community 8-13
10. As an advocate for leukemia research, the nurse along with many others succeeded in urging the U.S. Congress to debate and vote on a bill that significantly increases federal funding for this research. Which system level would such an intervention address? A)Upstream B)Mainstream C)Sidestream D)Downstream
A)Upstream
9. The school nurse notifies the community nurse that there have been five confirmed cases of pertussis in the sixth-grade classes. In addition to responding to the cluster of cases, the community nurse should immediately: A)Recommend that the school be closed B)Research the vaccine compliance in the school C)Recommend that notes be sent home to the parents regarding a pertussis epidemic D)Consult with the infection control physician at the local hospital
B)Research the vaccine compliance in the school
10. The nurse takes care of a dependent family member whose husband is in the military. Which government funding is most likely going to be used for home healthcare services for this client? A) Medicare B) Medicaid C) TRICARE D) Veterans Administration
C) TRICARE
20.The nurse reviews published research studies on clients with developmental disabilities who receive music therapy once a week. Using knowledge of research studies, what type of research study would entail an in -depth analysis of one group of developmentally disabled individuals and the effects of music therapy? A) Case control B) Case C) Clinical trial D) Cohort
B) Case
9. Which type of agency can be either profit or nonprofit? A) Private/voluntary B) Hospital based C) Proprietary D) Official
B) Hospital based
3.The nurse reads a research article that reviews causality. Using knowledge of research designs, which types of design examine causality? (Select all that apply.) A) Retrospective B) Quasi -experimental C) Experimental D) Randomized, control group E) Case -controlled
B) Quasi -experimental C) Experimental D) Randomized, control group
10.Which best describes the function of the grand nursing theory in nursing practice? A) Presents a systematic view of related statements to describe, explain, predict, or prescribe a phenomenon of interest B) Relates human experience to nursing practice and nursing care C) Assesses health patterns in 11 areas of family health D) Engages the family as a way to identify its strengths with attention to family dynamics and concerns related to health and illness
B) Relates human experience to nursing practice and nursing care
16.Which ensures that a study's results are not due to chance alone? A) Rejecting the null hypothesis B) Setting the p value to .05 C) Calculating the risk ratio D) Using a preventive study design
B) Setting the p value to .05
20.The nurse is approached by the health department to investigate and assess the rise in developmental disabilities in an isolated section in the community. To begin the assessment, the nurse should gather objective data from which source? A)Client interview—aggregate data B)Internet—aggregate data C)Internet—Wikipedia D)Direct observation of the area
B)Internet—aggregate data
3. The nurse is present when a mother begins cupping her child. She states that it will help to heal the child's respiratory tract infection. The nurse understands that the cultural belief that cupping will aid in the healing process is a: A)Shared instinct B)Learned behavior C)Private idiosyncrasy D)Genetically programmed idea
B)Learned behavior
6.The nurse conducts a community assessment. The community is large and the members range from affluent executives to poor migrant workers. To most accurately assess the community, the nurse should: A)Use a questionnaire written on a fifth-grade reading level B)Use multiple methods or perspectives C)Interview a subpopulation of each group represented D)Analyze census data
B)Use multiple methods or perspectives
19.Following a hurricane, the disaster team chooses to use a collaborative model to assess the needs of the community. Each team member is given a community analysis and assigned the task to create a tentative plan of action. Why would the use of a collaborative model hamper the progress of the assessment and plan in a disaster? (Select all that apply.) A)Individual decision-making creates bias. B)Assessment is time-consuming. C)Approach to problem solving is linear. D)Approaches must be preestablished. E)Collaboration is limited.
B,D
21.The nurse is scheduling a follow-up appointment for a client who recently immigrated from Nicaragua. The client agrees to a 9:00-AM appointment on the following Wednesday. The nurse should anticipate that on the following Wednesday, this client will: A)Show up half an hour before the scheduled time B)Not return at all for the follow-up appointment C)Arrive late for the appointment, after completing whatever tasks the client feels need to be accomplished first D)Arrive exactly on time
C)Arrive late for the appointment, after completing whatever tasks the client feels need to be accomplished first
13.To demonstrate true cultural sensitivity and awareness, the nurse must: A)Travel to other countries on occasion B)Become bilingual C)Be competent in his or her own cultural heritage D)Know the practices of all major cultures in one's region of the country
C)Be competent in his or her own cultural heritage
20.The nurse educator is responsible for conducting educational seminars for the staff. After the education component of the program, the group engages in discussion. It is important that nurses routinely attend educational programs related to cultural competence because: A)The information is lost when caring for clients in real life. B)One can't be competent at all times. C)Nurses can facilitate social change. D)Classes are necessary for regulatory compliance. Ans:
C)Nurses can facilitate social change.
