CH - Exam #3 (Ch's: 14, 16-21)

(14) A PHN advises the owners of a local supermarket chain about an employee wellness program. Which strategies would be the most effective? SELECT ALL THAT APPLY. 1) Conduct free biometric screenings once a month 2) Offer discounted memberships to local health clubs 3) Provide paid time off for employees without benefits 4) Organize walking groups that meet twice a week 5) Give employees a store gift card after an annual physical

*Answer 1, 2, 3, 4, and 5* are all correct

(18) A pediatric nurse is speaking with a Cambodian woman about her 4-year-old son. Which statement indicates an unusual birth? 1) "He was born right on the due date." 2) "My baby was born after only 30 weeks." 3) "He was born head first." 4) "My baby was born feet first."

2) "My baby was born after only 30 weeks."

(17) A public health nurse (PHN) is coordinating a program that assists victims of intimate partner violence (IPV) to become financially independent. Which is the most appropriate resource? 1) Financial Aid Office 2) Career Counseling Center 3) Behavioral Health Center 4) Federally Qualified Health Center (FQHC)

2) Career Counseling Center

(17) Telehealth provides health-related services where there is distance between the patient and provider using electronic information and telecommunication technology. Which patient has the greatest need for telehealth? 1) A pregnant woman who lives 20 miles outside the nearest metropolitan city 2) A student at a large university 3) A farmer with chronic obstructive pulmonary disease (COPD) 4) A married couple with two cars

3) A farmer with chronic obstructive pulmonary disease (COPD)

(14) Local healthcare providers contacted the local public health department (PHD) when they became concerned the incidence of sexually transmitted infections (STIs) was rapidly increasing. The PHD initiated actions to manage a potential outbreak of STIs. Place the following actions in the correct order (1-4): >> Provide treatment options for people diagnosed with a STI >> Ask those who test positive for a STI to provide names and phone numbers of their sexual partners >> Gather data from local physicians and hospitals on the number of cases of STIs they have received >> Screen people suspected of having a STI

#1) >> Gather data from local physicians and hospitals on the number of cases of STIs they have received #2) >> Screen people suspected of having a STI #3) >> Provide treatment options for people diagnosed with a STI #4) >> Ask those who test positive for a STI to provide names and phone numbers of their sexual partners

(18) A group of labor and delivery (L&D) nurses is developing an educational program about gestational diabetes. Place the following actions in order (1-4): >> Initiate the educational program for pregnant women >> Organize an interdisciplinary team including the local chapter of the American Dia. Assctn (ADA) >> Create interventions to meet program goal to reduce rates of gestational diabetes among pregnant women by 20% in 6 mo's >> Collect data on gestational diabetes & determine needs of target population

#1) >> Organize an interdisciplinary team including the local chapter of the American Dia. Assctn (ADA) #2) >> Collect data on gestational diabetes & determine needs of target population #3) >> Create interventions to meet program goal to reduce rates of gestational diabetes among pregnant women by 20% in 6 mo's #4) >> Initiate the educational program for pregnant women

(18) A public health nurse (PHN) visits the home of a single mother who is pregnant with her second child. When the mother lights a cigarette, the PHN explains which risks associated with tobacco use during pregnancy? SELECT ALL THAT APPLY. 1) Premature birth 2) Gestational diabetes 3) Sudden infant death syndrome (SIDS) 4) Low birth weight (LBW) 5) Delivery by cesarean section

*1 and 3 are correct* Feedback 1: Answer 1 is correct. Women who smoke during pregnancy are 30% more likely to deliver a premature infant. A preterm birth is defined as a birth that occurs before 37 weeks gestation. Feedback 2: Gestational diabetes is assctd w/ obesity & pregnancy. Feedback 3: Infants born to mom who smks are from 1.5 to 3X > likely to die from SIDS. Feedback 4: Tobacco is associated w/ LBW infants. LBW = < 2,500 gm or < 5.5 lb Feedback 5:Obesity in pregnancy is associated w/ ↑ risk for needing C-sec. Cesarean section is sugery, L/T ↑risk for cmplctns: infection, PE, DVT

(16) Jaime is a 70-year-old Latino male who speaks Spanish. He has type 2 diabetes, had a right below-the-knee amputation, and is dependent on his wheelchair for mobility. Jaime has two sons who live in different states; they visit two or three times a year. How might a primary care medical home (PCMH) benefit Jaime? SELECT ALL THAT APPLY. 1) A Spanish-speaking care coordinator will discuss Jaime's needs with him. 2) A pharmacy will dispense his insulin and glucose testing strips. 3) 24-hour telephone assistance will be available for health counseling. 4) A Spanish-speaking home health aide can visit him twice a week. 5) A Spanish-speaking social worker will provide behavioral health care.

*Answer 1, 2, 3, 4, and 5* are all correct

(16) A nurse working at a prenatal clinic is selecting patient educational materials. Which are most appropriate? SELECT ALL THAT APPLY. 1) Childhood vaccination schedules 2) Type 2 diabetes 3) Signs of miscarriage 4) RhoGAM 5) Percocet side effects

*Answer 1:* Educational materials about childhood vaccination schedules are appropriate for prenatal clients.. *Answer 3:* Educational materials about signs of miscarriage are appropriate for prenatal clients. *Answer 4:* Educational materials about RhoGAM are appropriate for prenatal clients. RhoGAM is given to pregnant women whose blood type is Rh-negative. The injection contains antibodies that prevent the baby's Rh positive blood cells from triggering an immune response in the mother. ..... 2 is incorrect. Educational materials about type 2 diabetes are not appropriate for prenatal clients. Prenatal clients should be educated about gestational diabetes

