A 32-year-old female visits the occupational health nurse because of malaise. Which of the following assessment data indicates that the client may be experiencing achievement-oriented stress?
Unintentional loss of 10 pounds in the past 3 weeks
A nurse volunteered to work at a natural disaster site. Which of the following questions should the nurse ask to determine if the 26-year-old individual being screened is depressed or has suicide ideation?
Have you thought of harming yourself?
Which of the following circumstances accounts for the leading cause of death in young adults?
Binge drinking and driving
When planning health care for young adults, the nurse should recognize that which of the following factors has the greatest impact on whether the interventions are effective?
The interventions should be culturally sensitive
When counseling a 23-year-old woman about oral, transdermal, injectable, vaginal ring, and implant contraceptive methods, the nurse should stress that these methods all carry the risk for which of the following events?
Blood clots
Which of the following interventions are appropriate relative to the nursing diagnosis: Health-Seeking Behaviors Related to Preconceptual Assessment and Preparation for Childbearing?
Referral to genetic counseling based on family history
A 35-year-old client asks the nurse working in a dermatology clinic what causes skin to wrinkle. The nurse should reply:
Wrinkles appear for a number of reasons including loss of fat beneath your skin and too much sun exposure.
A 45-year-old client asks the nurse if she thinks iron supplements would help increase her energy. She has gained 10 lb within the past year. The nurse should:
Ask the client to describe her daily activity and diet
The normal physiological changes that occur during middle age include:
50% reduction of glomerular filtration
The nurse conducting a community education program should stress that the leading cause of death in middle-age adults is:
Malignant disease
The nurse has received a grant to provide a community-based education series for middle-age adults. The nurse will make the greatest impact on the health of this age group if he or she focuses the series on:
Diet and exercise
A 5-year-old has a daily caloric intake of 1800 calories. Approximately what portion of the diet should be comprised of carbohydrates?
900 calories
Which of the following will a 5-year-old need help eating?
Chicken
A 4-year-old had an episode of enuresis. The parents should:
Have him change his own pajamas before going to bed
A 5-year-old is prescribed a medication that is renally excreted. As a result, the dose should be:
At the recommended dose
A 2-year-old has hives. Of the following items ingested, which is most likely to have caused the allergic reaction?
Oatmeal raisin cookies
Which of the following is a test for visual acuity?
Snellen Screening test
A 4-year-old asks her mother for a second cup of yogurt. The extra helping is likely for:
he child's imaginary friend
Calculate the approximate number of daily calories required by an 18-kg preschooler.
1620 calories
A 4-year-old tells his father that he invented a new song. The father's best response is to:
Congratulate his son on a job well done
Which recommendation is most useful at preventing burns in a preschooler?
Do not leave cigarettes and matches on the kitchen counter.
Appropriate outdoor play for a 5-year-old includes:
Playing in the park while being supervised by his parent
A child should not sit in the front seat of a car until the age of:
13
The hallmark of Piaget's preconceptual substage is:
Using language to function symbolically
A mother thinks her 2-year-old drank Drano�. The first thing she should do is:
Call the Poison Control Center
A preschooler and her school-age brother both received the same swimming tube as a gift. The brother accidentally took his sister's swimming tube. The sister protested that she needed her swimming tube to go swimming. This behavior is indicative of:
Concrete thinking
A common reason for nighttime awakening in the preschooler is:
Nightmares
The nurse suspects a 5-year-old has asthma. Which fact from the past medical history is a risk factor?
The child had RSV as an infant. Respiratory infection.
Which is the most common intraocular tumor in young children?
Retinoblastoma
The best way for parents to teach their child good hygiene is to:
Model the behavior at home
The nurse makes a home asthma visit. Which environmental finding has the potential to trigger an asthma exacerbation?
Leaky roof
Which behavior best indicates that the preschooler is socially ready to attend school?
He plays well with a group of neighborhood children.
The best way for the nurse to approach a 3-year-old during a physical exam is to:
Let him listen to your heart with the stethoscope
Which is a primary prevention method for avoiding child abuse?
Educating the public about violence and the potential for abuse
A child who recently learned how to throw a ball overhand is likely how old?
4 years old
A preschooler with a receptive vocabulary of up to 5600 words is likely how old?
48 months old
One way to address a Healthy People 2010 health promotion and disease prevention objective for preschoolers is to:
Regulate the paint allowed for use with toys
Which sleep ritual is age-appropriate for a preschooler?
