Population Health Final
o The nurse is notified that a possible anthrax exposure occurred at the local military base. Civilian workers are routed to the local hospital's emergency department. The nurse's responsibility is to set up PODs in the community. The function of the PODs in response to the anthrax exposure is to: ♣ Distribute decontaminated food ♣ Administer prophylactic medications ♣ Distribute decontaminated water ♣ Provide triage
Administer prophylactic medications
o The nurse assesses a 15-year-old client who shows some signs of possible drug addiction. The nurse reviews the client's health and family history, looking for key indicators for risk of substance dependence, such as: (Select all that apply.) ♣ Obesity ♣ Age at first use of illicit substance ♣ Family history of alcoholism ♣ Presence of a learning disability ♣ Early onset of diabetes
Age at first use of illicit substance Family history of alcoholism
o During an assessment, a teenager reveals a 2-year history of inhalant use. Using knowledge that fumes may be inhaled through the mouth, this will achieve a state of intoxication similar to: ♣ Alcohol ♣ Cannabis ♣ Cocaine ♣ Morphine
Alcohol
o Which mental illness is most likely to go untreated? ♣ Anxiety ♣ Bipolar disorder ♣ Depression ♣ Alcoholism
Alcoholism
o Response to a disaster is in its final phase. Although still in the recovery phase of the response, an evaluation meeting is arranged. The purpose of the evaluation meeting is to: ♣ Analyze the strengths and weaknesses of the response and submit a plan to improve response in the future ♣ Create a report that emphasizes the cohesiveness of the departmental response to the disaster ♣ Analyze the effectiveness of the disaster relief teams from respondent states ♣ Create a post-disaster report for FEMA
Analyze the strengths and weaknesses of the response and submit a plan to improve response in the future
Which best describes a nongovernmental organization? A. Agency that is based in only one country but provides services to many other countries B. Agency that acquires resources to help others from private rather than public sources C. A group that collects data related to healthcare use across a variety of professional and service parameters D. An organization that uses endowed funds or private fundraising to address the needs of individuals, families, and populations
B. Agency that acquires resources to help others from private rather than public sources
o The nurse is called to make an unscheduled visit to a new client in her home. The purpose of the visit is to admit the client and treat an abdominal wound. The nurse discovers that the client is from a culture unfamiliar to her. In this situation, the nurse should demonstrate cultural competence and awareness by: (Select all that apply.) ♣ Being open to the client's ideas and way of life ♣ Obtaining objective data when caring for the client ♣ Exhibiting respect and patience ♣ Being aware of your own culture ♣ Assuming that you have enough knowledge to get by
Being open to the client's ideas and way of life Exhibiting respect and patience Being aware of your own culture
o During an ice storm, people in one neighborhood banded together and shared the home of a neighbor who still had power and heat. Other neighbors provided food, water, and bedding. In another neighborhood the neighbors did not know one another and weathered the storm alone. Both neighborhoods are part of the same community. What characteristic did the people in the first neighborhood share that made them a subculture that those in the second neighborhood lacked? ♣ Belief in the value of cooperation ♣ Religion ♣ Socioeconomic status ♣ Geography
Belief in the value of cooperation
Which represents the correct order of events in the policy-making process? A. 1) Policy formulation, 2) policy assessment, 3) policy adoption, 4) policy implementation, 5) policy modification, 6) setting an agenda B. 1) Setting an agenda, 2) policy formulation, 3) policy assessment, 4) policy modification, 5) policy adoption, 6) policy implementation C. 1) Policy formulation, 2) setting an agenda, 3) policy implementation, 4) policy modification, 5) policy assessment, 6) policy adoption D. 1) Setting an agenda, 2) policy formulation, 3) policy adoption, 4) policy implementation, 5) policy assessment, 6) policy modification
D. 1) Setting an agenda, 2) policy formulation, 3) policy adoption, 4) policy implementation, 5) policy assessment, 6) policy modification
Which best describes a philanthropic organization? A. Agency that is based in only one country but provides services to many other countries B. Agency that acquires resources to help others from private rather than public sources C. A group that collects data related to healthcare use across a variety of professional and service parameters D. An organization that uses endowed funds or private fundraising to address the needs of individuals, families, and populations
D. An organization that uses endowed funds or private fundraising to address the needs of individuals, families, and populations
A nurse is coordinating a plan to bring vaccinations in a cost-effective way to a rural community that currently lacks access to them. This is an example of which public health intervention? A. Surveillance B. Outreach C. Screening D. Case Management
D. Case management
You have heard rumors in the hospital where you work of an Ebola outbreak in your community and you would like to investigate it further. Which of the following should be your first step in the investigation? A. Identify the names of the people infected by the virus B. Formulate and test hypotheses as to the most probable causative factors C. Implement a plan for control of the outbreak D. Establish the existence of the outbreak
D. Establish the existence of the outbreak
A community health nurse visits a village in Chad. The nurse has just finished assessing a 10-year-old girl who reports always being hungry. She lives in a home with her mother and father, who both work. She says she's never been to a healthcare provider before. Which level of poverty should the nurse most suspect in this girl and her family? A. Middle B. Moderate C. Relative D. Extreme
D. Extreme
A nurse performs a variety of tasks as part of the nurse's position at a hospital. Which task best exemplifies public health? A. Reading current nursing journals and integrating the latest research into daily practice B. Instructing a client on how to best care for a suture site at home C. Participating in a videoconference call with a client who lives in a remote area D. Facilitating a community-wide smoking cessation program one month out of the year
D. Facilitating a community-wide smoking cessation program one month out of the year
Which most accurately describes how disease patterns have changed from 1900 to the present? A. Morbidity and mortality from infectious diseases have increased. B. Morbidity and mortality from unintentional injuries have decreased. C. Morbidity and mortality from chronic degenerative conditions have decreased. D. Morbidity and mortality from noninfectious diseases have increased.
