The nurse is documenting the medical history of a young adult client who was recently diagnosed with type 1 diabetes mellitus. The client smokes 2 packs of cigarettes daily and the client's father died of a heart attack at the age of 45. Which annual screening is most important for the nurse include?

Renal insufficiency.

Peripheral neuropathy.

Hyperlipidemia.

Retinopathy.

Answer and Explanation

The Correct Answer is C

A. Renal insufficiency: While annual screening for renal insufficiency is important for individuals with diabetes to detect early signs of diabetic nephropathy, it is not as directly related to the immediate risks associated with smoking and family history of heart disease.

B. Peripheral neuropathy: Screening for peripheral neuropathy is essential for diabetes management, but it is not the most critical in the context of the client's smoking history and family history of early heart disease.

C. Hyperlipidemia: Given the client’s significant risk factors—including smoking two packs of cigarettes daily and a family history of early cardiovascular events—it is crucial to screen for hyperlipidemia. Smoking and a family history of early heart attack both increase the risk of cardiovascular disease, which is often associated with high cholesterol levels. Addressing hyperlipidemia can help mitigate the risk of cardiovascular complications.

D. Retinopathy: Screening for diabetic retinopathy is important for managing diabetes and preventing vision problems. However, in the context of the client's smoking and family history, addressing hyperlipidemia is a more immediate concern related to cardiovascular health.

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Naxlex Comprehensive Predictor Exams

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Correct Answer is D

Explanation

A) Instruct on technique of "stop, drop & roll" at assembly:
This is a primary prevention intervention aimed at educating students on how to prevent burns in the event of a fire. It does not address a specific identified problem but rather provides general safety education.

B) Involve the parent teacher association (PTA) in a fund raising event for the new gym:
This action focuses on raising funds for a new gym, which is related to school improvement and development rather than addressing an immediate health issue. It does not fall under secondary intervention for an identified problem.

C) Invite 1st grade parents to a "Meet the Teachers" event:
This intervention focuses on fostering relationships between parents and teachers and improving school engagement. While valuable, it does not address a specific health problem that requires secondary intervention.

D) Send letters to parents regarding a recent lice infestation:
This is a secondary prevention intervention aimed at addressing an already identified problem—in this case, a lice infestation. By informing parents, the nurse is helping to manage and control the spread of lice among students, which is a direct response to an identified health issue.

A. Low income families living in cramped quarters. B. Sexually active persons with multiple partners. C. IV drug users who share needles. D. Those who have recently received a blood transfusion.

Correct Answer is A

Explanation

A. Low income families living in cramped quarters: Hepatitis A is primarily spread through the fecal-oral route, often through contaminated food or water. Individuals living in overcrowded or unsanitary conditions are at a higher risk due to the increased likelihood of exposure to contaminated sources and poor hygiene practices. Thus, low-income families living in cramped quarters are particularly vulnerable to hepatitis A.

B. Sexually active persons with multiple partners: While hepatitis B and C are more commonly associated with sexual transmission, hepatitis A is less commonly spread through sexual activity. Hepatitis A transmission is more directly related to poor sanitation and hygiene rather than sexual behavior alone.

C. IV drug users who share needles: Intravenous drug users who share needles are at high risk for hepatitis B and C, not hepatitis A. Hepatitis A is not typically transmitted through blood but rather through contaminated food and water.

D. Those who have recently received a blood transfusion: Hepatitis A is not transmitted through blood transfusions. Hepatitis B and C are the types of hepatitis associated with blood transfusions. Hepatitis A is spread through ingestion of contaminated food or water.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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

Correct Answer is D

Explanation

Community health nurses are particularly concerned with the spread of communicable diseases such as hepatitis A. Which group of Individuals should the nurse identify as being at greatest risk for contracting this type of hepatitis?

Correct Answer is A

Explanation

A prescription for discharge is written for an elderly client who has asked to be discharged to home. The client lives alone and is able to walk 10 to 15 feet (3 to 4.5 meters) with assistance. Which action should the nurse implement first?

While assessing a child at the community health clinic, the nurse notes that the toddler has multiple bruises on his legs and buttocks. After reporting suspected child abuse to the supervisor, which action should the nurse take next?

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?

When assessing the health of a community, which is the most important information for the nurse to obtain?

The school nurse is assessing a group of middle school students for signs of scoliosis and discovers a student with a noticeable unequal symmetry of the upper and lower back. Which intervention is most important for the nurse to implement?

The nurse is planning a health fair for high school students. Which assessment is most important for the nurse to obtain?