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RELIAS RN PHARMACOLOGY TESTBANK
ACTUAL EXAM LATEST 100 % 2024-
PHARMACOLOGY RELIAS TEST. A+
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. "Red Man" Syndrome may occur during the administration of vancomycin (Vancocin), primarily due to – ans an increase in histamine production WRONG which medication is used to treat iron toxicity? – ans A) digoxin immune fab (Digibind) B) Naloxone (Narcan) C) Mephyton (Vitamin K) D) WRONG deferoxamine (Digibind) WRONG which of the following anticoagulant is MOST commonly administered for DVT prophylaxis in a patient who has undergone a hip replacement? – ans A)WRONG heparin B) Enoxaparin C) Aspirin D) Warfarin A nurse is caring for a patient with hyperparathyroidism and notes that the patient's serum calcium level is 13mg/dl. Which medication should the nurse prepare to administer as prescribed to the patient? – ans calcintonin (Miacalcin) A patient has a prescription to take Guaifenesin (Mucinex) every 4 hours, as needed. The nurse determines that the patient understands the MOST effective use of the medication if the patient states that he or she will: - ans take the medication with a full glass of water A patient's capillary blood glucose reading is 33mg/dl. Which of the following medications will the nurse administer if the patient is unable to tolerate PO? – ans Dextrose 50% IV push A provider orders one liter of NS to be infused over four hours. At what rate would you set the IV pump? – ans 250ml/hr Acetylsalicylic acid (Aspirin) has which of the following pharmacological effects? – ans Anti-inflammatory, anti-pyretic, decrease platelet aggregation Convert 1.2 milligrams to micrograms - ans1200 mcg
Normal Saline (NS) is the solution of choice over D5W when preparing to administer a blood transfusion because: - ans Normal Saline is an isotonic solution and prevents cell hemolysis Patient is to receive 5mg/kg of medication. Patient weighs 80kg. How much would you administer? – ans 400mg Sildenafil (Viagra) is prescribed to treat a patient with erectile dysfunction. A nurse reviews the patient's medical record and would question the prescription if which of the following is noted in the history? – ans Use of nitroglycerin Sildenaphil (viagra) is prescribed to treat a patient with erectile dysfunction. A nurse reviews the patient's medical record and would question the prescription of which of the following is noted in the history? – ans Use of Nitroglycerin The dosage of which drug must be tapered off slowly to prevent acute adrenal insufficiency? – ans prednisone (Deltasone) The patient is diagnosed with multiple myeloma. The physician has ordered cyclophosphamide (Cytoxan). Which instruction should be given to the patient? - ansIncrease daily water intake The patient is diagnosed with multiple Myeloma. The physician has ordered cyclophosphamide (Cytoxan). Which instruction should be given to the patient? – ans Increase daily water intake When a patient has pernicious anemia, the nurse would expect to give them: - ans Vitamin B When caring for a patient with a central line who is receiving TPN, what is the MOST important action on the part of the nurse to prevent CLABSI? – ans Perform correct sterile technique for dressing change at the CVC site When teaching a new nurse on how to administer IV push furosemide (Lasix), you emphasize that it should be given over two minutes to avoid: - ans tinnitus Which of the following is considered an antiplatelet medication? – ans clopidogrel (Plavix) Which of the following medications is known to cause orange-colored urine? – ans phenazopyridine (Pyridium) Which of the following medications should be held today considering that your patient received IV contract two hours ago fir a CT scan? – ans Metformin (Glucophage)
Your patient taking digoxin (Lanoxin) has an AM Potassium level of 3.0. This level may:
- ansIncrease risk of digoxin toxicity Your patient, a Type 1 diabetic with a history of schizophrenia is exhibiting signs and symptoms of tardive dyskinesia, Which of the following long-term medications is more likely the etiology of the problem? - anschlorpromazine (Thorazine) When implementing interventions at the systems-level of practice, the public health nurse would: a. Involve the entire community in solving the health problem. b. Identify health problems in the community. c. Change laws, policies, and practices that influence population-based issues. d. Provide outreach services to populations at risk. - ANSANS: C Systems-level practice consists of changing laws, policies, and practices that influence population-based issues. . Which statement regarding mutations is true? a. Mutations in the DNA sequence occur on a regular basis. b. Mutagens are a result of a mutation. c. Environmental factors can be linked to many mutations. d. Spontaneous mutations occur because of environmental exposure. - ANSANS: C A large number of agents are known to cause mutations. These mutations are attributed to known environmental causes. DNA replication is very accurate, thus, mutations do not occur on a regular basis. Mutagens are the factors that cause mutations. Spontaneous mutations occur naturally during DNA replication.
