ATI COMMUNITY HEALTH NURSING

A hospice nurse is teaching about expected grief reactions with the family of a client who has an stage pancreatic cancer. Which of the following information should the nurse include?

"A component of healthy grieving is the ability to openly express your anger." -The nurse should teach the family that they will experience feelings of anger, guilt, shame, and doubt while grieving. The ability to openly express their feelings of anger is an expected grief reaction. -The nurse should teach the family that they should continue experiencing feelings of hope while grieving. A sense of hopelessness is an indication of clinical depression -nurse should teach the family that their self-esteem is not altered while grieving. Disturbances in self-esteem is an indication of clinical depression -teach the family that they should expect emotions to fluctuate frequently while grieving. A persistent state of sadness is an indication of clinical depression.

A nurse manager at a community health clinic is presenting an in service for nurses about assessing clients who have experienced violence. Which of the following statements by a nurse indicates an understanding of the teaching?

"I should determine whether a client who has been sexually assaulted requires a rape kit examination." Clients who report sexual assault within a certain time frame should undergo a rape kit examination. In some cases, collection must be obtained within 24 hr of the occurrence. However, the time frame can vary based on the type of assault. The nurse should also provide information regarding support groups and resources for clients who were sexually assaulted.

A public health nurse is working in a community that has a population of 24,096. There are 20,096 existing cases of heart disease within the population. The nurse can determine which of the following from this information?

*prevalence proportion*

A community health nurse is assigned to leave a county level environmental task force. Which of the following activities to the nurse direct the task force to complete first?

*review the community-specific epidemiological data*

a nurse is providing teaching about health promotion to a group *adolescents* what topic is most important for the nurse to include in an attempt to *lower adolescent mortality rates*

*safety belt use*

faith community nursing

- Interest in spirituality - Interest in wellness and health promotion - Usually employed by the church - Holistic approach to healing

an ethical theory based on the idea that actions must be based on moral rules or duty, regardless of the consequences.

Deontology

A community health nurse suspects and I'll break up with scabies in the local area. Which of the following actions should the nurse take first?

Determine the incidence rate. The first action the nurse should take when using the nursing process is to perform an assessment. The nurse should determine the number of new cases of scabies in the community for comparison to prior incidence data in order to monitor for an increase.

A nurse is developing an educational program about bioterrorism and smallpox. The nurse should include in the teaching that the smallpox rash is expected to first appear in which of the following locations?

Face

following through with initiating a referral, if it is determined that the client needs the service. is an example of what ethical principle?

Fidelity

A community health nurse is planning a presentation for adults who will have a family history of Alzheimer's disease. Which of the following behaviors for the nurse include as an early manifestation of Alzheimer's disease?

Forgetting the location of common objects

A community health nurse is conducting a needs assessment of a community. The nurse should identify that which of the following methods will yield direct data?

Informant interviews informant interviews with community members or leaders will provide direct data. This information can help the nurse identify services needed by the community.

A nurse is caring for a client who has a positive gonorrhea culture. Which of the following actions should the nurse take?

Instruct the client that recent sexual partners will need to be treated. The nurse should instruct the client that sexual partners from the past 60 days should be referred for evaluation and treatment of gonorrhea.

A community health nurse is conducting a needs assessment of a community. The nurse should identify that which of the following methods will yield secondary data?

Medical records Health surveys Morbidity/mortality statistics (VISUAL STATS)

contact precautions

Methods of infection control that must be used for patients known or suspected to be infected with epidemiological microorganisms that can be transmitted by either direct or indirect contact.

A public health nurse is monitoring medication compliance with a group of migrant workers who were being treated for tuberculosis. The nurse should use information from which of the following resources to assist with this process?

