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A community health nurse is helping a group of nursing students plan a tertiary prevention program for a local community clinic that serves a majority Hispanic population. Which service project meets the requirement of a tertiary prevention program and would best serve this population?
- A. Teach clients about recommended immunizations for children.
- B. Instruct teens about prevention of sexually transmitted diseases.
- C. Take blood pressures at a local shopping mall in the community.
- D. Demonstrate foot care to a group of clients who have diabetes.
Correct Answer: D
Rationale: Demonstrating foot care for diabetic clients is tertiary prevention, focusing on managing complications of an existing condition, highly relevant for a Hispanic population with a high prevalence of diabetes.
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Several clients who have recently come to the local health clinic in a rural county are diagnosed with tuberculosis (TB). After reporting the occurrence to the health department, which community focused action should the nurse implement first?
- A. Collaborate with local schools in screening children.
- B. Develop a community educational program.
- C. Provide referrals for home health care follow up.
- D. Perform a community health assessment.
Correct Answer: D
Rationale: A community health assessment is the first step to understand the extent of the TB outbreak, identify high-risk groups, and tailor interventions like screening or education effectively.
The community health center has noticed a dramatic increase in influenza cases over prior years. The facility nurses have been charged with reviewing outcome data to determine if there is a trend in vaccination rates, and if a trend is noted, reasons for decline. An action plan will be developed to increase rates, if needed. The facility nursing team develops a plan to survey the community and facility records. Select all applicable action(s) that will facilitate gathering data for analysis.
- A. Client survey both in clinic and in the home
- B. Ask a set number of clients if they have had the flu
- C. Determine change in immunization rates from prior year to current year
- D. Generate influenza immunization and case reports from the electronic record for prior year and current year
- E. Develop an action plan to increase immunization rates
- F. Delineate geographic distribution of area to survey and review for patterns
Correct Answer: A,C,D,F
Rationale: Surveys (A), immunization rate changes (C), electronic record reports (D), and geographic distribution analysis (F) provide comprehensive data to identify vaccination trends and patterns.
A middle-aged client presents for an annual health visit at a community clinic. The client is 5 feet 10 inches (177.8 cm) tall, weighs 250 pounds (113.4 kg), and works as an accountant. The client has smoked at least one pack of cigarettes every day for the last 15 years. Which secondary prevention measure should the nurse recommend the client to follow?
- A. Smoking cessation.
- B. Compliance with antihypertensive and lipid lowering agents.
- C. Blood pressure and lipid screening.
- D. Increase physical activity and diet low in saturated fat.
Correct Answer: C
Rationale: Blood pressure and lipid screening are secondary prevention measures to detect cardiovascular issues early, critical for a smoker with obesity and high cardiovascular risk.
A nurse designs a series of four weekly classes for clients with type 2 diabetes mellitus. Which information should the nurse use as an outcome evaluation for the classes?
- A. Fasting blood glucose average readings were 20% lower at the end of the classes.
- B. Discussion of food exchanges and calories was a well-attended class.
- C. Demonstrating the use of a blood glucose meter was an effective teaching strategy.
- D. Parking convenience for attendees continued to be a major concern.
Correct Answer: A
Rationale: Lower fasting blood glucose readings directly indicate improved diabetes management, reflecting the classes' effectiveness.
The school nurse who is reviewing immunization records of students who will start kindergarten within the next month notes that most of the students have only received one dose of the measles, mumps, rubella (MMR) vaccine. Which intervention should the nurse implement?
- A. Contact kindergarten parents to remind them that the second dose of MMR is due at the start of the school year.
- B. Send notices home with the children on the first day of class advising that MMR vaccine series must be completed.
- C. Note in student records that the second dose of the MMR vaccine should be administered prior to entering first grade.
- D. Speak at the next parent-teacher association meeting to teach parents the benefits of immunizing their children.
Correct Answer: A
Rationale: Contacting parents before the school year ensures timely MMR second-dose administration, meeting school entry requirements.