Community Final Exam

A nurse is administering medications at school. Which of the following guidelines should be used by the nurse? a. A current drug reference should be available in case information is needed. b. The nurse should administer medications brought by the child. c. Medications cannot be administered without a physician order. d. Narcotics and controlled substances should be kept in a locked cabinet.

A A current drug reference should always be available so it can be consulted for information. All medications should be kept in a locked cabinet. Medications should be in the original container and have the original prescription label on it. The nurse is responsible for giving the medication and is expected by state law to know its action, side effects, and implications.

Which statement about disasters is true? a. They can be natural or human-made. b. They can be relieved without assistance. c. There is always injury and death when a disaster occurs. d. The timing of a disaster does not influence the types of injuries that will occur.

A A disaster is any natural or human-made incident that causes disruption, destruction, and/or devastation requiring external assistance. Although natural incidents like earthquakes of hurricanes trigger many disasters, predictable and preventable human-made factors can further affect the disaster. In the disaster response phase, the incident type and time predict subsequent injuries and illnesses.

A nurse speaks on behalf of others who are unable to speak for themselves. Which of the following roles is being performed? a. Advocate b. Caregiver c. Coordinator d. Collaborator

A A nurse speaking on behalf of others who are unable to speak for themselves is performing the role of advocate. A nurse is responsible for assisting clients and families by organizing and integrating the resources of other agencies or care providers to meet the clients' needs most efficiently in the role of coordinator. As a caregiver, the nurse provides direct care to the client. Nurses are collaborators when they take part in joint decision making with clients, families, groups, and communities.

A nurse responds to a human-made disaster. Which of the following describes what the nurse is responding to? a. Structural collapse b. Communicable disease epidemics c. Mud slides d. Floods

A A structural collapse would be considered a human-made disaster. Communicable disease epidemics, mud slides, and floods are considered to be natural disasters.

A nurse plans to collect data about morbidity and mortality among migrant workers in a community. Which of the following barriers is the nurse most likely to encounter? a. Difficulty securing a stable population b. Lack of resources c. Unwilling participants d. Fear of deportation

A Accurate morbidity and mortality data are difficult to obtain due to farm workers leaving when no longer working, going back to their home to receive medical services, and decreases in infectious diseases that are easier to record.

One effect of the use of block grants was a: a. reduction of federal expenditures. b. decreased ability of states to spend money on programming. c. guaranteed continuation of programs with demonstrated effectiveness. d. shift from hospital-based to community- based nursing care.

A Block grants enabled financial responsibility to shift from the federal level to the state level, thereby reducing expenditures. Block grants gave additional monies to state and local areas to improve access to care. Block grants have not caused a shift in care from hospital-based to community-based nursing care. Block grants have not guaranteed program continuation.

A nurse is working in a temporary shelter for victims following a natural disaster. Which condition is the nurse most likely to encounter? a. Stress b. Communicable disease c. Depression d. Injuries requiring first aid

A Causes of stress can be the shock of the disaster itself, loss of personal possessions, fear of the unknown, living in close proximity to total strangers, and boredom. Illnesses requiring first aid and communicable diseases are not the primary concern of the nurse working in the shelter. Immediately following the disaster, it is unlikely that the victims will immediately encounter depression because of the shock of the disaster.

A nurse is pursuing certification as an occupational health nurse. Which organization will provide this certification? a. American Board for Occupational Health Nurses b. Occupational Safety and Health Education and Research Center c. National Institute for Occupational Safety and Health (NIOSH) d. Occupational Safety and Health Administration (OSHA)

A Certification in occupational health nursing is provided by the American Board for Occupational Health Nurses. The Occupational Safety and Health Education and Research Center supports master's and doctoral education with emphases in occupational health nursing, industrial hygiene, occupational medicine, and safety. NIOSH examines potential hazards of new work technologies and practices. OSHA educates employers about occupational health and safety.

A nurse is caring for a migrant farm worker who has been working in the agricultural industry for the past 10 years. When questioned about environmental hazards, the client reports regular exposure to pesticides. Which of the following is the client at increased risk of developing? a. Cancer b. Memory loss c. Skin rashes d. Headaches

A Chronic exposure to pesticides may lead to cancer. Acute exposure to pesticides may cause memory loss, skin rashes, and headaches.

A nurse is implementing a secondary prevention strategy. Which of the following activities would the nurse most likely implement? a. Monitoring for prenatal care b. Treatment for anemia c. HIV prevention d. Tetanus immunization

A Monitoring for prenatal care is an example of a secondary prevention strategy. Treatment for anemia is tertiary prevention, and HIV prevention and tetanus immunization are primary prevention strategies.

A public health worker had displayed a competency in disaster medicine and public health. Which of the following describes what the worker has done? a. Communicate effectively with others b. Get involved in the chain of command c. Use a set of preplanned activities for every disaster d. Implement a community assessment

A Communicating effectively with others in a disaster or public health emergency is one of the competencies demonstrated in disaster medicine and public health. Involvement in the chain of command, using a set of preplanned activities for every disaster, and implementing a community assessment are not part of these competencies.

The state orders a person newly diagnosed with tuberculosis to be quarantined. Which of the following best describes the type of law that allows the state to do this? a. Constitutional b. Common c. Judicial d. State

A Constitutional law provides overall guidance for selected practice situations. Judicial law is based on court or jury decisions. Common law means that judges are bound by previous decisions unless they are convinced

A local health department provides a hypertension screening to all individuals. Which of the following general categories of health care functions is being used? a. Direct services b. Financing c. Information d. Policy setting

A Direct services are actions that provide health care directly to individuals. Financing occurs as the government pays for health care services. Information is used as all branches and levels of government collect, analyze, and disseminate data about health care and health status of the citizens. Policy setting occurs as all branches of government make policy decisions about health care.

An occupational health nurse is assessing slippery floors as a safety hazard in the work setting. Which of the following best describes the type of hazard the nurse is assessing? a. Enviromechanical b. Physical c. Chemical d. Psychosocial

A Enviromechanical agents are those that can potentially cause injury or illness in the workplace. They are related to the work process or to working conditions, and they can cause postural or other strains that can produce adverse health effects when certain tasks are performed repeatedly. Slippery floors are known as enviromechanical hazards. They can cause or potentiate accidents, injuries, strain, or discomfort.

Which of the following health problems ranks as one of the top five problems for farm workers aged 5 to -19 years? a. Dental problems b. Communicable diseases c. Gastrointestinal problems d. Stress

A Farm workers of all ages consistently have more dental disease than the general population.

A public health nurse (PHN) is working with a community during the recovery phase of a disaster. Which of the following attributes would be most important for the nurse to possess? a. Flexibility b. Organization skills c. Personable d. Sense of humor

A Flexibility is key to a successful recovery operation. The role of the PHN in the recovery phase of a disaster is as varied as in the preparedness and response phases, but the PHN's connection to the community puts the PHN in an incredible position of knowledge and awareness on the interprofessional recovery team. The attributes of being organized, personable, and having a sense of humor are not as important as flexibility when dealing with this phase of the disaster.

A nurse is partnering with an organization to improve affordable housing in rural areas of the country. Which of the following best describes who the nurse is collaborating with? a. Housing Assistance Council (HAC) b. Local housing authority c. Temporary Assistance for Needy Families (TANF) d. Public Housing Development for Families

A HAC is a nonprofit organization whose mission is to improve affordable housing in rural areas. TANF is a program that assists families in need. The local housing authority provides public housing assistance. Public Housing Development for Families promotes the development of local strategies for affordable public housing.

A school nurse reviews the standards of professional practice published by the NASN. Which professional standard will the school nurse rely upon when providing care? a. Interact with interdisciplinary health team members b. Communicate with teachers to effectively manage classrooms c. Teach cardiopulmonary resuscitation to every member of the school staff d. Do research on students at the school

A Interacting with interdisciplinary health team members is one of the criteria for school nurses developed by the NASN. The professional standards rely on nurses to give care based on 11 criteria: (1) develop school health policies and procedures; (2) evaluate their own nursing practice; (3) keep up with nursing knowledge; (4) interact with the interprofessional health care team; (5) ensure confidentiality in providing health care; (6) consult with others to give complete care; (7) use research findings in practice; (8) ensure the safety of children, including when delegating care to other school personnel; (9) have good communication skills; (10) manage a school health program effectively; and (11) teach others about wellness.

A nurse is assessing a client who has had an acute exposure to a pesticide. Which of the following symptoms is the client most likely to display? a. Memory loss b. Musculoskeletal problems c. Cancer d. Infertility

A Memory loss is a symptom that is displayed following an acute exposure to a pesticide. Musculoskeletal problems, cancer, and infertility are from chronic exposure.

The nurse is caring for a migrant family. During the interview, the mother tells the nurse that the family follows an Eastern migratory stream originating in southern Florida. Which of the following statements is accurate? a. This is one of the migratory streams that migrant farm workers traditionally follow. b. This is a unique migratory pattern. c. This is a traditional family-generated migratory pattern. d. This is an unpredictable pattern that may lead the family through southern California.

A Migrant workers traditionally have followed one of three migratory streams: (1) Eastern, originating in Florida; (2) Midwestern, originating in Texas; and (3) Western, originating in California.

A riverfront community builds a retaining wall to divert flood water away from the town. Which term describes what has happened? a. Mitigation b. A natural disaster c. Community resilience d. Rapid needs assessment

A Mitigation is defined as actions or measures that can either prevent the occurrence of a disaster or reduce the severity of the effects. A natural disaster, such as an earthquake or hurricane, causes disruption, destruction, and/or devastation requiring external assistance. Community resilience is defined as the sustained ability of a community to withstand and recover from adversity. A rapid needs assessment is based on the traditional model of community assessment where there is a rapid appraisal of a sector or region's population, social systems, and geophysical features.

A nurse is providing care to a family who has a child with a disability. Which of the following individuals would most likely report high levels of stress, anxiety, and depression? a. Mother b. Father c. Teacher d. Home health nurse

A Mothers are most often the caregivers in families with a child with a disability. Mothers of children with special health care need report higher levels of stress, anxiety, depression, and feelings of isolation compared with mother of unaffected children.

What is the purpose of NIOSH? a. Examine potential hazards of new work technologies and practices b. Educate employees about environmental risks and hazards c. Develop and maintain a database of work-related deaths d. Set standards that regulate workers' exposure to potentially toxic substances

A NIOSH examines potential hazards of new work technologies and practices. OSHA educates employees about environmental risks and hazards, develops and maintains a database of work-related deaths, and sets standards that regulate workers' exposure to potentially toxic substances.

A nurse becomes actively involved in the development of a health policy in the community. Which of the following describes why this is an important role of the nurse? a. Government and policy have a large impact on nursing and health. b. Policy affects nursing values as set forth by Florence Nightingale. c. Political science is a course of study that parallels nursing. d. Nurses must interpret laws to fit their practice.

A Nurses should be advocates for the health of the population. In order to do this, nurse professionals must have a working knowledge of government, health care law, the policy process, and the political forces that are shaping the future of health care. Policy does not affect nursing values. Political science does not parallel nursing. Nurses are unable to interpret laws to fit their practice.

An occupational health nurse maintains a log of injuries from contaminated sharps. Which of the following describes why the nurse must do this? a. Blood-borne Pathogen Standard b. OSHA c. DOL d. DOD

A OSHA is part of the DOL. The Blood-borne Pathogen Standard became effective in 2002. This act clarified the responsibility of employers to select safer needle devices as they become available and to involve employees in identifying and choosing the devices. The updated standard also required employers to maintain a log of injuries from contaminated sharps. The DOD is not involved in these activities.

A nurse has identified a point source of air pollution. Which of the following has the nurse identified? a. A smoke stack b. The number of cars and trucks c. The amount of fossil fuel consumed in a community d. Ground ozone levels

A Point sources of pollution are identifiable sources of air pollution, such as a smoke stack. Nonpoint sources come from more diffuse exposures, such as from cars and trucks. The amount of fossil fuel that is consumed and ground ozone levels do not identify sources of air pollution.

A nurse discusses with legislators the importance of passing legislation to ban smoking in all public places. Which of the following is the nurse becoming involved in? a. Policy b. Politics c. Law d. Health policy

A Politics is the art of influencing others to accept a specific course of action. Therefore political activities are used to arrive at a course of action (the policy). Policy is a settled course of action to be followed by a government or institution to obtain a desired end. Law is a system of privileges and processes by which people solve problems based on a set of established rules. Health policy is a set course of action to obtain a desired health outcome for an individual, family, group, community, or society.

