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The school nurse who is reviewing immunization records of students who will start kindergarten within the next month notes that most of the students have only received one dose of the measles, mumps, rubella (MMR) vaccine. Which intervention should the nurse implement?
- A. Contact kindergarten parents to remind them that the second dose of MMR is due at the start of the school year.
- B. Send notices home with the children on the first day of class advising that MMR vaccine series must be completed.
- C. Note in student records that the second dose of the MMR vaccine should be administered prior to entering first grade.
- D. Speak at the next parent-teacher association meeting to teach parents the benefits of immunizing their children.
Correct Answer: A
Rationale: Contacting parents before the school year ensures timely MMR second-dose administration, meeting school entry requirements.
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Tuberculosis (TB) screening at a federal prison reveals that two inmates have a positive skin test. Which action is most important for the nurse to take?
- A. Rescreen the entire prison population in 6 weeks.
- B. Start the two inmates on antitubercular medications.
- C. Refer the two Inmates for chest x-rays.
- D. Screen the prison guards for TB.
Correct Answer: C
Rationale: A chest x-ray is essential to determine if the positive skin test indicates active TB or latent infection, guiding appropriate treatment and preventing unnecessary medication use.
The school nurse is assessing a group of middle school students for signs of scoliosis and discovers a student with a noticeable unequal symmetry of the upper and lower back. Which intervention is most important for the nurse to implement?
- A. Make a referral to have the scoliosis further evaluated.
- B. Measure the degree of the thoracic and lumbar curvature.
- C. Ask about the student's ability to participate in sports.
- D. Review students health record for a recent growth spurt.
Correct Answer: A
Rationale: Referring for further evaluation by a specialist ensures accurate diagnosis and timely management of potential scoliosis, addressing the observed asymmetry.
A school nurse identifies 15 new students with positive tuberculin tests among the 500 at-risk students tested. Which is the rate per 1,000 with new positive tests?
- A. 3/1,000.
- B. 30/1,000.
- C. 1.7/1,000.
- D. 15/1,000.
Correct Answer: B
Rationale: The rate is calculated as (15/500) * 1,000 = 30/1,000, accurately reflecting the proportion of students with positive tests per 1,000.
The nurse is working with a Parent Teacher Organization (PTO) to increase safety for children walking to and from a nearby elementary school. Which action should the nurse include to help achieve this goal?
- A. Encourage residents with older homes along the school route to get their homes inspected for excessive lead levels.
- B. Advise the residents to keep their porch lights on during hours that children are walking to and from school.
- C. Lead a discussion about the benefits of designated safe houses located throughout the school neighborhood.
- D. Help the residents plan a campaign to remind people driving through the school zone to wear seatbelts at all times.
Correct Answer: C
Rationale: Designated safe houses provide a structured safety measure, offering refuge for children in emergencies, directly enhancing pedestrian safety.
A nurse is interested in studying the incidence of infant death in a particular city and wants to compare that city's rate to the state's rate. Which state resource should the nurse select to gather this information?
- A. Census data.
- B. Bureau of Vital Statistics.
- C. Disease registry.
- D. Department of Health.
Correct Answer: B
Rationale: The Bureau of Vital Statistics provides detailed data on vital events like deaths, making it the best resource for accurate infant mortality rates for city and state comparisons.