Nokea
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.
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A community health nurse is helping a group of nursing students plan a tertiary prevention program for a local community clinic that serves a majority Hispanic population. Which service project meets the requirement of a tertiary prevention program and would best serve this population?
- A. Teach clients about recommended immunizations for children.
- B. Instruct teens about prevention of sexually transmitted diseases.
- C. Take blood pressures at a local shopping mall in the community.
- D. Demonstrate foot care to a group of clients who have diabetes.
Correct Answer: D
Rationale: Demonstrating foot care for diabetic clients is tertiary prevention, focusing on managing complications of an existing condition, highly relevant for a Hispanic population with a high prevalence of diabetes.
The school nurse administers methylphenidate to an adolescent with Attention Deficit Hyperactivity Disorder (ADHD). When evaluating the drug's effectiveness, which information is most important for the nurse to review?
- A. Parent's report about behavior.
- B. Current grade report.
- C. Self-report about treatment progress.
- D. Past grade report.
Correct Answer: A
Rationale: Parents' reports on behavior provide critical insights into ADHD symptom management across settings, essential for evaluating methylphenidate's effectiveness.
A homeless client with alcohol dependency will be dismissed from the emergency department in 24 hours. The nurse notes that a tuberculin (TB) skin test was prescribed by the healthcare provider. Which intervention is most important for the nurse to implement prior to discharge?
- A. Explain to the client results should be read between 48 and 72 hours.
- B. Identify how the client will follow up to have the results read.
- C. Determine if the client understands the purpose of the tuberculin test.
- D. Give the client written Information about the tuberculosis test.
Correct Answer: B
Rationale: Ensuring follow-up for TB test reading is critical, especially for a homeless client, to confirm diagnosis and prevent missed results.
The nurse is working with a Parent Teacher Organization (PTO) to increase safety for children walking to and from a nearby elementary school. Which action should the nurse include to help achieve this goal?
- A. Encourage residents with older homes along the school route to get their homes inspected for excessive lead levels.
- B. Advise the residents to keep their porch lights on during hours that children are walking to and from school.
- C. Lead a discussion about the benefits of designated safe houses located throughout the school neighborhood.
- D. Help the residents plan a campaign to remind people driving through the school zone to wear seatbelts at all times.
Correct Answer: C
Rationale: Designated safe houses provide a structured safety measure, offering refuge for children in emergencies, directly enhancing pedestrian safety.
A school nurse identifies 15 new students with positive tuberculin tests among the 500 at-risk students tested. Which is the rate per 1,000 with new positive tests?
- A. 3/1,000.
- B. 30/1,000.
- C. 1.7/1,000.
- D. 15/1,000.
Correct Answer: B
Rationale: The rate is calculated as (15/500) * 1,000 = 30/1,000, accurately reflecting the proportion of students with positive tests per 1,000.