11.Who primarily regulates the provisions of home healthcare? (Select all that apply.) A) Insurance companies B) Local government C) State government D) Federal government
C,D
9.The community health nurse is using a genogram to aid in the family assessment. What aspect of family connections and relationships is included in the genogram? A) Influence of other systems on families B) Influence of groups on families C) Family relationships and their vital connections D) Relationships across two or more generations
D) Relationships across two or more generations
14.Which type of assessment considers a configuration of behaviors that occur sequentially over time? A)Asset-based assessment B)Epidemiologic model C)Collaborative model D)Functional health pattern
D)Functional health pattern
17. When the community collaborates in a plan to create services and education to enhance their health and well-being, the plan is most likely to: A)Create an environment that fosters change B)Have an increased rate of success C)Empower the community but diminish the rate of success D)Shift the focus from dependency to empowerment
D)Shift the focus from dependency to empowerment
21. The nurse works with 68-year-old client who is having great difficulty managing his blood glucose level. The nurse finds that the client is not following the diet that he had agreed to follow and is eating portions that are far too large. He apologizes and explains that he is grieving the loss of his wife, who died 2 weeks ago. The nurse shares condolences with him on his loss and explain that it is perfectly understandable to have trouble following a new diet while grieving. In this scenario, the nurse is using which principal approach in motivational interviewing? A) Expressing empathy B) Supporting self-efficacy C) Rolling with resistance D) Finding a discrepancy
A) Expressing empathy
9.The nurse is conducting a study on how regular physical activity affects the risk for developing lung cancer among smokers. One group leads a sedentary lifestyle whereas the other has agreed to undergo regular supervised exercise in the gym of a local hospital. During the study, the sole treadmill in the gym broke down and was unable to be used for the last half of the study. Several study participants who preferred the treadmill to other machines did not exercise as long or as intensely as they might otherwise have. Which threat to the external validity of the study does this represent? A) Interaction of history and intervention B) Interaction of selection and intervention C) Experimenter/participant effect D) Novelty
A) Interaction of history and intervention
14.Which exemplifies cultural diversity? A) People from South Korea, Brazil, and Nigeria all living in the same apartment complex B) A town in which everyone speaks Spanish, is originally from the same region in Mexico, and prepares similar types of food C) A university where all of the professors share the same political views D) A workplace in which accountants, lawyers, marketing executives, information technologists, and maintenance workers are all employed
A) People from South Korea, Brazil, and Nigeria all living in the same apartment complex
18.The physician approaches the client with a treatment plan for his cancer. The client states that his life is in God's hands and refuses conventional treatment. This is an example of: A)Fatalistic behavior B)Denial C)Anger D)Bargaining
A)Fatalistic behavior
12.Which criteria must an individual meet to receive Medicare for home health services? (Select all that apply.) A) Home bound B) Specific plan of care C) Skilled healthcare needs D) Intermittent care needs E) Continuous 24-hour necessity for care
A,B,C,D
12. The nurse decided to approach local organizations for financial and in-kind support for a new community health initiative. On which local resources can the nurse draw? (Select all that apply.) A)Catholic church B)Branch of Bank of America C)Car dealership D)Community Transformation Grant E)The Bill and Melinda Gates Foundation
A,B,C
17. The nurse reviews the logic model and formal evaluation plan of a grant proposal on a community rabies program. Which requirements should be included in the plan to support accountability? (Select all that apply.) A)Regular communication about funds that were not used B)Details of program activities C)Report of areas where there is no progress toward program goals D)Proof that the program can be reproduced effectively in other settings E)Explanation of how the program will be funded after grant funding expires
A,B,C
17.Using knowledge of the parish or faith community nurse, which interventions are likely to perform on the basis of the key roles of this type of nurse? (Select all that apply.) A) Teaching a class to faith community members on managing high blood pressure B) Providing counsel on preventing upper respiratory illness to member C) Referring a faith community member to a nutritionist for dietary counsel D) Assisting an obstetrician in the birth of a faith community member's child E) Administering vaccinations at a local health clinic
A,B,C
5.The community health nurse is reviewing guidelines for the 15-minute assessment to keep the interview focused and family centered. Which questions and considerations for the family assessment can be asked for the question "Who is part of the family?" (Select all that apply.) A) What is the nature of individuals' connections to one another? B) Does the individual live alone or have no living family members? C) What influences from the family of origin are present in daily life? D) Do members speak independently or is an interpreter present? E) What observations can be made about the interpersonal dynamics between members?
A,B,C
10.The nurse wishes to conduct a study on the effectiveness of animal -assisted therapy in alleviating symptoms of depression. One group of subjects would attend regular counseling sessions in the company of a dog, whereas the other group would attend regular counseling sessions without a dog present. In this study, the dogs would represent: A) Control group B) Treatment group C) Intervention D) Placebo
C) Intervention
5.The nurse is participating in study that considers the effect that use of netting around beds has on the incidence of malaria in a community of subjects in Africa. Which type of study would be best for this purpose? A) Cohort B) Case -control C) Preventive D) Therapeutic
C) Preventive
8.The nurse recently took a position in a national chain of home healthcare agencies directed at caring for clients who are on home hemodialysis. The services provided are often paid for privately by families, and any profit margin is used to benefit the owner of the agency. Which type of agency is this? A) Private/voluntary B) Hospital based C) Proprietary D) Official
C) Proprietary
14.The client wants to know how long Medicare will pay for skilled needs. How long can the nurse continue to provide this care before she must seek a renewal if skilled needs continue to exist? A) 30 days B) 45 days C) 60 days D) 90 days
C) 60 days
7. The nurse has recently been appointed to a community-based advisory board of an agency that is interested in providing fiscally sound, high-quality care for clients they decide will be their service population. Any profit margin that is acquired is reinvested in the operations of the home healthcare service. Which type of agency is this? A) Private/voluntary B) Hospital based C) Proprietary D) Official
A) Private/voluntary
14.Advantages of a case -control study include: (Select all that apply). A) Allows for the examination of multiple exposures for a single outcome B) Allows for the direct measure of the incidence of a disease C) Is generally quicker and less expensive to conduct than cohort studies D) Appropriate for studying rare exposures E) Requires fewer case -subjects
A) Allows for the examination of multiple C) Is generally quicker and less expensive to conduct than cohort studies E) Requires fewer case-subjects
18.The nurse studies the association of lead poisoning with residence in a home that was built before 1970. Which needs to be established to show an association between these two variables? A) A statistical relationship between lead poisoning and residence in a home built before 1970 B) That the presence or absence of residence in a home built before 1970 determines the presence or absence, respectively, of lead poisoning C) A relative risk of 1 D) A p value > 0.1
A) A statistical relationship between lead poisoning and residence in a home built before 1970
1. The nurse discusses home care options with an 85-year-old client who recently fractured her humerus in a fall in her house. She is recovering well now but says the experience has made her see that it is time for her to change her living arrangements. The client can still bathe herself and cook meals on occasion but says she would like to live where nursing care is available onsite and where communal dining and recreation options are offered. Which of the following living arrangements could the nurse recommend? A) Assisted living facility B) Independent living in a senior living facility C) Nursing home D) Apartment located near a hospital
A) Assisted living facility
12.The nurse reviews a published analytical research study that compares one group of clients who developed diabetes mellitus before the start of the study with a group of clients without diabetes mellitus. Which type of study design was used in this study? A) Case control B) Case C) Clinical trial D) Cohort
A) Case control
4.The nurse conducts a study that will follow a group of subjects for two decades. It involves one group of subjects who have a risk factor for developing diabetes and another group who do not have a risk factor. The goal is to establish a cause -and -effect relationship between the existence of the risk factor and the occurrence of diabetes. Which study design would be most appropriate? A) Cohort B) Case -control C) Preventive D) Therapeutic
A) Cohort
7.Which exemplifies a nuclear family? A) First-degree relatives who live together B) First- and second-degree relatives who live together C) First- and second-degree relatives who live in the same neighborhood D) Individuals who are not blood relatives but share a common locale of origin or culture
A) First-degree relatives who live together
1. The nurse is preparing a research study on the number of heart attacks in the community and the number of individuals who are actively involved in exercise programs following a heart attack. Using knowledge of research study design, which gold standard for a research design should be considered? A) Randomized, control group B) Quasi -experimental C) Experimental D) Descriptive epidemiologic
A) Randomized, control group
21.The nurse is conducting a cross -sectional study of people who are HIV positive and their exposure to certain risk factors. Given the nature of this type of study, which would be true? (Select all that apply.) A) Respondents are a sample that represents the entire population. B) The results of the study will allow determination of cause and effect. C) Data represent a point in time. D) Data are gathered via a questionnaire or interview. E) Subjects are randomly assigned to treatment and control groups.
