Community Health Exam 2

according to the CDC, how many American adults over the age of 18 have a prevalence of mental illness?

1 in 5

what age is the prevalence for depression highest?

18-25

Poverty rates among rural racial minorities is _____ higher than for rural whites

2-3x

what parameters indicate the perinatal period?

20 weeks gestation to 28th day of newborn life

Mental illness and homeless relationship

23% of homeless are mentally ill but deinstitutionalization has forced them back on the street.

the homeless mortality rate is ____ times higher than those who are not homeless

4-9

a public health nurse is developing an educational brochure on diabetes for the community clinic. Which group has a higher propensity toward the health disparities of cancer and diabetes?

African American

Preterm births and infant mortality higher in _____

Blacks

______ accounted for 44% new HIV infections and carry the "most severe burden of HIV of all racial/ethnic groups."

Blacks

Most common fatal injury is explosives impact upon the lungs.

Blast lung Injury

Which federal department bears the most responsibility in the event of a disaster in the US?

Department of Homeland Security

-Not stable regarding economy or industry -Infectious diseases remain the leading cause of death -Antibiotics and improved sanitation has helped to that developed countries don't have as many issues with this -Lower respiratory infections, ischemic heart disease, stroke, diarrhea, HIV/AIDs, preterm birth, malaria, road injuries, neonatal encephalitis, congenital

Developing Countries/less developed

Past experiences shared by family members , Present stage of family development , Future goals and tasks of family health, coping with transitions and attachments

Developmental family assessment

Environmental related killers in children under age 5

Diarrhea, Indoor air pollution, Malaria, Unintentional physical injuries

What type of education does the Community Emergency Response Team (CERT) program provide?

Disaster preparedness for hazards that may impact their area

-Shows the connection between a family and other systems in the ecological environment -Visually depicts family -environment interactions -Completed by the family and the nurse

Ecomap

A disease found in a certain group of people or certain area.

Endemic

An infectious disease spread in a community in a certain period of time.

Epidemic

replacement of infectious disease morbidity and mortality with that of chronic disease

Epidemiologic transition

learn from the past and prepare for future

Evaluation

Family members roles, Communication, Alliances and disputes, Prevailing beliefs-- spiritual and religious and basic family values, Health values, Members with influence and power, including source of income, Problem solving skills

Expressive Functional family assessment

True or False: you are a nurse in a free clinic. A Hispanic man comes into your clinic seeking treatment for nausea and vomiting. While collecting his health history, you discover he is an undocumented immigrant. You are required to report his presence in the US to local immigration authorities.

False

2 or more individuals who identify themselves as family and have some degree of interdependence on each other

Family

Holistic appraisal of health care needs; examination of cultural, spiritual, and developmental needs

Family Assessment

Agency that makes courses available regarding disaster; -Responsible for assessing and responding to disaster events in US -Provides training and guidance in all phases of disaster management -PROVIDES OVERSIGHT OF THE NATIONAL INCIDENT MANAGEMENT SYSTEM (NIMS)

Federal Emergency Management Agency (FEMA) (Part of DHHS)

A nurse wants to better understand the Incident Command System (ICS). Where should the nurse look for courses related to the ICS?

Federal Emergency Management Agency Website

Global research project that incorporates prevalence of certain disease or risk factor and relative harm it causes. Provides a tool to quantify health loss from hundreds of diseases, injuries, and risk factors, so that health systems can be improved and disparities can be eliminated.

Global Burden of Disease

Areas with shortage of HCP in primary care, dental care, and mental health. Can be based on: 1. Location - shortage of providers for entire population (ex. rural African villages) 2. Population Groups (ex. lack of HIV/AIDS providers in a vulnerable area) 3. Facilities (ex. lack of correctional facilities)

Health professional shortage area (HPSAs)

The development of new cases of a disease that occur during a specified period of time

Incidence

What is an operational incident management or resource allocation plan?

