FINAL EXAM
2. The developmental theory of human ecology emphasizes the complex relationship between a growing child and their immediate environment that helps the child to learn to: a. accommodate. b. achieve ego identity. c. create mental schemes. d. differentiate.
ANS: A
2. When planning a program for pregnant adolescents, the nurse should be aware that pregnant adolescents who decide to have a child experience an increased risk for: a. reduced lifetime earning potential. b. eating disorders. c. genetic diseases in their infants. d. weight gain.
ANS: A
3. Parents of a 12 year old have started the Weight Watchers program and are concerned about the appropriateness of their eating plan for the preteen's nutritional needs. The preteen's weight is within accepted guidelines for the given height. Which of the following would be the most appropriate guidance? a. A nutritional plan that includes whole foods, fruits, vegetables, lean protein and dairy sources, whole wheat breads, and legumes is healthy for the whole family. b. An extremely low-carbohydrate diet would be more effective to avoid obesity. c. Preteens naturally limit their own intake of unnecessary foods. d. The Weight Watchers plan is appropriate, but children can benefit from having convenient prepackaged processed snack foods to eat as soon as they come home from school.
ANS: A
4. A nurse providing a tertiary prevention intervention to a population of women who are HIV positive will most likely: a. educate about self-care and the women's rights as employees. b. establish a partnership with a community to initiate a community health center. c. help identify new cases and ensure that clients receive proper treatment. d. teach how to lobby state legislators.
ANS: A
4. A truck driver says, "At first I was just using 'meth' at parties, but now I think about it all the time and how am I going to get some." The term that best describes this individual's use behavior is: a. drug addiction. b. drug dependence. c. recreational drug use. d. substance abuse.
ANS: A
4. To detect the presence of the leading cause of disease burden for women in the United States, a screening program for women would include: a. blood pressure screening, mammography, and dietary assessment. b. testing for HIV/AIDS and sexually transmitted diseases. c. pap smear, screening for smoking, and assessment for exposure to violence. d. questions about a family history of depression, employment status, and chronic diseases.
ANS: A
5. In comparison with women, men: a. incur more work-related injuries. b. experience lower survival rates in the first year after myocardial infarction. c. metabolize alcohol more efficiently. d. more actively initiate preventive health care interventions.
ANS: A
5. The community health nurse visits the home of a pregnant teen who lives with her parents, one older brother, and two preteen sisters. The best strategy for meeting the objectives of Healthy People 2020 would be for the nurse to offer which of the following for the entire family? a. Anticipatory guidance addressing sexuality issues b. Assessment for financial assistance c. Assessment of family dynamics d. Environmental assessment addressing suitability for child rearing
ANS: A
6. A community health nurse directly contacts a mammography clinic to arrange an appointment for a migrant worker with limited English language skills. The nurse communicates with the client through an interpreter to ensure that the appointment is scheduled to meet her needs and that the client understands the procedure to be performed. The role played by the nurse in this encounter with a member of a vulnerable population can best be described as: a. advocacy. b. empowerment. c. partnership. d. social justice.
ANS: A
6. A recent movie release portrays a female drug user living with her abusive boyfriend, who has two children by different women, in a rundown inner city neighborhood with high levels of poverty and unemployment. This portrayal best describes the influence of which class of factors on societal responses to poverty and homelessness? a. Cultural b. Environmental c. Political d. Social
ANS: A
6. Teens are at higher risk for becoming pregnant because of the presence of multidimensional factors that include such things as adolescent immaturity, low levels of contraceptive use, and: a. early age of initiation of sexual activity, sexual victimization, and peer pressure. b. parenting styles, family structure, and paternity issues. c. partner pressure, discouragement of abortion, and poor nutrition. d. poor nutrition, preterm delivery, and late-term prenatal care.