D. Morbidity and mortality from noninfectious diseases have increased
A 47-year-old client and three members of his neighborhood have had their homes robbed and belongings scattered. The client contacts the police and, with their assistance, develops a neighborhood watch. The watch is organized and 24 families have been recruited to participate. The watch will be active throughout vacation months and as needed. This organization is representative of: A. Trans-theoretical model B. Theory of reasoned action C. Social learning D. Relapse prevention model
D. Relapse prevention model
o The occupational health nurse for a hydroelectric plant uses root cause analysis to investigate a recent accidental electrocution of a plant worker. The nurse currently is defining the characteristics of the case. In which step of the root cause analysis is the nurse? ♣ Define the problem ♣ Collect data ♣ Identify possible causal factors ♣ Identify the root cause
Define the problem
o Which is the most accurate definition of a risk assessment? ♣ Assessment of the adverse effects of chemical, physical, or biological agents on people, animals, and the environment ♣ Process to help determine whether an individual has been exposed to environmental contaminants ♣ Assessment of factors that determine a person's level of exposure to an environmental contaminant ♣ Determination of the likelihood of adverse effects in a group exposed to an environmental contaminant
Determination of the likelihood of adverse effects in a group exposed to an environment contaminant
o Environmental justice is an important consideration when working with tribal communities. In which way is traditional tribal practices most often directly affected by contaminated land and water? ♣ Spiritual practices ♣ Dietary practices ♣ Work opportunities ♣ Exercise opportunities
Dietary practices
o A client has just been pronounced dead. The first action the nurse should take is to: ♣ Remove all tubes ♣ Don gloves ♣ Grasp the eyelashes and gently pull the lids down ♣ Insert dentures into mouth
Don gloves
o The nurse researches whether the community would benefit from monthly blood pressure clinics. Which system level would such an intervention address? ♣ Upstream ♣ Mainstream ♣ Sidestream ♣ Downstream
Downstream
o In which phase of a school-based substance abuse program is information most likely to have meaning and applicability to students? ♣ Inoculation ♣ Primary ♣ Early relevance Tertiary
Early relevance
o Primary, secondary, and tertiary levels of prevention help reduce risk, identify and limit disabilities, and reduce complications of mental health problems. Which exemplifies a primary prevention strategy for mental health problems? ♣ Educate families and community groups about mental health issues, symptoms of stress, and barriers to seeking help ♣ Screen for mental health disorders ♣ Promote support groups for people with mental health disorders ♣ Initiate health-promotion activities as a part of rehabilitation services
Educate families and community groups about mental health issues, symptoms of stress, and barriers to seeking help
o Which exemplifies a physical hazard? ♣ Infectious agents ♣ Hazardous drug and toxin exposure ♣ Electric and magnetic fields ♣ Sexual harassment
Electric and magnetic fields
o Chloroquine-resistant malaria occurs in most of Africa, the Middle East, and Asia and all of the South Pacific islands. This type of disease occurrence is known as: ♣ Endemic ♣ Epidemic ♣ Pandemic ♣ Outbreak
Endemic
o The community health nurse works in a region where severe acute respiratory syndrome (SARS) has just been reintroduced into the environment. Which measure is imperative for the nurse to take to prevent spread of the disease? ♣ Prophylactic antibiotics ♣ Enhanced infection control measures ♣ Use of alcohol cleansers ♣ Report of clusters to the Centers for Disease Control and Prevention
Enhanced infection control measures
o The occupational and environmental health nurse provides leadership in developing occupational safety and health policy within the organization and function in an upper management role. The nurse has served as a consultant to both business and government and has designed and conducted significant research. At which American Association of Occupational Health Nurses (AAOHN) competency level in occupational and environmental health nursing is this nurse functioning? ♣ Advanced beginner ♣ Competent ♣ Proficient ♣ Expert
Expert
o The community health nurse addresses cyber bullying in the local middle schools. Currently, there are no policies in place for this issue. The most appropriate first step is to: ♣ Explore current programs to prevent bullying and youth violence ♣ Develop rules for acceptable and safe use of all electronic media for all students ♣ Ban use of the Internet at all schools ♣ Actively monitor students' social media postings
Explore current programs to prevent bullying and youth violence
o The physician approaches the client with a treatment plan for his cancer. The client states that his life is in God's hands and refuses conventional treatment. This is an example of: ♣ Fatalistic behavior ♣ Denial ♣ Anger ♣ Bargaining
Fatalistic behavior
o The nurse prepares to enter the room of a client with suspected Ebola virus disease (EVD). Which pieces of personal protective equipment (PPE) should the nurse wear? (Select all that apply.) ♣ Fluid-resistant gown ♣ Gloves ♣ Respirator ♣ Mask ♣ Goggles
Fluid-resistant gown Gloves Mask Goggles
o Which type of assessment considers a configuration of behaviors that occur sequentially over time? ♣ Asset-based assessment ♣ Epidemiologic model ♣ Collaborative model ♣ Functional health pattern
Functional health patterns
o The clinic clients respond negatively to the need for a yearly flu shot. They ask why the medical communities don't just create one shot that will last for several years. Which explanation should the nurse give? ♣ Genetic changes in the bacteria that cause the flu require a rotating course of antibiotics. ♣ Genetic changes make the flu virus resistant to the flu shot from year to year. ♣ There is more than one strain of the flu virus and you must be protected from all of them. ♣ The shots last only for 3 to 6 months and must be renewed on a yearly basis.
