A school nurse is implementing health screenings.
Which of the following assessment findings should the nurse recognize as the highest priority?
An adolescent who has psoriasis.
A child who has a BMI of 18.
An adolescent who has scoliosis.
A child who has nits.
The Correct Answer is D
Nits are the eggs of head lice and their presence indicates an infestation. Head lice can spread quickly among school children through close contact and shared items such as hats and combs. It is important for the school nurse to address this issue promptly to prevent further spread.
Choice A, an adolescent who has psoriasis, is not the highest priority because psoriasis is a chronic skin condition that is not contagious.
Choice B, a child who has a BMI of 18, is also not the highest priority because a BMI of 18 falls within the normal range for children.
Choice C, an adolescent who has scoliosis, is not the highest priority because scoliosis is a curvature of the spine that typically develops slowly over time and requires monitoring rather than immediate intervention.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
People living with HIV/AIDS have a much higher risk of suicide than the general population1.Some of the risk factors for suicidal ideation, suicide attempts and suicide deaths in this group are depression, advanced disease, neurological changes, stigma, poor social support, negative life events, physical pain and fear of rejection.
Based on these risk factors, the response by the client that indicates a higher risk for suicide isd. “I am afraid of experiencing pain near the end.”This response suggests that the client has a low perception of their physical health, a fear of losing control and a pessimistic outlook on their future.These are signs of hopelessness, which is a strong predictor of suicide.
The other responses do not necessarily indicate a high risk for suicide, although they may reflect some challenges that the client is facing. For example, response a. may indicate a desire for autonomy and dignity, response b. may indicate a coping strategy or denial, and response c. may indicate a source of emotional support or dependency. However, these responses do not imply that the client is thinking about harming themselves or ending their life.
Therefore, the home health nurse should assess the client’s level of hopelessness, suicidal ideation and suicide plan, and provide appropriate interventions and referrals to prevent a possible suicide attempt. The nurse should also monitor the client’s mood, pain, medication adherence and social support, and offer education, counseling and resources to improve the client’s quality of life.
Correct Answer is D
Explanation
The enzyme-linked immunosorbent assay (ELISA) tests a patient’s blood sample for HIV antibodies1.
Choice A is not the correct answer because the test results are not accurate 24 hours after HIV exposure.
It can take several weeks for the body to produce enough antibodies to be detected by an ELISA test1.
Choice B is not the correct answer because the test does not monitor the progression of HIV.
Choice C is not the correct answer because a positive result does not indicate initiation of immunoglobulin administration.
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