Why is it important for nurses to understand the premises of environmental health? a. Nurses should be able to assess risks and advocate for policies that support healthy environments. b. Toxicologists often consult nurses about environmental pollutants. c. Pollutant exposures such as lead are reported by nurses to the Environmental Protection Agency (EPA). d. Many Americans live in areas that do not meet current national air quality standards.

A Potential risks to health are concerns for professional nurses. It is the responsibility of the nurse to understand as much as possible about these risks: how to assess them, how to eliminate/reduce them, how to communicate and educate about them, and how to advocate for policies that support healthy environments. Toxicologists do not often consult nurses about environmental pollutants. Pollutant exposures are not routinely reported by nurses. Although there may be problems with air quality standards in the United States, this would not be the primary reason why nurses should understand environmental health.

A nurse is completing an exposure history using the mnemonic I PREPARE. What data would a nurse collect when asking questions about the first "P"? a. Present work b. Potential exposures c. Personal protective equipment use d. Past work

A Present work is the first "P". Potential exposures are part of the "I"—investigate potential exposures. Personal protective equipment use is not part of the mnemonic. Past work is the second "P."

A forensic nurse implements a program aimed at preventing domestic abuse. Which of the following levels of prevention is being used? a. Primary prevention b. Secondary prevention c. Tertiary prevention d. Assessment

A Primary prevention focuses on preventing violence and injuries before they occur—program focused on preventing domestic abuse. Secondary prevention occurs following the occurrence of injuries and crime. This includes direct care provided to victims and perpetrators as well as the collection of evidence. If disability, incarceration, or death occurs, tertiary prevention is applied in settings appropriate to address rehabilitation or identify factors that have put individuals at risk.

The nurse is doing a walk-through to identify workplace hazards. Which of the following levels of prevention is being implemented? a. Primary prevention b. Secondary prevention c. Tertiary prevention d. Assessment

A Primary prevention refers to those interventions aimed at preventing the occurrence of disease, injury, or disability. A walk-through is part of an assessment, which is part of primary prevention. Tertiary prevention includes those interventions aimed at disability limitation and rehabilitation from disease, injury, or disability. Secondary prevention occurs after a disease process has already begun.

A congressional mandate for the addition of folic acid to cereals in the United States to reduce neural tube defects in infants has been implemented. Which of the following levels of prevention has been addressed? a. Primary prevention b. Secondary prevention c. Tertiary prevention d. Assessment

A Primary prevention refers to those interventions aimed at preventing the occurrence of disease, injury, or disability. Secondary prevention interventions are aimed at screening and early detection. Tertiary prevention interventions are focused on treatment and rehabilitation. Assessment is not a level of prevention.

A nurse is providing education to prevent health problems in children. Which of the following levels of prevention is being used? a. Primary prevention b. Secondary prevention c. Tertiary prevention d. Assessment

A Primary prevention refers to those interventions aimed at preventing the occurrence of disease, injury, or disability. Providing education to prevent health problems in children is part of primary prevention. Secondary prevention includes the screening of children for various illnesses, monitoring their growth and development, and caring for them when they are ill or injured. Tertiary prevention is the continued care of children who need long-term health care services, along with education within the community.

A forensic nurse is applying the concept of distributive justice. Which of the following questions would be most appropriate for the nurse to ask? a. How will limited funds be spent? b. Who will benefit the most from the services? c. How will an additional service benefit the population? d. How will the privacy of the population be respected?

A Principles of distributive justice address questions in deciding what goods will be distributed to which persons in what proportions. This is best addressed by asking "How will limited funds be spent?" The principle of beneficence is addressed through "Who will benefit the most from the services?" and "How will an additional service benefit the population?" The principle of confidentiality is addressed through the question "How will the privacy of the population be respected?"

What has been the focus of the majority of scientific research in forensic nursing? a. Role of the forensic nurse and client population b. Sexual assault team response c. Client satisfaction with forensic nurses d. Collaboration with other disciplines

A Scientific research in forensic nursing is in its early stages. Currently, research is largely a description of the forensic nursing role and client population.

A nurse is polite and non-confrontational when working with the family of a migrant worker. Which of the following concepts is the nurse demonstrating? a. Simpatía b. Respeto c. Dignidad d. Personalismo

A Simpatía means having polite, non-confrontational relationships with others. Respeto means respect, dignidad means dignity, and personalismo is relating to the individual.

A nurse is providing emergency care to an assault victim. Which of the following would be the most appropriate action for the nurse to take? a. Support the privacy of the victim b. Assess the socioeconomic status of the victim c. Question the victim about the details of the assault d. Educate the victim about violence prevention

A Supporting the privacy of the assault victim is the most appropriate action for the nurse to take when providing care. When providing emergency care, it is not the most appropriate time to assess the client's socioeconomic status or educate the victim about violence prevention. The forensic nurse will need to document the victim's account of the assault; however, there will be law enforcement involved to collect this data.

A nurse is working with a member of the military. Which of the following describes the department that provides this person with health care services? a. Defense b. Labor c. Agriculture d. Justice

A The Department of Defense (DOD) delivers health care to members of the military, including their dependents and survivors, and to retired members and their families. The DOL houses the Occupational Safety and Health Administration (OSHA), which imposes workplace requirements on industries. The Department of Agriculture houses the Food and Nutrition Service, which oversees a variety of food assistance activities. The Department of Justice (DOJ) provides health services to federal prisoners.

An occupational health nurse is assessing the need for MSDSs at the worksite. Which of the following items would require an MSDS? a. Hand soap b. Eye goggles c. Aprons d. Earplugs

A The Hazard Communication Standard requires that all worksites with hazardous substances inventory their toxic agents, label them, and provide information sheets, called MSDSs, for each agent. Hand soap is a toxic agent. Eye goggles, aprons, and earplugs are not toxic agents and therefore, do not need an MSDS.

A nurse provides health services for women and children in the community. Which of the following provides the provisions to offer these services? a. Sheppard-Towner Act b. Public Protection of Maternity and Infancy program c. Early Periodic Screening and Developmental Testing (EPSDT) program d. Women, Infants, and Children (WIC) program

A The Sheppard-Towner Act also offered well-child and child-development services, provided adequate hospital services and facilities for women and children, and provided grants-in-aid for establishing maternal and child welfare programs. The Sheppard-Towner Act defined the role of the federal government in creating standards to be followed by states in conducting categorical programs, such as WIC and EPSDT programs.

The agency most heavily involved with the health and welfare concerns of United States citizens is the: a. USDHHS. b. PHS. c. Health Resources and Services Administration. d. WHO.

A The USDHHS is the agency most heavily involved with the health and welfare of United States citizens. It touches more lives than any other federal agency. The PHS was the first major federal government action relating to health. The Health Resources and Services Administration is part of the USDHHS. The WHO is concerned with access to health care across the world.

A nurse is caring for a disabled individual and her family. Which of the following may be a potential effect on the family? a. High out-of-pocket expenses to receive necessary services b. Alteration of self-concept and self-esteem c. Compliance with necessary legislation to maintain services d. Provision of health care services by the health department

A The cost of caring for a child with a disability often affects the family's financial well-being. One-third of children with disabilities who have insurance lack adequate coverage to meet their needs. Alteration of self-concept and self-esteem may affect individuals in the family, but not the family. Compliance with legislation and provision of health care services may be potential effects on the community.

What is the extent of the economic burden of injuries in the United States? a. It is extensive, including medical treatment and lost productivity. b. It is minimal, as limited funds are spent treating injuries. c. It varies depending on the extent of the injury. d. It has been reduced through risk reduction strategies.

A The economic burden of injuries in the United States is extensive, especially when considering the costs of medical care and treatment, productivity losses (lost wages, accompanying fringe benefits), and lost ability to perform normal household responsibilities.

When a school nurse reports suspected child abuse, there is a breach of confidentiality. Which of the following best describes why this breach is allowed? a. Civil immunity b. Sovereign immunity c. Nurse practice act d. Respondeat superior

A The law mandates that a health professional breach patient confidentiality norms to protect someone who may be in a helpless or vulnerable position. Sovereign immunity states that PHN practice has been granted personal immunity to cover all aspects of their practice. The nurse practice act defines the nurse's scope of practice. The doctrine of respondeat superior says that when a nurse is employed and functioning within the scope of that job, the one responsible for that negligence is the nurse's employer.

A nurse is providing care for a Mexican client who has sustained a farm injury. If a major decision about the client's treatment needs to be made, who would most likely make that decision? a. The male head of the family b. The wife/mother c. The person needing services d. The crew leader

A The male is considered to be the major decision maker in the family, whereas the female is considered the caretaker.

A nurse is conducting a community assessment in a healthy community. Which of the following findings should the nurse anticipate? a. Low crime rates b. High rates of injury c. Significant health disparities d. Low mortality rates

A The rate of injury and crime is lower in communities that promote good health. Where inequities of resources and education exist, health disparity, violence, and other crimes rise and accidental injuries occur more often.

A nurse is triaging victims following a disaster. Which of the following describes the action the nurse would take? a. Allocation of treatment based on the victim's potential for survival b. Assignment of tasks to the appropriate disaster response personnel c. Determination of the level of disaster and agency involvement d. Participation in community preparedness for the disaster response

A The triage process in disaster involves separating the casualties and allocating treatment based on the victim's potential for survival. Assignment of tasks to the appropriate disaster response personnel, determination of the level of disaster and agency involvement, and participation in community preparedness for the disaster response are not part of the triage process.

A nurse is working from a client who is part of the Mexican culture and is experiencing a folk illness. Which of the following actions by the client should the nurse anticipate? a. Prefer to seek care with a folk healer b. Consult the female leader of the family c. Rely on Western medicine to cure the ailment d. Become isolated and not seek care

A There are four common folk illnesses that a nurse may encounter with the Mexican client: (1) mal de ojo (evil eye), (2) susto (fright), (3) empacho (indigestion), and (4) caida de mollera (fallen fontanel). When faced with one of these illnesses, the traditional Mexican individual would prefer to seek care with a folk healer. Healers known as curanderos, herbalistas, and espiritualistas are often sources of health care for folk illnesses.

A nurse is working to improve the health and wellness of persons with disabilities. Which of the following actions should be taken by the nurse? a. Treat the whole person, not just the disability b. Focus on the disability and the related illnesses c. Acknowledge the ability, not the disability d. Ensure persons with disabilities have access to home health care

A To improve the health and wellness of persons with disabilities, the former Surgeon General Carmona suggested that health care providers should see and treat the whole person; educators should teach about disability; the public should focus on the person's abilities, not just the disability; and the community should ensure accessible health care and wellness services.

The basic science applied to understanding the health effects associated with chemical exposures is: a. toxicology. b. pharmacology. c. chemistry. d. environmental epidemiology.

A Toxicology is the study of the health effects associated with chemical exposures. Pharmacology is the branch of medicine concerned with the multiple aspects of drugs. Chemistry is the branch of science with deals with the way that matter is composed. Environmental epidemiology is concerned with the discovery of environmental exposures that cause or protect against illness or disease.

Which school health practice may occur in the future? a. Teaching health education using telehealth and telecounseling b. Using robotic nurses in schools c. Fulfilling the role of both classroom teacher and nurse by nurses d. Developing private practices for treatment of the entire family

A Using telehealth and telecounseling to provide health education is useful for homebound students and their parents. It is unlikely that there will be robotic nurses, that nurses will serve the role of both nurse and classroom teacher, and that private practices will be developed to treat the entire family.

A nurse vocalizes a concern that a group of refugees in the community is not receiving equal access to health care services when compared to the other residents in the community. Which of the following concepts is being applied? a. Victimization b. Perceptivity c. Questioning d. Beneficence

A Victimization occurs when individuals or groups are treated unfairly; generally when there is an imbalance of power. Perceptivity, as an element of intuitiveness, is one tool the forensic nurse uses to investigate injury; it involves an increased awareness of human behavior and environment that is interpreted by knowledge and lived experience in making expert decisions. Questioning has led to a greater understanding of what most would consider the unexplainable and unimaginable. Beneficence is an ethical principle that relates to caring.

An occupational health nurse is educating employees about work-related hazards. Which of the following hazards would the nurse most likely discuss in the presentation? a. Workplace stress leading to hypertension and cardiovascular disease b. Asbestos, plastics, lead, and solvents leading to dermatitis c. Cement dust and metals leading to bronchitis d. Hormones and nitroglycerine leading to reproductive effects

A Work-related stress or burnout has been defined as an important problem for many individuals. Responses to negative interpersonal relationships, particularly those with authority figures in the workplace, are often the cause of vague health symptoms and increased absenteeism. Education about stress would be pertinent to all workers, regardless of specific job or setting.

