Community Test 2

SATA-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?

A diagnosis of schizophrenia No means of transportation Language barriers

What statement about false negatives is accurate?

A false negative is when a patient passes a screening but, in fact, truly has the disease.

SATA-What factor contributes to the effectiveness of a health screening?

Acceptable degree of sensitivity Ease of administration Cost-effectiveness Acceptance by the community

SATA-Which factor is a part of the interrelated environment system?

Adequate fresh water Safety Housing

A comprehensive assessment must consider the entire community and the various populations living int he community. Which indicate a comprehensive assessment?

Adults and children living within ten miles of the center of town

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

During an intake assessment at the local health department, the nurse asks a hispanic client where in Mexico they were born. The client becomes angry and reports being were born in Colombia. What is the best action for the nurse to take?

Apologize for the culture insensitivity and make a mental note to be more careful in the future. fs

A new client is scheduled at the clinic. During the assessment, the nurse notes a circular, dark-pink indention on the client's abdomen. The nurse is aware the client is not from the US. What is the nurse's next best action in assessing this client?

Ask the client to describe usual health beliefs and practices when the client becomes sick.

In providing education to a client at the health department regarding the risk for heart disease, the nurse identifies several protective factors in the client's chart. Which of these items found in the client's chart indicates a protective factor?

Being active in the local church ministries

The occupational nurse would like to identify employees who are at risk for heart disease. The nurses has begun taking blood pressures on all new employees, with the intent of identifying early signs and symptoms so effective treatment can be sought. What ethical principle does this represent?

Beneficence

The public health nurse is performing a community assessment. What community-specific factors will the nurse consider when performing this assessment?

Boundaries Internal influences such as the local economy Purpose of the community Physical characteristics

SATA-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 health responsibilities of the family?

Care provision and management for the chronically ill, disabled, and aging family members Emotional support for the client and guidance during life cycle transitions

Identify the best intervention that considers the mental, physical, emotional, social, spiritual, and environmental health affecting a population with mental health challenges:

Case-Finding

SATA-Which factor is considered when determining social determinants of health?

Childhood Experience Place of birth Age Employment history

What intervention addresses the building of alliances among groups of people in the community, aligned toward a common purpose of well-being?

Coalition Building

Identify the best intervention that considers the mental, physical, emotional, social, spiritual, and environmental health affecting a population experiencing emergency disaster and terrorism issues;

Collaboration

A client seen at the health department has been diagnosed with a communicable sexually transmitted disease. The nurse realizes the client will need immediate education. What is the best rationale for the needed education? csdk

Communicable diseases are contagious and easily spread from one person to another.

When considering health behaviors, the term mainstream is used when discussing interventions directed toward which system level?

Community

When considering health views, which statement is the basis for discussions concerning the effects of culture?

Cultural world views are responsible for the different beliefs regarding the cause of illness.

What is the fundamental criterion for making a screening mandatory?

Degree of physical harm resulting from the lack of screening.

This intervention on the Public Health Wheel relates to specific and direct care actions provided by community health nurses, under the direction of a health care practitioner, as allowed by law. This includes any tasks a nurse delegates to appropriate personnel.

Delegated Functions

Developmental

Developmental family assessment involves the following factors: past experiences shared between family members present stage of family development future goals and tasks of family health, coping with transitions and attachments.

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

While taking a walk around the school at lung, the school nurse notices the cafeteria dumpsters are next to the playground. The nurse goes over to the dumpster to investigate and finds the dumpsters leaking, which is attracting bees. Which of the ten essentials is the nurse demonstrating?

Diagnosing

Income and Social Status

Did you know that higher income and social status are both linked to better health? when the income gap grows between the richest and poorest people, the difference in quality of health between the classes also grows.

SATA-A community nurse is working with clients in the communicable disease clinic. A client seeking treatment confides to the nurse that she has sex for money sometimes to pay her rent. The nurse provides that client with education on how to protect herself from further infection and offers her free condoms. Which of the elements of the American Nurses Association Code of Ethics is the nurse practicing while taking care of this client?

Dignity, regardless of personal attributes Compassion, regardless of the health problem Respect, regardless of social status

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

Direct Outreach

A child has been diagnosed with measles and excluded from school until no longer contagious. A teacher asks the school nurse why the child was infected since the child had received the required immunization. The nurse's best response is based on what fact about immunizations?

Each person is unique, and occasionally a person who received a vaccine will not respond and will get the disease.

Benefits of Screenings

Early detection-many screening tests detect early physiologic indicators of disease before the individual has any indication that they are ill, during the early and pathogenic periods. screening enables earlier intervention and management in the hopes of reducing mortality and suffering from a disease. Fast and Economical-screenings are also a rapid and economical way to determine which individuals require further medical testing

SATA-Which of the following are examples of inequities that may interfere with health?

Economic Social Political

SATA-a public health nurses providing education to pregnant teens on pregnancy nutrition. as part of the education, the nurse also encourages the teens to finish high school and go on to college when possible. whites the rationale for both the nutrition education and encouragement for continued education related to the determinants of health?