- A home health case manager is charged with identifying opportunities for health promotion and illness prevention. The fulfillment of this charge would best be demonstrated when the case manager: a. collaborates with a local chaplain to ensure that the spiritual needs of cancer clients are addressed. b. refers a new diabetic client to a nutrition counselor for dietary teaching. c. teaches a school nurse how to care for a client who will be returning to school and will require new asthma treatments. d. tracks the immunization status of clients and facilitates access to immunization when needed. - ANSANS: D Case management involves assessment—in this case, screening—and arrangement for delivery of services. Primary prevention includes case management to identify at-risk clients and arrange for services to prevent disease. Through nurse management activities, general community deficiencies in the quality or quantity of health services are
often discovered. Case management activities with individual clients and families will reveal the broader picture of health services in and health status of the community. Community assessment, policy development, and assurance activities that frame the core functions of public health actions are often the logical next step in the nurse case manager's practice to intervene at the community level to make changes. Therefore, the core components of case management and the nursing process are complementary. The nursing process function of assessment is complementary to the case management process function of case finding and includes such activities as applying screening tools according to program goals and objectives.
- A nurse is assigned to provide community outreach to a small town that was partially destroyed by a tornado 3 years earlier and has been rebuilt. The first client is a family who lost their home and their best friend in the tornado. The best intervention would include: a. assessment of the family's home environment to rule out safety issues. b. avoidance of discussion of the disaster of 3 years ago. c. consideration that the family will have worked through the emotional aftermath by now. d. support of the family in preparing a personal disaster response plan. - ANSANS: D The approach of relief activities needs to shift from short-term aid to long-term support. Promoting individual, family, and community preparedness increases safety in the event of disaster and can help children and adults feel empowered. This builds on the resilience of the individual, family, and/or community. Individuals and families still need to be assessed for indications of mental distress (case finding) and referred to a mental health professional if the need exists. Open discussions of the family's response to the slow process of recovery or long-term results of living under adverse conditions can uncover lingering mental distress or exacerbations of chronic conditions that require attention. During the initial stages of recovery environmental safety issues should have been addressed.
- A nurse performing home hospice case management notes the increasing number of hospice clients who lack caregivers in the home environment. The nurse identifies the potential need for a hospice house facility to meet the needs of these clients. The case management process frequently reveals larger picture issues such as which of the following?(Select all that apply.) a. Community cost concerns b. Community conflict resolution skills c. Community satisfaction d. Community weaknesses in quality of services e. Community weaknesses in quantity of services - ANSANS: D, E Case management activities with individual clients and families very often reveal the larger picture of health services and health status of a community. General community
- Advantages of community health program planning include ensuring that available resources are used to meet the needs of the population and: a. applying for grants. b. identifying clients and soliciting board members' support. c. identifying resources, activities, and needs. d. increasing the visibility of the program. - ANSANS: C Community health program planning is population focused and puts the well-being of the public above private interests. Systematic planning for meeting the needs of populations in a community has benefits for clients, nurses, employing agencies, and the community. It ensures that available resources are used to address the actual needs of people in the community, focuses attention on what the organization and health provider are attempting to do for clients, identifies resources and activities that are needed to meet the objectives of client services, reduces role ambiguity by giving responsibility to specific providers to meet program objectives, reduces uncertainty within the program environment, increases the ability of the provider and agency to cope with the external environment and anticipate events, allows for quality decision making, and provides better control over the actual program results. Identifying clients, soliciting board support, applying for grants, and promoting the actual program are steps in the implementation phase of program management.
