Question

Q1

History and Physical

Day 3, 0800:

An adult client who underwent right knee arthroplasty 3 days ago is

scheduled for discharge on postoperative day 4.

History:

Osteoarthritis

• Hypertension

• Hyperthyroidism

Home medications:

Celecoxib

Metoprolol

Levothyroxine

Social history:

The client's partner died 5 years ago; currently, the client lives with an

adult child who is retired.

A home health nurse is performing a home visit to determine safety needs for a client.

Home Assessment

Day 3, 1400:

Front entrance with 2 steps leading up to the front door, a ramp was recently added, and there is sufficient lighting. The living room has excessive furniture, creating narrow pathways for walking.

Rugs throughout the house are non-secure.

Highly polished wood floors throughout the house.

Two-story house with the clientS bedroom on the first floor Full bathroom on the first floor.

Walk-in shower with a shower chair in place. Elevated toilet.

No handrails present in the bathroom. Night lights in the hallway and bathroom.

A home health nurse is performing a home visit to determine safety needs for a client.

Exhibits

Which of the following findings by the nurse may present complications for the client? Select all that apply.

Answer 1

Correct Answers:

Flooring
Inside walking pathway
Rugs
Handrails

Rationale :

Highly polished wood floors, narrow walking pathways, non-secure rugs, and a lack of handrails in the bathroom increase fall risk for a post-surgical client.

Distractor Analysis :

Rationale for Incorrect Options to be Available Soon

Answer 2

Correct Answers:

One of the child's parents appears frightened of the other parent
One of the child's parents has a history of alcohol use disorder

Rationale :

🔍 One of the child's parents appears frightened of the other parent

🛑 Domestic violence or intimidation between adults in the home can indicate an abusive and unsafe environment, which increases the risk for child abuse or neglect.

🛑 Children in such households may be witnesses to or direct victims of violence, and caregivers who are frightened may be unable to protect the child effectively.

🛑 This situation reflects emotional control, fear, and possibly coercive behavior, which are common in abusive households where children are also at risk.

🔍 One of the child's parents has a history of alcohol use disorder

🍺 Substance abuse, including alcohol use disorder, is a well-documented risk factor for child maltreatment. It can lead to impaired judgment, emotional volatility, and poor supervision.

🍺 Parents with alcohol dependence may exhibit neglectful or violent behavior, especially under the influence, and may fail to respond appropriately to a child’s needs or injuries.

🍺 This risk increases when recurrent injuries (like a second fractured ulna) are noted without a clear or consistent explanation.

Distractor Analysis :

Rationale for Incorrect Options to be Available Soon

Answer 3

Correct Answers:

You should avoid sexual contact until therapy is complete.
Notify anyone with whom you have had sexual contact over the past 2 months-
You might experience painful urination until the infection has resolved.

Rationale :

🦠 You should avoid sexual contact until therapy is complete.

🚫 Chlamydia is a sexually transmitted bacterial infection, and clients should refrain from sexual activity until both they and their partners have completed the full course of treatment, usually a 7-day antibiotic regimen.

🚫 This prevents reinfection or transmission to others during the infectious period.

🚫 The CDC recommends abstinence during treatment and until 7 days after completion of a single-dose regimen or the end of a 7-day regimen.

🦠 Notify anyone with whom you have had sexual contact over the past 2 months.

📢 Sexual partners within the past 60 days must be notified, tested, and treated, as they may be infected and asymptomatic.

📢 Timely notification prevents ongoing transmission and supports public health tracking and intervention.

📢 Partner treatment is essential to break the cycle of reinfection and protect the community.

🦠 You might experience painful urination until the infection has resolved.

🔥 Dysuria (painful urination) is a common symptom of chlamydia, especially in the early phase of infection.

🔥 Symptoms may persist for a few days after starting antibiotics but should gradually resolve with treatment.

🔥 Persistent or worsening symptoms should prompt reassessment for possible co-infection or treatment failure.

Distractor Analysis :

Rationale for Incorrect Options to be Available Soon

Answer 4

Correct Answers:

Gonorrhea

Rationale :

📋 Gonorrhea is a nationally notifiable disease and must be reported to the Centers for Disease Control and Prevention (CDC) by healthcare providers and laboratories.

📋 Reporting helps track incidence and trends, identify outbreaks, and implement public health interventions to prevent transmission, particularly in pregnant clients where vertical transmission can cause serious complications (e.g., ophthalmia neonatorum).

📋 The CDC maintains a list of reportable sexually transmitted infections (STIs), which includes gonorrhea, chlamydia, syphilis, and HIV.

📋 Prompt reporting is essential for contact tracing, partner notification, and public health surveillance.

