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NR442 - RN Community Health Exam 2 Latest 2021, 2022
Community Health Nursing (NR-442)
Chamberlain University
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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 ‘=
Rationale : Administering antibiotics to a client who has AIDS and was diagnosed with Pneumocystis jiroveci is an example of tertiary prevention.
- 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
Rationale : Captopril prevents the conversion of angiotensin I to angiotensin II, causing bradykinin to accumulate. The client may experience coughing as a result of bradykinin accumulation.
- 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. Inability to concentrate b. Makes eye contact c. Excessive sleeping
d. Lack of interest in food
Rationale : The nurse should recognize that making eye contact is a characteristic of effective coping.
A public health nurse is providing information to a client who has an 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 will not have to completely stop drinking alcohol if I go into an inpatient treatment program." b. "Once I make it through detoxification, I will be free of my addiction." c. "I am not eligible for an outpatient program until I have completed an inpatient program first." d. "I can expect to get help with other aspects of my life while in treatment." Rationale : Successful treatment 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.
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?
Rationale : This is the appropriate instruction for a Rinne test, a hearing evaluation that compares air conduction and bone conduction of sound.
- A public health nurse is developing a presentation for local daycare providers about infectious childhood diseases. which of the following statements should the nurse include? a. "Respiratory syncytial virus is spread through contact with respiratory secretions from an infected person." b. "Rotavirus infections in children peak during the summer months." c. "Children who have fifth disease will exhibit bloody diarrhea." d. "Antiviral medications shorten the duration of shigella infection."
Rationale : The nurse should include this statement in the presentation, as respiratory syncytial virus (RSV) is spread by direct contact with respiratory secretions while within 3 feet of a person who is infected. Manifestations of RSV include dyspnea, tachypnea, coughing, and wheezing.
- 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. Teach a client who has a vision loss about safety in the home environment. b. Provide genetic counseling to the family of a newborn who has congenital cataracts. c. Consult with the local school nurse to schedule yearly vision screenings for students. d. Develop a plan of care for a client who was newly diagnosed with glaucoma.
Rationale : 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.
- 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. "Can you tell me more about your decision to stop your medicine?" c. "Don't you know what stopping your medicine will do to your heart?" d "Don't you think your doctor knows what's best for your heart?"
Rationale : The nurse is asking an open-ended question, which encourages continued communication and allows the nurse to investigate the reasons why the client has decided to stop taking the medicine.
- 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. Hold a care conference with the client and his family to discuss treatment options.
b. Contact service providers to determine the availability of services offered. c. Determine the client's ability to perform self-care. d. Evaluate the client's satisfaction with the case manager's services.
Rationale: The first action the nurse should take when using the nursing process is to assess the client's needs. Determining a client's needs is the first step of the case management process. Therefore, the nurse should first determine the client's ability to perform self-care.
- 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 who has diabetes mellitus and reports new erythema to the left foot c. A client who has COPD and needs a follow-up visit related to home oxygen therapy d. A client in a hip spica cast who reports pruritus under the cast
Rationale : When using the urgent vs nonurgent approach to client care, the nurse should determine that the client who has diabetes mellitus and a new onset of erythema to the left foot should be seen first. This client is at risk for infection and requires prompt evaluation and treatment.
- A home health nurse is scheduling client visits for the day. Which of the following clients should the nurse plan to visit first? a. Conducting screenings for dental caries in the local school system b. Reviewing county health records for data on cases of chickenpox c. Providing a client with information about preventing d. STIs Documenting medication compliance for clients who have tuberculosis
Rationale : Reviewing health records is an example of using epidemiological principles to analyze incidence and track outcomes of interventions for a particular disease or condition.
- 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
Rationale : Household members of a client who has active pulmonary tuberculosis are at risk for developing the disease. Therefore, taking isoniazid prophylactically for 6 to 12 months is recommended.
- 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. 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)
assaulted. Clients who have prior exposure to violence have a greater potential for continuing the violent and abusive behavior.
b. 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 c. d.
Rationale :
- 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 seconds; non responsive to painful stimuli. Which of the following actions should the nurse take? a. Apply a cervical spine collar and perform a focused 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
Rationale : Principles of triage indicate that clients who have extensive injuries and a low- probability of survival do not receive treatment. Therefore, the nurse should provide only comfort measures before moving on to assess the next client.
- 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 mL of purified protein derivative
Rationale: The nurse should inject 0 mL of purified protein derivative, which is equivalent to 5 tuberculin units.
- 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 for my 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
Rationale : Role conflict occurs when a client performs two or more roles that are in opposition to each other. Caring for children and a parent can cause feelings of stress for the client and lead to conflict within the family.
28. 29.
a. "I will need to purchase exercise equipment before I can start." b. "I should try to perform aerobic exercise for an hour a day, 5 days a week." c. "I will see my doctor before beginning an exercise program." d. "I should avoid participating in weight-lifting exercises."
Rationale : The client should see his provider before beginning an exercise program. The client should receive a complete physical exam and obtain approval for exercise.
- 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. Respiratory disorders b. Diabetes mellitus c. Sickle cell anemia d. Hypertension
Rationale : Farmers are at an increased risk for respiratory 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.
Instruct the interpreter to guide the nurse in providing information in a culturally- sensitive manner is correct. 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 these issues.
Ask the interpreter to add information she feels may be necessary is incorrect. The nurse should ask the interpreter to not add or omit any information because it can interfere with the accuracy of the content.