Migrant Clinicians Network (MCN) Migrant workers frequently change locations and move from job to job. This can interfere with the client adhering to the 6 to 12 month TB treatment plan. The MCN is a tracking program developed so that health care providers can access prior provider information and maintain TB treatment continuity for these clients.

nurse is preparing an educational program about influenza for a group of community health nurses. Which of the following activities should nurse include as an example of tertiary prevention?

administer antiviral medications within 48 hr to clients who have manifestations of influenza.

what should be administered for a client who has syphilis.

administer penicillin G

A public health nurse is lobbying Congress to increase funding for health screenings provided to migrant farm workers. Which of the following concepts is a nurse demonstrating?

advoacy

Measels

an infectious disease that produces small red spots all over the body *koplick spots* -fever -malaise -conjuctivitis -cold ss

The nurse should direct the task force to create program goals that align with Healthy People to?

assist in achieving national-level objectives by minimizing health issues caused by the interaction of community members with the environment.

population has been exposed to a specific agent. would be able to calculate?

attack rate

a nurse is assessing risks and benefits of meal delivery services for an older adult client who lives alone and has no transportation. is an example of what ethical principle?

beneficence

How is Gonnorhea tested?

collection of vaginal, cervical, or urine specimens.

Scabies

contagious skin disease transmitted by the itch mite, commonly through sexual contact

An adult child of a client who is terminally ill and at the end of life approaches a hospice nurse and asks,"What can I do to help relieve my fathers pain"? Which of the following intervention should the nurse suggest

"Give your father brief hand massages." Soft and brief hand massages can reduce pain and stress in palliative care settings.

home health nurse is visiting an older adult client and notes that unwashed dishes are piled up and newspapers cover the front steps;. Which of the following questions should the nurse ask the client to determine if the client is socially isolated?

"How often do you have visitors come to see you?" The nurse should ask this question because it addresses the issue of social isolation by determining the frequency of contact between the client and others.

A community health nurse is conducting a program regarding crime reduction strategies were older adult client at the senior center. We should the following statements in the cane understanding of information

"I should remove the identification tag that is on my key ring." -nurse should inform the clients to remove any identification tag on their key ring. If keys are lost along with identifying information, then the client is left vulnerable to home invasions. -lock all purchases and bags securely in the trunk where they are not visible to others. -inform the clients to use an optical viewer and not to open the door automatically. The door should not be opened for a stranger, and the client should not reveal they are home alone. -keep personal items, such as a purse, on the floor rather than the seat. Having them out of sight makes them harder for someone to grab.

A home health nurse is evaluating a caregiver technique for providing care to a client who has a chronic tracheostomy. Which of the following statements by the caregiver indicates an understanding of the procedure?

"I will use tap water to clean the inner cannula." -The caregiver should leave the old ties in place until the new ones are secured to prevent accidental displacement of the tracheostomy tube. -The caregiver should use a square knot when securing the ties to avoid accidental displacement of the tracheostomy tube. -The caregiver should fold the 4 inch x 4 inch (10 cm x 10 cm) gauze dressing before placing it at the tracheostomy site. Cutting the gauze can result in fine fibers being aspirated.

A nurse at a county health clinic is caring for a client who has recently assume the role of primary caregiver for their parent. Which of the following client statements indicates that they are experiencing role conflict?

"i feel overwhelmed for not having enough time for my mom and children." *Role conflict occurs when a client performs two or more roles that are in opposition of each other. Caring for children and a parent can cause feelings of stress for the client and lead to conflict within the family.*

A nurse at a county health clinic is caring for a client who has recently assume the role of primary caregiver for their parent. Which of the following client statements indicates that they are experiencing role strain?

"i hope my siblings will be able to visit and help care for my mom for a few days." *The client is exploring potential ways in which their siblings might be able to relieve the role of caregiver temporarily. This statement might be an indication that the client is experiencing role strain.*

A nurse is providing education regarding lead exposure to a group of clients who live in a housing development built in 1968. Which of the following client statements indicates an understanding of the teaching?

*"I will increase the amount of red meat and milk in my child's diet."* Children should receive adequate amounts of iron and calcium in their diets to prevent lead absorption from their environment.

which of the following transmission-based precautions should a nurse include for a client who has *diphtheria or mump?*

*Droplet precautions*

which of the following transmission-based precautions should a nurse include for a client who has *varicella, pulmonary tuberculosis, or measles.*

*airborne precautions* negative airflow room and the wearing of an N95 mask.

risk factor for future child mistreatment?