- Effects of homelessness on health care outcomes can be devastating and may include which of the following? (Select all that apply.) a. Higher incidence of acute and chronic disease b. Higher risk of physical trauma c. Crisis-oriented health care, usually in emergency departments d. Reduced eligibility for entitlement/assistance programs e. Lack of awareness of care options - ANSANS: A, B, C, E Homelessness is correlated with poor health outcomes. The incidence of acute and chronic illness, acquired immune deficiency syndrome (AIDS), and trauma is significantly higher among homeless persons. Although homeless persons are at higher risk for physiological problems, they have greater difficulty accessing health care services. Health care is usually crisis oriented and sought in emergency departments, and those who access health care have a hard time following prescribed regimens. Health problems of homeless clients are often directly related to poor preventive health care services. In addition to facing challenges related to self-care, homeless people usually give lower priority to health promotion and health maintenance than to obtaining food and shelter. They spend most of their time trying to survive. Just getting money to buy food is a major challenge. Although some homeless persons are eligible for entitlement programs such as Temporary Assistance for Needy Families (TANF), Women, Infants, and Children (WIC), or Social Security, others must beg for money, sell plasma or blood products, steal, sell drugs, or engage in prostitution. Barriers to treatment include lack of awareness of treatment options, lack of available space in
treatment facilities, inability to pay for treatment, lack of transportation, nonsupportive attitudes of service providers, and lack of coordinated services.
- In 1988, the Institute of Medicine (IOM) published a report on the future of public health and its mission that defined public health as: a. what public-private partnerships do to treat vulnerable populations. b. what the government does to ensure that vital programs are in place. c. what the U.S. Public Health Service does to prevent disease, promote health, and deliver services. d. what society does collectively to ensure the conditions in which people can be healthy. - ANSANS: D In 1988, the IOM's report stated that public health is "what we, as a society, do collectively to assure the conditions in which people can be healthy." Consequently, the mission of public health is "to generate organized community effort to address the public's interest in health by applying scientific and technical knowledge to prevent disease and promote health." This clearly places the emphasis on the desire of the population and community to ensure access to services that foster the health status of the overall community through the equitable distribution of resources addressed to community problems that affect health.
- In caring for migrant workers and their families, the nurse should first assess the migrant workers' lifestyle, especially their current: a. communicable diseases. b. educational level. c. housing arrangements. d. pesticide exposure. - ANSANS: C The way of life of migrant farmworkers and their families is stressful. They often have trouble finding decent and affordable housing. Available housing is often overcrowded and lacking in individual sanitation, bathing or laundry facilities, window screens, and fans or heaters. Housing may be located in hazardous areas next to fields or farm machinery. Housing may be rundown or structurally deficient. Some families may be living in cars or tents when housing is unavailable. All of these factors impact the health status of migrant families and need to be understood by the nurse to direct further assessment.
- Public health nursing specialists are interested in which of the following topic(s)? (Select all that apply.) a. Educational materials for individuals with HIV/AIDS b. Evaluation of an outreach program for at-risk pregnant teenagers c. Community subpopulations with high rates of type 2 diabetes d. New technologies to monitor diabetes e. Prevalence of hypertension among various age, race, and gender groups - ANSANS: B, C, E
Vulnerable populations are defined as those at greater risk for poor health status and health care access. In health care, risk is an epidemiologic term indicating that some people have a higher probability of illness than others. The natural history of disease model explains how certain aspects of physiology and the environment make it more likely that a certain individual will develop a particular health problem. However, not everyone who is at risk develops health problems. Some individuals are more likely to develop the health problems for which they are at risk. A vulnerable population group is a subgroup of the population that is more likely to develop health problems as a result of exposure to risk or to have worse outcomes from these health problems than the rest of the population.
