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A public health nurse has developed a research question and searched the literature for supporting
- A. In which step of evidence-based decision-making would the nurse compile the research findings and identify specific trends in the data?
- B. Defining the problem
- C. Synthesizing the literature
- D. Appraising the literature
Correct Answer: C
Rationale: The correct answer is C: Synthesizing the literature. In evidence-based decision-making, synthesizing the literature involves compiling research findings and identifying specific trends in the data. This step allows the nurse to analyze and interpret the information gathered from various sources to draw meaningful conclusions and make informed decisions. Defining the problem (choice B) is the initial step of evidence-based decision-making. Appraising the literature (choice D) comes after synthesizing, where the nurse evaluates the quality and relevance of the gathered evidence. Choices E, F, and G are not applicable in this context.
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Which database would the public health nurse use when conducting research to locate regularly updated systematic reviews?
- A. Cochrane Library
- B. Agency for Healthcare Research and Quality (AHRQ)
- C. Medline with Full Text
- D. Cumulative Index to Nursing and Allied Health Literature (CINAHL)
Correct Answer: A
Rationale: The correct answer is A: Cochrane Library. The Cochrane Library is renowned for regularly updated systematic reviews, providing high-quality evidence for healthcare decision-making. It follows strict methodology to ensure reliability. AHRQ (B) focuses on healthcare quality improvement, not systematically updated reviews. While Medline (C) and CINAHL (D) are databases for primary research articles, they do not specifically focus on systematic reviews. Therefore, Cochrane Library is the most appropriate database for the public health nurse's research needs.
A nurse is teaching participants at a community center about advance directives. Which of the following information should the nurse include in the teaching?
- A. A client must create a do-not-resuscitate order when completing advance directives.
- B. Advance directives cannot be changed once implemented.
- C. A health care surrogate makes health care decisions when the client is no longer able.
- D. Assigning a health care surrogate requires legal consultation.
Correct Answer: C
Rationale: The correct answer is C: A health care surrogate makes health care decisions when the client is no longer able. This information is crucial for understanding advance directives as it highlights the role of a health care surrogate in making decisions on behalf of the client when they are incapacitated. This empowers individuals to ensure their wishes are carried out even when they are unable to communicate them.
Choice A is incorrect because creating a do-not-resuscitate order is just one aspect of advance directives, not a mandatory requirement. Choice B is incorrect as advance directives can be updated or changed as long as the individual is competent to do so. Choice D is incorrect as assigning a health care surrogate does not always require legal consultation, although it may be recommended in some cases.
Which action will the public health team take during the Exposure Assessment stage of the EPA's four- step risk assessment following a train derailment resulting in a toxic chemical spill?
- A. Identifying potential negative outcomes due to exposure to the toxic chemicals
- B. Identifying how the amount of exposure relates to the severity of negative health outcomes
- C. Quantifying the extent, frequency, and length of contact of the community with the toxic chemicals
- D. Determining how the toxic chemicals are absorbed, metabolized, and eliminated from the body
Correct Answer: C
Rationale: During the Exposure Assessment stage, the public health team will quantify the extent, frequency, and length of contact of the community with the toxic chemicals. This is crucial for determining the level of risk posed by the exposure. Identifying potential negative outcomes (Choice A) is important but falls under the Hazard Identification stage. Understanding the relationship between exposure amount and health outcomes (Choice B) is part of the Dose-Response Assessment stage. Determining how chemicals interact with the body (Choice D) is covered in the Toxicokinetics stage. Therefore, choice C is correct as it directly addresses the primary focus of the Exposure Assessment stage.
A nurse is caring for an older client who is struggling to manage her type 2 diabetes mellitus. The nurse should recognize which social determinants of this client's health? (Select all that apply.)
- A. Household income of $23,000 per year
- B. Reading level of a third grader
- C. Medication ineffective due to error in prescription
- D. Originally from Sudan
Correct Answer: A
Rationale: The correct answer is A: Household income of $23,000 per year. This is a social determinant of health because low income can impact access to healthy foods, medications, and healthcare services, affecting diabetes management. Choice B, reading level, is related to health literacy but not specifically a social determinant in this scenario. Choice C, medication error, is a healthcare system issue. Choice D, origin from Sudan, is related to cultural background but not directly a social determinant affecting diabetes management.
A nurse manager is reviewing documentation with a newly licensed nurse. Which of the following notations by the newly licensed nurse indicates an understanding of the teaching?
- A. Administered 8 u regular insulin sq
- B. Check gastric residuals every 4 hours
- C. Compare the client's list of home medications to the admission prescriptions
- D. Measure the client's urine output every hour
Correct Answer: A
Rationale: The correct answer is A because it reflects proper documentation format, including the medication name, dose, route, and frequency. It demonstrates the nurse understands how to document medication administration accurately. Choice B is incorrect as it lacks specific details on the action to be taken. Choice C is incorrect as it does not imply any action related to medication safety. Choice D is incorrect as it does not specify the reason for measuring urine output.