A community health nurse is implementing preventive strategies in three different communities.
For all communities above, click the actions that the nurse should take to implement a community-level primary prevention intervention.
Advocate for regulations regarding industrial pollution.
Conduct screenings for health concerns.
Provide treatment for chronic conditions.
Initiate a school-based education program.
Provide information to leaders about creating a community garden.
Assist survivors in finding counseling.
Request yearly testing results from the water supply.
Correct Answer : A,D,E
Choice A rationale: Regulation of industrial pollution represents a primary prevention measure because it prevents harmful exposures before disease occurs. Airborne particulates, heavy metals like lead, and contaminated water from industrial discharge contribute to chronic respiratory disease, neurological impairment, and carcinogenesis. By addressing environmental hazards at their source, the nurse prevents the initial onset of illness across the population rather than intervening after disease develops, thus meeting the scientific definition of primary prevention at the community level.
Choice B rationale: Screening for health concerns such as elevated blood pressure, lead levels, or signs of abuse is classified as secondary prevention. This is because screening identifies disease at an early stage but does not prevent its occurrence. Normal blood pressure ranges are 90–120 mmHg systolic and 60–80 mmHg diastolic; detecting hypertension outside these limits is secondary rather than primary. Therefore, while scientifically beneficial, screening is not a primary prevention intervention.
Choice C rationale: Providing treatment for chronic conditions such as diabetes or hypertension falls under tertiary prevention. This strategy reduces complications, optimizes function, and delays progression of established illness but does not prevent disease onset. For example, diabetes management with insulin or hypertension management with antihypertensives reduces morbidity, yet the pathology already exists. As a result, this approach scientifically cannot be classified as primary prevention but instead as a tertiary, restorative intervention.
Choice D rationale: Implementing a school-based program on healthy relationships constitutes a primary prevention intervention because it aims to prevent intimate partner violence and unhealthy social patterns before they develop. Educational strategies modify risk factors by promoting protective behaviors in youth populations. Primary prevention focuses on avoiding the occurrence of violence, not detecting or treating it after occurrence. Therefore, this intervention is correctly categorized as primary prevention at the population level.
Choice E rationale: Providing information to leaders about creating a community garden represents a primary prevention activity because it addresses modifiable upstream determinants of chronic disease. Access to fruits and vegetables lowers the risk of hypertension, obesity, and type 2 diabetes. Normal fasting glucose should remain between 70–100 mg/dL, and diets high in processed foods elevate this risk. Community gardens improve nutrition access before illness develops, aligning with primary prevention science.
Choice F rationale: Assisting survivors in finding counseling represents tertiary prevention. At this stage, violence has already occurred, and counseling addresses the consequences to restore mental and emotional health. Tertiary prevention focuses on reducing long-term impacts rather than preventing the initial occurrence. Thus, while scientifically important for recovery and resilience, counseling does not fulfill the definition of primary prevention and is therefore not applicable as the correct answer here.
Choice G rationale: Requesting yearly water testing results is a secondary prevention measure. Surveillance identifies contaminants such as lead levels above the normal reference of less than 5 µg/dL in children but does not prevent the contamination from occurring. Monitoring allows early detection of exposure but still requires corrective action after the hazard is present. Therefore, this scientifically aligns with secondary prevention rather than primary prevention.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A rationale
Preparing medications for the week is a common and effective strategy for medication management, particularly for clients with complex medication regimens or memory issues. This practice, often done using pillboxes, helps ensure medication adherence and reduces the risk of missed doses or accidental overdoses. It's a proactive and safe habit that doesn't typically require further assessment.
Choice B rationale
Having to turn the head completely to see things beside them is a significant finding that suggests a limitation in peripheral vision. This could be indicative of various ophthalmological conditions, such as glaucoma, retinitis pigmentosa, or cataracts, all of which require professional evaluation. This finding is not a normal part of aging and warrants further assessment to prevent vision loss and promote safety.
Choice C rationale
Changing a hearing aid battery weekly is a normal and expected part of maintaining the device's functionality. The lifespan of a hearing aid battery varies depending on usage, but a weekly change is well within the typical range. This statement does not indicate a problem with the client's health or their ability to care for themselves.
Choice D rationale
Preparing all of their own meals is a positive indicator of a client's functional independence and ability to perform activities of daily living. It suggests they have the physical and cognitive capacity to plan, shop for, and cook meals, which is a sign of good health and well-being. This statement does not require further assessment.
Correct Answer is {"A":{"answers":"A,B,C"},"B":{"answers":"A"},"C":{"answers":"A,B,C"},"D":{"answers":"A,B"},"E":{"answers":"A,B,C"},"F":{"answers":"A,B"},"G":{"answers":"A"}}
Explanation
1️⃣ Malaise
- Measles ✅
- Rubella ✅
- Varicella ✅
Rationale: Malaise is a non-specific prodromal symptom common to many viral infections. In measles and rubella, it typically precedes rash onset. In varicella, it may accompany fever before vesicular eruptions. It’s not diagnostic but supports viral etiology.
2️⃣ Parent Report of Oral Findings
(Small white spots inside the mouth)
- Measles ✅
- Rubella ❌
- Varicella ❌
Rationale: These are Koplik spots, which are pathognomonic for measles. They appear 1–2 days before the rash and are small, bluish-white lesions on the buccal mucosa. Rubella and varicella do not present with this oral finding.
3️⃣ Parent Report of Skin Findings
(Raised rash on trunk)
- Measles ✅
- Rubella ✅
- Varicella ✅
Rationale: All three diseases present with rash, but the characteristics differ:
- Measles: Maculopapular rash starting at hairline, spreading downward.
- Rubella: Fine, pink maculopapular rash, often starting on face and spreading rapidly.
- Varicella: Vesicular rash in crops—papules, vesicles, and crusts at different stages, typically starting on trunk.
The raised rash on the trunk could fit any of these, depending on morphology and progression.
4️⃣ Respiratory Assessment
(Persistent cough, lungs clear)
- Measles ✅
- Rubella ✅
- Varicella ❌
Rationale:
- Measles: Classic triad includes cough, coryza, and conjunctivitis. Cough is often persistent and precedes rash.
- Rubella: Mild upper respiratory symptoms may occur, including cough.
- Varicella: Respiratory symptoms are uncommon unless complicated by pneumonia or secondary infection.
Clear lungs suggest no lower respiratory involvement, supporting viral prodrome rather than bacterial pneumonia.
5️⃣ Immunization Status
(No prior immunizations documented)
- Measles ✅
- Rubella ✅
- Varicella ✅
Rationale: All three diseases are vaccine-preventable. Lack of immunization significantly increases susceptibility. This is a key epidemiologic clue, especially in outbreak or school settings.
6️⃣ Nasal Assessment
(Clear nasal drainage bilaterally)
- Measles ✅
- Rubella ✅
- Varicella ❌
Rationale:
- Measles: Coryza (runny nose) is a hallmark prodromal symptom.
- Rubella: Mild rhinorrhea may occur.
- Varicella: Nasal symptoms are not typical unless secondary infection is present.
Clear drainage supports viral etiology, especially measles or rubella.
7️⃣ Eye Assessment
(Red, watery conjunctiva)
- Measles ✅
- Rubella ❌
- Varicella ❌
Rationale: Conjunctivitis is a classic measles symptom, part of the prodromal triad. Rubella may cause mild eye irritation but not true conjunctivitis. Varicella does not typically affect the eyes unless lesions appear periocular.
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