Community Exam 2 Questions

Which of the following should the home health nurse include when providing home health care for a client? A. Custodial care for the client B. Charge for each service provided C. Plan visits based on client needs D. Receive direct payments from the client

C. Plan visits based on client needs

The daily work of a Case Manager involves _________ patient care. A. Direct B. Indirect C. Quality

C. Quality

A nurse is planning a community health program. Which of the following should the nurse include as part of the evaluation plan? A. Determine availability of resources to initiate the plan. B. Gain approval for the program from local leaders. C. Establish a timeline for implementation of interventions. D. Compare program impact to similar programs.

D. Compare program impact to similar programs.

Which type of legislation provided assistance to workers who were unemployed because of work-related injuries? A.Disabilities laws B. Community living legislation C. Vocational rehabilitation acts D. Workers' compensation laws

D. Workers' compensation laws

What is the best description of where missionary nurses work? A. abroad B. primarily South America C. primarily Africa D. in the U.S. and abroad

D. in the U.S. and abroad

A school nurse suggests to teachers that they have a session on coping strategies and stress management techniques. The nurse also sets up a peer counseling program. Which of the following is the school nurse most likely trying to prevent? a. Adolescent suicides b. Bullying c. Obesity d. Teenagers engaging in violence

a. Adolescent suicides Suicide is the third leading cause of death in teenagers. To reduce the incidence of suicide in teenagers, the nurse can emphasize coping strategies and stress management techniques and organize a peer assistance program to help teenagers cope with school stresses.

Which of the following is the primary goal of case management? (Select all that apply.) a. To ensure that care coordination occurs across the continuum b. To emphasize evidence-based clinical decision making c. To manage resource use and control expenses d. To stress the advantages and benefits of community-based care

A, B, C The goals in case management are to reduce institutional care while maintaining quality processes and satisfactory outcomes; manage resource use through protocols, evidence-based decision making, guideline use, and disease-management programs; and control expenses by managing care processes and outcomes.

A occupational health nurse is consulting with senior management of a local industrial facility. When discussing work-related illness and injury, the nurse should include which of the following as physical agents? (Select all that apply) A. Noise B. Age C. Lighting D. Viruses E. Stress

A and C

As in Healthy People 2010, what are the two primary goals of Healthy People 2020? (Select all that apply.) a. Eliminate health disparities b. Expand health promotion activities in every community c. Improve funding, including diverting funds from other priorities to health care d. Improve health outcomes measures to be more consistent with other developed nations' outcomes e. Increase quality and years of healthy life f. Reduce mortality and morbidity figures nationwide

A and E As published, the two goals are to increase quality and years of healthy life and eliminate health disparities. Expanding health promotion activities in every community, improving funding and improving health outcomes, and reducing mortality and morbidity are not the primary goals of Healthy People 2020.

Which interventions address both the National Institute of Nursing Research themes and the overall goals of the Healthy People 2020 leading health indicators? (select all that apply) a. Establishing a new park with a well-lit track b. Establishing a smoking cessation campaign c. Providing reduced-cost transportation passes to senior citizens d. Providing free condoms at all federally funded health clinics

A, B, D Establishing a new park with a well-lit track, establishing a smoking cessation campaign, and providing free condoms at all federally funded health clinics all address the National Institute of Nursing Research themes and the Healthy People 2020 leading health indicators. A park, smoking cessation campaign, and free condoms address the themes of promoting health and preventing disease and the goal of increasing quality and years of healthy life. Providing reduced-cost transportation passes to senior citizens may indirectly affect the health of this population; however, it is not directly related to the themes of the National Institute of Research (promote health and prevent disease, improve quality of life through symptom management, and support palliative and end-of-life care, innovation, and nurse scientists) or the overall goals of Healthy People 2020 (increase quality and years of healthy life and eliminate health disparities).