Which organizations offer volunteer opportunities in disaster work for nurses? (Select all that apply.) a. ARC b. Citizens Corps c. American Nurses Association d. National Public Health Training Centers e. Sigma Theta Tau International

A, B ARC and Citizens Corps offer volunteer opportunities. The American Nurses Association and National Public Health Training Centers offer education and training opportunities. Sigma Theta Tau International is an honor society for nurses.

A nurse is planning nursing interventions for disabled individuals living in poverty. Which of the following factors should be taken into consideration? (Select all that apply.) a. This population may have difficulty securing employment. b. This population may have less access to health care. c. This population is better able to use community resources. d. This population may make healthier lifestyle choices. e. This population is more independent.

A, B Persons who are disabled and live in poverty are less likely to have the resources to provide for their own special needs. They often have difficulty securing employment and have barriers obtaining health insurance and accessing health care. This population is limited in their ability to access community resources and is at greater risk for disabling conditions resulting from lifestyle choices.

A school nurse develops emergency plans for students who may need immediate care while at school. Which of the following elements should be included in this plan? (Select all that apply.) a. When to call 911 for local emergency personnel b. Education about standard precautions for staff members c. Role children may play in providing basic first aid d. How to maintain confidentiality and privacy of injured students e. Where the shelter areas are located at the school

A, B, C According to the American Academy of Pediatrics' (AAP's) and American Heart Association's (AHA's) guidelines, the plan should address when to call 911 for local emergency personnel, education about standard precautions for staff members, and the role that children may play in providing basic first aid. Information related to how to maintain confidentiality and privacy of injured students is not part of the emergency plan. The location of the shelter areas is part of a school-wide emergency or disaster plan, but not for emergency plans for individual students.

A nurse would like to obtain certification as a forensic nurse. Which specialty certifications are available for the forensic nurse? (Select all that apply.) a. Legal Nurse Consultant b. Death Investigator c. Adolescent and adult SANE A d. Forensic Consultant e. Forensic nurse

A, B, C Certification is available as an adolescent and adult SANE A, Legal Nurse Consultant, and Death Investigator. Forensic Consultant and forensic nurse are not certifications that are available

A PHN working with a family living in poverty is concerned about their exposure to environmental hazards. Which of the following factors should the nurse consider that may put the family at risk? (Select all that apply.) a. Limited funds to pay for health care b. Poor nutrition c. Homes located closer to hazardous waste sites d. Less education e. Unsafe working conditions

A, B, C Families living in poverty are more likely to experience environmental justice issues such as disproportionate environmental exposures. Substandard housing, living closer to hazardous waste sites, working in more hazardous jobs, poorer nutrition, and less access to quality health care all contribute to this issue. Although limited education is related to poverty, it is not discussed as causing an increase in environmental exposure.

Which populations are at greatest risk for disruption after a disaster? (Select all that apply.) a. Single-parent families b. Children c. Substance abusers d. Middle-class families e. Young adults

A, B, C Single-parent families, children, and substance abusers are all at greater risk for disruption after disaster than a middle-class family or young adults.

Which factors are challenges of the migrant lifestyle? (Select all that apply.) a. Leaving one's home every year b. Traveling c. Experiencing uncertainty regarding work and housing d. Lack of resources e. Middle income wages

A, B, C, D Leaving one's home every year, traveling, experiencing uncertainty regarding work and housing, and lack of resources are some of the challenges of the migrant lifestyle. The specifics for payment differ depending on the location and type of work. Reports of average income for farmworkers have varied.

Which of the following conditions may contribute to disability? (Select all that apply.) a. Violence b. Tobacco use c. Lack of access to health care d. Unsanitary living conditions e. Extended family living arrangements

A, B, C, D Several conditions and inherited problems can cause disability: genetic disorders, acute and chronic illnesses, violence, tobacco use, lack of access to health care, as well as failure to eat correctly, exercise regularly, or manage stress effectively. Substance abuse, environmental problems, and unsanitary living conditions can cause disability.

Congress's legal base for actions in health care includes which of the following? (Select all that apply.) a. Providing for the general welfare b. Raising funds to support research c. Regulating commerce among the states d. Providing spending power e. Increasing revenue by raising taxes

A, B, C, D The legal base for actions in health care includes providing for the general welfare, regulating commerce among the states, providing spending power, and raising funds to support the military. Increasing revenue is not part of Congress's legal base for actions for health care.

An occupational health nurse is working in an occupational health and safety program. Which of the following services is the nurse most likely to provide? (Select all that apply.) a. Health/medical surveillance b. Health screening c. Case management d. Job task analysis e. Counseling

A, B, C, D The services provided by onsite occupational health programs range from those focused only on work-related health and safety problems to a wide scope of services that includes primary health care. An occupational health and safety program may include health/medical surveillance, health screening, case management, and job task analysis.

A school nurse is implementing strategies to prevent violence in the school setting. Which of the following interventions would most likely be used? (Select all that apply.) a. Support policies of zero tolerance for weapons on school property b. Facilitate student connectedness to the school community c. Encourage students to lock up and protect their personal property d. Serve as a positive role model e. Encourage students

A, B, D Supporting policies of zero tolerance for weapons on school property, facilitating student connectedness to the school community, and serving as a positive role model are all strategies that the nurse can use to prevent violence in the school setting. Student connectedness is encouraged if students play sports at school rather than with area clubs. Locking up and protecting personal property is not an effective strategy to prevent violence.

The CDC accomplishes its mission by: (Select all that apply.) a. Implementing prevention strategies b. Detecting and investigating health problems c. Dictating world health policy d. Fostering safe and healthful environments e. Protecting the population from bioterrorism events

A, B, D The CDC implements prevention strategies, detects and investigates health problems, and fosters safe and healthful environments. The CDC operates within the United States, not worldwide. The Department of Homeland Security is concerned with protecting the population from bioterrorism, not the CDC.

An occupational health has become a member of the AAOHN. Why would a nurse join this organization? (Select all that apply.) a. To promote the health and safety of workers b. To lobby in Congress for safer work places c. To advance the profession by supporting research d. To promote and provide continuing education in the specialty e. To obtain certification as a specialist in occupational health nursing

A, C, D The AAOHN is the professional organization for occupational health nurses. It supports the work of the occupational health nurse and advances the specialty by: promoting the health and safety of workers, defining the scope of practice and setting the standards of occupational health nursing practice, developing the code of ethics for occupational health nurses with interpretive statements, promoting and providing continuing education in the specialty, advancing the profession through supporting research, and responding to and influencing public policy issues related to occupational health and safety. A nurse joining the AAOHN would most likely not go to lobby in Congress; rather, AAOHN provides a lobbyist to address pertinent issues. Joining the AAOHN will not assist the nurse in obtaining specialty certification.

A nurse is working with an older person following a disaster. Which of the following emotions of the client should be anticipated by the nurse? a. Anger b. Fear of loss of independence c. Violence d. Regression

B A common reaction of older persons experiencing disaster may be fear of loss of independence. Young children may respond with regression. The community in general may respond will feelings of anger, sorrow, guilt, and perceived blame for the disaster or the outcomes of the disaster. Violence should not be anticipated with any of the populations discussed in the text.

A nurse is working with a client whose principal employment is in agriculture on a seasonal basis and has established temporary housing in the area while employed. Which of the following terms best describes this laborer? a. Seasonal farm worker b. Migrant farm worker c. Transient worker d. Share cropper

B A migrant farm worker is a laborer whose principal employment is in agriculture on a seasonal basis and, for the purposes of such employment, establishes a temporary abode. A seasonal farmworker returns to his permanent residence, works in agriculture for at least 25 days or parts of days, and does not work year round only in agriculture. A transient worker moves from place to place to find work. A share cropper is a tenant farmer who uses part of the crop to pay for rent.

Which statement is true about health care services for migrant workers? a. Clinics are usually found within walking distance from work. b. Undocumented workers fear deportation when using clinics. c. Health care records are kept by workers to allow for continuation of services. d. Clinics are most often open on weekends and keep evening hours.

B Clinics are usually a great distance from work and offer health services only during work hours. Health records do not typically follow the client.

The nurse, with agreement from the family, arranges for families to see social workers on the same day that they bring their children for follow-up care in a pediatric cardiology clinic. Which of the following roles is being performed? a. Caregiver b. Coordinator c. Collaborator d. Case finder

B A nurse is responsible for assisting clients and families by organizing and integrating the resources of other agencies or care providers to meet the clients' needs most efficiently in the role of coordinator. A nurse arranging for families to see social workers on the same day that they bring children to be followed up in a pediatric cardiology clinic is performing the role of coordinator. A nurse as a case finder identifies individuals with disabilities who need services. Nurses are collaborators when they take part in joint decision making with clients, families, groups, and communities. In the caregiver role, the nurse provides direct care to the client.

A site that provides primary health care services to children and youths by nurse practitioners in the school setting is a: a. primary care clinic. b. school-based health center. c. school health service. d. child health improvement plan.

B A site that provides primary health care services to children and youths by nurse practitioners in the school setting is a school-based health center. Primary care clinic refers to care that is typically provided in a physician's office. School health services provide the various types of services that are available in schools. A child health improvement plan is not a setting for health care services to be delivered.

A nurse is working with a client who has been diagnosed with a substance abuse disorder and bipolar disorder. Which of the following terms best describes what is being experienced by the client? a. Disability b. Dual diagnosis c. Handicap d. Functional limitation

B A substance abuse disorder concurrent with a mental illness disorder is a dual diagnosis. Disability is a condition (such as illness or injury) that damages or limits a person's physical or mental abilities. Handicap is a very powerful word; it symbolizes the person with a disability begging with a "cap in his hand." Functional limitations occur when individuals experience difficulty performing basic activities of daily living (ADLs) because of their disability.

The first industrial nurse is considered to be: a. Betty Moulder. b. Ada Mayo Stewart. c. Lillian Wald. d. Florence Nightingale.

B Ada Mayo Stewart was hired in 1885 by the Vermont Marble Company; she is often considered the first industrial nurse. Betty Moulder provided care of ailing coal miners and their families. Lillian Wald is known as the founder of public health nursing. Florence Nightingale is one of the pioneers of the nursing profession.

A nurse is working in an occupational health setting. Which of the following roles will the nurse most likely have? a. Administrator b. Clinicians/practitioner c. Consultant d. Educator

B An occupational health nurse could be employed in any of these roles. However, the majority of occupational health nurses work as nurse clinicians/practitioners.

A nurse is volunteering on a disaster medical assistant team as a first responder. Which of the following tasks would the nurse be prepared to perform? a. Set up immunization clinics b. Assist in triaging disaster victims c. Provide all the medical care for disaster victims d. Complete a needs assessment of the community

B As a first responder arriving on the scene, the plans for triaging of disaster victims should begin immediately. Setting up immunization clinics would not be a priority following a disaster. In responding to a disaster, it may be impossible to provide all of the medical care for disaster victims. It would not be appropriate to start with completing a needs assessment of the community following a disaster; this should be done before the disaster occurs.

Which factor may limit access to care for migrant farm workers? a. Unwillingness to seek affordable health care b. Lack of knowledge regarding services c. Availability of 24-hour health care services d. Adequate transportation

B Because of isolation, migrant farm workers lack usual sources of information regarding available services. Migrant workers typically are unable to afford health care, have limited services available, and may not have adequate transportation to get to health care services.

A nurse is educating migrant women to serve as links between the existing health care agencies and the migrant farm worker family. Which of the following best describes the role of these women? a. Migrant head start workers b. Outreach care workers c. Physician assistants d. Nurse aides

B Because these outreach workers are members of the migrant community, they are trusted and know the culture and the language. Physician assistants and nurse aides do not serve in this lay person role in the community.

A nurse is caring for a client who, according to the Social Security Administration, is considered disabled. Which of the following best describes the client? a. A wheelchair-bound person b. A person unable to engage in any gainful activity because of a medical impairment c. A handicapped person d. A person who has had a stroke or has lost the use of a lower extremity

B By definition, the Social Security Administration defines a disabled person as a person unable to engage in substantial, gainful activity by reason of medically determinable physical or mental impairment. A wheelchair-bound person, a handicapped person, or a person who has had a stroke may be able to engage in gainful activity.

Environmental health is important to nurses because chemical, biological, and radiological materials are: a. a major cause of global warming. b. often found in the air, water, and products we use. c. frequently linked to the development of chronic illnesses. d. products that nurses work with on a daily basis.