Education on health determinants can facilitate positive action and low education levels are associated with poorer health and greater stress

SATA-What is the goal of a community health assessment?

Effective assessment of existing community health problems Associating health need with possible community resource Identification of community health resources Prioritization of community-focused health interventions

A community nurse is reviewing the disease statistics of an assigned new area. What assessment framework is the nurse utilizing in assessing this community?

Epidemiological

What is the initial nursing intervention when conducting a cultural assessment regarding the health beliefs and values of a member of a non-white American culture?

Establishing an accepting environment

SATA-A public health nurse is developing a program based on the goals of the government initiative Healthy People 2020. What is a health indicator the nurse may use as a part of the program?

Exercise frequency Substance abuse Tobacco usage

Community organizing is an intervention that seeks to generate solutions to problems through interactive problem solving.

False

True or False-The social determinants of health are not related to the health status of a client.

False

During an assessment, the community health nurse is gathering data to determine what characteristics and possible health needs are similar for all community members. Which framework will the nurse choose in approaching this assessment analysis?

Familiarization

SATA-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?

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

Which nursing model used to assess family health needs employs venograms and ecomaps to identify relationships?

Family Systems (Anderson)

Functional

Functional family assessment involves the following factors: instrumental=nutritional assessment assessment of any medical conditions, disabilities or limitations expressive=family member roles, communication skills that are practiced and/or needed, alliances and disputes among family members, prevailing beliefs spiritual, religious and basic family values, family health values, members who have influence and power, including sources of income, problem solving skills.

Which model asks direct and probing questions to assess family health in 11 different areas?

Functional health patterns (Gordon)

Which tool is most useful to the community health nurse planning health promotion activities for both the environmental and community level systems?

Health impact pyramid

What is the source for established national objectives and health outcomes that guide health promotion in the United States?

Healthy People 2020

SATA-What does the term family assessment imply?

Holistic appraisal of health care needs Examination of culture, spiritual and developmental needs

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

How do family members cope with transitions and attachments within the family?

Research is an important part of the ten essentials of public health services. When the nurse uses research for community problems, what purpose does this serve?

Identification of new solutions

The state public health nurse would like to gather information on general predictive risk factors related to stroke. The nurse has identified the U.S. Adults National Health Interview Survey sponsored by the CDC as a good place to begin the search. Why would the nurse choose this type of assessment tool?

In this survey, data are analyzed to identify mortality risk for a population.

The community health nurse has identified a high rate of obesity in school-age children within one community. The nurse completes a community assessment and finds the median income in the area is 28,000 for a family of four. In what interrelated system will the nurse document this finding?

Income and social status

SATA-What are the levels of focused practice as noted on the Public Intervention Wheel?

Individual-focused practice Systems-focused practice Community-focused practice

The public health nurse is offering nutrition classes and developing a walking program for the community residents. Which of the ten essential public services is the nurse demonstrating?

Inform

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

Interventions are always based on assessment data

SATA-A community nurse who routinely works in the immunization clinic notes an influx of new patients from Russia. The nurse wants to improve self-awareness of this new population. What steps can the nurse take to cultivate cultural sensitivity toward this new client population?

Interview some of the new members and inquire about cultural value Demonstrate a genuine interest in the lives and culture of the new clients

A social history is vital assessment tool related to which nursing model?

Life span development (Rankin)

Education

Low education levels are associated with poorer health, greater stress, and even lower self-confidence

Which illness is considered communicable?

Malaria

SATA-Which factor affects the way a family identified its health risks?

Methods used to cope with stress Cultural view of wellness Past experiences with illness Ability to pay for health care

SATA-What are included in the ten essential services of public health?

Mobilize Enforce Inform

The immunization clinic nurse is assessing the Mantoux tuberculin skin test a client received two days ago. The result is positive. The client does not have signs or symptoms of active tb. The client is upset regarding the positive result and asks when to start the tb medication regimen. What is the nurse's best response to this question?

Not all people who are infected with tb have active tb, you will need further testing

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

Outreach is an effective strategy for intervening in substance abuse

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

Pamphlets

An occupational health nurse is checking employees' blood pressure at the annual benefits fair. The nurse has developed a questionnaire for the employees to complete, including demographic data such as age, gender, and ethnicity, as well as tobacco use. What interrelated system in health is the nurse assessing with this questionnaire?

Personal Biology

The community nurse is performing an assessment on a community related to an identified problem of obesity. Which approach is best to use for this type of community assessment?

Problem-oriented

SATA-A disease outbreak has been noted in one neighborhood. The community nurse understands a number of actions may be taken by the gov to contain the outbreak. What actions could be included in the containment?

Providing info about signs and symptoms of the illness to health care providers closing schools and churches until the outbreak is over setting up clinics for administration of passive immunity measures

When considering cultural influences, how would the nurse interpret a Chinese patient's lack of eye contact during a discussion about a newly prescribed medication as a sign of what?

Respect

In preparing a health and wellness care plan for the local senior citizen center, the nurse ensures the consideration of the three universal needs. What are the three universal human needs of the community?