(14) he county public health department (PHD) is managing a tuberculosis (TB) outbreak. Which interdisciplinary team members are the most appropriate to manage the outbreak? SELECT ALL THAT APPLY. 1) Physicians 2) IT specialists 3) Epidemiologists 4) Nutritionists 5) Environmental health specialists

*Answer 1:* Physicians, particularly infectious disease specialists, should be involved in managing a TB outbreak. *Answer 3:* Epdmlgsts deal w/ dz's of man & understand dz process of TB. They should be involved in managing TB outbreak. *Answer 4:* Malnutrition is considered a RF for TB. The nutritionist should be among the interdisciplinary team members managing a TB outbreak. *Answer 5:* Envrnmnal hlth spclsts have extensive knowledge of environmental RF for exposure & transmission of dz, inclu TB. Envrnmnal hlth spclsts should be among interdisciplinary team members managing TB outbreak.

(14) Following a widely publicized case of a toddler who died after being left locked in a hot car, the state public health department (PHD) decided to begin a campaign to educate the public. Which programs would be the most effective? SELECT ALL THAT APPLY. 1) Require hospitals to educate new mothers about the dangers of leaving children in hot cars 2) Place ads on television and social media warning about the dangers of leaving children in hot cars 3) Offer child passenger and infant seat safety checks at police and fire departments 4) Provide "Look Before You Lock" seminars at schools and libraries conducted by PHNs 5) Create legislation mandating jail time for individuals who leave children locked in hot cars

*Answer 1:* Requiring hospitals to educate new mothers on the dangers of leaving children locked in hot cars targets one of the most appropriate populations. *Answer 2:* Ads on television and social media educate the entire population, reach a large audience, and provide safety information. *Answer 4:* A "Look Before You Lock" campaign educates the community by providing information about how to avoid locking children in hot cars. Due to their knowledge of human health, disease, nursing care, and injury prevention, PHNs are the most appropriate healthcare professionals to conduct the seminars.

(16) A public health nurse (PHN) working at the community health clinic is developing a health education program about HIV. Which interventions should the nurse include? SELECT ALL THAT APPLY. 1) Distribute free condoms at the clinic 2) Perform free monthly HIV screenings 3) Distribute brochures about sexually transmitted infections (STIs) at the local college 4) Establish a clean needle exchange program 5) Teach abstinence only sex education classes at the high school

*Answer 1:* goal of primary prevention is to keep person free of dz. A free condom distribution program reduces the risk of acquiring HIV. *Answer 2:* The goal of secondary prevention is early detection and treatment of disease. Free monthly HIV screenings detect HIV early so treatment can be initiated. *Answer 3:* Distributing brochures about STIs is primary prevention that targets a population at high risk for STIs & HIV. CDC reported one in four people w/ HIV are between ages 13 & 24. Individuals w/ STIs are two to five times more likely to acquire HIV. *Answer 4:* A clean needle exchange program decreases risk of acquiring HIV. .... Answer *5 is incorrect*. The AAP reported sex edu programs that teach abstinence only are > likely to result in adolescents' having unprotected sex, which ↑'s risk for STIs

(16) Following a recent outbreak of shingles, a primary care nurse decides to educate people about the benefits of getting the shingles vaccine. Which is most in need of education? SELECT ALL THAT APPLY. 1) A 65-year-old retiree 2) A mother with HIV 3) A carpenter 4) A 10-year-old who never had chickenpox 5) A sexually active college student

*Answer 1:* shingles vaccine is recommended for people over the age of 50. *Answer 2:* should educate mother w/ HIV. People w/ HIV/AIDS have compromised immune systems & > likely to develop shingles

(18) A public health nurse (PHN) is speaking to a group of mothers of infants about child safety Which topic is the most appropriate? 1) "Back to Sleep" 2) "How to Initiate Breast Feeding" 3) "The Dangers of Smoking During Pregnancy" 4) "Preventing Unintentional Injuries"

1) "Back to Sleep"

(14) A mother of a newborn tells the nurse, "I don't think I can afford the baby's formula." Which is the best response? 1) "The WIC program provides free formula." 2) "If you breastfeed you won't need formula." 3) "I can only give you six bottles of formula." 4) "Can someone lend you money to buy formula?"

1) "The WIC program provides free formula."

(16) A client with diabetes has just completed a routine appointment with her primary physician. The office nurse notices the client has prescriptions for metformin (Glucophage) and canagliflozin (Invokana). What is the nurse's next question? 1) "Would you like to schedule your 6-month visit now?" 2) "Can you afford the prescriptions?" 3) "Would you like me to write refills for your medications?" 4) "Call for an appointment when you have a concern."

1) "Would you like to schedule your 6-month visit now?"

(18) A labor and delivery (L&D) nurse is reviewing charts to determine who would benefit from Maternal, Infant, Early Child Home Visiting (MIECHV). Which is the best candidate for MIECHV? 1) A 15-year-old who delivered 2 days ago 2) A 30-year-old woman who conceived using in vitro fertilization (IVF) 3) A 35-year-old attorney and mother of two 4) A 27-year-old primigravida

1) A 15-year-old who delivered 2 days ago

(18) The PHN is putting together an education program on the risk factors associated with maternal mortality. Which client has the *lowest* risk? 1) A woman with a body mass index (BMI) of 24 2) A woman with HIV 3) A woman with a hemoglobin A1c (HbA1c) of 7% 4) A woman with pregnancy-induced hypertension

1) A woman with a body mass index (BMI) of 24

(19) A graduate nurse is considering specializing in school nursing. School nursing advances the health and well-being of students and their: 1) Academic success and lifelong achievement. 2) Preparedness for a nursing career. 3) Success in competitive activities. 4) Social acceptance and friendships.

