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When the nurse identifies what appears to be ventricular tachycardia on the cardiac monitor of a client being evaluated for possible myocardial infarction, the first action the nurse should perform is to
- A. Begin cardiopulmonary resuscitation
- B. Prepare for immediate defibrillation
- C. Notify the 'Code' team and healthcare provider
- D. Assess airway, breathing, and circulation
Correct Answer: D
Rationale: The correct first action for the nurse to take when identifying what appears to be ventricular tachycardia in a client being evaluated for possible myocardial infarction is to assess the client's airway, breathing, and circulation. This step is crucial to determine the client's stability and the need for immediate intervention. Beginning cardiopulmonary resuscitation or preparing for immediate defibrillation without first assessing the airway, breathing, and circulation could delay potentially life-saving interventions. Notifying the 'Code' team and healthcare provider should come after ensuring the client's immediate needs are addressed.
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The nurse is conducting a process evaluation of a prevention education program for older adults who are at risk for substance abuse. Which data source provides the information the nurse needs to conduct this process evaluation?
- A. client's score on an alcohol screening instrument
- B. results of a urine drug and alcohol screen
- C. most recent community census data
- D. documentation of client education in the nursing record
Correct Answer: D
Rationale: Correct! Documentation of client education in the nursing record is the most appropriate data source for conducting a process evaluation of a prevention education program. This documentation provides insight into the educational process, its implementation, and the quality of education delivered. Choices A and B focus on assessing the clients directly for substance abuse, which is different from evaluating the educational process. Choice C, the most recent community census data, is not directly related to evaluating the specific prevention education program for older adults at risk for substance abuse.
The home health care agency can expect to obtain Medicare reimbursement for which home visit performed by a registered nurse or a practical nurse?
- A. assessment of the speech pattern of a mobile adult who had a mild stroke last year
- B. safety teaching for an older male client whose wife complains that he uses an unsafe ladder while painting
- C. wound care for a client who had postoperative infection following abdominal surgery two weeks ago
- D. evaluation of crutch use by a 65-year-old client who broke his tibia while snow skiing
Correct Answer: C
Rationale: The correct answer is C because wound care for a postoperative infection qualifies for Medicare reimbursement. Medicare typically covers skilled nursing care, like wound care, required due to a postoperative infection. Choices A, B, and D involve assessments, teaching, and evaluation, which may not always be eligible for Medicare reimbursement unless they are directly related to skilled nursing care for a specific medical condition.
What title should be given to this role in the occupational health nurse job description? A registered nurse who teaches and prepares nursing students to function as expert clinicians/practitioners, administrators, educators, researchers, or consultants at the work site.
- A. researcher
- B. case manager
- C. health educator
- D. health promotion specialist
Correct Answer: C
Rationale: The correct title for the role described in the job description is a health educator. A health educator is responsible for teaching and preparing nursing students for various professional roles. Choice A, researcher, is incorrect because the main focus in the job description is on teaching and preparing students, not conducting research. Choice B, case manager, does not align with the role of teaching and preparing nursing students. Choice D, health promotion specialist, is also not the best fit as the primary focus in the job description is on education and preparation, rather than promoting health within a specific population.
A client has developed thrombophlebitis of the left leg. Which nursing intervention should be given the highest priority?
- A. Elevate leg on 2 pillows
- B. Apply support stockings
- C. Apply warm compresses
- D. Maintain complete bed rest
Correct Answer: A
Rationale: The highest priority nursing intervention for a client with thrombophlebitis of the left leg is to elevate the leg on 2 pillows. Elevating the leg helps reduce swelling and pain associated with thrombophlebitis by promoting venous return. Applying support stockings (choice B) can be beneficial but is not the highest priority as elevation is more effective in the acute phase. Applying warm compresses (choice C) may worsen the condition by dilating the blood vessels, leading to increased pain and swelling. Maintaining complete bed rest (choice D) is important, but elevation takes precedence to improve circulation and reduce the risk of complications.
The social ecological model considers the complex interplay between which levels of influence?
- A. Individual, interpersonal, organizational, community, and policy
- B. Genetic, biological, environmental, social, and economic
- C. Personal, family, community, national, and global
- D. Health, wealth, education, environment, and politics
Correct Answer: A
Rationale: The correct answer is A: Individual, interpersonal, organizational, community, and policy. The social ecological model examines how individual, interpersonal, organizational, community, and policy factors interact to influence health and well-being. Choice B is incorrect because it includes genetic and biological factors that are not part of the social ecological model. Choice C is incorrect as it does not include organizational and policy levels of influence. Choice D is incorrect as it includes wealth and politics, which are not typically considered in the social ecological model.