Genetic changes make the flu virus resistant to the flu shot from year to year
o In assessing a 13-year-old Native American boy who lives on a reservation, the nurse finds that he regularly drinks alcohol and smokes cannabis. He says that most of his friends do so, as well. The nurse is aware that this rate of prevalence is far higher than that for 13-year-olds of all ethnicities nationwide. Which social conditions have researchers associated with this health disparity? (Select all that apply.) ♣ Greater availability of cannabis from local farms ♣ Higher socioeconomic status ♣ Lower academic attainment ♣ Proximity to Mexico and drug gangs ♣ College enrollment
Greater availability of cannibis from local farms Lower academic attainment Proximity to Mexico and drug gangs
o Which type of agency can be either profit or nonprofit? ♣ Private/voluntary ♣ Hospital based ♣ Proprietary ♣ Official
Hospital based
o The nurse visits a community along a creek where residents have begun to report upper respiratory illnesses and asthma. After investigating, the nurse learns that several miles upstream is a hazardous material disposal site. In addition, chemicals have leached through the soil into the creek water and have been carried downstream to this community. Although children are not allowed into the creek, they do often play along the bank. Which represents the route of exposure in this situation? ♣ Creek water ♣ Chemicals ♣ Bank of the creek ♣ Inhalation
Inhalation
o The nurse assesses a 77-year-old woman who has been caring for her husband who has Alzheimer disease in their home for the past 8 years. The client complains of exhaustion and depression. Which stressors should the nurse most suspect as the cause of this client's symptoms? ♣ Marital strain ♣ Caregiver burden ♣ Spillover ♣ Interfamily strain
Interfamily strain
o The nurse provides care covered by Medicare for a client over 2 hours during the day, 3 days during the week, for 60 days. Which type of care is the nurse providing? ♣ Interdisciplinary ♣ Skilled ♣ Intermittent ♣ Part-time
Intermittent
o The nurse assesses a client in the local neighborhood clinic. He exhibits signs and symptoms of tuberculosis (TB) yet has a negative tuberculin skin test result. The nurse suspects that the physician may further test the client because he: ♣ Visited Central America recently ♣ Is recovering from jet lag ♣ Is HIV positive ♣ Works in a factory setting
Is HIV positive
o In a parish nursing model, the nurse: ♣ Serves a health system with assignment to particular congregational settings ♣ Serves as a liaison between a health system and a congregation ♣ Is part of the ministry staff of the congregation ♣ Serves a particular faith community by virtue of a contract or job description
Is part of the ministry staff of the congregation
o The nurse visits the home of client in a low-income community and notices that paint is flaking off the walls and forming a dust in the corners of some rooms. The nurse asks the client when the house was built, and she responds that it was built in 1959. Which contaminant should the nurse expect to find in this home? ♣ Lead ♣ Radon ♣ Asbestos ♣ Pesticide
Lead
o The nurse performs motivational interviewing with a college student in the university health center regarding the student's history of binge drinking. The nurse hopes to ascertain the student's readiness to change her behavior and encourage her to make better choices related to alcohol use. The interview should begin with: ♣ Listening empathetically to establish trust ♣ Eliciting feelings about how the drinking behavior is affecting the student's life ♣ Noting discrepancies between attitudes toward alcohol and alcohol-associated harms ♣ Being supportive of the student's life goals
Listening empathetically to establish trust
o The home health nurse has to ensure that a safety plan is in place to address falls. Using knowledge that 55% of fall-related injuries occur with falls inside the home, a total of more than 60% of these falls occur in which two rooms? ♣ Living room and hallway ♣ Kitchen and bathroom ♣ Hallway and bedroom ♣ Living room and bedroom
Living room and bedroom
o According to current research findings, which group has the most experience with congregational health ministers? ♣ Mainline Protestant and African-American Protestant ♣ Conservative Protestant and Roman Catholic ♣ African-American Protestant and Conservative Protestant ♣ Mainline Protestant and Roman Catholic
Mainline Protestant and Roman Catholic
o The nurse works at a clinic in Arizona that provides bilingual (English and Spanish) care to low-income immigrant workers from Mexico. Which designation most accurately describes the area or the population this nurse serves? ♣ Health professional shortage area ♣ Medically underserved area ♣ Medically underserved population ♣ Inmates
Medically underserved population
o The chart of a client with brain cancer notes "CMO." Which intervention should the nurse most expect this client to receive? ♣ Chemotherapy for killing the cancer cells ♣ Radiotherapy for reducing the size of the tumor ♣ Morphine for pain management ♣ Antibiotic to fight off an infection
Morphine for pain management
o The nurse has recently been appointed to a community-based advisory board of an agency that is interested in providing fiscally sound, high-quality care for clients they decide will be their service population. Any profit margin that is acquired is reinvested in the operations of the home healthcare service. Which type of agency is this? ♣ Private/voluntary ♣ Hospital based ♣ Proprietary ♣ Official
Private/voluntary
o The occupational and environmental health nurse quickly obtains the information needed for accurate assessment and zoom in on the critical aspects of a problem in response to a client situation. The nurse uses highly developed clinical and managerial skills in the work environment. At which American Association of Occupational Health Nurses (AAOHN) competency level in occupational and environmental health nursing is this nurse functioning? ♣ Advanced beginner ♣ Competent ♣ Proficient ♣ Expert
Proficient
o After successfully implementing and managing a smoking cessation program in an inner-city neighborhood for 5 years, the group expands the efforts to include a nearby rural community. After a challenging first year, the nurse finds that with a few modifications the program is proving successful in the rural setting, as well. Which essential component of program design has been established by success in the rural community? ♣ Sustainability ♣ Program replication ♣ Clinical expertise ♣ Accountability
Program replication
o Primary, secondary, and tertiary levels of prevention help reduce risk, identify and limit disabilities, and reduce complications of mental health problems. Which exemplifies a tertiary prevention strategy for mental health problems? ♣ Screen for mental health disorders ♣ Refer high-risk people for diagnostic services ♣ Provide mental health services following stressful community events ♣ Promote support groups for people with mental health disorders
Promote support groups for people with mental health disorders
o The nurse recently took a position in a national chain of home healthcare agencies directed at caring for clients who are on home hemodialysis. The services provided are often paid for privately by families, and any profit margin is used to benefit the owner of the agency. Which type of agency is this? ♣ Private/voluntary ♣ Hospital based ♣ Proprietary ♣ Official
Proprietary
