A community health nurse is performing a home health admissions assessment with a client. The client reports being unable to obtain their prescriptions. Which of the following actions should the nurse take first?

Notify the client's family member regarding their inability to obtain prescriptions.

Call the local pharmacist on behalf of the client.

Assess the barriers to the client's ability to obtain prescriptions.

Initiate a referral to a social worker.

Answer and Explanation

The Correct Answer is C

Rationale:
A. Notify the client’s family member regarding their inability to obtain prescriptions: Involving family members can be helpful later, but the nurse must first understand why the client cannot obtain medications before deciding whether family assistance is necessary.

B. Call the local pharmacist on behalf of the client: Contacting the pharmacist may help resolve access issues such as refills or delivery, but this step is premature without identifying the specific barriers that prevent the client from getting medications.

C. Assess the barriers to the client’s ability to obtain prescriptions: The first action is assessment to determine the root cause of the problem. Barriers may include lack of transportation, financial hardship, limited mobility, or misunderstanding of the prescription process. Once the cause is identified, appropriate interventions or referrals can be made.

D. Initiate a referral to a social worker: A social worker can assist with financial or community resources, but the nurse should first gather assessment data to provide accurate information for an effective referral.

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Correct Answer is B

Explanation

Rationale:
A. Encouraging the client to become a self-advocate: While empowering the client is important, it does not directly demonstrate active coordination of care. It focuses on client autonomy rather than facilitating access to services.

B. Arranging an appointment for the client with a mobile health clinic: Actively setting up appointments ensures the client receives the necessary health services, demonstrating coordination of care. This involves direct intervention by the nurse to organize and link the client with appropriate resources.

C. Informing the client about providers who accept their health insurance: Providing information is supportive but does not involve actively managing or coordinating care on behalf of the client. It requires the client to take further steps independently.

D. Providing the client with information about transportation services: Sharing resources helps the client plan for access but does not constitute coordination unless the nurse arranges or facilitates the service directly.

A. Maintain the head of the bed at a 30 degree angle. B. Administer stool softeners to the client. C. Encourage the client to cough and deep breathe. D. Obtain client vital signs every 8 hr. E. Provide a quiet environment for the client.

Correct Answer is ["A","B","E"]

Explanation

Rationale:
A. Maintain the head of the bed at a 30 degree angle: Elevating the head of the bed promotes venous drainage from the brain and helps lower intracranial pressure (ICP). A 30-degree position optimizes cerebral perfusion without compromising blood flow to the brain tissue.

B. Administer stool softeners to the client: Stool softeners prevent straining during bowel movements, which increases intrathoracic and intracranial pressure. Preventing Valsalva maneuvers helps maintain stable ICP and reduces the risk of secondary brain injury.

C. Encourage the client to cough and deep breathe: Coughing can sharply increase ICP due to the rise in intrathoracic pressure. Clients with elevated ICP should be discouraged from coughing or performing any action that increases pressure in the head.

D. Obtain client vital signs every 8 hr: Clients with increased ICP require frequent monitoring, typically every 1 to 2 hours or continuously, depending on severity. Monitoring only every 8 hours is inadequate and could delay detection of critical changes in neurological status.

E. Provide a quiet environment for the client: Reducing environmental stimuli, such as noise and bright lights, prevents agitation and minimizes fluctuations in ICP. A calm and quiet setting supports cerebral stability and promotes healing.

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A community health nurse is performing a home health admissions assessment with a client. The client reports being unable to obtain their prescriptions. Which of the following actions should the nurse take first?

Nursing Test Bank

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