Saying good night to all 20 stuffed animals in the room before going to sleep
The school nurse conducting an in-service program for teachers is asked about general growth and development of school-age children. The nurse should reply:
Overall growth in school-age children is slower than during infancy and adolescence.
According to the American Heart Association, at what age should blood pressure screening begin?
3
The school nurse should suggest a follow-up exam for which of the following children?
10-year-old girl who has gained 11 lb in a year
The president of the Parent-Teacher Association asks the school nurse about the appropriateness of sponsoring a health fair that focuses on oral health for school-age children. Which of the following statements indicates the nurse's correct understanding
Almost 50% of children age 6 to 17 have dental caries, so a health fair that focuses on oral care is very appropriate.
Which of the following statements is correct?
Overweight children have joint and muscle pain more often than average-weight children.
The diet of the school-age child may be deficient in which of the following elements?
Iron
When planning a series on nutrition, the school nurse must take into account which of the following factors?
Television programs aimed at children are frequently sponsored by food-related companies.
The initiatives related to childhood nutrition outlined in Healthy People 2010 that have been most successful include:
Adequate food supplies at home
Which of the following activities is most likely to help children learn about good nutritional practices?
Participating in a "Try This" food day where a large variety of nutritious snacks are available
During a parent-nurse conference, the parent tells the nurse that her child sleeps approximately 7 hours per night. The nurse understands that a lack of adequate sleep may result in:
Obesity
A child who has a BMI of 34 visits the school nurse. The nurse recognizes that the child may experience which of the following?
Bullying by peers
The nurse working in a pediatric practice should make which of the following statements to parents concerned that their 8-year-old son has started wetting the bed at night?
I'm going to collect a urine sample from him and then we will talk about bed wetting.
Which of the following children is at risk for developing encopresis?
A 5-year-old child who has been in four foster care homes since age 3
When discussing sleep patterns in school-age children, the nurse should stress that:
School-age children generally agree with and adhere to a specific bedtime
Parents of an 8-year-old boy tell the nurse that they are concerned about their son because he occasionally sleepwalks. The nurse should reply:
This is not abnormal for a child of this age. He will most likely outgrow this tendency as his nervous system matures.
During a school gift fair, a parent asks the school nurse what gift would be most appropriate for her 6-year-old. The nurse should encourage the parent to purchase:
A jar of sea shells in various shapes, colors, and textures
The school nurse has written a grant to obtain funding for a vision screening program and glasses for children in his pre-K to 6th grade elementary school. The rationale for the funding should contain which of the following statements:
Approximately one in four children have vision problems
Which of the following statements concerning hearing is correct?
The rate of otitis media infections in school-age children has met Healthy People 2010 targets.
A third grade teacher asks the school nurse what she can reasonably expect from children in her classroom related to language ability. The nurse should reply:
You can expect that the children will write 'b' and 'd' without reversing them, and all of the letters in a word will be about the same size.
Each of the following children visits the school nurse on a regular basis. The nurse evaluates that which of these children may have educational difficulty and suggests follow-up care?
A 10-year-old who cannot sit still longer than 15 minutes
A parent asks the nurse working in a pediatric clinic how she can help her 6-year-old child feel good about himself. The nurse should reply:
Having your child help around the house with tasks such as setting the table will increase self-esteem.
Which of the following statements made by a parent is most helpful when discussing rules of the household?
I was upset when you did not feed the dog like you promised. We all need to help take care of him because he depends on us. Let's talk about what happened.
The nurse has been asked to conduct a community awareness program about accidents that impact the school-age child. Which of the following facts should the school nurse include in the program?
Drowning and motor vehicle accidents are the leading causes of fatality in the school-age population.
Nurses frequently care for children with URIs. The school nurse should implement which of the following nursing interventions?
Calling the parent of a child with a mild fever and mild sore throat to come to school to pick up the child and take the child to his or her health care provider
Smoking is a major health problem in the United States. Which of the following facts about smoking is true?
Each day over 6,000 children try smoking
Parents ask the nurse if any help is available to help them provide health care for theirchild. The parents fall into the "working poor" economic category because they earn too much money to qualify for Medicare but not enough to purchase health insurance
The state has an insurance program to assist them
During orientation, the new school nurse asks his preceptor about the role of the school nurse. The preceptor should reply:
We are an important part of the team that helps to maintain and improve children's health in a variety of ways from screenings to advocacy.