o Preventing intimate partner violence (IPV) and recurrence of violence requires targeting efforts at all three levels of prevention: primary, secondary, and tertiary. Which is a tertiary prevention strategy? ♣ Adding a question to the standard health history form that asks whether the client is currently experiencing abuse ♣ Putting up posters around the health provider's office that give tips on what to do if one is in an abusive relationship ♣ Screening a woman for evidence of abuse who has several risk factors for IPV ♣ Providing a woman who is being abused by her husband the number to an abuse hotline so that she can get help leaving him
Providing a woman who is being abused by her husband the number to an abuse hotline so that she can get help leaving him
o The nurse reads a research article that reviews causality. Using knowledge of research designs, which types of design examine causality? (Select all that apply.) ♣ Retrospective ♣ Quasi-experimental ♣ Experimental ♣ Randomized, control group ♣ Case-controlled
Quasi-experimental Experimental Randomized, control group
o The nurse is preparing to do a research study on the effects of tight insulin control for diabetes. Using the knowledge that epidemiologic research can be descriptive or analytical, which would be the strongest study design to consider? ♣ Retrospective ♣ Quasi-experimental ♣ Experimental ♣ Randomized, control group
Randomized, control group
o There is an outbreak of Middle East respiratory syndrome coronavirus (MERS-CoV) in the community. The nurse is responsible for the dissemination of the education plan adopted by the public health department. Key components of the plan should include: (Select all that apply.) ♣ Quarantining infected families in their homes ♣ Respiratory hygiene ♣ Hand hygiene ♣ Droplet precautions for visitors in contact with affected clients ♣ Contact precautions for all cases
Respiratory hygiene Hand hygiene Droplet precautions for visitors in contact with affected clients
o There are different methods for conducting risk assessment for environmental contaminants. Which formula determines the amount of risk? ♣ Hazard = exposure × risk ♣ Exposure = risk × hazard ♣ Risk = contaminant presence × exposure ♣ Risk = hazard × exposure
Risk=hazardxexposure
o Preventing intimate partner violence (IPV) and recurrence of violence requires targeting efforts at all three levels of prevention: primary, secondary, and tertiary. Which is a secondary prevention strategy? ♣ Creating and broadcasting a public service announcement that raises awareness about IPV ♣ Putting up posters around the health provider's office that give tips on what to do if one is in an abusive relationship ♣ Screening a woman for evidence of abuse who has several risk factors for IPV ♣ Providing a woman who is being abused by her husband the number to an abuse hotline so that she can get help leaving him
Screening a woman for evidence of abuse who has several risk factors for IPV
o The case manager for two families with children who have type 2 diabetes is struck by the differences between the families. In one family, the parents are intentional about providing fruits and vegetables for their child to eat, regularly remind him to check his blood glucose level, and make sure that he engages in some sort of outdoor activity every afternoon. In the other family, the kitchen is stocked primarily with potato chips and processed snack foods, the child does not monitor her glucose level consistently, and she spends her afternoons texting or watching videos on the sofa. By this comparison, the case manager realizes how critical the family is in forming the attitude the child has toward caring for his or her own health. Which grand nursing theory does this experience best illustrate? ♣ Science of Unitary Beings ♣ Health as Expanding Consciousness ♣ Roy Adaptation Model ♣ Self-care Agency
Self-care agency
o Epidemiologic studies are essential to target programs to populations in greatest need. To help measure progress toward improving mental health, which is a primary focus of epidemiologic studies? ♣ Physical costs ♣ Emotional costs ♣ Mental costs ♣ Social costs
Social costs
o The nurse wishes to compare the number of persons aged 40 to 49 years who die each year with the midyear population of persons in this age range, per 100,000 in population. Which type of rate is the nurse attempting to calculate? ♣ Adjusted ♣ Incidence ♣ Prevalence ♣ Specific
Specific
o Which injury has the highest incidence rate among occupational injuries and illnesses that result in days away from work? ♣ Sprains ♣ Broken bones ♣ Cuts ♣ Carpal tunnel syndrome
Sprains
o The school nurse follows up with a third grader who was recently diagnosed with attention-deficit/hyperactivity disorder (ADHD) to make sure that he takes his prescribed medication. What type of medication would the nurse most suspect this client is taking? ♣ First-generation antipsychotic ♣ Second-generation antipsychotic ♣ Mood stabilize ♣ Stimulant
Stimulant
o The community health nurse assesses the neighborhood in which the clients live. When observing the physical environment, the nurse notes that most of the homes in the neighborhood are well kept and the children playing in the yards are wearing clean clothing. The children appear well nourished. The nurse determines that the neighborhood has little need for a well-child clinic. This assessment is based on: ♣ Subjective data ♣ Objective data ♣ Cognitive analysis ♣ Valid data
Subjective data
o Four employees at a local restaurant have positive purified protein derivative (PPD) tuberculin skin tests and have been diagnosed with latent tuberculosis (TB) infection. Which employee would be at the greatest risk for contracting active TB disease? ♣ Works two jobs ♣ Vacations in South America ♣ Cooks the food ♣ Takes immunosuppressants
Takes immunosuppressants
o The community health nurse learns that there are statistically high levels of obesity and elevated cholesterol in the community. In addition, the community has a disproportionately high number of fast food restaurants, compared with surrounding communities. Which would be the most appropriate next step, based on these data? ♣ Gather support in the community to ban fast foods ♣ Gather further information regarding trans fats ♣ Target education and support programs ♣ Create local exercise programs
Target education and support programs
o Three years after exposure to a virulent form of the flu, a population faces the same flu strain. The public health department recognizes that there are members of the population who have not been exposed to the flu strain. Which is most likely to happen? ♣ The unexposed population will contract the illness ♣ The unexposed population is not likely to contract the illness ♣ The unexposed population will contract the illness and re-infect others ♣ The flu will reach epidemic proportions and both populations will become ill
The unexposed population is not likely to contract the illness
o Each employee in a small community hospital is informed that he or she needs a tuberculin skin test and of the date that the test is due. The kitchen employees tell the nurse that they don't need the test and never had to have it before. The nurse should respond with: ♣ The test does not need to be given if you do not have client contact. ♣ Tuberculosis guidelines require testing of an entire healthcare setting. ♣ The test will not hurt; we won't fire you if you test positive. ♣ The tuberculosis guidelines state kitchen workers are at risk.