B Chemical, biological, and radiological pollutants are often found in the air we breathe, the water we drink, and the products we use. These are not a major cause of global warming. They are not frequently linked to the development of chronic illnesses. These are not products that nurses work with on a daily basis.

A public health nurse (PHN) is working with a migrant farm worker who has experienced an exposure to a pesticide. When researching pesticides, the nurse looks at the "family" of the chemical. What similarities are found among chemicals that have been placed in the same family? a. Route of entry into the body b. Actions and associated risks c. Effects that they have on the body d. Potency and toxicity

B Chemicals are grouped so it's possible to understand the actions and risks associated with each group. Although some common health risks exist within these families of chemicals, the possible health risks for each chemical should be evaluated individually when a potential human exposure exists.

A nurse is employed as a forensic nurse during the 1950s. Which of the following tasks would the nurse most likely have been implementing? a. Working in a sexual assault clinic b. Identifying indicators of assault c. Implementing protocols for sexual assault care d. Receiving sexual assault nurse examiners (SANE) training

B During the 1940s through the 1960s, nurses became aware of their role in identifying indicators of assault. The first nurse-run sexual assault clinic opened in 1974, with subsequent development of the first protocols for sexual assault care. SANE programs appeared in the 1990s.

A nurse is working in a community that is experiencing the Honeymoon Phase after a disaster. Which of the following is characteristic of this phase? a. First responders work tirelessly to save others. b. Survivors share their stories. c. Medical personnel experience exhaustion. d. Community organizations rebuild the community.

B During the Honeymoon Phase, survivors rejoice for their survival and may share their experiences and stories. First responders work tirelessly to save others during the Heroic Phase. Medical personnel experience exhaustion during the Disillusionment Phase. The community begins to rebuild during the Reconstruction Phase.

A forensic nurse is demonstrating the role of advocate. Which of the following best describes the intervention being performed by the nurse? a. Partner with public health professionals to implement programming b. Promote programs that prevent injuries c. Investigate injuries in the community d. Provide holistic care to victims of violence

B Forensic nurses can demonstrate the role of advocate by promoting programs that prevent injuries. Partnering with public health professionals to implement programming demonstrates collaboration. Investigating injuries in the community demonstrates the role of epidemiologist. Providing holistic care to victims of violence demonstrates the role of caregiver.

A forensic nurse plans to collaborate with another professional to provide care to the client. Which of the following professionals would the nurse be most likely to collaborate with? a. Social worker b. Corrections officer c. Clinic manager d. Dietician

B Forensic nurses collaborate with corrections officers and law enforcement, epidemiologists, emergency department providers, psychiatric practitioners, and public health nurses.

A forensic nurse is implementing Hammer's definition of caring. Which of the following actions would the nurse most likely perform? a. Utilizing intuition when assessing a client b. Providing self-care and care for the client c. Assuring that the client's basic needs are met d. Assessing the bio-psychosocial and spiritual characteristics of the client

B Hammer recognized that in forensic nursing practice the caring component must address caring for oneself as well as caring for clients. A sense of self-worth must be cultivated and nurtured to the degree that caring is conscientious, objective, and demanding of the scientific truth. Caring must also be curious and questioning; it should be directed toward colleagues; and finally, caring should be about firm and valued concepts that inform practice.

A nurse supported the passage of needlestick legislation. Which of the following best describes the role of employers because of this legislation? a. Use Universal Precautions when dealing with all patients b. Select safer needle devices as they became available c. Provide needle disposal boxes d. Incinerate all infectious waste, including needles

B Health care facilities by law have to select safer needle devices and involve employees in identifying and choosing the devices. The needlestick legislation did not address the use of Universal Precautions, provision of needle disposal boxes, or incineration of all infectious wastes.

Which definition of disability is being used when a disability is considered to be a function of physical characteristics that place an individual at a disadvantage when compared to those without the characteristics? a. Social Model of Disability b. Medical Model of Disability c. Webster Dictionary definition of disability d. Social Security Administration definition of disability

B In the Medical Model of Disability, disability is considered to be a function of physical characteristics or conditions that place an individual at a disadvantage as compared to those without the characteristic or condition. This model emphasizes the disabled person and the need to modify the course of illness to give the disabled person a "normal" life. In the Social Model of Disability, emphasis is placed on systemic barriers as well as societal attitudes and stigmas that contribute to the perception that those with limitations or physical illnesses are disabled. Webster's Dictionary definition describes disability as a condition (such as illness or injury) that damages or limits a person's physical or mental abilities. The Social Security Administration uses the Medical Model of Disability for determination of disability.

A nurse wants to find more information about indoor air quality. Which of the following websites would be most helpful? a. The National Institutes of Health (NIH) b. The American Lung Association c. "Right to Know" d. The Occupational Safety and Health Administration (OSHA)

B Indoor air quality is a growing public health concern in office buildings, schools, and homes and is reflected in the alarming rise in asthma incidence in the United States, particularly among children. Sources of information about indoor air quality include the EPA and the American Lung Association. The NIH is part of the U.S. Department of Health and Human Services (USDHHS) and is responsible for health and biomedical research. "Right to Know" is part of a workplace safety legislation. OSHA regulates safety in factories and businesses.

Which statement about head lice is true? a. Prevalence of head lice in U.S. schools is nearly 50%. b. Most cases of head lice are found in white, middle-class children. c. Having head lice is associated with living in an unclean home. d. Most incidents of head lice occur in those with dirty hair.

B Lice are mostly found in white, middle-class children as a result of the oval shape of the hair shaft. Prevalence of head lice in U.S. schools ranges from 10% to 40%, being found most commonly in school-aged children, typically in late summer and autumn. Lice are more often seen in clean hair. The suggestion that lice are associated with unclean homes in poverty areas is incorrect.

A nurse is assessing a worker who has had a health reaction to a "safe" low-level exposure. Which of the following most likely describes what has happened? a. An allergic reaction b. A compromised immune system c. Hypersusceptibility d. Malnutrition

C A number of host factors appear to be associated with this hypersusceptibility: light skin, malnutrition, compromised immune system, glucose-6-phosphae dehydrogenase deficiency, serum alpha1-antritrypsin deficiency, chronic obstructive pulmonary disease, sickle cell trait, and hypertension. A worker who has a health reaction to "safe" low-level exposures is experiencing hypersusceptibility.

States have certain continuing education requirements for persons to renew a nursing license. Which of the following best describes the type of law that is being used? a. Constitutional law b. Legislation and regulation c. Judicial and common law d. Police power

B Licensing is regulated by each state's nurse practice act as a function of the board of nursing. Constitutional law provides overall guidance for selected practice situations. Judicial law is based on court or jury decisions. Common law means that judges are bound by previous decisions unless they are convinced that the older law is no longer relevant or valid. Police power is state power concerning health care. This power allows states to act to protect the health, safety, and welfare of their citizens.

Which of the following statements about disabilities is true? a. Disability includes sickness. b. Almost everyone will experience disability at some time during life. c. Disabilities are limited to physical impairments. d. Most disabled individuals require assistance with ADLs.

B Most men, women, and children of all ages, races, and ethnicities will experience disability at some time during their life. As a person ages, the likelihood of developing a disability increases. Disability is a condition (such as illness or injury) that damages or limits a person's physical or mental abilities.

A doctoral prepared nurse (PhD) at a university wants to submit a grant to study the impact of a nursing activity on patient outcomes. From which of the following federal agencies could this nurse potentially seek funding? a. Centers for Disease Control and Prevention (CDC) b. National Institute of Nursing Research (NINR) c. USDHHS d. WHO

B NINR funds the development of the knowledge base of nursing and promotion of nursing services in health care. The CDC, USDHHS, and WHO do not provide funding specific to nursing research.

Which population is at the greatest risk for experiencing work-related accidents with subsequent injuries? a. Workers of child-bearing age b. Workers with less than 1 year of experience c. Workers with diminished sensory abilities d. Workers with chronic illnesses

B New workers with less than 1 year of experience on the current job are at the greatest risk for experiencing work-related accidents with subsequent injuries. The highest percentages were in mining; agriculture, forestry, and fishing; construction; and wholesale and retail trade.

Which is considered a nonpoint source of pollution? a. Hazardous waste site b. Animal waste from wildlife c. Chlorine poured down a well d. Stagnant water

B Nonpoint sources come from more diffuse exposures to pollution. Animal waste is the only diffuse exposure given. The others are considered point sources; point sources are individual, identifiable sources such as smoke stacks.

An occupational health nurse is assessing workplace hazards. Which of the following would be the best method for the nurse to use? a. Review incident reports b. Walk through the worksite c. Interview key employees d. Read the Standard Industrial Classification (SIC) Code

B One of the best methods an occupational health nurse can use in assessing workplace hazards is to walk through the worksite. Reviewing incident reports, interviewing key employees, and reading the SIC Code do not provide the nurse with as much information as walking through the worksite.

Which statement about physically compromised persons who are experiencing poverty is true? a. They are more likely to have access to needed services. b. They are at greater risk for more rapid progression of disease processes. c. Their care is usually better coordinated. d. They require more nursing in-home care than persons not living in poverty.

B People who are disabled and live in poverty are less likely to have the resources to provide for their own special needs. Those living in poverty are less likely to have access to needed services or coordinated care. Those living in poverty do not require more nursing in-home care than those who are not in poverty.

A nurse is identifying agents that are part of the epidemiologic triad. Which of the following will the nurse most likely identify? a. Environmental pollution b. Radiation c. Susceptible human beings d. High-risk groups of individuals

B Radiation is an example of an agent. The agents, factors associated with illness and injury, are occupational exposures that are classified as biological, chemical, enviromechanical, physical, or psychosocial. Environmental pollution is part of the environmental factor in the epidemiologic triad. Susceptible human beings and high-risk groups of individuals are part of the host factor of the epidemiologic triad.

A nurse is implementing a tertiary prevention strategy. Which of the following activities would the nurse most likely implement? a. Diabetes screening b. Rehabilitation for musculoskeletal injury c. Birth control d. Pregnancy testing

B Rehabilitation for musculoskeletal injury is an example of tertiary prevention. Diabetes screening and pregnancy testing are secondary prevention strategies, and birth control is a primary prevention.

Which is a requirement of the Superfund Amendment and Reauthorization Act (SARA)? a. Applying stricter rules to determine Superfund sites b. Sharing written disaster plans with key resources in the community c. Authorizing each industry to write their own disaster plan d. Evaluating the effectiveness of a written disaster plan

B SARA requires that written disaster plans be shared with key resources in the community, such as fire departments and emergency departments. SARA does not apply stricter rules, authorize each industry to write their own disaster plan, or evaluate the effectiveness of a written disaster plan.

The nurse is caring for children when they need health care. Which of the following levels of prevention is being used? a. Primary prevention b. Secondary prevention c. Tertiary prevention d. Health promotion

B Secondary prevention includes the screening of children for various illnesses, monitoring their growth and development, and caring for them when they are ill or injured. Primary prevention refers to those interventions aimed at preventing the occurrence of disease, injury, or disability. Tertiary prevention is the continued care of children who need long-term health care services, along with education within the community.

A nurse collects evidence from a victim following a sexual assault. Which of the following levels of prevention is being used? a. Primary prevention b. Secondary prevention c. Tertiary prevention d. Assessment

B Secondary prevention occurs following the occurrence of injuries and crime. This includes direct care provided to victims and perpetrators as well as the collection of evidence. Primary prevention focuses on preventing violence and injuries before they occur. If disability, incarceration, or death occurs, tertiary prevention is applied in settings appropriate to address rehabilitation or identify factors that have put individuals at risk.

An employee who is blind brings a service animal to work. Which of the following legislative acts includes this provision? a. The Rehabilitation Act of 1973 b. The Americans with Disabilities Act of 1990 c. The Individuals with Disabilities Education Act of 1975 d. The Developmental Disabilities Act and Bill of Rights Act of 2000

B Service animals are defined and protected under the Americans with Disabilities Act of 1990. Service animals are working animals that are individually trained to perform tasks for persons with disabilities. This legislation allows service animals to accompany a disabled person into all areas open to the general public. The Rehabilitation Act of 1973 was the first legislation designed specifically to eliminate discrimination against the disabled; it required all federal agencies and programs receiving federal funds to hire disabled workers. The Individuals with Disabilities Education Act of 1975 guarantees all children with disabilities ages 3 through 21 the right to a free and appropriate public school education that will meet their individual needs. The Developmental Disabilities Act and Bill of Rights Act of 2000 requires the Administration of Developmental Disabilities under the U. S. Department of Health and Human Services (USDHHS) to ensure that people with developmental disabilities and their families receive the services and support that they need.

