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The public health RN is called to investigate a report of several cases of varicella at a daycare center. The daycare workers state that 5 children have been sent home over the past 2 weeks with fever and itchy blisters. Which intervention should the RN implement first?
- A. Validate that the children who were sent home had chickenpox.
- B. Ask the parents to take the child to see their pediatrician.
- C. Ask the parents to not send the child back to daycare until after 6 weeks.
- D. Tell the parents to send the child back to daycare; it was a mistake they were sent home.
Correct Answer: A
Rationale: The correct answer is to validate that the children who were sent home had chickenpox. This is crucial in confirming the presence of varicella, which is necessary for appropriate management and control of the outbreak. Option B is not the first intervention because the focus initially is on verifying the cases within the daycare center. Option C is incorrect as it suggests a prolonged exclusion period without confirming the diagnosis. Option D is inappropriate and potentially harmful, as sending a child back without proper assessment can lead to further spread of the infection.
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A client is admitted for COPD. Which finding would require the nurse's immediate attention?
- A. Nausea and vomiting
- B. Restlessness and confusion
- C. Low-grade fever and cough
- D. Irritating cough and liquefied sputum
Correct Answer: B
Rationale: Restlessness and confusion are signs of hypoxia and hypercapnia in a client with COPD, indicating that the client's condition may be deteriorating rapidly. Immediate attention is necessary to prevent further complications. Nausea and vomiting (Choice A) may be related to various factors but do not directly indicate respiratory distress. Low-grade fever and cough (Choice C) are common in COPD and may not require immediate intervention. Irritating cough and liquefied sputum (Choice D) are typical symptoms of COPD exacerbation but do not signal an immediate need for attention as restlessness and confusion.
Which of the following statements is correct regarding community health nursing?
- A. Evaluation of the health status of individuals and families should be done in consultation with them.
- B. The public health nurse (PHN) who works with communication for 6 can solely determine the needs of the community.
- C. Provision of PHN care is not in any way affected by policies of the agency where the nurse works.
- D. Professional growth and development of the PHN is the responsibility of the Department of Health (DOH).
Correct Answer: A
Rationale: The correct statement is that evaluation of the health status of individuals and families should be done in consultation with them. This approach ensures that the assessment is accurate and takes into account the perspectives and concerns of the individuals and families involved. Choice B is incorrect because determining the needs of the community should involve input from various stakeholders, not solely the PHN. Choice C is incorrect as the provision of PHN care can be influenced by the policies of the agency or organization where the nurse works. Choice D is also incorrect as while the DOH may play a role in setting standards, the professional growth and development of a PHN is typically a personal and professional responsibility.
A client has just returned to the medical-surgical unit following a segmental lung resection. After assessing the client, the first nursing action would be to:
- A. Administer pain medication
- B. Suction excessive tracheobronchial secretions
- C. Assist the client to turn, deep breathe, and cough
- D. Monitor oxygen saturation
Correct Answer: B
Rationale: After a segmental lung resection, the priority nursing action should be to suction excessive tracheobronchial secretions. This helps in preventing airway obstruction from secretions, ensuring the patency of the airway and optimizing respiratory function. Administering pain medication can be important but addressing airway clearance takes precedence. Assisting the client to turn, deep breathe, and cough is essential for respiratory hygiene but not the first action immediately post-op. Monitoring oxygen saturation is crucial, but ensuring airway clearance is the priority to prevent complications.
A client asks the nurse about including her 2 and 12-year-old sons in the care of their newborn sister. Which of the following is an appropriate initial statement by the nurse?
- A. Focus on your sons' needs during the first days at home.
- B. Tell each child what he can do to help with the baby.
- C. Suggest that your husband spend more time with the boys.
- D. Ask the children what they would like to do for the newborn.
Correct Answer: A
Rationale: The correct answer is A. Focusing on the older children's needs during the initial days at home is crucial as it helps them feel secure and valued during the transition. This approach allows the children to adjust to the new family dynamics and feel included in the care of their newborn sister. Choice B is incorrect as it focuses on tasks rather than addressing the children's emotional needs. Choice C is not the initial step and does not involve directly addressing the children's needs. Choice D puts the decision-making burden on the children rather than providing guidance and support.
The Healthy People project is designed to:
- A. track health care trends to anticipate insurance liabilities, especially for poor and urban populations
- B. demonstrate that social factors have a significant impact on individual and community health
- C. follow health indicators such as activity, substance use, mental health, and environmental issues
- D. demonstrate that access to health care in the United States is adequate for all populations
Correct Answer: C
Rationale: The Healthy People project is designed to follow health indicators such as activity, substance use, mental health, and environmental issues to improve public health outcomes. Choice A is incorrect because the project focuses on public health indicators rather than insurance liabilities. Choice B is incorrect as the project actually acknowledges the significant impact of social factors on health. Choice D is incorrect because one of the main goals of the Healthy People project is to identify and address disparities in access to healthcare, not to demonstrate that access is adequate for all populations.