Community Health Practice Exam NUR412
The nurse is screening children at the local community health clinic for infectious diseases. Which child is at highest risk for hepatitis B virus (HBV)? A.) a newborn B.) a 3 year old C.) a 7 year old D.) an 11 year old
A.) a newborn
Which bioterrorism agent is at high risk for use as a potential biological weapon that is readily transmitted by serval portals of entry? A.) anthrax B.) smallpox C.) botulism D.) tularemia
A.) anthrax
What is an example os a positive outcome for one of the leading health indicators of health people 2020? A.) a community has adopted a no smoking policy B.) a rural community has a public transportation system C.) the high school drop out rate has decreased by 15% D.) a county has decreased their divorce rate by 10%
A.) a community has adopted a no smoking policy
The nurse administers a booster dose of DTaP (diphtheria, tetanus, and pertussis) vaccine to an infant. Which level of prevention is the nurse implementing? A.) Primary prevention B.) Tertiary prevention C.) secondary prevention D.) primary nursing
A.) Primary prevention
A nurse working in a community health setting is performing primary health screenings. Which individual is at highest risk for contacting an HIV infection? A.) a 17 year old who is sexually active with numerous partners B.) a 45 year old lesbian who has been sexually active with two partner in a the past year C.) a 30 year old cocaine user who inhales the drug and works in a topless bar D.) a 34 year old male homosexual who is in a monogamous relationship
A.) a 17 year old who is sexually active with numerous partners
The RN at a migrant health center notes an increased incidence of dermatitis in seasonal farm workers at a local fruit farm. In response to this finding, it is most important for the RN to obtain which info as part of the community assessment? A.) availability of clean fresh water to wash hands after work B.) proper housing C.) access to health care services D.) access to transportation
A.) availability of clean fresh water to wash hands after work
Lillian Wald was a significant person in the history of American nursing. Which contribution can be attributed to her ? (select all that apply) A.) development of public health nursing practice B.) first nursing service for occupational health C.) campaigned for laws to require registration for nurses D.) established committee that was the forunner of the NLN E.) instituted a sliding scale fee for service
A.) development of public health nursing practice B.) first nursing service for occupational health D.) established committee that was the forunner of the NLN E.) instituted a sliding scale fee for service
During a visit to a community health clinical, a 45 year old native american female, who has a BMI of 35, complains of changes in her vision. Which condition is most important for the RN to be aware of in the client's family hx? A.) diabetes B.) glaucoma C.) hypertension D.) brain tumor
A.) diabetes
What action is best for the community health nurse to take if the nurse suspects that an infant is being physically abused? A.) follow agency protocols to report suspected abuse B.) report suspicious to the local child abuse reporting hotline C.) educate the child's caregivers about growth and development issues D.) call the police department to have the child removed from the home
A.) follow agency protocols to report suspected abuse
The home health nurse is admitting a client with parkinsons disease to the home healthcare service. In planning care for this client, which nursing diagnosis has priority? A.) impaired physical mobility related to muscle rigidity and weakness B.) ineffective coping related to depression and dysfunction due to disease progression C.) ineffective breathing pattern related to respiratory muscle weakness D.) fear related to constant possibility of experiencing seizures
A.) impaired physical mobility related to muscle rigidity and weakness
A community health nurse is conducting a neighborhood discussion group group about disaster planning. What information regarding the transmission of anthrax should the nurse provide to the group? A.) infection is acquired when anthrax spores enter a host B.) mature anthrax bacteria live dormant on inanimate objects C.) spores cannot survive for extended periods outside of a living host D.) anthrax is transmitted by respiratory droplets from person to person
A.) infection is acquired when anthrax spores enter a host
The nursing education coordinator is creating employee orientation materials for staff nurses who plan to work at a clinical that serves a lower socioeconomic neighborhood. What information should the educator include regarding the clinic's client population? (select all that apply) A.) most of the clients are unemployed or disabled B.) access to mass transit may be an issue C.) clients will need reminders to bring insurance cards D.) basic physiologic needs of this population are often unmet E.) clients who are homebound will qualify for Medicaid F.) non adherence to healthcare recommendations is likely
A.) most of the clients are unemployed or disabled B.) access to mass transit may be an issue D.) basic physiologic needs of this population are often unmet
