NR 442 Week 4 Clinical Judgment Practice Questions

Rationale: The priority is assessing individual needs and planning appropriate accommodations to facilitate safe return to work. This demonstrates tertiary prevention and care coordination. While options 2 and 4 address prevention, they don't prioritize the immediate needs of this specific employee. Option 1 doesn't address health needs. Question 3 A home health nurse arrives for an initial visit with an 80-year-old client who has dementia, impaired mobility, and dysphagia. The nurse observes multiple bruises of various colors, soiled dressings on stage II pressure ulcers, and an emaciated appearance. What is the nurse's priority action? 1. Document findings and plan to discuss at the next team meeting 2. Teach the son proper wound care techniques 3. Report suspected elder abuse to adult protective services immediately 4. Arrange for home health aide services to assist with bathing Answer: 3 Rationale: The assessment findings (multiple bruises of various colors, poor hygiene, malnutrition, untreated pressure ulcers, and missed medications for 2 months) indicate neglect and possible physical abuse. Nurses are mandated reporters and must report immediately to protect the vulnerable adult. While other options may eventually be needed, reporting abuse is the priority to ensure client safety. Question 4 A forensic nurse is called to the emergency department for a sexual assault victim. What is the nurse's primary responsibility? 1. Discuss the case details with police officers 2. Collect, preserve, and document chain of custody for evidence 3. Serve as a chaperone during the physical examination 4. Provide emotional support to the victim Answer: 2 Rationale: Pain control is the primary goal in hospice care, focusing on comfort and quality of life in terminal illness. While option 4 mentions support for home death (a hospice goal), pain management is the priority nursing intervention. Options 1 and 2 focus on cure or prolonging life rather than comfort, which contradicts hospice philosophy. Week 5: Vulnerable Populations Question 7 A community health nurse is assessing health disparities in a predominantly minority neighborhood. Which factor most significantly contributes to health inequities? 1. Genetic predisposition to certain diseases 2. Personal lifestyle choices 3. Limited access to healthcare services and health insurance 4. Cultural beliefs about traditional medicine Answer: 3 Rationale: While all factors may play a role, systemic barriers like limited healthcare access, lack of insurance, discrimination, and socioeconomic factors are primary drivers of health disparities among vulnerable populations. This aligns with social determinants of health. Options 1, 2, and 4 don't address structural inequities that create disparities. Question 8 During a home visit, the nurse notes a Mexican-American client appears passive during health teaching and avoids eye contact. What should the nurse conclude? 1. The client probably doesn't understand English 2. The client is not interested in the teaching 3. Cultural factors may explain the client's behavior 4. The client is uncomfortable with the home visit Answer: 3 4. Wait until more obvious signs of abuse are present Answer: 2 Rationale: Risk factors are present (pregnancy, young age, new relationship, previous concerning behavior, history of partner's anger), and