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While assessing a child at the community health clinic, the nurse notes that the toddler has multiple bruises on his legs and buttocks. After reporting suspected child abuse to the supervisor, which action should the nurse take next?
- A. Obtain a restraining order against the father.
- B. Encourage the mother to file a police report.
- C. Ask the child if his father ever spanks him.
- D. Refer the family to protective service agencies.
Correct Answer: D
Rationale: Referring to protective service agencies ensures a specialized investigation and intervention, prioritizing the child's safety and well-being.
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A homeless client with alcohol dependency will be dismissed from the emergency department in 24 hours. The nurse notes that a tuberculin (TB) skin test was prescribed by the healthcare provider. Which intervention is most important for the nurse to implement prior to discharge?
- A. Explain to the client results should be read between 48 and 72 hours.
- B. Identify how the client will follow up to have the results read.
- C. Determine if the client understands the purpose of the tuberculin test.
- D. Give the client written Information about the tuberculosis test.
Correct Answer: B
Rationale: Ensuring follow-up for TB test reading is critical, especially for a homeless client, to confirm diagnosis and prevent missed results.
A graduate nursing student requests information, including laboratory findings and chest x-ray results, about all clients with symptoms of HINI influenza A who have been seen during the last month in a community health clinic. Which action should the charge nurse take?
- A. Provide the information for research purposes only.
- B. Ask the student to sign a standard waiver form.
- C. Obtain written authorization from clients to release the information.
- D. Ask if permission has been obtained from the research committee.
Correct Answer: C
Rationale: Obtaining client authorization ensures compliance with privacy laws like HIPAA, protecting client confidentiality.
On a day when the temperature is expected to drop to below freezing during the night, the nurse is asked to determine which homeless adults are most in need of the limited spaces that are available in a shelter. It is most important for which person to be admitted for the night?
- A. A young person with diabetes mellitus.
- B. A middle-aged person who has hypertension.
- C. An older person who is malnourished.
- D. An adult who was hit by a car 3 weeks ago.
Correct Answer: C
Rationale: A malnourished older person is most vulnerable to hypothermia due to impaired thermoregulation, making shelter critical to prevent cold-related illnesses.
Which measure should the college health clinic nurse implement to reduce the incidence of meningococcal meningitis in college freshmen?
- A. Provide dorm teaching sessions about the need to finish prescribed antibiotic doses.
- B. Encourage incoming freshmen to obtain the meningococcal polysaccharide vaccine prior to dorm living.
- C. Require documentation from incoming freshmen that Haemphilus influenza type b (Hib) vaccinations are current.
- D. Develop a clinic protocol for the prophylactic use of isoniazid for positive reactors.
Correct Answer: B
Rationale: The meningococcal vaccine is the most effective measure to prevent meningococcal meningitis in high-risk dorm settings.
The school health nurse observes that a large percentage of Hispanic children in the elementary school are overweight. Which screening program should the nurse choose to target the highest priority health concern for this population?
- A. Diabetes mellitus.
- B. Hypothyroidism.
- C. English proficiency.
- D. Iron deficiency anemia.
Correct Answer: A
Rationale: Overweight Hispanic children are at high risk for type 2 diabetes, making diabetes screening a priority to detect and manage this condition early, given its increasing prevalence in this population.