A) Respondents are a sample that represents the entire population. C) Data represent a point in time. D) Data are gathered via a questionnaire or interview.
11.During an ice storm, people in one neighborhood banded together and shared the home of a neighbor who still had power and heat. Other neighbors provided food, water, and bedding. In another neighborhood the neighbors did not know one another and weathered the storm alone. Both neighborhoods are part of the same community. What characteristic did the people in the first neighborhood share that made them a subculture that those in the second neighborhood lacked? A)Belief in the value of cooperation B)Religion C)Socioeconomic status D)Geography
A)Belief in the value of cooperation
4. A Mexican-American client arrives at the emergency department. He reports abdominal pain and has been vomiting for 5 days. The nurse notes that he is exhibiting symptoms of dehydration, and his vital signs and labs confirm this. The nurse asks the client why he waited so long to seek medical care. He states that he is being treated by the Curandero and wishes to continue while in the hospital. The nurse recognizes the different cultural assumptions regarding care. This situation is an example of: A)Cross-cultural nursing B)Ethnocentrism C)Cultural safety D)Transcultural bias
A)Cross-cultural nursing
1. A group of teens develop their own method of texting in a language that they feel is all their own. The change is subtle, but the meanings and the feelings associated with the text are known only to a select few. This behavior is an example of: A)Culture B)Cultural competence C)Cultural safety D)Ethnocentrism
A)Culture
16.The nurse cares for a client in a community health clinic. The nurse is uncomfortable because the client remains very close when communicating. This discomfort makes it difficult to concentrate on the interview. When the nurse backs away, the client stops speaking and leaves. This is an example of: A)Differing views of personal space B)Treatment limitation C)Aggressive behavior D)Cultural bias
A)Differing views of personal space
13.The community health nurse explores pedestrian access to all healthcare facilities in the community. Which tool would be most helpful in performing this task? A)Geographic information systems B)Functional health pattern C)Epidemiologic model D)Developmental model
A)Geographic information systems
2. The nurse conducts a community assessment in a town once supported by multiple paper factories. The factories closed 2 years ago and most of the population is now out of work. The school nurse notes that 68% of the students are behind schedule in their physicals and immunizations. On the basis of this community assessment, the nurse should recommend: A)Initiation of neighborhood clinics at low or no cost to the community B)Creation of a task force to assess the impact of low income on immunization compliance C)A formal petition to the local government to mandate immunizations by imposing monetary fines on parents whose children are not immunized D)A tax relief program for new companies wishing to settle in the community
A)Initiation of neighborhood clinics at low or no cost to the community
16. The community is concerned about public safety and the care of their elders living at home. When the nurse assesses the community, the nurse finds there is potential to solve their problems within the community setting without outside resources. The plans to meet the community needs are accepted by the members of the community. Which action has been most successfully demonstrated in your assessment of this community? A)Make the assessment process empowering to the community B)Assess the community through interview and share findings in a timely manner C)Involve the community when there is difficulty with the assessment D)Create an environment of change within the community
A)Make the assessment process empowering to the community
19. The client is admitted to the hospital for new-onset hypertension and chest pain. During the admission interview you ask the client if she takes over-the-counter medications, and she states no. She adds that she routinely visits a folk healer. The nurse's response should include: A)Obtaining a list of the herbs and folk medications that are taken and notifying the physician B)Requesting the client to stop the ingestion of the folk herbs C)Calling poison control with the list of herbs and folk medications D)Encouraging the client to continue to take the herbs and folk medications
A)Obtaining a list of the herbs and folk medications that are taken and notifying the physician
7. The community health nurse assesses the neighborhood in which the clients live. When observing the physical environment, the nurse notes that most of the homes in the neighborhood are well kept and the children playing in the yards are wearing clean clothing. The children appear well nourished. The nurse determines that the neighborhood has little need for a well-child clinic. This assessment is based on: A)Subjective data B)Objective data C)Cognitive analysis D)Valid data
A)Subjective data
14. The nurse is reviewing the sources of funding for the local community health intervention program on smoking cessation. In the federal grant proposal, the nurse elaborates on all the various local organizations and private foundations that have pledged to support the program after initial funding from the grant ends. The nurse also explains the plan for ongoing fundraising efforts for the program for years to come. With these comments, the nurse is attempting to establish which essential component of funding? A)Sustainability B)Program replication C)Clinical expertise D)Accountability
A)Sustainability
18.The nurse assesses a family in which the wife and mother has recently been diagnosed with breast cancer. Which factors will likely affect the family's response to the health risk that this diagnosis presents? (Select all that apply.) A) What the husband and wife learned about dealing with serious illness in their families of origin B) Whether the family is covered by health insurance C) How the children tend to cope with stressful situations D) The response of fellow members of the family's mosque E) The incidence rate of breast cancer in the family's community
A,B,C,D
17.The nurse is selecting a health appraisal related to alcoholism to assess health risk in a client. Which are examples of information that should be included in the appraisal? (Select all that apply.) A) Signs and symptoms of alcoholism B) Recommended daily limit of alcoholic drinks consumed per day C) Examples, such as frequently drinking an alcoholic beverage in the morning D) Incidence rates of alcoholism in the United States E) Information on local substance abuse programs
A,B,C,E
2. The nurse is in charge of a local community program that uses a logic model as a planning and communication tool. Which key components are included in this model? (Select all that apply.) A)Milestones for completing a community health clinic B)Plan to conduct cholesterol screenings C)Need for a nurse practitioner to manage the clinic D)Malaria prevention programs for developing nations E)Possible locations for the health clinic
A,B,C,E