ANS: A
7. A nurse case manager identifies a potential health outcomes concern for a 1 year old with special needs living in an impoverished neighborhood, because this child is at increased risk for: a. developmental delays. b. ear infections. c. frequent colds and infections. d. irritability.
ANS: A
7. An occupational health nurse establishes a local business-sponsored smoking cessation clinic that incorporates the use of nicotine replacement therapy, behavioral treatments, and support groups. This strategy best exemplifies: a. population-focused tertiary prevention. b. individual-focused primary prevention. c. primary prevention education. d. secondary early detection.
ANS: A
8. Community-oriented nurses practice in a variety of settings and therefore, have the greatest opportunity to advance a major national health objective for children by: a. increasing the access to care. b. justifying the cost of care. c. promoting healthy lifestyles. d. providing anticipatory guidance.
ANS: A
8. Congress passed the Balanced Budget Act of 1997 with provisions intended to ensure the appropriateness of home health services for those who received them; however, the act may have increased health disparities for vulnerable populations such as: a. frail older adults. b. low-income families with newborns. c. poor clients discharged from acute care. d. clients requiring intravenous antibiotics.
ANS: A
8. In the 1980s, a major contributor to the improvement of services for individuals with chronic and persistent mental illness was the establishment of: a. consumer advocacy groups for people with mental illness. b. community mental health centers. c. managed mental health care. d. National Institute of Mental Health (NIMH).
ANS: A
8. To improve the health of frail elderly, community-based nursing programs will need to address: a. racial/ethnic and sociological disparities. b. culture, ethnicity, and race. c. media and marketing initiatives that target elderly concerns regarding quality of life and degree of disability. d. national vital statistics on morbidity and mortality.
ANS: A
8. When working with the poor or homeless, to develop effective nursing interventions the nurse should evaluate clients and populations in the context of: a. environment. b. improvement in the quality of services. c. human dignity. d. nursing theories.
ANS: A
9. A cultural belief and an environmental factor that may increase the risk of potential pesticide exposure for some migrant workers are: a. hot-cold balance and housing. b. cuarentena and distance from health care services. c. need to achieve high productivity and transportation challenges. d. disease causality and proximity to the farm fields.
ANS: A
9. When considering the scope of mental illness in the United States, the community health nurse must understand that mental disorders are: a. indiscriminate. b. treated largely by specialty services. c. most frequent in African Americans. d. rarely a secondary problem.
ANS: A
10. Which of the following are factors that significantly influence the health status of children in the United States? (Select all that apply.) a. Access to health care b. Education c. Infant mortality among minority groups d. Poverty status e. Risk-taking behavior
ANS: A, B, C, D, E
10. Effects of homelessness on health care outcomes can be devastating and may include which of the following? (Select all that apply.) a. Higher incidence of acute and chronic disease b. Higher risk of physical trauma c. Crisis-oriented health care, usually in emergency departments d. Reduced eligibility for entitlement/assistance programs e. Lack of awareness of care options
ANS: A, B, C, E
10. Disaster-related nursing is an evolving specialty. Nurses have unique skills that can be applied in which of the following aspects of disaster management? (Select all that apply.) a. Completion of the American Red Cross disaster management course and registration as a disaster responder b. Clinical management of blast lung injury c. Engagement of the BioWatch system d. Monitoring of the environment to contain infectious disease e. Planning and organization of mass prophylaxis and vaccine campaigns
ANS: A, B, D, E
10. A community-oriented nurse is developing goals for a community health center's senior center. The goals should focus on which of the following? (Select all that apply.) a. Meeting social and recreation needs b. Helping elders accept the inevitability of the debilitation of aging c. Maximizing functional status and minimizing functional decline d. Implementing secondary and tertiary prevention measures
ANS: A, C, D
9. Diabetes mortality rates continue to rise for all ethnic and socioeconomic groups, but evidence shows that which of the following are true? (Select all that apply.) a. Addressing the diabetic epidemic involves more than a focus on individual factors. b. Community-based education programs have done little to address the problem. c. Complications and mortality rates are highest among low-income and minority groups. d. Selection of healthy food options is both an availability issue and an education issue. e. Standard of living does not affect decision making.
