NUR 404 Exam 2 SU25 Community Health Nursing
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Free NUR 404 Exam 2 SU25 Community Health Nursing Questions
A client with sickle cell disease is in a vaso-occlusive crisis and reporting a severe headache with blurry vision. What intervention should the nurse perform first
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Administer analgesic medication
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Assess the client's neurological status
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Increase the client's intravenous fluids
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Administer 2 L of oxygen via nasal cannula
Explanation
Correct Answer B. Assess the client's neurological status
Explanation:
A severe headache with blurry vision in a client with sickle cell disease could indicate a stroke or other neurologic complication, which is a medical emergency. The first priority is to perform a focused neurological assessment to detect signs of increased intracranial pressure or neurologic compromise, guiding the urgency of medical intervention.
Why the Other Options Are Wrong:
A. Administer analgesic medication
Pain control is important in vaso-occlusive crisis, but it is not the priority when new or worsening neurological symptoms are present. Analgesics could mask changes in mental status.
C. Increase the client's intravenous fluids
Hydration helps reduce sickling, but it is a supportive measure. It does not address the immediate risk of a possible neurologic event.
D. Administer 2 L of oxygen via nasal cannula
Oxygen may be beneficial in sickle cell crisis, but it is not the first action when symptoms suggest potential neurological impairment, which takes precedence.
The nurse is caring for a child with acute nasopharyngitis. Which information should the nurse include in teaching the parents about this health problem
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An antibiotic is prescribed for children younger than 5 years of age
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A cough that accompanies a cold should rarely be suppressed
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Typically, the child will pull the ear when a cold is present
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Healthy children rarely have more than one cold per year
Explanation
Correct Answer B. A cough that accompanies a cold should rarely be suppressed
Explanation:
Coughing serves a protective purpose during colds by helping clear secretions from the airway. Unless the cough is severe, distressing, or disrupting sleep, it is usually not suppressed in children with nasopharyngitis. Supportive care, such as hydration and humidified air, is preferred.
Why the Other Options Are Wrong:
A. An antibiotic is prescribed for children younger than 5 years of age
Nasopharyngitis is typically caused by viruses, and antibiotics are not routinely indicated, regardless of age, unless a secondary bacterial infection is confirmed.
C. Typically, the child will pull the ear when a cold is present
Ear pulling may occur with otitis media, but it is not a typical sign of nasopharyngitis. It may warrant further assessment if present.
D. Healthy children rarely have more than one cold per year
This is incorrect. Young children, especially those in daycare or school settings, commonly have 6–10 colds per year due to immature immune systems.
A toddler is being treated for acetaminophen toxicity after an accidental overdose. The nurse should prepare to administer which medication
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Succimer
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Atropine
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Syrup of Ipecac
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Acetylcysteine
Explanation
Correct Answer D. Acetylcysteine
Explanation:
Acetylcysteine is the antidote for acetaminophen (paracetamol) toxicity. It works by replenishing glutathione, a substance that helps detoxify the harmful metabolite of acetaminophen in the liver. When given early, it can prevent or reduce liver damage. It may be administered orally or IV depending on the situation.
Why the Other Options Are Wrong:
A. Succimer
Succimer is used to treat lead poisoning, not acetaminophen toxicity. It acts as a chelating agent to remove heavy metals.
B. Atropine
Atropine is used in cases of organophosphate poisoning or to treat bradycardia, not for acetaminophen overdose.
C. Syrup of Ipecac
Syrup of Ipecac induces vomiting but is no longer recommended in poisoning cases due to the risk of aspiration and because activated charcoal and antidotes are safer and more effective.
Kawasaki syndrome is a diagnosis of exclusion. Treatment for this diagnosis may include IVIG and high-dose aspirin therapy to prevent (1), which can lead to coronary artery aneurysms and other long-term cardiac complications
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Gastrointestinal Symptoms
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Respiratory Symptoms
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Visual Disturbances
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Integumentary Symptoms
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Hearing Loss
Explanation
Correct Answer D. Integumentary Symptoms
Explanation:
Kawasaki syndrome is a pediatric vasculitis that often presents with prominent integumentary symptoms, such as a rash, peeling of the hands and feet, conjunctival redness, and strawberry tongue. These skin and mucous membrane changes are characteristic of the acute phase of the disease. While the major concern is cardiac involvement (like coronary artery aneurysms), the initial signs are largely integumentary.