A female disorder in which only one X chromosome is present instead of two is known as:
Turner syndrome
A disorder where males have an extra chromosome and typically are tall and initially thin, and do not develop secondary sex characteristics is known as:
Klinefelter syndrome
Which stage of male genital development is characterized by initial enlargement of the penis, mainly in length along with further growth of the testes and scrotum?
3
Which stage of female breast development is characterized by enlargement of the areolar diameter along with a small area of elevation around the papillae?
2
What percentage of adolescent females suffer from an eating disorder in the United States?
10%
The leading cause of death in adolescents between 15 and 19 years of age is which of the following?
Suicide
Females usually begin puberty:
2 years before males
Which behavior is most reflective of a teenager's behavior?
Riding an ATV without a helmet
A teenager has been using acne medications for the last 14 days. Her acne is no better, and in fact, it is a little worse. What advice should the nurse offer this girl?
The medications can make acne appear worse at first; try to give it a few more weeks.
Parents recently discovered that their teenage daughter has been drinking on a regular basis. They ask the nurse for advice on how to best help their daughter. The nurse should tell these parents to:
Enroll their daughter in a peer support group focused on teenage drinking
A mother is concerned because her daughter has been taking a nap every day after school. The nurse's best response is to say:
Tell me about your daughter's schedule.
Which teenage behavior is cause for concern?
A teenager who takes frequent naps and states it is because he is bored
Which teenager is at increased risk for acquiring a sexually transmitted disease and should be provided with anticipatory guidance?
A teenager who feels her friends and family do not care about her
Which is an indication that a teenager is at risk for not meeting his developmental task?
A teenager who is arrested for petty theft
Which behavior is cause for concern and requires further evaluation?
A teenager who is agitated and has trouble sleeping
A teenager is interested in getting a tattoo. She asks her nurse for advice. The nurse should respond by saying:
Tattoos are popular; however, they can lead to infection and/or bleeding.
After offering a teenager the HPV vaccine, the teenager responds by saying, "I can't have the vaccine because I have already been sexually active." The nurse should respond by saying:
You can still benefit from the vaccine, but there is a chance it will not be as effective.
To help their teenager meet his developmental task, parents should:
Maintain an ongoing dialogue about important issues and upcoming challenges
A teenager is due for her period on May 14th. The best day for her to perform a self-breast exam is:
May 23rd
A mother is concerned because her son plays football and another boy on the team was recently treated for CA-MRSA. The mother asks the nurse for her recommendation. The nurse should respond by saying:
Your son should always take precautions to avoid such infections by showering with soap and hot water after each game and practice.
A 14-year-old female is in for a physical exam. Which finding requires further investigation?
The lack of breast buds
The mother of a 13-year-old girl is concerned because her daughter has not started menstruating yet. The girl developed breast buds and started her height spurt at 12 years of age. Knowing this information, the nurse should tell the mother:
Based on when the breast buds first appeared, she should starting menstruating around the age of 14.
During a physical exam, a teenager asks the nurse if she can have a stronger medication for her constipation because the laxatives she has been taking are not helping. During the physical exam, the nurse notices striae and mild to moderate erosion of the
Bulimia nervosa
A teenager has a family history of Type 2 Diabetes Mellitus. He asks the nurse what he can do to try to prevent developing it himself. Which advice should the nurse give this client?
Encourage activity and a balanced diet
A mother is concerned because her 13-year-old daughter comes home happy one day and sad the next. The girl also argues with her younger sister more than she did in the past, and does not like participating in family activities anymore. The best initial re
Adolescence is a time of many changes. These changes can be stressful as teenagers struggle to come to terms with who they are. What other types of behaviors has she been displaying?
The best way to prevent an adolescent pregnancy is to:
Talk to teenagers about sex, including abstinence, contraception, and sexually transmitted diseases
A good way to initiate a discussion about drinking during a physical exam with a teenager is to say:
Do any of your friends drink?
When planning a community health education program for young adults, the nurse should consider that:
The number one cause of death for young adults is injury
During a health counseling session with a 20-year-old female client, the nurse should stress that:
Daily physical activity and weight control is one way to stay healthy.