Tuberculosis guidelines require testing of an entire healthcare setting
o As an advocate for leukemia research, the nurse along with many others succeeded in urging the U.S. Congress to debate and vote on a bill that significantly increases federal funding for this research. Which system level would such an intervention address? ♣ Upstream ♣ Mainstream ♣ Sidestream ♣ Downstream
Upstream
o The nurse is conducting a study on heart clients who are actively involved in exercise programs following a heart attack. The nurse should consider which as a threat to internal validity? ♣ Some subjects run faster on the treadmill when a researcher walks through the room. ♣ Including an exciting new cross-fit training program as one of the exercise options that can accommodate a few of the study subjects ♣ Your fervent belief from personal experience that intense cardiovascular exercise can speed recovery and prevent further heart attacks ♣ Using a variety of stationary bicycles for stress testing
Using a variety of stationary bicycles for stress testing
o A nurse, new to the community health agency, works in a culturally diverse area of the community. The nurse is responsible for providing holistic care to clients and to be culturally competent. The health agency requires the nurse to demonstrate which competency to exhibit cultural competence? (Select all that apply.) ♣ Value diversity ♣ Adopt the client's cultural values ♣ Acquire cultural knowledge ♣ Adapt to diversity ♣ Speak the language of the client
Value diversity Acquire cultural knowledge Adapt to diversity
o Which common problems should a school nurse be prepared to identify in students? (Select all that apply.) ♣ Vision impairment ♣ Malignant melanoma ♣ ADHD ♣ Scoliosis ♣ Need for orthodontia
Vision impairment ADHD Scoliosis
o The student-nurse discusses transmission that involves contact of a susceptible host with a vehicle. Based on the chain of infection links, which exemplifies a vehicle? ♣ Animals ♣ Insects ♣ Reptiles ♣ Water
Water
o Which occurred as a result of the passage of the Education for All Handicapped Children Act in 1975? ♣ Children with disabilities were provided tax-funded tutors for home education. ♣ Children with mental disabilities were entitled to a tax-funded education at a special education private school. ♣ Children with chronic or complex medical issues were entitled to a public education. ♣ Children with physical disabilities were provided grants to attend the college of their choice.
Children with chronic or complex medical issues were entitled to a public education
o The nurse conducts a study that will follow a group of subjects for two decades. It involves one group of subjects who have a risk factor for developing diabetes and another group who do not have a risk factor. The goal is to establish a cause-and-effect relationship between the existence of the risk factor and the occurrence of diabetes. Which study design would be most appropriate? ♣ Cohort ♣ Case-control ♣ Preventive ♣ Therapeutic
Cohort
o The nurse conducts biomonitoring of residents of a community exposed to mercury vapor from a manufacturing facility nearby. Which form of biomonitoring is the method for the purpose of determining exposure to this contaminant? ♣ Measuring heart rate ♣ Collecting blood or urine ♣ Assessing resp. rate ♣ Obtaining body weight and composition measures
Collecting blood or urine
o Many in the community have developed cancer. The EPA has discovered a leak of biohazardous waste from a local factory that has leached into the water table. The area is decontaminated and cleaned. The community identifies the need for a local hospice for those with cancer who are dying. Area communities participate in the fund drive. This type of community effort may best be described as: ♣ Geopolitical community ♣ Epidemiologic model ♣ Community of solution ♣ Developmental model
Community of solution
o The nurse conducts a well-child clinic in your community. The client population is culturally diverse, and, although the clinic is busy, it runs smoothly because it has an interpreter. In addition to the interpreter, it is important that the nurses treat each client that reflects his or her individual cultural needs. This is cultural: ♣ Bias ♣ Artwork ♣ Competence ♣ Beliefs
Competence
o The occupational and environmental health nurse faces many different practice issues every day and can function comfortably in roles as a clinician, coordinator, and case manager following company procedures, using assessment checklists and clinical protocols to provide treatment. At which American Association of Occupational Health Nurses (AAOHN) competency level in occupational and environmental health nursing is this nurse functioning? ♣ Advanced beginner ♣ Competent ♣ Proficient ♣ Expert
Competent
o As the occupational health nurse in a factory finds that five employees out of 30 have positive tuberculin skin test results. One employee on the 3-to-11 shift has been diagnosed with active tuberculosis (TB). She asks if this means that the whole factory has been exposed. The nurse replies that the probability of infection depends upon: (Select all that apply.) ♣ Concentration of infectious droplet nuclei in the air ♣ Duration of exposure to the infected person ♣ Proximity to the infected person ♣ The use of safety gloves by employees ♣ Physical exertion required in the job
Concentration of infectious droplet nuclei in the air Duration of exposure to the infected person Proximity to the infected person
o The community health nurse works in a receiving station after a radiological disaster. The nurse wears the requisite PPE and notes that the majority of the victims have blast injuries. A volunteer worker reports that many of the victims have dust on their clothes. The nurse's response to the dust is to: ♣ Recognize that the dust is common with blast injuries ♣ Consider it radioactively contaminated and notify HAZMAT ♣ Consider the dust a biological agent and therefore a contaminant ♣ Flush all wounds to prevent chemical contamination
Consider it radioactively contaminated and notify HAZMAT
o Which exemplify biological hazards? (Select all that apply.) ♣ Contaminated body fluids ♣ Poisonous plants ♣ Diesel exhaust ♣ Venomous snakes ♣ Aerosols
Contaminated body fluids Poisonous plants Venomous snakes
o A client is receiving adjuvant medications to increase the effectiveness to treat the pain associated with end-stage prostate cancer. Which exemplifies an adjuvant medication? ♣ Opioids ♣ Corticosteroids ♣ Antihistamines ♣ Antivirals
Corticosteroids
♣ Opioids ♣ Corticosteroids ♣ Antihistamines ♣ Antivirals
Corticosteroids
o The nurse is appointed to be a member of the risk communication team during a disaster response situation. During an evacuation, the nurse is informed that an increasing number of individuals are reluctant to leave their homes. To complete an orderly evacuation, it is necessary to: ♣ Involve the armed forces ♣ Declare martial law ♣ Create an environment of trust and credibility ♣ Disseminate information regarding the necessity of the evacuation
Create an environment of trust and credibility
o The nurse is measuring the occurrence of chronic obstructive pulmonary disease being investigated in the entire population. Which rate does this represent? ♣ Adjusted ♣ Attack ♣ Crude ♣ Incidence
Crude
o The nurse is caring for a client who refuses the food as served. He states that the food is foreign to him and will make him ill. All food must be blessed. The personal care attendant is upset by this behavior and states that the client should eat the food anyway. The client's behavior is most likely a result of: ♣ Psychosocial deficit ♣ Cultural belief ♣ Allergies ♣ Hygiene
Cultural behavior
o A client arrives at the clinic shaky and requesting a refill on a prescription for alprazolam (Xanax). The nurse suspects that the client might be experiencing substance withdrawal. Which comment by the client would most tend to confirm your suspicion? ♣ "Lately I've had to double up on my dose just for it to be effective." ♣ "I ran out of pills a week ago and have felt sweaty and agitated ever since." ♣ "I feel like I just can't function without the medicine." ♣ "The medicine has been wonderful. I think one more refill should do it for me."
