A graduate nursing student requests information, including laboratory findings and chest x-ray results, about all clients with symptoms of HINI influenza A who have been seen during the last month in a community health clinic. Which action should the charge nurse take?
- A. Provide the information for research purposes only.
- B. Ask the student to sign a standard waiver form.
- C. Obtain written authorization from clients to release the information.
- D. Ask if permission has been obtained from the research committee.
Correct Answer: C
Rationale: Obtaining client authorization ensures compliance with privacy laws like HIPAA, protecting client confidentiality.
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A client who recently returned from international travel presents to the clinic with high fever, chills, headache, and muscular aches. The healthcare provider suspects severe acute respiratory syndrome (SARS). To prevent transmission of the virus to others, which instruction is most important for the nurse to provide?
- A. Wear a N95 respirator mask during direct contact with others.
- B. Cover mouth and turn head when coughing
- C. Use meticulous hand washing technique.
- D. Discard all tissues used during coughing in a biohazard bag.
Correct Answer: A
Rationale: An N95 respirator mask is critical for preventing airborne transmission of SARS, offering superior protection compared to other measures like hand washing or tissue disposal.
Four students come to the school clinic simultaneously, seeking help from the school nurse. In which order of priority should the nurse provide care to these students? (Arrange the client with the highest priority first, on top, and lowest priority last, on bottom.)
- A. A 12-year-old child with history of asthma who is wheezing and reporting shortness of breath.
- B. A 7-year-old child who has type 1 diabetes mellitus and is experiencing extreme hunger and shakiness
- C. A 10-year-old child with bleeding lacerations on both knees after falling in gym class.
- D. A 5-year-old child who is crying uncontrollably because of an incontinent bowel episode.
Correct Answer: A,B,C,D
Rationale: Asthma exacerbation (A) is life-threatening, requiring immediate intervention. Hypoglycemia (B) is urgent to prevent complications. Bleeding lacerations (C) need prompt care but are less critical. Incontinence (D) is least urgent, focusing on comfort after addressing medical emergencies.
The community health nurse believes that immunization rates in a lower-socioeconomic section of the city are probably below the target set by the state health department. Which action should the nurse take first to intervene with this health problem?
- A. Review current epidemiological population data that might document a low immunization rate.
- B. Call a meeting of citizens to inform them of the importance of having their children immunized.
- C. Join a political action group that focuses attention on the issue in the local news media.
- D. Partner with a local children's hospital in setting up free 'shot' clinics in the neighborhood.
Correct Answer: A
Rationale: Reviewing epidemiological data confirms the extent of low immunization rates, providing a foundation for targeted interventions.
A school nurse identifies 15 new students with positive tuberculin tests among the 500 at-risk students tested. Which is the rate per 1,000 with new positive tests?
- A. 3/1,000.
- B. 30/1,000.
- C. 1.7/1,000.
- D. 15/1,000.
Correct Answer: B
Rationale: The rate is calculated as (15/500) * 1,000 = 30/1,000, accurately reflecting the proportion of students with positive tests per 1,000.
To promote heart healthy eating during a school health fair, the nurse presents information about a 'Mediterranean-based' approach to eating. To assess learning, the nurse sponsors a contest and asks the children to create a rhyme that shows foods that should be limited. Which selection should the nurse choose as the winner of the contest?
- A. Greens and beans.
- B. Meats and sweets.
- C. Fish on a dish.
- D. Berries or cherries.
Correct Answer: B
Rationale: The Mediterranean diet limits red meats and sweets, making 'meats and sweets' the correct choice for foods to restrict for heart health.
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