Leadership and Community Healt (Answer Key)

ty heal t h Leadershi p and communi s t i on:11of30 Que CORRECT   FLAG A charge nurse is preparing an educational session about addictive disorders for nursing staff. Which of the following should the nurse include as an etiological factor of addictive disorders? (Select all that apply). Being female Low self-esteem Family history of addiction Personality disorders Asian ethnicity There is a higher rate of addictive disorders in men versus women. Low selfesteem is considered a psychological factor associated with addictive disorders. Family history of addiction is an etiological factor associated with addictive disorders. Research supports the link between personality disorders and addictive disorders. Clients of Asian ethnicity have a lower rate of addictive disorders compared to other ethnicities. Que s t i o n:1 3of30 CORRECT   FLAG A nurse is caring for a group of clients. Which of the following clients should the nurse refer to a social worker? (Select all that apply.) A client who requires placement in an assisted living facility. A client who requests to secure an emergency notification system in the home. A client who requests to get school assignments while hospitalized on a pediatric unit. A client who requests to receive additional instructions on breastfeeding prior to discharge. A client who requests to obtain information on the adverse effects of antidepressant medication therapy. MY ANSWER A client who requires placement in an assisted living facility is correct. A social worker can assist in placing a client in an assisted living facility. A client who requests to secure an emergency notification system in the home is correct. It is within the scope of the social worker's expertise to identify community resources to meet client needs after discharge. A client who requests to get school assignments while hospitalized on a pediatric unit is correct. It is within the scope of the social worker's expertise to coordinate with school systems to meet the educational needs of children who are hospitalized. A client who requests to receive additional instruction on breastfeeding prior to discharge is incorrect. Instructions on breastfeeding are within the expertise of the nursing staff to complete, not a social worker. A client who requests to obtain information on the adverse effects of antidepressant medication therapy is incorrect. Antidepressant medications have unpleasant adverse effects which can be addressed by the provider, pharmacist, and nursing staff. This is not within the scope of practice of the social worker. Que s t i o n:2 0o f30 CORRECT   FLAG A nurse on a pediatric unit is caring for a child and his family. His parents define family as a husband, wife, and child. This definition is which type of family form? Extended family An extended family includes aunts, uncles, grandparents, and cousins. Blended family A blended family occurs when two families are brought together to create a new family form. Nuclear family MY ANSWER A nuclear family consists of parents and offspring. Intergenerational family An intergenerational family consists of a family form of two or more generations, such as grandparents caring for children or adult children living with their parents. Que s t i o n:2 1of30 CORRECT   FLAG A nurse is reinforcing teaching about self-care with a client who has pelvic inflammatory disease. The client does not speak English. Which of the following actions by the nurse is appropriate? Ask an assistive personnel (AP) who speaks the client's language to serve as an interpreter. The nurse should avoid using an AP to serve as an interpreter because the AP does not have the knowledge of health care terminology to provide accurate information. Ask the client's English-speaking family member to translate. Avoid using family members, especially children, as interpreters for medical information. Family members or laypersons do not have the knowledge of health care terminology to relay the correct information. Additionally, the client might not want the family to know about her condition. Seek assistance from a facility-approved interpreter. MY ANSWER The nurse should seek assistance from an interpreter who has knowledge of health care terminology. Use a translation dictionary to reinforce the teaching. This action does not provide the client with the opportunity to ask questions or to repeat the information in her own language. Que s t i o n:2 2of3 0 CORRECT   FLAG A nurse is caring for four clients who are postoperative from surgery 24 hr ago. At 1200 the nurse assesses the clients. Which of the following clients is the nurse's priority? A client who has a prescription for insulin and his premeal capillary blood glucose was 110 mg/dL and his post-meal capillary blood glucose is now 160 mg/dL Both blood glucose levels are within the expected reference range. This client is stable; therefore, he is not the nurse's priority. A client whose wound drainage at 0800 was sanguineous and now it is serosanguineous A change in the color of wound drainage from sanguineous to serosanguineous is an expected finding for a client who is 24 hr postoperative from surgery. Therefore, this client is not the nurse's priority. A client who reports pain as 4 on a scale of 1 to 10 at 0800 now reports pain as 6 The nurse should ask the client to rate his pain on a scale of 0 to 10 and provide care to manage the client's pain. However, this client is not the nurse's priority. A client whose blood pressure at 0800 was 138/86 mm Hg and at 1200 is 106/60 mm Hg A client who is postoperative is at risk for hemorrhage. A blood pressure decrease of 15 to 20 points is significant. This client is unstable; therefore, this client is the nurse's priority. Que s t i o n:2 3of3 0 CORRECT   FLAG A nurse is teaching a class on torts. The nurse should include which of the following situations as an example of negligence? A nurse identifies the absence of peripheral pulsation in a casted extremity in the early morning and reports it to the provider in the early afternoon. MY ANSWER Professional negligence is performing practice below the expected standard of care. It can be an act of omission, which is the failure to perform an act that a reasonable prudent person, under similar circumstances, would do. A reasonably prudent nurse would notify the provider of the neurovascular finding immediately. A client who is competent refuses an antidepressant medication. The nurse dissolves the medication in food and administers it to her without her knowledge. Battery is physical contact without the client's consent. Administering a medication against a client's wishes is an example of battery. A client who is alert and oriented makes an informed decision to leave the hospital against medical advice. The nurse applies restraints to the client to prevent him from leaving. False imprisonment is the act of detaining a client against his will without legal warrant. A nurse finds a client who is on a low-sodium diet eating salted potato chips. The nurse tells the client that she will apply wrist restraints if he does not stop eating the potato chips. Assault is the act of verbally threatening a client.  