Community Exam 2

The primary health care provider prescribes contact precautions for a client with hepatitis A. What nursing interventions are required for contact precautions?

Gown and gloves when handling articles contaminated by urine or feces

A nurse is caring for a community-dwelling older adult with hypertension. What interventions should the nurse take to ensure the client's well-being? Select all that apply.

Promote dietary modifications by using varied techniques Assess the client's current lifestyle and promote lifestyle changes Monitor the client's blood pressure and weight and establish blood pressure screening programs

pandemic

worldwide epidemic

indirect transmission

•occurs when the infectious agent is transported within contaminated inanimate materials such as air, water, or food (vehicle-borne transmission)(fomite)

incidence

•refers to all new cases of a disease or health condition appearing during a given time Number of persons developing a disease/ Total number at risk per unit of time

A registered nurse is teaching a student nurse regarding the precautions to be followed while caring for a client infected with Ebola virus. Which statement by the student nurse indicates the need for further teaching?

"I will not touch the prepared food for the infected client."

During a health symposium a nurse teaches the group how to prevent food poisoning. Which statement by one of the participants indicates the teaching is understood?

"Meats and cream-based foods need to be refrigerated."

A client with hepatitis B asks the nurse, "Are there any medications to help me get rid of this problem?" Which is the best response by the nurse?

"There are medications to help reduce viral load and liver inflammation."

A client with tuberculosis asks the nurse about the communicability of the disease. Which is the best response by the nurse?

"Untreated active tuberculosis is communicable."

A client who experiences anorexia and fatigue develops jaundice. A diagnosis of hepatitis A is made. The client's spouse and adult children who still live at home ask whether they should receive gamma globulin. Which is the most appropriate response by the nurse?

"You should call your primary health care provider immediately about getting gamma globulin."

A nurse is conducting cholesterol screening for a manufacturing corporation during a health fair. A 50-year-old man who is 6 feet (183 cm) tall and weighs 293 pounds (133 kg) puts out his cigarette and asks the nurse how to modify his risk factors for coronary artery disease. On which risk factors should the nurse help the client focus? Select all that apply.

weight smoking

community nurse role in communicable disease

• Investigating reportable communicable diseases requires a systematic approach. -Review the information. -Clarify that the disease is suspect or lab confirmed. -Review the case definition. -Review the disease information. Use specific questionnaires when available

endemic

•Numbers of disease within a population

epidemic

•Significant increase in a disease

web of causation

•The implication that intervention (or breaking of the web at any point nearest to the disease) could profoundly impact the development of that disease. multiple things can imply to disease (THINK UPSTREAM THINKING)

Prevalence

•all of the people with a particular health condition existing in a given population at a given point in time Number of persons with a characteristic /// Total number in population

direct transmission

•occurs by immediate transfer of infectious agents from a reservoir to a new host

vector transmission

•occurs when the infectious agent is carried by a vector (nonhuman carrier such as an animal or insect)

A nurse is teaching a client about prophylactic measures that minimize the risk of contracting hepatitis B. Which actions should be included in this teaching plan? Select all that apply.

screening of blood donors Maintaining a monogamous sexual relationship

Which type of immune preparation, made from donated blood, contains antibodies that provide passive immunity?

specific immune globulin

susceptibility stage

the disease is not present and individuals have not been exposed

What is epigenetics?

the study of how the environment affects which genes are expressed

define genomics

the study of individual genes in order to understand the structure of the genome, including the mapping of genes

define genetics

the study of the function and effect of single genes that are inherited by children from their parents.

When searching the internet for information about important public health issues , the nurse understand what is true of government websites

they contain accurate and up to date information

men leading cause of death

unintentional injury

A nurse is teaching a health class about heart disease to older adult women. The nurse discusses the most common prodromal symptom reported by women with acute coronary heart disease that usually is not experienced by men. Which response indicates a woman in the group understands the teaching?

unusual fatigue

How is HIV spread?

Sexual contact, or exchange of body fluids such as blood when drug users share needles.

What statement is true about community stakeholders

They should represent all groups in the community

How is malaria transmitted?

mosquitos

resolution stage

A solution is achieved.

john snow

Mapped the occurrence of cholera in London

The nurse teaches a health class about communicable diseases and states that the virus that causes chickenpox can also cause another disease. Which disease is the nurse describing?

herpes zoster

A child is diagnosed with hepatitis A. The client's parent expresses concern that the other members of the family may get hepatitis because they all share the same bathroom. What is the nurse's best reply?