The RN is serving on a medical center committee to update goals and protocols based on the national standards. Which goal most directly addresses the healthy people 2020 initiative? A.) reduce ED wait time for indigent clients B.) providing transportation for medically challenged clients C.) provide access to health services D.) refer clients to local health departments for medical services
A.) reduce ED wait time for indigent clients
When asked to help develop interventions to combat obesity among children, the community health nurse should stress the importance of implementing which activity? A.) set goals that are focused on developing healthier lifestyles B.) develop strict diet plans for school-aged children C.) provide diet classes for the obese children during school hours D.) require all children to participate in organized team sports
A.) set goals that are focused on developing healthier lifestyles
The nurse is working in a community clinic that serves a population comprised mainly of migrant families. In planning the use of resources for secondary prevention, which activity should be the priority? A.) skin testing for tuberculosis B.) glucose monitoring for diabetes C.) blood work for cardiovascular disease D.) height and weight for altered nutrition
A.) skin testing for tuberculosis
The nurse plans to implement a community health program targeting teenage smoking. Prior to initiating this program, which information is most important for the nurse to obtain? A.) the incidence of smoking among the teenage population in this community B.) the amount of available funding for tobacco prevention education programs C.) the target objectives for teenage smoking described by heathy people 2020 D.) satisfaction data from programs that targeted the teenage population in this community
A.) the incidence of smoking among the teenage population in this community
an assessment conducted last year on the health needs of children who attended a middle school indicated that bicycle injuries were a priority problem, so the RN developed a bicycle safety program, 6 weeks after completion of the program, a survey was sent home to parents and students. Which finding is the best indicator that the program was effective? A.) the number of students wearing helmets increase by 10% B.) the number of students with bruises from falls from their bicycle decreased C.) students wearing seatbelts while in cars D.) students were taught how to cross the street on their bicycle
A.) the number of students wearing helmets increase by 10%
While discussing the science of nursing, the nurse identifies the domain of nursing theory. Which linkages should the nurse provide to describe nursing's paradigm? A.) the person, the environment or situation, and health B.) stress reduction, self care, and a systems model C.) curative care, restorative care, and terminal care D.) self actualization, fundamental needs, and belonging
A.) the person, the environment or situation, and health
True or False One of the goals of healthy people 2020 initiative for school health is to increase the number of locked guns at home. Decrease the number of guns in schools. Kids are getting killed more and more due to gun violence in schools
False
The public health RN is called to investigate a report of several cases of varicella at a day care center. The day care workers state that 5 children have been sent home over the past 2 weeks with fever and itchy blisters. Which intervention should the RN implement first? A.) validate that the children who were sent home had chickenpox B.) ask the parents to take the child to see their pediatrician C.) ask the parents to not sent the child back to daycare until after 6 weeks D.) tell the parents to send the child back to daycare it was a mistake they were sent home
A.) validate that the children who were sent home had chickenpox
A male client is brought to the emergency department as the result of a motorcycle accident. He was not wearing a helmet at the time of the accident, and states he has no intention of ever wearing one. Within the framework of the Transtheroetical Model (TTM), which response should the nurse provide? A.) wearing a helmet or not is certainly an individual decision B.) you should seriously consider wearing a helmet C.) Riding a motorcycle with a helmet increases your safety D.) I really think you don't have the facts about helmet use
A.) wearing a helmet or not is certainly an individual decision
The school RN is assessing a group of middle school students for signs of scoliosis and discovers a female student with a noticeable unequal symmetry of the upper and lower back. Which intervention is most important for the RN to implement? A.) sent the student home B.) make a referral to have the scoliosis further evaluated C.) withdraw the student from all physical activities D.) tell the student to not carry her backpack on her back
B.) make a referral to have the scoliosis further evaluated
The nurse is preparing to discharge an elderly, recently widowed female client following a mild stroke. At this time she is able to walk with the aid of a walker. As part of the discharge planning what referral is most important for the nurse to make? A.) pastoral care B.) meals on wheels C.) grief support group D.) physical therapy
B.) meals on wheels
True or False Providing water for hand washing to prevent contact dermatitis in migrant farm workers is an example of secondary prevention
