Nokea
The community health nurse has been notified of several incidents. Which situation requires immediate follow-up? A client with
- A. pulmonary tuberculosis (TB) is still testing positive despite 2 months of treatment.
- B. hepatitis A who works as a cook at a local healthcare facility.
- C. human immunodeficiency virus (HIV) with an undetectable viral load (VL) and reports having recent unprotected sexual intercourse.
- D. Lyme disease and is refusing further treatment with intravenous antibiotics because of nausea and vomiting.
Correct Answer: B
Rationale: Hepatitis A in a cook (B) poses an immediate public health risk due to potential foodborne transmission, requiring urgent follow-up. Persistent TB (A), HIV with undetectable load (C), and Lyme disease refusal (D) are less immediate threats.
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The nurse is conducting a teaching session with the parents of a child newly diagnosed with asthma. The priority topic for the nurse to cover is
- A. how to use a peak flow meter.
- B. signs and symptoms of an asthma attack.
- C. the need to stay current with immunizations.
- D. community resources available for asthma management.
Correct Answer: B
Rationale: Recognizing signs and symptoms of an asthma attack (B) is critical for parents to initiate prompt intervention, preventing severe exacerbations. Peak flow meter use (A), immunizations (C), and community resources (D) are important but secondary to immediate safety education.
The nurse is planning a staff education program about conflict resolution strategies. Which of the following would be an effective strategy in conflict resolution?
- A. Attempt to compare the person or situation to other people and situations.'
- B. Avoiding the conflict may ease frustration for those involved.'
- C. The goal of conflict resolution is to create a win-win situation for all.'
- D. Passively listen as individuals express themselves.'
Correct Answer: C
Rationale: Aiming for a win-win situation (C) is an effective conflict resolution strategy, promoting mutual benefit and collaboration. Comparing situations (A) is unhelpful, avoidance (B) delays resolution, and passive listening (D) lacks active engagement.
The nurse has obtained assistance from a licensed practical/vocational nurse (LPN/VN). Which tasks would be appropriate for the RN to delegate to the LPN/VN? Select all that apply.
- A. performing tracheostomy care
- B. initiate a transfusion of packed red blood cells
- C. flushing a peripherally inserted central catheter (PICC)
- D. inserting an indwelling urinary catheter
- E. administer enteral feedings via nasogastric tube
- F. titrate a medication
Correct Answer: A, C, D, E
Rationale: LPNs can perform tracheostomy care (A), flush PICCs (C), insert urinary catheters (D), and administer enteral feedings (E) per scope of practice. Initiating blood transfusions (B) and titrating medications (F) require RN judgment due to potential complications and dose adjustments.
The nurse is gathering evidence for a quality improvement committee focused on fall prevention. To provide the highest quality scholarly evidence, the nurse plans on gathering findings from
- A. expert opinions.
- B. randomized controlled trials (RCTs).
- C. C. quantitative studies.
- D. D. qualitative studies.
Correct Answer: B
Rationale: Randomized controlled trials (B) provide the highest level of evidence for fall prevention due to their rigorous methodology. Expert opinions (A), quantitative studies (C), and qualitative studies (D) are lower in the evidence hierarchy.
The registered nurse (RN) supervises a licensed practical/vocational nurse (LPN). Which statement by the LPN/VN requires follow-up by the RN?
- A. I bathed the client already this morning'
- B. I passed out letters and packages to the clients this morning.'
- C. The client refused his prescribed valproic acid, so I snuck it into his food.'
- D. I will be joining the clients with their games today in the day room.'
Correct Answer: C
Rationale: Hiding medication in food (C) is unethical, unsafe, and violates client autonomy, requiring immediate RN follow-up. Bathing (A), distributing mail (B), and joining games (D) are within the LPN’s scope and do not require intervention.