They often connect at-risk individuals to the work of the health department
Which of the following statements accurately describes public health nurses?
Assisting a sexually active adolescent to receive contraceptive information
Which of the following would be an example of primary prevention?
A family chooses not to inform a client that he is terminally ill. This is an example of
ask the client why he or she sought treatment from the healer, as well as to describe what occurred during the treatment.
When a client shares the fact that he or she has been treated by a lay healer, the most appropriate initial response by the nurse would be to
risk marker for health problems caused by social conditions
The Centers for Disease Control uses race as a
is a helpful cushion against disintegration
For both clients and their families, denial is a common reaction to a diagnosis of chronic illness. As a defense mechanism, denial
Sheltered workshops and programs that encourage public and private industries to use rehabilitated persons to the fullest extent possible are part of
Discussing contraceptive options for a pregnant teenager
Which of the following would be an example of tertiary prevention?
the practices of one's family
For John Westerhoff, spiritual development is a four-stage process that is heavily dependent on
Educating expectant parents on issues related to growth and development
Which of the following would be a primary prevention strategy to prevent child abuse?
Check the woman for adequate IV fluid maintenance
A seventy-year-old woman had a total hip replacement five hours ago. She complains of nausea, but she is still only semi-alert from the surgical anesthesia. Which of the following would be an appropriate first nursing intervention?
Wound site evaluation
Assessment of pain medication effectiveness
A client is in extreme pain following major abdominal surgery. Which of the following is an effective comfort strategy at this time?
"I understand why you want to try this treatment. If you know the name of the herbal medication, I can look for additional information for you."
A middle-aged man who suffers from disabling arthritic pain confides to the nurse that he is going to try a new herbal medicine guaranteed to cure arthritis. Which of the following is the nurse's best response?
a situational loss in which the family's coping mechanisms may be strained.
A nurse is caring for the family of a person who was critically injured in a car accident. Here, the nurse would understand that this family is experiencing
Presence of advance directives
Which of the following represents an area of ethical concern that should be considered when determining the plan of care for a dying patient?
Integrity vs. despair
John is an eighty-two-year-old man who is happily married with twelve grandchildren and twenty great-grandchildren whom he sees quite often; this brings him a lot of joy. Many times, John reflects on his life and is filled with a sense of happiness and great accomplishment. According to Erik Erikson's stages of life span development, in which stage is John?
Her parents can't afford to take her to the doctor.
Which of the following statements describes a socioeconomic factor that would influence a child's growth and development?
Sharon, a pediatric nurse, is performing a routine eye exam on a one-year-old boy in the office when she notes that the child's eyes do not seem to be lining up in the same direction when focusing. Instead, his eyes appear to be crossing. Sharon is concerned because she knows that if left untreated, cross-eye can lead to what condition?
encouraging the teens to delay first sexual encounters.
using peer education to provide sex education materials.
discussing the benefits and risks of sexual activity with teens
A public health nurse is preparing for a lecture she is to present at the local high school discussing responsible sexual behavior. According to Healthy People 2010, all of the following are appropriate interventions for Monica to include
Tammy has been assigned to a diabetic patient with numerous health care needs who is having a difficult time following his diabetic diet. The patient's lab results reveal elevated hemoglobin A1C, cholesterol, and blood sugar levels. Tammy has provided the patient with information on healthy food options for a diabetic and provided instruction on daily exercise. In which phase of the nursing process is Tammy?
Patient's respirations are 38/min and O2 sat is 92%. The nurse administers O2 as prescribed.
An ER nurse is providing care for an eighty-year-old man diagnosed with influenza. According to Maslow's Hierarchy of Needs and the information given, which action should the nurse take first?
Nurse leaving patient alone in room to change into hospital gown and knocking prior to reentry
Which of the following comfort measures is considered indirect?
"I really don't understand why you are scared to take this medicine. I have several other patients I am taking care of, so do you want it or not?"
A labor and delivery nurse is assigned to a patient who has just given birth to her baby via emergency C-section. The patient rates her pain as a 10/10 on the pain scale. The nurse provides the patient with 5 mg Percocet per physician orders. The mother states, "I am afraid I will become addicted to pain medicine if I take that." Which of the following responses by the nurse is a rejecting response?