A 26-year-old has a total cholesterol of 206 mg/dL and an LDL of 110. The nurse evaluates this result as indicating that:
The client requires counseling about cardiac disease risk factors
The public health nurse is conducting a screening of young adults for metabolic syndrome. When asked about the syndrome, the nurse should reply:
This syndrome is a warning sign that the person could develop heart disease. When we discover that someone has metabolic syndrome, we recommend dietary and activity level changes.
The university health services nurse is preparing a disease prevention program for college students. What information should the nurse include in the program?
Living in the dorm increases one's risk of developing meningococcal disease.
A 30-year-old female client with a BMI of 36 is counseled by the nurse regarding weight reduction options. Place the options in the order they should be utilized, from first to last.
1. Gastric stapling
2. Medication to reduce appetite
3. Nutrition and ex
4, 3, 2, 1
When the nurse discusses optimal activity for young adults, she should stress that:
Moderately brisk walking is an appropriate aerobic exercise
The nurse working in the college health center is asked about a safe way to obtain a tan. The nurse should reply:
Be sure to use sunblock agents and do not sunbathe between 10 AM and 2 PM.
The nurse can best help to prevent bicycle/motorcycle fatalities by working with his community to mandate:
Use of helmets
Which of the following reflects Piaget's theory as applied to young adults?
Voting for a candidate based on analysis of the candidate's positions on current issues
Which of the following adults has transitioned to Erikson's intimacy versus isolation and loneliness stage of development?
A 26-year-old female who has a long-term relationship with a female companion
Which of the following young adults exemplifies Kohlberg's postconventional level of moral reasoning?
A 30-year-old who volunteers at a soup kitchen one day a month
The nurse working in occupational health who organizes a stress reduction workshop should take which of the following statements into consideration?
Work is of primary importance to young adults and helps form their self-image
The school nurse has invited the mother of a 10-year-old child to a meeting to discuss the child's recent aggression toward his classmates. The child has confided in the school nurse that his parents are getting divorced. The nurse must take into account
Going to a professional marriage counselor is the best way to learn to deal with the divorce.
A 19-year-old college student is seen by the health services nurse. The young woman is distraught that she had unprotected sex 4 days ago and is afraid she may have become pregnant. The nurse should make which of the following statements:
Let's talk about your options.
The nurse working in the college health center is planning a program about STDs. What information should the nurse include in the program?
STDs can be transmitted by any intimate contact, not just sexual intercourse.
A nurse formed a political action committee to advocate for health insurance. Which of the following groups have the highest rate of uninsured people?
Hispanic Americans
A nurse has been asked to develop a visit plan for a mobile mammogram van. When deciding which neighborhoods to visit, the nurse takes into consideration that:
The death rate from breast cancer is higher in Hispanic women than for women in other ethnic groups
The nurse collects the following assessment data from a female client: Hispanic ethnicity, BMI 29kg/m2, age 41. Based on the data the nurse should:
Discuss her dietary and exercise lifestyle changes
A nurse working in a rural location is interested in starting a weight management group for clients in the area. Which of the following interventions is most likely to ensure success?
Asking for a list of topics that interest the group
A 52-year-old postmenopausal woman tells the nurse that she is afraid that she will develop osteoporosis like her mother did. The appropriate response by the nurse is:
Tell me about your diet, how much walking you do each day, and what medications you take.
Which of the following statements about alcohol intake is correct?
More women die from complications of alcoholism than do men.
The occupational health nurse is planning a health fair for employees. What dental health information should be included?
In addition to screening for tooth decay, dentists screen for mouth cancer.
Which of the following people has exceeded the recommended guidelines for activity?
During activity, the person's pulse rate should not exceed 220 minus the age times 0.75
A 63-year-old client complains to the nurse that she has insomnia and sleeps only 6 hours a night. The nurse should reply:
Many people your age need less than 8 hours of sleep a night. Do you feel excessively tired during the day?
The nurse conducted a 5-week education series about health maintenance. Which of the following statements by a participant indicates the analysis stage of cognition as defined by Bloom's taxonomy?
Food has calories based on composition. Fat is more calorie-dense than is protein. If I eat calorie-dense foods and do not do moderate exercise at least 5 days a week, I will gain weight.
A 62-year-old client states to the nurse, "I have trouble with my peripheral vision. Sometimes, I do not notice objects unless they are in front of me." This person most likely has:
Glaucoma
Which of the following middle-age adults has successfully transitioned to Erikson's generativity-versus-stagnation stage of development?