Incident Command System

-Stable economy, wide range of industry and technology -Leading cause of death is chronic disease: CVD, CA, CVA -Ischemic heart disease, stroke, lung cancer, self-harm, alzheimer's disease, cirrhosis, COPD, colorectal cancer, lower respiratory infections, road injuries

Industrialized countries/developed country

Nutritional assessment, Any medical conditions, disabilities, or limitations

Instrumental Functional family assessment

The nurse is asked about performing community health interventions. Which is a correct statement?

Interventions are always based on assessment data

A nurse is anticipating the response for a flu outbreak. Where is the response expected to begin?

Local

________ racial/ethnic groups tend to have poorer health status

Minority

Minimizing the effects of disaster. Take measures to limit damage, disability, and loss of life. Examples: building codes and zoning; vulnerability analyses; public education.

Mitigation

Refers to the disease state of an individual, or the incidence of illness on a population

Morbidity

Number of deaths per population in a given time or place

Mortality

what is a meeting that a family member could attend to learn more about MDD or addiction?

NAMI

Overseen by FEMA; developed to allow responders from different jurisdictions and disciplines to work more cohesively in response to natural disasters, emergencies, and terrorist acts; approach provides a proactive resource system to terrorist attacks, natural disasters, and other emergencies.

National Incident Management System (NIMS)

A nurse is called up to a volunteer emergency disaster response team because a hurricane is devastating the region. The nurse recognizes that this disaster is:

Natural

What statement about children and adolescent populations is true?

Of all children who are poor, ⅓ are African American

Which is a true statement about health interventions in specific populations?

Outreach is an effective strategy for intervening in substance abuse

Disease prevalence over an entire country or the world.

Pandemic

A nurse wants to help as a result of a recent disaster in the community. In addition to carrying a nursing license and CPR certification cards, what should the nurse first consider when entering the scene?

Personal safety

_______ is the leading cause of death for children up to age 5

Pneumonia

One of the most important indicators of the health and well-being of all Americans, regardless of where they live.

Poverty

Planning how to respond. Identify all hazards, proactive planning, and evaluate possible damage. Examples: preparedness plans; emergency exercises/training; warning systems.

Preparedness

The number of existing cases divided by the population content; measured at a point (percentage) in time not in intervals

Prevalence

Poor are less likely to use _________ services.

Preventative

Frequency with which new cases happen in a community

Rate

Returning the community to normal. Examples: temporary housing; grants; medical care.

Recovery

Efforts to minimize the hazards created by a disaster. Implementation of disaster plan, provide emergency care, and restore communication and transportation. Examples: search and rescue; emergency relief.

Response

-Rural dwellers have lower education levels, higher unemployment rates, lower income levels. -Accidents and injuries r/t environmental conditions, agricultural machinery, geographic isolation and working alone, and delayed access to emergency or trauma care -Acute and chronic illnesses r/t musculoskeletal discomfort, respiratory conditions, hearing loss, HTN, chemical exposure, secondary conditions related to demanding farm work -Health Disparities exist: rural population more likely to be older, less educated, live in poverty, lack health insurance, & experience a lack of available healthcare providers and access to health care -Isolation, lack of healthcare access, economic depression, unhealthy behaviors -More negative health behaviors (alcohol, tobacco, and drug use; obesity) that contribute to excess deaths and chronic disease and disability rates -Higher number of unintentional injuries -Lack of health insurance is one of leading health indicators -Due to lack of health care - health problems in rural residents may be more serious by the time they are diagnosed -Higher rates of chronic disease than people in urban areas -Higher rates of certain types of cancer from chemical exposure -Higher rates of obesity, smoking, sedentary lifestyles, alcohol use, firearms usage, suicide, vehicular accidents; lower rates of seat belt use

Rural populations

dyspnea, hemoptysis, cough, chest pain, tachycardia, hypoxia, cyanosis, apnea, wheezing, decreased breath sounds, hemodynamic instability.

S/sx of blast lung injury

What statement is true about social justice? Social justice refers to:

Sharing common burdens and advantages

What best describes primary prevention of a disaster?