Teach patient about common irrational fears associated with using opioid analgesics
A home health nurse is visiting a spinal fusion surgery patient who is seven days postoperative. During his assessment, the patient rates his pain as a 9 out of 10 on the pain scale, complaining that he is unable to get any sleep. In addition, he admits to not going to the physical therapist because it is too painful for him to get in and out of the car. The nurse realizes that the patient's comfort is being affected by his pain and therefore formulates several plans of care for him: Patient will take pain medication as prescribed to help alleviate pain, administer pain medications shortly before bedtime to help with sleep, patient will use guided imagery to help him manage pain, and patient will attend all physical therapy appointments. Ten days later, the nurse makes another visit and discovers that the patient has gone to two of his four physical therapy appointments, is still having difficulty sleeping, and rates his pain as an 8 out of 10 on the pain scale. The patient admits to not taking his pain medication as prescribed and states, "I am really concerned that I will become addicted to my pain medications and won't be able to stop using them." Which of the following is the most appropriate adjustment to the patient's plan of care?
"Your husband seems to be exhibiting signs of depression and anger, which is not uncommon with people who suffer from chronic pain. I will assess him for depression, and we can take it from there."
The nurse is evaluating a client who sustained a debilitating back injury several months ago at his job. The client is no longer able to work. Privately, the client's wife tells the nurse that her husband, who used to love outdoor sports and was very active with his children, now lays in bed all day and will hardly speak to anyone. When he does speak, he is extremely angry. Which response by the nurse to the client's wife would be most appropriate?
Development of a deep vein thrombosis (DVT)
A CCU nurse is taking care of a seventy-nine-year-old woman who is one day postoperative following mitral valve replacement surgery. The nurse writes the following in her narrative notes: "Approximately 100 mL drainage from chest tube; patient rates her sternal incision pain a 9 out of 10 on the pain scale; patient has not been up to walk since surgery." About which of the following should the nurse be most concerned if the patient's pain does not get under control?
decreasing the pain impulse.
B. mimicking enkephalin and endorphin.
D. reducing the transmission of noxious stimuli.
Morphine and other opioid medications work to reduce pain in all of the following ways
Ineffective airway clearance related to postoperative incisional chest pain
A nurse is taking care of a patient who is thirty-six hours postoperative following a right thoracotomy. The patient is refusing to perform her breathing exercises and has not been up to walk since her surgery stating, "It hurts too bad to move; I just want to lay here." The patient has been taking 15 mg morphine po q4h and has not had a bowel movement since surgery. Which of the following nursing diagnoses will take priority for this patient?
Internal: Decision support
Dr. Smith, a primary care physician, has a diabetes management clinic in his office. Dr. Smith's RN, Amy, is in charge of running the clinic and seeing all of the patients. She and Dr. Smith meet once a week to go over established protocols and current research associated with long-term diabetic care. In addition, Amy attends diabetic conferences twice a year to make sure her information is up-to-date. Which component of the chronic care module are Amy and Dr. Smith utilizing?
Fear related to possible loss of home because of inability to pay mortgage
A forty-nine-year-old man recently suffered a cerebral vascular accident. He is now bedridden, and his wife has been left responsible for taking care of him and their three teenage children. The man owned his own business and did not have any long-term care insurance; the wife is a stay-at-home mom. The family is receiving social security payments, but it is not enough to pay for their bills, and now their mortgage is four months past due. The family is very concerned that they will lose their house. The wife is unable to get a job, as she needs to stay at home at take care of her husband. They have no family support to help them. Of the following nursing diagnoses, which would take priority?
Encourage the father to discuss the mother's death with his son, and help him express his feelings of sadness about her loss.
A three-year-old-boy's mother has just died. The father asks the nurse what he can do to help the son with his grief response to the loss of his mother. Which of the following nursing interventions is most appropriate?
A forty-three-year-old man with COPD who has about one year left to live
Which of the following patients would be eligible for palliative care but not for hospice care?
Emotional support and healing
Which of the following is not one of the three desired outcomes of hospice care, according to the Hospice and Palliative Care Organization's 1999 statement?