Choose an interpreter who speaks the workers' language and dialect is correct. The nurse should choose an interpreter who can speak the clients' native language, including the specific dialect, in order to facilitate accurate communication.
Evaluate the interpreter's approach to clients prior to the educational session is correct. The nurse should evaluate the style of the interpreter prior to the educational session to determine if she is able to develop a trusting relationship with the migrant workers in order to promote effective communication.
Encourage the interpreter to paraphrase the workers' questions and responses is incorrect. The nurse should ask the interpreter to translate the workers' comments and questions using their own words to increase the accuracy of the communication.
needs a BP check A school-age child whose percutaneous endoscopic gastrostomy (PEG) tube needs changing
Rationale : When using the airway, breathing, circulation approach to client care, the nurse should determine that the client who recently experienced status asthmaticus is the priority. Therefore, the nurse should visit this client first.
- The individuals living in crowded areas, such as dormitories, should receive the meningococcal vaccine.
a. b. c. d.
Rationale :
- 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 is at 13 weeks of gestation. e. b. The client states she is leaving her partner. c. The client recently started a new job. d. The client visits friends without her partner's knowledge.
Rationale : A client's decision to leave her partner places her at greatest risk for intimate partner abuse because the perpetrator can view her as a possession and fear loss of control. Whether the client actually leaves the relationship or just threatens to leave, the client is at greatest risk for violence during this time. A client's decision to leave her partner places her at greatest risk for intimate partner abuse because the perpetrator can view her as a possession and fear loss of control. Whether the client actually leaves the relationship or just threatens to leave, the client is at greatest risk for violence during this time.’
- 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? a. Distributive justice b. Respect for autonomy c. Fidelity d. Beneficence
Rationale : The nurse is demonstrating the ethical principle of beneficence by determining if the client needs this service to maintain his health.
- A school nurse is conducting visual acuity testing for a school-age child. Which of the following actions should the nurse take? a. Allow the child to keep her glasses on during the testing. b. Have the child stand 5 feet away from the Snellen letter chart. c. Progress to the next line once the child reads two symbols correctly. d. Begin the test by instructing the child to use both eyes to read the chart.
Rationale : When using the Snellen letter chart to assess a school-age child's visual acuity, the nurse should allow the child to keep her glasses on during the test.
- A PHN 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. Mortality rate b. Attack rate c. Prevalence proportion
d. Incidence proportion
Rationale : The prevalence proportion can be calculated by using the number of people who were affected at a given time and the total population.
- 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. "If I begin palliative care, I will have to stop my chemotherapy." b. "I can begin palliative care when I have less than 6 months to live." c. "This type of care can help me with pain control." d. "My family will not be involved with this type of care program."
Rationale : Clients who have cancer might require complicated treatments that can cause pain, disfigurement, and emotional and psychological distress. Palliative care provides support and management of the disease process regardless of the prognosis, including pain management.
- A nurse is providing blood pressure screenings for older adults as a local community center. Which of the following should the nurse identify as increasing a client's risk for developing HTN? African American a. BMI of less than 30 level c. African American race HDL d. Greater than 70 mg/dL
b. Daily walking routine
Rationale : The nurse should identify that clients who are African American have a greater risk of developing hypertension. She should instruct these clients to participate in regular blood pressure screenings to aid in early detection.
- A PHN 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. A list of residents who have experienced a hurricane in the past & won’t need evacuation.
Rationale : Antiviral medications are administered to individuals who have been exposed to influenza type A to provide immediate protection and to help prevent an outbreak.
- Administer antiviral medication to clients at the facility: a. "Rinse your toothbrush with hydrogen peroxide after each use." b. "Clean your bathroom fixtures with a chlorine bleach solution." c. "Use shared hand towels to dry your hands after washing." d. "Use condoms during sexual contact for 2 weeks."
Rationale : The client should clean his bathroom 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.
- 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? (SATA) Provide environmental health information. Refer the client for a TB screening. Provide skin cancer information. Recommend a dental health screening. a. The client should clean his bathroom 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. b. Less autonomy in providing client care c. Disinterest by members of the population in providing input for community health programs d. Lack of cohesiveness among community members e. Unavailability of outreach services
Rationale : Lack of availability of outreach services is a barrier to health care for residents in rural areas.
- 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? Face Posterior shoulders Abdomen Lower extremities a. Face b. Posterior shoulders c. Abdomen d. Lower extremities Rationale : The RN should teach that the smallpox rash is expected to first appear on the face.
Less autonomy in providing client care Disinterest by members of the population in providing input for community health programs Lack of cohesiveness among community members Unavailability of outreach services
Less autonomy in providing client care Disinterest by members of the population in providing input for community health programs Lack of cohesiveness among community members Unavailability of outreach services
- A CHN 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? i. Less autonomy in providing client care ii. Disinterest by members of the population in providing input for community health programs Lack of cohesiveness among community members Unavailability of outreach services
Rationale :
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?
Rationale :
A CHN 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? 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. a. b. c. d. Unavailability of outreach services.
Rationale : Observe the client's technique for drawing up insulin. MY ANSWER 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.
- A nurse in a rural community is planning education for a young adult clean (particularly for ACT/SAT planning. Which of the following actions should the nurse take?
a. Provide environmental health information. b. Refer the client for a tuberculosis screening. c. Provide skin cancer information. d. Recommend a dental health screening. e. Provide forms to apply for Medicare.
NR442 - RN Community Health Exam 2 Latest 2021, 2022
Course: Community Health Nursing (NR-442)
University: Chamberlain University
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