Community
1. Which task should the nurse recommend be referred to an occupational therapist for assistance to a client with COPD?
1. Assessing the client's home for safety and accessibility, help develop strategies to improve safety, accessibility, and comfort.
Other important facts:
If the nurse is unable to leave a telephone message, do a drop in visit and leave an agency card.
For client with spills of industrial acid on both arms and legs at work, the nurse should remove nonadherent clothing and wristwatch.
Infectious or those suspected of infectious diseases such as TB should be isolated right away.
With this "level", the occupational health nurse plays a key role in the rehabilitation and restoration of the worker to an optimal level of functioning.
What is tertiary level
Child abuse should be suspected if_____? SATA
A. The caregiver's explanation is not reasonable.
B. If the injury is not consistent with the explanation?
C. Has multiple bruises on his knees and elbows?
D. If injury does not corelate with the child’s developmental capabilities.
All except "C" are correct. Injury or bruising on knees and elbows is very common among very active and young children.
What is this?
1. Also known as domestic abuse, spouse abuse, domestic violence, courtship violence, battering, marital rape or date rape, it is important to understand that the main issue is an imbalance of power.
2. If not addressed this will not end but escalate.
3. Remove the victim of from the situation and send to shelter
What is Intimate Partner Violence (IPV)?
Gives the nurse the opportunity to establish a trust relationship with the client and family to establish credibility as a resource for health information and community referrals in a nonthreatening environment.
What is the first home visit?
Select All the Correct Statements R/T cultural competency?
A. Clients who have language barriers may not seek medical care because of frustration.
B. The nurse should recognize her own beliefs in order to provide unbiased care to the client.
C. Culturally competent care is for all clients.
D. Cultural competence care increases the cost of health care.
E. If the nurse is unfamiliar with the culture/ethnicity of the client, she should get firsthand information from the client.
F. Cultural competency increases communication.
All the statements are correct Except for "D".
Research shows that cultural competence care decreases the cost of health care.
True or False
A client with pneumonia may need another sputum cx (not a 2nd XRAY) if no improvement is seen.
Some antibiotics may cause constipation encourage stool softener with encouragement to ambulate. (GET A WALKER IF TOO WEAK TO AMBULATE)
All statements are true.
Encourage ambulation with walker
Encourage hydration to thin out secretions
May need a 2nd sputum cx.
Why hospice nurses are at such high risk for substance abuse? SATA
A. Nature of their profession. Isolation and stress of seeing death too often
B. Nurses have a tendency for addiction
C. Easy access
D. Belief in the power of meds (they can solve all problems)
All statements are true EXCEPT "B".
Which statements are true regarding this population? SATA
A. A family about to lose their home is homeless.
B. Homeless population priority is roof above their head.
C. Homeless population often delay seeking healthcare and often get worse quickly.
"A" is incorrect. This will be imminent homelessness.
B and C are correct.
Which of the following statements are true?
A. Clients who are not understood may not seek medical care because of frustration.
B. The nurse should assess and recognize her own beliefs in order to provide unbiased care to the client.
C. Culturally competent care is for all clients.
D. Cultural competence care decreases the cost of health care.
E. Culturally competent care is for compliant clients.
F. Culturally competent care is expensive.
A, B, C & D are correct.
Clients who are not understood may not seek medical care because of frustration. The nurse should recognize her own beliefs in order to provide unbiased care to the client. Culturally competent care is for all clients. Cultural competence care decreases the cost of health care.
Rural population have the following challenges r/t healthcare. SATA
A. Healthcare is expensive and unaffordable to rural population which is also poor.
B. Fewer healthcare workers are available.
C. Unique disorders/diseases r/t to occupation exists in this population (exposure to chemicals, pesticides etc).
D. Higher level of education in this population
E. Access to health care is # 1 priority to rural population.
F. To nurses working in rural areas migrant & seasonal workers should be their #1 priority.
All statements are true except for "D"
Rural population is poor and have lower level of education. Due to poverty rural population cannot afford our very expensive healthcare. In addition there are very few workers who are willing to go and work for less in rural areas.
Makes up the largest professional group providing health care services to employees in highly complex work environments.
What is the occupational health nurse
The most critical health care issues among the incarcerated population are_____? SATA
A. HIV, Hepatitis and STDS
B. Mental health, violence and substance abuse
C. Isolation and stress
D. A & B are incorrect.
E. Chronic diseases and Osteoporosis
A, B, C & E are correct.
1. True or False
Poor sanitation and overcrowding are social and environmental factors to contribute to disease development.
1. True
Some other things to remember for Exam 2.
1. The nurse should report issues that are potentially life-threatening (such as threat of violence to society and self) to the treatment team. Although trust is the hallmark of the nurse-client relationship, confidentiality does not extend to these situations.
2. To introduce a health promotion plan, the nurse must complete an assessment and get the perspective of the local community. Forming partnership with the community members is CRUCIAL.
3. For a home health nurse it is okay to do a drop in visit to the client's home and leave information.
4. A prison nurse is not required to be in an enclosed space with the prisoner. This is a dangerous situation, and a safety issue.
Breathing and relaxation techniques during labor is important in prenatal education.