Which legislation required that schools make allowances to balanceeducational and health care needs of children with special needs? a. Rehabilitation Act b. Individuals with Disabilities Education Act c. No Child Left Behind d. Education for All Handicapped Children Act

B The Individuals with Disabilities Education Act guarantees educational services. The Rehabilitation Act states that children cannot be excluded from schools because of a handicap. No Child Left Behind states that all children must receive standardized education in a healthy environment. Education for All Handicapped Children states all children should attend school in the least restrictive environment.

The National Association of School Nurses (NASN) recommends which educational preparation for school nurses? a. Licensed practical nursing b. Bachelor of science in nursing (BSN) and certification in school nursing c. School nurse practitioner d. Master of science in nursing with specialization in school nursing

B The NASN recommends that school nurses be registered nurses (RNs) with BSNs and special certification in school nursing. Licensed practical nursing education is insufficient. School nurse practitioner and master of science in nursing with specialization in school nursing exceeds the minimum recommendations for school nurses.

A nurse is caring for a client who has a disability. Which of the following would be the correct way to refer to this individual? a. A handicapped person b. A person who has an amputation c. An amputee d. A wheelchair-bound afflicted person

B The Person First Movement advocates for political correctness in defining persons with disabilities. In other words, refer to a "woman who is blind" rather than a "blind woman" or a "person with diabetes" rather than a "diabetic."

A bioterrorism attack has occurred in the United States. Which of the following programs would be used to provide large quantities of medications to the American public? a. Cities Readiness Initiative b. Strategic National Stockpile (SNS) c. Public Health Information Network (PHIN) d. Project BioShield

B The SNS has the capacity to provide large quantities of medicine and medical supplies to protect the American public in a public health emergency. The Cities Readiness Initiative aids cities in increasing their capacity to deliver medicines and medical supplies during a public health emergency. The PHIN helps ensure information access and sharing. Project BioShield is a program to develop and produce new drugs and vaccines against potential bioweapons.

A nurse researcher wants to get information on the occurrence of an internationally important disease. Which of the following websites would be the best place to seek this information? a. The United Nations b. The WHO c. The World Bank d. The World Health Assembly

B The WHO publishes day-to-day information about international occurrence of disease, injury, and death. The United Nations deals with human rights, world peace, international security, and the promotion of economic and social advancement of all of the world's people. The World Health Assembly is the WHO's policy-making body. The World Bank provides funding for lesser- developed countries.

A nurse is employed in an occupational health setting. Which of the following activities would be a primary role of the nurse? a. Caring for employees and their families b. Providing health promotion and emergency care c. Updating the Material Safety Data Sheets (MSDSs) d. Reporting communicable diseases

B The customary role of the occupational health nurse extends beyond emergency treatment and prevention of illness and injury and also includes the promotion and maintenance of health, overall risk management, care for the environment, and efforts to reduce health-related costs in business. The occupational health nurse does not typically care for families of employees, update MSDSs, or report communicable diseases.

A nurse is employed by the U.S. Department of Health and Human Services (USDHHS). Which of the following branches of government is the nurse working for? a. Judicial b. Executive c. Legislative d. Health

B The executive branch includes regulatory departments, one of which is the USDHHS. The judicial branch is composed of a system of federal, state, and local courts guided by the opinions of the Supreme Court. The legislative branch is made up of the Senate and the House of Representatives, whose members are elected by the citizens of particular geographic areas. There is not a health branch of the government.

The leading cause of death in children and teenagers is: a. leukemia. b. injuries. c. suicide. d. diabetes.

B The leading cause of death in children and teenagers is injuries.

Which statement about migrant and seasonal farm workers is true? a. There are more than 10 million working in the United States. b. The majority are Mexican. c. Most are employed in the Northeastern states. d. Thirty-five percent are undocumented workers.

B The majority of migrant farm workers are foreign-born (72%) and predominantly Mexican (68%). Estimates suggest there are approximately 1.0 to 1.8 million hired farmworkers. Five states account for 65% of all farm workers: (1) California, (2) Florida, (3) Washington, (4) Oregon, and (5) North Carolina. Of the migrant and seasonal farmworkers, 52% have legal authorization to work in the United States.

A forensic nurse has collected trace evidence. Which of the following best describes what has been collected? a. Fingerprints b. Bloodstains c. Hand gun d. Autopsy report

B The most common types of trace evidence from victims of violence are clothing, bullets, bloodstains, hairs, fibers, and small pieces of material, such as fragments of metal, glass, paint, and wood.

A school nurse is coordinating the health care for children with complex health problems. Which of the following roles is being implemented? a. Health educator b. Case manager c. Consultant d. Counselor

B The nurse may perform the role of case manager for the child who is disabled or chronically ill needing to see many health care providers. The role of case manager is used when coordinating the health care of students with complex health problems. The role of health educator is used when teaching students about the importance of proper nutrition. As a consultant, the school nurse can provide professional information about proposed changes in the school environment and their impact on the health of the children. As a counselor, the school nurse may be the person whom the children trust to tell important secrets about their health.

An occupational health nurse is involved in disaster planning. Which of the following actions would be most appropriate for the nurse to take? a. Assess for possible disasters b. Prevent injuries and death of workers c. Store Medical Data Sheets in a safe place d. Collaborate with government authorities to plan disaster management

B The occupational health nurse is a key player in occupational disasters. The goals of a disaster plan are to prevent or minimize injuries and deaths of workers and residents, minimize property damage, provide effective triage, and facilitate necessary business activities. A disaster plan requires the cooperation of different personnel within the company and community. There are not Medical Data Sheets rather MSDSs.

When planning, delivering, and financing responsibility for programs is shifted from the federal level to the state level, it is called: a. evolution. b. devolution. c. block granting. d. state administration.

B The process of shifting the responsibility for planning, delivering, and financing programs from the federal level to the state level is called devolution. This was a major effort during the Reagan administration. Block grants have increased because of devolution. State administration does not describe this shift of responsibility; rather it describes who is administering the program. Evolution describes how something is gradually developed.

A nurse is employed in the school setting. Which of the following activities would the nurse most likely perform? a. Care for children who are home sick from school b. Coordinate the health education program of the school c. Facilitate school attendance for students with communicable diseases d. Schedule appointments to specialists for students with chronic disease

B The school nurse's role is comprehensive and often involves coordinating activities, such as coordinating the school health program. A common misperception is that school nurses only put bandages on cuts and soothe children with stomachaches. However, that is not their major role. School nurses give comprehensive nursing care to the children and the staff at the school. At the same time, they coordinate the health education program of the school, consult with school officials to help identify and care for other persons in the school community, and provide leadership in promoting health and safety.

A nurse is examining the future of disaster management. Which of the following should the nurse anticipate? a. Vague and unorganized future due to constant emergence of new disasters b. Increasing sophistication in technology and surveillance c. Lack of involvement by national and state officials d. Decreasing need for public health workers to provide care

B The terrorist event of September 11, 2001, and the anthrax cases have increased the awareness for the need to plan for disasters. Technology and surveillance will continue to advance. Disaster management continues to change and become more organized as learning occurs after each incident, producing progressive best practices. National and state officials are very involved in disaster management. PHNs are particularly critical members of the multidisciplinary disaster health team given their population-based nursing focus and specialty knowledge in epidemiology and community assessment skills.

When would it be appropriate for a nurse to use a Geographic Information System (GIS)? a. Recording client data collected at a foot clinic b. Determining neighborhoods that have an increased incidence of lead poisoning c. Evaluating effectiveness of a farm safety program d. Scheduling health promotion programs in the community

B The use of a GIS allows the PHN to apply the principles of epidemiology into practice. GIS allows nurses to code data so that it is related spatially to a place on earth and is helpful in determining concentrated areas for incidence of disease and illness. An electronic health record (EHR) would be the most appropriate place to record client data from a foot clinic. Evaluation of effectiveness of a farm safety program would need to be done through some type of assessment or evaluation method—GIS would not be useful to collect this data. GIS is not a scheduling system and would not be helpful when scheduling health promotion programs in the community.

Acts of bioterrorism or natural disasters, such as earthquakes, will often have more casualties because: a. they cause the most widespread destruction. b. victims have little time to make evacuation preparations. c. those with chronic conditions cannot escape in time. d. the early warning systems are not effective.

B The use of weapons of mass destruction or natural disasters, such as earthquakes, will often have more casualties because victims have little time to make evacuation preparations. The other answers are false.

A nurse is implementing the Centers for Disease Control and Prevention (CDC) School Health Program within a school. Which components of school health will need to be evaluated? (Select all that apply.) a. Health promotion for students b. Nutrition services c. Counseling, psychological, and social services d. Health education e. Community safety

B, C, D Components of the CDC School Health Program includes health education, physical education, health services, nutrition services, counseling, psychological, social services, healthy school environment, health promotion for staff, and family/community involvement.

A nursing student is researching various health care services that are provided in prisons. Which of the following describes these services? a. Funded by the DOD b. Focus on health promotion interventions c. Must be provided at an adequate level d. Are available to those diagnosed with a chronic illness

C Health care services for prisoners are required at an adequate level for all incarcerated individuals. This is administered by the DOJ. Prisoners will receive health care services when diagnosed with chronic illnesses as well as acute illnesses.

A nurse is assessing for environmental health risks in the community. Which of the following approaches would be most appropriate for the nurse to use? (Select all that apply.) a. Ask legislators to provide a list of environmental pollutants in the area b. Develop a list of exposures associated with urban, rural, or suburban settings c. Assess the risk by medium such as air, water, soil, or food d. Divide the environment into functional locations: home, school, workplace, and community e. Recruit community members to sign a petition to decrease pollution

B, C, D Developing a list of exposures associated with urban, rural, or suburban settings, assessing the risk by medium such as air, water, soil, or food, and dividing the environment into functional locations: home, school, workplace, and community are ways a nurse can assess the environment. Asking legislators for a list of pollutants or recruiting community members to sign a petition are not effective means to assess for environmental health risks.

A nurse is working with individuals who meet the definition of work disability as defined by the United State Census Bureau. Which of the following best describes these individuals? (Select all that apply.) a. An individual who has resigned from a position because of discrimination b. An individual who has retired or left a job for health reasons c. An individual who did not work because of long-term mental illness d. An individual who did not work in the past 12 months because of illness e. An individual who has recently been terminated

B, C, D Work disability includes a person who has a problem or disability that prevents him or her from working, has a service-connected disability, has retired or left a job for health reasons, did not work because of long-term physical or mental illness, or did not work in the past 12 months because of illness or disability.

Which is considered a forensic environment? (Select all that apply.) a. Crime scene b. Courtroom c. Mental health nursing unit d. Prison e. Emergency department

B, D Forensic environments include courtrooms, jails, prisons, and psychiatric facilities for the criminally insane.

A nurse is writing to a legislator to advocate for funds to support advanced practice nursing education. Which of the following considerations should be made by the nurse? (Select all that apply.) a. Limit the letter to one page in length b. Identify oneself as a nurse c. Provide only factual information d. Share personal knowledge about the issue e. Arrange a face-to-face meeting as soon as possible

B, D When writing to a legislator, the letter should be a maximum of two pages in length and opinions should be expressed. Additionally, the nurse should identify oneself as a nurse and share knowledge about the issue.

A nurse responds to a natural disaster. Which of the following is the nurse most likely responding to? a. Transportation accident b. Pollution c. Communicable disease epidemic d. Fire

C A communicable disease epidemic would be considered a natural disaster. Transportations accidents, pollution, and fire are considered human-made disasters.

A school nurse is preparing to administer a prescription medication to a student. Which of the following information is necessary for the nurse to have? a. A copy of the prescription label on bottle b. A small container for the medication c. Signed consent parental consent form d. A signed order from the physician

C A current, signed parental consent form for administering the medication is essential for the student's file. The prescribed drug must have the original prescription label on it and be in the original container so that there are no errors. It is recommended that the physician contacts the school nurse or vice versa, but a signed order from the physician is not necessary.

What effect does alcohol consumption have on migrant farm workers? a. Provides relaxation and is important for migrant workers' well-being b. Adds additional risks to pesticide exposure c. Poses safety hazards for farm workers d. Allows migrant workers to sleep better, thus improving daytime productivity

C Alcohol can contribute to farm-related injuries. Drug and alcohol use has been identified as a significant source of stress. Alcohol can also contribute to health problems, greater risk for human immunodeficiency virus (HIV), violence in camps/home sites, domestic violence, and decreased funds for personal and family needs.

