Nokea
For whom is the community health nurse primarily responsible?
- A. individuals
- B. populations
- C. families
- D. class E citizens
Correct Answer: B
Rationale: Community health nurses are primarily responsible for populations. While they do provide care and support to individuals and families within the community, their focus is on the health and well-being of entire populations. Choice A is incorrect as the primary responsibility is broader than just individuals. Choice C is incorrect as families are part of the population but not the sole focus. Choice D, 'class E citizens', is too specific and not a standard term in public health, making it an incorrect choice.
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The nurse at a health fair has taken a client's blood pressure twice, 10 minutes apart, in the same arm while the client is seated. The nurse records the two blood pressures of 172/104 mm Hg and 164/98 mm Hg. What is the appropriate nursing action in response to these readings?
- A. Refer the client to a nutritionist after providing health teaching about a low-sodium diet.
- B. Place the client in a recumbent position and call the paramedics for transport to the hospital.
- C. Talk with the client to assess whether there is stress in the client's life and refer to a counseling service.
- D. Take the client's blood pressure in the other arm and then schedule a healthcare practitioner's appointment for as soon as possible.
Correct Answer: D
Rationale: The appropriate nursing action in response to significantly high blood pressure readings like 172/104 mm Hg and 164/98 mm Hg is to confirm the readings by taking the blood pressure in the other arm. This can help rule out any error or issue specific to that arm. The nurse should then schedule a healthcare practitioner's appointment for as soon as possible to further assess the client's condition and determine the appropriate intervention.
Choice A is incorrect because solely referring the client to a nutritionist for a low-sodium diet without further assessment or confirmation of the blood pressure readings is premature. Choice B is incorrect as the client is already seated, and calling paramedics for immediate transport to the hospital is not warranted based solely on the blood pressure readings provided. Choice C is incorrect as stress may not be the sole reason for the high blood pressure readings, and further assessment is required before referring the client to counseling services.
The nurse administers a booster dose of DTaP (diphtheria, tetanus, and pertussis) vaccine to an infant. Which level of prevention is the nurse implementing?
- A. Primary prevention.
- B. Tertiary prevention.
- C. Secondary prevention.
- D. Primary nursing.
Correct Answer: A
Rationale: The correct answer is A: Primary prevention. Administering a booster dose of DTaP vaccine to an infant is an example of primary prevention. Primary prevention aims to prevent disease or injury before it occurs by preventing exposure to risk factors. Tertiary prevention focuses on reducing the impact of a disease or injury that has already occurred, while secondary prevention involves early detection and treatment to prevent the progression of disease. Choice B, tertiary prevention, is incorrect as it deals with managing the consequences of a disease rather than preventing it. Choice C, secondary prevention, is also incorrect as it focuses on early detection and treatment rather than vaccination to prevent the disease. Choice D, primary nursing, is unrelated to the level of prevention being implemented in this scenario.
The nurse is caring for an acutely ill 10-year-old client. Which of the following assessments would require the nurse's immediate attention?
- A. Rapid bounding pulse
- B. Temperature of 38.5 degrees Celsius
- C. Profuse diaphoresis
- D. Slow, irregular respirations
Correct Answer: D
Rationale: The correct answer is D, slow, irregular respirations. In an acutely ill child, this assessment can indicate impending respiratory failure or neurological compromise, necessitating immediate intervention. Rapid bounding pulse (choice A) may indicate tachycardia but is not as immediately concerning as compromised respirations. A temperature of 38.5 degrees Celsius (choice B) is elevated but may not be the most urgent concern unless accompanied by other symptoms. Profuse diaphoresis (choice C) can indicate increased sympathetic activity but is not as critical as respiratory compromise.
The nurse is preparing an orientation class for new employees at an inner city clinic that serves a low-income population. Which information should the nurse include in the presentation to these new employees?
- A. A lack of transportation is a major barrier for the clinic's clients.
- B. Basic physiologic needs are likely to be unmet in this clinic's client population.
- C. Printed material is less effective for this population with limited reading skills.
- D. Group education classes are often poorly attended by non-compliant clients.
Correct Answer: B
Rationale: The correct answer is B because addressing basic physiologic needs is crucial for low-income populations. Ensuring that basic needs such as food, shelter, and safety are met is essential for these clients to engage effectively in their healthcare. Choice A talks about transportation, which can be a barrier but may not be the major impediment. Choice C focuses on printed material and reading skills, which are important but not as fundamental as addressing basic physiologic needs. Choice D makes assumptions about client attendance based on compliance, which is not the most critical information to include in an orientation about serving a low-income population.
The nurse working in a community health clinic that serves recent Somali immigrants notes that most mothers refuse to give permission for routine immunizations of their preschoolers. Which individual is likely to have the most influence on these women's perceptions about their children's healthcare needs?
- A. husbands
- B. clinic healthcare providers
- C. older females
- D. tribal chief
Correct Answer: D
Rationale: In many Somali communities, the tribal chief holds significant influence over health decisions. The tribal chief often plays a crucial role in shaping community beliefs and practices, including healthcare decisions. While husbands may have some influence, the tribal chief typically holds more authority in community matters. Clinic healthcare providers have a role in educating and advising, but the tribal chief's influence is often more profound in this cultural context. Older females may have some influence, especially in familial matters, but the tribal chief is usually the key decision-maker in community health issues.