1) Academic success and lifelong achievement.

(18) A group of pediatric nurses and physicians are discussing environmental hazards in the Neonatal Intensive Care Unit (NICU). They are concerned about infants' potential for exposure to the chemical bisphenol A (BPA). What is the most likely source of BPA in the NICU? 1) Baby bottles 2) Blood pressure cuffs 3) Bed linens 4) Exam gloves

1) Baby bottles

(17) Community leaders enlist the help of the public health department (PHD) to prevent a flu epidemic. The public health nurse's (PHN) role is to address the need for protection against influenza. Which is the nurse's best action? 1) Become immersed in the community 2) Go the library and research flu epidemics 3) Tell community members they need to get flu shots 4) Teach residents the signs and symptoms of influenza

1) Become immersed in the community

(17) PHN conducts a follow-up visit with the family of whose 2-year-old child was recently diagnosed with autism. The mother tells the PHN about the outcome of the referrals the PHN provided. The mother has enrolled her child in an early intervention program and joined the National Autism Association. The work between the PHN and the family represents: 1) Collaboration. 2) Partnership. 3) Empowerment. 4) Outreach.

1) Collaboration.

(14) The county public health department (PHD) wants to reduce the incidence of influenza in the community by 20% this year. Which is a community level of care? 1) Conduct workshops and distribute influenza fact sheets at schools and libraries 2) Mandate all county pharmacies and clinics to provide free flu shots 3) Enact legislation requiring county residents to receive the flu vaccine 4) Schedule individual home visits to give flu shots to residents aged 65 years and older

1) Conduct workshops and distribute influenza fact sheets at schools and libraries Health education is a community level intervention. PHDs can enlist PHNs to educate the community, such as holding workshops and providing influenza fact sheets at public locations.

(17) PHN is involved with an after school program for at-risk teens in an urban community. The PHN recognizes the health problem with the lower prevalence is: 1) Excessive alcohol use 2) Drug use and addiction 3) Sexually transmitted infections (STIs) 4) Violence and crime

1) Excessive alcohol use People in rural areas are more likely to use alcohol excessively. There is a lower prevalence of excessive alcohol use in urban communities.

(17) A student nurse is working at a public health department (PHD) that serves many rural areas. The program the student is least likely to observe is a: 1) Gun violence education program 2) Mobile dental clinic 3) Federally Qualified Health Center (FQHC) 4) Telehealth program

1) Gun violence education program

(14) Town officials are concerned recent flooding and mudslides have contaminated the local water supply. Which is the priority action? 1) Issue a boil water alert 2) Monitor the incidence of waterborne illnesses 3) Administer hepatitis B vaccine to all residents 4) Supply bottled water to all residents

1) Issue a boil water alert

(16). A nurse working in a pediatric office notices an increase in the number of obese children. During a windshield assessment of the neighborhood, the nurse determines which is a contributing factor? 1) Numerous fast food restaurants 2) Athletic sports facilities 3) A variety of grocery stores 4) Well-maintained parks and playgrounds

1) Numerous fast food restaurants

(16) A primary care nurse who does not speak Spanish has noticed an increase in the number of patients who only speak Spanish. The nurse wants patients to understand how to manage their health. Which is the best option? 1) Provide educational materials written in Spanish 2) Take a Spanish immersion class 3) Smile and be friendly while assessing patients 4) Ask the clinic manager to hire a translator

1) Provide educational materials written in Spanish

(19) A high school health teacher is preparing next semester's lessons and asks the school nurse for a recommendation about priority topics for 15- and 16-year-old students. Which is the best recommendation? 1) Sexually transmitted infections (STIs) 2) Oral health 3) Diabetes prevention 4) Cancer screening

1) Sexually transmitted infections (STIs)

(18) Using data from the local community assessment, neonatal nurses identified maternal-child health needs in the community. Which is the best method to prioritize the maternal-child health needs? 1) Short-term mortality risk 2) Long-term morbidity risk 3) Protective factors 4) Funding resources

1) Short-term mortality risk

(19) A high school nurse is preparing a diabetes education program for faculty and staff. Which content is most important? 1) Signs and symptoms of hypoglycemia 2) How to perform blood glucose testing 3) How to self-administer insulin 4) Signs and symptoms of hyperglycemia

1) Signs and symptoms of hypoglycemia

(16) A nurse works at a healthcare center in a community where there is a high prevalence of type 2 diabetes among Latinos. Which is the best primary prevention intervention? 1) Talk with school officials about keeping the physical education program 2) Recommend all community members have a HbA1c blood test 3) Teach residents with type 2 diabetes to inspect their feet every day 4) Encourage patients with a BMI > 30 to start a weight loss program

1) Talk with school officials about keeping the physical education program

(17) PHN presents a lecture at an urban high school to educate students about signs indicating a person has S/I. Students complete pre-test and post-test to evaluate their learning. Which post-test responses indicate the program was effective? SELECT ALL THAT APPLY. 1) The person gives away his favorite CDs 2) The person says he is thinking about buying a gun 3) The person expresses a specific plan about how to commit suicide 4) The person says he loves life 5) The person enjoys an active social life with friends

1, 2, 3 are correct

(19) A local high school is holding a seminar on bullying. The school nurse explains to parents that bullying can cause? SELECT ALL THAT APPLY. 1) Poor self-esteem 2) Thoughts of and attempts at suicide 3) An even temper 4) Headaches 5) Elevated mood

1, 2, 4 are correct

(19) The school nurse tells the parents of an asthmatic student to have the doctor complete an asthma action plan. The parents ask the nurse what an asthma action plan is. Which responses are best? SELECT ALL THAT APPLY. 1) "An asthma action plan indicates which asthma medicines to give and when to give them." 2) "An asthma action plan lists signs of an asthmatic episode." 3) "An asthma action plan specifies exercises that should be avoided." 4) "An asthma action plan increases the use of the peak flow meter." 5) "An asthma action plan includes a list of general asthma triggers."

