A client is receiving atenolol (Tenormin) 25 mg PO after a myocardial infarction. The nurse determines the client's apical pulse is 65 beats per minute. What action should the nurse implement next?

Correct Answer: C

Rationale: In this scenario, the correct action for the nurse to take is to administer the medication (Option C). Atenolol is a beta-blocker commonly used after a myocardial infarction to reduce the workload on the heart by decreasing heart rate and blood pressure. A pulse rate of 65 beats per minute falls within the normal range for an adult, especially for a client on atenolol therapy. Administering the medication as prescribed will help maintain the client's cardiac stability and prevent further complications. Option A (Hold the medication) is incorrect because the client's pulse rate of 65 bpm is not indicative of bradycardia in this context. Holding the medication without a valid reason could lead to inadequate treatment and potential complications. Option B (Call the healthcare provider) is unnecessary at this point since the client's pulse rate is within the expected range for someone on atenolol therapy after a myocardial infarction. There is no immediate need to contact the healthcare provider based on the information provided. Option D (Check the blood pressure) is not the priority in this situation. While monitoring blood pressure is important, the client's pulse rate is the primary parameter to assess when administering atenolol, as it directly reflects the drug's effect on heart rate. Educationally, this scenario highlights the importance of understanding the rationale behind medication administration in specific clinical contexts. It emphasizes the need for nurses to critically think, apply pharmacological knowledge, and make evidence-based decisions to provide safe and effective care to clients, especially in post-myocardial infarction settings where medication management plays a crucial role in recovery.

Correct Answer: C

Rationale: The correct answer is C) contact kindergarten parents to remind them that the second dose of MMR is due at the start of the school year. This intervention is the most direct and effective way to ensure that students receive the necessary immunizations in a timely manner. By directly contacting parents, the school nurse can communicate the importance of completing the vaccine series and provide clear instructions for compliance. Option A is incorrect because simply noting in student records does not actively ensure that the second dose is administered. Option B is less effective as sending notices home on the first day of class may lead to delays in compliance. Option D is also incorrect as speaking at a PTA meeting may not reach all parents and may not result in immediate action. In an educational context, this question highlights the role of the school nurse in promoting and maintaining the health of students through effective communication and proactive measures to ensure compliance with immunization requirements. It emphasizes the importance of timely vaccination to prevent the spread of vaccine-preventable diseases in a school setting.

Correct Answer: A

Rationale: In this scenario, the correct action for the nurse to implement is to determine home navigational safety hazards (Option A). This is crucial because the nurse has observed the client being unsteady while ambulating, which indicates potential safety risks within the home environment. By assessing and identifying these hazards, the nurse can create a safer space for the client to move around independently and reduce the risk of falls or accidents. Option B, maintaining the client's privacy while in the bathroom, is not the most appropriate action in this situation as the primary concern is the client's safety while ambulating. While privacy is important, it is secondary to ensuring the client's physical safety. Option C, recommending that the client obtain a walker, and Option D, encouraging the client to obtain a medical alert device, are also not the most immediate actions to take. While both of these interventions may be beneficial for the client in the long run, addressing the home safety hazards is the most critical step to prevent immediate harm or injury to the client. In the context of community health nursing, it is essential for nurses to prioritize client safety and well-being during home visits. By addressing environmental safety concerns, nurses can empower clients to maintain their independence and quality of life while minimizing the risk of accidents or injuries in their home environment.

Correct Answer: C

Rationale: In this scenario, the correct action for the nurse to take is to advise the child's parents to obtain a medical evaluation of the brownish thickening on the child's neck (Option C). This is the most appropriate response as the nurse has identified a potentially concerning physical finding that requires further assessment by a healthcare provider. By recommending a medical evaluation, the nurse ensures that the child receives timely and appropriate care for any underlying condition. Option A is incorrect because reviewing the child's medical folder for a list of allergies is not relevant to addressing the brownish thickening on the neck. Option B, instructing the child's parents to begin treatment without a proper diagnosis, is inappropriate as it may not address the root cause of the issue and could potentially lead to incorrect or ineffective treatment. In an educational context, this question highlights the importance of thorough assessment and appropriate referral in community health nursing. It emphasizes the role of the nurse in recognizing abnormal findings, advocating for the well-being of the child, and collaborating with other healthcare professionals to ensure comprehensive care. By understanding the rationale behind the correct response, nursing students can develop critical thinking skills and clinical judgment necessary for effective practice in community health settings.

Correct Answer: C

Rationale: In this scenario, the correct answer is C) older females. Older females, likely grandmothers or elder women in the Somali community, hold significant influence over health decision-making for children. In many cultures, including Somali, older women are respected for their wisdom and experience, often playing a pivotal role in shaping beliefs and practices related to healthcare. They may hold traditional beliefs or have cultural values that impact the mothers' perceptions of their children's healthcare needs. Option A) husbands may have influence in decision-making, but in the context of this community, older females are typically more influential in matters related to childcare. Option B) clinic healthcare providers may have authority, but cultural beliefs and values may supersede their recommendations. Option D) tribal chief might hold authority, but in this case, it is more likely that the influence of older females within the community is stronger. Educationally, this question highlights the importance of cultural competence in community health nursing. Understanding the cultural dynamics and influencers within a specific population is crucial for providing effective and respectful care. Nurses must consider and respect the cultural beliefs and values of the community they serve to build trust and promote positive health outcomes.