- A client newly diagnosed with HPV infection, herpes simplex virus 2 (HSV-2) infection, and syphilis asks, "Okay, so how do I get rid of all this stuff?" In developing a plan of care, the nurse recognizes that it is essential to address: a. correct use of condoms to prevent transmission of all STDs. b. cures for each of the STDs identified. c. risk of skin-to-skin contact in transmitting the identified STDs. d. safety of sexual contact in the absence of lesions. - ANSANS: C The client needs to understand which STDs are transmitted by skin-to-skin contact and which are transmitted by body fluids. The client also needs to understand which infections are curable with antibiotics (syphilis) and which are virus infections that are treatable but not curable (HPV, HSV-2 infections). In HSV-2 infection, although the ability to pass the infection is higher when active lesions are present, some individuals can spread the infection even when they are asymptomatic. HPV transmission occurs through direct contact with the warts that result from HPV, but the virus has also been detected in semen, and exposure to the virus through body fluids is also possible. In addition, the challenge of HPV prevention is that condoms do not necessarily prevent infection because warts can grow in areas that are not covered by barriers such as condoms and skin-to-skin contact may occur.
- A community health nurse is conducting a community assessment as part of a program planning initiative and is seeking a tool that is low cost, allows clients to participate in identification of need, and would stimulate community support for the program. The nurse would most likely use which of the following? a. Community forum b. Focus group c. Indicators approach d. Survey - ANSANS: B There are several types of needs assessment tools, including community forums, focus groups, key informants, indicators approach, survey of existing agencies, and general surveys. Both community forums and focus groups are low-cost tools. The focus group provides clients with the opportunity to participate in identification of needs and can help
increase community support for a program. The focus group method has several disadvantages, such as being time consuming to carry out and tending to focus on irrelevant or political "hot button" issues. Leading focus groups requires strong skills in group process to maintain the focus of the group.
- A registered nurse is seeking a position as a public health nurse. In reviewing the job description, the nurse would expect to find a description of a position that focused on functions such as: a. monitoring pregnant teenagers for symptoms of complications of pregnancy. b. offering free hypertension screening and treatment referral at local health fairs to low- income, uninsured, community members. c. partnering with local seasonal farmworkers to design a program aimed at preventing illness and injury, and advocating for this population with local political and community leaders. d. preventing injury among a population of elderly residents in an assisted living facility and treating residents' chronic illnesses. - ANSANS: C The scope of practice of public health nurses is population focused and community oriented, with a primary emphasis on population-level interventions that target strategies for health promotion and disease prevention. In addition, public health nursing is concerned with the health of all members of a population or community, particularly vulnerable populations, and uses political processes as a major intervention strategy.
- During a home visit, a case manager for a community health center notes marked pitting edema, shortness of breath, and increased fatigue in a 52-year-old male client who lives alone. The client is admitted to the hospital, where he is diagnosed with congestive heart failure. The case manager works with the hospital's utilization manager to devise a discharge plan. The case manager's most logical next step would be to: a. assess the client; obtain information on the scope of services covered by the benefit plan for the client; if needed services are not covered, seek to identify and arrange for the resources to provide these services. b. call the client, reintroduce himself or herself, and explain his or her role as a case manager for homebound clients. c. discuss with the family their schedule of availability to offer care in the client's home; ensure that the client has daily visits by family members. d. investi - ANSANS: A Case management has been described as a set of logical steps and process of interaction within a service network that ensures that a client receives needed services in a supportive, effective, efficient, and cost-effective manner. The National Case Management Task Force defines case management as a collaborative process that assesses, plans, implements, coordinates, monitors, and evaluates the options and services to meet an individual's needs, using communication and available resources to promote quality cost-effective outcomes. Case management has been defined in the public health nursing literature as the establishment of an appropriate plan of care
and the equipment may not be properly maintained. The workers' low educational level may impede their ability to comprehend essential training or warnings. In most states, migrant farmworkers are not protected by the same occupational health regulations and worker's compensation benefits as workers in other industries. Workers may fear loss of their jobs if they report injuries and may not be able to afford personal protective equipment.