15.The nurse assesses a community undergoing change. Five years ago, a series of setbacks caused the local foundry to close. Through interviews, the nurse discovers that generations of families worked at the foundry. Research indicates that no other businesses have been able to provide work for those who no longer work at the foundry. Developmental data gathered through this research into the community's history will help the nurse: (Select all that apply.) A)Determine what resources were available before the foundry closed B)Determine what variables may have enhanced or detracted from community development C)Develop an understanding of the community's strengths and resources today D)Understand cultural changes within the community over time E)Identify where in the community health clinics are most needed
A,B,D
4. Which changes in the environment (second level from the bottom of the health impact pyramid) make the choice for a healthy behavior the default or easy choice? (Select all that apply.) A)Iodization of salt B)Restrictions on smoking in public places C)Community immunization programs D)Changing food manufacturing to eliminate trans fats E)Treatment of hypertension
A,B,D
7. Which aspects of Lewin's change theory will help people visualize and create needed change? (Select all that apply.) A)Unfreezing the status quo B)Changing or moving to a new state C)Enforcing the status quo D)Refreezing to sustain the change or changes made E)Increasing restraining forces
A,B,D
16.Which are included in the five types of health risk factors that affect families? (Select all that apply.) A) Genetics B) Age C) Intelligence D) Personal health habits and lifestyle E) Environment
A,B.D.E
16. The nurse reviews the job descriptions of the community health workers who work with community health nurses and other members of the program team. These workers are responsible for: (Select all that apply.) A)Serving as a cultural and language bridge to members of target population B)Performing minor surgical procedures C)Providing health education and outreach to community D)Offering assistance in accessing services E)Prescribing commonly used medications
A,C,D
19.Which are among the key categories of indicators of health presented in Healthy People 2020? (Select all that apply.) A) Physical activity B) Exposure to allergens C) Responsible sexual behavior D) Tobacco use E) Occupation
A,C,D
5. At an international nurses' conference, nurses from all around the world make contact. The various communities represented at this conference most likely: (Select all that apply.) A)Vary significantly in composition B)Have no shared interests and goals related to health and safety C)Are challenged in their attempts to identify its members D)Thought of as members of a global community E)Do not need to assess their communities' needs because they are obvious
A,C,D
6.A nurse, new to the community health agency, works in a culturally diverse area of the community. The nurse is responsible for providing holistic care to clients and to be culturally competent. The health agency requires the nurse to demonstrate which competency to exhibit cultural competence? (Select all that apply.) A)Value diversity B)Adopt the client's cultural values C)Acquire cultural knowledge D)Adapt to diversity E)Speak the language of the client
A,C,D
7.The nurse is called to make an unscheduled visit to a new client in her home. The purpose of the visit is to admit the client and treat an abdominal wound. The nurse discovers that the client is from a culture unfamiliar to her. In this situation, the nurse should demonstrate cultural competence and awareness by: (Select all that apply.) A)Being open to the client's ideas and way of life B)Obtaining objective data when caring for the client C)Exhibiting respect and patience D)Being aware of your own culture E)Assuming that you have enough knowledge to get by
A,C,D
13. The nurse researches the role of nurse-managed health centers in the city. Which are common characteristics of these centers? (Select all that apply.) A)Led by advanced-practice nurses B)Serve upper-income mothers and children C)Emphasize health promotion, disease prevention, and health education D)Provide clinical practice for nursing students and faculty E)Offer specialized programs to meet the needs of specific population aggregates
A,C,D,E
15.The nurse reviews the official document called the Scope and Standards of Home Health Nursing Practice. Using knowledge about the document providing guidelines for nurses involved in home healthcare practice, which are included in the standards of care? (Select all that apply.) A) Assessment by collecting data about home care clients B) Implementation of nurse-centered actions in collaboration with physicians C) Diagnosis through the analysis of data D) Outcome identification that helps identify nurse-sensitive measures E) Planning nurse-sensitive interventions directed at the identified outcomes
A,C,D,E
1. Which are recommendations made by the World Health Organization's Commission on Social Determinants of Health (CSDH)? (Select all that apply.) A)Improve conditions under which all people are born, grow, live, work, and age B)Provide increased funding for research of genetic disorders C)Ensure more equitable distribution of power, money, and resources D)Instill a sense of personal responsibility for one's health in each person E)Expand knowledge of the social determinants of health Ans:
A,C,E
15.A client is admitted to the hospital. On admission, it is noted that the client does not speak English. It will take 20 minutes for the hospital interpreter to arrive. The nurse decides to wait for the interpreter rather than relying on the client's husband. Appropriate rationales for this decision include that the interpreter is: (Select all that apply.) A)More likely to be fluent in both languages B)More likely to be familiar with the client's symptoms C)Trained in ethics and will be better at explaining cultural differences D)More likely to understand the client's needs E)More likely familiar with technical healthcare terms
A,C,E
8.Reasons blended families are becoming more widespread include an increase in the number of: (Select all that apply.) A) People who remarry following a divorce B) People who remain single after being widowed C) Recognized gay and lesbian relationships D) Married couples having children E) Couples cohabiting with children from prior relationships
A,C,E
13.The nurse investigates a family's health routines and rituals as part of the overall family assessment. Which exemplify family health routines? (Select all that apply.) A) Siblings all brushing their teeth together before bed every night B) Parents taking their 9-month-old child to the health clinic when he has a fever C) Entering a 5K run/walk charity event each year as a family D) Taking a walk together around the neighborhood after dinner each evening E) The mother having a mammogram performed every year
A,D
3. The case manager works with a client who has type 2 diabetes and heart disease. In this role, which actions should the nurse take in managing the client's diseases? (Select all that apply.) A) Provide weekly coaching sessions by telephone for blood glucose management. B) Supervise cardiac stress tests in the exercise room of the local hospital. C) Administer emergency insulin when the client arrives at the hospital in a diabetic coma. D) Demonstrate use of a glucose meter to the client. E) Review heart-healthy and diabetic-friendly food options with the client and his family.