Walter is in the acceptance stage of grief while the family is in the denial stage. Walter and his family are engaged in mutual pretense regarding his impending death.
The nurse is caring for a sixty-nine-year-old man named Walter who is dying from lung cancer. The physician estimates that Walter has less than a month left to live. Walter's family is a consistent presence in the unit and consists of his wife of forty-nine years, named Fannie, and three grown children. Fannie and the children refuse to talk about Walter's impending death. The nurse hears them making such comments as, "When you get out of the hospital we will..." and "Don't be so negative; you can still get better." When the nurse is alone with Walter, he says, "I know that I am going to die and that is okay; I have had a long life and I have done my best to beat this disease. But I know it is going to beat me instead. How do I make my family understand? I feel like I can't even talk to them about my death because they don't want to hear it, so I have given up trying to say anything about it." The nurse observes Fannie and notes that she is extremely tired since she spends most of her days and nights with Walter in his hospital room. She occasionally verbalizes harsh, angry words at the nurses when she feels that they are being "negative" about his condition or his prognosis. As part of her assessment, the nurse would correctly note which of the following about Walter and his family?
Anticipatory grieving related to impending loss
The nurse is caring for a sixty-nine-year-old man named Walter who is dying from lung cancer. The physician estimates that Walter has less than a month left to live. Walter's family is a consistent presence in the unit and consists of his wife of forty-nine years, named Fannie, and three grown children. Fannie and the children refuse to talk about Walter's impending death. The nurse hears them making such comments as, "When you get out of the hospital we will..." and "Don't be so negative; you can still get better." When the nurse is alone with Walter, he says, "I know that I am going to die and that is okay; I have had a long life and I have done my best to beat this disease. But I know it is going to beat me instead. How do I make my family understand? I feel like I can't even talk to them about my death because they don't want to hear it, so I have given up trying to say anything about it." The nurse observes Fannie and notes that she is extremely tired since she spends most of her days and nights with Walter in his hospital room. She occasionally verbalizes harsh, angry words at the nurses when she feels that they are being "negative" about his condition or his prognosis. Which of the following nursing diagnoses would be most appropriate for Walter's spouse Fannie?
anxiety and sleeplessness.
While caring for Dexter, a new patient on the unit, the nurse becomes concerned that Dexter is experiencing sensory overload. The findings that would support this concern are
Infant feeding plans
A nurse who is familiar with Hispanic-American customs would want to initiate a discussion regarding which of the following before discharging Maria with her new infant?
Manipulative body-based therapy and biologically based therapy
Rose will not go see a physician. Instead, she relies on her chiropractor and a health food store owner to give her advice on her health care. She gets chiropractic adjustments three times per week and follows a strict diet of organic whole foods. When she feels ill, she goes to the health food store and purchases supplements based on plants and herbs. Rose is following which types of health practices?
In which of the following energy therapies does the practitioner modulate the person's energy field without physically touching the patient?
While obtaining an initial assessment, the nurse learns that her patient, Malika, is a Mexican American. The nurse recognizes that this heritage places Malika at high risk for
Having limited resources, a community agency wants to offer a primary prevention program for women. Cognizant of the causes of death in women, the agency should target
Collecting immunization information for all of the children in a particular neighborhood
A community health nurse works on all of the following projects. In which one is the nurse working with an aggregate group?
Educate the family about helmet and traffic safety.
The community nurse is working with a family that includes three children aged six, eight, and nine. Which intervention would be most important to include in the family's care plan?
the acute and chronic care of individuals and families
The focus of today's community-based nurse is
According to both community health nursing and public health nursing, what is the primary focus of clinical care?
Home health nurse
Raoul is a fifty-nine-year-old man who lives alone and was recently diagnosed with COPD. He is living at home and learning to manage his disease. Which type of nurse will be most helpful to educate Raoul about how the disease will affect his daily life and how to manage the changes to his activities of daily living?