- Which of the following best represents the concept of homelessness as crisis poverty? a. Man with chronic alcoholism and drug abuse living in a halfway house b. Recently unemployed man evicted from his apartment c. Teenager living on the streets and abusing drugs d. Woman with schizophrenia who is living in a shelter - ANSANS: B Crisis poverty is a conception of homelessness that views the homeless as people whose lives are generally marked by hardship and struggle. For this group, homelessness is often transient or episodic. Their homelessness may result from lack of employment opportunities, lack of education, obsolete job skills, and/or domestic violence.
- A community health nurse is serving as a case manager for premature infants receiving home health care. The case manager arranges for an in-home apnea monitor and daily home visits by a registered nurse who specializes in high-risk pediatrics. The case manager is demonstrating which of the following case manager roles? a. Consultant and coordinator b. Mentor and liaison c. Monitor and reporter d. Standardization monitor and negotiator - ANSANS: A The case manager is responsible for fulfilling a variety of roles. The nurse is acting as a consultant when working with suppliers to arrange for the apnea monitor. The nurse is acting as a coordinator when arranging for needed heath care services such as daily home visits by a specially trained pediatric registered nurse.
- A community-oriented nurse is writing a grant application for funding for a nurse-run clinic serving clients with chronic illnesses. The grant application asks for information regarding program benefits, effectiveness, and efficiency. The most effective tool to obtain this information would be: a. cost studies. b. Mobilizing for Action through Planning and Partnerships (MAPP) model. c. Planning Approach to Community Health (PATCH) method. d. Tracer method. - ANSANS: A Cost studies are essential to show the value of nursing in the marketplace now and in the future. All cost studies involve three major tasks: financial, research, and statistical.
The financial tasks include identifying total program costs. The statistical tasks include identifying appropriate, quantifiable measures for analyzing data. The research tasks include setting up an appropriate study design to answer questions about benefit, efficiency, or effectiveness. Types of cost studies include cost-accounting, cost-benefit, cost-effectiveness, and cost-efficiency studies.
- A nurse is assigned to teach clients STD prevention information. The nurse updates her teaching plan to incorporate new guidelines from the Centers for Disease Control and Prevention. She includes which of the following as updated information during her next teaching session? a. Always use spermicides with condoms to reduce the risk of contracting chlamydia or gonorrhea. b. Condoms can be effective in preventing infections transmitted by fluids from mucosal surfaces but are not always effective in preventing infections transmitted by skin-to-skin contact. c. Condoms should not be used during oral sex, because they are not effective in preventing transmission of infection. d. When genital ulcers are present, condoms should be used to prevent the spread of infection. - ANSANS: B The lesions of HSV-2 and HPV infection as well as other lesions capable of transmitting STDs can occur on all parts of the male and female genitalia and rectum. Condoms are effective in reducing transmission via body fluids from the penis and vagina. However, lesions not covered by a male or female condom can still transmit infection even with proper condom use
- A public health nurse leader is encountering barriers when trying to shift the public health agency's efforts to a population-focused practice. The reasons peers are not supportive of the proposed shift to a population focus are most likely related to: a. agency colleagues' push for nurses to focus on population initiatives. b. costs associated with staff training and revision of documents. c. lack of support from the agency's funding sources. d. opinions that nursing should focus on the provision of direct client care and services.
- ANSANS: D Barriers to implementing population-focused care include lack of understanding of the public health nurse role and its relationship to other roles in nursing, such as direct care and services; workplace role socialization that determines what roles are appropriate and inappropriate or accessible and inaccessible for nurses; and lack of comprehensive training at the graduate level in the disciplines basic to public health such as epidemiology, biostatistics, community development, service administration, and policy formation.
- Deinstitutionalization of chronically ill individuals from publicly funded psychiatric hospitals had the unintended consequence of: a. moving clients to readily available community-based care.
variety of emergency responding units with personnel coming from different parts of the country, the challenge of working together in unison may require the use of the NIMS, which provides all responders with a protocol and common language for working together. The importance of interoperable communication equipment is stressed by the NIMS.
