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A nurse is caring for an older client who is struggling to manage her type 2 diabetes mellitus. The nurse should recognize which social determinants of this client's health? (Select all that apply.)
- A. Household income of $23,000 per year
- B. Reading level of a third grader
- C. Medication ineffective due to error in prescription
- D. Originally from Sudan
Correct Answer: A
Rationale: The correct answer is A: Household income of $23,000 per year. This is a social determinant of health because low income can impact access to healthy foods, medications, and healthcare services, affecting diabetes management. Choice B, reading level, is related to health literacy but not specifically a social determinant in this scenario. Choice C, medication error, is a healthcare system issue. Choice D, origin from Sudan, is related to cultural background but not directly a social determinant affecting diabetes management.
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A staff nurse is observing a newly licensed nurse suction a client’s tracheostomy. Which of the following actions by the newly-licensed nurse requires intervention by the staff nurse?
- A. Waits for 2 minutes between suctions
- B. Engaging in policy development and encourage and assist persons to communicate their needs
- C. Giving a very informative and engaging presentation
- D. Identifying and planning for high-risk populations
Correct Answer: A
Rationale: The correct answer is A because waiting for 2 minutes between suctions is not recommended practice for tracheostomy care. Suctioning should be performed as needed based on the patient's clinical presentation, not on a fixed time interval. Waiting too long between suctions can lead to ineffective removal of secretions, compromising the patient's airway.
Choice B, C, and D are incorrect because they are unrelated to the scenario of suctioning a tracheostomy. Choice B refers to policy development and communication skills, Choice C mentions giving a presentation, and Choice D involves planning for high-risk populations. These choices do not pertain to the immediate nursing intervention needed during tracheostomy care.
A nurse on a medical surgical unit is performing medication reconciliation for a newly admitted client. Which of the following actions should the nurse take?
- A. Compare the client's list of home medications to the admission prescriptions written for the client
- B. Working with community groups to create policies to improve the environment
- C. Recognizing the reasons why 30 minutes of walking each day is one of the best health promotion activities
- D. Asking community leaders what interventions should be chosen
Correct Answer: A
Rationale: The correct answer is A because medication reconciliation involves comparing the client's list of home medications with the admission prescriptions to ensure accuracy and prevent medication errors. This step is crucial in identifying any discrepancies or omissions in the client's medication regimen. Choice B is incorrect as it pertains to community policy development, unrelated to medication reconciliation. Choice C is incorrect as it focuses on health promotion activities, not medication reconciliation. Choice D is incorrect as it involves seeking community leaders' input, not relevant to medication reconciliation.
Which action by the nurse is an example of engaging in environmental justice?
- A. Using the environment to assist in client recovery
- B. Encouraging communities to engage in composting
- C. Eliminating lead-based paint in public housing
- D. Educating the community on proper disposal of hazardous materials
Correct Answer: C
Rationale: The correct answer is C: Eliminating lead-based paint in public housing. This action exemplifies environmental justice as it aims to address a specific environmental hazard that disproportionately affects marginalized communities living in public housing. By removing lead-based paint, the nurse is advocating for a safe and healthy living environment for all individuals, regardless of their socioeconomic status. This action promotes fairness and equality in environmental protection. In contrast, choices A, B, and D focus on general environmental initiatives that may not directly target environmental injustices or disparities. Therefore, choice C is the most effective in addressing environmental justice concerns.
A community health nurse is reviewing the reports for a group of clients. The nurse should identify that which of the following disorders is on the CDC's national notifiable conditions list?
- A. Lyme disease
- B. Providing care with a focus on the aggregates needs
- C. Having the goal of health promotion and disease prevention
- D. Health disparities among any groups are morally and legally wrong
Correct Answer: A
Rationale: The correct answer is A: Lyme disease. The CDC's national notifiable conditions list includes diseases that are required to be reported to the CDC for public health monitoring and control. Lyme disease is on this list due to its potential for widespread transmission and public health impact. The other choices are incorrect as they do not relate to the concept of notifiable conditions or public health surveillance. Providing care with a focus on aggregate needs, having goals of health promotion, and addressing health disparities are important aspects of community health nursing but are not directly related to notifiable conditions.
A community health nurse is developing a plan to improve the community's environmental health. Which of the following actions should the nurse take first?
- A. Encourage community involvement in environmental improvement.
- B. Establish a timeframe for environmental improvements.
- C. Request funding from community organizations.
- D. Collect information about the community's environmental status.
Correct Answer: D
Rationale: The correct answer is D - Collect information about the community's environmental status. This is the first step because it allows the nurse to assess the current environmental health issues in the community. By gathering data, the nurse can identify specific problems and prioritize interventions based on evidence. This information will guide the development of an effective plan tailored to address the community's specific needs.
Choice A is incorrect because community involvement should come after assessing the environmental status. Choice B is incorrect as setting a timeframe is premature without understanding the extent of the issues. Choice C is incorrect as funding should be sought once the plan is developed.