*changing providers 3 times during pregnancy* Frequently changing health care providers is a risk factor for future child maltreatment because it can indicate that the client is experiencing partner violence and is attempting to hide it from the provider. Clients who experience violence are at a higher risk for perpetrating violence against their own children.

occupational health nurse in factories performing a routine tuberculosis screening and identifying an employee who has a positive Mantoux tuberculin test. Which of the following actions should the nurse plan to take?

*chest XRAY* The presence of a positive Mantoux skin test can indicate the client has been exposed to the tuberculosis organism. A chest x-ray will determine if the disease is active or dormant.

which of the following transmission-based precautions should a nurse include for a client with *Clostridium difficile?*

*contact precautions* Contact precautions eliminate the exposure to contaminated body fluids and items.

what activity should the nurse identify as a primary prevention strategy

*demonstrate proper hand washing techniques* the goal of which is to promote health and prevent diseases from developing.

The nurse should use what type of equipment when administering medication to a client who has an infection that requires *contact precautions, such as shigellosis, herpes simplex, or scabies.*

*disposable equipment*

a nurse is planning a community health promotion program for hypertension prevention. which of the following interventions should a nurse include as a tertiary prevention strategy.

*implement an exercise program for clients who have hypertension*

A community health nurse is made aware that several children, who are from the same family and did not receive immunizations, has contracted measles. Which of the following actions should the nurse take?

*report this information to the state health department* The CDC lists *measles as a nationally notifiable disease*. Requirements for reporting diseases are state mandated, rather than federally mandated. Therefore, the nurse should report this occurrence to the state health department, which then determines if it will report to the CDC.

*report suspected child neglect to proper authorities* is an example of what prevention?

*secondary prevention* the goal of which is to detect and treat a condition in its early stages, often before manifestations become apparent.

when conducting a home visit for an older adult client what indicates possible neglect?

*taking outdated prescriptions*

what is a barrier to health care resources to residents in a rural area community?

*unavalivality of outreach resources*

a nurse is preparing to administer medication to a client who has *active tuberculosis.* which of the following precautionary measures should the nurse take?

*use the N95 respirator* A client who has active tuberculosis requires airborne precautions to prevent the spread of droplet nuclei smaller than 5 microns. The nurse should wear an N95 respirator when administering medication to prevent transmission of the infection.

a nurse is preparing to administer medication to a client who has *shigellosis, herpes simplex, or scabies..* which of the following precautionary measures should the nurse take?

*wear gloves* The nurse should wear gloves when administering medication to a client who has an infection that requires contact precautions, such as shigellosis, herpes simplex, or scabies.

a nurse is preparing to administer medication to a client who has *wound irrigation.* which of the following precautionary measures should the nurse take?

*wear protective eyewear* The nurse should wear protective eyewear when performing a procedure that might cause a splash or splatter, such as wound irrigation.

. A nurse is planning to teach a community group about the meaning of meningococcal vaccine. The nurse should identify that which of the following client should receive the vaccine?

A client who is moving into a college dormitory Individuals living in crowded areas, such as dormitories, should receive the meningococcal vaccine. -meningococcal vaccine is not recommended for an infant who has bronchiolitis -The minimum age for immunization with the meningococcal vaccine is 8 weeks.

Smallpox

A highly contagious viral disease characterized by fever, weakness, and skin eruption with pustules that form scabs; responsible for killing Native Americans.

A public health nurse is participating in a disaster preparedness planning committee for a local community that is at risk for hurricanes. Which of the following information should the nurse contribute to the plan?

A list of areas within the community where residents speak multiple languages The public health nurse, who is most familiar with the community, should contribute this information to the disaster plan to assist in aiding and evacuating residents who are at high-risk.

provides evidence-based clinical guidelines for client care, such as pain management, cancer screening, and diabetes mellitus treatment.

Agency for Healthcare Quality and Research (AHRQ)

A school nurse is conducting visual acuity testing for a school age child using a Snellen letter chart. Which of the following actions should the nurse take?

Allow the child to keep her glasses on during the testing. -When using the Snellen letter chart to assess a school-age child's visual acuity, the nurse should allow the child to keep her glasses on during the test. -the child should stand or sit at least 10 feet away from the chart. The chart should be placed at the child's eye level. -the child should progress to the next line once she is able to read at least four symbols on the current line. -instruct the child to cover the right eye first, and then move to the left eye. The final step is to have the child read the chart using both eyes.

provides information about STIs and immunization guidelines.

