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The nurse is documenting the medical history of a young adult client who was recently diagnosed with type 1 diabetes mellitus. The client smokes 2 packs of cigarettes daily and the client's father died of a heart attack at the age of 45. Which annual screening is most important for the nurse include?
- A. Renal insufficiency.
- B. Peripheral neuropathy.
- C. Hyperlipidemia.
- D. Retinopathy.
Correct Answer: C
Rationale: Given the client's smoking habit and family history of early heart attack, screening for hyperlipidemia is critical to address cardiovascular risk, which is heightened by these factors and diabetes.
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The community health center has noticed a dramatic increase in influenza cases over prior years. The facility nurses have been charged with reviewing outcome data to determine if there is a trend in vaccination rates, and if a trend is noted, reasons for decline. An action plan will be developed to increase rates, if needed. The facility nursing team develops a plan to survey the community and facility records. Select all applicable action(s) that will facilitate gathering data for analysis.
- A. Client survey both in clinic and in the home
- B. Ask a set number of clients if they have had the flu
- C. Determine change in immunization rates from prior year to current year
- D. Generate influenza immunization and case reports from the electronic record for prior year and current year
- E. Develop an action plan to increase immunization rates
- F. Delineate geographic distribution of area to survey and review for patterns
Correct Answer: A,C,D,F
Rationale: Surveys (A), immunization rate changes (C), electronic record reports (D), and geographic distribution analysis (F) provide comprehensive data to identify vaccination trends and patterns.
During a community health screening fair for older adults, the nurse observes a client who has pale, bluish feet, with sores on both lower extremities that are healing poorly. Which intervention should the nurse implement?
- A. Refer to healthcare provider for complete evaluation.
- B. Send client to the emergency department for treatment.
- C. Instruct client to apply antibiotic ointment to sores.
- D. Create a list of foods that promote wound healing.
Correct Answer: A
Rationale: Pale, bluish feet with poor-healing sores suggest serious conditions like peripheral vascular disease, requiring a comprehensive healthcare provider evaluation.
The nurse is planning a health fair for high school students. Which assessment is most important for the nurse to obtain?
- A. Weight and height.
- B. Sexual activity.
- C. Immunization history.
- D. Visual acuity.
Correct Answer: B
Rationale: Assessing sexual activity is critical for high school students to address sexual health, STIs, and pregnancy risks, guiding tailored education and interventions.
A community health nurse is helping a group of nursing students plan a tertiary prevention program for a local community clinic that serves a majority Hispanic population. Which service project meets the requirement of a tertiary prevention program and would best serve this population?
- A. Teach clients about recommended immunizations for children.
- B. Instruct teens about prevention of sexually transmitted diseases.
- C. Take blood pressures at a local shopping mall in the community.
- D. Demonstrate foot care to a group of clients who have diabetes.
Correct Answer: D
Rationale: Demonstrating foot care for diabetic clients is tertiary prevention, focusing on managing complications of an existing condition, highly relevant for a Hispanic population with a high prevalence of diabetes.
One hundred families in a community refuse to have their children immunized because of religious beliefs. When one documented case of whooping cough occurs within this aggregate, which intervention should the nurse implement?
- A. Immunize all children under age 5 in the one hundred family aggregate.
- B. Immunize all members of the one hundred families.
- C. Quarantine the one hundred family aggregate.
- D. Quarantine all family members of the child with whooping cough.
Correct Answer: D
Rationale: Quarantining the affected child's family members prevents whooping cough spread, targeting those most likely exposed.