Follow Facility Policy To Activate The Disaster Plan

A chare nurse in an emergency department is informed that a tornado touched down in a nearby town and mass casualties are en route. which of the following actions should the nurse take first? A. Follow Facility policy to activate the disaster plan B. Prepare the triage rooms. C. Obtain additional supplies D. Call in off-duty staff A is correct The nurse has little information other than that several clients are expected in a short period of time. According to evidenced-based practice, the nurse should first follow the facility's policy for activating the disaster plan (this might mean calling the nursing supervisor or the administrator). The disaster plan will then delineate the role and responsibilities of all responders, ensuring that clients are treated in a safe and orderly manner by an adequate number of caregivers. b. The nurse should prepare the triage rooms to facilitate rapid client prioritization; however, evidence-based practice indicates that the nurse should take a different action first. c. The nurse should obtain additional supplies to ensure the emergency department is stocked and ready for treatment of clients; however, evidence-based practice indicates that the nurse should take a different action first. d. The nurse might need to call in off-duty staff to care for a high number of incoming clients; however, evidence-based practice indicates that the nurse should take a different action first. A nurse is planning to participate in a public educaiton program about prevention of West Nile virus. Which of the following instructions should the nurse include in her presentation? A. "Eliminate sources of standing water." B. "Make sure your immunizations are up to date." C. "Keep all of your pets indoors." D. "Spray insect nests with a repellant that contains DEET." A is correct Standing water provides an environment for mosquitoes to lay eggs. Therefore, clients should empty water from flower pots, pet food and water dishes, birdbaths, swimming pool covers, buckets, barrels, and cans at least once per week. Discarded tires and other items that collect water should be disposed of. b. There is no known immunization against the West Nile virus; therefore, clients should be educated about other prevention measures. c. West Nile virus is not transmitted through pets, but can be transmitted from person to person through blood products, breast milk, or organ transplantation. d. West Nile virus can be transmitted when an infected mosquito bites a human to take in blood. Diethyltoluamide (DEET) is the most effective and best-studied insect repellent available. Studies using humans and mosquitoes report that only products containing DEET offer long-lasting protection after a single application; however, DEET only repels, it does not kill. There would be no benefit to spraying DEET anywhere except on the human body or clothing. A nurse is performing a community assessment in a rural setting. Which of the following types of health care should the nurse recognize is most likely to be absent in this setting? A. Tertiary care B. Primary prevention C. Chronic care D. Secondary prevention A is correct Tertiary care, or specialized care through consultation, is usually obtained following a referral from a primary care provider. Specialists provide tertiary care and typically work in large medical centers that have personnel and facilities for special procedures. This level of care is not readily available in most rural settings. b. Primary prevention is the prevention of disease before it happens, such as through immunizations or wellness promotion. Primary prevention usually takes place in either a primary care provider's office or wellness clinic. Primary care providers, although not as numerous in rural settings, are more available than other levels of care. Providers and nurses trained in family practice or internal medicine traditionally provide primary care and primary prevention in rural settings. c. Chronic care is required by clients who have chronic health conditions. Primary care providers provide care to clients who have chronic conditions in rural communities. In this setting, clients who have chronic care needs are often provided care by family members in the home. Continuing or long-term health care can also be found in long-term care facilities. d. The focus of secondary prevention is early detection and treatment of acute illness and injury to prevent disability and mortality. This type of care is typically provided in a primary care provider's office or wellness clinic. Primary care providers, although not as numerous in a rural setting, are more available than other levels of care. A triage nurse is in an emergency department when several hundred clients who were injured in a train collision arrive at the facility for treatment. The nurse should determine that which of the following clients requires immediate treatment? A. A client who has neck pain and was transported to the facility on a backboard B. A client who has epigastric and left-arm pain and is diaphoretic C. A client who has nasal and orbital ecchymosis and a respiratory rate of 16/min D. A client who has abdominal pain and is 2 months pregnant B is correct The nurse should apply the unstable versus stable priority-setting framework. Using this framework, unstable clients are the priority because of needs that threaten the client's survival. Threats or problems involving the airway, breathing, or circulatory status are life-threatening needs that the nurse should address first. Clients whose vital signs or laboratory values indicate a risk for becoming unstable are also a higher priority than clients who are stable. The nurse might also need to use nursing knowledge to determine which option describes the most unstable client. Therefore, the triage nurse should recognize that a report of severe epigastric and left-arm