Nokea
A nurse is working with a community health care team to devise strategies for preventing violence in the community. Which of the following interventions is an example of tertiary prevention?
- A. Presenting community education programs about stress management
- B. Developing resources for victims of abuse
- C. Urging community leaders to make nonviolence a priority
- D. Assessing for risk factors of intimate partner abuse during health examinations
Correct Answer: B
Rationale: The correct answer is B: Developing resources for victims of abuse. Tertiary prevention focuses on minimizing the impact of established disease or injury. By providing resources for victims of abuse, the community health care team is helping to support those who have already experienced violence, thus reducing potential long-term consequences. Choices A, C, and D are examples of primary and secondary prevention strategies, which aim to prevent violence before it occurs or identify and intervene early in cases of violence. These interventions are important but do not fall under tertiary prevention.
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An occupational health nurse is discussing health promotion with a client who has a history of obesity. Which of the following comments indicates the client is using rationalization as a coping mechanism?
- A. I have lots of health problems from being obese
- B. I am obese, it's in my genes
- C. I have difficulty resisting the items in vending machines
- D. I know you don't like me because I am obese
Correct Answer: B
Rationale: The correct answer is B because the client is using rationalization by attributing their obesity to genetics rather than taking personal responsibility. This deflects accountability and provides a justification for their weight issue. Choice A acknowledges the health problems related to obesity. Choice C acknowledges a specific struggle with resisting temptations. Choice D reflects projection, attributing dislike to the nurse. Other choices are incomplete.
A client states, 'My life has no meaning right now.' What is the nurse's best response?
- A. Have you been thinking about harming yourself?
- B. How long have you been feeling this way?
- C. Tell me what is going on with you right now.
- D. Do you really think your life has no purpose?
Correct Answer: A
Rationale: The correct answer is A. By asking the client if they have been thinking about harming themselves, the nurse is directly addressing the potential risk of suicide, which is crucial when a client expresses feelings of hopelessness. This question helps assess the client's safety and determine the need for immediate intervention. Choices B, C, and D are not as direct in addressing the potential risk of self-harm and may not provide the necessary urgency in ensuring the client's safety. Asking about self-harm is critical in assessing the severity of the client's distress and ensuring appropriate interventions are implemented promptly.
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 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.
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.