False
Which of the following patients would the home care nurse asses first ? A.) 65 year old make with known COPD and difficulty breathing after climbing a flight of stairs B.) a 78 year old with CHF who has gained 4lbs according to her tele-monitoring C.) 50 year old with bilateral leg swelling and difficulty walking D.) a 60 year old with lower back pain
B.) a 78 year old with CHF who has gained 4lbs according to her tele-monitoring
During an initial clinic visit, the nurse is taking the history for a client who wants to confirm her pregnancy. The client's last child has a history of low birth weight. Which additional finding is most important for the nurse to consider? A.) cigarette smoking B.) african american ethnicity C.) poor nutritional status D.) limited maternal education
B.) african american ethnicity
Several employees who have a 10 year or longer hx of smoking ask the occupation nurse for assistance with smoking cessation. The RN develops a 2 month program that includes weekly group sessions on lifestyle changes and use of OTC products. Which measurements provides the best indication of the program's effectiveness? A.) encourage the employees to disclose if they have joined another smoking cessation group B.) ask the employees to inform the group if they stop smoking and id they start back up again C.) survey the employees about their smoking habits D.) observe if the employees are smoking in the smoking designated areas
B.) ask the employees to inform the group if they stop smoking and id they start back up again
The multidisciplinary home health care team is discussing a female client diagnosed with Parkinsons disease. The home health care nurse reports the client is getting worse and her husband is no longer able to care for her in the home. Which action should the home health nurse implement first? A.) request a Chaplin to counsel with the couple B.) assign a home health care aide to provide daily care C.) talk to the husband about placing his wife in a nursing home D.) contact the client's children to discuss the situation
B.) assign a home health care aide to provide daily care
The nurse is preparing an orientation class for new employees at an inner city clinical that serves a low-income population. Which information should the nurse include in the presentation to these new employees? A.) a lack of transportation is the major impediment for the clinic's clients B.) basic physiologic needs are likely to be unmet in this clinic's client population C.) printed material is less effective for this population that has limited reading skills D.) a group of education class is often poorly attended by noncompliant clients
B.) basic physiologic needs are likely to be unmet in this clinic's client population
The home health nursing director is conducting an educational program for registered nurses and practical nurses about Medicare reimbursement. To obtain payment for Medicare services, what must be included in the client's record? A.) a prescription form the healthcare provider for each visit made B.) documentation of a skilled care service provided during the visit C.) a copy of the client's health history and social security card D.) a record of the preventative healthcare services provided during the visit
B.) documentation of a skilled care service provided during the visit
A 16 year old female client returns to the clinic because she is pregnant for the third time by a new boyfriend. Which vaccine should the nurse plan to administer? A.) measles-mumps-rubella B.) hepatitis B C.) human papillomavirus D.) pneumococcal
B.) hepatitis B
A nurse organizes a community action group to help resolve health problems in a low income neighborhood with a large population of recent immigrants from Africa. What problem should the nurse address first? A.) high rate of unemployment B.) low immunization of children C.) provision of substandard health care D.) access to bilingual care providers
B.) low immunization of children
The RN is making a home visit to a female client with end stage heart disease. She has a living will and states she will never go back to the hospital. During the visit, the RN notes that the client is pale and sob while speaking. The RN discovers 3+ edema in both ankles and bilateral pulmonary crackles. Which intervention should the RN implement first? A.) order a CXR B.) obtain a peripheral O2 stat reading C.) obtain order for CBC D.) tell he patient to stay in bed
B.) obtain a peripheral O2 stat reading
Which client has the greatest risk for developing community-acquired pneumonia? A.) a 40 year old first grade teacher who works with underprivileged children B.) a 75 year old retired secretary with exercise induced wheezing C.) a 60 year old homeless person who is an alcoholic and smokes D.) a 35 year old aerobics instructor who skips meals and eats only vegetables
C.) a 60 year old homeless person who is an alcoholic and smokes
the nurse is teaching a community group about risks of cardiovascular disease. Several clients ask the nurse to determine their risk. Which client should the nurse identify as having the greatest risk for cardiovascular disease? A.) a male with a serum cholesterol level of 199 mg/dl B.) a female with a serum cholesterol level of 201 mg/dl C.) a male with a low density lipoprotein level of 200 mg/dl D.) a female with a low density lipoprotein level of 160 mg/dl