"I ran out of pills a week ago and have felt sweaty and agitated ever since."
o The faith community nurse recently visited with a member of the congregation, Sandy, who is recovering from a hysterectomy. Following a church service one Sunday, another member of the congregation, Patricia, approaches you and says, "How is Sandy recovering from her surgery?" Which is the most appropriate response? ♣ "She still has some bleeding, but overall she's doing well." ♣ "You mean her hysterectomy? She's doing really well." ♣ "I'm afraid I can't share any details, but I'm sure she'd love a call or text from you." ♣ "I'm sorry, Patricia, but that's none of your business."
"I'm afraid I can't share any details, but I'm sure she'd love a call or text from you."
o The client states a history of substance abuse but reports current abstinence. If valid, this report means that the client has not used alcohol or illicit substances in at least how many months? ♣ 3 ♣ 6 ♣ 9 ♣ 12
12
o The nurse is responsible for the construction of an isolation unit during an H5N1 outbreak. The unit is designated for only those clients with a confirmed diagnosis of H5N1. Which unit would be easily adapted to client needs? ♣ 12-room unit with negative air pressure units ♣ 15-room unit with a portable supply of PPEs ♣ 8-room unit with four code carts ♣ 12-room unit with four to six air changes per hour
12-room unit with negative air pressure units
o On the basis of the understanding of demographic risk factors related to mental illness, which individual would be most likely to have an untreated psychiatric disorder? ♣ 50-year-old Caucasian man ♣ 35-year-old Korean woman ♣ 12-year-old Hispanic girl ♣ 18-year-old African-American man
18-year-old African American man
o According to the U.S. Bureau of Labor Statistics, how many workers in all industries, including state and local governments, had a reportable injury or illness in 2011? ♣ 3.8 of 100 ♣ 4.2 of 100 ♣ 5.8 of 100 ♣ 6.2 of 100
3.8 of 100
o A man who lives in a homeless shelter is diagnosed with active tuberculosis (TB). The shelter keeps a list of those who are assigned beds, and the majority of those sleeping there are regulars. Which finding would indicate a positive tuberculin skin test result using a two-step process? ♣ 4-mm induration ♣ 2 ♣ 6 ♣ 3
6-mm induration
o The client wants to know how long Medicare will pay for skilled needs. How long can the nurse continue to provide this care before she must seek a renewal if skilled needs continue to exist? ♣ 30 days ♣ 45 days ♣ 60 days ♣ 90 days
60 days
Health People 2020 (HP 2020) is a guidepost for nurses and interdisciplinary teams in community and public health. New focal areas for HP 2020 include: (Select all that apply.) A. Adolescent health B. Diabetes C. Genomics D. Nutrition and weight status E. Social determinants of health
A. Adolescent health C. Genomics E. Social determinants of health
A nurse is interested in exploring initiatives related to health, poverty, and development in Africa. Which organization would most likely be involved in such an initiative? A. Bill and Melinda Gates Foundation B. Living Proof Project C. International Committee of the Red Cross D. Oxfam International
A. Bill and Melinda Gates Foundation
Nurses are effective and influential shapers of healthcare policy because of their expertise in: (Select all that apply.) A. Clinical practice B. Administration C. Education D. Political science E. Research
A. Clinical practice B. Administration C. Education E. Research
In researching cases of West Nile virus in the community, the nurse explores how the interactions among people infected with this virus, mosquitoes, and the environment they share contribute to outbreaks of this disease. Which epidemiologic model is used in this case? A. Epidemiological triad B. Wheel of causation C. Web of causation D. Natural history
A. Epidemiological triad
The nurse works to identify epidemiologic transitions in the community. Which is an example of a demographic transition? A. High fertility and high mortality, resulting in slow population growth B. Progressive declines in mortality, as epidemics become less frequent C. High and fluctuating mortality, due to poor health, epidemics, and famine D. Further declines in mortality, increasing life expectancy, and predominance of noncommunicable diseases
A. High fertility and high mortality, resulting in slow population growth
Secondary HIV prevention or positive prevention is used when caring for African-American women living with HIV by addressing which behavioral risks? (Select all that apply.) A. Interpersonal mistrust B. Alcoholism C. Poor adherence to treatment D. Smoking E. Compromised self-advocacy in sexual relationships
A. Interpersonal mistrust C. Poor adherence to treatment E. Compromised self-advocacy in sexual relationship
The nurse works in a facility that provides hospice care for clients with cancer diagnoses. The nurse recognizes that the care provided in this facility is tertiary in nature. The nurse develops a plan for the clients that would include the tenets of tertiary prevention. The plan would include: (Select all that apply.) A. Palliative care B. Pain control C. Isolation D. Supportive spiritual development E. Diminished involvement of significant others
A. Palliative care B. Pain control D. Supportive spiritual development
The hospital board is in the process of developing a policy regarding the use of cell phones within the hospital. After 6 months of a policy being in place and weeks of ongoing evaluation of the policy by individual board members, the board decided to expand the areas where cell phone use is permitted to include all waiting rooms and some client rooms. Which stage of policy-making does this action represent? A. Policy modification B. Policy adoption C. Policy implementation D. Policy assessment
A. Policy modification
The local clinic is dedicated to the well adult and child. It has evening hours and offers varied programs for the community. The programs include immunizations and classes on fire safety, health education, and car safety, to name a few. How would the nurse explain the level of prevention used in this setting to your colleagues? A. Primary B. Secondary C. Tertiary D. Quaternary
A. Primary
Which represent ways nurses can actively engage in policy making? (Select all that apply.) A. Testify at congressional hearings B. Disseminate information on health issues in the media C. Serve as members of governing boards D. Document client symptoms following a physical examination E. Review articles in recent nursing journals
A. Testify at congressional hearings B. Disseminate information on health issues in the media C. Serve as members of governing boards