ANS: A, C, D
10. Environmental factors that place children at risk for mental health issues include: (Select all that apply.) a. crowded living conditions. b. genetic predisposition. c. lack of consistent caregivers. d. neighborhood violence. e. separation from parents.
ANS: A, C, D, E
1. A community health nurse is applying for funding to help reduce the incidence of the most common cause of childhood morbidity and mortality in the community. The requested grant should seek to: a. educate the community about the dangers of lead paint for young children. b. teach elementary school children how to choose and use a helmet for biking. c. teach kindergarten children how and when to wash their hands. d. teach kindergarten children how to brush their teeth.
ANS: B
1. A nurse volunteering at a local homeless shelter notes that many of the clients have acute and chronic illnesses and are in need of primary health care services. The most effective strategy to consider when networking with homeless individuals, families, or populations is to: a. form a community partnership to establish a clinic for homeless persons. b. create a trusting environment and establish a therapeutic relationship. c. collaborate with the local United Way to obtain funding for primary care services. d. dialogue with local clergy to address the unmet primary care need for homeless persons.
ANS: B
1. The population group that is likely to be the MOST vulnerable is: a. children with a family history of sickle cell disease and hypertension. b. homeless pregnant teens in a substance abuse program. c. nNative Americans at risk for diabetes. d. overweight children.
ANS: B
1. To develop a baseline for a presentation at the local women's club about the status of women's health in the community, a community-oriented nurse researches national vital statistics to establish the leading cause of women's deaths in the United States. In the United States, the leading cause of death for women is: a. cancer. b. heart disease. c. stroke. d. infectious disease.
ANS: B
1. To target populations at greatest risk for suicide, a community-based prevention program should consider outreach to: a. adolescent females, adults older than age 65 years, and men. b. depressed elderly men and persons with a prior history of suicide attempt(s). c. married men, elderly women, and adolescents with a family history of suicide. d. middle-aged men and healthy females with a family history of suicide.
ANS: B
2. Counseling regarding hormone replacement therapy (HRT) should include the following information: a. menopause is a result of hormone deficiency, and therefore HRT is appropriate for all women to treat all symptoms. b. HRT should be used to prevent osteoporosis only among women who are unable to take non-estrogen medication. c. research concludes that HRT does prevent heart disease in menopausal women. d. HRT should be considered for prevention of osteoporosis in all women.
ANS: B
2. The nurse case manager in a migrant farmworker clinic assesses this vulnerable population from the perspective of occupational and environmental risks related to: a. contaminated water, applied chemicals, and unfamiliar farm equipment. b. naturally occurring plant substances, pesticides, and fear of injury reporting. c. traffic accidents, weather, lack of worker supervision, and inadequate sewage. d. weather, pesticides, and strict enforcement of occupational regulations.
ANS: B
2. Which of the following best represents the concept of homelessness as crisis poverty? a. Man with chronic alcoholism and drug abuse living in a halfway house b. Recently unemployed man evicted from his apartment c. Teenager living on the streets and abusing drugs d. Woman with schizophrenia who is living in a shelter
ANS: B
3. A client acknowledges that his cocaine use is damaging his career and marriage, but the client has not investigated local treatment options. The nurse encourages the client to weigh the pros and cons of the drug problem and think about the solution to the problem, because the nurse recognizes that the client is in the change stage of: a. action. b. contemplation. c. precontemplation. d. preparation.
ANS: B
5. A migrant worker comes to the migrant health clinic holding the abdomen and complaining of empacho. The nurse may encounter this complaint when dealing with migrant workers who are: a. natives of Guatemala. b. natives of Mexico. c. natives of Panama. d. newly arrived from Haiti.
