Several employees who have a 10-year or longer history of smoking ask the occupational nurse for assistance with smoking cessation. The RN develops a 2-month program that includes weekly group sessions on lifestyle changes and use of OTC products. Which measurement provides the best indication of the program's effectiveness?
- A. Encourage the employees to disclose if they have joined another smoking cessation group.
- B. Ask the employees to inform the group if they stop smoking and if they start back up again.
- C. Survey the employees about their smoking habits.
- D. Observe if the employees are smoking in the designated smoking areas.
Correct Answer: C
Rationale: Surveying the employees about their smoking habits provides measurable data on program effectiveness. By collecting data directly from the employees through surveys, the occupational nurse can track changes in smoking habits, frequency, and quantity of cigarettes smoked. This direct feedback allows for a more accurate assessment of the program's impact on smoking cessation. Choices A and B rely on self-disclosure and may not provide reliable or objective data. Choice D does not directly measure changes in smoking habits but rather observes behavior in designated areas, which may not reflect overall smoking cessation progress.
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After 3 days, the nurse notes that James has chest indrawing and stridor. His mother returned him to the health center immediately. The nurse should:
- A. Change the antibiotic to second-line antibiotics
- B. Advise the mother to observe the child and continue giving the antibiotics
- C. Give the first dose of antibiotics and refer urgently
- D. Observe the child at the center
Correct Answer: C
Rationale: Chest indrawing and stridor are signs of severe respiratory distress. In this situation, immediate referral is essential. Giving the first dose of antibiotics before referral can help initiate treatment, but urgent referral for further evaluation and management is crucial. Choice A is incorrect because simply changing the antibiotic without assessing the severity of the symptoms and providing urgent care is not appropriate. Choice B is incorrect as advising the mother to observe the child and continue antibiotics delays necessary intervention for a potentially life-threatening condition. Choice D is incorrect as observing the child at the center is not sufficient when signs of severe illness are present.
Following-up Mrs. Luy, G5P4, you notice her eldest son is underweight and her youngest daughter looks thin and pale. Mrs. Luy's present pregnancy would mean another additional member of the family. This can be considered as:
- A. health deficit
- B. health deficit and health threat
- C. health threat
- D. foreseeable crisis
Correct Answer: C
Rationale: The correct answer is C: 'health threat.' The new pregnancy poses a health threat due to the potential strain on resources and the existing issues with the children, such as underweight and being pale. Choice A is incorrect as it does not fully capture the potential risks associated with the new pregnancy. Choice B is also incorrect as it includes 'health deficit,' which is not explicitly mentioned in the scenario. Choice D, 'foreseeable crisis,' is not the most fitting description of the situation presented.
A school nurse is assessing a child who has frequent absences from school due to asthma. Which of the following is the priority nursing action?
- A. Teaching the child how to use an inhaler
- B. Assessing the child's asthma management plan
- C. Discussing the importance of school attendance with the parents
- D. Referring the child to a pulmonologist
Correct Answer: B
Rationale: The correct answer is to assess the child's asthma management plan. This is the priority action as it allows the nurse to evaluate the current treatment regimen, identify any gaps or areas for improvement, and ensure that the plan is being effectively implemented. Teaching the child how to use an inhaler (Choice A) may be important but should come after assessing the management plan. Discussing the importance of school attendance with the parents (Choice C) is secondary to ensuring proper asthma management. Referring the child to a pulmonologist (Choice D) may be necessary but is not the priority at this stage; first, the nurse needs to evaluate the current plan in place.
A client with asthma is receiving albuterol (Proventil). The nurse should monitor the client for which of the following side effects?
- A. Hypoglycemia
- B. Hyperkalemia
- C. Tachycardia
- D. Hypotension
Correct Answer: C
Rationale: The correct answer is C: Tachycardia. Albuterol can cause tachycardia as a side effect due to its stimulant effect on the heart. It acts as a beta-2 adrenergic agonist, leading to increased heart rate. Hypoglycemia (choice A) is not a common side effect of albuterol. Hyperkalemia (choice B) is also not typically associated with albuterol use. Hypotension (choice D) is less likely to occur as albuterol usually causes tachycardia rather than hypotension.
As community health nurses engage in the process of community empowerment, it is essential that they:
- A. gather data from the community
- B. form partnerships with people in the community
- C. make decisions for the people in the community
- D. accept responsibility for people's actions
Correct Answer: B
Rationale: In the process of community empowerment, community health nurses should form partnerships with the community rather than making decisions for them, gathering data alone, or accepting responsibility for their actions. Forming partnerships ensures that the community is actively involved in decision-making processes, leading to sustainable and effective outcomes. Gathering data is important but not the central aspect of empowerment, while accepting responsibility for people's actions is not a core principle of empowerment but rather promoting accountability within the community.
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