Distractor Analysis :

Rationale for Incorrect Options to be Available Soon

Answer 5

Correct Answers:

"It helps me relax more deeply."

Rationale :

👐 Therapeutic touch (TT) is a type of complementary therapy based on the idea that the practitioner can facilitate healing and relaxation by using their hands to detect and manipulate the client's energy field, typically without physical contact.

👐 Clients often report that therapeutic touch induces a calming effect, reduces anxiety, and promotes relaxation, which supports its use in stress reduction and holistic care.

👐 The main outcome of therapeutic touch is enhanced emotional well-being, which is frequently described by clients as feeling more relaxed or centered.

👐 While therapeutic touch is not scientifically proven to alter physiological processes like immunity or energy levels, it is widely used in nursing to enhance comfort and promote relaxation.

Distractor Analysis :

Rationale for Incorrect Options to be Available Soon

Answer 6

Correct Answers:

Report of rash and fever among over half the attendees at a recent college sports event

Rationale :

🧬 A sudden outbreak of symptoms like rash and fever affecting a large group of people in a public setting (e.g., college sports event) strongly suggests an unusual and possibly intentional exposure, making it a red flag for bioterrorism.

🧬 Bioterrorism attacks often involve the deliberate release of biological agents (e.g., smallpox, anthrax, plague) in populated areas, causing rapid illness in clusters of people.

🧬 The unusual clustering, acute presentation, and the setting (a large public event) make this scenario particularly suspicious and warrant immediate investigation and public health response.

🧬 Surveillance systems rely on healthcare professionals to report such atypical, widespread illnesses to detect potential bioterrorism early and prevent further spread.

Distractor Analysis :

Rationale for Incorrect Options to be Available Soon

Answer 7

Correct Answers:

Measure noise levels at various locations in the facility.

Rationale :

🔊 Physical hazards refer to environmental factors that can cause bodily harm without direct contact. Common workplace physical hazards include noise, vibration, radiation, temperature extremes, and unsafe machinery.

🔊 Measuring noise levels helps identify areas where sound exposure exceeds safe thresholds (generally 85 decibels or more over an 8-hour shift), which can cause permanent hearing loss or stress-related illnesses.

🔊 This action allows the occupational health nurse to recommend engineering controls (e.g., sound barriers), administrative controls (e.g., rotating shifts), or personal protective equipment (e.g., earplugs).

🔊 Regular noise assessments are also part of compliance with Occupational Safety and Health Administration (OSHA) standards and demonstrate proactive safety planning.

Distractor Analysis :

Rationale for Incorrect Options to be Available Soon

Answer 8

Correct Answers:

The client attends a health seminar and has a cholesterol test.

Rationale :

🧪 Secondary prevention focuses on early detection and prompt intervention to identify diseases in their preclinical or early stages, allowing for timely treatment to prevent progression.

🧪 Attending a health seminar and undergoing a cholesterol screening is a classic example of secondary prevention. The test aims to detect hyperlipidemia or cardiovascular risk before symptoms occur.

🧪 If abnormalities are found early, the client can receive lifestyle counseling or medication, thereby reducing the risk of more severe outcomes like heart attacks or strokes.

🧪 This action bridges awareness and proactive health monitoring, both of which are essential to the goals of secondary prevention.

Distractor Analysis :

Rationale for Incorrect Options to be Available Soon

Answer 9

Correct Answers:

A client who has rubeola virus

Rationale :

🦠 Rubeola virus, also known as measles, is a highly contagious viral illness and is a nationally notifiable disease in the United States.

🦠 Healthcare providers are required to report confirmed or suspected measles cases to their state or local health department, which then reports to the Centers for Disease Control and Prevention (CDC).

🦠 Prompt reporting is essential for outbreak detection, public health response, and containment efforts, especially due to the risk of rapid community transmission and complications such as pneumonia, encephalitis, and death.

🦠 Reporting supports vaccination campaigns, surveillance, and ensures appropriate contact tracing and isolation measures are implemented quickly.

Distractor Analysis :

Rationale for Incorrect Options to be Available Soon

Answer 10

Correct Answers:

Providing health services at work sites

Rationale :

🚜 Migrant populations often face significant barriers to accessing healthcare, including transportation issues, long work hours, language differences, and lack of insurance.

🚜 Offering care directly at work sites meets the population where they are, improving accessibility and compliance, especially for seasonal or agricultural workers who may not be able to take time off.

🚜 This intervention aligns with culturally competent and accessible care, ensuring essential services like immunizations, screenings, and health education reach underserved populations.

🚜 Providing on-site care is a proven public health strategy for improving health outcomes and addressing the unique vulnerabilities of transient or marginalized groups.