ANS: B
5. A nurse working in a clinic in an inner city with high poverty and unemployment rates recognizes the need for programs for women because impoverished women are at higher risk for: a. decreased access to social services. b. poorer health status. c. exposure to environmental toxins. d. poorer academic success.
ANS: B
5. Many factors contribute to the fragmentation and access issues associated with the current mental health system. A community-oriented nursing strategy that can be used effectively to improve the quality of care for clients with persistent mental illness is: a. comprehensive client history taking and family interventions. b. agency networking and interagency collaboration. c. milieu therapy and psychobiological interventions. d. screening for signs of mental health disorders.
ANS: B
6. A nurse takes the time to read and understand the community's disaster plans and participates in mock disaster drills as a leader of the triage team. The nurse obtained disaster management training through the local Red Cross chapter and registered with the state as a disaster management nurse. The best description of the nurse's activities is: a. American Red Cross disaster training. b. community preparedness. c. personal preparedness. d. professional preparedness.
ANS: B
7. Adolescents who feel competent as parents have enhanced self-esteem, which, in turn, positively influences their relationship with their child and response to the child's cues signaling basic needs or distress. It is important for the nurse to initiate parenting education for both parents as early as possible to increase the teens' understanding of their child's growth, development, and needs in order to reduce the risk for: a. academic behavior problems in the future. b. abusive parenting. c. limited verbal communication with the infant. d. negative parenting feedback.
ANS: B
7. Health education is often used as a strategy in working with vulnerable populations. The benefits of health education can be greatly affected by the individual's or group's: a. cycle of dependency. b. health literacy. c. level of income. d. race and ethnicity.
ANS: B
7. Research in neurobiology demonstrates that new learning actually changes brain structure, as exemplified by the effect of traumatic experiences on brain biochemistry. The use of both somatic and psychosocial interventions in the treatment of mental illness is supported by the scientific understanding of: a. blood-brain barrier. b. brain plasticity. c. serotonin reuptake. d. single-photon emission computed tomography.
ANS: B
8. An extensive train derailment occurs in the suburbs of a large metropolitan area. First responders determine that although no fatalities occurred, the derailed cars contain a noxious gas that diffuses readily into the air. The event easily overwhelms the capability of the local responders and hazmat teams are required. The local office of emergency management would coordinate through the emergency operation center to request assistance through which of the following? a. Environmental Protection Agency (EPA) b. Mutual aid agreement c. NIMS d. National Response Plan
ANS: B
8. Factors that are associated with decreased sexual risk behaviors in teens include higher levels of parental education and: a. age-restricted discussion of sexual issues. b. good family health practices. c. strict parental rules on behaviors. d. membership in the white majority versus other racial groups.
ANS: B
9. An unemployed individual with acquired immune deficiency syndrome (AIDS) develops recurrent opportunistic infections that require repeated visits to the health clinic and the purchase of various medications to combat the infections and treat their associated side effects. This best demonstrates how the stress caused by poor health status can be related to: a. barriers to access. b. cascade effects. c. cumulative risk. d. socially based inequity.
ANS: B
1. The community health nurse can serve as an advocate for the vulnerable migrant population by engaging in which of the following actions? (Select all that apply.) a. Becoming culturally and linguistically competent b. Collecting necessary data on migrant workers' lifestyle and health status c. Educating communities about the migrant workers in their areas d. Educating policymakers about successful programs for migrant workers e. Using lay health workers to provide health education in migrant camps
ANS: B, C, D
10. A nurse planning a primary intervention program for adolescent pregnancy reviews trends in adolescent pregnancy, births, abortions, and adoption and notes that comparisons with other developed countries indicates which of the following? (Select all that apply.) a. Adolescent pregnancy rates continue to rise because of unreliable contraceptive methods. b. Use of contraceptives is improving among teens in the United States. c. Decreases in pregnancy among teens ages 15-17 have been attributed to reduced sexual activity. d. Female students are more likely to initiate sexual activity before the age of 13 years. e. Changes in parental notification or consent requirements for minors impacted rates of teen abortions.
