Nokea
A client states, 'My life has no meaning right now.' What is the nurse's best response?
- A. Have you been thinking about harming yourself?
- B. How long have you been feeling this way?
- C. Tell me what is going on with you right now.
- D. Do you really think your life has no purpose?
Correct Answer: A
Rationale: The correct answer is A. By asking the client if they have been thinking about harming themselves, the nurse is directly addressing the potential risk of suicide, which is crucial when a client expresses feelings of hopelessness. This question helps assess the client's safety and determine the need for immediate intervention. Choices B, C, and D are not as direct in addressing the potential risk of self-harm and may not provide the necessary urgency in ensuring the client's safety. Asking about self-harm is critical in assessing the severity of the client's distress and ensuring appropriate interventions are implemented promptly.
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A nurse at a local health department is caring for several clients. Which of the following infections should the nurse report to the state health department?
- A. Herpes simplex virus
- B. Group B Streptococcus B hemolytic
- C. Human papillomavirus
- D. Tuberculosis
Correct Answer: D
Rationale: The correct answer is D: Tuberculosis. The nurse should report tuberculosis to the state health department because it is a notifiable infectious disease, meaning it is required by law to be reported to public health authorities. Tuberculosis is a serious respiratory infection that can spread easily and pose a public health risk if not properly monitored and controlled. Reporting helps in tracking and controlling the spread of the disease through appropriate public health interventions. Choices A, B, and C are not typically reportable to the state health department as they are not considered highly contagious or pose significant public health risks compared to tuberculosis.
A community health nurse is planning a program for adolescents about preventing STIs. Which of the following actions should the nurse take first?
- A. Collect data to identify barriers to learning
- B. Establish methods to evaluate program outcomes
- C. Obtain visual aids that feature adolescents
- D. Provide computer-based education
Correct Answer: A
Rationale: The correct answer is A: Collect data to identify barriers to learning. This should be the first step because understanding the specific challenges and obstacles that adolescents face in learning about preventing STIs is crucial for designing an effective program. By collecting data, the nurse can tailor the program to address the specific needs of the target audience, ensuring that the information is relevant and accessible.
Choice B, establishing methods to evaluate program outcomes, would come later in the program planning process after the content has been developed and implemented. Choice C, obtaining visual aids featuring adolescents, and choice D, providing computer-based education, are also important but should be considered after identifying barriers to learning to enhance the effectiveness of the program.
A nurse is providing teaching to a client who speaks a different language than the nurse, and an interpreter is present. Which of the following findings should the nurse document to show that the client understands the teaching?
- A. Client smiles at the nurse.
- B. Client asks questions to the interpreter.
- C. Client makes eye contact with the nurse frequently.
- D. Client points to printed resources when the nurse speaks.
Correct Answer: B
Rationale: The correct answer is B: Client asks questions to the interpreter. This indicates that the client is actively engaging with the information being provided, seeking clarification, and demonstrating an understanding of the teaching. Asking questions shows the client is processing the information and trying to make sense of it. Smiling at the nurse (A) may indicate politeness or agreement but does not necessarily reflect comprehension. Making eye contact (C) can show attentiveness but not necessarily understanding. Pointing to printed resources (D) may indicate a desire for more information but doesn't confirm comprehension.
A nurse is conducting a community assessment. Which of the following information should the nurse include as part of the windshield survey?
- A. Demographic data
- B. Mortality rate
- C. Informant interviews
- D. Housing quality
Correct Answer: D
Rationale: The correct answer is D: Housing quality. In a windshield survey, the nurse observes the community from a car to assess physical environment, including housing conditions. This information is crucial for identifying health risks and community needs. Demographic data (A) and mortality rates (B) are important but are typically gathered through other means. Informant interviews (C) involve talking to community members, not part of a windshield survey. Other choices (E, F, G) are not relevant to a windshield survey.
A nurse is planning a priority intervention to reduce obesity in the community. Which of the following actions should the nurse take?
- A. Encourage enrollment and attendance at weight reduction programs
- B. Educate children at a daycare center about nutrition and exercise
- C. Distribute health risk appraisal questionnaires at community functions
- D. Measure the BMI of older adults at a community senior center
Correct Answer: B
Rationale: The correct answer is B: Educate children at a daycare center about nutrition and exercise. This is the priority intervention because educating children about nutrition and exercise can help prevent obesity in the long term. By teaching healthy habits early on, the nurse can make a significant impact on reducing obesity rates in the community. Encouraging enrollment in weight reduction programs (A) may help individuals who are already obese but does not address prevention. Distributing health risk appraisal questionnaires (C) and measuring BMI of older adults (D) are important but not the priority for reducing obesity in the community.