Nokea
A community health nurse is evaluating the effectiveness of a recent smoking cessation program. Which outcome indicates success?
- A. increased attendance at support group meetings
- B. reduced number of cigarettes smoked per day
- C. higher sales of nicotine replacement products
- D. lower relapse rate among participants
Correct Answer: D
Rationale: The correct answer is D: lower relapse rate among participants. A lower relapse rate indicates that participants are successfully quitting smoking and maintaining their cessation, which is the ultimate goal of a smoking cessation program. Increased attendance at support group meetings (choice A) may demonstrate engagement but does not necessarily indicate successful smoking cessation. Similarly, higher sales of nicotine replacement products (choice C) may reflect increased product usage but not necessarily successful smoking cessation. While reducing the number of cigarettes smoked per day (choice B) is a positive change, it does not guarantee successful smoking cessation or long-term abstinence.
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The nurse is documenting the medical history of a young adult who was recently diagnosed with type 1 diabetes mellitus. The client smokes 2 packs of cigarettes a day, and his father died of a heart attack at the age of 45. Which annual screening is most important for the nurse to include?
- A. peripheral neuropathy
- B. renal insufficiency
- C. retinopathy
- D. hyperlipidemia
Correct Answer: D
Rationale: The most important annual screening for the nurse to include is hyperlipidemia. Given the client's smoking history, family history of premature heart disease, and the increased risk of cardiovascular complications associated with diabetes, screening for hyperlipidemia is crucial. This screening is essential in assessing the client's risk of developing cardiovascular disease, which is a significant concern in this case. Peripheral neuropathy (choice A) is a common long-term complication of diabetes but may not be the most immediate concern in this scenario. Renal insufficiency (choice B) is also a complication of diabetes, but given the client's high cardiovascular risk, hyperlipidemia screening takes priority. Retinopathy (choice C) is an important complication of diabetes affecting the eyes, but in this case, focusing on cardiovascular risk assessment through hyperlipidemia screening is more critical.
In a community clinic where a recent case of tuberculosis (TB) has been diagnosed, which client who attended the clinic is at the highest risk for presenting with TB?
- A. a young adult who works as a daycare worker
- B. an adult who works in a corporate office
- C. an adolescent who attends the community high school
- D. an adult with a history of alcoholism and homelessness
Correct Answer: D
Rationale: Individuals who are homeless and have a history of alcoholism are at the highest risk for presenting with TB in this scenario. Homeless individuals often live in crowded conditions with poor ventilation, increasing the likelihood of TB transmission. Additionally, alcoholism can weaken the immune system, making individuals more susceptible to developing TB. The other options, such as a daycare worker, an office worker, or a high school student, do not inherently carry the same level of risk factors for TB transmission as being homeless with a history of alcoholism.
The nurse is caring for a client with cirrhosis of the liver. Which laboratory result requires immediate intervention?
- A. Serum albumin of 3.5 g/dL.
- B. Prothrombin time (PT) of 12 seconds.
- C. Hemoglobin of 10 g/dL.
- D. Serum ammonia level of 180 mcg/dL.
Correct Answer: D
Rationale: The correct answer is D, the serum ammonia level of 180 mcg/dL. An elevated serum ammonia level indicates hepatic dysfunction and can lead to hepatic encephalopathy, which is a medical emergency requiring immediate intervention. Options A, B, and C are within normal ranges or slightly abnormal values for clients with cirrhosis and do not pose an immediate threat. Serum albumin levels may indicate malnutrition, prothrombin time may reflect liver synthetic function, and hemoglobin levels can be affected by various factors but do not require immediate intervention in this scenario.
To prepare a presentation on the greatest health concern facing the city, how should the health nurse begin collecting data?
- A. Review morbidity data for the city's population compiled by the Bureau of Vital Statistics
- B. Conduct a random telephone survey to determine the public's perception about health problems
- C. Survey major hospitals in the area to determine the most common reasons for admissions
- D. Call American Medical Association members to determine the most frequently treated diagnoses
Correct Answer: A
Rationale: The correct answer is to review morbidity data for the city's population compiled by the Bureau of Vital Statistics. Morbidity data provides detailed and accurate information on the health issues prevalent in the city's population. This data is essential as it reflects actual health conditions rather than perceptions or specific hospital data. Conducting a telephone survey (choice B) may provide subjective opinions rather than objective data. Surveying hospitals (choice C) may only capture data on hospitalized cases and may not represent the entire population. Contacting American Medical Association members (choice D) may provide insights into medical treatments but may not reflect the overall health concerns of the city's population.
The nurse is providing care for a client with syndrome of inappropriate antidiuretic hormone (SIADH). Which laboratory result requires immediate intervention?
- A. Serum sodium of 140 mEq/L.
- B. Serum potassium of 4.5 mEq/L.
- C. Serum osmolality of 280 mOsm/kg.
- D. Serum sodium of 130 mEq/L.
Correct Answer: D
Rationale: The correct answer is D: Serum sodium of 130 mEq/L. In SIADH, there is excess release of antidiuretic hormone leading to water retention and dilutional hyponatremia. A serum sodium level of 130 mEq/L indicates severe hyponatremia, which can result in neurological symptoms, such as confusion, seizures, and coma. Therefore, immediate intervention is required to prevent further complications. Choice A, a serum sodium of 140 mEq/L, is within the normal range and does not require immediate intervention. Choice B, serum potassium of 4.5 mEq/L, is also within the normal range and is not directly related to SIADH. Choice C, serum osmolality of 280 mOsm/kg, is a measure of the concentration of solutes in the blood and may not be the most critical parameter to address in a client with SIADH and severe hyponatremia.