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a home health nurse is visiting a client who had a stroke 2 months ago. which of the following findings should the nurse report to the interprofessional care team?
- A. the client dresses her affected side first.
- B. the client bears weight on their arms when using crutches
- C. the client coughs when swallowing her medications
- D. the client’s caregiver fills a pill organizer weekly
Correct Answer: D
Rationale: The correct answer is D because it indicates the caregiver's involvement in medication management, which is crucial for a client post-stroke. The nurse should report this to ensure medication adherence and safety. Choice A is not concerning as it shows the client's independence in dressing. Choice B could be a normal weight-bearing technique with crutches. Choice C may indicate dysphagia, which is important but not as immediate as medication management.
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a client who has diabetes mellitus asks a home health nurse to help her adapt some of her traditional cultural foods to fit her meal plan. which of the following is the first action the nurse should take when assisting this client?
- A. provide the client with a printed recipe
- B. observe the client during preparation of traditional foods
- C. use cookbooks to include traditional foods in meal plans
- D. explain diabetes exchange list
Correct Answer: D
Rationale: The correct answer is D: explain diabetes exchange list. The nurse should first explain the diabetes exchange list to the client as it educates on portion sizes and food groups suitable for managing diabetes. This empowers the client to make informed choices. Providing a printed recipe (A) assumes the client understands portion control. Observing the client during food preparation (B) doesn't address education on appropriate food choices. Using cookbooks (C) may not align with the client's cultural preferences or dietary needs. The other choices are incomplete without addressing the foundational education needed for diabetes management.
in the last month three cases of tuberculosis have been referred to the health department. which of the following is the priority information for the community health nurse to obtain from each client?
- A. demographics
- B. house hold members
- C. occupation
- D. health history
Correct Answer: D
Rationale: The correct answer is D: health history. Obtaining the health history is crucial to assess the severity of tuberculosis, previous treatments, and potential risk factors. This information helps in determining the appropriate treatment plan and preventing the spread of the disease. Demographics (A) may provide general information but do not directly impact the management of tuberculosis. Household members (B) are important for contact tracing but not the priority. Occupation (C) is relevant for identifying potential exposure, but health history takes precedence.
A nurse is working to reduce individual and family violence in the local community. Which of the following actions by the nurse demonstrates a primary prevention strategy to achieve this goal?
- A. Conducting counseling for at-risk parents.
- B. Assessing a family for marital discord.
- C. Teaching parenting techniques to new parents.
- D. Providing treatment for a young adult who has a substance use disorder.
Correct Answer: C
Rationale: The correct answer is C: Teaching parenting techniques to new parents. Primary prevention aims to prevent violence before it occurs by promoting healthy behaviors and addressing risk factors. Teaching parenting techniques to new parents helps build strong family relationships, enhances parenting skills, and reduces the likelihood of violence. Choices A, B, and D are not primary prevention strategies. Counseling for at-risk parents (A) is a secondary prevention strategy aimed at early detection and intervention. Assessing a family for marital discord (B) is a tertiary prevention strategy focused on addressing existing issues. Providing treatment for substance use disorder (D) is also a tertiary prevention strategy aimed at treating an existing condition.
a school nurse is implementing health screening. which of the following assessment finding should the nurse recognize as the highest priority?
- A. a child who has a BMI of 18
- B. an adolescent who has scoliosis
- C. an adolescent who has psoriasis
- D. a child who has nits
Correct Answer: B
Rationale: The correct answer is B: an adolescent who has scoliosis. Scoliosis is a condition where the spine curves abnormally, potentially leading to serious health issues if not addressed early. The nurse must prioritize assessing scoliosis as it can affect the individual's posture, mobility, and even breathing. BMI of 18 (choice A) may indicate underweight but doesn't pose an immediate health threat. Psoriasis (choice C) is a skin condition that, while uncomfortable, is not life-threatening. Nits (choice D) are treatable and not urgent.
a nurse of a community clinic is preparing an educational guide about cultural variances in expression of pain. which of the following information should the nurse include?
- A. middle eastern cultural practices include hiding pain from close family members
- B. native American cultural practices include being outspoken about pain
- C. PuertoRican cultural practices include the view that outspoken expressions of pain are shameful
- D. Chinese cultural practices include enduring pain to prevent family dishonor
Correct Answer: C
Rationale: The correct answer is C, as Puerto Rican cultural practices often view outspoken expressions of pain as shameful. This information is important for the nurse to include in the educational guide because understanding cultural variances in expressing pain is crucial for providing culturally sensitive care. Choice A is incorrect because Middle Eastern cultures may not necessarily hide pain from close family members. Choice B is incorrect as it generalizes Native American cultural practices about being outspoken about pain. Choice D is incorrect as it oversimplifies Chinese cultural practices regarding pain.