A nurse is assessing persons arriving at an alternate care center following a disaster. Which of the following actions should the nurse take first? a. Assess the amount of equipment and medications needed for each client b. Determine if the client has a psychological condition requiring special attention c. Assess whether this type of facility is appropriate for the client d. Determine if the client has a support system to assist with additional care needs

C Alternate care centers may be used to shelter patients with medical needs designated as "non-ambulatory care/hospital overflow" e.g., care of non-ambulatory patients with less intense medical needs. After determination of the appropriateness of the facility, the nurse can then provide medical care as needed. It should not be necessary to initially determine if the client has a psychological condition or limit the amount of equipment or medications.

A nurse who is working in a home care setting attends a local legislative meeting. Which of the following best describes why the nurse needs to be knowledgeable of health policy? a. Provide safe nursing care b. Prevent elder abuse c. Receive payment for the services provided d. Influence future legislation

C Although nurses should be involved in influencing future legislation by contacting their legislators, the best response is that nurses need to be knowledgeable of the current health policies needed so that payment can be received for services they are providing. Health policy does not address safe nursing care provision. Prevention of elder abuse can be part of health policy, but this is not the main reason why nurses should have this knowledge.

A school nurse is providing health information to school administrators, teachers, and parent-teacher groups. Which of the following roles is being implemented? a. Health educator b. Case manager c. Consultant d. Counselor

C As a consultant, the school nurse provides health information to various school groups. The role of case manager is used when coordinating the health care of students with complex health problems. The role of health educator is used when teaching students about the importance of proper nutrition. As a counselor, the school nurse may be the person whom the children trust to tell important secrets about their health.

A nurse maintains current information about agencies whose services are of potential use to the disabled and directs clients to the resources that can meet their needs. Which of the following roles is being demonstrated? a. Educator b. Caregiver c. Referral agent d. Advocate

C As a referral agent, the nurse directs clients to the resources that can meet their needs. A nurse speaking on behalf of others who are unable to speak for themselves is performing the role of advocate. In the caregiver role, the nurse provides direct care to the client. Nurses serve as educators who provide clients at any level with sufficient knowledge to enable them to care for their own needs.

A nurse fulfills the environmental health competency of "assessment and referral." Which of the following actions has the nurse most likely completed? a. Advocating for public policy changes b. Understanding policy framework and major pieces of legislation c. Completing an environmental health history d. Describing the scientific principles about environmental health

C Assessment and referral states that all nurses should be able to successfully complete an environmental health history, recognize the potential environmental hazards and sentinel illnesses, and make appropriate referrals for conditions with probably environmental causes. Advocating for public policy changes is part of advocacy. Understanding policy framework and legislation is part of legislation and regulation. Describing the scientific principles of environmental health is part of basic knowledge and concepts.

An occupational health nurse has conducted a walk-through assessment and has identified potential hazards in the workplace. The nurse recognizes that it will be easiest to modify exposure to which hazard? a. Bacteria b. Aerosols c. Noise d. Burnout

C Controlling physical agents, such as noise, can usually be accomplished through engineering strategies and personal protective equipment. It is much harder to change biological agents (bacteria), chemical agents (aerosols), and psychosocial agents (burnout).

An occupational health nurse refers an employee to an employee assistance program. Which of the following problems would most likely be addressed? a. Obesity b. Smoking c. Alcohol abuse d. Lack of exercise

C Employee assistance programs are designed to address personal problems such as marital/family issues, substance abuse, or financial difficulties. These issues are addressed because they affect the employee's productivity. These efforts are cost-effective for businesses.

Epidemiology: a. is a science that studies the poisonous effects of chemicals. b. explains the association between learning disabilities and exposure to lead-based paint at the cellular level. c. helps nurses understand the strength of the association between exposure and health effects. d. is a method for tracking the prevalence of health outcomes.

C Epidemiology studies the incidence and prevalence of disease, helping nurses understand the strength of the association between exposure and health effects. Toxicology is the science that studies the poisonous effects of chemicals. Environmental surveillance provides data with which to track and analyze the incidence and prevalence of health outcomes. Epidemiology does not examine causes at the cellular level.

A nurse assesses the factors that may place a client at risk for injury from a violent act by considering the role these factors play before, during, and after the violent act. The work of which theorist is being applied? a. Matrix b. Maslow c. Haddon d. Hammer

C Haddon developed a matrix when examining methods to identify the risk of injury. The matrix looks at factors related to personal attributes, vector or agent attributes, and environmental attributes before, during, and after an injury or death. Hammer recognized that in forensic nursing practice, the caring component must address caring for oneself as well as caring for clients. Maslow's theory focuses on clients' meeting their hierarchy of needs.

A nurse is providing direct client care while working in a correctional setting. Which of the following levels of prevention is being used? a. Primary prevention b. Secondary prevention c. Tertiary prevention d. Assessment

C If disability, incarceration, or death occurs, tertiary prevention is applied in settings appropriate to address rehabilitation or identify factors that have put individuals at risk. Primary prevention focuses on preventing violence and injuries before they occur. Secondary prevention occurs following the occurrence of injuries and crime. This includes direct care provided to victims and perpetrators as well as the collection of evidence.

Which population would have been the focus of care for an occupational health nurse in the early 1900s? a. Injured workers b. All workers c. Families d. The community

C In the early days of occupational health nursing, the nurse's work was holistic and centered on the family. The care provided by Betty Moulder and Ada Mayo Stewart focused on both ill workers and their families.

A nurse identifies a child who may be abused or receives information from a teacher that a child may have been abused. Which of the following actions must the nurse take? a. Call the police immediately to take the child to a safe place b. Contact the parents and ask about it c. Contact the legal authorities as well as the school's principal d. Examine the child to see if the abuse really occurred

C It is the law in most states for child abuse or suspected child abuse to be reported. When a nurse identifies a child who may be abused, or receives information from a teacher about potential abuse, the nurse must contact the appropriate legal authorities as well as the school's principal. A confidential file should be made about the incident. In all cases, the child must be protected from harm, and those who have no right to know that child abuse or neglect is suspected should not be given any information.

Which statement about chemical agents is accurate? a. Chemicals are not ordinarily found in the body tissues of the general population. b. Most chemicals have been studied to determine the effects of exposure on humans. c. Chronic exposure to low-level doses of workplace chemicals below standards constitutes a potential health risk. d. Human effects of chemical exposure are associated with single agents rather than with the interaction of agents.

C It is true that chronic exposure to low-level doses of workplace chemicals below standards constitutes a potential health risk. Most chemicals have not been studied epidemiologically to determine the effects of exposure on humans. As a consequence of general environmental contamination with chemicals from work, home, and community activities, a variety of chemicals have been found in the body tissues of the general population. Predicting human responses to chemical exposures are complicated because multiple chemicals often combine and interact to create a new chemical agent.

A nurse is sued for malpractice and goes to court. Which of the following types of law is being used? a. Constitutional b. Common c. Judicial d. Institutional

C Judicial law is based on court or jury decisions. Constitutional law provides overall guidance for selected practice situations. Common law means that judges are bound by previous decisions unless they are convinced that the older law is no longer relevant or valid. Institutional law is not a type of law that has particular importance in the United States.

Which types of industries are noted for high degrees of hazards associated with the work? a. Data entry, animal rescue, and hospice b. Engineering, science, and laboratories c. Manufacturing, mining, and agriculture d. Aeronautics, plastics, and nursing

C Manufacturing, mines, construction, and agriculture are noted for their high degree of hazards associated with their work. However, no worksite is free of occupational health and safety hazards.

A nurse may need to use medical coercion with a client. Which of the following medical diagnoses would the client most likely have? a. Human immunodeficiency virus (HIV) b. Depression c. Schizophrenia d. Hypertension

C Medical coercion may be necessary in certain situations. These situations include incapacity to make decisions and making decisions that could result in harm to self or harm to others in the absence of interventions. For instance, mentally ill inmates may be medically coerced to take psychotropic medications against their will if the mental disorder is serious, the inmate is dangerous to himself, and the medication prescribed is in the inmate's best medical interest. Schizophrenia is the diagnosis most likely to require medical coercion.

The greatest single source of air pollution in the United States is from: a. waste incineration. b. power plants. c. motor vehicles. d. molds.

C Mobile sources such as cars and trucks are the greatest single source of air pollution in the United States. Waste incineration and power plants are major contributors after motor vehicles. Molds contribute to poor indoor air quality.

A nurse works at the individual level to reduce pollution in the environment. Which of the following actions would most likely be taken by the nurse? a. Provide a tax incentive to factories that do not pollute b. Make laws related to allowed levels of pollution in the area c. Recycle paper, glass, cans, and plastic d. Move to an area with less pollution

C Nurses can reduce pollution by doing their part, which can include choosing to recycle paper, glass, cans, and plastic. Providing a tax incentive and creating laws would not be completed at the individual level to reduce pollution in the environment. Moving to an area with less pollution would not help to improve the problem.

A nurse is assessing the occupational health risks of a migrant farm worker. Which health risk is the nurse most likely to find? a. Denial of care when going to the emergency room b. Difficulty obtaining affordable health insurance c. Increased exposure to chemicals and work-related injuries d. Episodic violence from farm owners and employers

C Occupational health risks for migrant farm workers include working conditions, exposure to chemicals, and using machinery. Denial of care and difficulty obtaining health insurance are not occupational health risks. Episodic violence from farm owners is not a known occupational health risk.

A nurse is addressing the problem of air pollution in the community. Which of the following would be the first step the nurse would take? a. Setting standards b. Monitoring c. Permitting d. Compliance

C Permitting is a process by which the government places limits on the amount of pollution emitted into the air or water. Environmental standards may describe a permitted level of emissions, a maximum containment level, an action level for environmental cleanup, or a risk-based calculation. Monitoring is an ongoing process after an action has happened. Compliance refers to the processes for ensuring that permit/standard/regulatory requirements are met.

A nurse implements a health promotion education program for physically compromised adults. Which of the following would be the most important reason to provide programming for this population? a. Health promotion interventions are similar among those with disabilities. b. Establishment of health-promoting behaviors is difficult. c. Information and counseling is needed to prevent other health problems. d. Community resources can be accessed through these presentations.

C Physically compromised clients need information and counseling for health-promoting behaviors and for prevention of the progression of a condition or pathology. Primary prevention is the most important strategy so that other conditions do not occur. Health promotion strategies may be different depending on the condition. Information about community resources can be provided during the presentation, but they would not be able to be accessed during the presentation. It may be difficult for the client to establish health-promoting behaviors; however, this does not explain why these presentations are important.

A nurse is a political advocate for the migrant population. Which of the following best describes the action being taken by the nurse? a. Upholding immigration laws and deporting illegal aliens b. Passing laws to improve the living conditions of migrant farm workers c. Educating communities about the health problems of migrant farm workers d. Learning to speak Spanish for better communication with migrant farm workers

C Political advocacy can include educating communities about these individuals. This education helps to provide legislators and policy makers at local, state, and national levels with the information needed to make policy decisions.

The practices of physicians, nurses, and other health care providers are differentiated by which of the following? a. Health Resource and Services Administration (HRSA) b. State board of nursing c. Scope of practice d. USDHHS

C Scope of practice involves defining nursing, setting its credentials, and then distinguishing between the practices of nurses, physicians, and other health care providers. HRSA and USDHHS do not differentiate the practices of health care providers. The state board of nursing only addresses the scope of practice of nursing, not the other health care providers.

A nurse in the occupational health arena is implementing a secondary prevention strategy. Which of the following best describes the action that was taken by the nurse? a. Providing education on safety in the workplace to prevent injury b. Working with chronically diabetic workers to ensure appropriate medications c. Screening for hearing loss resulting from noise levels in the plants d. Ensuring that a person with cardiovascular disease attends a rehab program

C Secondary prevention occurs after a disease process has already begun—screening for hearing loss. Tertiary prevention includes those interventions aimed at disability limitation and rehabilitation from disease, injury, or disability—working with chronically diabetic workers and ensuring that a person with cardiovascular disease attends rehab. Primary prevention is aimed at prevention of a disease before it occurs—providing education on safety in the workplace to prevent injury.

An employer offers a limited duty program after an employee has experienced a cumulative trauma injury. Which of the following levels of prevention is being implemented? a. Primary prevention b. Secondary prevention c. Tertiary prevention d. Assessment

C Tertiary prevention includes those interventions aimed at disability limitation and rehabilitation from disease, injury, or disability—limited duty program after injury. Primary prevention refers to those interventions aimed at preventing the occurrence of disease, injury, or disability. Secondary prevention occurs after a disease process has already begun.

