NR-436 Community, Public, and Population Health Nursing - Set 4 - Part 3

Correct Answer: Pairing every student with a mentoring adult

A sustained relationship with a caring adult is among the strongest protective factors in adolescence, and mentoring builds it deliberately for every student rather than leaving it to chance. Option a is incorrect because fear based imagery is a warning strategy, exactly what the school asked the nurse to move past. Shock wears off quickly and can raise interest among some teenagers. Option b is incorrect because removing a student from the building severs the school bond that protects against further risk. Exclusionary discipline predicts more fighting and more dropout, not less. Option c is incorrect because a leaflet about penalties transmits information and threat, adding nothing to a teenager's sense of belonging. Knowledge of the rules was never the missing ingredient here.

Correct Answer: Home based personal care with medication reminders

Support is matched to need at the lowest level that keeps the client safe. Personal care in the home covers bathing, dressing and prompting, and it preserves the living situation she has chosen. Option a is incorrect because that setting exists for people who need round the clock nursing supervision. Sending a woman who is safe overnight there strips away independence she has not lost, and Medicare would not fund it. Option b is incorrect because assisted living does provide help with self-care, yet it requires giving up her own apartment. A less restrictive option delivers the same daily assistance without any move at all. Option d is incorrect because campuses combining independent, assisted and nursing levels usually charge a large entrance fee and are chosen years ahead. Nothing in this situation calls for relocation at all.

Correct Answer: "Reduced intake is expected now, and fluids may worsen secretions."

Anorexia and decreased fluid intake are normal at the end of life. Forced feeding and intravenous fluids often increase secretions and discomfort, so mouth care and ice chips serve comfort better. Option b is incorrect because framing the choice as causing death loads guilt onto a grieving spouse and misstates the physiology. The illness is driving the decline; withheld fluids are not what ends the life. Option c is incorrect because routine hydration is not a comfort measure in the dying phase and frequently adds edema, secretions, and a difficult breathing pattern. Comfort here comes from mouth care, not from a line. Option d is incorrect because cutting analgesia to restore appetite trades comfort for a goal the body can no longer meet. Pain would return while intake stayed low, leaving the client worse off in both respects.

Correct Answer: Decline both requests as custody rather than nursing functions

Health information stays protected within legitimate security limits, and restraint used for discipline is a custody act. Nurses keep decisions clinical, since taking part in punishment destroys the therapeutic relationship across the whole facility. Option a is incorrect because releasing a medication roster hands over clinical information without any legitimate security purpose attached. Half a refusal still breaches confidentiality and teaches residents that disclosure follows any officer's request. Option b is incorrect because helping restrain someone as punishment converts the nurse into an instrument of discipline. Residents who watch that happen will not present at sick call, and the health service loses its whole population. Option d is incorrect because the paycheck does not decide where duty lies. Dual loyalty resolves in favor of the client, and care decisions remain clinical no matter which organization signs the employment contract.

Correct Answer: Screen at worksites and barbershops, then link to care

Taking screening to places men already gather answers the barriers the interviews found, and pairing the event with linkage to a medical home turns a single reading into ongoing care. Option a is incorrect because a letter tells men to do the very thing the interviews showed they cannot do without losing pay. Most have no provider to be referred back to. Option b is incorrect because one extra afternoon still requires shift workers to leave the job and travel across a rural county. The office remains the destination, which is the obstacle itself. Option c is incorrect because awareness was never the gap here. These men can already name the risk, and a message about danger does nothing about lost wages or the missing usual source of care.

Correct Answer: Notify parents, refer, and confirm the child was seen

Screening without referral and follow-up accomplishes nothing. The nurse notifies the guardian in writing, refers to an appropriate provider, helps remove barriers to access, and documents whether the child was actually examined. Option a is incorrect because filing a result changes nothing for a child who still cannot see the board. Records document the finding; they do not connect anyone to an eye examination or glasses. Option c is incorrect because waiting a full year leaves uncorrected vision in place through an academic year of reading and testing. Rescreening later detects the same problem the nurse has already detected. Option d is incorrect because aggregate reporting serves program evaluation and district planning rather than individual children. A percentage sent upstairs never reaches the family that has to book the appointment.

Correct Answer: Remove the lead hazard from the housing

Screening and diet only manage exposure that already happened. Removing deteriorated paint, dust, and contaminated soil from the buildings is primary prevention, and it is the only step that keeps the next children from being poisoned. Option a is incorrect because more frequent testing is secondary prevention, finding harm that has already occurred. A test result never pulls a flake of paint off a windowsill in any apartment. Option b is incorrect because handwashing reduces how much dust a child swallows but leaves the source in place. Behavior change by tenants cannot compensate for a building that keeps shedding lead. Option c is incorrect because iron and calcium reduce how much lead the gut absorbs, which helps an individual child modestly. Nutrition counseling is useful support, though the exposure itself continues unchanged.

Correct Answer: Ask her to gather every product she takes

The brown bag review has the client bring out every prescription, over the counter product, vitamin, herbal and eye drop in the house. Only then can duplication and interaction be seen. Option b is incorrect because the agency record reflects what was prescribed, not what sits in the cupboard. Borrowed tablets, herbal products and old bottles still in use never reach that document. Option c is incorrect because three separate calls yield three partial lists and still miss the drugstore aisle. Prescribers rarely know what their colleagues ordered, which is the very gap causing the danger. Option d is incorrect because an organiser helps adherence once the regimen is known to be safe. Loading a box with duplicated or inappropriate drugs simply makes the client take them more faithfully.

Correct Answer: Risk behaviours cluster, so programming should address them together

Adolescent risk behaviours travel together, so a student engaged in one is likely engaged in others. Programmes that build broad skills and connectedness reach the whole cluster instead of chasing one behaviour. Option a is incorrect because splitting the work into separate campaigns ignores the shared roots underneath, and the same small group of students would sit through four disconnected messages. Resources thin out for no added gain. Option b is incorrect because co occurrence of these behaviours is one of the most consistently replicated findings in adolescent health research. Dismissing the pattern as error would discard usable local planning data. Option d is incorrect because association between behaviours does not establish that one produces the others. Vaping and fighting more plausibly share upstream drivers such as low connectedness, poor supervision, and peer norms.

Correct Answer: Falls are multifactorial and need combined measures

No single change prevents falls reliably. The evidence supports an individualised bundle of strength and balance exercise, medication review, orthostatic blood pressure management, vision correction, safe footwear and lighting along the night route. Option a is incorrect because faulty mounting is worth checking, yet it explains only the bathroom itself. This fall happened on the way there, in darkness, which points at lighting and gait instead. Option c is incorrect because blaming the client shifts attention away from causes the nurse can actually treat. Weakness, sedating drugs, urgency at night and a dark hallway are not matters of willingness. Option d is incorrect because treating falls as an inevitable part of growing old is ageism dressed as realism. Most falls have identifiable contributors, and structured programmes lower the rate in this age group.