"All family members, including your child, need to wash their hands after using the bathroom."

A nurse educates a client about the role played by an individual in taking responsibility for health and wellness and its impact. What instructions should the nurse give? Select all that apply.

"An individual should know that lifestyle choices affect his or her quality of life and well-being." "An individual should take responsibility of health and wellness by making proper lifestyle choices." "An individual should realize that illness prevention has a positive economic impact on his or her life.

A nurse is instructing a group of clients in the community about food preparation. Which statement indicates a client is at an increased risk for contracting botulism?

"I save money when I buy the slightly damaged cans of vegetables."

Isoniazid (INH) is prescribed as a prophylactic measure for a client whose spouse has active tuberculosis (TB). Which statements made by the client indicate that there is a need for further teaching? Select all that apply.

"I sometimes allow our children to sleep in our bed at night." "I know I also have tuberculosis because the skin test was positive." "I plan to attend a wine tasting event this evening.

artificial passive immunity

injection of antibodies

tertiary prevention of communicable disease

needed to ensure additional people are not infected and those who are ill receive care and treatment. Ongoing disease transmission can be interrupted through treatment, isolation, or quarantine

mortality rate

number of deaths from a disease in relation to the population in a given time per thousand

morbidity rate

number of people affected in relation to the total population in a given time period

what did john snow use to detect cholera

disease mapping

What is the final step in the nurse's health assessment of a community

Analysis

What action describes artificial active immunity?

Antibodies are made after an antigen is injected into the body

Which type of hepatitis virus spreads through contaminated food and water?

Hep A

naturally acquired active immunity

, a person who contracts a disease often develops long-lasting antibodies that provide immunity against future exposures.

Agent

-A factor that causes or contributes to a health problem or condition

Environment

-All the external factors surrounding the host that might influence vulnerability or resistance

Chain of Causation

-Causation in noninfectious disease: environmental exposure and potential health outcomes (nine elements) Agent, host, environment

incubation period

-Exposure to onset of symptoms

Host

-Susceptible human or animal who harbors and nourishes a disease-causing agent

cross immunity

-immunity to one agent providing immunity to another related agent

active immunity

-long-term, sometimes lifelong; acquired naturally or artificially

passive immunity

-short-term; acquired naturally or artificially

What is CAGE?

1.CAGE helps screen with alcohol à 2 or more clinical significant problem

5 screenings that are done for all adults

1.Height and Weight-(BMI) obesity. 2. Blood pressure- (HTN). 3. Depression. 4.Alcohol. 5. Smoking <- always choose one of these on tests, no matter what age because it can effect all ages

A client with tuberculosis asks the nurse how long drug therapy will be continued. What is the nurse's most accurate reply?

6-12 months

Ebola

A contagious viral disease originating in Africa. It is transmitted by blood and body fluids and causes body organs and vessels to leak blood, usually resulting in death.

A nurse is taking blood pressures at a health fair. Which finding should cause the nurse to advise the client to have the blood pressure checked by a primary healthcare provider?

A diastolic blood pressure that remains greater than 90 mm Hg

what is cholera

A disease that causes fatal diarrhea and dehydration

A client who is receiving a screening test for tuberculosis (TB) asks the nurse what a positive reaction will mean. What should the nurse explain that a positive reaction indicates

A previous exposure to organism

cohort study

A type of epidemiologic study where a group of exposed individuals (individuals who have been exposed to the potential risk factor) and a group of non-exposed individuals are followed over time to determine the incidence of disease

Case-control study

A type of epidemiologic study where a group of individuals with the diseases, referred to as cases, are compared to individuals without the disease, referred to as controls

A spouse of a client with pulmonary tuberculosis (TB) receives a tuberculin skin test. The nurse reads the test and identifies an area of induration greater than 10 mm. What does this result indicate to the nurse?

Additional tests are necessary

How to fix the episode-triad

BREAK A CHAIN OF ONE YOU CAN BREAK THE CHAIN OF DISEASE

subclinical disease stage

Beginning of pathological process and changes within the body. This is the pre-symptomatic stage of disease in which changes have occurred that lead toward illness but disease is not yet clinically detectable. At this stage there is secondary prevention intervention.

