Nokea
A nurse is working with a care manager for a client who participates in a health maintenance organization. The nurse should identify that a health maintenance organization provides which of the following payment structures?
- A. The client is participating in a fee-for-service health care insurance program
- B. The provider is paid a fixed sum for the client on a monthly or yearly basis
- C. The client pays the insurer a percentage of the total costs for each service rendered by the provider
- D. The provider bills the client directly for a predetermined percentage of the cost of services
Correct Answer: B
Rationale: The correct answer is B. In a health maintenance organization (HMO), the provider is paid a fixed sum for the client on a monthly or yearly basis. This payment structure incentivizes providers to focus on preventive care and cost-effective treatments. This model aims to keep clients healthy and reduce unnecessary services.
A: Fee-for-service is not characteristic of an HMO.
C: This describes a cost-sharing model, not typical of an HMO.
D: Providers do not bill clients directly in an HMO.
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A community health nurse is providing teaching to a group of clients who have alcohol use disorder. Which of the following findings should the nurse include in the teaching as a manifestation of alcohol withdrawal?
- A. Bradycardia
- B. Hypothermia
- C. Increased appetite
- D. Insomnia
Correct Answer: D
Rationale: The correct answer is D: Insomnia. Alcohol withdrawal commonly presents with symptoms such as difficulty sleeping, restlessness, and anxiety due to the disruption of the central nervous system. Insomnia is a hallmark manifestation of alcohol withdrawal syndrome. Bradycardia (A) is not typically associated with alcohol withdrawal; instead, tachycardia is more common. Hypothermia (B) is rare in alcohol withdrawal, as alcohol tends to cause vasodilation and can lead to increased body temperature. Increased appetite (C) is not a typical symptom of alcohol withdrawal; in fact, decreased appetite or nausea is more common. Therefore, the correct choice is D based on the typical manifestations of alcohol withdrawal.
A community health clinic nurse manager is reviewing the incidence rate of chlamydia in the state. In a given year, 3,144 new cases were reported, and the population was estimated at 325,986. Which of the following is the incidence rate in the state for the year?
- A. About 300 reported cases per 100,000 population
- B. About 1 reported case per 10,000 population
- C. About 10 reported cases per 1,000 population
- D. About 3 reported cases per 10,000 population
Correct Answer: A
Rationale: The correct answer is A: About 300 reported cases per 100,000 population. To calculate the incidence rate, you divide the number of new cases by the total population, then multiply by the desired unit of measure (per 100,000). In this case, (3,144/325,986) * 100,000 = 964.5 cases per 100,000 population. Therefore, the answer is approximately 300 reported cases per 100,000 population. Choice B is incorrect as it would be 31.44 cases per 10,000 population. Choice C would result in 3.144 cases per 1,000 population. Choice D would yield 31.44 cases per 10,000 population.
A faith-based organization asks a community health nurse to develop a mobile meal program for older adults. Which of the following actions should the nurse plan to take first?
- A. Determine potential funding sources for the program
- B. Inquire about the availability of volunteers
- C. Identify alternative solutions to address concerns
- D. Perform a needs assessment
Correct Answer: D
Rationale: The correct answer is D: Perform a needs assessment. This is because conducting a needs assessment is the first crucial step in program planning. It helps the nurse to gather data on the specific needs and preferences of older adults in the community. This data will guide the nurse in developing a mobile meal program that is tailored to meet the actual needs of the target population.
Option A: Determining potential funding sources should come after identifying the specific needs of the population, as funding sources will be based on the program's requirements.
Option B: Inquiring about the availability of volunteers is important but should be considered after understanding the needs of the older adults.
Option C: Identifying alternative solutions is premature without first understanding the actual needs of the population through a needs assessment.
In summary, performing a needs assessment is the first step as it provides essential information to guide the development of an effective and targeted mobile meal program for older adults.
A school nurse is assessing a child who has been stung by a bee. The child's hand is swelling, and the nurse notes that the child is allergic to insect stings. Which of the following findings should the nurse expect if the child develops anaphylaxis? (SATA)
- A. Bradycardia
- B. Nausea
- C. Hypertension
- D. Urticaria
- E. Stridor
Correct Answer: B, D, E
Rationale: Correct Answer: B, D, E
Rationale:
1. Nausea: Anaphylaxis can cause gastrointestinal symptoms like nausea due to the release of inflammatory mediators.
2. Urticaria: Anaphylaxis commonly presents with hives (urticaria) as a manifestation of allergic reaction.
3. Stridor: Anaphylaxis can lead to upper airway swelling, causing stridor due to compromised breathing.
Summary of Incorrect Choices:
A. Bradycardia: Anaphylaxis typically causes tachycardia due to the body's response to the allergen.
C. Hypertension: Anaphylaxis usually results in hypotension due to vasodilation and increased vascular permeability.
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.