A community health nurse is planning a program for adolescents about preventing STIs. Which of the following actions should the nurse take first?
- A. Collect data to identify barriers to learning
- B. Establish methods to evaluate program outcomes
- C. Obtain visual aids that feature adolescents
- D. Provide computer-based education
Correct Answer: A
Rationale: The correct answer is A: Collect data to identify barriers to learning. This should be the first step because understanding the specific challenges and obstacles that adolescents face in learning about preventing STIs is crucial for designing an effective program. By collecting data, the nurse can tailor the program to address the specific needs of the target audience, ensuring that the information is relevant and accessible.
Choice B, establishing methods to evaluate program outcomes, would come later in the program planning process after the content has been developed and implemented. Choice C, obtaining visual aids featuring adolescents, and choice D, providing computer-based education, are also important but should be considered after identifying barriers to learning to enhance the effectiveness of the program.
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A home health nurse is planning the initial home visit for a client who has dementia and lives with his adult son's family. Which of the following actions should the nurse take first during the visit?
- A. Encourage the family to join a support group
- B. Provide the family with information about respite care
- C. Educate the family regarding the progression of dementia
- D. Engage the family in informal conversation
Correct Answer: D
Rationale: The correct answer is D: Engage the family in informal conversation. This is the first action the nurse should take during the initial visit because building rapport and establishing trust with the family is crucial in the care of a client with dementia. By engaging in informal conversation, the nurse can observe family dynamics, assess the family's understanding of the client's condition, and gather valuable information about the client's daily routine and needs. This lays the foundation for effective communication and collaboration moving forward.
A: Encouraging the family to join a support group can be beneficial but should come after establishing rapport and assessing the family's needs.
B: Providing information about respite care is important, but it is not the priority during the initial visit.
C: Educating the family about the progression of dementia is important, but it should be done after building rapport and assessing their current understanding.
A nurse is providing teaching to a 50-year-old female client. Which of the following statements should the nurse include in the teaching?
- A. You should have a complete eye examination every 2 years until the age of 64
- B. You should have your hearing screened every 5 years
- C. You should have your stool tested for blood every other year until the age of 74
- D. You should have your fasting blood glucose level checked every 6 years
Correct Answer: A
Rationale: Correct Answer: A - You should have a complete eye examination every 2 years until the age of 64.
Rationale: Regular eye exams help detect common eye conditions such as glaucoma and cataracts early, especially as people age. The American Academy of Ophthalmology recommends eye exams every 2 years for adults aged 40-64. This statement is important for the client's eye health maintenance.
Summary of other choices:
B: Incorrect - Hearing screenings are typically recommended annually for adults over 50, not every 5 years.
C: Incorrect - Stool tests for blood are usually done every year, not every other year until the age of 74, to screen for colorectal cancer.
D: Incorrect - Fasting blood glucose levels should be checked more frequently, at least every 3 years, for early detection of diabetes.
A school nurse is implementing health screening. Which of the following assessment findings should the nurse recognize as the highest priority?
- A. A child who has a BMI of 18
- B. An adolescent who has scoliosis
- C. An adolescent who has psoriasis
- D. A child who has nits
Correct Answer: B
Rationale: The correct answer is B: An adolescent who has scoliosis. Scoliosis is a spinal deformity that can progress and cause serious health issues if left untreated. The school nurse should prioritize this assessment finding to ensure early detection and appropriate interventions to prevent further complications. A: A child with a BMI of 18 may indicate underweight but is not as urgent as scoliosis. C: Psoriasis is a skin condition that may require management but is not immediately life-threatening. D: Nits (lice eggs) are a common issue but do not pose a significant health risk compared to scoliosis.
A nurse is teaching a group of school-age children about healthy snack options. Which of the following snacks should the nurse include?
- A. Cheesecake
- B. Air-popped popcorn
- C. Milkshake made with whole milk
- D. Baked potato chips
Correct Answer: B
Rationale: The correct answer is B: Air-popped popcorn. Popcorn is a whole grain snack that is high in fiber and low in calories, making it a healthy option for school-age children. It provides sustained energy and promotes satiety. It is also a good source of vitamins and minerals. Cheesecake (A) is high in sugar and saturated fat, not a healthy choice. Milkshake made with whole milk (C) is high in sugar and saturated fat, lacking nutritional value. Baked potato chips (D) are still high in fat and calories compared to air-popped popcorn. Overall, air-popped popcorn is the best choice among the options provided for a healthy snack for school-age children.
A charge nurse on a medical-surgical unit is assisting with the emergency response plan following an external disaster in the community. In anticipation of multiple client admissions, which of the following current clients should the nurse recommend for early discharge?
- A. A client who is receiving heparin for deep-vein thrombosis.
- B. A client who is 1 day postoperative following a vertebroplasty.
- C. A client who has cancer and a sealed implant for radiation therapy.
- D. A client who has COPD and a respiratory rate of 44/min.
Correct Answer: B
Rationale: The correct choice is B: A client who is 1 day postoperative following a vertebroplasty. This client is the most stable among the options provided. Early discharge is appropriate because the client is 1 day postoperative, likely past the critical immediate postoperative period. Discharging this client will create space for incoming emergency admissions. Choice A should not be discharged early as managing deep-vein thrombosis with heparin requires close monitoring to prevent complications. Choice C should not be discharged early due to the need for ongoing cancer treatment. Choice D should not be discharged early as the client with COPD and a high respiratory rate of 44/min requires close monitoring and intervention to prevent respiratory distress.