Three cancers

Colorectal , breast, cervical

evidence based practice process

Cultivate a spirit of inquiry. Ask the burning clinical question in PICOT format.* Search for and collect the most relevant best evidence. Critically appraise the evidence (i.e., rapid critical appraisal, evaluation, and synthesis) Integrate the best evidence with one's clinical expertise and patient preferences and values in making a practice decision or change. Evaluate outcomes of the practice decision or change based on evidence. Disseminate the outcomes of the EBP decision or change

the similarities between the nursing process and the epidemiological process is

Entire ADPIE model

Three characteristics support the use of the nursing process in community health nursing

First, the nursing process is a problem-solving process that addresses community health problems at every aggregate level with the goals of preventing illness and promoting public health. Second, it is a management process that requires situational analysis, decision-making, planning, organization, direction, and control of services, as well as outcome evaluation. As a management tool, the nursing process addresses all aggregate levels. Third, it is a process for implementing changes that improve the function of various health-related systems and the ways that people behave within those systems.

The registered nurse determines that the new graduate understands the type(s) of hepatitis that generally develop into a chronic hepatitis infection if the graduate identifies which disease(s)? Select all that apply.

HEP B HEP C HEP D

What does the host have?

HOST HAS INHERIANT RESISTANCE -> BODY IS REJECTING THE VIRUS <<< ON TEST

A client is diagnosed as having the hepatitis B virus (HBV). The nurse reviews the client's health history for possible situations in which exposure may have occurred. Which event does the nurse determine is most likely the source of this infection?

Had a small tattoo on the arm three months ago

Hippocrates

He looked at diseases in relation to time and season, place, environmental conditions and disease control. His main contribution to epidemiology is the emphasis on epidemiologic observation

The nursing instructor determines that the student nurse understands the type(s) of hepatitis that most commonly are spread by consuming contaminated food and water or by fecal contamination if the student identifies which of these diseases? Select all that apply.

Hep A Hep E

What is the only vaccine given at birth?

Hep B

Incorporating Genomics and Genetics into Practice...What is Needed?

Identification Referral Provision of Education, Care, and Support

Completing health history

Identify by getting a health history (get the patients data, parent's data, grandparent's data), refer, support (IRS)

What action does the nurse perform during the analysis stage of community health assessment

Identify causal factors for health indicators

What should the nurse consider when selecting health indicators in a community

If the indicators relate to standards published by state or national entities

How is community diagnosis different from an individual diagnosis

Individual goals creates goals for individual care Community diagnosis creates a tentative hypothesis

A parent of three young children has contracted tuberculosis. Which does the nurse expect the healthcare provider to prescribe for members of the family who have a positive reaction to the tuberculin skin test and are candidates for treatment?

Isoniazid

How is Hepatitis A transmitted?

It is usually transmitted person-to-person through the fecal-oral route or consumption of contaminated food or water

Who is the father of epidemiology?

John Snow

A client who has become a mother for the first time asks the nurse several questions related to her new parenting role. After answering her questions, the nurse recommends that she join a support group for new mothers at the local YWCA. Which type of prevention is this?

primary

Which are examples of actively acquired specific immunity? Select all that apply.

recovery from measles recovery from chickenpox immunization with live or killed vaccines

A nurse is teaching an adult health and wellness class about bladder cancer. Which activities should the nurse include in the teaching session that increase risk? Select all that apply.

Smoking two packs of cigarettes a day Working with dyes used in rubber every day

A client is admitted with possible tuberculosis. To make a definitive diagnosis, the nurse expects which diagnostic test to be prescribed?

Sputum test for acid-fast bacilli

Clinical disease stage

Stage of clinical disease in which there are detectable signs/symptoms of disease. At this stage there is tertiary prevention intervention.

How is TB spread?

TB bacteria are spread through the air from one person to another. The TB bacteria are put into the air when a person with TB disease of the lungs or throat coughs, speaks, or sings. People nearby may breathe in these bacteria and become infected.

The nurse at a health fair has taken a client's blood pressure twice, 10 minutes apart, in the same arm while the client is seated. The nurse records the two blood pressures of 172/104 mm Hg and 164/98 mm Hg. What is the appropriate nursing action in response to these readings?

Take the client's blood pressure in the other arm and then schedule a healthcare practitioner's appointment for as soon as possible.