A nurse is collecting data to identify health needs in the local community. Which of the following are examples of secondary data the nurse should review? Select all that apply A. Birth statistics B. Previous health survey results C. Windshield survey D. Community forum E. Health records

A, B, E

A nurse is preparing to conduct a windshield survey. Which of the following data should the nurse collect as a component of this assessment? Select all that apply A. Ethnicity of a community B. Individuals who hold power within the community C. Natural community boundaries D. Prevalence of disease E. Presence of public protection

A, C, E

The nurse is coordinating a case management system of care for which of the following purposes? Select all that apply: A. Avoids fragmented services B. Encourages the client to direct the decision making of the care C. Coordinates designated components of health care D. Assists the client with method of payment E. Provides continuity of services F. Matches the intensity of the services

A, C, E, F

Why are nurses increasingly providing care in clients' homes rather than in hospitals? (Select all that apply.) a. Home care is less expensive. b. It is much more efficient to give care in the home. c. Nurses prefer to give home care with individual attention. d. People prefer to receive care in their homes rather than in hospitals.

A, D An increasing number of clients are receiving care in the home because it is less expensive and clients prefer to receive care in familiar and comfortable settings. It is not more efficient nor more convenient, since travel time has to be considered. Nurses differ as to their preferred employment setting.

The nurse is caring for a terminally ill child who is receiving palliative care. When explaining the purpose of palliative care to the child's caregiver, the nurse recognizes the need for additional instruction when the caregiver makes which statement? A. "Palliative care interventions hasten death." B. "Palliative care promotes optimal functioning." C. "Palliative care will provide pain management." D. "Palliative care will provide symptom management."

A. "Palliative care interventions hasten death." Rationale: Palliative care interventions do not serve to hasten death; rather, they provide pain and symptom management, attention to issues faced by the child and family with regard to death and dying, and promotion of optimal functioning and quality of life.

A nurse applied for a case manager position at the local hospital because the job description of the case manager is to: A. Help clients determine the best care for the least cost. B. Provide a service that costs very little to offer. C. Decide what treatment will be provided. D. Eliminate the competition from other providers.

A. Help clients determine the best care for the least cost.

A nurse is conducting a community assessment. Which of the following data collection methods is the nurse using when having direct conversations with individual members of the community? A. Key informant interviews B. Participant observation C. Focus groups D. Health surveys

A. Key informant interviews

Which of the following factors should the home health care nurse consider when planning care for a client in the home? A. The family should be included in all care rendered in the home B. The nurse will perform physical therapy exercises if needed C. The client is the only one designated to receive services D. All care should be completed in a designated period of time

A. The family should be included in all care rendered in the home

A nurse is planning a health fair for a local community. Which of the following should be the nurse's most important consideration when deciding which screening programs will benefit the population the most? A. prevalent health problems in the community B. health care facilities available to clients in the community C. cost of the screening programs D. demographics of the community

A. prevalent health problems in the community Knowing the most prevalent health problems of a population will help the nurse to decide which screening programs are needed most and which to make available

Community diagnoses are based on... A. the community assessment process B. the intuition of the skilled community nurse C. a single method, without bias D. court records

A. the community assessment process

The occupational health nurse for an electronics factory compiles an occupational health history for each worker. Which should be included? (Select all that apply.) A) Location of facility exits and entries B) Chronological record of all past work and potential exposures C) An occupational exposure inventory D) List of exposures in the home or community E) Availability of emergency equipment

B, C, D Components of the occupational health history include characteristics of the workers' present jobs, a chronological record of all past work and potential exposures, an occupational exposure inventory, and a list of other exposures in the home or community. The location of facility exits and entries and the availability of emergency equipment are aspects of a workplace walk-through.

What are the leading health indicators found in Healthy People 2020? (Select all that apply.) a. Financial issues b. Health system issues c. Individual behaviors d. Issues related to legal and illegal immigration e. Legislative issues f. Physical and social environmental factors

B, C, F Ten leading health indicators are identified in Healthy People 2020, including individual behaviors, physical and social environmental factors, and health systems issues. Financial issues, issues related to legal and illegal immigration, and legislative issues are not found in Healthy People 2020.

A nurse is completing a needs assessment and beginning analysis of data. Which of the following actions should the nurse take first? A. Determine health patterns within collected data. B. Compile collected data into a database. C. Ensure data collection is complete. D. Identify health needs of the local community.