C.) a male with a low density lipoprotein level of 200 mg/dl
True or False Suspected elder abuse in the community setting should be reported directly to the authority
False
Which intervention should the public health nurse implement when attempting to address one of the leading health indicators of healthy people 2020? A.) lead a weekly water aerobics class for the elderly at a community center B.) teach a class on cultural awareness to nursing students at the university C.) design and implement a no smoking campaign at the local high school D.) write a grant to help provide glucometers to individuals who cannot afford one
C.) design and implement a no smoking campaign at the local high school
Which presentation of infectious disease is acquired through an indirect transmission? A.) syphilis contracted from a sexual partner B.) measles resulting from a daycare center outbreak C.) malaria following exposure in a mosquito infested area D.) nosocomial influenza spreading rapidly in a long term carrier
C.) malaria following exposure in a mosquito infested area
A senior high school student, whose immunization status is current, asks the school nurse which immunization will be included in the precollege physical. Which vaccine should the nurse tell the student to expect to receive? A.) hep C b.) influenza type B (HIB) C.) measles, mumps, rubella (MMR) D.) diphtheria, tetanus, pertussis (DTaP)
C.) measles, mumps, rubella (MMR)
The community health nurse is planning a series of educational courses about the healthcare system and meeting healthcare needs for the community center. Which adjunct issue should the nurse address for a group of older adults? A.) peer concerns B.) adult daycare C.) retirement issues D.) vocational concerns
C.) retirement issues
A community health RN believes that immunization rates in a lower socioeconomic section ofd the city are probably below the target set by the state health department. What action should the RN take FIRST to intervene with this health problem? A.) take a health history on the members of the community B.) initiate an immunization program for the community C.) review current epidemiological population data that might document a low immunization rate D.) refer all clients to the local health department
C.) review current epidemiological population data that might document a low immunization rate
A home health nurse knows that a 70 year old male client who is convalescing at home following a hip replacement, is at risk for developing decubitus ulcers. Which physical characteristic of aging contributes to such a risk? A.) 16% increase in overall body fat B.) reduced melanin production C.) thinning of the skin with loss of elasticity D.) calcium loss in bones
C.) thinning of the skin with loss of elasticity
The home health care agency can expect to obtain Medicare reimbursement for which home visit performed by a registered nurse (RN) or a practical nurse (PN)? A.) assessment of the speech pattern of a mobile adult who had a mild stroke last year B.) safety teaching for an older male client whose wife complains that he uses an unsafe ladder while painting C.) wound care for a client who has postoperative infection following abdominal surgery two weeks ago D.) evaluation of crutch use by a 65 year old male client who broke his tibia while snow skiing
C.) wound care for a client who has postoperative infection following abdominal surgery two weeks ago
The nurse is administering the measles, mumps, rubella (MMR) vaccine to a 12 month old child during the well baby visit. Which age range should the nurse advise the parents to plan for the child to receive the MMR booster based on the current recommendations and guidelines by the Center for Disease Control (CDC)? A.) 13 to 18 years of age B.) 11 to 12 years of age C.) 18 to 24 months of age D.) 4 to 6 years of age
D.) 4 to 6 years of age
Which of the following is a coluntary organization? A.) NIH B.) FDA C.) CDC D.) ADA
D.) ADA
Which ethnicity has the highest risk for diabetes? A.) African American B.) Hispanic Americans C.) Asian American D.) Native American
D.) Native American
After accepting the position of school nurse in a public elementary school, what strategy is best for the nurse to use to obtain an overview understanding of the student body? A.) review all the health records of the students presently registered for classes B.) talk with the current officers of the parent teacher association C.) send home a survey form to parents of third grade students D.) conduct a windshield survey of the geographic areas served by the school
D.) conduct a windshield survey of the geographic areas served by the school
The nurse is conducting a process evaluation of a prevention education program for older adults who are risk for substance abuse. Which data source provides the information the nurse needs to conduct this process evaluation? A.) client's score on an alcohol screening instrument B.) results of a urine drug and alcohol screen C.) most recent community census data D.) documentation of client education in the nursing record
D.) documentation of client education in the nursing record
True or False The elderly client who is independent in his home does not need to have home safety assessment completed.