Team-based disaster planning

Infections of disease, Chronic long term health conditions, social conditions

The Eras of health conditions

the lead federal agency for public health and medical services during a public health or medical disaster. Supplemental services are provided to state, local, and territorial governments: -Disaster medical assistance teams (DMAT) -US public health service officers -Epidemiological personnel from the CDC -Veterinary support

USDHHS

________________in poverty have lower reported levels of physical functioning and higher levels of body discomforts.

Women of childbearing age

Poor __________ are four times more likely to be below average in school and 3 times more likely to drop out.

adolescents

Public health services encompass a wide variety of activities. Which are considered core functions of public health service? (select all that apply): a. Community participation b. Public policy c. Sanitation reform d. Assurance e. Assessment

b. Public policy d. Assurance e. Assessment

a public health nurse begins work in a new community. Which is the best first step in working towards community change?

building relationships with community members and leaders

poorest citizens in rural America

children

With decrease in infectious disease, increased life expectancy→ _________

degenerative disease

what are the comorbidities of Alzheimer's Disease?

depression, psychosis, aggression

98% of maternal deaths occur in ________ countries: Infection, Hemorrhage, Eclampsia, Unsafe abortion, Obstructed labor/ruptured uterus

developing

what outreach method includes the nurse reaching out to individuals and families through home visits, churches, or school meetings?

direct outreach

Preparedness, Mitigation, Response, Recovery, and Evaluation.

disaster management continuum

work, school, friends, recreation, religion, etc

external family assessment

______-headed families have highest rates of poverty

female

Extremely rural area, i.e., Alaska (think 'Alaska Frontier' the show)

frontier area

-Graphically displays family information in a way that provides a quick view of complex family patterns -A diagram of the family's genealogy or family relationships. -Completed by the family

genogram

Communicable diseases—5 of 10 leading causes of death, major preventive measure is __________

immunization

Poor are more likely to use __________services

in-patient

Interventions for "era of infections of disease"

integrated management of childhood illness (IMCI), polio endgame, and oral rehydration therapy

family composition, rank of members, genders, boundaries, subsystems

internal family assessment

which of the following risk factors may contribute to child abuse?

living in poverty and residential instability

Action taken to prevent or reduce the harmful effects of a disaster on human health or property. Limits the damage, disability, and loss of life; Ex: reinforcing highways, developing communication strategies, educating professionals, building zones and codes, vulnerability analyses, public education.

mitigation

which of these locations of strategies would be an effective way for the nurse to communicate the dangers of diabetes to introverts?

pamphlets

______ is the leading risk for poor health outcomes

poverty

Major causes of death for those under age 5

prematurity, birth trauma/asphyxia, pneumonia, & diarrheal diseases

what is the role of the community health nurse for a patient with Alzheimer's?

provide emotional support, respite care, ADLs

towns with population of less than 2500 or in open country

rural

which lifestyle choices or behaviors most strongly determine long-term health outcomes in developed nations?

smoking and alcohol consumption

Refers to sharing common burdens and advantages. Refers to the fair and equitable distribution of wealth, economic opportunity, and access to privileges in society and is tied to human rights. The "view that everyone deserves equal economic, political and social rights and responsibilities."

social justice

Regional poverty differences are highest in the _____

south

Poor _____________ are more likely to have children with complications.

teen women

A nurse is in a disaster preparedness training course. The nurse best demonstrates knowledge of disasters by which statement?

"Disasters are unexpected events requiring support from outside the community"

A new nurse is working in a community setting. The nurse is concerned about the possibility of a disaster affecting the community. Which statement reflects understanding of the best next step?

"I should find out if the community has a disaster preparedness plan"

The nurse is employed at a public health clinic in an urban setting. The nurse is in charge of triaging clients when they enter the clinic for walk-in hours. What is the best response by the nurse when describing this role in terms of public health service?

"I'm performing assessment of clients"

The nurse is trying to determine which government agency is responsible for rebuilding the physical structures in the community. Which is the nurse's best response?

"The Department of Defense- Army Corps of Engineers will be responsible for rebuilding the physical structures"

A nurse is performing triage during a disaster. This nurse should identify which client as needing immediate transportation to a hospital?

A client who is burned over 50% of his body

__________ employees have a higher fatal injury rate compared to all other types of workers

Agricultural

What intervention can be used to prevent adverse health consequences and empower vulnerable populations through the sharing of knowledge, skills, and information?

