Nokea
A community health nurse is lecturing students at a nearby community college about high-risk behavior. Which of the following should the nurse include in the lecture?
- A. Suicide is the most common cause of death in this age group.
- B. Cancer is the third most common cause of death in this age group.
- C. Homicide is the second most common cause of death in this age group.
- D. College-age students are more likely to die from unintentional injuries.
Correct Answer: D
Rationale: Unintentional injuries (e.g., car accidents) are the leading cause of death in college-age students. Suicide and homicide rank lower, and cancer is not third.
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A client who sustained a thoracic cord injury a year ago returns to the clinic for a follow-up visit, and the nurse notes a small reddened area on the coccyx. The client is not aware of the reddened area. After counseling the client to relieve pressure on the area by adhering to a turning schedule, which action by the nurse is most appropriate?
- A. Teaching the client to feel for reddened areas
- B. Asking a family member to assess the skin daily
- C. Teaching the client to use a mirror for skin assessment
- D. Scheduling the client to return to the clinic daily for a skin check
Correct Answer: C
Rationale: The client should be encouraged to be as independent as possible. The most effective means of skin self-assessment for this client is with the use of a mirror. The redness cannot be felt. Asking a family member to assess the skin daily does not promote independence. It is unnecessary and unrealistic for the client to return to the clinic daily for a skin check.
The school nurse teaches an athletic coach how to prevent dehydration among athletes practicing in the hot weather. What is the best advice for the nurse to give to the coach?
- A. Drink plenty of fluids before and after practice.
- B. Have the athletes take a salt tablet before practice.
- C. Reschedule practice for before school and after sunset.
- D. Provide a fluid break every 30 minutes during practice.
Correct Answer: D
Rationale: Hot weather accelerates the body's loss of fluid and electrolytes during strenuous physical activity, so the nurse encourages the coach to schedule fluid breaks at 30-minute intervals so that the athletes can periodically rest and restore body fluids. Drinking fluid before and after practice is a reasonable suggestion; however, because the hot weather accelerates fluid and electrolyte losses, body fluids must be periodically replenished to maintain the fluid and electrolyte balance. Although a sodium load increases fluid retention, the nurse avoids suggesting salt tablets for the athletes because the nurse needs approval from each athlete's primary health care provider before recommending the salt. Rescheduling practice times is unrealistic.
Which should the nurse identify as a situational crisis?
- A. Divorce
- B. Retirement
- C. Loss of a job
- D. An earthquake
- E. The birth of a child
- F. Death of a loved one
Correct Answer: A,C,F
Rationale: A situational crisis arises from an external rather than an internal source and often is unanticipated. Examples of external situations that can precipitate a situational crisis include divorce, the loss of a job, the death of a loved one, an abortion, a change in job, a change in financial status, and severe physical or mental illness. A maturational crisis occurs at a developmental stage; examples include marriage, the birth of a child, and retirement. An adventitious crisis, or crisis of disaster, is not a part of everyday life and is unplanned or accidental. This type of crisis can result from a natural disaster (flood, fire, earthquake), a national disaster (acts of terrorism, war, riots, airplane crashes), or a crime of violence (rape, assault, murder, bombing, spousal or child abuse).
The nurse provides discharge instructions to the mother of a child who was hospitalized for heart surgery. Which instruction should the nurse provide to the mother?
- A. The child can play outside for short periods of time.
- B. After bathing, rub lotion and sprinkle powder on the incision.
- C. The child may return to school 1 week after hospital discharge.
- D. Notify the primary health care provider if the child develops a fever greater than 100.5°F (38°C).
Correct Answer: D
Rationale: Notifying the primary health care provider if the child develops a fever greater than 100.5°F (38°C) is critical to detect potential infections post-heart surgery. The child should not play outside for several weeks to avoid infection or injury. No creams, lotions, or powders should be applied to the incision until fully healed. The child should not return to school until 3 weeks after discharge, starting with half days.
A client is receiving lipids (fat emulsion) intravenously at home, and the client's spouse manages the infusion. The home care nurse makes a visit and discusses potential side and adverse effects of the therapy with the client and the spouse. After the discussion, the nurse expects the spouse to verbalize that, in case of a suspected adverse effect, which action is the priority?
- A. Stop the infusion.
- B. Contact the nurse.
- C. Take the client's blood pressure.
- D. Contact the local area emergency response team.
Correct Answer: A
Rationale: Signs/symptoms of an adverse effect to lipids (fat emulsion) include chest and back pain, chills, vertigo, cyanosis, diaphoresis, dyspnea, fever, flushing, headache, nausea and vomiting, and thrombophlebitis of the vein. The priority action is to stop the infusion to limit the adverse response. Although contacting the nurse, taking the client's blood pressure, and contacting the local emergency response team are correct interventions, the priority is to stop the infusion.