B. Compile collected data into a database.

You are caring for a hospice client who is at the end of life. Based on this client's signs and symptoms, the client is comatose, dehydrated, free of pain, constipated, without distress and expected to die in a day or two. Which of the following is an appropriate client outcome or an appropriate intervention for this client? A. The client will be free of constipation B. The client will remain free of pain and distress C. The administration of an antiemetic to prevent vomiting and further dehydration D. The administration of an enema to correct the constipation

B. The client will remain free of pain and distress Based on this client's signs and symptoms and the fact that the client is expected to die in a day or two, the appropriate client outcome for this client is that the client will remain free of pain and distress. "The client will be free of constipation" requires interventions such as an enema which are not indicated when death is imminent unless, of course, the client is adversely affected with pain and discomfort as the result of it which is not the case with this client. Additionally, the administration of an antiemetic to prevent vomiting is not indicated because there is no evidence in this question that the client is actually vomiting.

A school nurse is scheduling visits with a physical therapist for a child who has cerebral palsy. In which of the following roles is the nurse functioning? A. Direct caregiver B. Consultant C. Case manager D. Counselor

C. Case manager The nurse is functioning in the role of a case manager. As a case manager, the nurse coordinates comprehensive services for students with complex health needs. As a direct caregiver, a nurse provides illness or injury care to children at school. As a consultant, a nurse provides information to families, administrators, teachers, and parent-teacher groups to encourage decisions that promote the health of students. As a counselor, a nurse develops a trusting relationship with students and provides support on issues affecting their lives.

Adolescent females should be counseled to... A. Increase protein consumption from a variety of sources. B. Divide their daily caloric intake among six meals. C. Take daily calcium and iron supplements. D. Decrease their vitamin D intake

C. Take daily calcium and iron supplements.

What does workers' compensation legislation in all states require from the employer? A. To allow an employee to return to his or her position regardless of how long the employee was not at work because of illness or disability B. To assume the cost of occupational disabilities only if the employer was in some way at fault C. To assume the cost of occupational disabilities regardless of whose fault the injury was D. To carry health insurance for their employees that will pay for injuries that occurred at work

C. To assume the cost of occupational disabilities regardless of whose fault the injury was

Which of the following methods may help a community health nurse gain entry into a community? A. making clear who is in charge B. knocking on doors C. joining certain clubs or societies D. aligning mainly with leaders of the group

C. joining certain clubs or societies

A nurse is talking to a client who asks for additional information about hospice. Which of the following is an appropriate statement by the nurse? A. "Clients who require skilled nursing care at home quality for hospice care." B. "One function of hospice is to provide teaching to clients about life-sustaining measures." C. " Hospice assists clients to develop the skills needed to care for themselves independently." D. "A component of hospice care is to control the client's symptoms."

D. "A component of hospice care is to control the client's symptoms."

In caring for a client with a terminal condition, the nurse understands that the case management role in the hospital: A. Begins when the order is written to begin chemotherapy. B. Ends when the client is discharged to a home health service. C. Is not appropriate because a diagnosis of a terminal condition has been made. D. Begins when the client receives the diagnosis of cancer.

D. Begins when the client receives the diagnosis of cancer.

A family member asks the nurse to explain the purpose of hospice care. Which of the following is the best response? Hospice care: A. Is appropriate when the patient desires to intentionally end his life B. Focuses on minimizing the disease process as rapidly as possible C. Focuses on symptom management for patients not responding to treatment D. Is holistic care for patients dying or debilitated and not expected to improve

D. Is holistic care for patients dying or debilitated and not expected to improve Rationale: Hospice care focuses on holistic care of patients actively dying or not expected to improve. It helps patients face death with dignity and comfort. Euthanasia refers to the deliberate ending of a life. Palliative care is aggressively planned care that manages symptoms of patients whose disease process no longer responds to treatment. Aggressive medical treatment is aimed at stopping the disease process.