- Vulnerability is multidimensional, and one of the primary contributors to vulnerability is: a. gender. b. race and ethnicity. c. resource limitations. d. urban or rural residency. - ANSANS: C Resource limitations are strongly related to health. Lack of adequate social, educational, and economic resources make people more vulnerable and more likely to experience health disparities, and poverty is a primary cause of vulnerability. A correlation has been found between individual indicators of socioeconomic status (e.g., income, education, and occupational status) and a range of health indicators (e.g., morbidity and mortality resulting from various health problems). Not only do individual-level socioeconomic characteristics seem to matter, but population-level characteristics such as income inequality also make a difference. Resource limitations affect the individual's ability to show resilience in the face of problems and crises. Resource limitations may also place individuals and families at risk because of substandard housing, impoverished neighborhoods, and hazardous environments. Although race has been correlated with poor health outcomes, poverty seems to be a key contributing factor for minority populations. Poverty is more likely to affect women and children than other groups.
- A community health nurse is the case manager for a homebound client recovering from a hip replacement. The nurse works with the client and his family to prioritize needs and services, and to address these care needs. These activities represent which step in the nursing process? a. Assessment and planning/outcome b. Diagnosis and planning c. Implementation d. Planning/outcome - ANSANS: D The case management process function of problem prioritizing and planning to address care needs is complementary to the planning/outcome step of the nursing process.
- A nurse is working with a disaster medical assistance team as it responds to a disaster. A new team member excitedly insists that its personnel can exceed their 12- hour shifts and do not need breaks. The best intervention on the part of the nurse is to: a. arrange for the team member to be transferred to another unit.
b. arrange for the team member to leave duty, return home, and talk with his or her pastor. c. educate the rescuer about necessary stress-management techniques and offer to pair up with the individual so that each can monitor the other's stress level. d. help the team member to call home to speak with his or her family. - ANSANS: C The nurse needs to be aware that rescue workers are repeatedly exposed to stress and, despite their training in managing such situations, have a higher than normal risk of developing post-traumatic stress syndromes. The nurse can assist the new team member by educating the rescuer about the importance of stress-management and self- management techniques. The nurse could pair up with the new team member so that they could monitor each other's stress responses and could provide guidance in adhering to stress management techniques.
- A nurse providing a tertiary prevention intervention to a population of women who are HIV positive will most likely: a. educate about self-care and the women's rights as employees. b. establish a partnership with a community to initiate a community health center. c. help identify new cases and ensure that clients receive proper treatment. d. teach how to lobby state legislators. - ANSANS: A Helping clients understand their rights to protect from on-the-job discrimination is part of the nurse-advocate role. Tertiary prevention includes educating women with a chronic disease such as HIV about self-care strategies and health-promotion activities to minimize risky behaviors and poor health outcomes. Enhancing levels of self-esteem and empowerment can prevent feelings of powerlessness and hopelessness, which contribute to vulnerability.
- A woman comes to the community health center complaining of increasing lower abdominal pain, fever, and abnormal menses for several months. During the assessment, the client indicates that she is aware that her husband has had multiple sex partners in the past 2 years. Appropriate intervention by the nurse would be to: a. arrange to have the client referred for medical evaluation for pelvic inflammatory disease (PID) and appropriate intervention and treatment. b. contact the health department to confirm the spouse's diagnosis of Chlamydia infection to determine the client's exposure, give the client antibiotics, and have her return to the clinic if symptoms worsen. c. provide STD prevention and treatment education and refer the client to the health department for STD screening for gonorrhea and/or Chlamydia infection. d. supply the client with nonsteroidal anti-inflammatory drugs and caution her to call the after- - ANSANS: A Nursing assessment should always include taking a comprehensive sexual history to determine an individual's potential risk for STDs. Each sexual partner is potentially exposed to all the STDs of all the persons with whom their partner has been sexually active. PID is a serious infection involving the fallopian tubes and is the most common
as a whole (individual to families to groups to community flow). This is different from public health nursing, which is the synthesis of nursing theory and public health theory applied to promoting and preserving the health of populations. The focus of public health nursing practice is the community as a whole and the effect that the community's health status, including health care resources, has on the health of individuals, families, and groups (community to groups to families to individual flow). Both community health and public health nursing are considered to be community-oriented practices involving free-living (noninstitutionalized) clients. Community-based nursing practice is setting specific, and care is provided to clients where they live (home health or hospice nursing, community-based clinic), work (occupational health nursing), and/or attend school (school nursing). The emphasis of community-based nursing practice is acute and chronic care (illness care) and the provision of comprehensive, coordinated, and continuous services, usually within a specialty area.
