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A migrant farm worker who lives in a mobile home with several other workers visits the Migrant Health Care Center. The client reports Increasing episodes of dizziness, headaches, abdominal cramps, and difficulty breathing. Which nursing action has the highest priority?
- A. Gather information about the client's recent exposure to pesticides.
- B. Obtain a blood sample to assess for possible lead paint exposure.
- C. Ask about the length of his workday and frequency of rest breaks.
- D. Determine the number and age of persons living in the mobile home.
Correct Answer: A
Rationale: Symptoms like dizziness and breathing difficulty suggest pesticide poisoning, a common risk for farm workers, requiring immediate investigation to guide treatment.
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An adolescent tells the school nurse that she is pregnant. Her last menstrual period was 4 months ago, and she has not yet received any medical care. She smokes but denies any other substance use. Which interventions should the nurse implement? (Select all that apply.)
- A. Encourage smoking cessation.
- B. Arrange for childcare.
- C. Offer nutritional instruction.
- D. Refer for prenatal care.
- E. Teach breastfeeding methods.
- F. Notify her parents.
Correct Answer: A,C,D
Rationale: Smoking cessation, nutritional instruction, and prenatal care referral are critical to improve maternal and fetal health outcomes. Childcare and breastfeeding education are less immediate, and notifying parents requires careful consideration of confidentiality.
After assessing the health care needs of an elementary school, the nurse determines that an increased prevalence of pediculosis capitis is a priority problem. The nurse develops a 2-month program with the goal to eradicate the condition in the school. The program includes educational pamphlets sent home to parents and regular assessment of children by the school nurse. Which action should the nurse implement to evaluate the effectiveness of the program?
- A. Evaluate the teacher's ability to identify pediculosis capitis 2 months after initiation of the program.
- B. Measure the prevalence of pediculosis capitis among the children after four months.
- C. Survey parents 3 weeks after pamphlets are sent home to assess their understanding of the condition.
- D. Conduct an initial examination of each child in the school to obtain baseline data.
Correct Answer: B
Rationale: Measuring prevalence after the program compares pre- and post-intervention rates, directly assessing the program's success in reducing pediculosis cases.
While presenting a workshop titled, 'Improving Access to Health Services' to community leaders, the community health nurse is asked by a city council member to explain the reason for addressing this issue. Which statement provides the best response?
- A. The Centers for Disease Control and Prevention (CDC) has identified this problem as a variable in morbidity.
- B. The Community Health Improvement Process is used for issues in high risk populations.
- C. The Institute of Medicine includes 'access' as one of its priority recommendations.
- D. The committee for 'Healthy People 2030' has identified 'access' as a national goal.
Correct Answer: D
Rationale: Healthy People 2030' identifies access as a national goal, underscoring its importance in public health, making it a compelling reason for addressing the issue.
A community health nurse is planning strategies to prevent an increase in the incidence of osteoporosis in the community. Which activity should the nurse include?
- A. Ensure that all meals delivered to persons receiving Meals-on-Wheels include fresh or canned fruit.
- B. Schedule blood pressure screenings during craft club hours for elderly women at the senior center.
- C. Lobby the local school board to increase physical education classes at all schools in the district.
- D. Collaborate with a local scout troop to determine families that need wheelchair ramps installed.
Correct Answer: C
Rationale: Increasing physical education promotes weight-bearing exercises, essential for building bone density and preventing osteoporosis, especially in youth.
The city health department director asks the community health nurse to make a presentation describing the greatest health concern facing the city. How should the nurse begin to collect the data needed for this presentation?
- A. Review morbidity data for the city's population compiled by the Bureau of Vital Statistics.
- B. Conduct a random telephone survey to determine the public's perception about health problems.
- C. Call American Medical Association members to determine the most frequently treated diagnoses.
- D. Survey major hospitals in the area to determine the most common reasons for admissions.
Correct Answer: A
Rationale: Morbidity data from the Bureau of Vital Statistics provides comprehensive, objective information on disease prevalence, identifying major health concerns.