A home health nurse is doing an assessment of an older adult client's home. Which of the following findings should the nurse realize may be the greatest potential hazard? A. a walk-in shower B. a straight staircase with arm rails C. a large area rug in the living room D. a small rug in front of the kitchen sink

D. a small rug in front of the kitchen sink Small rugs that are not attached to the floor are the greatest potential hazard to the client, due to risk for falling

A nurse is responding to a community-wide request for health care providers to come to the scene of a bomb explosion. Reporting to the disaster scene coordinator, the nurse is told that as the victims are rescued they are triaged, and either transported or sent to the parking lot for a secondary assessment. The nurse is asked to assist in the secondary assessment process to do which of the following? A. evaluate effectiveness of resuscitation B. identify life-threatening injuries C. initiate treatment of airway and breathing problems D. determine the extent of additional injuries

D. determine the extent of additional injuries The secondary assessment begins after the primary (triage) assessment is completed and life-threatening injuries are addressed. The object is to determine the extent of the client's injuries so that the nurse can help determine the order in which a large group of clients with less critical injuries will be treated and transported

What is the typical population of faith communities? A. the elderly B. the poor C. an exact reflection of the communities where they are located D. diverse in every aspect, sometimes within one congregation

D. diverse in every aspect, sometimes within one congregation

Which of the following represents causes of mortality many more times likely for men than for women? A. colorectal cancer, cirrhosis of the liver, homicide, heart disease B. lung cancer, drug abuse, suicide, heart disease, and AIDS C. prostate cancer, motor vehicle accidents, and suicide D. lung cancer, motor vehicle accidents, cirrhosis of the liver, heart disease, and AIDS

D. lung cancer, motor vehicle accidents, cirrhosis of the liver, heart disease, and AIDS

An occupational health nurse frequently teaches employees about the risks of the work environment. This nursing action is considered which of the following? A. accident prevention B. secondary prevention C. tertiary prevention D. primary prevention

D. primary prevention

All Case Managers are nurses and are employed solely in healthcare systems across America. True or False?

False

Case Mangers regularly use bedside nursing skills such as inserting Foley tubes, nasogastric tubes, and inserting IV's. True or False?

False

Which of the following best explains why every client doesn't receive care from a case manager? a. Case management time is demanding; thus it is restricted to complex cases. b. Many health agencies do not employ case managers. c. Most clients would not benefit from case management. d. Most nurses do not know how to function as case managers.

a. Case management time is demanding; thus it is restricted to complex cases. Case management can be labor intensive, time consuming, and costly. Because of the increasing number of clients with complex problems in nurses' caseloads, the intensity and duration of activities required to support the case management function may soon exceed the demands that the direct caregiver can meet.

Two nurses plan to walk under a huge downtown bridge where various homeless persons live. Why would the nurses go to such an unsafe area? a. To assess the needs of the homeless who live there b. To demonstrate their courage and commitment c. To distribute some of their own surplus clothes to those who can use them d. To share with various churches and other charities what is needed

a. To assess the needs of the homeless who live there In most nursing practices, the client seeks out and requests assistance. In public health nursing, the nurse often reaches out to those who might benefit from a service or intervention, beginning with assessment of needs.

Which of the following public health nurse applicants is the least qualified for a position of case manager in a rural county? a. A 24-year-old who has a master's degree in public health b. A 34-year-old who will be moving from a large city c. A 44-year-old who was born and raised in the community d. A 54-year-old who, until recently, was a member of the community's school board

b. A 34-year-old who will be moving from a large city Case management competency requires the following knowledge and skills: knowledge of community resources and financing methods; written and oral communication and documentation skills; negotiation and conflict-resolution skills; critical-thinking processes to identify and prioritize problems from the provider and client views; and identification of best resources for the desired outcomes. Because communities are unique, someone new to the area will lack knowledge of community resources and financing methods. There is nothing in the descriptions of the other public health nurses that indicates a lack of current knowledge or skills.

A nurse is using a case management plan to maximize patient care outcomes. Which of the following describes an important consideration that should be made by the nurse? a. Case management plans should be used only by nurses to manage care. b. Case management plans should be individualized for each client. c. Case managements plans provide additional expense to the client and family. d. Case management plans focus on the natural progression of the disease.

b. Case management plans should be individualized for each client Adaptation of the case management care plan to each client's characteristics is a crucial skill for standardizing the process and outcome of care. It links multiple provider interventions to client responses and offers reasonable predictions to clients about health outcomes. Institutions report that sharing case management plans with clients empowers the clients to assume responsibility for monitoring and adhering to the plan of care.

