrest, pulseless, or having chest
pain. This would be an overreaction based on the current assessment findings.
Determining if friends or family are nearby (Option C) is part of a holistic
assessment and can be helpful for gathering more history or providing support,
but it does not address the immediate physiological need. The priority is
medical stabilization.
3. Post-Arthroplasty Home Safety
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An older adult male who fractured his right hip is discharged to home one week following
an arthroplasty. Which adjustment to the clients home environment is most important for
the home health nurse to implement?
a. Lower the temperature on the clients water heater
b. Encourage the client to wear rubber soled shoes
c. Ensure that an elevated toilet seat is installed
d. Leave motion activated light in the living room
Rationale
The correct answer is c. The most important priority for a client post-hip
arthroplasty is to prevent hip dislocation by adhering to hip precautions. These
precautions typically include avoiding hip flexion greater than 90 degrees, avoiding
adduction (crossing the legs), and avoiding internal rotation.
Installing an elevated toilet seat (Option C) directly addresses the risk of
excessive hip flexion. A standard-height toilet requires a person to bend their
hips well beyond 90 degrees to sit down, which could dislocate the new hip
prosthesis. An elevated seat reduces the amount of flexion needed, making
toileting safer and is therefore the most critical environmental modification.
Lowering the water heater temperature (Option A) is a general safety measure
to prevent burns, particularly for older adults who may have decreased
sensation, but it is not specific to the risks associated with hip arthroplasty.
Wearing rubber-soled shoes (Option B) is a good fall prevention strategy,
which is important, but it is secondary to preventing the specific, high-risk
complication of hip dislocation.
Using motion-activated lights (Option D) is also an excellent fall prevention
strategy, especially for nighttime mobility, but it does not address the
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