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Several clients who have recently come to the local health clinic in a rural county are diagnosed with tuberculosis (TB). After reporting the occurrence to the health department, which community focused action should the nurse implement first?
- A. Collaborate with local schools in screening children.
- B. Develop a community educational program.
- C. Provide referrals for home health care follow up.
- D. Perform a community health assessment.
Correct Answer: D
Rationale: A community health assessment is the first step to understand the extent of the TB outbreak, identify high-risk groups, and tailor interventions like screening or education effectively.
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The epidemiological triad can be used to frame strategies for the prevention of farm machinery injuries. Which action should the nurse take to focus on the agent?
- A. Provide rehabilitation services to injured farm hands.
- B. Work with legislators to mandate safe tractor design.
- C. Teach farm workers not to smoke around farm equipment.
- D. Translate written vehicle instructions into picture format.
Correct Answer: B
Rationale: Mandating safe tractor design targets the agent (machinery) in the epidemiological triad, reducing injury risk by improving equipment safety features.
A 66-year-old client is retiring and will no longer have health insurance through a place of employment. Which agency should the client be referred to by the employee health nurse for health insurance needs?
- A. Women, Infant, and Children program.
- B. Consolidated Omnibus Budget Reconciliation Act provisions.
- C. Medicare.
- D. Medicaid.
Correct Answer: C
Rationale: Medicare is the federal health insurance program for those 65 and older, making it the most suitable for a 66-year-old retiree's insurance needs.
Four students come to the school clinic simultaneously, seeking help from the school nurse. In which order of priority should the nurse provide care to these students? (Arrange the client with the highest priority first, on top, and lowest priority last, on bottom.)
- A. A 12-year-old child with history of asthma who is wheezing and reporting shortness of breath.
- B. A 7-year-old child who has type 1 diabetes mellitus and is experiencing extreme hunger and shakiness
- C. A 10-year-old child with bleeding lacerations on both knees after falling in gym class.
- D. A 5-year-old child who is crying uncontrollably because of an incontinent bowel episode.
Correct Answer: A,B,C,D
Rationale: Asthma exacerbation (A) is life-threatening, requiring immediate intervention. Hypoglycemia (B) is urgent to prevent complications. Bleeding lacerations (C) need prompt care but are less critical. Incontinence (D) is least urgent, focusing on comfort after addressing medical emergencies.
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.
The elementary school nurse has identified a problem requiring a secondary intervention. Which intervention should the nurse implement?
- A. Instruct on technique of 'stop, drop & roll' at assembly.
- B. Involve the parent teacher association (PTA) in a fund raising event for the new gym.
- C. Invite 1st grade parents to a 'Meet the Teachers' event.
- D. Send letters to parents regarding a recent lice infestation.
Correct Answer: D
Rationale: Sending letters about a lice infestation is a secondary prevention intervention, addressing an identified problem to control its spread.