Why would a public health nurse want to know about morbidity and mortality statistics on the local, state, and national level? a. To be able to share current trends in health problems with the community b. To be able to observe the community's statistics over time and compare the community with other communities c. To justify local budgets and the need for increased income from citizens d. To publicize current health issues and suggest appropriate actions to citizens

b. To be able to observe the community's statistics over time and compare the community with other communities Although being informed and being able to educate the public is always preferred and nurses often do have to justify budgets, data are needed to compare the local community with itself over time and with other communities so that problems may be recognized and action taken to confront health issues. The first step is always to recognize problems as they develop.

Which of the following would be the best way for the school nurse to fulfill his or her responsibilities in an emergency situation? a. Tell all staff to call 911 if the nurse is not in the building. b. Arrange to always be available, even if only by phone. c. Create and share an emergency plan with all teachers and staff. d. Wear a pager so that the nurse can come as soon as humanly possible.

c. Create and share an emergency plan with all teachers and staff. The American Health Association recommends that the school nurse create an emergency plan with at least two different staff members identified and responsible for implementing the plan if the nurse is not in the building at the time of the emergency. The plan would include when to call 911 and how to get a child to the hospital via ambulance if needed.

A new public health nurse carefully assessed all the local mortality and morbidity data in preparation for making appropriate planning suggestions at a meeting next week. What other action is crucial before the nurse can feel prepared? a. Ask other nursing staff their perceptions of the community's needs b. Assess the nurse's own assets, strengths, and ability to contribute c. Meet members of the community to determine their culture and values d. Review discussions and decisions from previous meetings

c. Meet members of the community to determine their culture and values Community health nurses must work with the community. It is essential to assess an aggregate's needs and resources and identify its values. The best way to do this is by meeting with the members of the community to determine their culture and values. Assessing one's own assets, asking other nursing staff, and reviewing previous discussions will not allow the nurse to assess the needs of the community.

An occupational health nurse at a local factory is using primary prevention strategies to reduce the environmental health risks among the employees. Which of the following activities would the nurse most likely implement? a. Checking radiation detectors to monitor for unsafe levels of radiation exposure b. Irrigating the eyes of an employee who has had a chemical splash to the face c. Teaching new employees who will work outdoors about the signs and symptoms of heat-related illness d. Using spirometry to rule out obstructive or restrictive lung disease for workers who will be wearing mask respirators

c. Teaching new employees who will work outdoors about the signs and symptoms of heat-related illness Education is a primary preventive strategy. When examining the sources of environmental health risks in communities and planning intervention strategies, it is important to apply the basic principles of disease prevention.

Which of the following best explains why school nurses are involved in helping teachers with the task of teaching children how to practice problem solving, communication, and other life skills? a. Teacher shortages have required nurses to be increasingly involved in teaching life skills. b. Because so many nurses want to be employed in schools, this responsibility was assumed to increase employment opportunities. c. States are requiring nurses to screen and to teach life skills. d. Nurses have been enlisted in this role to help reduce risk factors for future health problems in school children.

d. Nurses have been enlisted in this role to help reduce risk factors for future health problems in school children. School health nurses were originally involved in this capacity in 1987 after the CDC began funding schools for HIV-prevention education programs. This program was so successful that it was expanded to include programs to teach children prevention of other chronic illnesses caused in part by risk factors such as poor diet, lack of exercise, and smoking. The schools are actively involved in helping the children practice problem solving, communication, and other life skills so that they can reduce their risk factors for health problems.

5.What is the primary problem seen in Healthy People 2020's emphasis on choosing healthy lifestyle behaviors, such as daily exercise or healthy food choices? a. Emphasis on other lifestyle choices, such as not smoking and minimal use of alcohol or drugs, is also needed. b. All of us must work together to make unhealthy behaviors socially unacceptable. c. It costs more to make healthy choices, such as buying and eating fresh fruits and vegetables as opposed to quick and cheap fast-food choices. d. Public policy emphasizes personal responsibility but ignores social and environmental changes needed for well-being.

d. Public policy emphasizes personal responsibility but ignores social and environmental changes needed for well-being. Although all responses are accurate, the primary problem is the emphasis on personal choices in the Healthy People 2020 objectives. Emphasis on personal choices ignores the need for community responsibility and action that addresses environmental or cultural restraints to health