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A prescription for discharge is written for an elderly client who has asked to be discharged to home. The client lives alone and is able to walk 10 to 15 feet (3 to 4.5 meters) with assistance. Which action should the nurse implement first?
- A. Review the home medication schedule with the client and family.
- B. Provide the client with information about medical alert devices.
- C. Arrange for a bedside commode to be delivered to the home.
- D. Meet with the case manager to plan a home safety evaluation.
Correct Answer: D
Rationale: A home safety evaluation is critical to identify hazards and ensure the client's limited mobility is accommodated, preventing falls and ensuring safety.
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A migrant farm worker who lives in a mobile home with several other workers visits the Migrant Health Care Center. The client reports Increasing episodes of dizziness, headaches, abdominal cramps, and difficulty breathing. Which nursing action has the highest priority?
- A. Gather information about the client's recent exposure to pesticides.
- B. Obtain a blood sample to assess for possible lead paint exposure.
- C. Ask about the length of his workday and frequency of rest breaks.
- D. Determine the number and age of persons living in the mobile home.
Correct Answer: A
Rationale: Symptoms like dizziness and breathing difficulty suggest pesticide poisoning, a common risk for farm workers, requiring immediate investigation to guide treatment.
According to the Centers for Disease Control and Prevention, which diseases are reportable infectious diseases? Select all that apply.
- A. Pediculosis.
- B. Bacterial conjunctivitis.
- C. Anthrax.
- D. Diphtheria.
- E. Tuberculosis.
Correct Answer: C,D,E
Rationale: Anthrax, Diphtheria, and Tuberculosis are reportable due to their severe public health implications, potential for outbreaks, and, in the case of anthrax, bioterrorism concerns. Pediculosis and bacterial conjunctivitis, while public health concerns, are not typically mandated for reporting to the CDC.
A community health nurse is planning strategies to prevent an increase in the incidence of osteoporosis in the community. Which activity should the nurse include?
- A. Ensure that all meals delivered to persons receiving Meals-on-Wheels include fresh or canned fruit.
- B. Schedule blood pressure screenings during craft club hours for elderly women at the senior center.
- C. Lobby the local school board to increase physical education classes at all schools in the district.
- D. Collaborate with a local scout troop to determine families that need wheelchair ramps installed.
Correct Answer: C
Rationale: Increasing physical education promotes weight-bearing exercises, essential for building bone density and preventing osteoporosis, especially in youth.
An adolescent tells the school nurse that she is pregnant. Her last menstrual period was 4 months ago, and she has not yet received any medical care. She smokes but denies any other substance use. Which interventions should the nurse implement? (Select all that apply.)
- A. Encourage smoking cessation.
- B. Arrange for childcare.
- C. Offer nutritional instruction.
- D. Refer for prenatal care.
- E. Teach breastfeeding methods.
- F. Notify her parents.
Correct Answer: A,C,D
Rationale: Smoking cessation, nutritional instruction, and prenatal care referral are critical to improve maternal and fetal health outcomes. Childcare and breastfeeding education are less immediate, and notifying parents requires careful consideration of confidentiality.
The epidemiological triad can be used to frame strategies for the prevention of farm machinery injuries. Which action should the nurse take to focus on the agent?
- A. Provide rehabilitation services to injured farm hands.
- B. Work with legislators to mandate safe tractor design.
- C. Teach farm workers not to smoke around farm equipment.
- D. Translate written vehicle instructions into picture format.
Correct Answer: B
Rationale: Mandating safe tractor design targets the agent (machinery) in the epidemiological triad, reducing injury risk by improving equipment safety features.