A nurse is coordinating an initiative in the community to make sure that the healthcare needs of local refugees and asylees are recognized and addressed. Which federal agency should this nurse contact, as it is directly involved with the health and healthcare of refugees and asylees in the United States? A. United States Department of Health and Human Services B. National Institutes of Health C. Agency for Healthcare Research and Quality D. Centers for Disease Control and Prevention
A. United States Department of Health and Human Services
Who in the history of epidemiology developed mortality surveillance systems, addressed basic epidemiologic concepts, and is considered the founder of modern statistics? A. William Farr B. John Graunt C. Florence Nightingale D. John Snow
A. William Farr
o The community health nurse is assessing stressful life events in a family. Which exemplifies a life event related to illness and family care strains? ♣ A history of police reports of a 23-year-old man's hitting his girlfriend ♣ A couple in their 40s divorcing ♣ A 63-year-old woman's sense of responsibility as the oldest among her siblings for taking care of her chronically ill parents ♣ A 35-year-old woman not speaking to her sister for 5 years after not being invited to her wedding
A 63-year-old woman's sense of responsibility as the oldest among her siblings for taking care of her chronically ill parents
o A client is fearful of being infected with the Ebola virus. To which reliable source of family risk reduction information should this client turn? ♣ A report from the client's neighbor whose daughter was recently infected with the Ebola virus ♣ Information the client's wife reported from a newspaper article about the Ebola virus that she read ♣ Data from an Internet site that the client's daughter conveyed ♣ A conversation the client has with his healthcare provider
A conversation the client has with his HCP
o The nurse enters a client's home to provide care to a wound and teach the client's wife how to care for the wound. The nurse is comfortable with the client's culture and the fact that it is matriarchal in nature. As teaching begins, the husband interrupts and states that the woman does not change bandages according to his culture. He asks if the nurse is familiar with his culture and then says that all members of his neighborhood follow its principles. The nurse should suspect that the client is a member of: ♣ A cult ♣ An orthodox religious group ♣ A subculture ♣ An occupation
A subculture
o Which are examples of primary prevention activities? (Select all that apply.) ♣ A program helping military veterans with amputations adapt to their new circumstances ♣ HIV screening open to the whole faith community ♣ A weight-lifting program for seniors to maintain strong bones ♣ A community vegetable garden to promote healthy eating ♣ Leg exercises to help people recovering from hip fractures to walk again
A weight-lifting program for seniors to maintain strong bones A community vegetable garden to promote health eating
o To demonstrate true cultural sensitivity and awareness, the nurse must: ♣ Travel to other countries on occasion ♣ Become bilingual ♣ Be competent in his or her own cultural heritage ♣ Know the practices of all major cultures in one's region of the country
Be competent in his or her own cultural heritage
o An older woman in a rural health clinic tells the nurse that this is the first time she's been in a medical facility for more than 10 years. She shows signs of advanced diabetes, including significant necrosis in her feet. When asked why she didn't come in sooner, she says, "I don't drive, myself, and I hate asking my son to bring me—I feel like such a burden." This situation exemplifies which of the seven A's of challenges to elders in rural areas? ♣ Awareness ♣ Adequacy ♣ Acceptability ♣ Assessment
Acceptability
o While visiting the home of an 89-year-old woman out in the country, the nurse learns that her primary care provider's office is one hour's drive away. The client states, "I've just stopped going in for appointments in the past few years. It's just too far for me to drive by myself." This situation exemplifies which of the seven A's of challenges to elders in rural areas? ♣ Availability ♣ Accessibility ♣ Affordability ♣ Awareness
Accessibility
o A client wants to know the best way to avoid sexually transmitted infections (STIs). The nurse should mention: ♣ Abstinence ♣ Monogamous relationship with an infected partner ♣ Washing the genitals after sex ♣ Use of latex condom
Abstinence
o Which best defines program replication? ♣ Ability to replicate a successful program in the same community a second time ♣ Ability to reproduce a successful program within a different community ♣ Ability to replicate a successful program with a new sample aggregate ♣ Ability to implement a successful program with the same population aggregate
Ability to reproduce a successful program within a different community
o When speaking with an older man in a rural community about his lifelong smoking habit, the nurse is alarmed to learn that he has never heard that cigarette smoking is the major cause of lung cancer. This situation exemplifies which of the seven A's of challenges to elders in rural areas? ♣ Availability ♣ Accessibility ♣ Affordability ♣ Awareness
Awareness
o International health experts indicate that the avian flu is the virus most likely to cause the next pandemic. What may improve its transmissibility to the public? ♣ Increase in consumption of chicken ♣ Increase in autoimmune disease incidence ♣ Shift to zoonotic transmission ♣ Antigenic shift
Antigenic shift
The nurse collects specific data related to risk factors, health indicators, and health outcomes that determine the burden of disease. Which data would the measure known as HALE yield about health indicators and outcomes? A. Average number of years a newborn is expected to live if current mortality rates continue to apply B. Average number of years that a person can expect to live in "full health" by taking into account years lived in less than full health due to disease and/or injury C. Quantifying the burden of disease to a healthy life on the basis of the loss of years related to the burden of disease. The gap in years reflects the current state of health compared with an optimum state of health of a nation. D. Quantifying the burden of acute illness to a healthy life on the basis of the loss of years related to the burden of acute illness. The gap in years reflects the current state of health compared with an optimum state of health of a nation.