Risk for injury related to lack of physical support for movement
Karla is a home health nurse conducting an in-home assessment for a new patient named Mabel. Mabel is an eighty-one-year-old woman returning home following hip surgery. She lives with her husband of sixty years, Frank. Frank is eighty-seven years old and is limited in his mobility; he generally uses a walker to move around the home, which is on one level and has no stairs for entry. Until the fall that precipitated Mabel's surgery, she did most of the housecleaning and food preparation. Frank and Mabel are both clear-minded and astute. Mabel has four medications that she must take daily in addition to the pain medication prescribed by her doctor for the postoperative period. The couple has three adult children, but all of them live several hundred miles away and are only able to visit occasionally. Karla formulates all of the following nursing diagnoses for Frank and/or Mabel. Which will take priority?
jumping using both feet
which activity should a nurse suggest to a mother of a normal 2 1/2 y/o child?
an 89 y/o pt states, "i live alone and i have little money. on sunndy days, i don't use my air conditioner. i don't like to get a flu shot". what nursing diangosis would be a priority when using maslow's hierachy of needs?
turn the head side to side before changing lanes to compensate for peripheral vision
which statement best teaches and older adult about safety issues related to driving?
teaching patients about making health care decisions
which nursing aciton would create a healing environment that would best facilitate feelings of self worth in patients in a ltc?
challenge the belief that others always come first
which self healing method should nurses use to foster their own health and well being?
d/c the bath if the child shivers during the sponge bath
which instructions would the nurse provide to a mother asking about how to do a cooling sponge batht for her 5 y/o dtr who has a fever of 102o?
a pt expresses interest in mind body therapies to increase the release of insulin from the pancreas to improve his diabetes. which therapy would the nurse recommend?
how the pain affects self care abilities
the nurse is planning home care for a patient with chronic pain related to degeneration of the vertebrae. which assessment is a priority?
see themselves as sick when the disease interferes with their daily functioning
a patient with a chronic illness says to the nurse, "you know i'm not sick now. i feel better each day". how should the nurse interpret the patient's statement? patients who respond in this way
an active and strong spirituality
the nurse provides care for a patient who has just been placed in an extended care facility. the patient is alert, oriented, and able to do limited self care. which patient attribute would most likely contribute positively to the patient's adaptation to the loss of independence?
which clinical manifestation in an adolescent with CF causes the greatest disruption in the adolescent's ability to successfully attain erickson's stage of identity vs role confusion?
what kind of dancing did you do?
i used to perorm with the NYC ballet, and look at me now!" sobs and 83 y/o patient who is w/c bound. which is the nurse's best response?
brief periods of intense feelings may occur at significant times
which description best describes a substantial resolution of grieving?
stay at the bedside as much as possible
which nursing action best relieves stress for a newly admitted dying patient and his family?
change in respiratory patterns
what is the most distressing change for parents to observe in a dying child?
establish a trusting relationship
the nurse is developing a care plan for a family with a nursing diagnosis of anticipatory grieving related to a dx fo advanced ovarian cancer in the mother. the nurse should consider which intervention to be of primary importance?
which symptom should the nurse report as a common side effect associate with the use of narcotic analgesics in a dying patient?
explore meanings, relationships, and hope with the patient
which psychosocial nursing intervention best supports a dying patient's preferences?
i'm glad the casket can remain open
what statement shows that a family member correctly understands the transplant coordinator's explanation about organ donation?
down and back
the nurse teaches parents to administer ear drops to their 1 y/o child. which action by the parents during administration of the drops indicates that they have understood the instruction?
a patient shows normal vision and hearing but has difficulty making decisions. he is often drowsy and appears depressed. which sensory concern does the patient most likely have?
includes the clinical manifestations of fatigue, irritability, reduced problem solving and scattered thoughts.
to induce relaxation of the ciliary muscle
mydriatics are used during eye surgery for which purpose?
tachycardia, diarrhea, hypertension
which adverse systemic effect may occur when using pilocarpine eye drops?
enhances the pooling of blood in the anterior chamber, so that gravity can aid in keeping the hyphen away from the optical center of the cornea
following a trauma to the eye, a pt experiences a mild hyphen. the nurse instructs the patient to maintain an upright position and rest in bed for a few days. which rationale supports this intervention?
eye pain is not relieved by the ordered analgesic
the nurse is assessing a patient following the removal of a attract. which observation indicates a complication?
during a nursing history a patient indicates high dosage use of furosemide for several years. the nurse should assess this patient for which side effect of the medication?