Safety Security Sense of belonging

Which grand nursing theory presents the goal of identifying family health patterns for the purpose of making positive changes?

Science of unitary beings

A school nurse is checking the students in the seventh grade for scoliosis. What type of assessment is scoliosis testing?

Screening

Identify the best intervention that considers the mental, physical, emotional, social, spiritual, and environmental health of a population's cultural influences:

Screening

The nurse is unsure which members of a local community have been affected by exposure to chemical poisoning. What strategy from public health interventions wheel should the nurse employ?

Screening

SATA-What are strategies from the Public Health Intervention Wheel?

Screening Health Teaching Advocacy Case management

When considering community health assessment, which intervention is an example of secondary prevention?

Screenings

A public health nurse is administering a Tuberculin test to a hospital employee. What type of screening is the test?

Selective

SATA-What are examples of predictive health factors at the family, community, and/or society level?

Smoking cigarettes Chronic stress and anxiety

Which value is central to nursing and public health?

Social Justice

Which variable is most likely to influence the health of a community?

Social determinants of health

The school nurse is preparing to address the Parent Teacher Association at the school to provide education on the importance of obtaining vaccination. Who is affected by this type of public health outreach?

Society

Structural

Structural family assessment involves the following factors: internal=family composition, rank order of members, gender, subsystems (clustering), boundaries (clear, diffuse) external=work, school, friends, recreation, religion, and greater contextual environment in which the family resides

Which section of the public health nursing intervention wheel focuses on significant health threats such as contagious diseases but it also used with other health events such as chronic disease, injury and violence?

Surveillance

Which characteristic of a system also applies to communities and health?

That what affects one part of the system, affects the system as a whole

A school nurse has identified a depression screening instrument to use for middle-school students who are referred. by the teaching staff. What ethical consideration should the nurse make prior to preforming the screening of students?

The availability of resources if the student has a positive screening.

SATA-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?

The family composition Each member's gender

A school nurse has determined there may be an outbreak of salmonella within the school and possibly the community. Who would the school nurse contact to report the possible outbreak? A

The local health department

A community health nurse is partnering with several community members to resolve an identified problem of homelessness. one of the community members questions why there are so many homeless people when the unemployment rate is below 3% in the community and surrounding area. What would be the nurse's best response to this question?

There are several interrelating systems that lead to homelessness, including social environmental and personal biology.

True or False-Health teaching is used in conjunction with virtually all interventions. it is frequently implemented in conjunction with, or sequentially to, counseling and/or consolation.

True

True or False-Social Justice is the fair and equitable distribution of social benefits and burdens and is tied to issues of human rights.

True

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.

SATA-Which group is more susceptible to health disparities and discrimination in health care systems?

Unemployed persons Ethic or racial minorities Runaway teenagers

SATA-What situation is true concerning a patient diagnosed with latent TB?

Usually has a positive skin test Has a normal sputum test Has a normal chest x-ray

A client at the public health clinic reports performing self-breast examinations monthly. Which protective health factor does this represent?

Valuing health

SATA-Which disease is vaccine-preventable?

Varicella Influenza Smallpox Measles

Health Services

access to and use of quality services is an important factor but, as you can see its not the only factor. nonetheless, access to services that prevent and treat injury and disease still significantly influence health.

Personal Biology

genetic inheritance plays a part in determining life span, health, and the likelihood of developing certain illnesses. gender, age and any number personal biological factors influence your patients health. these all combine to influence personal behavior and coping skills, which in turn affect whether your patient has balanced eating habits, stays active, smokes, drinks and deals with life's stresses and challenges.

Healthy People 2020 indicators

physical activity overweight and obesity tobacco use substance abuse

Physical Environment

physical environment including access to safe water and clean air, healthy work places, safe houses, communities and roads, also affects health. those who are employed are healthier, especially when they have a sense of control over their working conditions.

Protective Health Factors

protective health factors are biological psychological characteristics that increase resilience and protect health. adequate sleep, a healthy diet and exercise all protect against certain health problems, such as heart disease. not having the genetic predisposition to type 2 diabetes, heart disease alcoholism or mental illness. not being exposed to alcohol or drugs prenatally. healthy lifestyle choices, such as wearing helmets when riding a motorcycle or bicycle or not smoking.

Family Assessment Tools

pyramid containing top=structural middle=developmental bottom=functional

Predictive Health Factors

risk, or predictive, factors are biological and psychological characteristics that we engage in that put us more "at risk" to become ill or injured. for example, tobacco use is a risk factor for COPD, heart disease and lung disease. other examples include stress, poor nutrition and poor sleep habits there are also predictive factors that place individuals at risk for disease that don't have to do with individual health behavior choices for example, a person being treated with chemo for cancer may be susceptible to infections or even secondary types of cancer

SATA-Which area of questioning is explored when assessing family health routines?

self-care illness care safety and precaution mental health behaviors

Social Support Networks

social support networks are critical for health, when you receive greater support from families, friends, and communities, you have better health. people also depend on their culture for support and inspiration through their customs and traditions.