A,D,E
5. Which exemplify clinical interventions (the level just above the middle of the health impact pyramid)? (Select all that apply.) A)Administration of insulin injections for diabetes B)Restrictions on smoking in public places C)Community immunization programs D)Instruction provided by a nurse regarding proper nutrition E)Treatment of hypertension
A,E
13.The nurse provides care covered by Medicare for a client over 2 hours during the day, 3 days during the week, for 60 days. Which type of care is the nurse providing? A) Interdisciplinary B) Skilled C) Intermittent D) Part-time
C) Intermittent
11. Which best describes a prospective study? A) Descriptive study in which participants are enrolled before the health outcome of interest has occurred B) Analytic study in which participants are enrolled before the health outcome of interest has occurred C) Descriptive study in which participants are enrolled after the health outcome of interest has occurred D) Analytic study in which participants are enrolled after the health outcome of interest has occurred
B) Analytic study in which participants are enrolled before the health outcome of interest has occurred
18.The home care agency has just received a client referral from a physician and assigned the case. Within how many hours from receiving the referral should the nurse plan to make the initial visit to this client, on the basis of typical agency policy? A) 12 hours B) 24 hours C) 36 hours D) 48 hours
B) 24 hours
19.The nurse wishes to conduct research on the number of cancer clients who are actively involved in exercise programs following chemotherapy. To prepare, the nurse reviews similar, published research studies. The nurse knows that maturation can be a threat to internal validity of the research study. Which is an example of maturation? A) A heat wave occurred during the study and clients who normally exercised outside were unable to do so. B) A client developed fatigue and was unable to complete the exercise program. C) Repeated stress tests on stationary bicycles demotivated clients from participating. D) Inclusion of a former Olympic athlete in the study skewed the results.
B) A client developed fatigue and was unable to complete the exercise program.
4. The case manager works with a 10-year-old girl who has asthma. Because the client's family has trouble affording inhalers, the case manager researches client assistance programs through which they could receive free medications. This aspect of case management is known as: A) Care management B) Advocacy C) Disease management D) Interdisciplinary collaboration
B) Advocacy
15.In comparison with other generations, members of generation X: A) Respect authority, but want recognition for their individual contributions B) Are likely to multitask and have more than one career in their lifetimes C) Prefer authoritarian leadership and direct personal interaction with superiors and others D) Are goal oriented and focused people who desire guidance
B) Are likely to multitask and have more than one career in their lifetimes
2. During a home visit of a client with high blood pressure with whom the nurse has developed a strong therapeutic relationship, the nurse learn that the client keeps a large salt shaker near the stove and heavily salts whatever he is cooking. He also keeps a salt shaker on the dinner table and adds more salt when eating. The nurse suggests removing the salt shaker near the stove and only lightly salting food when eating as a way to help reduce the client's sodium intake. This intervention would most likely achieve the goals for assessment associated with which nursing theory? A) Science of Unitary Beings B) Health as Expanding Consciousness C) Roy Adaptation Model D) Self-care Agency
B) Health as Expanding Consciousness
15. After successfully implementing and managing a smoking cessation program in an inner-city neighborhood for 5 years, the group expands the efforts to include a nearby rural community. After a challenging first year, the nurse finds that with a few modifications the program is proving successful in the rural setting, as well. Which essential component of program design has been established by success in the rural community? A)Sustainability B)Program replication C)Clinical expertise D)Accountability
B) Program replication
3. There are several approaches to family assessment that use particular concepts that nurses typically encounter in practice. These models provide an organized framework with which to conduct a family assessment. Which is the aim of the family assessment in the Life Span Development approach? A) To identify family routines and rituals that could influence family health B) To identify family health practices within a social and historical context C) To assess health patterns in 11 areas of family health D) To engage the family as a way to identify its strengths, with attention to family dynamics and concerns related to health and illness
B) To identify family health practices within a social and historical context
12.In a 15-minute family interview, after asking a question, the nurse pauses and remains silent while the grandmother, whose English is limited, replies to the question. The nurse makes eye contact with her and nods while she talks. When she is finished, the nurse asks a few follow-up questions. Which principle to maximize information during an interview is demonstrated in this behavior? A) Manners B) Use of therapeutic conversation C) Use of therapeutic questions D) Acknowledgment of family strengths
B) Use of therapeutic conversation
18. Which best defines program replication? A)Ability to replicate a successful program in the same community a second time B)Ability to reproduce a successful program within a different community C)Ability to replicate a successful program with a new sample aggregate D)Ability to implement a successful program with the same population aggregate
B)Ability to reproduce a successful program within a different community C)Ability to re
2.The nurse is caring for a client who refuses the food as served. He states that the food is foreign to him and will make him ill. All food must be blessed. The personal care attendant is upset by this behavior and states that the client should eat the food anyway. The client's behavior is most likely a result of: A)Psychosocial deficit B)Cultural belief C)Allergies D)Hygiene
B)Cultural belief
17. A new client, who is Latin American, is getting settled in the hospital. She is expecting her family to arrive soon. A physician enters and informs the client that she requires surgery and asks that she sign the necessary documents. The client refuses and becomes agitated. Which is the most likely cultural reason for the client's reluctance to sign the documents? A)Client is reluctant to have the surgery. B)Decision of importance is typically made by the family as a group. C)Client does not feel comfortable with the surgeon. D)Client is medicated and is having difficulty making a decision.