keep the ear dry when bathing
what should the clinic nurse teach the parent of a child newly diagnosed with acute otitis externa?
risk for fluid volume deficit related to increased fluid output, altered intake, and medications
which is an appropriate nursing diagnosis for a patient with vertigo?
spiritual distress related to perception of disharmony with nature
the wife of a native american patient tells the nurse that her husband is very depressed about his illness. which nursing diagnosis would be most appropriate in this situation?
provide the patient with a diet that is free of pork and pork products
which nursing action best illustrates understanding of the dietary practices of patients who are muslim?
recognizes the origins of her/his own values
which nursing action is essential to provide competent care for families from different cultures?
what ethnic cultural group believes that health is a state of balance within the body?
see health as a harmony between body, mind, and spirit. illness or disharmony results form natural causes or divine punishment
are more likely to accept a scientific modal and see health as a result of their health promotion activities
involves the patient's entire family in the treatment of the patient
a hispanic american patient requests that a curandero be involved in the treatment. what fact should the nurse know about the traditional role of the curandero before formulation a plan of care for the patient?
would you like me to notify your priest?
a hospice nurse is making a home visit to a patient who is roman catholic. the patient tells the nurse that he has not seen a priest yet. which initial response by the nurse would be most therapeutic?
impaired home maintenance management
a home care nurse is visiting a mother of 3 young children who is undergoing chemotherapy. the woman states, "my house has never been so disorganized. i just can't keep up". which priority nursing diagnosis would the nurse identify?
motor vehicle safety
based on the developmental level of school age children, what educational focus should be a priority for the school nurse?
inform school officials about the program
what is the first step the community based nurse would take when preparing a middle school educational program on STD's?
walk vigorously for 20 min at least 3x/wk
the nurse in a workplace setting is discussing potential health problems of the young adult. which instruction will assist in promoting health?
a nurse is screening healthy young adults. which area is included in the health risk screen?
1) follows 3 step command, "go to toilet, use it, and wash your hands".
2)balances on alternate feet with eyes closed
3) ties shoes with a bow
this is the behavior of a 5 y/o
according to psychodynamic theory, an individual who places a high value on self control is most likely to experience which initial response when that control is threatened?
offer pain medications at regular intervals
which primary nursing intervention offers the patient the most comfort during the first 12 hrs following abdominal surgery?
during which stage of growth and development can the nurse begin to use the FACES rating scale in assessing pain in children?
this age group responds to pain by body movement and crying. verbal language is in its infancy
follow up with the patient at frequent intervals
the nurse provides care for a patient with chronic illness. the pt is knowledgeable about the dx and self care, but does not follow the therapeutic routines at home.
an adolescent with which condition will likely have the greatest difficulty coping with the chronic disease?
assist the pt to id safe activity levels
which nursing intervention is a priority for the patient with a chronic illness?
the degree of disability
a patient who is middle aged has been diagnosed with chronic illness. the number of lifestyle changes necessary will be influenced by which factor?
death is considered a passage to the next phase in life
what is the one common characteristic in the conceptualization of death in all cultures?
a pt tells the nurse many details about his parent' death and funeral. he says, "i feel no loss or pain". which defense mechanism is this pt using?
the grieving process involves rapidly changing beliefs and emotions that are manageable over time
which statement characterizes the research finding on the grieving process?
has a healthy self esteem
which characteristic is the most common in successful resolution of the grief response? the person who is grieving ....
discuss the POA for health care
a nurse is starting palliative care with a terminally ill pt who is the single parent of 3 children ages 27, 21, and 17. which step should be taken to assure that the patient's wishes are followed?
the patient is experiencing noisy respirations. it would be unusual to give which medication?
altered body image from surgical scarring
wich loss most strongly impacts an individual's sense of self?
bargaining (is the stage of death that occurs when a person develops hope that death will be postponed)
a 35 y/o athlete is diagnosed with cancer and is told he only had 3 mo left to live. the athlete tells everyone he does not believe that death is going to happen so soon. he believes that his life was not meant to be over yet. in which stage of dying is the athlete?
is the stage of death that occurs when a person feels at peace with life and accepts that death will occur
is the stage of death that occurs when the dying person accepts the certainty of death. a period of _______ tends to occur before full acceptance
instruct the parents on how to control the child's pain
when providing home care for a child who has a terminal illness, which nursing intervention is a priority?