ANS: B, C, E
10. Vulnerable population groups are those that, in comparison with the population as a whole, have which of the following characteristics? (Select all that apply.) a. Better access to health care services but poor health outcomes b. Greater likelihood of exposure to risk factors c. Multiple risk factors but equal health outcomes d. Worse health outcomes
ANS: B, D
10. Marijuana (Cannabis sativa or C. indica) is the most widely used illicit drug in the United States. Which of the following are facts about marijuana of which the nurse should be aware? (Select all that apply.) a. It decreases appetite. b. Tolerance and physical dependence can develop. c. It is highly toxic. d. It can be a safe therapeutic agent. e. It may be contaminated.
ANS: B, D, E
1. In caring for migrant workers and their families, the nurse should first assess the migrant workers' lifestyle, especially their current: a. communicable diseases. b. educational level. c. housing arrangements. d. pesticide exposure.
ANS: C
2. In an effort to decrease health disparities and improve life expectancy, the Social Security Act was amended in 1998 to provide federal funding to: a. assure access to health care for elderly Americans. b. build hospitals to care for the medically indigent. c. insure children without health insurance. d. provide supplementary income for citizens with disabilities.
ANS: C
2. Primary prevention programs for adolescents at risk for ATOD problems should focus on: a. encouraging competitiveness and success in aggressive sports. b. encouraging focus on short-term solutions rather than long-term planning. c. screening and treating psychiatric disorders and influencing social norms. d. teaching adolescents to "just say no."
ANS: C
3. A nurse has obtained state funding for the development of an adolescent treatment program that supports Healthy People 2020 mental health objectives. The program should address: a. reduction of adolescent suicide attempts and prevention of teen obesity and depression. b. reduction of eating disorder relapses and stress-related hypertension in teens and preteens. c. reduction of suicide attempts and eating disorder relapses, and assessment and treatment for adolescents in the juvenile justice system. d. treatment of eating disorders and increased access to mental health treatment in middle and high schools.
ANS: C
3. At the request of a local senior women's group, a nurse is developing an osteoporosis primary prevention program. An appropriate strategy for the program would be to: a. design a nurse-directed program instead of a peer-directed program. b. encourage exercise and consideration of HRT. c. promote diets rich in calcium and vitamin D and daily weight-bearing exercise. d. promote swimming and supplementation with calcium and vitamin D.
ANS: C
3. The definition of a migrant farmworker includes which of the following? a. Farmer who helps his neighbors on their farms after his own crop fails b. High school student who works part time at his uncle's rose farm c. Teenager who moved with his family ten times in 2 years to work different crops d. Woman who works in the crop fields in the summer and at a grocery store in the winter
ANS: C
3. Vulnerability is multidimensional, and one of the primary contributors to vulnerability is: a. gender. b. race and ethnicity. c. resource limitations. d. urban or rural residency.
ANS: C
4. A nurse is working with a disaster medical assistance team as it responds to a disaster. A new team member excitedly insists that its personnel can exceed their 12-hour shifts and do not need breaks. The best intervention on the part of the nurse is to: a. arrange for the team member to be transferred to another unit. b. arrange for the team member to leave duty, return home, and talk with his or her pastor. c. educate the rescuer about necessary stress-management techniques and offer to pair up with the individual so that each can monitor the other's stress level. d. help the team member to call home to speak with his or her family.
ANS: C
4. A parent is concerned that her child should not receive a diphtheria-pertussis-tetanus immunization inoculation because of a runny nose. The child is afebrile and otherwise asymptomatic. The most appropriate intervention for the nurse is to: a. defer the immunization to avoid masking the symptoms of the illness. b. defer the immunization until the child's next well-child examination. c. educate the parent regarding the safety of immunization during a minor acute illness. d. reschedule the immunization after the sinus drainage has cleared.
