Nokea
The community health nurse believes that immunization rates in a lower socioeconomic section of the city are probably below the target set by the state health department. What action should the nurse take first to intervene with this health problem?
- A. join a political action group that focuses attention on the issue in the local news media
- B. partner with a local children's hospital in setting up free 'shot' clinics in the neighborhood
- C. review current epidemiological population data that might document a low immunization rate
- D. call a meeting of citizens to inform them of the importance of having their children immunized
Correct Answer: C
Rationale: The most appropriate initial action for the community health nurse to take when addressing low immunization rates in a lower socioeconomic area is to review current epidemiological data. By reviewing this data, the nurse can gather evidence that documents the low immunization rate in the community. This information is crucial to support the need for targeted interventions to increase immunization rates. Choices A, B, and D involve actions that may be important at later stages of intervention but are not the first step. Joining a political action group, partnering with a hospital for clinics, or holding a community meeting are all valuable strategies, but they should be based on evidence obtained from reviewing epidemiological data to ensure targeted and effective interventions.
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The healthcare provider is conducting a health assessment for a family in a rural area. Which intervention should the healthcare provider prioritize to address the family's health needs?
- A. Providing information on local healthcare resources
- B. Teaching the family about proper nutrition
- C. Assisting the family in scheduling medical appointments
- D. Connecting the family with transportation services
Correct Answer: A
Rationale: In rural areas, access to healthcare may be limited. Providing information on local healthcare resources is essential to ensure the family can access necessary services. While proper nutrition (choice B) and medical appointments (choice C) are important, having access to healthcare resources is fundamental. Transportation services (choice D) may be helpful but addressing the availability of healthcare resources should be the priority.
The client with liver cirrhosis needs immediate intervention for which abnormal laboratory result?
- A. Prothrombin time (PT) of 14 seconds.
- B. Bilirubin of 1.2 mg/dL.
- C. Albumin of 4 g/dL.
- D. Ammonia level of 80 mcg/dL.
Correct Answer: D
Rationale: An elevated ammonia level of 80 mcg/dL indicates hepatic encephalopathy, a serious complication of liver cirrhosis that requires immediate intervention. Ammonia is a neurotoxin that accumulates in the blood due to impaired liver function, leading to cognitive impairment and altered mental status. Monitoring and lowering ammonia levels are crucial in managing hepatic encephalopathy to prevent further neurological deterioration. Prothrombin time, bilirubin, and albumin levels are important parameters in assessing liver function and overall health status in clients with liver cirrhosis, but an elevated ammonia level poses an immediate threat to neurological function and warrants prompt attention.
An 80-year-old client is given morphine sulfate for postoperative pain. Which concomitant medication should the nurse question that poses a potential development of urinary retention in this geriatric client?
- A. Nonsteroidal anti-inflammatory agents.
- B. Antihistamines.
- C. Tricyclic antidepressants.
- D. Antibiotics.
Correct Answer: C
Rationale: The correct answer is C: Tricyclic antidepressants. Drugs with anticholinergic properties, such as tricyclic antidepressants, can exacerbate urinary retention associated with opioids in older clients. Nonsteroidal anti-inflammatory agents (Choice A) do not typically cause urinary retention. Antihistamines (Choice B) may cause urinary retention but are not the primary concern in this scenario. Antibiotics (Choice D) are not associated with an increased risk of urinary retention compared to tricyclic antidepressants.
The nurse is designing a community health project based on a report provided by the World Health Organization that describes healthcare problems in the United States. Which healthcare issue should the nurse give the highest priority when planning the project?
- A. overuse of diagnostic technology
- B. government-based health insurance
- C. the neonatal and infant mortality rates
- D. number of people without access to healthcare
Correct Answer: D
Rationale: The correct answer is D: number of people without access to healthcare. Ensuring access to healthcare is fundamental to addressing a wide range of health issues and is a priority for improving overall community health. Option A, overuse of diagnostic technology, though important, is not the highest priority when considering basic access to healthcare. Option B, government-based health insurance, is relevant but may not directly address the issue of lack of access for all individuals. Option C, neonatal and infant mortality rates, is crucial but addressing access to healthcare for all individuals is a more immediate and foundational concern for the community health project.
When developing a program to support caregivers of elderly patients, which topic should be prioritized in the first session?
- A. Managing medication schedules
- B. Recognizing signs of caregiver burnout
- C. Effective communication with healthcare providers
- D. Navigating insurance and financial issues
Correct Answer: B
Rationale: Recognizing signs of caregiver burnout is the most critical topic to prioritize in the first session. Caregiver burnout can have detrimental effects on both the caregiver and the elderly patient's well-being. By addressing this issue early on, caregivers can learn to identify the signs of burnout, take necessary steps to prevent it, and ensure they can continue providing effective care for their loved ones. Managing medication schedules, effective communication with healthcare providers, and navigating insurance and financial issues are also important aspects to cover in the program. However, recognizing signs of caregiver burnout is essential for the overall health and quality of care provided by the caregivers.