A nurse is providing ongoing care to a pregnant teenager. Which of the following levels of prevention is being used? a. Primary prevention b. Secondary prevention c. Tertiary prevention d. Health promotion

C Tertiary prevention is the continued care of children who need long-term health care services, along with education within the community. Ongoing care to a pregnant teenager is part of tertiary prevention. Secondary prevention includes the screening of children for various illnesses, monitoring their growth and development, and caring for them when they are ill or injured. Primary prevention refers to those interventions aimed at preventing the occurrence of disease, injury, or disability.

Which environmental law sets basic structure for regulating pollutants to United States waters? a. Safe Drinking Water Act b. Toxic Substance Control Act c. Clean Water Act d. Pollution Prevention Act

C The Clean Water Act sets basic structure for regulating pollutants to United States waters. The Safe Drinking Water Act authorized the EPA to establish safe standards of purity and required all owners or operators of public water systems to comply with primary standards. The Toxic Substance Control Act gives the EPA the ability to track the 75,000 industrial chemicals currently produced or imported into the United States. The Pollution Prevention Act focused industry, government, and public attention on reduction of the amount of pollution through cost-effective changes in production, operation, and use of raw materials.

A nurse is interested in census data. Which federal department's website would be a good place to start? a. Department of Labor (DOL) b. USDHHS c. Commerce Department d. World Health Organization (WHO)

C The Commerce Department handles the United States Census and population estimates and projections. The DOL has information about the consumer price index, employment, and earnings. The USDHHS has information about the national vital statistics and several health-related surveys. The WHO has statistics about world health.

Employees working with hazardous chemicals have the "Right to Know" about the chemicals they are working with through the creation of the: a. Material Safety Data Sheet (MSDS). b. Consumer Confidence Report. c. Hazard Communication Standard.

C The Hazard Communication Standard requires employers to maintain a list of all hazardous chemicals that are used on site. Each of the chemicals should have an associated chemical information sheet known as an MSDS, which is written by the chemical manufacturer. Consumer Confidence Reports summarize the results of the annual testing of the public water supply. The EPA sets forth policies, regulations, and public laws for the safety of the environment and the population.

What is the most common disability occurring in the United States in persons aged 18 years and older? a. Diabetes b. Stroke c. Arthritis d. Cancer

C The most common disability found in the United States in persons aged 18 years and over is arthritis. Diabetes continues to be the leading cause of kidney failure, non-traumatic lower-extremity amputations, and blindness among adults ages 20 to 74. Stroke and cancer are not among the leading causes of disability.

Which was the first legislation that specifically required certain prevention programs for workers? a. Occupational Safety and Health Act b. NIOSH c. Mine Safety and Health Act d. SIC Code

C The Mine Safety and Health Act was enacted in 1968. It was the first legislation that specifically required certain prevention programs for workers. The Occupational Safety and Health Act established OSHA and NIOSH to carry out the Act's purpose of ensuring "safe and healthful working conditions for working men and women." NIOSH examines potential hazards of new work technologies and practices. The SIC Code did not require certain protection programs fo workers.

What is the main purpose of the National Center for Injury Prevention and Control? a. Assist victims of violence b. Maintain records of the incidence of injuries c. Coordinate the prevention of injuries, violence, and their consequences d. Encourage collaboration among professionals from various disciplines

C The National Center for Injury Prevention and Control was established to coordinate the prevention of injuries, violence, and their consequences. The work of this center includes providing grants that fund prevention programs, dissemination of research findings, and maintenance of a website, blogs, podcasts, and electronic newsletters. This funding helps to inform the public of the epidemiology of injury and to provide other resources for professionals.

What is the purpose of the National Incident Management System (NIMS)? a. Create a new branch of government that deals with bioterrorism b. Establish a way for the Red Cross to carry out its mission c. Develop a nationwide all-hazards approach to domestic incident management d. Extend presidential power to act quickly upon acts of bioterrorism

C The National Response Framework is a unified, all-discipline, all-hazards approach to domestic incident management. It is built upon scalable, flexible, and adaptable coordinating structures to align key roles and responsibilities linking all levels of government and organizations. The Homeland Security Act of 2002 created a new branch of government that deals with bioterrorism, the U.S. Department of Homeland Security. The NIMS did not impact the Red Cross or extend presidential power to act upon bioterrorism.

The Office of Homeland Security has a mission to rebuild the crumbling public health infrastructures of each state and provide: a. vaccines for smallpox, anthrax, and plague. b. regulation of nuclear weapons. c. surveillance of bioterrorism threats. d. regulation of foreign nurses entering the United States.

C The USDHHS and the federal agency, the Office of Homeland Security, have provided funds to address serious bioterrorism threats to the people of the United States. The Office of Homeland Security does not provide vaccinations, regulation of nuclear weapons, or regulation of foreign nurses entering the United States.

Which legislation changed the availability of federal services accessible to certain immigrants to the United States? a. Migrant Health Act of 1962 b. Supplemental Security Income (SSI) c. Welfare reform legislation of 1996 d. Food stamps

C The Welfare reform legislation of 1996 changed the availability of federal services accessible to certain immigrants in the United States. The Migrant Health Act provides funds for primary and supplemental health services to migrant workers and their families. Because of the welfare reform legislation of 1996, many legal immigrants and unauthorized immigrants are ineligible for services such as SSI and food stamps.

A nurse is found to be negligent. Because of the doctrine of respondeat superior, who is responsible for the negligence? a. Administrator b. Nurse's immediate supervisor c. Nurse's employer d. Nurse

C The doctrine of respondeat superior says that when a nurse is employed and functioning within the scope of that job, the one responsible for that negligence is the nurse's employer. In some instances, if the agency is found liable, the agency may in turn sue the nurse for negligence.

Which example contains the components necessary to form an epidemiologic triangle? a. Pesticides, water, food b. Lead, mercury, soil c. Trichloroethylene, water, infants d. Children under 12, elderly, temperature

C The epidemiologic triangle consists of an agent (chemical), host (community consisting of several variants), and environment (air, water, soil, etc.). The other examples do not contain an agent, host, and environment.

The first major federal government action relating to health was the: a. passage of the Social Security Act. b. creation of the National Institutes of Health (NIH). c. creation of the Public Health Service (PHS). d. creation of Medicare and Medicaid.

C The first major federal governmental action relating to health was the creation in 1798 of the PHS. The Social Security Act was passed in 1935. The NIH was founded in 1887. Medicare and Medicaid were created in 1965.

A nurse is completing the first phase of a risk assessment. Which of the following questions would the nurse most likely try to answer? a. Has the chemical been released into the environment? b. How much and by which route of entry can the chemical enter the body? c. Is the chemical known to be associated with a negative health effect? d. What is the prediction for potential harm?

C The first phase is determining if a chemical is known to be associated with negative health effects (in animals or humans): Is the chemical known to be associated with a negative health effect? The second step is determining if the chemical has been released into the environment: Has the chemical been released into the environment? The third step is estimating how much and by which route of entry the chemical might enter the human body: How much and by which route of entry can the chemical enter the body? The final step takes into account the previous steps: What is the prediction for potential harm?

A nurse would like to propose legislation requiring all schools to employ a registered nurse. Which of the following would be the first step taken as the nurse implements the legislative process? a. Introducing the bill to the legislature b. Moving the bill to the other house c. Developing the policy option into a bill d. Hearings, testimony, and lobbying

C The first step in the legislative process is developing the policy option into a bill. This is then followed by introducing the bill to the legislature; hearings, testimony, and lobbying; and the bill moving to the other house.

A nurse investigates the interpretation of a state's right to grant abortions. Which of the following branches of government would the nurse be looking at? a. Executive b. Legislative c. Judicial d. Federal

C The judicial branch interprets laws and their meaning, as in its ongoing interpretation of states' rights to define access to reproductive health services for citizens of the states. The executive branch suggests, administers, and regulates policy. The legislative branch identifies problems and proposes, debates, passes, and modifies laws to address those problems. The federal branch refers to the top level of government agencies.

A nurse is conducting an occupational health assessment. Which of the following best describes the rationale for this assessment? a. It is required by OSHA. b. It is required by NIOSH. c. It helps to identify agent and host factors that place employees at risk. d. It helps to educate workers about potential hazards.

C The purpose of this assessment is to become knowledgeable of the work processes and the materials, the requirements of various jobs, the presence of actual or potential hazards, and the work practices of employees. This assessment allows the nurse to identify agents and host factors that place employees at risk. An occupational health assessment is not required by any organization.

A child's parents have requested that their child be exempt from obtaining the required immunizations for a religious reason. What action should a school nurse take related to this request in order to be compliant with the law? a. Deny entry into school for children without the required immunizations b. Educate the parents about the need for immunizations c. Be aware of the state laws regarding acceptable reasons for exemption d. Allow the student to attend school without the immunizations

C The state mandates the rules about having immunizations that the nurse must follow. Thus, it is the responsibility of the school nurse to be aware of the laws in the state regarding acceptable reasons for immunization exemption.

A nurse is assessing host factors as part of the epidemiologic triad. Which of the following factors would the nurse most likely assess? a. Crowding b. Shift work c. Worker's family d. Chemical exposure

C The worker's family is considered a part of the host factor. Crowding and shift work are environmental factors, and chemical exposure is the agent factor.

How would a registered nurse become a forensic nurse? (Select all that apply.) a. No additional education is needed after obtaining an undergraduate nursing degree b. Complete additional course work in police science c. Enroll in a certificate program for forensic nursing d. Select a graduate program that offers a track in forensic nursing e. Complete a nurse practitioner program

C, D There are three primary routes for training in forensic nursing. Additional skills and knowledge can be gained through continuing education courses or basic concepts introduced in generalist education. Certificate programs and graduate programs offer additional opportunities to specialize in forensic nursing.

The nurse organizes developmental vision and hearing screening of young children to identify those with disabilities. Which of the following roles is being performed by the nurse? a. Caregiver b. Coordinator c. Collaborator d. Case finder

D A nurse as a case finder identifies individuals with disabilities who need services. A nurse is responsible for assisting clients and families by organizing and integrating the resources of other agencies or care providers to meet the clients' needs most efficiently in the role of coordinator. Nurses are collaborators when they take part in joint decision making with clients, families, groups, and communities. In the caregiver role, the nurse provides direct care to the client.

A school nurse is teaching a group of teenagers about the dangers of using "club drugs." The nurse provides information that which drug may cause a very high body temperature leading to death? a. Gamma hydroxybutyrate (GHB) b. Rohypnol c. Alcohol d. Ecstasy

D A very high body temperature can lead to death when taking ecstasy. GHB, Rohypnol, and Ecstasy are known as "club drugs."

A city sets the standard of an acceptable level of emissions or a maximum contaminant level allowed for factories. Which of the following concepts is being applied? a. Controlling pollution b. Waste minimization c. Land use planning d. Environmental standard

D An example of an environmental standard is an acceptable level of emissions or a maximum contaminant level allowed. Although this does help to control pollution, environmental standard is best applied in this example. Setting a standard for emissions does not impact waste minimization or land use planning.

Which statement about migrant and seasonal farm workers is true? a. The economic status of migrant workers has improved over the last decade. b. This is a transient population that does not need nursing care. c. Most migrant workers are eager to accept health care services. d. Availability of food in the United States depends on these individuals.

D Availability and affordability of food in the United States depends on these individuals, yet their economic and social status has not changed significantly over the past decades. Most migrant workers do not seek out health care services.

An employee has come into contact with a biological agent. Which of the following considerations should be made by the nurse? a. The biological agent may cause accidents in the work environment. b. The biological agent is commonly found in the agriculture industry. c. The biological agent may potentiate stress in the workplace. d. The biological agent indicates exposure to bacteria, viruses, fungi, or parasites.

D Biological agents are living organisms whose excretions or parts are capable of causing human disease, usually by an infectious process. Biological hazards are common in workplaces such as health care facilities and clinical laboratories where employees are potentially exposed to a variety of infectious agents, including viruses, fungi, and bacteria.

Which of the following disorders has been identified as an occupational health risk for agricultural workers? a. Stroke b. Heart disease c. Diabetes d. Cancer

D Cancer is an identified but not well-documented health problem for migrant farm workers associated with their exposure to chemicals. Other identified health risks are musculoskeletal injuries, traumatic injuries, respiratory problems, dermatitis, infectious diseases, and eye problems.

A nurse is working with low-income disabled families who have young children. Which of the following considerations should be made by the nurse? a. The children who are at greatest risk for abuse have physical disabilities. b. The children who are at greatest risk for abuse have developmental delays. c. The children who are at greatest risk for abuse have mental retardation. d. The children who are at greatest risk for abuse have cognitive disabilities.