B)Decision of importance is typically made by the family as a group.
10.During a conference after rounds, a nurse states, "They are in the United States now; you would think that they would act like us." This nurse is exhibiting: A)Cultural humility B)Ethnocentrism C)Cultural competence D)Cross-cultural nursing
B)Ethnocentrism
20. Which best illustrates systems theory? A)School systems in two different counties each setting up their own independent afterschool exercise programs B)Father being challenged to stop smoking because his daughter learned of the hazards of smoking from a smoke cessation program at her middle school C)Hospital requiring all of its nurses to wear an identification badge while on duty D)Physician in one state deciding to stop accepting Medicaid clients, while another physician in another state begins accepting Medicaid clients
B)Father being challenged to stop smoking because his daughter learned of the hazards of smoking from a smoke cessation program at her middle school
1.Community assessment is a critical process for the future because it can: A)Identify the need for a community commission B)Identify a method to improve the health of at-risk clients C)Provide a means of grant funding for clinics D)Provide a client base for at-risk neighborhoods
B)Identify a method to improve the health of at-risk clients
10. There are 12 students with confirmed cases of the H1N1 flu in grades 6 to 8 at the local middle school in the community. The community nurse advises the caregivers of the ill children to keep the children home for a minimum of 5 to 7 days. Which should be the nurse's next step? A)Recommend closing the school for 6 weeks B)Implement education in the school setting regarding respiratory and hand hygiene C)Require each child in the school to undergo a physical evaluation by the school nurse D)Initiate a system of discipline in the school setting for improper hand washing
B)Implement education in the school setting regarding respiratory and hand hygiene
16.What services is telehealth used to deliver? (Select all that apply.) A) Chronic care and specialty consultations B) Home telenursing C) Electronic referrals to specialists in expert health facilities D) Transmission of healthcare information to people in the same geographical area
B,C
3. Which characterize health inequities? (Select all that apply.) A)Necessary B)Unfair C)Resulting from social injustices D)Avoidable E)Natural
B,C,D
9.The nurse is caring for a client who is from a culture for which the nurse has a limited knowledge base. The nurse conducts the admission interview using cultural humility. Which should the nurse ask in the interview? (Select all that apply.) A)Yes or no questions B)About traditions C)Open-ended questions D)How the client has addressed the illness E)If the cause of the illness is spiritual
B,C,D
11. The nurse is conducting a 15-minute interview with a family. On the basis of the five leading principles for interviewing, appropriate actions for the nurse to take include: (Select all that apply.) A) Having family members share their family history with you, going back several generations B) Listening actively as the family members speak C) Constructing an ecomap of the family D) Asking family members to prioritize their needs and to express their expectations regarding nursing care E) Pointing out the strong relationships they enjoy in their family and explaining how they will help them cope with the health issue of concern
B,C,D,E
19.The community health nurse can receive a referral to a home health agency at any time. Which phases are included in a home visit? (Select all that apply.) A) Plan personal safety of visit B) Initiating a visit C) Preparation D) Actual visit E) Termination of the visit
B,C,D,E
11. Select the examples of social marketing. (Select all that apply.) A)Ad campaign for a new brand of toothpaste B)Brochure placed in obstetricians' offices promoting the benefits of breastfeeding C)Infomercial on television presenting the advantages of a piece of exercise equipment D)Billboard illustrating the dangers of texting while driving E)Posters placed in college dormitories encouraging condom use
B,D,E
6.The community health nurse is assessing stressful life events in a family. Which exemplifies a life event related to illness and family care strains? A) A history of police reports of a 23-year-old man's hitting his girlfriend B) A couple in their 40s divorcing C) A 63-year-old woman's sense of responsibility as the oldest among her siblings for taking care of her chronically ill parents D) A 35-year-old woman not speaking to her sister for 5 years after not being invited to her wedding
C) A 63-year-old woman's sense of responsibility as the oldest among her siblings for taking care of her chronically ill parents
8.The nurse reviews published research studies on the number of heart clients who are actively involved in exercise programs following a heart attack in preparation of conducting similar research. Using knowledge of research validity, which threat to external validity must be considered? A) Loss of a subject due to a second heart attack B) Selection of a subject who does not meet the eligibility criteria for the study C) A subject pedaling faster on the stationary bicycle whenever an examiner walks in the room D) An unexpected increase in a subject's appetite that could affect the study
C) A subject pedaling faster on the stationary bicycle whenever an examiner walks in the room
7.The nurse is conducting a study that will consider how heart clients respond to various interventions following a heart attack. The nurse is concerned about the threat that testing could pose to the internal validity of the study. How might testing affect the study? A) The long commute that a subject must take to a testing center as part of the study might change the subject's response to an intervention. B) One subject develops an unrelated anemia, which causes fatigue, which in turn affects the outcome of the study. C) Multiple measurements of participants' cortisol levels could cause stress in the participants and thus influence their cortisol levels, thereby altering the outcome of the study. D) Mistakes are made when a number of subjects who should have been assigned to one intervention group are assigned to another, which may affect the outcome of the study.
