A nurse case manager is providing discharge planning for a client. The nurse is functioning in which of the following roles when arranging for the delivery of medical equipment to the client's home?
- A. Consultant
- B. Systems allocator
- C. Coordinator
- D. Advocate
Correct Answer: C
Rationale: The correct answer is C: Coordinator. In this scenario, the nurse is functioning as a coordinator by arranging for the delivery of medical equipment to the client's home. As a coordinator, the nurse is organizing and facilitating the necessary resources and services to meet the client's needs. This role involves collaborating with various healthcare providers and agencies to ensure a smooth transition for the client post-discharge.
The other choices are incorrect because:
A: Consultant - This role involves providing expert advice or recommendations based on specialized knowledge. The nurse in the scenario is not simply providing advice but actively coordinating services.
B: Systems allocator - This role involves allocating resources within a healthcare system. While the nurse is arranging for resources, the focus is on the specific client's needs rather than broader system allocation.
D: Advocate - This role involves speaking up for the client's rights and needs. While advocacy may be a part of the nurse's role, in this scenario, the primary focus is on coordination of services.
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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. Household members
- C. Occupation
- D. Health history
Correct Answer: B
Rationale: The correct answer is B: Household members. This is the priority information for the nurse to obtain as tuberculosis is highly contagious and can spread within households. By knowing the household members, the nurse can assess the risk of transmission and provide appropriate guidance for testing and treatment. Demographics (A) may provide background information but are not as crucial as identifying close contacts. Occupation (C) and health history (D) are important but do not directly address the immediate risk of transmission within the household.
A community health nurse is planning an educational program for a group of women who are postmenopausal. Which of the following outcomes is appropriate for this program?
- A. Clients will schedule bone density screening
- B. Clients will arrange for mammograms every 3 years
- C. Clients will start hormone replacement therapy
- D. Clients will significantly decrease caloric intake
Correct Answer: A
Rationale: The correct answer is A: Clients will schedule bone density screening. This outcome is appropriate because postmenopausal women are at increased risk for osteoporosis, making bone density screening crucial for early detection and prevention. It is a proactive measure to assess bone health and reduce the risk of fractures.
Explanation for why other choices are incorrect:
B: Clients will arrange for mammograms every 3 years - While mammograms are important for breast cancer screening, the focus of this program is on postmenopausal women's specific health needs related to bone health.
C: Clients will start hormone replacement therapy - Hormone replacement therapy has risks and benefits and should be individualized based on a woman's specific health history and needs. It is not a universal recommendation for all postmenopausal women.
D: Clients will significantly decrease caloric intake - Caloric intake is important for overall health, but the specific focus of this program is on bone health and screening, not weight management.
A first response team is working at the location of a bombing incident. A nurse triaging a group of clients should give treatment priority to which of the following clients?
- A. A client who has superficial partial-thickness burn injuries over 5% of his body
- B. A client who has a femur fracture with a 2+ pedal pulse
- C. A client who is ambulatory and exhibits manic behavior
- D. A client who has a rigid abdomen with manifestations of shock
Correct Answer: D
Rationale: The correct answer is D: A client who has a rigid abdomen with manifestations of shock. This client should receive treatment priority because a rigid abdomen can indicate internal bleeding or organ damage, which are life-threatening conditions requiring immediate medical attention to prevent further complications. Manifestations of shock, such as hypotension and tachycardia, also indicate a critical condition that needs urgent intervention to stabilize the client's condition and prevent deterioration.
Choice A is incorrect because superficial partial-thickness burn injuries, although painful and requiring treatment, are not immediately life-threatening compared to internal injuries like in choice D. Choice B is incorrect as a femur fracture with a palpable pedal pulse indicates distal circulation is intact, making it a lower priority compared to the critical condition in choice D. Choice C is incorrect as manic behavior, while concerning, does not pose an immediate threat to the client's life compared to the potentially life-threatening conditions in choice D.
A parish nurse is counseling a family following a client's recent diagnosis of heart disease. Which of the following actions should the nurse take first?
- A. Discuss the benefits of eating a well-balanced diet with the client's family
- B. Assist the client and the client's partner with finding an affordable exercise program
- C. Offer to accompany the client and the client's partner during health care provider visits
- D. Ask family members about the impact of the disease on relationships within the family
Correct Answer: D
Rationale: The correct answer is D: Ask family members about the impact of the disease on relationships within the family. This is the first action the nurse should take because understanding the family dynamics and relationships can provide valuable insight into how the diagnosis is affecting everyone involved. By assessing the impact on relationships, the nurse can better tailor interventions to support the entire family unit and address any emotional or communication challenges that may arise.
Option A is incorrect as discussing diet benefits should come after assessing the family dynamics. Option B is incorrect because addressing exercise programs should also come after understanding the family's needs. Option C is incorrect as accompanying to provider visits is important but not the first priority.
A community health nurse is working with a family that is struggling to adapt following the loss of a family member. Which of the following actions should the nurse take first?
- A. Refer the family to a grief support group.
- B. Determine the roles of individual family members.
- C. Encourage the family to assign specific tasks to individual family members.
- D. Assist the family to establish a daily routine.
Correct Answer: B
Rationale: The correct answer is B: Determine the roles of individual family members. This is the first step because understanding the roles within the family will help identify strengths and resources to support them through the grieving process. By determining roles, the nurse can assess each family member's needs and abilities, facilitating targeted interventions. Referral to a grief support group (A) may be beneficial later, but understanding family dynamics comes first. While assigning tasks (C) and establishing a routine (D) are important, they should come after identifying roles to ensure they are tailored to the family's specific needs.