Nokea
A patient who has multiple health issues is discharged after a recent hospitalization. Which of the following comprehensive programs would a community health nurse refer the patient to if the patient is not under medical supervision but does have insurance?
- A. private health care practitioner
- B. a patient-centered medical home
- C. hospital clinic
- D. subacute facility
Correct Answer: B
Rationale: The correct answer is B: a patient-centered medical home. A patient-centered medical home provides comprehensive, coordinated care for patients with multiple health issues. It offers a team-based approach to managing care, including primary care, specialists, and other services. The patient does not need to be under medical supervision, but having insurance is beneficial for accessing the services offered. Referring the patient to a private health care practitioner (A) may not provide the level of coordination needed. Hospital clinics (C) typically focus on acute care, not comprehensive management. Subacute facilities (D) are for patients who need ongoing medical supervision and rehabilitation, which may not be necessary in this case.
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Which group is an example of a community of solution?
- A. That lives within a specific geographic location.
- B. Concerned with reducing teenage suicides.
- C. With the same ethnic background.
- D. In which all members enjoy hiking.
Correct Answer: B
Rationale: The correct answer is B because a community of solution is a group focused on addressing a specific issue or problem, in this case, reducing teenage suicides. This group works together to find solutions and support individuals affected by this issue. Choice A is incorrect because it refers to a geographic community, not a community of solution. Choice C is incorrect as it focuses on ethnic background, not a common goal or problem-solving. Choice D is incorrect as enjoying hiking is a shared interest, not a shared purpose of solving a particular issue.
As an important tool for planning a community health survey was conducted, the first tangible outcome of collaboration and teamwork with the Local Health Department and its Rural Health Units (RHUs) was observed. This later led to case findings activities via collection and examination of stools from children for suspected parasitism. Which of the following community nursing diagnoses will guide the Parish Health Team for concrete action?
- A. Parasitism as a foreseeable crisis
- B. Malnutrition as a health deficit
- C. Parasitism as a health deficit
- D. Parasitism as a health threat
Correct Answer: D
Rationale: The correct answer is D: Parasitism as a health threat. This diagnosis guides the Parish Health Team to take concrete action because parasitism poses a direct risk to the community's health. By identifying parasitism as a health threat, the team can prioritize interventions to prevent and control the spread of parasites, ensuring the well-being of the population.
Choices A, B, and C are incorrect:
A: Parasitism as a foreseeable crisis - This choice does not provide a clear direction for action and lacks a sense of urgency compared to a health threat.
B: Malnutrition as a health deficit - While malnutrition is a significant issue, the question specifically mentions suspected parasitism as the focus of case findings activities.
C: Parasitism as a health deficit - This choice does not emphasize the immediate danger posed by parasitism, unlike the concept of a health threat.
Which of the following describes a valid way to collect data for community assessment?
- A. Using a library database to conduct a literature review
- B. All of these strategies are helpful in conducting a community assessment
- C. Using surveys or questionnaires to gather information from members of the community
- D. Reading government documents to determine if similar data have already been collected
Correct Answer: B
Rationale: The correct answer is B because conducting a community assessment involves utilizing multiple strategies to gather comprehensive data. This includes using library databases for literature reviews (A), surveys/questionnaires to collect community input (C), and examining government documents for existing data (D). By combining these methods, a more thorough and accurate assessment can be achieved. Option B acknowledges the importance of employing a variety of strategies to ensure a well-rounded approach to data collection. Options A, C, and D are individually valid methods but do not encompass the full range of strategies necessary for a comprehensive community assessment.
The appropriate order of steps in active management of the third stage of labor include:
- A. Cord clamping and cutting, controlled cord traction, ergometrine administration, and inspection to be sure the placenta is intact.
- B. Intravenous oxytocin, cord clamping and cutting, and fundal massage
- C. Intramuscular injection oxytocin, controlled cord traction with counter traction to the uterus, uterine massage
- D. Controlled cord traction, fundal massage and oxytocin
Correct Answer: C
Rationale: The correct order of steps in active management of the third stage of labor includes: 1) Intramuscular injection of oxytocin to prevent postpartum hemorrhage, 2) Controlled cord traction with counter traction to the uterus to facilitate placental delivery, and 3) Uterine massage to aid in uterine contraction and reduce bleeding.
Rationale for Correct Answer (C):
- Intramuscular oxytocin is administered first to prevent excessive bleeding.
- Controlled cord traction with counter traction assists in the gentle delivery of the placenta.
- Uterine massage helps the uterus contract and reduce the risk of hemorrhage.
Summary of Incorrect Choices:
- A (Incorrect): Incorrect order of steps, ergometrine administration is not recommended.
- B (Incorrect): Incorrect order, fundal massage should be done after cord traction.
- D (Incorrect): Incorrect order, oxytocin should be administered before cord traction.
Barriers to a patient's engagement in self-care include all of the following except:
- A. Mental health issues
- B. Lack of knowledge
- C. High health literacy
- D. Financial issues
Correct Answer: C
Rationale: The correct answer is C: High health literacy. High health literacy actually facilitates a patient's engagement in self-care by enabling them to understand health information and make informed decisions. Mental health issues, lack of knowledge, and financial issues are barriers as they can affect a patient's ability to effectively manage their own care. Mental health issues may result in poor motivation or cognitive impairment, lack of knowledge can lead to incorrect practices, and financial issues can limit access to necessary resources.