C) Multiple measurements of participants' cortisol levels could cause stress in the participants and thus influence their cortisol levels, thereby altering the outcome of the study.
15.Clients in the nurse's caseload have been requested to participate in a therapeutic trial about H1N1 influenza. Using knowledge of trials, the nurse tells the clients that the trial: A) Is based on primary prevention of H1N1 influenza Page 46 B) Is dependent variable manipulated by the researcher C) Focuses on limiting the spread of H1N1 influenza D) Focuses on reducing the incidence of H1N1 influenza
C) Focuses on limiting the spread of H1N1 influenza
4.The community health nurse has limited time for family assessments because of demanding caseloads or staffing shortages. Using your knowledge that focused family interviews of 15 minutes or less can yield a wealth of information, which is an example of an activity that will acknowledge the family's strengths? A) Ask family members if they see an area that could be changed B) Allow everyone present to voice observations, insights, or concerns before offering how they could change the situation C) Share any genograms and ecomaps that illustrate relationships with family members D) Collaborate with the family to set priorities, plan care, and evaluate goals
C) Share any genograms and ecomaps that illustrate relationships with family members
17.The best description of a type II error is that it occurs when: A) The null hypothesis is rejected when it is true. B) One rejects the alternative hypothesis when it is false. C) The null hypothesis is accepted when it is false. D) One accepts the alternative hypothesis when it is true.
C) The null hypothesis is accepted when it is false.
12.The nurse enters a client's home to provide care to a wound and teach the client's wife how to care for the wound. The nurse is comfortable with the client's culture and the fact that it is matriarchal in nature. As teaching begins, the husband interrupts and states that the woman does not change bandages according to his culture. He asks if the nurse is familiar with his culture and then says that all members of his neighborhood follow its principles. The nurse should suspect that the client is a member of: A)A cult B)An orthodox religious group C)A subculture D)An occupation
C)A subculture
3. While completing a community assessment, the nurse notes that the computer companies in the community hire a disproportionate number of their employees from local suburban communities rather than the community in which the company is housed. To create an accurate assessment, the nurse should collect data on: A)All of the company's employees but count those living outside the community separately, as outliers B)Only the employees that live in the community, disregarding the others as statistically irrelevant C)All of the company's employees and include those living outside the community as part of the aggregate D)Only the employees that live in the community in your initial assessment; then collect data on the others as part of a separate assessment for the community in which they live.
C)All of the company's employees and include those living outside the community as part of the aggregate
6. The nurse prepares community program objectives that are specific, measurable, achievable, relevant, and time bound (SMART) to help in planning interventions and establishing measurement systems to evaluate programs and outcomes. Which is a measurable objective? A)Program will reduce teenage obesity. B)Fewer teens will start smoking. C)Blood pressure for children aged 12 to 18 years in Marks School will be reduced by 5% after petting the dog for 1 day in March 2019. D)Number of older minority residents in Legacy Independent facility receiving a flu shot will triple.
C)Blood pressure for children aged 12 to 18 years in Marks School will be reduced by 5% after petting the dog for 1 day in March 2019.
4. Many in the community have developed cancer. The EPA has discovered a leak of biohazardous waste from a local factory that has leached into the water table. The area is decontaminated and cleaned. The community identifies the need for a local hospice for those with cancer who are dying. Area communities participate in the fund drive. This type of community effort may best be described as: A)Geopolitical community B)Epidemiologic model C)Community of solution D)Developmental model
C)Community of solution
5. The nurse conducts a well-child clinic in your community. The client population is culturally diverse, and, although the clinic is busy, it runs smoothly because it has an interpreter. In addition to the interpreter, it is important that the nurses treat each client that reflects his or her individual cultural needs. This is cultural: A)Bias B)Artwork C)Competence D)Beliefs
C)Competence
8.The nurse is caring for a client who is a refugee from Haiti. The client's family has been displaced because of an earthquake in their country. The client has healing fractures on his right arm as well as fractured ribs. He tells the nurse that, before care begins, the nurse must consult with his Voodoo healer. Which is the nurse's best response? A)Teaching the client that he is in the United States and should abide by Western medical practices B)Informing the physician that the client is noncompliant C)Consulting with the healer and updating the physician regarding treatment and any herbal medications that may be used D)Encouraging the client to use a complementary approach to his care
C)Consulting with the healer and updating the physician regarding treatment and any herbal medications that may be used
21.Which is the first step in developing a plan for evaluating a community-level intervention? A)Determine indicators or measures to answer evaluation questions B)Decide what method you will use to collect data C)Develop evaluation questions D)Decide how you will communicate your results
C)Develop evaluation questions
8. The community health nurse is responsible for the general health of the community on multiple levels. The nurse discovers an increase in the number of sick days used by children aged 7 to 11 years at the local elementary school in recent weeks. Research indicates that the families of asthmatic children tend to be less educated and less likely to comply with current treatment plans. Using the epidemiologic approach, the next step in the care plan should be to: A)Conduct a broad-based survey of all families with asthmatic children within several communities B)Determine trends that interfere with family problem-solving techniques C)Develop school-based education programs for both the children and their caregivers D)Submit a proposal to the town for neighborhood asthma clinics
C)Develop school-based education programs for both the children and their caregivers
14.A client, diagnosed with hypertension, is prescribed a no-added-salt, low-fat diet. He agrees and repeats the teaching principles. At the next visit, the nurse notices salted meat on the counter and the client shows the nurse his food diary. The diet in the past week does not reflect the physician's orders. What cultural component may have contributed to the noncompliance with the diet order? A)Diet may be too lean B)Wife cooks according to the husband's preferences C)Diet may not meet the cultural criteria for food choices D)Food tastes bland and unappetizing
C)Diet may not meet the cultural criteria for food choices
8. Which most accurately describes the purpose of force field analysis? A)Unfreezing the status quo B)Changing or moving to a new state C)Identifying the forces driving the change and those resisting it D)Refreezing to sustain the change or changes made
C)Identifying the forces driving the change and those resisting it
12. The community health nurse learns that there are statistically high levels of obesity and elevated cholesterol in the community. In addition, the community has a disproportionately high number of fast food restaurants, compared with surrounding communities. Which would be the most appropriate next step, based on these data? A)Gather support in the community to ban fast foods B)Gather further information regarding trans fats C)Target education and support programs D)Create local exercise programs
C)Target education and support programs
11.The new community health nurse introduces herself to the local minister and attends various neighborhood meetings. The nurse learns about the ethics, values, and culture of the neighborhood. The community is vocal about the need for public safety and the care of the homeless, especially in the winter. Which is the best rationale for considering all of the influences in the neighborhood affecting their health and well-being? A)The information can be used to obtain funds to create shelters for the homeless B)A neighborhood watch may be created with police support C)The information will help to effectively assess the community D)It will help the nurse create a controlled clinical environment
C)The information will help to effectively assess the community
19. The nurse is in the process of forming a coalition to support a community flu shot program. Which step should the nurse take as part of this process? (Select all that apply.) A)Assign members of the coalition to tasks in a random manner. B)Seek out people with similar opinions and roles in the community. C)Consider how each member of the coalition and the organization or group represented will benefit from the work of the coalition. D)Understand group dynamics and members' motives for serving. E)Form a group that is heterogeneous but able to show mutual respect.
