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SCORE: 100 ELAPSED: 5:45
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TIME xxxx
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PAUSE
Bridgett Allen Room
Bridgett Allen, 17-year-old girl with Down Syndrome. She is a new member of a program that
provides vocational training and group home residence for adolescents with disabilities.
Bridgett has moved several hours from home to be part of this program. Bridgett has a history
of a repair of a ventricular septal defect at age 6. Since the surgery, Bridgett has had episodes
of supraventricular tachycardia (SVT) about once every few months. She generally reverts to
normal sinus rhythm with non-medication-based interventions. Bridgett also has frequent ear
infections. Bridgett’s BMI is 33 and she is recommended to lose weight. Bridgett takes a
multivitamin and birth control pills daily. It is required she be on birth control while in the group
home. This is a new medication for her. Bridgett is visited by the community health nurse for
health counseling and her group home counselor and other staff are provided education to
assist in keeping Bridgett healthy. Bridgett is able to care for herself and her personal hygiene
needs, she can assist in meal preparation, and in housekeeping chores. She sometimes
struggles with impulse and emotional control. Although Bridgett has a cardiologist that follows
her care, she lacks local access to primary care and other resources she used at home.
You responded correctly to 10 out of 10 evaluations:
Category Your response Explanation
Community Assessment Increased The group home and new community are new environments that may be assessed.
acuity
Culture/Beliefs/ Normal acuity There is no indication that this is a concern at this time.
Spirituality
Disease/Illness Increased The client’s care includes all levels of prevention related to SVT, infections, and weight management.
Prevention acuity
Education/ Counseling Increased The client and group home staff require education. Bridgett may benefit from counseling and education.
acuity
Health Promotion Increased The client may benefit from weight loss and other health promotion strategies.
acuity
Resource Identification Increased The client may benefit from additional resources.
acuity
Risk Reduction Increased The client may benefit from nutritional risk reduction.
acuity
Self-Management Increased The client and group home staff may benefit from enhanced self- management.
acuity
Social Determinants of Increased The client may benefit from focus on social determinants, including financial resources, access to care, and access to
Health acuity other resources.
Surveillance Normal acuity This client does not have a condition that requires public health surveillance.
, COMMUNITY HEALTH XXXXXXX
SCORE: 96
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TIME ELAPSED: 37:14
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PAUSE
Bridgett Allen Scenario 1
Bridgett states “My ear really hurts. It really hurts when I swallow.” The
community health nurse recommends that the group home staff take Bridgett
to the local community health clinic. The nurse practitioner assesses Bridgett’s
ears via an otoscope and determines that her left tympanic membrane is
swollen and red. The nurse practitioner prescribes oral amoxicillin for 10 days.
The nurse provides teaching to the group home staff. Which information
should the nurse include in teaching about this medication?
You correctly selected 3 out of 6 actions:
Status Label Explanation
Medicare will provide medication at no This is not correct. Medicare is healthcare subsidy for elder adults and does not
cost to clients provide subsidy for medications for adolescents.
The entire ten-day course should be This is correct. The whole 10-day course must be completed to ensure
taken. bacterial eradication and reduce the incidence of antibiotic resistance.
The client and staff may note diarrhea This is correct. The penicillins are known to cause diarrhea.
during the course of the medication.
This medication has numerous, dose- This is not correct. This medication is relatively safe with few severe side
limiting side effects. effects.
Fluid intake should be limited while on This is not correct. Water should be encouraged during the course of the
the medication. medication to enhance excretion.
This medication is safe for clients who This is not correct. Amoxicillin is a penicillin (PCN) derivative and is not safe for
have a penicillin allergy. clients with a PCN allergy.