Pre-Assessment Quiz CLOSE Question 24 loaded rationals provided Que s t i o n:2 4o f3 0 CORRECT   PAUSE FLAG Anur s ei st eachi nganewl yl i censednur s eaboutmet hodst or educ ecost sofcl i entcar e.Whi chof henewl yl i c ensednur sei ndi cat esunder st andi ngoft het eachi ng? t hef ol l owi ngst at ement sbyt hr eef our t hsf ul l . " " Ishoul dwai tt oempt ymycl i ent ' sdr ai nabl ecol ost omyunt i li ti st The nurse should empty the client's drainable colostomy when it is one-third to onehalf full. If the nurse waits until it is three-fourths full, the skin seal can break and cause skin breakdown. Therefore, it is not cost-effective for the nurse to plan to take this action. " Ishoul ddel egat epr ov i di ngc l osedi r r i gat i ont ot heass i s t i veper sonnel( AP) . " It is cost-effective to delegate basic tasks to the AP, but the nurse should not delegate a skill requiring the use of sterile technique to the AP. agec l i ent st or ecei v eanannualfl ui mmuni z at i on. " " Ishoul dencour MY ANSWER Cost containment is the delivery of effective and efficient care. Cost is maintained without loss of quality. The nurse should encourage clients to receive an annual flu immunization to prevent the need for treatment and hospitalization necessary with influenza. er i l e " Ishoul dr ecommendt hatmycl i ent swhohav eanes t abl i shedt r acheos t omyusest t echni queathomet opr ovi deos t omycar e. " The nurse should recommend that clients who have a tracheostomy older than 1 month use clean technique to perform tracheostomy care. Qu e st i o n25l oad edr a t i o na l spr o v i de d Que s t i o n:25o f30 CORRECT   FLAG A nurse educator is discussing community mental health with a group of nursing students. Which of the following sites should the educator identify as a source of secondary prevention? Day care center A day care center offers primary public health prevention. Outpatient rehabilitation center An outpatient rehabilitation center offers tertiary public health prevention. Community recreational center A community recreational center offers tertiary public health prevention. Crisis center MY ANSWER A crisis center, which has the goal of early detection and treatment of mental health disorders, is an example of secondary public health prevention. Que s t i o n:26of30 INCORRECT   FLAG A nurse is planning care for four clients and is assigning tasks to a licensed practical nurse (LPN) and an assistive personnel (AP). Which of the following should the nurse assign to the LPN? Complete an admission assessment for a client who has COPD. It is not within the scope of practice for an LPN to complete an admission assessment. The LPN can contribute data, but the RN must complete the plan of care. Measure I&O for a client who has an indwelling urinary catheter. MY ANSWER Even though measuring I&O is within the scope of practice of an LPN, this task does not require a licensed personnel to perform it; therefore, the RN should delegate this task to the AP. Reinforce teaching to a client to begin taking enoxaparin at home following a hip arthroplasty. Reinforcing teaching with a client is within the scope of practice of a LPN; therefore, the RN should delegate this task to the LPN. Develop a plan of care for a client who has cholecystitis. It is not within the scope of practice for an LPN to develop a plan of care. The LPN can contribute to the plan of care, but the RN is responsible for the development of the plan. Que s t i on:27o f30 CORRECT   FLAG A nurse is caring for an older adult client who is disoriented and has a history of falls. Which of the following actions should the nurse take? (Select all that apply.) Raise all side rails on the client's bed. Obtain a prescription to restrain the client PRN. Check on the client hourly. Instruct the client in the use of the call light. Apply an ambulation alarm to the client's leg. MY ANSWER Raise all side rails on the client's bed is incorrect. Raising all side rails is considered a restraint. For a client who is disoriented, the risk for injury is greater with all side rails of the bed raised. If the client attempts to get out of bed, she may try to climb over the side rail or climb out at the foot of the bed. The nurse should place the bed in the lowest position. Obtain a prescription to restrain the client PRN is incorrect. Restraints are not prescribed PRN. Written restraint prescriptions are for a specific event and must have start and end times. Temporary restraints might be needed for clients who are confused, disoriented, repeatedly fall, or try to remove medical devices. Check on the client hourly is correct. Implementation of hourly rounds facilitates safety by reducing client falls. Hourly nursing actions should include toileting, turning, and ensuring that possessions and call lights are within reach. Instruct the client about the use of the call light is correct. Call lights are used for communication with nursing staff. When clients call for and wait for assistance before getting out of bed, the occurrence of accidents and falls is minimized. Nursing staff should make sure the call light is within the client's reach and should instruct the client frequently about its use. Apply an ambulation alarm to the client's leg is correct. The ambulation alarm signals when the client's leg is in a dependent position, such as over the side rail or on the floor. The signal alerts the staff to check on the client immediately. Que s t i on:28o f30 INCORRECT   FLAG A nurse is among the first responders to a mass-casualty incident and does not know what type of personal protective equipment (PPE) is needed. Which of the following actions should the nurse take? Wait until the type of equipment needed is known. The nurse should not delay care to the injured in a mass-casualty incident by waiting to learn which type of PPE is needed. Decontaminate victims before intervening. MY ANSWER The nurse should don PPE prior to implementing decontamination to prevent selfcontamination. Choose the highest level of protection equipment available. When the level or type of PPE is unknown, the nurse should wear the highest level of protection. Use a dosimeter to measure the level of radiation in the area before intervening. The nurse should wear a dosimeter to monitor personal radiation exposure over time; it does not determine the quantity of radiation at a given location. This action also does not prevent personal contact with hazardous materials.