ANS: C
4. For the pregnant adolescent, the factors that pose the greatest nutritional challenge are: a. chronological age and fetal growth. b. family support and teen attitude. c. lifestyle, growth, and development. d. need to limit weight gain and increase exercise.
ANS: C
4. The migrant clinic's mobile van program provides health education through lay health workers; screening for pesticide illness, tuberculosis (TB), and diabetes; pregnancy testing; and treatment for some acute and chronic illnesses typically seen in this vulnerable population. In dealing with this population's beliefs about disease causality, this program demonstrates the application of the health promotion and disease prevention principle of: a. advocacy. b. cultural competency. c. outreach. d. primary prevention.
ANS: C
4. Within the impoverished older adult population, the most vulnerable group may be: a. elderly couples living in poverty with serious chronic illnesses. b. elderly men with alcoholism and limited incomes. c. homeless older adults. d. newly widowed, low-income elderly women.
ANS: C
5. A school nurse is working with a parents and teachers organization to improve the health status of students in an urban lower socioeconomic community that has a high concentration of Hispanic and African American individuals. Given the demographics of the community, the nurse is aware that these children will be at highest risk for: a. asthma. b. attention deficit disorder. c. obesity. d. poisoning.
ANS: C
5. A very toxic psychoactive drug that is a stimulant, causes tolerance to develop within hours, and has dangerous health impacts for those in the vicinity during use is: a. alcohol. b. crack cocaine. c. nicotine. d. volatile solvents.
ANS: C
5. After performing an assessment of a client seeking treatment for hypertension at the local free clinic, the nurse informs the client that the family's children may qualify for enrollment in the state children's health insurance program. The nurse provides the enrollment forms and reviews them with the client, emphasizing how to apply for the benefits. This best exemplifies which principle for intervening with vulnerable populations? a. Carrying out primary prevention b. Setting family-centered, culturally sensitive goals c. Trying to minimize the "hassle factor" d. Using the MAP-IT approach
ANS: C
6. Although all men are at risk for developing prostate cancer, those at greatest risk are men who: a. have erectile dysfunction. b. fail to undergo prostate-specific antigen testing or digital rectal screening. c. are African American. d. have multiple sex partners.
ANS: C
6. An undocumented migrant farmworker has been diagnosed with TB. The local health department initiates treatment by dispensing the first month's supply of medication and educates the client on the need to continue treatment for 6-12 months. A major challenge that the client may face to ongoing treatment for TB is: a. affordable care. b. discrimination. c. fragmented services. d. language barriers.
ANS: C
6. Some health care organizations, like the American Nurses' Association, American Public Health Association (APHA), and several state nurses' associations, passed formal resolutions to support the use of medicinal marijuana based on its low level of toxicity, dependence, or addiction, and therapeutic safety and benefits especially in the control of pain. These resolutions have impacted changes in state legislation but to date, despite formal petition in 2002 to remove cannabis from the Drug Enforcement Agency's (DEA) Schedule I of Controlled Substances, and an extensive review and report by the Department of Health and Human Services (DHHS) in 2010, a DEA final ruling has not been received. This collective action by health care organizations to influence policymakers to put the emphasis on health care instead of law enforcement can best be described as: a. assessment. b. advocacy. c. education. d. surveillance.
ANS: C
6. The Mental Health Study Act of 1955 ultimately resulted in a shift in the locus of care for persons with severe mental illness from large psychiatric wards in hospitals to community mental health clinics. The Community Mental Health Centers Act of 1963 provided matching funds to states for the establishment of community-based mental health clinics that provided five basic services. In addition to these basic five services, states were encouraged to offer: a. 24-hour emergency services and inpatient care. b. consultation/education for community agencies and professionals. c. diagnostic and rehabilitative precare and aftercare services. d. partial hospitalization and outpatient care.
