Nokea
A client with rheumatoid arthritis is receiving methotrexate (Rheumatrex). The nurse should monitor the client for which of the following adverse effects?
- A. Leukopenia
- B. Hyperglycemia
- C. Hypertension
- D. Hypokalemia
Correct Answer: A
Rationale: The correct answer is A: Leukopenia. Methotrexate, used in the treatment of rheumatoid arthritis, can lead to bone marrow suppression, resulting in leukopenia. This condition increases the risk of infections due to decreased white blood cell count. Choices B, C, and D are incorrect because methotrexate is not known to cause hyperglycemia, hypertension, or hypokalemia as its primary adverse effects.
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What action is best for the community health nurse to take if the nurse suspects that an infant is being physically abused?
- A. Follow agency protocols to report suspected abuse.
- B. Report suspicions to the local child abuse reporting hotline.
- C. Educate the child's caregivers about growth and development issues.
- D. Call the police department to have the child removed from the home.
Correct Answer: A
Rationale: When a community health nurse suspects that an infant is being physically abused, the best course of action is to follow agency protocols to report the suspected abuse. This is essential to ensure that the appropriate authorities are informed, and proper interventions can be initiated. Reporting suspicions to the local child abuse reporting hotline (Choice B) can be a part of the agency protocols but may not cover all necessary steps. Educating the child's caregivers about growth and development (Choice C) is not appropriate in cases of suspected abuse, as the immediate focus should be on the safety and well-being of the infant. Calling the police department to have the child removed from the home (Choice D) is not the primary role of the nurse; the proper authorities should handle the removal process after an investigation.
In providing comprehensive family health care, the nurse utilizes four (4) basic processes. These are listed in the order in which they are carried out as follows:
- A. assessment, planning, intervention, and evaluation
- B. assessment, intervention, planning, and evaluation
- C. planning, assessment, intervention, and evaluation
- D. planning, intervention, evaluation, and assessment
Correct Answer: A
Rationale: The correct order for the basic processes in providing comprehensive family health care is assessment, planning, intervention, and evaluation. Assessment is the first step to gather information, followed by planning to set goals and strategies, then intervention to implement the plan, and finally evaluation to assess the outcomes. Choice A is correct as it follows this logical sequence. Choices B, C, and D are incorrect because they do not follow the correct order of these essential processes in nursing care.
The nurse is caring for a 75-year-old client in congestive heart failure. Which finding suggests that digitalis levels should be reviewed?
- A. Extreme fatigue
- B. Increased appetite
- C. Intense itching
- D. Constipation
Correct Answer: A
Rationale: Extreme fatigue can be a sign of digitalis toxicity, especially in older adults, and warrants a review of the client's medication levels and potential adjustment. Increased appetite, intense itching, and constipation are not typically associated with digitalis toxicity and do not directly indicate a need for a review of digitalis levels.
What title should be given to this occupational health nurse job description? A registered nurse who establishes a provider network, recommends treatment plans that assure quality and efficacy while controlling costs, monitors outcomes, and maintains communication among all involved.
- A. manager
- B. researcher
- C. case manager
- D. health promotion specialist
Correct Answer: C
Rationale: The correct answer is C: case manager. A case manager in healthcare coordinates care, monitors outcomes, and ensures quality and cost-effectiveness. In this job description, the nurse is mainly focused on coordinating care, recommending treatment plans, monitoring outcomes, and maintaining communication among all involved, which aligns with the responsibilities of a case manager. Choices A, B, and D are incorrect because the job description does not primarily involve general management, research, or health promotion specialization.
A nurse working in a community health setting is performing primary health screenings. Which individual is at highest risk for contracting an HIV infection?
- A. A 17-year-old who is sexually active with numerous partners.
- B. A 45-year-old lesbian who has been sexually active with two partners in the past year.
- C. A 30-year-old cocaine user who inhales the drug and works in a topless bar.
- D. A 34-year-old male homosexual who is in a monogamous relationship.
Correct Answer: A
Rationale: The correct answer is A. A 17-year-old who is sexually active with numerous partners is at the highest risk for contracting an HIV infection due to engaging in risky sexual behavior with multiple partners, increasing the likelihood of exposure to the virus. Choice B is less risky as the individual has had a relatively lower number of sexual partners in the past year. Choice C, although involving drug use, does not directly correlate with a higher risk of contracting HIV unless needles are shared. Choice D, a 34-year-old male homosexual in a monogamous relationship, has a lower risk compared to choice A as long as the relationship remains monogamous.