After assessing the health care needs of an elementary school, the nurse determines that an increased prevalence of pediculosis capitis is a priority problem. The nurse develops a 2-month program with the goal to eradicate the condition in the school. The program includes educational pamphlets sent home to parents and regular assessment of children by the school nurse. Which action should the nurse implement to evaluate the effectiveness of the program?

Evaluate the teacher's ability to identify pediculosis capitis 2 months after initiation of the program.

Measure the prevalence of pediculosis capitis among the children after four months.

Survey parents 3 weeks after pamphlets are sent home to assess their understanding of the condition.

Conduct an initial examination of each child in the school to obtain baseline data.

Answer and Explanation

The Correct Answer is B

A) Evaluate the teacher's ability to identify pediculosis capitis 2 months after initiation of the program:
Evaluating the teachers’ ability to identify pediculosis capitis is important for ongoing surveillance, but it does not directly measure the effectiveness of the program in reducing the prevalence of the condition. This action focuses more on teacher training rather than the program's overall impact.

B) Measure the prevalence of pediculosis capitis among the children after four months:
Measuring the prevalence of pediculosis capitis among children after the implementation of the program is the most effective way to evaluate the program's success. By comparing the prevalence before and after the program, the nurse can assess whether the interventions (educational pamphlets and regular assessments) have led to a reduction in cases.

C) Survey parents 3 weeks after pamphlets are sent home to assess their understanding of the condition:
Surveying parents about their understanding of pediculosis capitis is useful for evaluating the reach and impact of the educational component. However, it does not directly measure the effectiveness of the program in reducing the actual prevalence of pediculosis capitis among children.

D) Conduct an initial examination of each child in the school to obtain baseline data:
Conducting an initial examination provides valuable baseline data on the prevalence of pediculosis capitis before the program begins. However, this action alone does not evaluate the effectiveness of the program; it must be followed by assessments after the program’s implementation to determine if there has been a reduction in cases.

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Correct Answer is B

Explanation

A) 3/1,000:
To calculate the rate per 1,000, you divide the number of new positive tests by the total number of students tested, then multiply by 1,000. For 15 new positive tests among 500 students, the rate is (15/500) * 1,000 = 30/1,000. Thus, 3/1,000 is incorrect.

B) 30/1,000:
The correct calculation for the rate per 1,000 is determined by dividing the number of new positive tests (15) by the total number of students tested (500) and then multiplying by 1,000. Therefore, (15/500) * 1,000 = 30/1,000. This rate accurately reflects the proportion of students with positive tests per 1,000.

C) 1.7/1,000:
The rate of 1.7/1,000 would result from incorrect calculations. Using the correct formula, the rate per 1,000 should be 30/1,000.

D) 15/1,000:
The rate of 15/1,000 suggests that there are 15 positive tests per 1,000 students, which does not reflect the actual number of new positive tests (15) among 500 students. The correct rate calculation yields 30/1,000, not 15/1,000.

A. Collaborate with local schools in screening children. B. Develop a community educational program. C. Provide referrals for home health care follow up. D. Perform a community health assessment.

Correct Answer is D

Explanation

A) Collaborate with local schools in screening children:
While screening children in local schools is an important step in controlling the spread of tuberculosis (TB), it is a more specific action that should come after a broader community assessment. Identifying high-risk groups and areas within the community is crucial before targeting specific populations for screening. This ensures that resources are allocated effectively and that screening efforts are well-directed.

B) Develop a community educational program:
Developing a community educational program is essential for raising awareness about TB, its transmission, and prevention strategies. However, before implementing such a program, it is important to conduct a community health assessment to understand the current level of knowledge, the prevalence of the disease, and the specific needs of the community. This assessment will provide valuable information to tailor the educational program appropriately.

C) Provide referrals for home health care follow up:
Providing referrals for home health care follow-up is crucial for managing and monitoring individuals with TB. However, this action is more focused on individual care rather than addressing the community-wide impact of the disease. Before setting up individual follow-ups, a community health assessment will help in understanding the overall scope of the TB outbreak and guide the development of more comprehensive intervention strategies.

D) Perform a community health assessment:
Conducting a community health assessment is the most appropriate initial action. This step involves evaluating the overall health status of the community, identifying the extent of the TB outbreak, and determining the community’s needs and resources. The assessment will provide a foundation for implementing targeted interventions, such as educational programs, screening efforts, and follow-up care. Understanding the community's health status and needs is essential for planning effective responses and controlling the spread of TB.

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Naxlex Comprehensive Predictor Exams

A school nurse identifies 15 new students with positive tuberculin tests among the 500 at-risk students fested. Which is the rate per 1,000 with new positive tests?

Correct Answer is B

Explanation

Several clients who have recently come to the local health clinic in a rural county are diagnosed with tuberculosis (TB). After reporting the occurrence to the health department, which community focused action should the nurse implement first?

Correct Answer is D

Explanation

A community health nurse is helping a group of nursing students plan a tertiary prevention program for a local community clinic that serves a majority Hispanic population. Which service project meets the requirement of a tertiary prevention program and would best serve this population?

The elementary school nurse has identified a problem requiring a secondary intervention. Which intervention should the nurse implement?

A migrant farm worker who lives in a mobile home with several other workers visits the Migrant Health Care Center. The client reports Increasing episodes of dizziness, headaches, abdominal cramps, and difficulty breathing. Which nursing action has the highest priority?

The nurse notes that the influenza immunization rates are much lower for certain demographic groups than for others. Which intervention is likely to be most useful in increasing the rates of immunization in these under-served immunization groups?

The city health department director asks the community health nurse to make a presentation describing the greatest health concern facing the city. How should the nurse begin to collect the data needed for this presentation?

The parish nurse notes that an older adult client has had a 5 lb (2.3 kg) weight loss since a check-up one month ago. The client has good hygiene, still drives a car, and lives alone. To which agency should the nurse refer this client?

Tuberculosis (TB) screening at a federal prison reveals that two inmates have a positive skin test. Which action is most important for the nurse to take?