1, 2, 4 are correct

(18) A public health nurse (PHN) is speaking to a group of women at a prenatal clinic. A woman with a body mass index (BMI) of 34 asks how weight could affect her pregnancy. Which replies are most appropriate? SELECT ALL THAT APPLY. 1) "You may develop gestational diabetes during pregnancy." 2) "You are more likely to have a cesarean section." 3) "Your baby will be a normal weight throughout his life." 4) "Your baby may develop a neurological birth defect." 5) "Your blood pressure may go up while you are pregnant."

1, 2, 4, 5, are correct

(19) The Board of Education consults the school nurse as part of its initiative to improve nutrition among school-age children. Which are the nurse's recommendations? SELECT ALL THAT APPLY. 1) Replace candy bars in vending machines with 100 calorie granola bars 2) Provide french fries and dessert only once a week in school meals 3) Encourage eligible families to participate in the School Breakfast Program 4) Increase the number of fruits and vegetables available in school meals 5) Replace milk in school lunches and with bottled water

1, 3, 4 are correct

(18) A pediatric hospital is planning an intervention program to reduce the number of premature infant births. Which is included in the at-risk population? SELECT ALL THAT APPLY. 1) A woman who developed a Staphylococcus infection during pregnancy 2) A pregnant woman taking daily prenatal vitamins 3) A woman whose partner hit her while she was pregnant 4) A woman who waited three years between pregnancies 5) A woman who planning to have a labor-induced birth

1, 3, 5 are correct

(17) Community leaders in Peaceville, Florida, have decided to promote a healthy living program for their growing senior population. Which are coalition building strategies? SELECT ALL THAT APPLY. 1) Hold a fundraiser to fund the coalition's work 2) Reward the person responsible for the success of the program 3) Create groups within the team with its own specific identity 4) Identify challenges to progress and develop plans to remove them 5) Get the word out about their programs

1, 4, 5 are correct

(16) While reviewing the health history of a man with lower abdominal pain, the nurse notices the man's father died from colon cancer. Which is the priority assessment? 1) "Do you have a history of diabetes?" 2) "Have you ever had a colonoscopy?" 3) "Have you had any abdominal surgeries?" 4) "How many drinks do you have in a week?"

2) "Have you ever had a colonoscopy?"

(16) A client tells the nurse he takes his blood pressure pills every other day because he has a fixed income and the prescription lasts longer this way. Which is the best response? 1) "You have to take the pills every day so you won't have a stroke." 2) "Let's complete an application to get low cost blood pressure medication." 3) "Can your son buy your medication for you every other month?" 4) "Ask your doctor to prescribe a medicine you can afford."

2) "Let's complete an application to get low cost blood pressure medication."

(19) At a town PTA meeting, parents are expressing anger about the high school's decision to teach students about birth control methods in addition to abstinence-only birth control. Which statement by the school nurse best explains the rationale for the school's decision? 1) "Adolescents are going to have sexual intercourse regardless of what they are taught." 2) "Teen pregnancy rates are highest in states with abstinence-only programs." 3) "Adolescents should be responsible for the consequences of their actions." 4) "The district does not receive funding for abstinence-only programs."

2) "Teen pregnancy rates are highest in states with abstinence-only programs."

(16) The nurse is reviewing a 45-year-old client's history during his annual physical and learns the client works as a carpenter. What is the nurse's best response? 1) "You need the shingles vaccine." 2) "When was your last tetanus shot?" 3) "You should get a flu shot today." 4) "It's time for the third hepatitis B shot."

2) "When was your last tetanus shot?"

(16) Joe is an unemployed 30-year-old man who lives in an urban neighborhood. Joe has HTN and type 2 diabetes, and his BMI is 32. He pays rent and other living expenses with disability income he receives from Medicare. Which would benefit him most? 1) The Home Delivered Meals program 2) A patient-centered medical home (PCMH) 3) A federally funded health clinic 4) A private home health aide

2) A patient-centered medical home (PCMH) PCMH provides comprehensive physical and mental health care and includes personal physicians, advanced practice nurses, pharmacists, nutritionists, social workers, educators, and care coordinators.

(17) To meet the growing need for primary care providers, advanced practice nurses (APNs) provide health care at nurse-managed primary health centers. Which client is most likely to be seen by an APN? 1) A 27-year-old man with a ruptured appendix 2) A single mother whose 6-month-old needs a well-child exam 3) A 40-year-old woman with small bowel obstruction (SBO) 4) A 16-year-old who just attempted suicide

2) A single mother whose 6-month-old needs a well-child exam

(14) A nursing faculty is discussing how to best address the need for additional public health workers. The best option is to: 1) Require all nursing students to take a course in public health nursing. 2) Aggressively recruit and offer incentives to public health nurse educators. 3) Offer students a paid externship at the local public health department. 4) Invite the local PHD to speak to students about career opportunities in public health.