ANS: C
7. A new primary health clinic is established in a predominantly African American neighborhood to address the top causes of mortality in the local adult population. The nurse at the clinic uses a community-focused nursing process to plan interventions aimed at reducing the incidence of: a. cardiovascular accident, lung cancer, and alcoholism. b. depression, alcohol abuse, and obesity. c. heart disease, stroke, and homicide. d. mental illness, drug and alcohol abuse, and heart disease.
ANS: C
7. The local hospital emergency department has recently noted an increase in gastroenteritis cases among migrant farmworkers. The local health department is informed of the rise in cases and schedules a case mapping of: a. bars frequented by migrant workers. b. farm fields employing migrant workers. c. housing for migrant workers. d. restaurants frequented by migrant workers.
ANS: C
8. A community health nurse seeks to enhance the health promotion and health-service-seeking behaviors of the migrant farmworkers in local apple orchards. An evidence-based strategy that would be effective for this mobile population is educating: a. advocacy groups for migrant farmworkers. b. local policymakers. c. migrant lay health workers. d. workers seeking care at the migrant health clinic.
ANS: C
9. A client receiving morphine on a regular basis for pain management must be gradually weaned off the drug to avoid withdrawal symptoms. This best illustrates the state of neuroadaptation known as: a. biopsychosocial effects. b. drug addiction. c. drug dependence. d. substance abuse.
ANS: C
9. The nurse is following a pregnant teen who attends the local high school. The nurse plans to discuss self-care activities that will be important for the teen during her pregnancy and assist in keeping the teen in school. The nurse's interventions will involve the teen and the staff and teachers at the local high school. These interventions should address specific needs related to: a. adequate hydration and screening for depression. b. desk space and desk location in the classroom. c. frequency of bathroom breaks and modifications to bookbag weight. d. use of the stairs and consumption of high-carbohydrate sodas for snacks.
ANS: C
9. To provide effective care and advocacy for individuals, families, and populations living in poverty, nurses must first: a. apply epidemiologic principles for prevention. b. develop resource expertise in the community. c. examine their personal beliefs, values, and experiences. d. understand the federal criteria and guidelines for poverty.
ANS: C
1. A community assessment reveals a high incidence of alcohol-related chronic liver disease and cirrhosis in the local community. A primary prevention harm-reduction program would focus on: a. detoxification, addiction treatment, and codependency. b. drug education, drug treatment, and recovery. c. polysubstance abuse, assessment of recreational drug use, and drug testing. d. promotion of a healthy lifestyle and resilience factors, and drug education.
ANS: D
1. A high school teen tells the school nurse that she wants to become pregnant. The most appropriate nursing action is to: a. clarify the intent and inform the teen's parent(s) of the potential to influence her behaviors. b. discourage the teen's interest in pregnancy when she has a full life ahead of her. c. encourage the teen to use contraception if she intends to be sexually active. d. provide preconception counseling and emphasize the need to achieve good health.
ANS: D
1. A nurse is assigned to provide community outreach to a small town that was partially destroyed by a tornado 3 years earlier and has been rebuilt. The first client is a family who lost their home and their best friend in the tornado. The best intervention would include: a. assessment of the family's home environment to rule out safety issues. b. avoidance of discussion of the disaster of 3 years ago. c. consideration that the family will have worked through the emotional aftermath by now. d. support of the family in preparing a personal disaster response plan.
ANS: D
2. The highest priority for a nurse who is among the first responders to a disaster is: a. arranging for shelter for disaster providers. b. beginning community assessment as soon as possible to ensure a rapid recovery. c. beginning surveillance and planning needed health education for disaster survivors. d. immediately developing plans for effective triage and client management.