B. Average number of years that a person can expect to live in "full health" by taking into account years lived in less than full health due to disease and/or injury
A high school graduate has decided to pursue a career in public health nursing. Which represents the minimum educational credential that this student will need to obtain entry into public health nursing practice? A. Associate's B. Baccalaureate C. Master's D. Doctorate
B. Baccalaureate
An immigrant from Guatemala, age 47, is admitted to the coronary care unit with congestive heart failure. This is the fourth admission for this client, and the physician believes that the client's inability to adhere to his diet and medication regimen is the reason for his frequent admissions. The physician refers the client to the local community health nurse, on discharge from the hospital. Which would be most appropriate for the nurse to include in this client's plan of care? A. Insisting that the client adhere to his diet B. Developing culturally relevant and gender-sensitive interventions C. Teaching the family to adapt their cultural dietary plans to the client's diagnosis D. Assessing the client's financial needs and obtaining financial assistance as needed
B. Developing culturally relevant and gender-sensitive interventions
Why has there been an increase in the number of acute and chronically ill people residing in the community who need professional nursing care? A. Shorter length of stay in long-term care facilities B. Increase in ambulatory surgery C. Decrease in the use of outpatient clinics D. Increase in the length of stay in EDs
B. Increase in ambulatory surgery
The nurse is locating populations in her region who are exposed to lead-based paint and providing them with information regarding the dangers of lead poisoning. This is an example of which public health intervention? A. Surveillance B. Outreach C. Screening D. Case Management
B. Outreach
The hospital board is in the process of developing a policy regarding the use of cell phones within the hospital. At the current meeting, the board has decided to allow use of cell phones only within certain waiting areas within the hospital, and nowhere else. Which stage of policy-making does this action represent? A. Policy formation B. Policy adoption C. Policy implementation D. Policy assessment
B. Policy Adoption
A client reluctantly came to the clinic only after his daughter insisted that he do so. The nurse finds that he has type 2 diabetes. When the nurse explains that he has a serious condition, the client brushes it off and says, "I can still work and provide for my family. I'm not sick." Which model of health has this client adopted? A. Clinical model B. Role performance model C. Adaptive model D. Eudaemonistic model
B. Role performance model
Using the tenets of secondary prevention, the committee seeks to establish an HIV/AIDS clinic. The nurse states that it is important for the location of the clinic to be associated with the local hospital. The committee states that the cost of the clinic associated with the hospital is higher than one that is free standing. Which presents the best rationale for the nurse's suggestion? A. Third-party insurance will reimburse the clinic visits only if the clinic is attached to the hospital. B. The hospital can more easily implement programs of care for the clients. C. The hospital will cover the clients only if the clinic is approved by the hospital governance board. D. The hospital will have a vested interest in the success of the clinic.
B. The hospital can more easily implement programs of care for the client
In researching an outbreak of malaria in the developing nation where the nurse currently works, the nurse decides to not focus on the role of mosquitoes in transmitting the disease but on how the physical environment of the community, biological aspects of the community, and social customs interact to affect the prevalence of this disease. Which epidemiological model is the nurse using? A. Epidemiologic triad B. Wheel of causation C. Web of causation D. Natural History
B. Wheel of causation
The nurse conducts a class on the basics of nutrition to a group of obese adults. The nurse counsels the audience, telling them that they need to change their behaviors. By the end of the class, the nurse has lost the audience. To enhance audience participation and learning in the next class, the nurse should: A. Use consistent methods of persuasion B. Offer advice while the participants are passive C. Encourage the group to participate in the decision making D. Encourage the group to continue ambivalent behaviors
C. Encourage the group to participate in the decision making
Which best describes a multilateral agency? A. Is based in only one country but provides services to many other countries B. Is responsible for the health and welfare of citizens nationally C. Receives funding from both governmental and nongovernmental sources D. Acquires resources to help others from private rather than public sources
C. Receives funding from both governmental and nongovernmental sources
The nurse meets with a group of fellow nurses. They discuss the number of children who have died in hot cars and how likely they are to gain support from their state legislators to address the problem. The nurses are currently in which step of the policy-making process? A. Policy formulation B. Policy adoption C. Setting an agenda D. Policy assessment
C. Setting an agenda
The nurse explores all of the possible factors that contribute to coronary artery disease in the community as links in multiple interrelated chains. Which epidemiologic models is the nurse using? A. Epidemiologic triad B. Wheel of causation C. Web of causation D. Natural History
C. Web of causation
o The nurse reviews a published analytical research study that compares one group of clients who developed diabetes mellitus before the start of the study with a group of clients without diabetes mellitus. Which type of study design was used in this study? ♣ Case control ♣ Case ♣ Clinical trial ♣ Cohort
Case control
o The nurse wishes to determine how many people in the city die from heart attacks each year per 100,000 in population. Which type of rate is the nurse attempting to calculate? ♣ Age-specific mortality rate ♣ Cause-specific mortality rate ♣ Case fatality rate ♣ Crude mortality rate
Cause-specific mortality rate
Which rate measures the number of people in a given population who have influenza at a given point in time? ♣ Adjusted ♣ Incidence ♣ Prevalence ♣ Specific
Prevalence
o The nurse is participating in study that considers the effect that use of netting around beds has on the incidence of malaria in a community of subjects in Africa. Which type of study would be best for this purpose? ♣ Cohort ♣ Case-control ♣ Preventive ♣ Therapeutic
Preventive
o The nurse cares for a client whose husband of 50 years died last week. The nurse arrives at her home to find her staring out of a window in a stupor, her face devoid of any emotion. When the nurse speaks with her, the client seems withdrawn and distant. Which phase of grief should the nurse most suspect this client to be in? ♣ Numb shock ♣ Emotional turmoil ♣ Reorganization ♣ Resolution
Numb shock
o After examining a young woman, the nurse asks her questions about some bruises on her back. The client confides that her husband has started hitting her when they argue. The nurse makes recommendations about getting help; the client dismisses them and states, "It's just a few bruises. I think I can handle it." Which long-term consequences of exposure to violence, according to Healthy People 2020, should the nurse discuss with this client? (Select all that apply.) ♣ Premature death ♣ Breast cancer ♣ Disability ♣ Lost productivity ♣ Obesity
Premature death Disability Lost productivity
Incidence rates for groups exposed to a secondhand smoke are compared with the incidence rates for people who are not exposed to secondhand smoke. This will measure the: A. Incidence density b. Prevalence ratio c. Relative risk ratio d. Specific rate
c. Relative risk ratio