Rn can break HIPPA and share the threat of violence by a client (such as threat of mass shooting) and share it with police or other team members.
Ethnocentrism occurs when people view the world from the perspective of their own cultural background and viewpoint.
The best response by the home health nurse to a client who asks the nurse to pick up his groceries is "I will help you find some resources that can assist you with shopping.“
If the home health RN enters a house where the partner is violent and abusive, the nurse should return to the agency and report the incidence
If planning a nutritional plan for the community. the nurse should determine local perspective about nutritional needs
Primary prevention for homeless community is advocate for low cost housing.
1. True or False
Every disabled child has the right to be mainstreamed in the education system and be treated with respect and dignity.
2. Q. For which population caregivers are responsible for most of the caregiving required?
1. True!
2. Population with disability
What are routine screening for older adults?
1. Cancer
2. DM & HTN
3. Vision & hearing
4. Osteoporosis
•Select all the risk factors of homelessness
•A. Losing a job
•B. Housing expenses are too high
•C. Cost of living is too high
•D. Lack of motivation to make life better
•E. Lack of college education
•F. Lack of or insufficient social services
All EXCEPT "D & E" are correct.
Nursing interventions for migrant workers? SATA
1. Arrangement needs to be made to have an interpreter.
2. Providing information during an already scheduled lunch break will better meet their needs.
3. Address health care topics that may be unique to this population.
4. Health care and health education should be withheld for undocumented migrants.
5. Health Promotion contains diverse education strategies to meet the needs of different types of learners.
Since the primary language of the clients is Spanish, an arrangement needs to be made to have an interpreter. Migrant workers may not be able to take breaks for health care education, so providing information during an already scheduled lunch break will better meet their needs. A health promotion program geared toward a large group of individuals should contain diverse education strategies to meet the needs of different types of learners. The nurse should address health care topics that may be unique to this population. For example, they may have been exposed to distress, violence, or may have had limited access to preventative or curative services prior to arriving in the country. While many migrant workers have work permits, some may be undocumented and will not be able to provide a permit. Health care and health education should not be withheld.
Which of the following statements are True: SATA
A. Client has the right to refuse treatment even when the surgery, diagnostic is scheduled and consent is signed
B. If the client is depressed or suicidal, ask if they have a plan.
C. Immediately assess client for suicidal ideation if client is giving away personal belonging.
D. Determine the risk of suicidal risk if client's favorite teacher, actor or friend died recently.
All statements are correct and true.
•What are the common risk factors of suicide in adolescents?
•A. Previous attempts
•B. Depression
•C. Drug and alcohol abuse
•D. Disruptive and unsupportive family background
•E. Relationship conflicts
•F. Adequate coping skills
•G. Psychiatric illnesses
•H. Recent suicide or death of someone cherished
•H. The ready availability of lethal means to commit suicide.
All EXCEPT "F" are correct.
What are the qualifications to be admitted to hospice? SATA
A. To qualify for hospice the client needs to be terminal with less than 6 months to live.
B. Must be a full DNR
C. Can receive radiation or chemotherapy
D. Can receive pain meds and other comfort measures. .
"C" is incorrect. Patient should not be on chemo., antibiotics or any other aggressive treatment
Which of the following factors may hinder nutrition in elderly. SATA
A. loose dentures, loose or rooting teeth.
B. Inability to afford quality foods
C. Social isolation
D. Chronic illness or functional disabilities
E. Poor eyesight, fatigue, malaise
F. A, B and D are correct.
All the factors (A - E) affects the nutrition in elderly.
'F" is incorrect.
What is the most appropriate intervention for Intimate Partner Violence?
A. Refer to mental health services.
B. Provide information the victim of violence on how to deescalate the situation.
C. Provide information on shelters
D. Refer to social services
C is correct. Provide information regarding shelter
A. The victim needs immediate shelter, victim is not at fault here and must not be blamed or sent out to mental health services.
B is incorrect because violence in most cases escalate
D. Providing shelter is a priority, social services will follow once the victim is safe.
Some hard facts
1. Adolescent dating violence is associated with poverty, child maltreatment, witnessing intimate partner violence, lower educational level, and substance abuse. Adolescent dating violence occurs in all races, in males and females, and all regions. Adolescent dating violence may lead to violence later in life.
2. In triage situation severe injuries are a priority, so is exposure to bioterrorism such as exposure to anthrax.
3. Fractures are usually tagged as "yellow"
4. Red are respirations greater than 30, hemorrhage, disoriented, confusion and burns.
5. Black are unresponsive, or whose respirations are 4-5 after repositioning of the head.
6. Green are walking wounded.
Facts to remember:
1. Emergency services should be called every time an epinephrine pen is administered
2. Veterans who experienced sexual assault, harassment, or rape during service are known as military sexual trauma. It is associated with obesity, arthritis, eating disorders, substance abuse, irritable bowel syndrome, PTSD, and other mental health consequences.
3. The nurse's role in the incident command structure is to collect information regarding alternative strategies.
4. Chest pain and SOB is a priority in triage situation.
5. A prison nurse should never be alone with a prisoner.
6. School nurse can do screening, administer emergency treatment, keep record of immunizations but not give immunizations.