Nokea
A homeless client with alcohol dependency will be dismissed from the emergency department in 24 hours. The nurse notes that a tuberculin skin test was prescribed by the healthcare provider. What intervention is most important for the nurse to implement prior to discharge?
- A. Identify how the client will follow-up to have the results read
- B. Give the client written information about the tuberculosis test
- C. Determine if the client understands the purpose of the tuberculin test
- D. Explain to the client results should be read between 48 and 72 hours
Correct Answer: A
Rationale: The most important intervention for the nurse to implement prior to the discharge of a homeless client with alcohol dependency who had a tuberculin skin test prescribed is to identify how the client will follow-up to have the results read. This is crucial to ensure proper diagnosis and treatment. Providing written information (Choice B) is helpful but not as critical as ensuring the follow-up plan. Determining if the client understands the purpose of the test (Choice C) is important but not as immediate as ensuring the follow-up plan. Explaining when the results should be read (Choice D) is important, but the priority is to make sure the client has a plan in place for follow-up.
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A client with a history of hypertension is admitted with a blood pressure of 180/110 mm Hg. Which medication should the nurse prepare to administer?
- A. Atenolol (Tenormin)
- B. Nifedipine (Procardia)
- C. Hydrochlorothiazide (Microzide)
- D. Clonidine (Catapres)
Correct Answer: D
Rationale: In this scenario of severe hypertension (180/110 mm Hg), the nurse should prepare to administer Clonidine (Catapres), which is an antihypertensive medication commonly used to rapidly lower blood pressure in acute situations. Atenolol and Nifedipine are also antihypertensive medications, but Clonidine is more appropriate for immediate blood pressure reduction in this critical situation. Hydrochlorothiazide is a diuretic often used for long-term management of hypertension, not for rapid lowering of severely elevated blood pressure.
During the physical assessment, which finding should the nurse recognize as a normal finding?
- A. Regular pulsation at the epigastric area when the client is supine.
- B. A loud, harsh murmur at the second right intercostal space.
- C. Dullness over the lung fields.
- D. Increased tactile fremitus.
Correct Answer: A
Rationale: The regular pulsation at the epigastric area when the client is supine is a normal finding. This phenomenon is caused by the regular and recurrent expansion and contraction of an artery due to waves of pressure caused by the ejection of blood from the left ventricle. Choices B, C, and D describe abnormal findings during a physical assessment. A loud, harsh murmur at the second right intercostal space indicates an abnormal heart sound, dullness over the lung fields may suggest consolidation or fluid in the lungs, and increased tactile fremitus can be a sign of lung consolidation or pathology.
The nurse is preparing an orientation class for new employees at an inner-city clinic that serves a low-income population. Which information should the nurse include in the presentation to these new employees?
- A. A lack of transportation is the major impediment for the clinic's clients.
- B. Basic physiological needs are likely to be unmet in this clinic's client population.
- C. Printed material is less effective for this population that has limited reading skills.
- D. A group education class is often poorly attended by non-compliant clients.
Correct Answer: A
Rationale: The correct answer is A. Addressing transportation issues is crucial when working with low-income populations as lack of transportation can be a significant barrier to accessing healthcare services. This information is important for new employees to understand the challenges faced by the clinic's clients and to strategize ways to overcome this barrier. Choices B, C, and D are incorrect because while they may be relevant considerations, addressing transportation barriers should be a priority given its impact on accessing care for this specific population.
The healthcare provider is caring for a client with diabetes insipidus. Which finding indicates that the treatment is effective?
- A. Urine output is decreased.
- B. Thirst is decreased.
- C. Weight loss is observed.
- D. Urine specific gravity is within the normal range.
Correct Answer: D
Rationale: In diabetes insipidus, the body loses excessive amounts of water, leading to diluted urine with low specific gravity. Therefore, when the urine specific gravity is within the normal range, it indicates that the kidneys are properly concentrating urine, which is a sign of effective treatment for diabetes insipidus. Choices A, B, and C are incorrect because in diabetes insipidus, there is polyuria (excessive urination), persistent thirst due to fluid loss, and potential weight loss due to fluid imbalance, so these findings would not indicate effective treatment.
A community health nurse is developing a program to reduce the incidence of teen pregnancy. Which strategy is most likely to be effective?
- A. Distribute free condoms at local high schools
- B. Offer comprehensive sex education classes
- C. Promote abstinence-only education
- D. Provide access to reproductive health services
Correct Answer: B
Rationale: Comprehensive sex education has been shown to be more effective in reducing teen pregnancy rates compared to abstinence-only education. Providing comprehensive sex education equips teens with knowledge about safe sex practices, contraception methods, and healthy relationships, which empowers them to make informed decisions. Distributing free condoms and providing access to reproductive health services are important components, but without proper education, teens may not understand how to use these resources effectively. Promoting abstinence-only education limits information and may not address the reality of teen sexual behavior, potentially leading to higher pregnancy rates.