which subjective response to a weber test indicates a conductive hearing loss in the right ear? when compare to the hearing in the left ear, the sound in the right ear is .......
i should not drive the car or truck while wearing the patch
which statement made by a pt being discharged following treatment for a corneal abrasion of the right eye indicates that the nurse's teaching has been successful?
constrict the pupil (pilocarpine is used to treat glaucoma. as a direct acting mitotic, pilocarpine blocks the parasympathetic receptors and stimulates muscles of the pupil and cilia. as a result the pupil constricts)
the nurse is teaching a patient about the use of pilocarpine eyedrops. what should the nurse explain to the patient about the desired effect of this medication?
reduce the production of aqueous humor
this is the role of beta adrenergic blockers like timoptic and carbonic anhydrase inhibitors like trusopt.
place all personal items on the right side of the patient's bedside table
which nursing action should be included in the plan of care for a patient with left homonymous hemianopsia?
assesses the patient's external auditory canal for pressure ulcers
an older adult patient has a new hearing aid. which intervention by the older adults caregiver is correct? the caregiver .....
a large ball with a bell inside it (it provides gross motor and hearing stimulation, key goals for a child who is blind)
which is the most appropriate toy for a 5 y/o child who is blind?
seat the child in the center of a semicircle
which is the best action to recommend to a grade school teacher who is working with a child who has a significant hearing impairment?
is responsible for coordination of movement and integration of information received through the senses
places objects directly in front of the patient (glaucoma patients lose their peripheral vision)
which nursing action is assistive to the care of a patient who has advanced glaucoma?
the patient has different personal space requirements than the nurse
a pt from a different culture steps back whenever a staff member approaches. the nurse's response should be based upon which understanding?
asking about the meaning of a patient's religious medal
which nursing behavior demonstrates cultural competency?
urge the patient to mention the use of ginseng to the dr
an asian patient who has dm reports drinking a ginseng preparation. which initial action by the nurse would be best?
the incidence of a specific illness in the population at a particular time
which describes morbidity?
assist the family member in considering alternative care options
a community health nurse has made several visits to the family of a patient with alzheimer's disease. a family member states, "i have no time for myself". which intervention is most appropriate?
the medical condition of the patient is predictable
what is the most important criterion to consider when home care is the proposed care setting?
modulation of the ascending pain signal from the dorsal horn (nonadrenergic agonists attach to alpha 2 nonadrenergic receptors in the dorsal horn, thereby modulating the ascending pain signal)
by which mechanism do nonadrenergic drug agonists relieve pain?
what binds to receptors in te dorsal horn, inhibit release of neurotransmitters, and interfere with the relay of the pain signal across the synapse
1) tells his parent that he feels better
2)states he is really hungry
which observations indicate that the analgesic administered postoperatively to a 7 y/o child may be effective?
ensure the patient's access to knowledge and respectful treatment
as the patient advocate, the nurse should make which of the following a priority action in the care of a chronically ill patient?
assist patients in setting priorities for important self care activities
which action should the nurse include in the plan of care to enable patients with a chronic illness to develop a realistic plan for daily living?
a patient who is dying from lung cancer remarks, " cancer has made me want to be closer to god". which spiritual concept is the patient experiencing?
is thought to involve a person's recognition that there is something greater than the self
is an action taken by a person related to an act or attitude formerly committed. it often brings relief from feeling of shame and/or guilt
discuss the POA for health care
a nurse is starting palliative care with a terminally ill patient who is the single parent of 3 children ages 27, 21, and 17. which step should be taken to assure that the patient's wishes be followed?
flashing lights, a shower of spots or a sensation of a curtain being pulled down over part of the visual field
the nurse is assessing a patient with a retinal detachment should expect the patient to present with which sign?
provides an interpreter for patients who do not speak english
which nursing action demonstrates cultural competence in patient care?
occult blood testing each year is recommended for men and women beginning at age 50
a 52 y/o woman questions the need for colorectal screening. which is the most appropriate response by the nurse?
after the disease has occurred BUT before the person notices that anything is wrong