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A nurse is counseling a group of clients from a town that was affected by a hurricane 6 months ago. For which of the following clients should the nurse initiate a referral to assess for the presence of posttraumatic stress disorder? (Select all that apply.)
- A. A client who describes feeling disconnected from those around him following the hurricane.
- B. A client who has frequent nightmares about the hurricane.
- C. A client who expresses a realization that life will not return to the way it was before the hurricane.
- D. A client who describes having persistent feelings of anger about the hurricane.
- E. A client who describes having persistent feelings of anger about the hurricane.
Correct Answer: A, B, E
Rationale: The correct answer is A, B, E. Feeling disconnected, having nightmares, and persistent anger are common symptoms of posttraumatic stress disorder (PTSD) following a traumatic event like a hurricane. Referring these clients for further assessment is crucial to determine if they meet the criteria for PTSD diagnosis. Choice C describes a realistic assessment of the situation and does not necessarily indicate PTSD. Choice D, which is repeated, also describes persistent anger, which is a symptom but is already covered by choice E.
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A nurse in the emergency department is interviewing a client immediately following a sexual assault. Which of the following actions should the nurse take first?
- A. Determine the client's current anxiety level
- B. Evaluating the number of clients presenting with similar diseases
- C. Giving a very informative and engaging presentation
- D. Weighing students to identify those who are overweight
Correct Answer: A
Rationale: The correct answer is A: Determine the client's current anxiety level. This is the first action the nurse should take as it helps assess the immediate emotional well-being of the client. By understanding the client's anxiety level, the nurse can provide appropriate support and interventions to address any distress or trauma experienced. Evaluating the number of clients with similar diseases (B), giving a presentation (C), and weighing students (D) are not relevant or appropriate actions in this situation. The priority is to address the client's emotional needs and ensure their safety and well-being.
What is the primary goal of integrating environmental health into nursing practice?
- A. Improving health care infrastructure
- B. Enhancing patient satisfaction
- C. Promoting environmental justice
- D. Reducing health care costs
Correct Answer: C
Rationale: The primary goal of integrating environmental health into nursing practice is to promote environmental justice. This involves addressing health disparities caused by environmental factors impacting vulnerable populations. By advocating for fair treatment and equal access to a healthy environment, nurses can contribute to improving overall health outcomes. Improving health care infrastructure (A) focuses on facilities and resources, not specifically on environmental justice. Enhancing patient satisfaction (B) and reducing health care costs (D) are important but not the primary goal of environmental health integration in nursing practice.
The nurse is performing an environmental assessment in an apartment building where many people have reported burning eyes, skin rash, stuffy nose, and sore throat. Which type of hazard does the nurse anticipate is present in the apartment building?
- A. Radon
- B. Mice
- C. Mold
- D. Lead
Correct Answer: C
Rationale: The correct answer is C: Mold. Mold can cause symptoms like burning eyes, skin rash, stuffy nose, and sore throat. Mold thrives in damp environments, common in buildings. Radon (A) is a colorless, odorless gas found in soil and can cause lung cancer. Mice (B) can carry diseases but do not typically cause these symptoms. Lead (D) exposure can lead to neurological issues, not the symptoms described. The other choices are not relevant to the symptoms reported.
A school nurse is developing a primary prevention strategy for school-aged children. Which of the following interventions would the nurse most likely implement?
- A. Developing individualized exercise programs for overweight children
- B. Drafting policy for increases in noncompetitive physical activity programs
- C. Monitoring body mass index (BMI) in children to identify elevations before they become difficult to manage
- D. Notifying parents and/or guardians of their child's height–weight scale in comparison with national norms
Correct Answer: B
Rationale: The correct answer is B because drafting policies for increases in noncompetitive physical activity programs aligns with primary prevention strategies. This intervention focuses on promoting overall health and preventing health problems before they occur. This approach targets the entire school population rather than individual children, making it a more effective primary prevention strategy.
Choice A is incorrect as it focuses on individualized interventions rather than population-based prevention. Choice C focuses on early detection rather than prevention. Choice D, while involving parents, does not address primary prevention but rather provides information after the fact.
A nurse is caring for a client who is wearing anti-embolic stockings. Which of the following interventions should the nurse include in the plan of care?
- A. Determine if the stockings are binding
- B. Palpate the distal pulse to the cast
- C. Waits for 2 minutes between suctions
- D. Ask security to detain the client until the provider is notified
Correct Answer: A
Rationale: The correct answer is A: Determine if the stockings are binding. This is important because anti-embolic stockings should not be too tight as it can impede circulation, leading to complications. Palpating the distal pulse to the cast (B) is unrelated to anti-embolic stockings. Waiting for 2 minutes between suctions (C) is not relevant to the care of a client wearing anti-embolic stockings. Asking security to detain the client until the provider is notified (D) is inappropriate and violates the client's rights.