pain accompanied by diaphoresis is a classic manifestation of a myocardial infarction, which is life-threatening. This client needs immediate treatment. a. A client who has neck pain and was transported to the facility on a backboard is stable; therefore, there is another client the triage nurse should recommend for immediate treatment. Neck pain is most commonly associated with a whiplash injury. c. A client who has nasal and orbital ecchymosis and a respiratory rate of 16/min is stable; therefore, there is another client the triage nurse should recommend for immediate treatment. A broken nose or a black eye is common following a collision. A respiratory rate of 16/min indicates that the client has an adequate airway. d. A client who has abdominal pain and is 2 months pregnant is stable; therefore, there is another client the triage nurse should recommend for immediate treatment. Although the client's pregnancy can cause a complication, at 2 months of gestation little can be done to prevent fetal demise if she has suffered serious abdominal trauma. A nurse is providing teaching to a client who has a prescription for ciprofloxacin following exposure to anthrax. Which of the following statements by the client indicates that further teaching is required? A. "I will limit my intake of coffee, tea, or cola beverages." B. "I will wear a large-brim had and long sleeves if I am out in the sun." C. "I will take the ciprofloxacin with an antacid if I get an upset stomach." D. "I will avoid taking ciprofloxacin along with dairy products." C is correct Ciprofloxacin is an antibiotic prescribed for a wide range of serious skin infections and is also effective against inhalation anthrax. Taking ciprofloxacin with antacids can impair the absorption of the medication, reducing its effectiveness. a. Ciprofloxacin is an antibiotic prescribed for a wide range of serious skin infections and is also effective against inhalation anthrax. The client should avoid caffeine while taking ciprofloxacin because it can trigger adverse effects of the nervous system, including irritability, anxiety, and restlessness. b. Ciprofloxacin is an antibiotic prescribed for a wide range of serious skin infections and is also effective against inhalation anthrax. A common adverse effect of ciprofloxacin is extreme photosensitivity, so clients taking ciprofloxacin must avoid sun exposure to prevent sunburns and blistering. d. Ciprofloxacin is an antibiotic prescribed for a wide range of serious skin infections and is also effective against inhalation anthrax. Taking ciprofloxacin with dairy products can impair the absorption of the medication, reducing its effectiveness, so clients should not take ciprofloxacin with milk or other dairy products. A community health nurse is planning a study with the goal of improving the environmental health of a community. Identify the sequence the nurse should follow when conducting the research. Design the study. Formulate the research questions. Analyze the findings. Review related literature. 1. Formulate the research questions 2. Review related literature 3. Design the study 4. Analyze the findings The nurse should use proper scientific process in developing and conducting nursing research. First, he should formulate the research questions. Next, he should conduct a thorough review of the related literature. Next, he should select the research design. Then, after collecting results, he should analyze the data. An industrial health nurse is caring for a client who states, "I have been under a lot of stress lately. " When the nurse suggests stress management techniques, the client calmly states that he has a pistol in his car and intends to take his life in the parking lot after work that day. Which of the following actions should the nurse take? A. Have the industrial facility's security officers search the client's car and remove the pistol. B. Call emergency medical services to transport the client to a proper treatment facility C. Contact the client's family member to pick him up from work and take him for treatment. D. Explore with the client the reasons he feels that he has no options except suicide. B is correct Client safety is the nurse's primary concern. The client must be transported to a treatment facility as soon as possible. In addition, the nurse should not leave the client alone until he is safely evaluated by or admitted to a proper care facility. a. There may be privacy and legal issues associated with having a facility employee enter a client's private vehicle. c. Privacy issues and HIPAA regulations restrict the nurse from contacting the client's family without his permission. In addition, once the client has revealed his suicidal intent to the nurse, it is the nurse's responsibility to make certain that he receives proper mental health care as soon as possible. d. Once the client has revealed his suicidal intent to the nurse, it is the nurse's responsibility to make certain that he receives proper mental health care as soon as possible. The tertiary intervention phase will involve exploration of the client's feelings about suicide. A public health nurse is caring for an older adult client who has chronic airflow limitation disease and is a former cigarette smoker. The client's medications include ipratropium bromide and albuterol inhalers, and she has a new prescription for home oxygen to use as needed. The nurse should recognize that this client's primary prevention needs include which of the following? A. Periodic pulmonary function tests B. Review of appropriate use of oxygen in the home C. Yearly mammography examinations D. Annual influenza immunizations D is correct An influenza immunization is an example of primary prevention. This client should receive influenza immunizations annually because she is at increased risk for complications of influenza. a. Periodic pulmonary function tests for a client who has an existing lung