Centers for Disease Control and Prevention (CDC)

nurse is giving a presentation about family violence a look at community center. Which of the following information should the nurse include?

Child maltreatment is more common in homes where partner violence is present. Child maltreatment is very common in homes where partner violence is present.

is the idea that an individual's rights and needs should be balanced with social responsibility. This includes the idea that individuals are shaped by the cultural values of their community and do not live in isolation.

Communitarianism

fairly determining which clients should receive meal delivery when there are a limited amount of services available for clients. is an example of what ethical principle?

Distributive justice

when teaching a client who is overweight about steps to take to begin an exercise program. what statements indicates the client has an understanding of the teaching?

I will see my doctor before beginning an exercise program." -Walking, jogging, lifting half-gallon jugs filled with sand, or doing sit-ups and push-ups are all types of exercise that do not require special equipment. -When beginning a new exercise program, the client should aim to perform aerobic exercise three to five times a week or every other day for about 30 min. -balance a routine of strength training exercises with aerobic activities. Performing different types of exercise can help the client increase activity tolerance.

School Nurse is serving on a community disaster planning committee looking at school shooting scenarios. Which of the following actions should the nurse plan to take during the response please?

Perform triage and provide hands-on care as needed to victims. During the response phase of disaster planning, the school nurse's role can include triage, providing hands-on care, coordinating the first-aid response team, and serving as a counselor to those in need.

is the dominant approach to ethical decision-making and is comprised of the principles of respect for autonomy, nonmaleficence, beneficence, and distributive justice.

Principlism

asking the client if they want this service and respecting the client's choice. is an example of what ethical principle?

Respect for autonomy

A case manager at a home health agency is obtaining equipment for a clients home use. Which of the following actions is a relation of client confidentiality?

The case manager left a clipboard with the client's prescription information face up on the office desk.

when living/remodeling a house built in 1968 about lead paint. the nurse should inform the client about ...

The client should use a *wet-sanding technique* to prevent aerosolizing lead particles. The client should *wet mop wood floors* to prevent aerosolizing lead particles. The client should use *cold tap water* to prepare infant formula because hot water dissolves lead more quickly from the pipe than cold water.

community health nurse is discussing the role of a faith community nurse with a chaplain. Which of the following information should the nurse include in the discussion?

The faith community nurse can facilitate support groups for substance abuse

what should be administered for a client who has human papillomavirus.

Topical imiquimod 5% cream

triaging a client who has a large, open occipital wound and the following findings: respiratory rate 6/min, agonal pattern, capillary refill time 4.5 sec, nonresponsive to painful stimuli. Which of the following actions should the nurse take?

Turn the client to left semi-Fowler's position and begin assessing the next client.

an organization that reviews preventative services and suggests appropriate services for primary medical care and topics for research.

U. S. Preventive Services Task Force (USPSTF)

A hospice nurse is caring for a client who is at the end of life he has developed dyspnea and noisy breathing. Which of the following actions should the nurse take?

Use a fan in the client's room. A fan moves the air, which stimulates the client's trigeminal nerve and can minimize the sensation of dyspnea. -position the client with the head of the bed elevated. This increases chest expansion and decreases dyspnea . -NOT administer the client's pain medication intramuscularly because of decreased circulation, which results in poor absorption of the medication. . -Suctioning is uncomfortable and distressing for a client and is not effective for a client who is at the end of life.

should the nurse document the name of the person the client accuses of the violence in the medical record?

