RELIAS RN PHARMACOLOGY EXAM ACTUAL EXAM QUESTIONS
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1. A home health case manager is charged with identifying opportunities for health
promotion and illness prevention. The fulfillment of this charge would best be
demonstrated when the case manager:
a. collaborates with a local chaplain to ensure that the spiritual needs of cancer
clients are addressed.
b. refers a new diabetic client to a nutrition counselor for dietary teaching.
c. teaches a school nurse how to care for a client who will be returning to school
and will require new asthma treatments.
d. tracks the immunization status of clients and facilitates access to immunization
when needed. - ANSWER: ANS: D
Case management involves assessment—in this case, screening—and arrangement
for delivery of services. Primary prevention includes case management to identify
at-risk clients and arrange for services to prevent disease. Through nurse
management activities, general community deficiencies in the quality or quantity
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of health services are often discovered. Case management activities with
individual clients and families will reveal the broader picture of health services in
and health status of the community. Community assessment, policy development,
and assurance activities that frame the core functions of public health actions are
often the logical next step in the nurse case manager's practice to intervene at the
community level to make changes. Therefore, the core components of case
management and the nursing process are complementary. The nursing process
function of assessment is complementary to the case management process function
of case finding and includes such activities as applying screening tools according
to program goals and objectives.
1. A nurse is assigned to provide community outreach to a small town that was
partially destroyed by a tornado 3 years earlier and has been rebuilt. The first client
is a family who lost their home and their best friend in the tornado. The best
intervention would include:
a. assessment of the family's home environment to rule out safety issues.
b. avoidance of discussion of the disaster of 3 years ago.
c. consideration that the family will have worked through the emotional aftermath
by now.
d. support of the family in preparing a personal disaster response plan. -
ANSWER: ANS: D
The approach of relief activities needs to shift from short-term aid to long-term
support. Promoting individual, family, and community preparedness increases
safety in the event of disaster and can help children and adults feel empowered.
This builds on the resilience of the individual, family, and/or community.
Individuals and families still need to be assessed for indications of mental distress
(case finding) and referred to a mental health professional if the need exists. Open
discussions of the family's response to the slow process of recovery or long-term
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results of living under adverse conditions can uncover lingering mental distress or
exacerbations of chronic conditions that require attention. During the initial stages
of recovery environmental safety issues should have been addressed.
1. A nurse performing home hospice case management notes the increasing
number of hospice clients who lack caregivers in the home environment. The nurse
identifies the potential need for a hospice house facility to meet the needs of these
clients. The case management process frequently reveals larger picture issues such
as which of the following?(Select all that apply.)
a. Community cost concerns
b. Community conflict resolution skills
c. Community satisfaction
d. Community weaknesses in quality of services
e. Community weaknesses in quantity of services - ANSWER: ANS: D, E
Case management activities with individual clients and families very often reveal
the larger picture of health services and health status of a community. General
community weaknesses in the quality and quantity of services often are discovered.
The nurse can then intervene at the community level to initiate changes. In this case,
the nurse identified a deficiency in the quality of hospice services to individuals who
did not have a caregiver in the home environment and the parallel concern of the
lack of hospice-related facilities to meet the needs of these clients to achieve a
quality dying process.
1. A nurse volunteering at a local homeless shelter notes that many of the clients
have acute and chronic illnesses and are in need of primary health care services.
The most effective strategy to consider when networking with homeless
individuals, families, or populations is to:
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a. form a community partnership to establish a clinic for homeless persons.
b. create a trusting environment and establish a therapeutic relationship.
c. collaborate with the local United Way to obtain funding for primary care
services.
d. dialogue with local clergy to address the unmet primary care need for homeless
persons. - ANSWER: ANS: B
Nurses need to be able to work with poor and homeless clients to promote,
maintain, and restore health. Nurses must be prepared to look at the whole picture:
the person, the family, and the community interacting with the environment. In
working with the homeless, it is important to create a trusting environment. Trust
is essential to the development of a therapeutic relationship with poor or homeless
persons. Many clients and families have been disappointed by interactions with
health care and social systems. They are now mistrustful and see little hope for
change. Establishing a trusting relationship lays the foundation for a more
comprehensive assessment of clients' perception of their health care needs and a
determination of factors that may contribute to their current health status issues.
1. A school nurse is teaching a class of sophomores about the relationship between
the risk of sexually transmitted disease (STD) and risk-taking behaviors. A key
point to include is:
a. all STDs are easily preventable with consistent condom use.
b. once a young woman is pregnant, she is no longer at risk for most STDs.