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The community health center has observed a significant increase in influenza cases compared to previous years. The nursing staff is tasked with reviewing outcome data to identify any trends in vaccination rates and reasons for any decline. What actions should the nursing team take to gather data for analysis?
- A. Delineate the geographic distribution of the area to survey and review for patterns.
- B. Ask a set number of clients if they have had the flu.
- C. Generate influenza immunization and case reports from the electronic record.
- D. Determine the change in immunization rates from the previous year to the current year.
Correct Answer: C
Rationale: Generating influenza immunization and case reports from the electronic record would provide direct data about the number of people who have been vaccinated and the number of influenza cases. This information could be used to identify trends and understand reasons for any decline in vaccination rates.
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A 2-month-old infant contracts a disease through vertical transmission. Which situation should the nurse investigate further to ascertain how the infant might have been exposed to the disease?
- A. The infant received a scheduled immunization.
- B. The father fed the infant spoiled baby food.
- C. The mother is breastfeeding the infant.
- D. The infant was bitten by an infected mosquito.
Correct Answer: C
Rationale: Breastfeeding is a common method of vertical transmission. Certain infections in the mother can be passed to the infant through breast milk. Therefore, if a 2-month-old infant contracts a disease that could be transmitted vertically, it would be important to investigate if the mother could be the source of the infection.
The home health nurse visits a young adult client who has AIDS with Kaposi's sarcoma and peripheral neuropathies. The client's parents, who are the caretakers, tell the nurse that their child sleeps most of the time. The nurse assesses that the client is semi-conscious with stable vital signs, cries out in pain when turned or moved, has a fentanyl patch in place, and skin lesions that are closed and dried. Which intervention should the nurse implement?
- A. Give a complete bed bath to further assess the client.
- B. Remove the fentanyl patch as directed by prescription.
- C. Call for ambulance transportation to the hospital immediately.
- D. Discuss end-of-life decisions with the client's parents.
Correct Answer: D
Rationale: Discussing end-of-life decisions with the client's parents is the most appropriate intervention. The client is semi-conscious, sleeps most of the time, and is in significant pain. These symptoms suggest that the client's condition is deteriorating. It is important to have conversations about end-of-life care preferences and decisions to ensure that the client's wishes are respected and that the parents are prepared.
An older adult client has lost 5 lbs (2.3 kg) since their last check-up a month ago. The client maintains good hygiene, still drives, and lives alone. To which organization should the parish nurse refer this client?
- A. The Social Security Administration office.
- B. The Senior Citizen Center.
- C. The Women, Infants, and Children office.
- D. The Adult Day Care Center.
Correct Answer: B
Rationale: The Senior Citizen Center offers a variety of services to older adults, including meal programs, health and wellness programs, and opportunities for social interaction. This could help address the client's weight loss and potential social isolation.
A healthcare provider requested a community health nurse to make weekly visits to a 10-year-old patient for weight reduction, monitoring fingerstick blood glucose levels, and severe headaches. The nurse is reviewing the patient's data. Which data warrants follow-up?
- A. The patient reports being teased by his friends for being “overweight.â€.
- B. The patient prefers solitary play situations.
- C. The patient lives with his mother and younger brother in subsidized housing in an inner city setting.
- D. The patient reports becoming easily short of breath.
Correct Answer: D
Rationale: The patient reporting that they become easily short of breath is a significant concern. Shortness of breath could indicate a number of health issues, including asthma, heart conditions, or other respiratory problems. This warrants immediate follow-up.
The nurse is triaging victims of a tornado at an emergency shelter. An adult who has been wandering and crying comes to the nurse. Which action should the nurse take?
- A. Check the client's temperature, blood sugar, and urine output.
- B. Arrange for the client to be transported for laboratory tests and an electrocardiogram (ECG).
- C. Delegate care of the crying client to an unlicensed assistant.
- D. Direct the client to the shelter's nutrition center to obtain water and food.
Correct Answer: D
Rationale: Directing the client to the shelter's nutrition center to obtain water and food is the best action in this situation. The client may be dehydrated or hungry, which could be contributing to their distress. Providing for these basic needs can help to calm the client and provide a sense of safety and stability.