A client who was exposed to hepatitis A asks why an injection of gamma globulin is needed. Before responding, what should the nurse consider about how gamma globulin provides passive immunity?

The antigen is neutralized by the antibodies that it supplies.

multiple causation

The principle that each change in a system is caused by numerous factors.

Ebola transmission

The virus spreads through direct contact (such as through broken skin or mucous membranes in the eyes, nose, or mouth) with: blood/bodily fluids objects infected humans semen

A client newly diagnosed with tuberculosis has a productive cough. Which is the most appropriate nursing intervention to teach the client?

Use disposable tissues

A client is diagnosed with hepatitis A. The nurse takes the client's history. Which employment history is most likely linked to the development of hepatitis A?

Works at a plumbing business

A school nurse is teaching a health class of 12-year-olds about hepatitis C. Which statement by a student indicates an understanding of the origin of the disease?

You can catch it while getting a tattoo

How is Hepatitis C transmitted?

a blood-borne virus. Today, most people become infected with the hepatitis C virus by sharing needles or other equipment to inject drug

A nurse explains to the parents of a 4-year-old child with chickenpox that immunity by antibody formation during the course of the illness provides what?

active natural immunity

secondary prevention of communicable disease

activities of screening and disease investigation

women leading cause of death

alzheimers

A nurse is teaching a group of adults about the signs and symptoms of colorectal cancer. Which common clinical manifestations should the nurse include in the teaching program? Select all that apply.

anemia rectal bleeding change in bowel habits

What are the symptoms of tuberculosis? Select all that apply.

anorexia night sweats hemoptysis

reservoir

any person, animal, or substance in which an infectious agent normally lives and multiplies and then is transmitted from its source to a susceptible host

Which type of immunity will clients acquire through immunizations with live or killed vaccines?

artificial active immunity

artificially acquired active immunity

attained through vaccine inoculation. Such vaccines are prepared from killed (inactivated) or live attenuated (weakened) organisms administered to artificially produce or increase immunity to a particular disease

The nurse reviews the medical records of four male clients. Which client will the nurse assess most closely for developing prostate cancer?

black 55yr old

what cancer is most common in women

breast cancer

the nursing process in community health focuses on?

caring for the client within his or her family; whereas the focus of the epidemiological process is on caring for the population of the community as a whole

what cancer do more women die from

cervical cancer

Which topic is most important for the nurse to teach in a community health promotion class of middle-aged adults?

cessation of smoking

The nurse provides discharge teaching to a client with tuberculosis. Which treatment measure does the nurse reinforce as the highest priority?

consistently taking prescribed meds

qA client is diagnosed with pulmonary tuberculosis, and the healthcare provider prescribes a combination of rifampin and isoniazid. The nurse evaluates that the teaching regarding the drug is effective when the client reports which action as most important?

continue to take the medication even if you feel better

natural history of disease model

creates levels of prevention

Eco-epidemiology

current trend of epidemiology

A nurse is teaching a community group about the basics of nutrition. A participant questions why fluoride is added to drinking water. The nurse should respond that it is a necessary element added to drinking water to promote what?

dental health

Which instruction would be most beneficial for an aging African-American client with hypertension?

hav an annual urinalysis`

While instructing a community group regarding risk factors for coronary artery disease, the nurse provides a list of risk factors that cannot be modified. What should be included on the list?

heredity

A nurse is teaching a client about self-management techniques for smoking cessation. Which statement made by the client indicates the need for further teaching?

i should visit all places where i started smoking

Herd immunity

immunity in most of a population

A nurse is teaching a client about breast health promotion and prevention practices. Which action described by the client indicates the need for further teaching?

increasing meat consumption

How is Hepatitis B transmitted?

is transmitted when blood, semen, or another body fluid from a person infected with the virus enters the body of someone who is not infected. This can happen through sexual contact; sharing needles, syringes, or other drug-injection equipment; or from mother to baby at birth.

A nursing student is listing modifiable risk factors that affect client physical health and wellness. Which risk factors listed by the nursing student are accurate? Select all that apply.

lifestyle and environment

primary prevention of communicable disease

methods such as utilizing mass media education campaigns, one-on-one education, and immunization.

Which type of immunity is acquired through the transfer of colostrum from the mother to the child?

natural passive immunity