A nurse is preparing an educational program about breastfeeding for a group of new parents. The nurse should use which of the following instructional strategies to promote psychomotor learning?
- A. Review flashcards that identify holding technique with the group
- B. Show the group a video on breastfeeding techniques
- C. Facilitate a discussion group about the benefits of breastfeeding
- D. Provide dolls for the group to demonstrate proper positioning
Correct Answer: D
Rationale: The correct answer is D because providing dolls for the group to demonstrate proper positioning promotes psychomotor learning by engaging them in hands-on practice. This allows participants to physically practice and internalize the correct techniques, enhancing muscle memory and skill acquisition. The other choices lack the hands-on component required for psychomotor learning. A: Flashcards are visual aids that may help with cognitive learning but do not involve physical practice. B: Watching a video is passive learning and does not actively engage participants in practicing skills. C: Facilitating a discussion focuses on cognitive understanding rather than physical practice.
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A home health nurse manager is caring for a client who has methicillin-resistant Staphylococcus aureus. Which of the following actions should the nurse take?
- A. Remove fresh flowers from the client's home
- B. Wear a mask when within 3 feet of the client
- C. Encourage the client to use a HEPA filter in the house
- D. Double bag soiled dressing in polyethylene bags
Correct Answer: D
Rationale: The correct answer is D: Double bag soiled dressing in polyethylene bags. This is important to prevent the spread of methicillin-resistant Staphylococcus aureus (MRSA) to others. Double bagging the soiled dressing in polyethylene bags helps contain the bacteria and reduces the risk of transmission.
Choice A: Removing fresh flowers is not directly related to preventing the spread of MRSA.
Choice B: Wearing a mask within 3 feet of the client may not be effective in preventing MRSA transmission.
Choice C: Using a HEPA filter is not specifically targeted at preventing MRSA transmission.
In summary, choice D is correct because it directly addresses the prevention of MRSA transmission, while the other choices are not as directly related to this specific concern.
During a home health visit, a school-age child who has muscular dystrophy confides in the nurse that he was struck by his parents. Which of the following actions should the nurse take first?
- A. Report the incident to local authorities.
- B. Check the child for injuries.
- C. Refer the parent to a social service agency.
- D. Enroll the parent in anger management classes.
Correct Answer: A
Rationale: The correct answer is A: Report the incident to local authorities. The first priority in this situation is to ensure the safety and well-being of the child. By reporting the incident to local authorities, the nurse can initiate a formal investigation to protect the child from further harm. Checking for injuries (B) is important but secondary to ensuring the child's safety. Referring the parent to a social service agency (C) may be appropriate but not the first step in cases of suspected abuse. Enrolling the parent in anger management classes (D) is not the immediate priority when a child is at risk of harm.
A home health nurse is caring for a client who has chemotherapy-induced nausea that has been resistant to relief from pharmacological measures. Which of the following interventions should the nurse initiate? (Select all that apply)
- A. Use seasonings to enhance the flavor of foods
- B. Provide sips of room temperature ginger ale between meals
- C. Maintain the head of the client's bed in an elevated position after eating
- D. Offer 120 ml (4 oz.) of cold 2% milk as a meal replacement
- E. Assist the client in using guided imagery
Correct Answer: B, C, E
Rationale: The correct interventions for the client with chemotherapy-induced nausea are B, C, and E.
B: Providing sips of room temperature ginger ale can help alleviate nausea due to its antiemetic properties.
C: Maintaining the head of the client's bed in an elevated position after eating can prevent acid reflux and reduce nausea.
E: Assisting the client in using guided imagery can help distract from nausea and promote relaxation.
Incorrect choices:
A: Using seasonings may exacerbate nausea in some clients.
D: Offering cold milk as a meal replacement may not be well-tolerated by a nauseated client and could worsen symptoms.
In summary, the correct interventions focus on soothing the stomach, promoting relaxation, and preventing exacerbation of nausea, while the incorrect choices may not directly address the client's symptoms or could potentially worsen them.
The partner of an older adult client who has Alzheimer's disease reports that he is not eating. The client's partner refuses to assist the client with feeding and insists the client feed himself without help. What is the priority action the nurse should take?
- A. Arrange for Meals on Wheels assistance
- B. Determine the client's ability to self-feed
- C. Direct the home health aide to assist with meals
- D. Refer the client's partner to an Alzheimer's support group
Correct Answer: B
Rationale: The correct answer is B: Determine the client's ability to self-feed. This is the priority action because it addresses the immediate concern of the client not eating due to the partner's refusal to assist. By assessing the client's ability to self-feed, the nurse can identify any barriers or challenges the client may be facing, such as physical limitations or cognitive impairments. This assessment will guide the nurse in developing an appropriate plan of care to ensure the client's nutritional needs are met.
The other choices are incorrect because they do not directly address the client's current situation.
A: Meals on Wheels assistance may be helpful but does not address the immediate need for the client to eat.
C: Directing the home health aide to assist assumes the client is willing to accept help, which may not be the case.
D: Referring the client's partner to an Alzheimer's support group is important for long-term support but does not address the immediate issue of the client not eating.
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.
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