An adolescent tells the school nurse that she is pregnant. Her last menstrual period was 4 months ago, and she has not yet received any medical care. She smokes but denies any other substance use. Which interventions should the nurse implement? (Select all that apply.)

Encourage smoking cessation.

Arrange for childcare.

Offer nutritional instruction.

Refer for prenatal care.

Teach breastfeeding methods.

Notify her parents.

Answer and Explanation

Correct Answer : A,C,D

A. Encourage smoking cessation:
Smoking during pregnancy can have serious consequences for both the mother and the fetus, such as increased risks of preterm birth, low birth weight, and developmental issues. Encouraging smoking cessation is crucial for improving both maternal and fetal health.

B. Arrange for childcare:
While childcare is an important consideration, it is not an immediate priority at this stage. The focus should be on ensuring the adolescent receives proper prenatal care and support for her health and the health of the baby.

C. Offer nutritional instruction:
Good nutrition is vital for a healthy pregnancy. Offering nutritional instruction helps the adolescent understand how to meet her dietary needs and those of her developing baby, contributing to better pregnancy outcomes.

D. Refer for prenatal care:
Prenatal care is essential for monitoring the health of both the mother and the fetus, providing necessary medical interventions, and offering support. Referring the adolescent for prenatal care is critical for addressing her medical needs throughout her pregnancy.

E. Teach breastfeeding methods:
While teaching breastfeeding methods is important, it is not the most immediate concern. This can be addressed later in the pregnancy or closer to delivery when the adolescent is more prepared to consider breastfeeding.

F. Notify her parents:
Unless the adolescent gives explicit consent or there are concerns for her safety or the safety of the baby, the nurse should maintain confidentiality. In many cases, the decision to notify parents is complex and requires careful consideration of the adolescent's autonomy and legal rights.

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Correct Answer is B

Explanation

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.

A. Women, Infant, and Children program. B. Consolidated Omnibus Budget Reconciliation Act provisions. C. Medicare. D. Medicaid.

Correct Answer is C

Explanation

A) Women, Infant, and Children program:
The Women, Infant, and Children (WIC) program provides nutritional assistance to low-income pregnant women, new mothers, and young children. It is not designed for general health insurance needs and is not applicable to a 66-year-old retiring from employment.

B) Consolidated Omnibus Budget Reconciliation Act provisions:
The Consolidated Omnibus Budget Reconciliation Act (COBRA) allows employees and their families to continue their health insurance coverage for a limited period after leaving employment. While COBRA can provide temporary coverage, it may not be the most appropriate long-term solution for a retiree who will likely need ongoing health insurance coverage beyond the COBRA continuation period.

C) Medicare:
Medicare is a federal health insurance program specifically designed for individuals aged 65 and older. Since the client is 66 years old and retiring, Medicare is the most appropriate agency to refer to for health insurance needs. Medicare provides comprehensive health coverage for seniors and is suited to their age group.

D) Medicaid:
Medicaid provides health coverage for low-income individuals and families, including some older adults with limited income and resources. However, for a 66-year-old client who is retiring and is likely eligible for Medicare, Medicaid may not be the primary insurance option unless the client has specific low-income needs that qualify them for additional assistance. Medicare is the primary program for seniors.

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An adolescent tells the school nurse that she is pregnant. Her last menstrual period was 4 months ago, and she has not yet received any medical care. She smokes but denies any other substance use. Which interventions should the nurse implement? (Select all that apply.)

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Naxlex Comprehensive Predictor Exams

Correct Answer is B

Explanation

A 66-year-old client is retiring and will no longer have health insurance through a place of employment. Which agency should the client be referred to by the employee health nurse for health insurance needs?

Correct Answer is C

Explanation

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