Nokea
A staff nurse is observing a newly licensed nurse suction a client’s tracheostomy. Which of the following actions by the newly-licensed nurse requires intervention by the staff nurse?
- A. Waits for 2 minutes between suctions
- B. Engaging in policy development and encourage and assist persons to communicate their needs
- C. Giving a very informative and engaging presentation
- D. Identifying and planning for high-risk populations
Correct Answer: A
Rationale: The correct answer is A because waiting for 2 minutes between suctions is not recommended practice for tracheostomy care. Suctioning should be performed as needed based on the patient's clinical presentation, not on a fixed time interval. Waiting too long between suctions can lead to ineffective removal of secretions, compromising the patient's airway.
Choice B, C, and D are incorrect because they are unrelated to the scenario of suctioning a tracheostomy. Choice B refers to policy development and communication skills, Choice C mentions giving a presentation, and Choice D involves planning for high-risk populations. These choices do not pertain to the immediate nursing intervention needed during tracheostomy care.
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Which intervention by the nurse is an example of a tertiary prevention strategy to improve environmental health?
- A. Conducting risk assessments for environmental contaminants
- B. Developing emergency response plans for environmental hazards
- C. Performing regular community environmental health assessments
- D. Implementing pollution prevention strategies
Correct Answer: D
Rationale: Correct Answer: D - Implementing pollution prevention strategies
Rationale: Tertiary prevention aims to reduce the impact of disease or injury by minimizing disability and promoting rehabilitation. Implementing pollution prevention strategies falls under tertiary prevention as it focuses on reducing exposure to harmful environmental factors, thereby preventing further health complications. This intervention directly addresses the root cause of environmental health issues by mitigating pollution, which can lead to improved health outcomes for individuals and communities.
Summary of other choices:
A: Conducting risk assessments for environmental contaminants - This falls under primary prevention as it aims to identify and prevent exposure to environmental hazards before they occur.
B: Developing emergency response plans for environmental hazards - This falls under secondary prevention as it focuses on early detection and prompt intervention during environmental emergencies.
C: Performing regular community environmental health assessments - This falls under primary prevention as it aims to identify potential environmental health risks and prevent them from occurring in the first place.
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 caring for a client following application of a cast. Which of the following actions should the nurse take first?
- A. Palpate the distal pulse to the cast
- B. Engage employers to have wellness centers at each industrial site
- C. Ensure timely and effective medical intervention and treatment for community members
- D. Giving some of their own surplus clothes to those who can use them
Correct Answer: A
Rationale: The correct answer is A: Palpate the distal pulse to the cast. This is the first action the nurse should take as it assesses the circulation to the extremity. Checking the distal pulse ensures that there is no compromise to blood flow post-casting, which is crucial in preventing complications like compartment syndrome. Engaging employers (B), ensuring community medical interventions (C), and donating clothes (D) are unrelated and not urgent in this scenario. It is important to prioritize patient safety and monitor for any potential complications following cast application.
A nurse in a family practice clinic is screening an adolescent client for idiopathic scoliosis. Which of the following assessments should the nurse perform as part of this screening?
- A. Measure the truncal rotation
- B. Administered 8 u regular insulin sq
- C. Determine if the stockings are binding
- D. Arrange for an ethics committee meeting
Correct Answer: A
Rationale: The correct answer is A: Measure the truncal rotation. When screening for idiopathic scoliosis, assessing truncal rotation is essential as it helps in detecting the presence of spinal curvature. Truncal rotation is a key indicator of scoliosis as the spine rotates along with the curvature. This assessment involves observing the symmetry of the shoulders and scapulae, which can indicate spinal rotation. Therefore, measuring truncal rotation is a crucial step in identifying potential scoliosis in adolescents.
Summary:
B: Administered 8 u regular insulin sq - Irrelevant to scoliosis screening, this is related to diabetes management.
C: Determine if the stockings are binding - Irrelevant to scoliosis screening, this is related to circulation issues.
D: Arrange for an ethics committee meeting - Irrelevant to scoliosis screening, this is related to ethical considerations in healthcare.
Which is a Healthy People 2020 goal?
- A. Decrease the incidence of preventable disease, disability, injury, and premature death
- B. Reduce health inequity, decrease disparities, and improve the health of certain groups
- C. Create social and physical environments that promote good health for all
- D. Promote healthy development and healthy behaviors for the geriatric stage of life
Correct Answer: B
Rationale: The correct answer is B because reducing health inequity, decreasing disparities, and improving the health of certain groups aligns with the overarching goal of achieving health equity for all in Healthy People 2020. This goal focuses on addressing the social determinants of health to ensure that everyone has the opportunity to achieve their highest level of health. Choices A, C, and D are important aspects of public health but do not specifically address health equity and disparities among different population groups. Therefore, B is the most appropriate choice for a Healthy People 2020 goal.