Why the Other Options Are Wrong:
A. Gastrointestinal Symptoms
Gastrointestinal symptoms may be present (e.g., abdominal pain), but they are not the hallmark nor the key symptom that leads to the diagnosis or complications of Kawasaki disease.
B. Respiratory Symptoms
Kawasaki disease is not primarily a respiratory illness and does not usually begin with cough, congestion, or breathing difficulty. These symptoms are not central to its presentation.
C. Visual Disturbances
Visual issues are not typically associated with Kawasaki disease. The eye involvement seen (non-exudative conjunctivitis) does not usually cause vision loss or disturbances.
E. Hearing Loss
Although rare cases may report transient hearing loss, it is not a defining or primary symptom and is not central to the diagnosis or treatment strategy.
Which stressors are commonly observed in hospitalized toddlers
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Social isolation
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Interrupted routines
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Fear of being hurt
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Sleep disturbances
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Self-concept disturbances
Explanation
Correct Answers:
B. Interrupted routines
C. Fear of being hurt
D. Sleep disturbances
Explanation of Correct Answers:
B. Interrupted routines
Toddlers thrive on consistent routines. Hospitalization disrupts their normal patterns for eating, sleeping, and playing, which can cause anxiety, irritability, and regression.
C. Fear of being hurt
Toddlers do not fully understand medical procedures and often fear pain from needles, exams, or treatments. This is a common and significant stressor.
D. Sleep disturbances
Strange environments, noises, and frequent interruptions in the hospital often lead to poor sleep, which increases stress and affects emotional regulation.
Explanation of Incorrect Answers:
A. Social isolation
Social isolation is more relevant to older children and adolescents. Toddlers primarily miss parents or primary caregivers rather than peers or broader social contact.
E. Self-concept disturbances
Toddlers are still developing their sense of self. Self-concept issues are not commonly recognized stressors at this developmental stage; this concern is more typical in school-aged children and adolescents.
An 18-month-old girl is diagnosed as having atopic dermatitis. When interviewing her parents, they describe the following care measures. Which one would lead you to think more health teaching is needed
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To dry lesions, the father applies alcohol to lesions daily
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To aid healing, the father applies hydrocortisone cream to the lesions
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After a bath, the mother applies Eucerin cream
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The mother gives her a daily bath without using soap
Explanation
Correct Answer A. To dry lesions, the father applies alcohol to lesions daily
Explanation:
Applying alcohol to lesions is harmful and inappropriate for atopic dermatitis. Alcohol is extremely drying and irritating, which worsens the skin barrier breakdown and increases itching and inflammation. This indicates a lack of understanding of proper skin care for eczema and calls for immediate education.
Why the Other Options Are Wrong:
B. To aid healing, the father applies hydrocortisone cream to the lesions
Hydrocortisone cream is a standard topical treatment for mild to moderate atopic dermatitis and helps reduce inflammation and itching when used as directed.
C. After a bath, the mother applies Eucerin cream
Eucerin is a thick emollient, and applying it after bathing helps lock in moisture — a highly recommended practice in eczema care.
D. The mother gives her a daily bath without using soap
Daily bathing without soap helps hydrate the skin without introducing irritants. It’s a correct approach for children with eczema.
After assisting the provider with an amniotomy on a laboring client, what is the nurse's priority action
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Adjust the intravenous fluid infusion rate
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Provide clean gown and linens for the client
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Assess the fetal heart rate
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Assist the client to wash the perineum
Explanation
Correct Answer C. Assess the fetal heart rate
Explanation:
The priority nursing action after an amniotomy (artificial rupture of membranes) is to assess the fetal heart rate (FHR). This is critical because cord prolapse or fetal distress can occur when the membranes rupture, and the FHR may reveal signs such as bradycardia or variable decelerations that indicate complications.