2) Aggressively recruit and offer incentives to public health nurse educators. Since there is a shortage of nursing faculty, the best option is to aggressively recruit nurse educators specializing in public health nursing. This can be done by offering incentives such as competitive salaries

(17) Members of the community enlist the help of the PHN to address the issue of childhood obesity. The community members are skeptical when the PHN suggests working with a research team. Which response is best? 1) Community-based participatory research (CBPR) adds credibility to their work 2) CBPR engages the community as an equal partner in the research process 3) CBPR has the finances the community needs solve their problems 4) CBPR serves as the leader of the coalition and delegates work

2) CBPR engages the community as an equal partner in the research process

(14) Which concerns were local boards of health focused on during the late 18th century? 1) Sanitation 2) Communicable diseases 3) Maternal and child health 4) Rural health

2) Communicable diseases

(18) A public health nurse (PHN) is planning a lecture on teen pregnancy. The PHN excludes information about: 1) Cephalopelvic disproportion (CPD) 2) Down's syndrome 3) Obtaining early prenatal care 4) Gonorrhea

2) Down's syndrome

(14) Approximately 20% of the population of North Orange, New York, lives at or below the U.S. Federal Poverty Guidelines. Many residents have health care coverage through Medicaid or Medicare, but there are very few providers in the community who accept Medicaid or Medicare and residents use the emergency department for nonurgent health issues. Also, Medicaid and Medicare reimbursement rates to the hospital are less than the actual cost for services. The hospital and public health department (PHD) decide to address the problem. Which is the best solution? 1) Petition the state to build a county hospital 2) Establish a federally qualified health center (FQHC) 3) Contract with the hospital to provide primary care 4) Provide Family Nurse Practitioners in every school

2) Establish a federally qualified health center (FQHC) PHDs can obtain funding to provide health care through FQHCs to serve an underserved area or population, provide comprehensive services, and offer a sliding fee scale. Medicaid and Medicare reimbursement rates are higher, FQHCs have a governing board of directors and an ongoing quality assurance program.

(16) Which type of physician would someone with a foot wound have gone to in 1942? 1) Podiatrist 2) General practitioner 3) Infectious disease specialist 4) Dermatologist

2) General practitioner Before the end of World War II (1945), general practitioners provided health care from birth to death.

(18) A group of labor and delivery (L&D) nurses agreed to participate in a community health fair. They are collecting local and state population level data to: 1) Decide the language for educational materials. 2) Identify risk factors related to the population. 3) Conduct a case study. 4) Write a report for the L&D nurse manager.

2) Identify risk factors related to the population.

(19) The school district recently eliminated its physical education program due to budget cuts. Which is the school nurse's best action? 1) Teach a class about healthy eating 2) Organize a walking group that meets after school 3) Ask parents to circulate a petition to reinstate the physical education program 4) Instruct students to do jumping jacks every day

2) Organize a walking group that meets after school

(16) Local primary care nurses want improve the community's health by addressing childhood obesity from a population health perspective. Which best represents a population-focused intervention? 1) Refer parents of overweight children to the dietitian 2) Outreach to community leaders to plan a health fair 3) Monitor height, weight, and HbA1C levels of overweight children 4) Request a public health nurse (PHN) educate parents during a home visit

2) Outreach to community leaders to plan a health fair

(19) The school nurse does not agree with the principal's plan to suspend a student who has a consistent pattern of absenteeism. Which is the nurse's best action? 1) Ask the parent to provide medical documentation for each absence 2) Perform a thorough physical and behavioral assessment 3) Talk to the student about the importance of attending school regularly 4) Ask the principal to speak with the parent before making a final decision

2) Perform a thorough physical and behavioral assessment

(14) he nurse tells the family of a patient who died the death certificate will be sent to the public health department (PHD). Which individual certifies information regarding the cause of death? 1) The funeral director 2) The medical examiner 3) The nurse 4) The hospitalist

2) The medical examiner

(17) Camden, New Jersey is an example of "broken window theory." Which would a PHN doing a community assessment on Camden expect to find? SELECT ALL THAT APPLY. 1) Collaboration between police and community 2) Abandoned buildings 3) Street violence and gang activity 4) Increased marijuana use 5) A thriving community center

2, 3, 4, are correct

(19) At a school board meeting, a group of parents of disabled children request that the school board approve several changes be made to accommodate their children's needs. Which accommodations should the school nurse anticipate? SELECT ALL THAT APPLY. 1) Build more staircases 2) Install elevators 3) Create a dedicated space for special health accommodations 4) Construct smaller restrooms 5) Purchase specialized furniture

2, 3, 5 are correct

(18) A public health nurse (PHN) visits the family of a 3-year-old boy with recurring otitis media (OM). Which assessment identifies a risk factor for OM? 1) "How much alcohol do you drink?" 2) "Was your home built before 1973?" 3) "Does anyone in the home smoke?" 4) "Did you take folic acid supplements during pregnancy?"

3) "Does anyone in the home smoke?"

(17) A public health nurse (PHN) working at a community health fair in rural Kansas is speaking with a man who recently had a stroke as a result of undiagnosed hypertension. Which statement best represents the reason for the client's undiagnosed hypertension? 1) "I was in denial for many years." 2) "I couldn't have prevented it anyway." 3) "I don't have a car and the nearest healthcare center is 35 miles away." 4) "My father also had a stroke so it runs in the family."

3) "I don't have a car and the nearest healthcare center is 35 miles away."

(19) The school nurse is meeting with parents to develop a health plan for a student newly diagnosed with type 1 diabetes. The father states "The medicine and supplies cost so much. How are we going to pay for everything?" Which is the nurse's best reply? 1) "Your child may not need medicine every day." 2) "The school can help pay for diabetes supplies." 3) "I'll help you sign up for Medicaid insurance." 4) "We will use as few supplies as possible at school."

