A nurse is counseling a group of clients from a town that was affected by a hurricane 6 months ago. For which of the following clients should the nurse initiate a referral to assess for the presence of posttraumatic stress disorder? (Select all that apply.)
- A. A client who describes feeling disconnected from those around him following the hurricane.
- B. A client who has frequent nightmares about the hurricane.
- C. A client who expresses a realization that life will not return to the way it was before the hurricane.
- D. A client who describes having persistent feelings of anger about the hurricane.
- E. A client who describes having persistent feelings of anger about the hurricane.
Correct Answer: A, B, E
Rationale: The correct answer is A, B, E. Feeling disconnected, having nightmares, and persistent anger are common symptoms of posttraumatic stress disorder (PTSD) following a traumatic event like a hurricane. Referring these clients for further assessment is crucial to determine if they meet the criteria for PTSD diagnosis. Choice C describes a realistic assessment of the situation and does not necessarily indicate PTSD. Choice D, which is repeated, also describes persistent anger, which is a symptom but is already covered by choice E.
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Which database would the public health nurse use when conducting research to locate regularly updated systematic reviews?
- A. Cochrane Library
- B. Agency for Healthcare Research and Quality (AHRQ)
- C. Medline with Full Text
- D. Cumulative Index to Nursing and Allied Health Literature (CINAHL)
Correct Answer: A
Rationale: The correct answer is A: Cochrane Library. The Cochrane Library is renowned for regularly updated systematic reviews, providing high-quality evidence for healthcare decision-making. It follows strict methodology to ensure reliability. AHRQ (B) focuses on healthcare quality improvement, not systematically updated reviews. While Medline (C) and CINAHL (D) are databases for primary research articles, they do not specifically focus on systematic reviews. Therefore, Cochrane Library is the most appropriate database for the public health nurse's research needs.
Which is a Healthy People 2020 goal?
- A. Decrease the incidence of preventable disease, disability, injury, and premature death
- B. Reduce health inequity, decrease disparities, and improve the health of certain groups
- C. Create social and physical environments that promote good health for all
- D. Promote healthy development and healthy behaviors for the geriatric stage of life
Correct Answer: B
Rationale: The correct answer is B because reducing health inequity, decreasing disparities, and improving the health of certain groups aligns with the overarching goal of achieving health equity for all in Healthy People 2020. This goal focuses on addressing the social determinants of health to ensure that everyone has the opportunity to achieve their highest level of health. Choices A, C, and D are important aspects of public health but do not specifically address health equity and disparities among different population groups. Therefore, B is the most appropriate choice for a Healthy People 2020 goal.
A nurse is striving to practice patient-centered care at a hospital. Which action best exemplifies providing patient-centered care?
- A. Having a client complete a self-reported functional status indicator and then reviewing itwith the client
- B. Explaining to a client the benefits of computer-assisted robotic surgical techniques, whichthe hospital recently implemented
- C. Recording a client's signs and symptoms in an electronic health record
- D. Performing continuous glucose monitoring of a client while the client is in the hospital
Correct Answer: A
Rationale: The correct answer is A because it involves actively engaging the client in their care by having them complete a self-reported functional status indicator and then reviewing it together. This approach empowers the client to participate in decision-making regarding their health, promotes open communication, and fosters a collaborative relationship between the nurse and the client. Choices B, C, and D do not directly involve the client in their care or prioritize their perspective. B focuses on technology rather than the client's needs, C involves documentation rather than active involvement, and D focuses on monitoring without involving the client in the process.
Which type of study will the nurse use to understand the experiences of an immigrant group in the community?
- A. Qualitative
- B. Randomized control
- C. Needs assessment
- D. Quality improvement
Correct Answer: A
Rationale: The nurse would use a qualitative study to understand the experiences of an immigrant group because qualitative research focuses on exploring and understanding individuals' experiences, perspectives, and behaviors in-depth. This type of study allows for gathering rich, detailed data through methods like interviews, observations, and focus groups, which are well-suited for capturing the complexities and nuances of immigrant experiences. A randomized control study (B) involves intervention and control groups for causality, not suitable for exploring experiences. Needs assessment (C) focuses on identifying needs and gaps in services. Quality improvement (D) aims to enhance processes and outcomes within a specific setting.
A nurse in a community clinic is caring for a client who requests assistance with smoking cessation. The nurse should expect a prescription for which of the following medications?
- A. Naltrexone
- B. Chlordiazepoxide
- C. Clonidine
- D. Bupropion
Correct Answer: D
Rationale: The correct answer is D: Bupropion. Bupropion is an antidepressant that is also FDA-approved for smoking cessation. It works by reducing nicotine cravings and withdrawal symptoms. Naltrexone (A) is used for alcohol and opioid dependence, not smoking cessation. Chlordiazepoxide (B) is a benzodiazepine used for alcohol withdrawal. Clonidine (C) is used to manage withdrawal symptoms in opioid and alcohol dependence, not specifically for smoking cessation. Therefore, Bupropion is the most appropriate choice for assisting the client with smoking cessation.