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A public health nurse is managing several projects for the community. Which of the following interventions should the nurse identify as a primary prevention strategy?
- A. Teaching parenting skills to expectant mothers and their partners.
- B. Conducting mental health screenings at the local community center
- C. Referring clients with obesity to community exercise programs
- D. Providing crisis intervention through a mobile counseling unit
Correct Answer: A
Rationale: The correct answer is teaching parenting skills to expectant mothers and their partners. This intervention is a primary prevention strategy aimed at educating individuals before a problem or condition develops. By teaching parenting skills, the nurse is promoting healthy behaviors and relationships, which can prevent future issues. The other options involve secondary or tertiary prevention strategies by identifying and treating existing conditions or providing interventions after a problem has occurred.
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A charge nurse is recommending postpartum client discharge following a local disaster. Which of the following should the nurse recommend for discharge?
- A. A 42-year-old client who has preeclampsia and a BP of 166/110 mm Hg
- B. A 15-year-old client who delivered via emergency cesarean birth 1 day ago
- C. A client who received 2 units of packed RBCs 6 hr ago for a postpartum hemorrhage
- D. A client who delivered precipitously 36 hr ago and has a second-degree perineal laceration
Correct Answer: D
Rationale: The most appropriate client to recommend for discharge following a local disaster in the postpartum unit is the one who delivered precipitously 36 hours ago and has a second-degree perineal laceration. This client's condition is stable enough for discharge, and the timing and extent of the perineal laceration are within expectations for a safe discharge. Clients with conditions such as preeclampsia, recent emergency cesarean birth, or recent administration of packed RBCs for postpartum hemorrhage require further monitoring and care before being considered for discharge.
A client with fibromyalgia requests pain medication. Which of the following medications should the nurse administer?
- A. Pregabalin
- B. Lorazepam
- C. Colchicine
- D. Codeine
Correct Answer: A
Rationale: Pregabalin is commonly used to manage pain associated with fibromyalgia. It works by reducing the number of pain signals sent out by damaged nerves. Lorazepam is a benzodiazepine used for anxiety, not pain management. Colchicine is primarily used for gout treatment, and codeine, while an analgesic, is not typically the first-line choice for fibromyalgia pain due to its potential for side effects and misuse.
A nurse is talking with another nurse on the unit and smells alcohol on her breath. Which of the following actions should the nurse take?
- A. Confront the nurse about the suspected alcohol use.
- B. Inform another nurse on the unit about the suspected alcohol use.
- C. Ask the nurse to finish administering medications and then go home.
- D. Notify the nursing manager about the suspected alcohol use.
Correct Answer: A
Rationale: Confronting the nurse about the suspected alcohol use is the most appropriate action in this situation. It is essential to address the issue directly and express concerns about patient safety and potential impairment. By addressing the situation promptly, the nurse can potentially prevent harm and provide support to the colleague in need.
A client who is at 38 weeks gestation, is in active labor, and has ruptured membranes is being cared for by a nurse. What action should the nurse take?
- A. Insert an indwelling urinary catheter
- B. Apply fetal heart rate monitor
- C. Initiate fundal massage
- D. Initiate an oxytocin IV infusion
Correct Answer: B
Rationale: When caring for a client in active labor with ruptured membranes, the priority action for the nurse is to apply a fetal heart rate monitor. This helps monitor the well-being of the fetus during labor and delivery, enabling timely interventions if any fetal distress is detected. Inserting an indwelling urinary catheter may be required in some cases, but it is not the priority in the given scenario. Fundal massage is typically done after delivery to help the uterus contract and prevent postpartum hemorrhage. Initiating an oxytocin IV infusion may be indicated to augment labor, but it is not the initial action needed in this situation.
A healthcare professional is reviewing laboratory data for a client who has chronic kidney disease. Which of the following findings should the healthcare professional expect?
- A. Increased creatinine.
- B. Increased hemoglobin.
- C. Increased bicarbonate.
- D. Increased calcium.
Correct Answer: A
Rationale: In chronic kidney disease, the kidneys are unable to effectively filter waste products from the blood, leading to an accumulation of creatinine. Creatinine levels are commonly elevated in individuals with impaired kidney function, making it a key indicator of kidney health. Therefore, an increased creatinine level would be an expected finding in a client with chronic kidney disease.