Why the Other Options Are Wrong:
A. Adjust the intravenous fluid infusion rate
This may be necessary depending on labor progression, but it is not the immediate priority following membrane rupture.
B. Provide clean gown and linens for the client
This is part of routine comfort care after ensuring fetal well-being, not a priority over FHR assessment.
D. Assist the client to wash the perineum
Perineal care is important for hygiene but is not urgent. It follows after confirming there are no complications for the fetus.
The nurse is assessing a client who is 2 weeks postpartum. The nurse would be concerned about mastitis if which of the following were noted
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Urinary frequency
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Flu-like symptoms
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Unilateral breast tenderness
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Unilateral breast erythema
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Uterine tenderness
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Bilateral breast firmness
Explanation
Correct Answers:
B. Flu-like symptoms
C. Unilateral breast tenderness
D. Unilateral breast erythema
Explanation of Correct Answers:
B. Flu-like symptoms
Clients with mastitis often experience fever, chills, fatigue, and body aches, which mimic flu symptoms. These are systemic signs of infection.
C. Unilateral breast tenderness
Mastitis usually affects one breast and causes localized pain or tenderness. This is a common early symptom.
D. Unilateral breast erythema
Redness or warmth over one breast is a hallmark of mastitis, often indicating inflammation or infection in a localized area.
Explanation of Incorrect Answers:
A. Urinary frequency
This symptom is more commonly associated with a urinary tract infection (UTI) and is not related to mastitis.
E. Uterine tenderness
Uterine tenderness may suggest endometritis, not mastitis. It involves a different postpartum complication.
F. Bilateral breast firmness
This could be related to engorgement or milk production, which is normal in lactating clients and not specific to mastitis.
What is the expected language skill level for the 2-3 year old toddler? The toddler would
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Not speak but be able to follow commands
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Speak in two-word sentences using both a noun and verb
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Speak clearly with all words understandable
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Know 800-900 words by age 2
Explanation
Correct Answer B. Speak in two-word sentences using both a noun and verb
Explanation:
By age 2 to 3, toddlers are expected to begin forming simple two-word sentences such as "want juice" or "go park," often combining a noun and a verb. This stage marks a major developmental milestone in expressive language and indicates growing communication skills.
Why the Other Options Are Wrong:
A. Not speak but be able to follow commands
This is more typical of a child closer to 12–18 months. By age 2, children are generally using spoken words and phrases.
C. Speak clearly with all words understandable
Clarity of speech improves over time. At age 2–3, many toddlers still mispronounce words. Full clarity is not expected until around age 4.
D. Know 800–900 words by age 2
While vocabulary grows rapidly, the average 2-year-old typically knows about 200–300 words. Knowing 800–900 words is more aligned with children closer to age 3–4.
. If the fetal monitor demonstrates the following pattern, which action would the nurse perform first?
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Prepare for vaginal delivery
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Administer oxygen at 3–4 liters via nasal cannula
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Turn the client or ask the client to turn on their side
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Perform a vaginal exam to assess for the umbilical cord
Explanation
Correct Answer C. Turn the client or ask the client to turn on their side
Explanation:
The image shows variable decelerations, which are abrupt drops in fetal heart rate and are often caused by umbilical cord compression. The first nursing action is to reposition the client, typically to a side-lying position, to relieve cord pressure and improve fetal oxygenation. This is a rapid and non-invasive intervention that can immediately impact fetal status.
Why the Other Options Are Wrong:
A. Prepare for vaginal delivery
This is premature. Delivery may be necessary if the condition persists, but initial interventions to relieve the decelerations must be attempted first.
B. Administer oxygen at 3–4 liters via nasal cannula
Oxygen may be helpful, but repositioning is more immediate and effective in relieving cord compression, making it the priority action.
D. Perform a vaginal exam to assess for the umbilical cord
This is appropriate after repositioning, especially if variable decelerations persist or worsen, to rule out cord prolapse. However, it's not the first step.
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