ANS: D
2. The role of the community mental health nurse on a multidisciplinary team caring for clients with mental illness is best exemplified by which of the following? a. Providing psychometric testing, case management, and advocacy services b. Role-playing conflict management skills, dispensing medication, working with insurance companies to maximize reimbursement c. Teaching medication self-management, providing therapeutic counseling, providing family intervention d. Teaching medication management and self-management skills, coordinating care including assessment, referral, and follow-up
ANS: D
3. Deinstitutionalization of chronically ill individuals from publicly funded psychiatric hospitals had the unintended consequence of: a. moving clients to readily available community-based care. b. shortening hospital stays in mental health facilities. c. increasing the funding for community-based services. d. increasing the number of homeless persons.
ANS: D
3. The challenges faced by a pregnant teen when attempting to establish paternity may be impacted by: a. beliefs that impregnating a women proves masculinity. b. demands for involvement in the child's birth. c. denial of paternity because of associated financial obligations. d. involvement of the legal system to acknowledge paternity.
ANS: D
3. The emergency support functions of the National Response Framework (NRF) and the National Incident Management System (NIMS) provide: a. authority to step in and take control of state, local, and voluntary organizations during disasters. b. command and control for American Red Cross and Disaster Medical Assistance teams. c. oversight of federal and state response operations, with minimal interaction with other organizations. d. written approach, protocol, and common language for responders from federal agencies and other voluntary organizations.
ANS: D
4. The one common factor shared by ethnic and cultural groups such as African Americans, Asian and Pacific Islander Americans, and Native Americans with regard to mental health care is their: a. care-seeking behavior for symptoms of depression. b. higher than normal rates of anxiety disorders. c. increasing incidence of eating disorders. d. low utilization of mental health services.
ANS: D
5. The major factor that has led to sharply increased insurance payouts following disasters in the United States in recent decades has been: a. El Niño. b. geography. c. technology. d. human development.
ANS: D
6. In implementing an antismoking program in the local middle school, a school nurse is aware that programs are more effective when they are consistent with the developmental stage of the target age group. Besides including information about immediate health risks and cosmetic effects, the nurse should also consider: a. teaching behavior modification techniques. b. describing effects on the environment. c. outlining laws regarding tobacco sales to minors. d. teaching the social skills to resist peer pressure.
ANS: D
7. After a mock disaster drill, the nurse participates in a "hot wash" of the exercise in which participants from all units speak about successes, problem solving, failures, and unanticipated challenges or obstacles faced during the mock disaster drill. This activity best addresses the public health workforce competency of: a. describing the agency chain of command. b. identifying the limits of one's own knowledge, skill, and authority. c. recognizing unusual events that might indicate an emergency. d. writing after-action reports, updating implementation plans, and implementing changes.
ANS: D
7. Nurses should assess environmental health hazards at each health care visit because of the direct impact of the environment on the health of children. The most appropriate interventions would include: a. community assessments and referrals for treatment. b. lobbying efforts and education for public policy changes. c. neighborhood screening programs and education. d. referrals for treatment and counseling for risk reduction.
ANS: D
8. Americans rely heavily on prescription drugs and over-the-counter drugs to relieve or mask anxiety, tension, fatigue, and physical and emotional pain. Attitudes toward ATOD problems in our society today are influenced by this "quick fix" attitude, as well as by the myth that: a. alcoholism is a disease. b. any drug can be abused. c. biopsychosocial factors affect addiction. d. there are good drugs and bad drugs.
ANS: D
9. A nurse wishes to become actively involved in disaster management and is extremely interested in providing first aid and delivering aggregate health promotion, disease prevention, and emotional support. It would be ideal for the nurse to train and volunteer as which of the following? a. Community emergency response team member b. Disaster medical assistance team member c. Member of the Medical Reserve Corps d. Red Cross shelter manager
ANS: D
9. To work effectively with a child and family, a nurse must understand the cognitive abilities of children at each stage of development. Cognitive development leads to: a. achievement of ego identity and mastery of the previous stage. b. developmental milestones in the quality of the parent-child relationship. c. internal psychosocial developmental crisis points. d. increasing problem solving behavior.
ANS: D