A 60-year-old female who retired last year and now does volunteer work at a homeless shelter 2 days a week
A 52-year-old woman going through menopause tells the nurse working in the women's health center that she is interested in slowing down the aging process and asks if she should take estrogen. The nurse should reply:
The safety of long-term estrogen therapy is inconclusive. It is primarily used short-term to relieve hot flashes.
The occupational health nurse is asked to develop a plan to reduce work-related injuries. The nurse stresses that the most effective way to reduce work-related injuries is to:
Make the work environment smoke-free
Research has demonstrated which of the following effects of divorce on middle-age adults and children?
Children of divorced parents may have life-long difficulty forming relationships
When discussing sexuality with middle-age men and women, the nurse should stress that:
Rates of new HIV infection in middle-age people is higher than in other age groups.
The occupational health nurse plans injury-prevention educational sessions based on the premise that:
All workers need continued education related to safety issues
Which of the following medications is generally recommended to help preserve cardiovascular health in middle-age women?
Aspirin
When planning health promotion projects, the nurse should keep in mind that the fastest growing population is comprised of:
Non-White older adults age 65 and older
A nurse interested in conducting a health promotion program for older adult Korean Americans will be most successful if he or she:
Plans for weekly meetings during which topics of interest are discussed
Which of the following statements made by a client best identifies someone who will benefit from health-promotion interventions?
I have a new grandchild and want to be part of her life.
Which of the following statements concerning nutrition and older adults is true?
Most older adults are not aware of food assistance programs.
Which of the following statements concerning urinary incontinence is correct?
Physiological changes cause overflow incontinence
Which of the following nursing diagnoses is a priority related to the problem of urinary incontinence?
Risk for impaired skin integrity
A 75-year-old client tells the nurse that he has difficulty staying asleep during the night. Which response made by the nurse is correct?
Let's talk about your sleep schedule and things that may prevent you from getting a restful night's sleep.
The nurse conducting a community education program about cognition in older adults should stress that:
Assessment for dementia should be part of routine physical exams
The new unit nurse manager of a long-term care unit should include which of the following directives for staff nurses?
Encourage residents to participate in unit activities such as Scrabble� and bingo
Which of the following menus is recommended for older adults?
Turkey bacon, lettuce, and tomato sandwich on whole wheat bread with two teaspoons of low-fat mayonnaise, 10 vegetable chips, and ice tea with artificial sweetener
Which of the following people is at greatest risk of injury?
An 80-year-old who does not have air conditioning or a fan
According to Erikson's theory of development, which of the following older adults has successfully navigated the stage of ego integrity versus despair?
An 80-year-old male who has informed his children that he has made his funeral arrangements
A nurse conducting a staff development program about human sexuality for nurses who work in long-term care facility is correct in stating:
Older adults need to practice safe sex.
he clinic nurse has seen the following four clients today. Which of the clients is demonstrating a healthy coping pattern?
The client who talks about the "good times" she and her husband had prior to his illness and death 1 year ago
A nurse is assigned to provide care for a 96-year-old bedridden client who experiences severe pain from a chronic neurological disease. The client asks the nurse to please help him leave this world so that his suffering ends. According to the 1994 ANA pos
Contact the pain care specialist
During a home visit occurring in the summer, the nurse should assess for which of the following items in the home?
Fan
The community health nurse has obtained a grant to offer a "Safe Driving" series for older adults. What information should the nurse stress during the series?
Relearning the art of defensive driving can help reduce the likelihood that an older driver will be involved in a motor vehicle accident
As part of a community-wide flu vaccination program for older adults, the nurse is assisting at a vaccination clinic. What question should the nurse ask prior to administering the vaccine?
Do you have any food allergies?
A 72-year-old client comes to the clinic complaining of sweating at night, a loss of appetite, and a fever. He is accompanied by his daughter who reports that her father has periods of acute confusion. The priority nursing intervention related to this cli
Prepare the client for a chest x-ray
The son of a 70-year-old client dying of cancer asks the nurse to tell him about the Hospice program, so he can help his father decide if the program would be of benefit to him. The nurse should reply:
Hospice care can take place either at home or in a Hospice facility.
Which of the following statements is correct concerning cultural views of older adults?
The older an East Asian person is, the more respect they receive from others in the family.