Nokea
A school nurse is conducting vision and hearing testing on fifth-grade children. Which level of prevention is the nurse demonstrating?
- A. Primary
- B. Secondary
- C. Tertiary
- D. Health promotion
Correct Answer: B
Rationale: The school nurse conducting vision and hearing testing on fifth-grade children is demonstrating the secondary level of prevention. Secondary prevention involves identifying and treating health conditions early to prevent their progression. In this scenario, the nurse's aim is to detect any existing vision or hearing problems in the children at an early stage so that appropriate interventions can be initiated to prevent further impairment or complications. This aligns with the goals of secondary prevention, which focuses on early detection, prompt intervention, and minimizing the impact of a health condition.
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Which of the ff is an assessment finding in a client with bonchiectasis?
- A. Same amount of sputum at all stages of the disease
- B. Non productive cough
- C. Expectoration of small amounts of sputum
- D. Worsening cough with position changes
Correct Answer: C
Rationale: Bronchiectasis is a condition characterized by the abnormal widening and thickening of the bronchial tubes, leading to a build-up of mucus. One of the common assessment findings in clients with bronchiectasis is the expectoration of small amounts of sputum. This is due to the increased mucus production and impaired clearance from the airways. The sputum may be foul-smelling and may contain pus or blood due to chronic infection and inflammation in the bronchial tubes.
The nurse is admitting a newborn with hypospadias to the nursery. The nurse expects which finding in this newborn?
- A. Absence of a urethral opening is noted.
- B. Penis appears shorter than usual for age.
- C. The urethral opening is along the dorsal surface of the penis.
- D. The urethral opening is along the ventral surface of the penis.
Correct Answer: D
Rationale: Hypospadias is a congenital condition where the opening of the urethra is located on the ventral surface of the penis instead of the tip. This results in the ventral placement of the urethral meatus compared to the normal dorsal position. It can typically be visually identified when examining the newborn's genitalia. A key characteristic of hypospadias is the abnormal positioning of the urethral opening, which distinguishes it from other conditions affecting the male genitalia.
The nurse is working in a support group for client with acquired immunodeficiency syndrome (AIDS). Which point is most important for the nurse to stress?
- A. Avoiding the use of recreational drugs and alcohol
- B. Refraining from telling anyone about the diagnosis
- C. Following safer-sex practices
- D. Telling potential sex partners about the diagnosis, as required by the law
Correct Answer: C
Rationale: Following safer sex practices is the most important point for the nurse to stress when working in a support group for clients with acquired immunodeficiency syndrome (AIDS). Safer sex practices, such as using condoms consistently and correctly, can help reduce the risk of transmitting the virus to others or acquiring other sexually transmitted infections. While avoiding the use of recreational drugs and alcohol is beneficial for overall health, it is not as crucial as practicing safer sex. Refraining from telling anyone about the diagnosis is not recommended, as social support is important for individuals living with AIDS. Telling potential sex partners about the diagnosis is also essential, not only for ethical reasons but also to prevent the transmission of the virus.
At the present time, the best treatment for cancer is complete __________ before metastasis occurs:
- A. Chemotherapy
- B. Radiation
- C. Surgical removal
- D. All of the above
Correct Answer: C
Rationale: The best treatment for cancer at the present time is complete surgical removal before metastasis occurs. Surgery is often the most effective method to remove the primary tumor and eliminate cancer cells in the affected area. While chemotherapy and radiation therapy are important in treating cancer, surgical removal of the tumor provides the best chance for complete eradication of cancer cells, especially if it is done before the cancer has spread to other parts of the body.
The nurse would monitor the client for which of the following?
- A. Trousseau's sign
- B. Hypoglycemia
- C. Hypokalamia
- D. Respiratory changes
Correct Answer: A
Rationale: Trousseau's sign is a clinical sign characterized by carpal spasm induced by inflating a blood pressure cuff above the systolic pressure for a few minutes. It is indicative of hypocalcemia, specifically low calcium levels in the blood. Therefore, the nurse would monitor the client for Trousseau's sign to assess for potential hypocalcemia. This could prompt the healthcare provider to order further diagnostic tests or interventions to address the underlying calcium imbalance. Options B, C, and D do not directly relate to monitoring for Trousseau's sign.