NUR 439 Community Health

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Sample questions from NUR 439 Community Health

This material has 90 questions with answers and rationales. Here are the first 5.

1. 1.During a community disaster drill, several clients arrive at a shelter after a building collapse. Which client should the triage nurse tag as immediate (red) using the START system?

   • A.A client who is apneic after the airway is repositioned
   • B.A client who is walking and reports minor abrasions
   • C.A client with an open forearm fracture who is alert and has a respiratory rate of 24/min
   • D.A client with a respiratory rate of 34/min and delayed capillary refill

   Rationale: A respiratory rate greater than 30/min or poor perfusion indicates an immediate, life-threatening problem under START triage. The client with the open fracture is breathing adequately and has no stated perfusion deficit, so the client is delayed rather than immediate. The apneic client remains expectant/deceased if breathing does not resume after airway repositioning, while the walking client is categorized as minor. In mass-casualty triage, prioritize rapid physiologic criteria over injury appearance.

2. 2.At a rural public health clinic, the RN is coordinating care for four clients. Which task is appropriate to delegate to an experienced unlicensed assistive personnel (UAP)?

   • A.Assess a child with asthma who reports increasing shortness of breath
   • B.Obtain and document the blood pressure of a stable adult attending a scheduled screening
   • C.Evaluate whether a client understands instructions about a new medication
   • D.Teach a client newly diagnosed with hypertension how to follow a low-sodium diet

   Rationale: Obtaining a routine blood pressure for a stable client is a predictable task that can be delegated to a trained UAP, with the RN responsible for interpreting the result and follow-up. Teaching about diet and medication understanding requires nursing judgment and evaluation. Assessing increasing shortness of breath is also an RN responsibility because the client's condition may be changing. Delegation does not transfer the RN's accountability for oversight.

3. 3.A client states, "I cannot afford the insulin and have started taking it every other day." Which action by the community health nurse is the best initial response?

   • A.Recommend substituting an over-the-counter medication until the next appointment
   • B.Notify the prescriber that the client is nonadherent and request discharge from the clinic
   • C.Assess the client's immediate symptoms and connect the client with medication-assistance resources
   • D.Explain the risks of skipping doses and ask the client to resume the prescribed schedule

   Rationale: The nurse should assess for immediate complications and address the financial barrier through appropriate assistance programs and coordination with the prescriber. Simply instructing the client to resume treatment does not resolve the stated access problem. Discharging the client would disrupt care, and an over-the-counter substitute is not an appropriate replacement for prescribed insulin. Community case management focuses on identifying barriers and linking clients with feasible resources.

4. 4.Refer to the client's chart. Which action should the public health nurse take first?

   • A.Arrange immediate confirmatory testing and medical follow-up for the child
   • B.Recommend that the child avoid all outdoor activity until the next annual visit
   • C.Reassure the caregiver that the result is within the expected range for age
   • D.Wait for a second screening result before informing the caregiver

   Answer and rationale are in the full material.

5. 5.A home health agency receives a referral for an adult recovering from a stroke. The client has stable vital signs but lives alone and has difficulty obtaining food and transportation to appointments. Which action best demonstrates the role of the community health nurse as a care coordinator?

   • A.Provide the client with a list of services and close the referral
   • B.Ask the client's neighbor to manage medications and attend appointments
   • C.Complete a nursing assessment and collaborate with the client to connect with meal and transportation services
   • D.Request hospital readmission until the client has reliable transportation

   Answer and rationale are in the full material.