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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A community health nurse is planning a program for adolescents about preventing STIs. Which of the following actions should the nurse take first?
- A. Collect data to identify barriers to learning
- B. Establish methods to evaluate program outcomes
- C. Obtain visual aids that feature adolescents
- D. Provide computer-based education
Correct Answer: A
Rationale: The correct answer is A: Collect data to identify barriers to learning. This should be the first step because understanding the specific challenges and obstacles that adolescents face in learning about preventing STIs is crucial for designing an effective program. By collecting data, the nurse can tailor the program to address the specific needs of the target audience, ensuring that the information is relevant and accessible.
Choice B, establishing methods to evaluate program outcomes, would come later in the program planning process after the content has been developed and implemented. Choice C, obtaining visual aids featuring adolescents, and choice D, providing computer-based education, are also important but should be considered after identifying barriers to learning to enhance the effectiveness of the program.
A newly hired occupational health nurse is assessing hazards in the work environment. Which of the following actions will help the nurse detect potential physical hazards?
- A. Survey workers about job-related emotional stress.
- B. Measure the noise levels at various locations in the facility.
- C. Identify industrial toxins that are present in the environment.
Correct Answer: B
Rationale: The correct answer is B: Measure the noise levels at various locations in the facility. This action will help the nurse detect potential physical hazards because excessive noise can lead to hearing damage and other health issues. By measuring noise levels, the nurse can identify areas where noise levels exceed safe limits and implement control measures.
Surveying workers about emotional stress (Choice A) is important for psychological well-being but does not directly address physical hazards. Identifying industrial toxins (Choice C) is important for chemical hazards, not physical hazards related to noise. The other choices are not provided, but measuring noise levels is the most relevant action for detecting physical hazards in this scenario.
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.
A community health nurse is planning a smoking cessation class. Which of the following factors will have the greatest effect on the success of the class?
- A. Presenter's teaching strategies
- B. Presenter's credibility
- C. Client's motivation
- D. Client's education level
Correct Answer: C
Rationale: The correct answer is C: Client's motivation. Motivation plays a crucial role in behavior change like quitting smoking. Without intrinsic motivation, clients may not fully engage in the class or follow through with quitting. Presenter's teaching strategies (A) and credibility (B) are important but not as impactful as client motivation. Client's education level (D) may influence comprehension but not motivation.
A nurse is caring for a client who is unconscious. Which of the following actions should the nurse take when providing oral care for the client?
- A. Test for the presence of the client's gag reflex
- B. Place the client in the supine position
- C. Use a firm toothbrush for tooth and gum care
- D. Use 2 gauze-wrapped fingers to hold the mouth open
Correct Answer: A
Rationale: The correct answer is A: Test for the presence of the client's gag reflex. This is important to prevent aspiration during oral care. By testing the gag reflex, the nurse can ensure the client's airway is protected. Placing the client in the supine position (choice B) can increase the risk of aspiration. Using a firm toothbrush (choice C) can damage the delicate tissues in the mouth. Using 2 gauze-wrapped fingers to hold the mouth open (choice D) can increase the risk of injury to the client's oral mucosa.