3) "I'll help you sign up for Medicaid insurance."

(16) An instructor asks a nursing student what the term primary health care means in the United States and in the global community. The student is correct when he states: 1) "In the United States and the global community, primary health care refers to the level of care provided to individuals, families, and populations." 2) "In the United States, primary health care refers to the level of care provided to populations, and in the global community primary health care refers to the level of care provided to individuals and families." 3) "In the United States, primary health care refers to the level of care provided to individuals and families, and in the global community primary health care refers to the level of care provided to populations." 4) "In the United States primary health care refers to the level of care provided to individuals, and in the global community primary health care refers to the level of care provided to families."

3) "In the United States, primary health care refers to the level of care provided to individuals and families, and in the global community primary health care refers to the level of care provided to populations."

(18) Nurses at a pediatric hospital are conducting a lecture series on child safety. Which lecture addresses the under-five mortality rate? 1) "The Dangers of Drinking and Driving" 2) "Bike Safety in the Community" 3) "Preventing Injuries in the Home" 4) "Warning Signs of Suicide"

3) "Preventing Injuries in the Home"

(14) A new mother asks the labor and delivery nurse why her infant's weight, length, and head measurement are reported to the public health department (PHD). Which is the nurse's best response? 1) "The PHD stores the information as a backup to the hospital's database." 2) "The PHD sends the information to the pediatrician's office." 3) "The PHD monitors and evaluates health trends in the population." 4) "The PHD sends the information to the PHN before your home visit."

3) "The PHD monitors and evaluates health trends in the population."

(19) While observing a 12-year-old student in the classroom, the school nurse notes the student is looking around the room while the teacher is talking, fidgeting with pencils, and dropping papers on the floor. When discussing concerns with the parents, which is the nurse's best statement? 1) "Your child has an attention disorder. You should ask your primary care provider about medication." 2) "Your child appears to have an emotional disorder. You should make an appointment with a behavioral health specialist." 3) "Your child may have an attention disorder. You should make an appointment with your primary care provider." 4) "Your child's behaviors are interfering with other students' learning."

3) "Your child may have an attention disorder. You should make an appointment with your primary care provider."

(19) The parents of 6 year-old boy inform the school nurse their child has a life-threatening peanut allergy. Which is the nurse's best response? 1) "Your child will eat lunch at the peanut-free table." 2) "Our school policy prohibits any food snacks or treats." 3) "Your child will have an EpiPen with him at all times." 4) "All teachers have been trained how to use an EpiPen."

3) "Your child will have an EpiPen with him at all times."

(19) Terry is a 10-year-old boy who weighs 36 kg and is at the 75th percentile for weight for children his age. Which is the nurse's best statement? 1) "Your son's weight is less than average and he needs additional calories in his diet." 2) "Your son's weight places him in the overweight category. Increasing his physical activity will help control his weight." 3) "Your son's weight is where it is expected to be. He should continue to be active and eat healthy." 4) "Your son's weight places him in the obese category. He is at risk for developing diabetes."

3) "Your son's weight is where it is expected to be. He should continue to be active and eat healthy." .. A healthy weight ranges between the 5th and 85th percentiles.

(16) A nurse is preparing a hepatitis B injection for which at-risk patient? 1) A school social worker 2) A migrant farm worker 3) A first semester nursing student 4) A patient with type 2 diabetes

3) A first semester nursing student

(19) The school nurse is speaking with a group of high school students about dating violence and tells them the lowest risk factor associated with dating violence is: 1) Alcohol use 2) Tobacco use 3) Being sexually active 4) High risk sexual behaviors

3) Being sexually active

(14) A public health nurse (PHN) wants to create a health program to address obesity in the community. What is the nurse's first action? 1) Request that schools remove all vending machines 2) Petition the city council to tax soda at a higher rate 3) Collect data regarding obesity rates and diabetes 4) Distribute educational materials at fast food restaurants

3) Collect data regarding obesity rates and diabetes The first step in developing a health program is to perform a community assessment. The PHN should collect data regarding obesity rates and diabetes first.

(18) As part of a county-wide initiative to reduce the number of preterm births, a local hospital is developing a program to teach pregnant women about the risks associated with preterm birth. Which is the least effective strategy? 1) Contact the local March of Dimes chapter for funding 2) Compare local and national epidemiological and demographic data 3) Counsel women to avoid caffeinated beverages 4) Establish an outreach program focused on obtaining early prenatal care

3) Counsel women to avoid caffeinated beverages

(17) PHD asks a PHN to investigate a town's sudden increase in STIs. After speaking with members of the community, stakeholders, and key informants, what is the PHN's next action? 1) Identify availability of resources 2) Enact a plan to increase awareness of STIs 3) Create a core group of local leaders 4) Measure the outcomes of the plan

3) Create a core group of local leaders

(19) According to Healthy People 2020, one of the objectives for early and middle childhood is to increase the population of children who are ready for school. Which assessment is least likely to determine school readiness? 1) Physical 2) Cognitive 3) Environmental 4) Social-emotional

3) Environmental ...HP2020: increase proportion of children who ready for school in all 5 domains of hlthy dvlpmnt: physical , social-emotional , approaches to learning, language, & cognitive

(14) The nurse knows public health departments (PHDs) with the weakest infrastructure are challenged to provide public health services for which population? 1) City dwellers 2) Mothers and children 3) Farmers 4) Single-parent households

3) Farmers

(14) Public health departments (PHDs) are facing increasing population-level health concerns while at the same time there is an increasing shortage of public health nurses (PHNs). Which is a priority? 1) Increase the number of PHDs serving rural areas 2) Create certification programs for public health assistants 3) Fund advanced education for nurses specializing in public health 4) Increase PHN salaries to compete with private nursing salaries

3) Fund advanced education for nurses specializing in public health

(14) The mission of public health in the mid-19th century was focused on: 1) Housing conditions and slavery. 2) Maternal death and communicable diseases. 3) Housing conditions and communicable diseases. 4) Women's suffrage and communicable diseases.