disorder are an example of tertiary prevention. b. Review of appropriate use of oxygen in the home is an example of tertiary prevention. c. Screening examinations, such as a mammogram, are examples of secondary prevention. A charge nurse in an emergency department is notified by the county's emergency medical services that there has been a multiple- casualty crash involving a truck carrying radioactive waste. Which of the following actions should the nurse take first? A. Designate a decontamination area to accommodate clients who are irradiated B. Notify the admissions office to clear as many critical care beds as possible C. Clear the department of all nonurgent clients and move those awaiting admission to a holding area. D. Determine the number of casualties the emergency department can accommodate C is correct Evidenced-based practice indicates the nurse should first clear the emergency department of nonurgent clients and open up as many treatment areas as possible. Casualties of the crash will be brought to the emergency department, so the nurse must make room to accommodate the high number of clients. a. The nurse should designate an area in which to decontaminate clients who are irradiated to prevent cross contamination of hospital staff; however, evidence-based practice indicates that the nurse should take a different action first. b. The nurse should notify the admissions office to clear critical care beds to allow for treatment of incoming clients who may have more critical injuries; however, evidence-based practice indicates that the nurse should take a different action first. d. The nurse should determine the number of casualties the emergency department can accommodate as an ongoing part of managing the flow of people in and out of the facility and to ensure resources are not overwhelmed. However, evidence-based practice indicates that the nurse should take a different action first. A home health nurse is caring for a client who is living in a mental health group home. During a visit, the nurse discovers that the client has been hoarding psychotropic medications. Which of the following actions should the nurse take first? A. Have the client transported to an acute care facility. B. Determine the reason for the client's hoarding behavior C. Alert the staff that has been administering the client's medications D. Require the client to return any hoarded medications B is correct The nurse should apply the nursing process priority-setting framework when caring for this client. The nurse can use the nursing process to plan client care and prioritize nursing actions. Each step of the nursing process builds on the previous step, beginning with assessment or data collection. Before the nurse can formulate a plan of action, implement a nursing intervention, or notify a provider of a change in the client's status, she must first collect adequate data from him. Assessing or collecting additional data will provide the nurse with knowledge to make an appropriate decision. Therefore, the nurse should first determine the reason for the client's hoarding behavior. a. The nurse should have the client transported to an acute care facility if harm is suspected; however, there is another action the nurse should take first. c. The home health nurse should alert the staff that the client is hoarding his medications as part of quality improvement to prevent similar occurrences in the future; however, there is another action the nurse should take first. d. The nurse should retrieve the medications from the client to prevent him from harming himself; however, there is another action the nurse should take first. A community health nurse (chn) is conducting a needs assessment of a community. the nurse should ID that which method will yield direct data -Informant interviews A home health nurse (hhn) is evaluating a caregiver's technique for providing care to a client who has a chronic tracheostomy. -I will use tap water to clean the inner cannula a nurse is assessing the risks and benefits of a meal delivery services for an older adult client who lives alone and has no transportation. Which ethical principle -beneficence A chn suspects an outbreak of scabies in the local area. Which action should the nurse take first -determine incidence rate A case manager at a home health agency is obtaining equipment for a client's home use. Which action is a violation of confidentiality -left a clipboard with prescription info face up on office desk a chn is planning a presentation for adults who have a fam hx of Alzheimer's disease. Which behavior should the nurse include as an early manifestation of Alzheimer's -Forgetting the location of common objects An occupational health nurse in a factory is performing a routine TB screening and ID an employee who has a positive Mantoux tuberculin test. Which action should the nurse plan to take -Instruct the employee that they will need to obtain a chest x-ray A public health nurse is participating in a disaster preparedness planning committee for a local community that is at risk for hurricanes. Which info should the nurse contribute to the plan -A list of areas w/in the community where residents speak multiple languages A hospice nurse is teaching about expected grief reactions with the family of a client who has end-stage pancreatic cancer. Which info should the nurse include -a component of healthy grieving is the ability to openly express your anger A nurse is planning to teach a community group about the meningococcal vaccine. the nurse should ID that which client should receive the vaccine? -client who is moving into a college dorm A nurse is preparing community edu program bout health care needs during pregnancy. The nurse should include that which vaccine is safe to admin to a client who is pregnant -Tdap A chn is caring for an adolescent who is seeking help for an unplanned pregnancy. Which action should the nurse take first -Help the client obtain a provider for prenatal care A nurse in a community center is preparing to administer a tuberculin skin test to multiple clients to screen for TB. Which action should the nurse take -Inject 0.1mL of purified protein derivative A school nurse is notified that a school-age child has pertussis. Action should nurse take -1) Instruct the parent to keep child at home for 2wks after initial symptoms first present -2) Encourage family members to obtain prophylactic tx -3) Check the immunization status of the child's classmates A public health nurse is lobbying Congress to increase funding for healht screenings provided to migrant farm workers. Which concepts is the nurse demonstrating? -Advocacy Community leaders have requested a meeting with a chn to discuss creating a mobile meals program. -the need for the program a nurse is giving a presentation about family violence at a local community center. -Child maltreatment is more common in homes where partner violence is present An adult child of a client who is terminally ill and at the end of life approaches a hospice nurse and asks,"What can I do to help relieve my father's pain?" -Give your father brief hand massages A nurse is developing an edu program about bioterrorism and smallpox. -face A community health nurse is working with community where the incidence of violence has increased -Provide victims of violence with referral info to crisis lines A chn is working in a mobile health care clinic. which of the following clients should the nurse assess first -new onset of confusion Nurse is assessing a new client at a public health clinic. Which of the following areas should the nurse address as part of the cultural assessment -illness practices a nurse is conducting a home visit for an older adult client. -taking outdated prescriptions a chn is made aware that several children, who are from the same family and did not receive immunizations, have contracted measles. -Report this information to the state health department a nurse is caring for a client who has a positive gonorrhea culture. -Instruct the client that recent sexual partners will need to be treated A school nurse is discussing levels of prevention with a teacher. Primary prevention -demonstrate proper handwashing a school nurse is serving on a community disaster planning committee looking at school shooting scenarios. action during response phase -Perform triage and provide hands-on care as needed to victims a chn is conducting a program regarding crime reduction strategies for older adult clients at the senior center -I should remove the ID tag that is on my key ring preventing C diff -contact precautions A nurse is preparing an edu program about influenza for a group of community health nurses. Teriary prevention -admin antiviral med w/in 48hr to clients who have manifestations A nurse on the scene following a mass casualty explosion is triaging a client who has a large, open occipital wound and the following findings -Turn the client to left semi-Fowler's position and beign assessing the next client A public health nurse is monitoring medication compliance for a group of migrant workers who are being treated for TB. -MCN a nurse manager at a community health clinic is presenting an in-service for nurses about assessing clients who have experienced violence. -I should determine whether a client who has been sexually assaulted requires a rape kit examination A nurse is providing edu regarding lead exposure to a group of clients who live in a housing development built in 1968. Which statements -I will increase the amt of red meat and milk in my child's diet A nurse in a county health department is caring for a client who states,"I've been drinking too much in the evenings since my friend died last year." -can i give you some info about AA A home health nurse is visiting an older adult client and notes that unwashed dishes are piled up ... -How often do you have visitors come to see you A school nurse is conducting visual acuity testing for a school-age child using a Snellen letter chart -allow the child to keep her glasses on during the test A community health nurse is participating in a quality improvement plan for a local health department -1)focus groups -2)written audits -3)satisfaction -4)interviews a chn is teaching a client who is overweight about steps to take to begin an exercise program -I will see my doctor before beginning an exercise program a chn is discussing the role of a faith community nurse with a chaplain -facilitate susbstance abuse support groups a chn is assigned to lead a county-level envi task force -review community-specific epidemiological data a chn is working to meet health care needs of residents in a rural community -unavailability of outreach services a chn is providing teaching about health promotion to a group of adolescents. Which topic is the most important for the nurse to include in an attempt to lower adolescent mortality rates -safety belt use a nurse is preparing to administer medication to a client who has active TB -N95 A public health nurse is working in a community that has a population of 24,096 -prevalence proportion a public health nurse is planning a community health promotion program for HTN prevention. Tertiary prevention strategy -exercise program A hospice nurse is caring for a client who is at the end of his life and has developed dyspnea and noisy breathing -use a fan A nurse at a county health clinic is caring for a client who has recently assumed the role of primary caregiver for their parent. Role conflict -i feel overwhelmed with not having enough time for my mom as well as my children a nurse at a county health department is caring for a client who is at 28 wks of gestation. Factor for future child maltreatment -changed providers 3 times a chn is providing care to a client who has stopped taking their prescribed bp med. -determine reason for discontinuing the med