- When planning a new community health center, a nurse will integrate knowledge of the nursing process and program management. The nurse's initial and most critical step for funding purposes would be: a. finding the lay leaders in the community. b. identifying the target population's health problems and needs. c. outlining the major causes of mortality in the community. d. prioritizing the community's problems. - ANSANS: B The program management process is parallel to the nursing process and consists of a rational decision making system designed to help nurses know when to make a decision to develop a program (assessment and problem identification); where they want to be at the end of the program (goal setting); how to decide what to do to ensure a successful program (planning); how to develop a plan to go from where they are to where they want to be (implementation); how to know that they are getting there (formative evaluation); and what to measure to know that the program has successful outcomes (summative evaluation). Planning for effective and efficient programs must be based on determination of the needs of populations within the community. Identification of at-risk groups and documentation of the health needs of the targeted population provide the basic justification and rationale for the proposed program plan. Such documentation of needs is essential if funding will be sought to implement the plan. An assessment of health needs may be approached as either a community assessment or a population needs assessment.
- Within the impoverished older adult population, the most vulnerable group may be: a. elderly couples living in poverty with serious chronic illnesses. b. elderly men with alcoholism and limited incomes. c. homeless older adults. d. newly widowed, low-income elderly women. - ANSANS: C Homeless older adults are the most vulnerable of the impoverished older adult population. They have long lived in poverty, have fewer supportive relationships, and
are likely to have become homeless as a result of catastrophic events. Life expectancy for homeless older adults is significantly lower than that for older housed adults. Permanent physical deformities, often secondary to poor or absent medical care, are common among homeless older adults. Homeless older adults suffer from untreated chronic conditions, including tuberculosis, hypertension, arthritis, cardiovascular disease, injuries, malnutrition, poor oral health, and hypothermia. As with younger homeless persons, older adults who are homeless must focus their energy on survival, which leaves little time for health promotion activities.
- A case manager employed by a health maintenance organization is charged with discontinuing home health services for a disabled homebound elderly client in an effort to reduce costs. The case manager reviews the client's record and determines that home health services are still indicated for this client. The ethical dilemma faced by the case manager is: a. beneficence. b. justice. c. nonmaleficence. d. veracity. - ANSANS: A Beneficence—"doing good"—becomes an ethical dilemma when the insurer's goal of containing costs supersedes the case manager's duty to improve health and relieve suffering. This ethical tenet of nursing practice to act in the best interest of the client also involves fidelity to the nurse-client trust relationship. Duty to clients to secure benefits on their behalf and to limit unnecessary expenditures can create dilemmas when the goals are not uniform. Advocacy on this client's behalf with accurate and updated information based on sound assessment, evidence-based practice, and liability risk management could produce a favorable outcome for all parties. The incorrect action would be to do nothing.
- A community-oriented nurse has identified obesity as a problem in the middle school. The next step in a population-focused practice is to make information available about the health of the middle school students. This describes the core public health function of: a. assessment. b. assurance. c. policy development. d. research. - ANSANS: A Assessment is a core function of public health and refers to systematically collecting data concerning the population, monitoring the population's health status, and making information available on the health of the community. In a community-oriented approach, a nurse would apply both nursing and public health theory. In this case, assessment would be the first step from the perspective of both theories. Because the practice is population focused and community oriented, it would involve the assessment