3) Housing conditions and communicable diseases.

(17) A student nurse learns poor air quality in urban areas has a negative effect on the health of the population. Which nursing diagnosis is best? 1) Social isolation 2) Hopelessness 3) Ineffective breathing pattern 4) Risk for injury

3) Ineffective breathing pattern

(17) Community leaders identified a problem of narcotics abuse exists among residents. After several informal town meetings, the community is ready and motivated to solve the problem. Which is the next priority action? 1) Locate money to pay for substance use treatment programs 2) Ask the police to investigate suspected narcotics abusers 3) Initiate linkages with multiple organizations to identify solutions 4) Hire a public health nurse (PHN) to educate the public

3) Initiate linkages with multiple organizations to identify solutions

(14) An unknown number of injuries and fatalities are anticipated following the derailment of a commuter train during rush hour in New York City. Which is the public health nurse's best response? 1) Determine whether there are adequate medical response teams 2) Set up the command post at the site of the derailment 3) Initiate the community's emergency response plan 4) Debrief hospital staff and first responders

3) Initiate the community's emergency response plan

(17) Community leaders in Jonestown, Pennsylvania, want to establish a community partnership to educate children regarding the risks of tobacco use. Which community organization is least likely to work with the target population? 1) The Board of Education 2) The local parent-teacher association (PTA) 3) Planned Parenthood 4) The public health department (PHD)

3) Planned Parenthood Planned Parenthood is an agency focused on women's health and prenatal care and would be least likely to work with children.

(18) Neonatal nurses want to address the potential for adverse health effects related to infants' exposure to DHEP in the hospital's newborn nursery and Neonatal Intensive Care Unit (NICU). Current scientific and epidemiological data establishing a cause and effect, however, are not yet available. Which principle should the nurses use to support a need to create a program protecting the infants' health? 1) Environmental health principle 2) Community health principle 3) Precautionary principle 4) Evidence gathering principle

3) Precautionary principle

(16) Leaders of a Haitian Baptist church are concerned about members of their congregation who cannot afford routine healthcare services such as annual physicals. What is the best way to provide assistance? 1) Put signs up around the church encouraging members to have their blood pressure checked 2) Contact the Susan J. Komen Foundation to request funding for breast cancer screening 3) Recruit volunteer nurses from the community to perform monthly blood pressure screenings 4) Hire an instructor from the park district to hold weekly exercise classes

3) Recruit volunteer nurses from the community to perform monthly blood pressure screenings

(14) A nurse from the Public Health Department (PHD) visits a family who cannot afford their son's asthma medications. Which member of the PHD's interdisciplinary team is the best resource? 1) Physician 2) Pharmacist 3) Social worker 4) Nutritionist

3) Social worker

(17) .A 35-year-old recovering alcoholic decides to renew his faith and begins attending church. During worship time, he talks with the parish nurse and reflects about his whole experience of receiving spiritual care. Place the following in order (1-4): >> "I now have God in my life and look forward to being an active member of this church." >> "I didn't know churches had nurses! I'm so glad I have someone I can talk to now." >> "I am a person of value and I am stronger than the addiction." >> "It's hard being a recovering alcoholic. I have good days and bad days and I get angry at myself when I have bad days."

4 phases: 1) pt finds a safe place to tell his story & be accepted; 2) pt can release his burden & reorient thoughts; 3) pt revises self perception; 4) pt finds new place w/ God in church community *#1)* >> "I didn't know churches had nurses! I'm so glad I have someone I can talk to now." *#2)* >> "It's hard being a recovering alcoholic. I have good days and bad days and I get angry at myself when I have bad days." *#3)* >> "I am a person of value and I am stronger than the addiction." *#4)* >> "I now have God in my life and look forward to being an active member of this church."

(16) A nurse is performing blood pressure screening at a community health fair and identifies a woman whose blood pressure is 140/81 mm Hg. When the nurse tells her she may have hypertension, the women replies, "I just lost my job. I can't afford to pay for blood pressure medications." Which is the best response? 1) "Ask your doctor to prescribe a less expensive blood pressure medication." 2) "The stress of losing your job will make your blood pressure higher. You need the medication." 3) "The local pharmacist will know where you can find the lowest priced medication." 4) "Here is the phone number for the clinic that provides health care and medication based on income."

4) "Here is the phone number for the clinic that provides health care and medication based on income."

(17) A public health nurse (PHN) is planning a community health fair for residents in a large urban neighborhood. Which educational materials are *least* appropriate for the target population? 1) "What is Syphilis?" 2) "Beating Drug Addiction" 3) "Non-violent Problem Solving" 4) "Take Care of Your Teeth!"

4) "Take Care of Your Teeth!" .... Rural areas see greater disparities in poor dentition versus urban areas. STI's, substance abuse, and interpersonal violence are much more prevalent in urban neighborhoods

(19) Katie is a 15-year-old high school student taking a class in health education. Which indicates the objective of the health education component of a coordinated school health program is being met? 1) "Today we learned about dance and keeping rhythm." 2) "I went to the school nurse because I had a migraine headache." 3) "I was wheezing today after being in the physical science lab." 4) "The best way to prevent diabetes is to exercise and avoid eating fast food."

