Nokea
Which of the following is the best intervention for a client with less than 6 months to live who is seeking comfort care?
- A. Set up a meeting with the hospice team
- B. Arrange a meeting with the client's family
- C. Discuss advance directives (DNR & living will) with the patient
- D. Ask the provider to decrease the patient's heart medications
Correct Answer: A
Rationale: The correct answer is A: Set up a meeting with the hospice team. This is the best intervention because hospice care focuses on providing comfort and support for terminally ill patients. By involving the hospice team, the client can receive specialized care tailored to their needs, including pain management and emotional support. Arranging a meeting with the family (B) may be important but not the immediate priority. Discussing advance directives (C) is important but can be done after ensuring the client's comfort care needs are addressed. Asking the provider to decrease heart medications (D) should only be done after consulting with the hospice team.
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The public health RN is engaging with a teen in his community who is concerned about how he will be able to stay part of his friend group when they are all vaping and your client does not want to take part but does not want to feel awkward. Using motivational interviewing techniques, the RN says to the client, 'I understand this concern. Please tell me more about this and how it feels awkward for you.' The RN's question is an example of:
- A. Moving the teen to find a new friend group.
- B. Addressing the problem of teen awkwardness.
- C. Agreeing that awkwardness is hard.
- D. Using open-ended questioning.
Correct Answer: D
Rationale: The correct answer is D: Using open-ended questioning. The RN's question is open-ended, allowing the teen to express thoughts and feelings freely. This technique helps the client explore their concerns and motivations, fostering self-reflection and problem-solving. This approach aligns with motivational interviewing principles, aiming to evoke the client's own reasons for change.
Choices A, B, and C are incorrect:
A: Moving the teen to find a new friend group - This option involves a directive approach, which is contrary to motivational interviewing's collaborative and client-centered nature.
B: Addressing the problem of teen awkwardness - While acknowledging the teen's feelings, this choice focuses on the issue rather than facilitating the client's exploration of their own perspective.
C: Agreeing that awkwardness is hard - This choice reflects empathy, but it does not encourage the client to elaborate on their feelings and thoughts, limiting the depth of the conversation.
What factor most influences health disparities?
- A. Genetic factors
- B. Lifestyle choices
- C. Access to health care services
- D. Cultural beliefs
Correct Answer: C
Rationale: The correct answer is C: Access to health care services. Health disparities are largely influenced by unequal access to healthcare services, leading to disparities in health outcomes. Lack of access can result in delayed diagnosis, inadequate treatment, and poor management of health conditions. Genetic factors (A) play a role in health, but they do not solely determine health disparities. Lifestyle choices (B) can impact health but are often influenced by socio-economic factors, which tie back to access to healthcare. Cultural beliefs (D) can impact health behaviors, but without access to appropriate healthcare, disparities will persist.
When studying for an epidemiology quiz, what does public health nursing surveillance involve?
- A. Having all carriers transferred to one main facility for care
- B. Gathering data to work toward primary illness prevention
- C. Establishing the incubation period of a disease
- D. Determining the colonization rate of the disease
Correct Answer: B
Rationale: Step-by-step rationale for why choice B is correct:
1. Public health nursing surveillance involves gathering data to prevent illnesses before they occur.
2. Surveillance helps identify trends and risk factors for diseases to inform prevention strategies.
3. By focusing on primary prevention, surveillance aims to reduce the burden of disease on populations.
4. Choice A is incorrect as it does not align with the purpose of surveillance.
5. Choice C is incorrect as establishing the incubation period is part of disease investigation, not surveillance.
6. Choice D is incorrect as colonization rate determination is more focused on transmission dynamics, not surveillance.
What is the FIRST STEP for thermal protection of a newborn?
- A. Drying the baby thoroughly immediately after birth
- B. Covering the baby with a clean, dry cloth after the cord has been cut
- C. Drying the baby thoroughly after the cord has been cut
- D. Covering the baby with a clean, dry cloth immediately after birth
Correct Answer: A
Rationale: The correct answer is A: Drying the baby thoroughly immediately after birth. This is the first step for thermal protection as it helps prevent heat loss and hypothermia in the newborn. By drying the baby immediately after birth, any amniotic fluid on the skin is removed, allowing the baby's body temperature to stabilize. Covering the baby with a clean, dry cloth after drying would be the next step to maintain warmth. Choices B, C, and D are incorrect because they do not address the crucial initial step of drying the baby immediately after birth to prevent hypothermia.
When assisting clients in changing their behavior, what would be the most effective approach?
- A. Counseling through the Ask, Advise, Assess, Assist, and Arrange approach
- B. Encouraging them to interact with others who also need to change their behavior
- C. Showing them how the inappropriate behavior is hurting their friends and family
- D. Using subtle rewards when small steps are taken toward the appropriate behavior
Correct Answer: A
Rationale: The correct answer is A because the Ask, Advise, Assess, Assist, and Arrange approach is evidence-based and widely recognized for behavior change. Asking about behavior, advising to change, assessing readiness, assisting in making changes, and arranging follow-ups are key steps in effective behavior change interventions. Encouraging interaction with others (B) may help, but not as structured as A. Guilt-tripping (C) can lead to resistance and harm the therapeutic relationship. Subtle rewards (D) may provide short-term motivation but lack the systematic approach of A.