Yes, for future reference in a possible legal cases

a community health nurse is working in a mobile care clinic. which client should nurse see first?

a client who has a new onset of confusion and slurred speech. acute changes in mental status and speech might indicate the client is experiencing a neurological problem that requires immediate intervention. Therefore, the nurse should assess this client first.

improve the health of populations groups by identifying risk factors and optimal approaches that reduce disease and promote health

community health nurses use epidemiological concepts to?

what is a priority for the nurse to do for a client who is a recipient of violence regardless of the type, such as physical, psychological, or sexual.

develop a safety plan

is the study of the distribution and determinants of health and disease in human populations and is the principle of the science of public health. entails a body of knowledge derived from epidemiological research and specialized epidemiological methods and approaches to scientific research.

epidemology

small groups of individuals who use the health department services, for process evaluation of a facility. This information allows for a review of a facility's strengths and weaknesses in the quality of client care delivery.

focused group

a community health nurse is participating in a quality improvement plan for a local health department. what 4 techniques should nurse use as a process of evaluation for a facility?

focused groups written audits satisfaction survey interviews

when caring for an adolescent who is seeking help for unplanned teen pregnancy, what should the nurse do first?

help the client obtain a provider for prenatal care

a number of people newly diagnosed with heart disease over a period of time could help calculate?

incidence porportion

A nurse in a community center is preparing to administer eight tuberculin skin test to multiple clients to screen for tuberculosis. Which of the following actions should the nurse take?

inject 0.1 ML of purified protein derivative to form the wheel.

withdrawing from social activities experiencing incontinence neglecting personal hygiene manifestations of Alzheimer's disease in what stage?

later stages

number of affected people who died could help calculate what?

mortality rate

things nurse should do when planning to administer a tuberculin skin test

prepare the inner aspect of the forearm for the injection. inject the purified protein derivative intradermally, which requires a 5° to 15° angle. create a wheal that is approximately 6 mm in diameter.

Providing disaster training to school personnel is the role of the school nurse during what phase of disaster planning?

preparedness phase

can be calculated by using the *number of people who were affected at a given time* and the *total population.*

prevalence proportion

Performing assessments and identifying potential hazards is the role of the school nurse during what phase of disaster planning?

prevention phase

Provide immunizations at long-term care facilities. is what type of prevention?

primary prevention

Provide education about risk factors for hypertension. would be what prevention measure?

primary prevention strategies for a healthy population to prevent or delay hypertension, which can include providing community education about risk factors and early intervention.

what type of precautions should be implemented for clients who are *highly susceptible to infections, such as clients who have severe dermatitis, major burns, leukemia, or who are undergoing chemotherapy.*

protective environment precautions

serving as a liaison between resources and those in need is the role of the school nurse during what phase of disaster planning?

recovery phase

assessments of clients' perception of their care made via telephone or written questionnaires, for process evaluation of a facility.

satisfaction survey

*Provide information to occupational nurses about the reasons for employees to not come to work.* is what type of prevenetion?.... involves ways to prevent the spread of an existing infection, includes isolating individuals who have manifestations of illness.

secondary prevention

*conduct vision and hearing screening for kindergarten enrollment* is example of what prevention?

secondary prevention

Conduct a hypertension screening clinic for the community. would be what prevention measure?

secondary prevention early detection and treatment for clients who are at risk for developing hypertension, which can include conducting a hypertension screening clinic for the community.

Teach clients who have a family history of hypertension how to monitor blood pressure. would be what type of prevention measure?

secondary prevention strategies for early detection and treatment for clients who are at risk for developing hypertension, which can include teaching clients who have a family history of hypertension to monitor their blood pressure.

Droplet Precautions

spiderman! sepsis, scarlet fever, streptococcal pharyngitis, parvovirus, pneumonia, pertussis, influenza, diptheria, epiglottitis, rubella, mumps, meningitis, mycoplasma or meningeal pneumonia, adeNovirus (Private room and mask) *require the use of appropriate hand hygiene, the wearing of a surgical mask when within 3 feet of the client, and the use of dedicated care equipment.*

*Provide victims of violence with referral information to crisis lines* Referring victims of violence to available community resources is what prevention strategy?

tertiary prevention strategy

*provide nutritional counseling for students who have diabetes* is an example of what prevention?

tertiary prevention, which begins once a disease becomes apparent and includes attempts to limit the progression of the disease and subsequent disability.

performed as the first step in quality assurance when the health department determines the needs of the community, the services to offer, and develops a philosophy and overall objectives for a facility.

values self-study

written evaluations of the quality of care provided by the health department, for process evaluation of a facility. This information allows for a review of a facility's strengths and weaknesses in the quality of client care delivery.

written audits