ATI RN Community Health Online Practice 2016 B

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 should 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