4) "The best way to prevent diabetes is to exercise and avoid eating fast food."

(19) The school nurse is developing a district-wide wellness program. Which is a desired measurable outcome? 1) Participants report feeling better at the start of the school year. 2) Participants bring healthier snacks and lunches to school. 3) District health insurance costs will increase by 25% within the next 10 months. 4) Absenteeism rates will decrease by 25% by the end of the current school year.

4) Absenteeism rates will decrease by 25% by the end of the current school year.

(17) The nursing instructor asks a community health nursing student how to improve a rural community's access to health care. Which indicates the need for further teaching? 1) Utilize a patient-centered medical home (PCMH) model of health care 2) Increase the number of healthcare providers in rural areas 3) Utilize Telehealth services 4) Accept more students from urban areas into nursing schools

4) Accept more students from urban areas into nursing schools Nursing schools should accept more students from rural backgrounds, rather than urban areas, because they are more likely to return to rural areas to practice.

(16) The family nurse practitioner (FNP) at the school clinic notes an increase in the number of students newly diagnosed with asthma. After further investigation, the FNP learns the students attend the same school. What is the FNP's priority action? 1) Inform the principal there is a toxin in the school causing students' asthma 2) Exclude students with asthma from attending school until the school environment is examined 3) Request parents obtain an order from their healthcare provider for additional use of rescue inhalers 4) Ask an environmental health specialist from the public health department to assess the school

4) Ask an environmental health specialist from the public health department to assess the school

(19) The school nurse is concerned about bullying in the school after a student reported another student had been bullying her and posting hateful things on social media sites. The nurse knows bullying occurs among 20% of adolescents in grades 9-12. Which is the best population level intervention? 1) Educate all peer mediators about bullying reduction 2) Ask the principal to send a letter to parents about bullying 3) Meet with the principal to request a 10 day suspension for the bully 4) Collaborate with principal to establish a bullying reduction program

4) Collaborate with principal to establish a bullying reduction program

(18) A nurse is planning a nutrition education program for clients at a prenatal clinic in a large urban area. Which should the nurse consider first? 1) Appropriate educational materials 2) Time and location for program 3) Eligibility for the Women, Infants, and Children (WIC) program 4) Cultural food practices during pregnancy

4) Cultural food practices during pregnancy

(16) A woman comes to the health clinic and tells the nurse she is scared because her neighbor has a bed bug infestation in her home. Which is the best response? 1) Advise her to call a professional exterminator 2) Suggest she vacuum the mattresses and launder all bedding in hot water 3) Tell the woman to apply insect repellant before she goes to bed 4) Describe what bed bugs look like, where to find them, and how to eradicate them

4) Describe what bed bugs look like, where to find them, and how to eradicate them

(19) The school nurse writes a letter to parents of middle school age children recommending they get vaccinated before the start of the school year. Using CDC guidelines, which vaccinations does the nurse recommend? 1) Shingles 2) Varicella 3) HPV for girls 4) HPV for all students

4) HPV for all students

(18) A labor and delivery nurse (L&D) is reviewing the health history of the mother of a newborn with a neural tube defect (NTD). The L&D nurse would most likely expect the mother: 1) Has Crohn's disease. 2) Is a smoker. 3) Took folic acid supplements during pregnancy. 4) Has a body mass index (BMI) of 32.

4) Has a body mass index (BMI) of 32.

(14) The public health nurse (PHN) is visiting a client newly diagnosed with tuberculosis. The medical team is concerned the client may be unable to adhere to the medication regimen. What is the best method to promote adherence? 1) Call the client every day to ask if medications were taken 2) Send daily text messages and email reminders 3) Monitor adherence with a microchip in the medication bottle cap 4) Observe the client take the medication at the public health department

4) Observe the client take the medication at the public health department

(18) A public health nurse (PHN) is speaking with a Nigerian woman at a prenatal clinic. The woman tells the PHN her 3-year-old died before she came to the United States. The nurse realizes the most likely cause of the child's death was: 1) Leukemia. 2) SIDS. 3) Tuberculosis. 4) Pneumonia.

4) Pneumonia. (pneu. & influenza = major causes of death in young children in Nigeria)

(14) Smithville, West Virginia is a small rural community. Smithville falls under which type of public health department (PHD) jurisdiction? 1) County based 2) City based 3) Federal 4) Regional

4) Regional Multicounty or regional jurisdictions make up 8% of PHDs and are the proposed method for strengthening public health services in rural areas. Smithville is a small rural community and falls under the jurisdiction of a multicounty, or regional based, PHD.

(17) A group of community organizers partnered with police, business owners, and the public health department (PHD) to address concerns about rising crime rates in the community related to lack of job opportunities and police presence. They are using the 6 step guide from the Center on Education & Training for Employment at Ohio State University to develop an action plan. What is their next step? 1) Begin police on foot patrols immediately 2) Establish a goal to decrease crime by 25% 3) Open a job training center 4) Select one representative from each organization

4) Select one representative from each organization

(18) A group of labor and delivery (L&D) nurses are putting together a program to reduce the number of women who develop gestational diabetes. Which measurable outcome objective is best? 1) The number of women with gestational diabetes will decrease. 2) The number of women without gestational diabetes will increase by 25% . 3) The number of women with Type 2 diabetes will decrease by 25% within six months. 4) The number of women with gestational diabetes will decrease by 25%.

4) The number of women with gestational diabetes will decrease by 25%.