Health teaching

Which is a secondary prevention strategy during a disaster that can be performed by a nurse?

Victim triage

are vulnerable populations at increased risk for maternal disease like gestational diabetes?

Yes! Many factors, such as lack of access to healthcare, poor nutrition, and environmental risks created in low-income houses, contribute to the likelihood of maternal disease for this population

A nurse is studying the community's disaster preparedness plan. What are key features of an effective disaster plan? (select all that apply): a. Developing communication networks b. Developing leadership c. Establishing transportation routes d. Establishing clear authority e. Evaluating local governments

a. Developing communication networks c. Establishing transportation routes d. Establishing clear authority

describe environmental adaptations of older adults aging in place

adding light to the staircase, adding a non-slip mat in the shower

when planning care for a patient with down syndrome, what should the nurse do?

assess the patients current developmental level and plan care accordingly

What are the benefits of the National Incident Management System (NIMS)? (select all that apply): a. To enable global disaster management b. To integrate personnel, facilities, and equipment c. To allow for a common organizational structure d. To enable state lead disaster management e. To facilitate disaster preparation

b. To integrate personnel, facilities, and equipment c. To allow for a common organizational structure e. To facilitate disaster preparation

global health is determined by a number of factors. Which factors are considered part of the social and physical environment? (select all that apply) a. individual biology b. neighborhood crime c. number of abandoned houses d. individual behavior e. personal choice f. policies and laws

b. neighborhood crime c. number of abandoned houses f. policies and laws

a public health nurse is developing a program based on the goals of Health People 2020. What is a health indicator that nurse may use as a part of the program? (select all that apply) a. technology usage b. environmental quality c. tobacco usage d. exercise frequently e. substance abuse

c. tobacco usage d. exercise frequently e. substance abuse

the community health nurse knows what is an important concern when caring for a child in foster care?

childhood trauma and lack of stability contributes to developmental, physical, mental, and psychosocial problems

Migrant workers have more ________ conditions

chronic

a home health nurse is creating a care plan for an individual who recently had surgery. Which tasks does the home health nurse understand as a health responsibilities of the family? (select all that apply) a. socialization of members regarding a sense of duty toward optimal health b. providing education about cost containment and when to use the health care system c. development of the members' sense of caring within the family as a unit d. emotional support for the client and guidance during life cycle transitions e. care provision and management for the chronically ill, disabled, and aging family members

d. emotional support for the client and guidance during life cycle transitions e. care provision and management for the chronically ill, disabled, and aging family members

during a family assessment, the community health nurse must examine both the internal and external structure of the family. What factors will be assessed to determine the internal structure of the family? (select all that apply) a. what religion the individuals observe b. where individuals work c. where the family goes to exercise d. the family composition e. each member's gender

d. the family composition e. each member's gender

people who live with blindness are at an increased risk for which illnesses?

falls, anxiety, major depressive disorder

what are three common health concerns of hospitalized homeless individuals?

frostbite, leg ulcers, HIV/AIDS

what are some problems affecting Rural, Migrant, and Immigrant workers?

malnutrition, hypertension, lack of insurance

Life expectancy is consistently lower for _______ races

minority

the strongest risk factors during childhood pointing to involvement in serious but not necessarily violent criminal behavior

physical aggression

a nurse works in a program supported by the world health organization (WHO). What best describes the role of a nurse in a tuberculosis initiative?

to administer vaccinations

in an impatient setting, Dennis is experiencing alcoholic substance abuse withdrawal. He will be experiencing which symptoms?

tremors, seizures

True or False: measuring the prevalence of vulnerable populations is difficult

true (vulnerable populations are not distinct and overlap)

what is the definition of family in community health?

two or more people who identify themselves as a family and rely on each other to some extent to meet basic needs

A nurse is concerned about biological warfare in the US. Which statement best answers this concern?

"The US has stockpiled vaccines and antidotes in the event of biological warfare"

A nurse is working with the local government to respond to a disaster. The government has exceeded its resources. Which statement demonstrates the best next step?