False
The nurse is designing a community health project based on a report provided by the World Health Organization that describes healthcare problems in the United States. Which healthcare issue should the nurse give the highest priority when planning the project? A.) overuse of diagnostic technology B.) government based health insurance C.) the neonatal and infant mortality rates D.) number or people without access to healthcare
D.) number or people without access to healthcare
A community health nurse is planning to implement an outreach program for a community group. Which criteria should the nurse clarify about the program when examining sources for funding? A.) focuses on multiple health problems or concerns B.) identifies populations and individuals in need of healthcare services C.) evaluates variations in health services and health status among populations D.) offers healthcare services to community members in local factories, schools, and churches
D.) offers healthcare services to community members in local factories, schools, and churches
The nurse at a health fair has taken a client's blood pressure twice, 10 minutes apart, in the same arm while the client is seated. The nurse records the two blood pressures of 172/104 mm Hg. What is the appropriate nursing action in response to these readings? A.) refer the client to a nutritionist after providing health teaching about a low sodium diet B.) place the client in a recumbent position and call the paramedics for transport to the hospital C.) talk with the client to assess whether there is stress in the client's life and refer to a counseling service D.) take the client's blood pressure in the other arm and then schedule a healthcare practitioner's appointment for as soon as possible
D.) take the client's blood pressure in the other arm and then schedule a healthcare practitioner's appointment for as soon as possible
The nurse is planning an immunization campaign targeting the children of migrant farm workers in the community. Which data should the nurse review before exploring solution options when developing this program plan? A.) uncertain risks B.) potential outcomes C.) priority of solutions D.) target populations data
D.) target populations data
Which topic should the nurse include in planning a secondary prevention project for the local retirement community? A.) safety measures in the home B.) adult immunization program C.) rehabilitation after surgery D.) vision and hearing screenings
D.) vision and hearing screenings
True or False A Genogram shows representation of the family's interactions with other groups and organizations, and is accomplished by using a series of circles and lines
False
True or False An Ecomap is a pictorial display of a person's family relationship and medical history
False
True or False It is important that the community health nurse teach the elderly client with diabetes about foot care so the client does not need to be evaluated by the podiatrist.
False
True or False It is not necessary to assess for drug interactions with the elderly since the pharmacist usually educates the client about their medications.
False
True or False Acanthosis nigricans is skin condition seen in children that is characterized by dark, thick, velvety skin in body folds and creases: most often affects the armpits, groin, and neck
True
True or False Among migrant families, tuberculosis rates are unusually high and should be a priority focus for secondary prevention. The incidence and the risk for spread of tuberculosis is a priority in this population
True
True or False Elderly clients who are discharged from the hospital mist have a home safety evaluation completed by the case manager prior to discharge.
True
True or False Frequent and untreated STI's such as chlamydia has a high risk for pelvic inflammatory disease
True
True or False Initial treatment for new onset of hypertension includes blood pressure check for 2-3 weeks before starting antihypertensive medications. Follow up care and then antihypertensive medication if BP remains elevated
True
True or False Migrant workers are at risk for TB, exposure for pesticides and other hazardous materials, risk for skin cancer, risk for dental problems
True
True or False Prophylactic Relenza can be used for influenza A and B treatment: for community outbreaks beginning within 5 days of outbreak and can administer up to 28 days
True
True or False RN must do initial assessment of patient: ADL's can be delegated to a nursing care aide
True
True or False Risk factor assessment and screening for the diabetic client with a family history of CV disease must include lipid panel
True
True or False Signs and symptoms of Lyme disease include red, circular rash at site of bite, tiredness, fever, chills, joint pain, muscle aches, headache, stiff neck, and swollen lymph nodes
True
True or False The U.S Department of Health and Human Services (USDHHS) is the federal agency most heavily involved with the health and welfare of U.S. citizens
True
True or False The classroom setting is environment for best teaching to an adolescent
True
True or False The community health nurse can advocate for findings for the clinic with the help if community members voicing their concerns and calling on political leaders to act
True
True or False The community health nurse may use the ecomap to assess the elderly and community groups working relationship
True
True or False The school nurse monitors the children for all of their state-mandated immunizations is an example of primary prevention
True
True or False When assessing for abuse and neglect during a home visit, the nurse must conduct a physical assessment and mental health assessment first
True
True or False Voluntary agency in the public health setting is supported by charities (such as United Way, Medicare, Medicaid, etc)
true
True or false Vertical transmission is a disease causing agent (pathogen) from mother to bab y during the period immediately before and after birth
true
