The school nurse is conducting an audit of incident reports for adolescent students. Which finding is the best indication that the Healthy People 2020 objectives are being addressed?
- A. the absenteeism rate has increased greatly over the past two years
- B. during the last year fewer firearms were retrieved on school property
- C. the number of requests for pregnancy testing is higher than last year
- D. decline in the number of students enrolled in school during the year
Correct Answer: B
Rationale: The correct answer is B. A decrease in firearms retrieved on school property is a positive indication that the Healthy People 2020 objectives are being addressed. This finding suggests progress in reducing violence and improving safety in schools, which aligns with the goals of promoting overall health and safety among adolescents. Choices A, C, and D do not directly relate to the Healthy People 2020 objectives. Increased absenteeism, higher requests for pregnancy testing, and a decline in student enrollment do not necessarily reflect the specific health and safety goals outlined in Healthy People 2020.
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The public health nurse is called to investigate a report of several cases of chickenpox at a daycare center. The daycare worker states that five children have been sent home over the past two weeks with fever and itchy blisters. Which intervention should the nurse implement first?
- A. Validate that the children sent home did develop chickenpox
- B. Report the presence of a viral endemic at the daycare center
- C. Confirm the number of children with symptoms
- D. Determine how many people have been exposed
Correct Answer: A
Rationale: Validating that the children sent home did develop chickenpox is the most crucial initial step for the nurse. This intervention ensures that the appropriate public health measures are implemented for the containment of chickenpox. Reporting a viral endemic or confirming the number of children with symptoms may be important but are secondary to confirming the diagnosis. Determining the number of people exposed comes after confirming the diagnosis to assess the extent of the outbreak and implement necessary control measures.
The healthcare provider is assessing a client who has a nasogastric tube to low intermittent suction. Which finding indicates that the client may have developed hypokalemia?
- A. Muscle weakness and cramps.
- B. Nausea and vomiting.
- C. Constipation.
- D. Increased blood pressure.
Correct Answer: A
Rationale: Muscle weakness and cramps are characteristic signs of hypokalemia, a condition marked by low levels of potassium in the blood. Potassium is essential for proper muscle function, and its deficiency can lead to muscle weakness and cramps. In the context of a client with a nasogastric tube to low intermittent suction, the loss of potassium through suctioning can contribute to the development of hypokalemia. Nausea and vomiting (choice B) are more commonly associated with gastrointestinal issues rather than hypokalemia. Constipation (choice C) is not a typical finding of hypokalemia; instead, it can be a sign of other gastrointestinal problems. Increased blood pressure (choice D) is not a direct manifestation of hypokalemia; in fact, low potassium levels are more commonly associated with decreased blood pressure.
A client with hypertension is being seen in a community clinic. The nurse notes that the client has not been taking their prescribed medication regularly. What is the most appropriate initial intervention?
- A. Educate the client on the importance of medication adherence
- B. Explore the reasons for non-adherence with the client
- C. Refer the client to a hypertension specialist
- D. Adjust the client's medication regimen
Correct Answer: B
Rationale: The most appropriate initial intervention when a client is not adhering to prescribed medication is to explore the reasons for non-adherence with the client. Understanding the client's perspective can help identify barriers to adherence, such as side effects, cost, forgetfulness, or misunderstanding of the treatment. By addressing these reasons, the nurse can work collaboratively with the client to develop strategies to improve medication compliance. Educating the client on the importance of adherence (Choice A) may be necessary but should come after exploring the reasons for non-adherence. Referring the client to a hypertension specialist (Choice C) or adjusting the medication regimen (Choice D) should be considered after addressing the underlying reasons for non-adherence.
The nurse is providing discharge teaching to a client with chronic obstructive pulmonary disease (COPD). Which statement by the client indicates a need for further teaching?
- A. I will use my albuterol inhaler before exercising.
- B. I will avoid secondhand smoke.
- C. I will get a flu shot every year.
- D. I will limit my fluid intake to 2 liters per day.
Correct Answer: A
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
An 80-year-old client is given morphine sulfate for postoperative pain. Which concomitant medication should the nurse question that poses a potential development of urinary retention in this geriatric client?
- A. Nonsteroidal anti-inflammatory agents.
- B. Antihistamines.
- C. Tricyclic antidepressants.
- D. Antibiotics.
Correct Answer: C
Rationale: The correct answer is C: Tricyclic antidepressants. Drugs with anticholinergic properties, such as tricyclic antidepressants, can exacerbate urinary retention associated with opioids in older clients. Nonsteroidal anti-inflammatory agents (Choice A) do not typically cause urinary retention. Antihistamines (Choice B) may cause urinary retention but are not the primary concern in this scenario. Antibiotics (Choice D) are not associated with an increased risk of urinary retention compared to tricyclic antidepressants.