Distractor Analysis :

Rationale for Incorrect Options to be Available Soon

QLexNursing

2 :
A school nurse is reviewing the family history of a school-age child who has a fractured ulna for the second time. Which of the following findings places the child at risk for child abuse? (Select all that apply.)

🔍 One of the child's parents appears frightened of the other parent

🔍 One of the child's parents has a history of alcohol use disorder

3 :
A nurse is counseling a client who has a new diagnosis of chlamydia. Which of the following information should the nurse include in the teaching? (Select all that apply)

🦠 You should avoid sexual contact until therapy is complete.

🦠 Notify anyone with whom you have had sexual contact over the past 2 months.

🦠 You might experience painful urination until the infection has resolved.

4 :
A nurse in an antepartum clinic is reviewing the medical records of four clients. Which of the following infectious conditions should the nurse report to the Centers for Disease Control and Prevention?

5 :
A nurse is evaluating outcomes for a client who is using alternative and complementary therapies. Which of the following statements should the nurse expect the client to make about therapeutic touch?

6 :
A nurse is developing a surveillance guide to assist with monitoring for bioterrorism attacks. Which of the following situations should the nurse include as an indication of possible bioterrorism?

7 :
A newly hired occupational health nurse is assessing hazards in the work environment. Which of the following actions will help the nurse detect potential physical hazards?

8 :
A nurse at a primary care provider's office is conducting a client history. Which of the following client actions should the nurse identify as a secondary prevention activity?

9 :
A nurse in a health department is reviewing the infection reports for a group of clients. For which of the following clients should the nurse file a report with the CDC?

10 :
A community health nurse is working with a migrant population. The nurse should recognize that which of the following interventions is necessary to provide care to this population?

QLexNursing

2 : A school nurse is reviewing the family history of a school-age child who has a fractured ulna for the second time. Which of the following findings places the child at risk for child abuse? (Select all that apply.)

🔍 One of the child's parents appears frightened of the other parent

🔍 One of the child's parents has a history of alcohol use disorder

3 : A nurse is counseling a client who has a new diagnosis of chlamydia. Which of the following information should the nurse include in the teaching? (Select all that apply)

🦠 You should avoid sexual contact until therapy is complete.

🦠 Notify anyone with whom you have had sexual contact over the past 2 months.

🦠 You might experience painful urination until the infection has resolved.

4 : A nurse in an antepartum clinic is reviewing the medical records of four clients. Which of the following infectious conditions should the nurse report to the Centers for Disease Control and Prevention?

5 : A nurse is evaluating outcomes for a client who is using alternative and complementary therapies. Which of the following statements should the nurse expect the client to make about therapeutic touch?

6 : A nurse is developing a surveillance guide to assist with monitoring for bioterrorism attacks. Which of the following situations should the nurse include as an indication of possible bioterrorism?

7 : A newly hired occupational health nurse is assessing hazards in the work environment. Which of the following actions will help the nurse detect potential physical hazards?

8 : A nurse at a primary care provider's office is conducting a client history. Which of the following client actions should the nurse identify as a secondary prevention activity?

9 : A nurse in a health department is reviewing the infection reports for a group of clients. For which of the following clients should the nurse file a report with the CDC?

10 : A community health nurse is working with a migrant population. The nurse should recognize that which of the following interventions is necessary to provide care to this population?

2 :
A school nurse is reviewing the family history of a school-age child who has a fractured ulna for the second time. Which of the following findings places the child at risk for child abuse? (Select all that apply.)

3 :
A nurse is counseling a client who has a new diagnosis of chlamydia. Which of the following information should the nurse include in the teaching? (Select all that apply)

4 :
A nurse in an antepartum clinic is reviewing the medical records of four clients. Which of the following infectious conditions should the nurse report to the Centers for Disease Control and Prevention?

5 :
A nurse is evaluating outcomes for a client who is using alternative and complementary therapies. Which of the following statements should the nurse expect the client to make about therapeutic touch?

6 :
A nurse is developing a surveillance guide to assist with monitoring for bioterrorism attacks. Which of the following situations should the nurse include as an indication of possible bioterrorism?

7 :
A newly hired occupational health nurse is assessing hazards in the work environment. Which of the following actions will help the nurse detect potential physical hazards?

8 :
A nurse at a primary care provider's office is conducting a client history. Which of the following client actions should the nurse identify as a secondary prevention activity?

9 :
A nurse in a health department is reviewing the infection reports for a group of clients. For which of the following clients should the nurse file a report with the CDC?

10 :
A community health nurse is working with a migrant population. The nurse should recognize that which of the following interventions is necessary to provide care to this population?