Health Promotion and Maintenance

A registered nurse coordinating an occupational health and wellness program at a corporate facility is planning activities for the upcoming fiscal year. Which of the proposed activities should the nurse classify as primary prevention strategies? Select all that apply.

A nurse in a gastrointestinal outpatient clinic is instructing a client with a new colostomy on how to independently change their one-piece ostomy pouching system at home. In what order should the client be taught to perform these actions? Arrange the steps in the correct sequence.

A nurse is caring for a laboring client at 37 weeks gestation who has severe preeclampsia. The provider has prescribed a strict total fluid restriction of $125\text{ mL/hr}$, which includes all oral and intravenous (IV) intake.

The client is receiving a continuous IV infusion of magnesium sulfate at a rate of $2\text{ g/hr}$. The magnesium sulfate is supplied as $40\text{ g}$ in $1,000\text{ mL}$ of sterile water. The client also has a continuous IV infusion of oxytocin running at $15\text{ mL/hr}$. Over the past 4 hours, the client has consumed $4\text{ oz}$ of ice chips and $120\text{ mL}$ of water.

Assuming the oral intake is distributed evenly across the 4 hours, what is the maximum rate in $\text{mL/hr}$ at which the nurse should program the primary IV pump to deliver lactated Ringer's solution? (Record your answer as a whole number.)

A gravid client at 40 weeks of gestation is undergoing an induction of labor with intravenous oxytocin. The external fetal monitor displays a continuous pattern where the fetal heart rate gradually decreases, with the nadir occurring consistently after the peak of the uterine contractions. The heart rate recovers to the baseline only after the contractions have completely ended. Based on these findings, which intervention is most critical for the nurse to implement?

A nurse is conducting a comprehensive admission assessment on a 75-year-old client being admitted to a rehabilitation facility following a total hip arthroplasty. Which of the documented assessment findings should the nurse recognize as expected physiological adaptations to the aging process? Select all that apply.

An ambulatory care nurse is counseling a 49-year-old client recently diagnosed with metabolic syndrome. The client reports working 60 hours a week, sleeping 4 to 5 hours a night, and eating mostly processed convenience foods. The client states, "I bought a gym membership and plan to do high-intensity interval training for two hours every day after work to fix my metabolism."

Which response by the nurse is the most appropriate?

A nurse in a community health clinic is developing a health promotion plan for a 65-year-old female client with a history of type 2 diabetes mellitus. During the assessment, the client states, "My mother had a severe stroke at my age, so I am very worried. I have also been occasionally losing my balance when walking, but I know feeling unsteady is just a normal part of getting older." Which of the following nursing actions represents the highest priority secondary prevention intervention for this client?

A home health nurse is developing a comprehensive self-care and health promotion plan for an older adult client who has advanced rheumatoid arthritis (RA), severe left-sided heart failure, and type 2 diabetes mellitus with advanced peripheral neuropathy. Which of the following interventions should the nurse include in the client's plan of care? Select all that apply.

A public health nurse is conducting a comprehensive physiological and functional assessment of an older adult client living independently in the community. Which of the following documented findings represent expected biological adaptations of senescence rather than pathological processes requiring acute medical intervention? Select all that apply.

A nurse in a college health clinic is assessing an 18-year-old client who admits to engaging in frequent binge drinking at weekend parties. Which initial response by the nurse is most appropriate?

A community health nurse is conducting an educational session for a group of older adult clients regarding expected physiological changes associated with the aging process. Which of the following statements by the clients indicate an accurate understanding of normal aging transitions? Select all that apply.

A client who experienced a recent episode of syncope is being evaluated in the clinic. The nurse is preparing to perform a focused assessment of the client's neck vessels. Arrange the following assessment actions in the safest and most appropriate sequence.

An advanced practice registered nurse conducts a comprehensive wellness examination for a 77-year-old client who lives independently. The client's caregiver provides a list of observed physical and behavioral changes that have occurred over the past year. Which of the following findings should the nurse identify as expected, age-related developmental and physiological transitions rather than pathological concerns? Select all that apply.

An occupational health nurse is developing a comprehensive lifestyle modification plan for a 65-year-old night-shift security guard who has newly diagnosed primary hypertension and a body mass index (BMI) of 31 kg/m². Which of the following nursing interventions are appropriate? Select all that apply.

Following a precipitous vaginal birth of a macrosomic newborn, a client is transferred to the postpartum unit. During the initial assessment 45 minutes after delivery, the nurse observes a continuous, steady trickle of bright red vaginal blood. Palpation reveals the uterine fundus is midline and firmly contracted at the level of the umbilicus. The client's heart rate is 118 beats/minute, blood pressure is 90/58 mmHg, and respiratory rate is 22 breaths/minute. The client states, "I feel incredibly dizzy and my mouth is extremely dry." Which action is the highest priority for the nurse to perform?

An occupational health nurse at an industrial manufacturing plant is reviewing proposed employee wellness initiatives for the upcoming quarter. Which of the following activities accurately represent secondary disease prevention measures? Select all that apply.

A medical-surgical nurse is providing discharge education to a 58-year-old client recently diagnosed with stage II chronic kidney disease and essential hypertension. The client asks the nurse for strategies to manage the new diagnoses and prevent further renal damage. To correctly implement a tertiary disease prevention strategy, what specific instruction must the nurse provide?

A pediatric clinic nurse is developing a self-care management plan for a 6-year-old client recently diagnosed with moderate persistent asthma. The nurse is discussing daily routines and responsibilities with the child and their parents. Which instruction best promotes appropriate self-care competency for this client?

The interdisciplinary team is managing a client's induced labor. Analysis of the continuous electronic fetal tracing reveals a baseline heart rate of 155 bpm with minimal variability. The nurse notes a pattern of gradual, symmetrical decreases in the fetal heart rate where the onset, nadir, and recovery of each deceleration occur after the beginning, peak, and end of the respective uterine contractions. Given these findings, which of the following immediate actions must the nurse implement? Select all that apply.

A community health nurse is developing a comprehensive self-care and health maintenance plan for an 84-year-old client with mild cognitive decline who lives with family. Which actions by the nurse are appropriate? Select all that apply.