C,D,E
6. A student is considering becoming a home health nurse. In researching this type of nursing, the student finds that several key factors have played a part in the development of home healthcare as it is today? These include: (Select all that apply.) A) Increase in the number of hospitals nationwide B) Reduction in the incidence of chronic diseases C) Development of health insurance D) Rising costs in healthcare E) Increase in medical and nursing specialization
C,D,E
13.The nurse researches the relationship between frequent ingestion of fast foods and obesity. The nurse finds that in a population that eats at least five fast food meals per week on average, the incidence rate of people who are obese is 735/1,000 population. In the population that eats only one fast food meal per week on average, the incidence rate of people who are obese is 245/1,000 population. Based on these findings, what is the relative risk of developing obesity in those who eat at least five fast food meals per week? A) 0.3 B) 0.7 C) 1 D) 3
D) 3
20.A client is fearful of being infected with the Ebola virus. To which reliable source of family risk reduction information should this client turn? A) A report from the client's neighbor whose daughter was recently infected with the Ebola virus B) Information the client's wife reported from a newspaper article about the Ebola virus that she read C) Data from an Internet site that the client's daughter conveyed D) A conversation the client has with his healthcare provider
D) A conversation the client has with his healthcare provider
2.A community care nurse at a healthcare agency assists in coordinating a plan for providing health services in the most cost-effective way possible to a large number of members living in the region. This work is known as: A) Case management B) Home healthcare C) Interdisciplinary collaboration D) Care management
D) Care management
5.The case manager for a 12-year-old boy who is obese and prediabetic. To help the client develop a diet that will promote weight loss and control of his glucose level, the case manager decides to consult with a dietician, who provides several current journal articles that present findings on various diets. This aspect of case management is known as: A) Care management B) Advocacy C) Disease management D) Interdisciplinary collaboration
D) Interdisciplinary collaboration
21.The nurse assesses a 77-year-old woman who has been caring for her husband who has Alzheimer disease in their home for the past 8 years. The client complains of exhaustion and depression. Which stressors should the nurse most suspect as the cause of this client's symptoms? A) Marital strain B) Caregiver burden C) Spillover D) Interfamily strain
D) Interfamily strain
20.The home health nurse has to ensure that a safety plan is in place to address falls. Using knowledge that 55% of fall-related injuries occur with falls inside the home, a total of more than 60% of these falls occur in which two rooms? A) Living room and hallway B) Kitchen and bathroom C) Hallway and bedroom D) Living room and bedroom
D) Living room and bedroom
2.The nurse is preparing to do a research study on the effects of tight insulin control for diabetes. Using the knowledge that epidemiologic research can be descriptive or analytical, which would be the strongest study design to consider? A) Retrospective B) Quasi -experimental C) Experimental D) Randomized, control group
D) Randomized, control group
1. The case manager for two families with children who have type 2 diabetes is struck by the differences between the families. In one family, the parents are intentional about providing fruits and vegetables for their child to eat, regularly remind him to check his blood glucose level, and make sure that he engages in some sort of outdoor activity every afternoon. In the other family, the kitchen is stocked primarily with potato chips and processed snack foods, the child does not monitor her glucose level consistently, and she spends her afternoons texting or watching videos on the sofa. By this comparison, the case manager realizes how critical the family is in forming the attitude the child has toward caring for his or her own health. Which grand nursing theory does this experience best illustrate? A) Science of Unitary Beings B) Health as Expanding Consciousness C) Roy Adaptation Model D) Self-care Agency
D) Self-care Agency
6.The nurse is conducting a study on heart clients who are actively involved in exercise programs following a heart attack. The nurse should consider which as a threat to internal validity? A) Some subjects run faster on the treadmill when a researcher walks through the room. B) Including an exciting new cross -fit training program as one of the exercise options that can accommodate a few of the study subjects C) Your fervent belief from personal experience that intense cardiovascular exercise can speed recovery and prevent further heart attacks D) Using a variety of stationary bicycles for stress testing
D) Using a variety of stationary bicycles for stress testing
18.The community health nurse works in a community recently devastated by a tornado. Many of the survivors are cared for in their homes. Care is needed for those who are ill, recovering, or in hospice. To provide the most holistic and effective care to the community, the nurse should: A)Refer the clients to an outreach center B)Consult with the hospice nurse and the social worker C)Provide care according to the physician's orders D)Collaborate with other health care workers and the clients
D)Collaborate with other health care workers and the clients
9.The nurse researches whether the community would benefit from monthly blood pressure clinics. Which system level would such an intervention address? A)Upstream B)Mainstream C)Sidestream D)Downstream
D)Downstream