D Children with cognitive disabilities under the age of six and from low-income families are at the highest risk for abuse or neglect. Children who have developmental delays, mental retardation, or physical disabilities are not at increased risk.

Community preparedness is being used to plan for a disaster. Which of the following tasks is being implemented? a. Assembling emergency supplies b. Understanding the workplace disaster plan c. Taking a disaster training course d. Developing an evacuation plan to remove individuals from danger

D Community preparedness involves developing an evacuation plan to remove individuals from danger. Assembling emergency supplies is an example of individual preparedness. Understanding the workplace disaster plan is an example of preparedness in the workplace within the community. Taking a disaster training course is an example of professional preparedness.

A nurse uses the scope and standards for forensic nursing practice to differentiate this practice from other nursing specialties. Which parameter best describes the practice of forensic nursing? a. Assessment includes assessing the community for potential violence. b. Identification of outcomes of care are accomplished by collaborating with health care professionals. c. Coordination of care involves education and other strategies to prevent injuries well after the occurrence. d. Evaluation of outcomes relates to program evaluation.

D Coordination of care relevant to forensic outcomes often involves education and other strategies to prevent injuries well after the occurrence, perhaps after the death of an individual who has been injured. Assessment includes the collection of forensic data, identification of realistic outcomes of care are most commonly performed in collaboration with a team of professionals outside of nursing and medicine, and evaluation of outcomes may involve dissemination of results to the client and the community.

Developmental disabilities, which continue throughout a person's lifetime, start before which age? a. 7 b. 12 c. 17 d. 22

D Developmental disabilities are chronic impairments that occur during development, starting before age 22, and last throughout the person's lifetime.

A client has a developmental disability. Which of the following areas would the nurse anticipate limited functioning? a. Dependent living, education, and finances b. Race, gender, and ethnicity c. Care giving, dependence, and limitation d. Self-help, language, and learning

D Disabilities limit functioning in at least three of seven areas, including self-help, language, learning, mobility, self-direction, independent living, and economic self-sufficiency.

A nurse is participating in the preparedness stage of disaster management. Which of the following describes what is happening? a. Heightened inspection and increased security in the community b. Incorporation of provision of pets into local disaster plans c. Purchase of personal protective equipment for all citizens d. Assembly of disaster kits for the home, workplace, and car

D Disaster kit assembly for the home, workplace, and car, especially by nurses, occurs during the preparedness phase. Heightened inspection and increased security in the community is part of the prevention activities. Purchase of personal protective equipment for all citizens and incorporation of provision of pets into local disaster plans are not realistic plans for preparedness.

A forensic nurse assesses a child who has injuries that indicate possible abuse. What is the best way to document the assessment findings? a. Tape recorded statements from the child b. Digital photographs of injuries c. Video recording to record statements and show injuries d. Written documentation and photography

D Documentation of all forms of violence should include written documentation as well as photography.

A facility is inspected after it has obtained a permit. The inspection is completed for the purpose of observing whether the plans submitted in the permit application are being implemented as approved. Which of the following environmental protection strategies is being applied? a. Controlling pollution b. Waste minimization c. Land use planning d. Environmental monitoring

D Environmental monitoring would be an inspection of a facility after a permit is obtained to observe whether the plans submitted in the permit application are being implemented as approved. Permitting is an important step in controlling pollution. Waste minimization and land use planning are activities aimed at prevention of pollution.

A nurse believes additional funding is necessary to support a home-delivered meal program for the elderly. Which of the following would be the best way to share these ideas with a legislator? a. Send an e-mail b. Write a formal letter c. Attend a town hall meeting d. Schedule a face-to-face visit

D Face-to-face visits with legislators are viewed as the most effective means of communication. Sending an e-mail, writing a letter, and attending a town hall meeting are all ways to share ideas with a legislator but are not viewed as the most effective method for sharing.

How does Healthy People 2020 address persons with disabilities? a. Suggests specific therapies and techniques for working with this population b. Recognizes disabled individuals as productive citizens c. Recommends the development of community health centers d. Emphasizes increased access to services for this population

D Healthy People 2020 has a greater emphasis on increasing access to services that can increase independence and foster community living. Healthy People 2020 does not suggest specific therapies or techniques, recognize disabled individuals as productive or nonproductive citizens, or recommend the development of community health centers.

The most disabling occupational condition reported in 2011 was/were: a. cuts and punctures. b. fractures. c. bruises. d. sprains and strains.

D In 2011, sprains and strains were by far the most frequent disabling conditions, accounting for 38% of the cases of days away from work.

A nurse is planning to provide culturally effective care to Mexican migrant farm workers. Which of the following strategies should be used by the nurse? a. Learn how to speak Spanish to improve communication b. Understand that traditional beliefs and practices are more common among the well- educated population c. Consult the female head of household about health care matters d. Recognize that cultural backgrounds of the workers will vary depending on their place of origin

D It would be incorrect to assume that all Mexicans have the same cultural beliefs. The nurse must remember that beliefs and practices differ between regions and localities of a country, and among individuals. Mexico is a multicultural country; therefore, the cultural backgrounds of Mexican immigrants vary depending on their place of origin.

How have nurses historically learned to identify a possible relationship between environmental chemical exposures and their potential harm? a. Extrapolation by toxicologists b. Biomonitoring c. Completing chemistry courses d. Observing signs and symptoms in clients

D Nurses have historically made discoveries related to chemical exposure when people presented with signs and symptoms related to known chemical toxicity. Extrapolation by toxicologists and biomonitoring are modern methods. Completing a chemistry course does not show how to identify these possible relationships.

What is the purpose of OSHA? a. Educate occupational health and safety professionals b. Identify and research occupational health and safety hazards c. Distribute research findings relevant to occupational health and safety d. Educate employers about occupational health and safety

D OSHA educates employers about occupational health and safety. NIOSH identifies and researches occupational health and safety hazards, distributes research finding relevant to occupational health and safety, and educates occupational health and safety professionals.

A nurse takes action to protect the health, safety, and welfare of citizens, such as requiring immunizations of children before admission to school. Which of the following levels of power is being used? a. Executive b. Legislative c. Judicial d. Police

D Police power is state power concerning health care. This power allows states to act to protect the health, safety, and welfare of their citizens. Executive power comes as the executive branch suggests, administers, and regulates policy. Legislative power occurs as this branch of government identifies problems and proposes, debates, passes, and modifies laws to address those problems. Judicial power occurs as the judicial branch interprets laws and their meaning, as in its ongoing interpretation of states' rights to define access to reproductive health services for citizens of the states.

Which setting is a forensic nurse most likely to be employed? a. Physician's office b. Urgent care center c. School-based health center d. Medical examiner's office

D Practice arenas for forensic nurses include health care facilities such as private clinics and emergency departments, criminal justice centers for victims of crime, medical examiner offices, police departments, correctional facilities, and mental health centers.

A nurse is implementing a primary prevention strategy. Which of the following activities would the nurse most likely implement? a. Urine screening for pesticide exposure b. Tuberculosis (TB) skin testing c. Treatment of lead poisoning d. Reduction of pesticide exposure

D Reduction of pesticide exposure is an example of primary prevention. Urine screening and TB skin testing are secondary prevention, and treatment of lead poisoning is tertiary prevention.

A nurse is responding to a disaster. Which of the following is the priority of the disaster response? a. Clean up the environment b. Handle the stress reaction of the victims c. Bring in as many aid workers and nurses as possible d. Reestablish sanitary barriers and focus on basic needs

D Reestablishing sanitary barriers and focusing on water, food, waste disposal, vector control, shelter, and safety are the first goals. After this has been established, the nurse can address the cleanup of the environment, the stress reactions of the victims, and the need to bring in additional workers.

A PHN is organizing a multidisciplinary team to address the issue of water pollution in the community. The most likely members that would be invited to address this issue would be: a. physicians, water sanitation workers, and occupational therapists. b. pharmacologists, radiologists, and epidemiologists. c. nurse practitioners, pharmacologists, and environmentalists. d. geologists, meteorologists, and chemists.

D Scientists who study how pollutants travel in air, water, and soil are geologists, meteorologists, and chemists. The other professionals are not experts in the area of water pollution in the community.

A nurse experiences a stress reaction while working with the survivors of a disaster. Which of the following best describes what has happened? a. The nurse makes decisions to assist with care coordination of the survivors. b. The nurse tells the supervisor of the disaster the details of the care that was provided. c. The nurse cries after returning home at the end of the day. d. The nurse refuses to follow orders.

D Symptoms that may signal a need for stress management assistance include the following: being reluctant or refusing to leave the scene until the work is finished; denying needed rest and recovery time; feelings of overriding stress and fatigue; engaging in unnecessary risk-taking activities; difficulty communicating thoughts, remembering instructions, making decisions, or concentrating; engaging in unnecessary arguments; having a limited attention span; and refusing to follow orders.

The focus of the Division of Nursing is to: a. enhance nursing's competence in providing high-tech skills. b. apply disease prevention, environmental health, and health promotion concepts. c. provide scholarships for advanced nursing education. d. ensure an adequate supply and distribution of qualified nursing personnel to meet the nation's health needs.

D The Division of Nursing is the key federal focus for nursing education and practice, and it provides national leadership to ensure an adequate supply and distribution of qualified nursing personnel to meet the health needs of the nation. The Division of Nursing does not enhance the competency of the profession. The Division of Nursing does not apply nursing concepts. The Division of Nursing does not provide scholarships.

A nurse is developing and coordinating an emergency response plan for a community. With which of the following organizations would the nurse collaborate? a. American Red Cross (ARC) b. National Disaster Medical System (NDMS) c. Centers for Disease Control and Prevention (CDC) d. Emergency Management Agency (EMA)

D The EMA is responsible for developing and coordinating emergency response plans in a defined area. The ARC works with communities in the preparedness, response, and recovery phases of a disaster. The CDC studies the effect that disasters have on population health and continuously develops new prevention strategies. The NDMS provides nurses the opportunity to work on specialized disaster response teams.

A homicide has occurred in a community. To whom would this information need to be reported? a. United States Public Health Service b. World Health Organization (WHO) c. Centers for Disease Control and Prevention (CDC) d. National Violent Death Reporting System (NVDRS)

D The NVDRS was initiated by the CDC in an effort to develop a national state-based surveillance system that could identify the cause and manner of death, leading to prevention efforts by pulling together data on violent deaths, unintentional firearm injury deaths, and deaths of undetermined intent. The United States Public Health Service and WHO have the goal of reducing injury, but homicides are not reported to these organizations.

A nurse is working for the federal government to provide for the protection of the public's health. Which of the following actions would the nurse most likely complete? a. Interpreting decisions related to women's right to privacy b. Setting up immunization clinics for smallpox vaccine c. Regulating nursing at the state level d. Monitoring the influx of disease at the borders

D The United States Constitution gives the federal government the authority to provide for the protection of the public's health. By monitoring the influx of disease at the borders the public's health is being protected. Interpreting decisions does not support the protection of the public's health. Smallpox has been eradicated so it would not be necessary to set up immunization clinics. Regulation of nursing at the state level does not support protection of the public's health by the federal government.

A nurse is implementing a primary prevention strategy for migrant workers. Which of the following activities would the nurse most likely implement? a. Caring for persons afflicted with pesticide exposure b. Setting up clinics for persons with HIV c. Doing research in the field related to heat stress d. Educating about prevention of such illnesses as HIV and infectious diseases

D The primary level of prevention often includes education for the prevention of diseases, measures to reduce pesticide exposure, and immunizations. Caring for persons afflicted with pesticide exposure, setting up clinics for persons with HIV, and doing research in the field related to heat stress are examples of tertiary prevention.

A nurse is caring for an individual who has been a victim of trauma. Which of the following most likely describes the client that the nurse is caring for? a. A middle-class, Caucasian female b. A middle-class, African American male c. A low-income, Caucasian male d. A low-income, African American female

D Trauma victims are overrepresented in minority, disenfranchised, and disadvantaged groups. Where inequities of resources and education exist, health disparity, violence, and other crimes rise and accidental injuries occur more often.

A school nurse is demonstrating community outreach in practice. Which of the following interventions is most likely being used by the nurse? a. Coordinating health care of students with complex health problems b. Teaching students about the importance of proper nutrition c. Providing direct care to ill and injured students d. Participating in a community health fair

D When participating in community outreach, nurses are involved in community health fairs, using that opportunity to teach others. The role of case manager is used when coordinating the health care of students with complex health problems. The role of health educator is used when teaching students about the importance of proper nutrition. The role of direct caregiver is used when providing direct care to ill and injured students.