"We should contact the National Response Framework for help"

Following a disaster, a nurse assesses high psychological distress among coworkers. What is the best response of the nurse addressing the nurse's colleagues?

"We should look into professional debriefing as a group"

________________ are a MAJOR cause of death in migrant workers.

Accidents and injuries

________ report higher metabolic and vascular disease, as well as cognitive impairment.

Blacks/Hispanics

A nurse wants to understand the potential intensity of a recent disaster on a community. What is the best question to ask when determining intensity?

How destructive was the disaster to the infrastructure?

a community health nurse is caring for a 32-year-old patient that is at 25 weeks gestation and is experiencing preterm labor symptoms. After receiving treatment in the hospital, and managing the symptoms, the patient is being discharged with an order for strict bedrest. She states that she is worried about following these instructions, since she is the primary caretaker for her two young children. What is the best response by the nurse?

I understand that you are feeling worried about caring for your children while on bedrest. Would you like me to provide you some resources for cost-free childcare?

The ___________ of a disaster is the range of its effect, either geographically or in terms of the number of people impacted.

Scope

A nurse attempts to quickly determine the needs of the community following a disaster. The nurse identifies clients who are in need of immediate placement in emergency housing. Which term describes emergency housing during a disaster?

Secondary Prevention

The nurse is asked what is meant by "vulnerability" in the context of community health nursing. What is the best response?

Vulnerability is any factor that increases the chances for poor health

The nurse admits a client to the emergency room without health insurance. The client is considered part of what type of population?

Vulnerable

describe the age and scenarios of older adults aging in place

a 70 year old female who lives at home with a caretaker

The nurse is aware that environmental factors can mitigate or exacerbate disasters. What are environmental factors? (select all that apply) a. Air temperature b. Political unrest c. Building stability d. Scope and intensity e. Coastal flooding

a. Air temperature b. Political unrest c. Building stability e. Coastal flooding

The nurse has learned about complex systems developed to intervene in the event of a disaster. What are the responsibilities of the Department of Homeland Security? (select all that apply) a. Disaster housing b. Incident Command Systems c. Search and rescue operations d. Firefighting e. Public health management

a. Disaster housing b. Incident Command Systems c. Search and rescue operations

A nurse needs to identify hazards in a clinic. What are potential dangers in the event of a disaster? (select all that apply): a. Electricity b. Oxygen c. Waiting Room d. Medication Room e. Exit doors

a. Electricity b. Oxygen d. Medication Room

What correctly identifies a public health nurse's role in the prevention of a disaster? (select all that apply): a. Identifying community risk factors b. Developing a disaster plan c. Organizing a disaster drill for the community d. Triage during the disaster e. Public health disease surveillance

a. Identifying community risk factors b. Developing a disaster plan c. Organizing a disaster drill for the community

The nurse is involved in supervision using the Incident Command System (ICS). The nurse should recognize the following are functional areas of the system. (select all that apply): a. Operations b. Command c. Partnering d. Leadership e. Logistics

a. Operations b. Command e. Logistics

What are the risk factors for susceptibility to disease in vulnerable populations? (select all that apply): a. Relative risk b. Health status c. Character flaws d. Resource availability e. Income

a. Relative risk b. Health status d. Resource availability e. Income

which statements reflect the teen pregnancy situation in the case study at Montrose High School? (select all that apply) a. after the intervention, Montrose students experienced more than double the access to prenatal care for pregnant students b. after the intervention, Montrose students experienced a reduction in the rate of infant mortality and low birth weight to even out with state averages c. before the intervention, the principal and parents were supportive of the school nurse's health plans d. before the intervention, Montrose students suffered from lower birth weight and higher infant mortality rates than the state overall e. after the intervention, Montrose students experienced a decline in the number of births to teens under 16.

