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A home health nurse is examining the lab results of several patients with a history of heart failure (HF). Which patient's finding should the nurse immediately report to the healthcare provider?
- A. Potassium level of 3.7 mEq/L (3.7 mmol/L).
- B. B-type natriuretic peptide (BNP) level of 550 pg/mL (550 ng/L).
- C. Total cholesterol level of 190 mg/dL (4.92 mmol/L).
- D. Glycosylated hemoglobin (A1C) level of 7%.
Correct Answer: B
Rationale: B-type natriuretic peptide (BNP) levels are used to diagnose and monitor heart failure. A BNP level of 550 pg/mL (550 ng/L) is significantly higher than the normal range, which is less than 100 pg/mL. High BNP levels indicate that the heart is working harder than normal, which is a common occurrence in heart failure. Therefore, this result should be reported immediately to the healthcare provider.
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A 23-year-old single mother of three visits the Department of Health walk-in clinic with symptoms of abdominal pain, painful urination, fever, and vaginal discharge. She states that these symptoms began three days ago and she initially thought it was a urinary tract infection (UTI) until the vaginal discharge became purulent and bloody. She reports having three sexual partners over the past 60 days. She has visited the clinic three times in the past 12 months for similar concerns, but no sexually transmitted infections were diagnosed on those three prior visits. Given the history of clinic visits over the past 12 months with similar concerns, the nurse determines that client education should focus on prevention. What type of preventive education should the nurse identify for this client?
- A. Primary prevention, which would include education on safe sex practices.
- B. Secondary prevention, which would include regular screenings for sexually transmitted infections.
- C. Tertiary prevention, which would include education regarding prescribed treatments for sexually transmitted infections.
- D. Quaternary prevention, which would include strategies to avoid unnecessary or harmful interventions.
Correct Answer: A
Rationale: Primary prevention includes measures that prevent the occurrence of a specific disease or health condition. In the context of sexually transmitted infections (STIs), primary prevention would involve education on safe sex practices. This could include information on the use of condoms, the importance of regular STI testing, and the risks associated with having multiple sexual partners.
A 2-month-old infant contracts a disease through vertical transmission. Which situation should the nurse investigate further to ascertain how the infant might have been exposed to the disease?
- A. The infant received a scheduled immunization.
- B. The father fed the infant spoiled baby food.
- C. The mother is breastfeeding the infant.
- D. The infant was bitten by an infected mosquito.
Correct Answer: C
Rationale: Breastfeeding is a common method of vertical transmission. Certain infections in the mother can be passed to the infant through breast milk. Therefore, if a 2-month-old infant contracts a disease that could be transmitted vertically, it would be important to investigate if the mother could be the source of the infection.
The public health nurse is investigating a report of several chickenpox (varicella virus) cases at a daycare center. The daycare worker mentions that five children have been sent home over the past two weeks with fever and itchy blisters. What should be the nurse's initial action?
- A. Report the presence of a viral endemic at the daycare center.
- B. Confirm the number of children exhibiting symptoms.
- C. Verify that the children sent home did indeed develop chickenpox.
- D. Determine the number of people potentially exposed.
Correct Answer: C
Rationale: The nurse's initial action should be to verify that the children sent home did indeed develop chickenpox. This is because chickenpox is a highly contagious disease caused by the varicella-zoster virus. Early identification and confirmation of the disease can help in implementing appropriate control measures to prevent further spread.
In the event of a communication breakdown during a disaster, what actions should be taken?
- A. Contact a larger hospital to see how they handle disaster communication.
- B. Find out who did not follow the Communication tree.
- C. Have one person follow-up for all the hospital to see where the breakdown occurred.
- D. Confirm that all essential staff are on either the lockdown team or the relief team.
Correct Answer: D
Rationale: Confirming that all essential staff are on either the lockdown team or the relief team ensures that everyone knows their roles and responsibilities, which is crucial for effective communication during a disaster.
During a community health screening fair for older adults, a nurse notices a client with pale, bluish feet and sores on both lower extremities that are healing poorly. What should be the nurse's intervention be?
- A. Instruct the client to apply antibiotic ointment to the sores.
- B. Create a list of foods that promote wound healing.
- C. Refer the client to a healthcare provider for a complete evaluation.
- D. Send the client to the emergency department for treatment.
Correct Answer: C
Rationale: The client's symptoms of pale, bluish feet and sores on both lower extremities that are healing poorly suggest a severe and untreated medical condition, possibly related to circulation or skin integrity. Therefore, the nurse should refer the client to a healthcare provider for a complete evaluation.