a. after the intervention, Montrose students experienced more than double the access to prenatal care for pregnant students b. after the intervention, Montrose students experienced a reduction in the rate of infant mortality and low birth weight to even out with state averages d. before the intervention, Montrose students suffered from lower birth weight and higher infant mortality rates than the state overall

while working in the free clinic, the public health nurse is assessing a migrant farm worker who has an infection of the right hand. The nurse cleans the wound, applies antibiotic cream, and wraps the area to keep it clean. The nurse is conducting an assessment to determine if the client has any contributing factors related to health disparities. Which of these are contributing factors to health disparities? (select all the apply) a. language barriers b. educational obtainment c. a diagnosis of schizophrenia d. part-time employment e. no means of transportation

a. language barriers c. a diagnosis of schizophrenia e. no means of transportation

where may a disability be present?

a. mobility, perception, or memory b. speech, hearing, or eyesight c. continence, dexterity, or physical coordination

which group is more susceptible to health disparities and discrimination in health care systems? (select all the apply) a. runaway teenagers b. ethnic or racial minorities c. people who did not finish high school d. individuals in drug treatment programs e. unemployed persons

a. runaway teenagers b. ethnic or racial minorities e. unemployed persons

Which are examples of personal services and home visits for people that are at risk? (select all that apply): a. Disease surveillance b. Treatment services for targeted conditions c. Leadership and policy planning d. Clinical preventive services e. Primary care for unserved and underserved people

b. Treatment services for targeted conditions d. Clinical preventive services e. Primary care for unserved and underserved people

a community nurse is preparing to develop a plan to work with families as the clients in a local community. What reasons would a family assessment need to be completed with the families prior to developing the plan? (select all that apply) a. community health nurses must first gauge the actual need of all members of the local community b. community health nurses sometimes make visits to clients and their families c. members usually rally around families to ensure the health of the community d. families are a significant building block of the local community e. families often have unique values and needs

b. community health nurses sometimes make visits to clients and their families d. families are a significant building block of the local community e. families often have unique values and needs

a nurse develops a program in an at-risk population as a result of disability related life year (DALY) health data. Which program goal best targets a reduction in DALY risk factors?

client will increase exercise to 3 days a week

a community health nurse is working with the nearby American Indian reservation to develop a program to reduce health disparities. What is a known health disparity of the American Indian that the nurse will want to address?

diabetes

you are caring for a 47-year-old male in the emergency department for a severe rash. He tells you he manages his own lettuce farm. What is the priority screening question to ask him specific to his rash?

do you wear gloves when handling insecticides on your farm?

True or False: the vulnerable populations conceptual model includes demographic, social, and health belief variables

false (it addresses resource availability, relative risk, and health status)

Differences in the quantity and burden of the disease and other health conditions present in different groups (people in different cultural/racial/ethnic/social groups experience different health problems at a higher rate than other groups)

health disparity

what is the most common physical complication that people with down syndrome experience?

heart disease

what is an atrioventricular defect?

holes between the chambers of the left and right sides of the heart, and the valves that control the flow of blood between these chambers may not be formed correctly

in completing a developmental family assessment, what question would the community health nurse include?

how do family members cope the transitions and attachments within the family?

what kind of statements by mothers indicate a further need for teaching about her son's prognosis of DMD?

if my son gets an infection I will treat him with leftover antibiotics we have in our pantry at home

you are a nurse giving discharge instructions to a patient with muscular dystrophy. Which teaching will you include in your instructions?

it is important to do deep breathing exercises to strengthen your diaphragm and lungs

what is the most common reason for hospitalization of the homeless population?

mental illness

what does The Family First Prevention Services Act work to improve the foster care system?

moves the initial focus of social work to preventing the child's home and environment from becoming so bad that the child needs to be removed instead of removing the child immediately from their home

which primary prevention strategies are best within community health of the homeless population?

providing immunizations at free health clinics

how can the community health nurse contribute to the care of abused children?

recognizing, identifying, and assessing children and adolescents

which nursing diagnosis is not a priority for the maternal-child health population?

risk of impaired faith process

you are beginning your freshman year at Clemson and notice one of your classmates is visually impaired. Name interventions, specific to visual impairment most likely to promote her wellness and success?

using assistive technology, such as "text to speech" and "screen reading" software

does the Fair Labor Standards Act require employers of Seasonal Workers to provide provisions for children?

yes