Population Health Final, Pop health Final Exam-back of the book questions, pop final

A nurse demonstrates cultural competence by using statements such as: "I know how you feel." "Tell me about your health care beliefs." "Let me show you the way you should do this." "You can do things in a more modern way now."

"Tell me about your health care beliefs."

The nurse must ask about violence at each prenatal and postpartum visit, especially with vulnerable populations such as teenagers, as well as observe for signs of violence on each visit. The nurse should be aware that the peak for postpartum intimate partner violence may be observed at various times according to ethnic group, such as: 6 months for white mothers. 10 months for white mothers. 3 months for African-American and Hispanic/Latino mothers. 12 months for African-American and Hispanic/Latino mothers.

3 months for African-American and Hispanic/Latino mothers.

Since 1998, nurse practitioners (NPs) and clinical nurse specialists (CNSs) are reimbursed by Medicare Part B at a rate that is what percent of physician rates for the same service? 50% 70% 85% 95%

85%

Which of the following domains are used in evaluating the strength of evidence? A. QUALITY B. QUANTITY C. COST EFFECTIVENESS D. CONSISTENCY E. USEFULNESS

A,B,D

Which of the following factors has influenced the implementation of evidence-based practice in health care? a. Increased expectations of consumers b. Advances in technology c. Nursing shortages d. Increases in lawsuits e. Implementation of electronic health records

A,B,D

The Clean Air Act of 1970 was amended in 1990 to meet unaddressed or insufficiently addressed problems that included which of the following? A. Addressing acid rain B.Addressing excessive noise and heat or cold extremes C. Addressing ground-level ozone D. Addressing stratospheric ozone depletion E.Tracking 75,000 industrial chemicals

A,C,D

There are many barriers that affect the actual implementation of evidence-based practice (EBP) in a nursing environment. Which statements reflect the most significant concerns of nurses in the community-focused setting? a.EBP requires compliance by the client. b.EBP requires little support. c.EBP demands change. d.EBP questions long-standing nursing practice. e. Lack of resources

A,D,E

A nurse overhears the doctor saying, "Let's not give him codeine; he is Asian." The nurse reflects on the comment and determines that the: (select all that apply) a. doctor is culturally competent b. doctor is prejudiced. c. doctor should have called an interpreter. d. doctor's ability to assess pain based on culture may be limited. e. doctor is planning care based on racial enzymatic differences.

A,E

Finding resources to implement evidence-based practice (EBP) in community health will continue to be a challenge because of the emphasis on quality care, equal distribution of health care resources, and cost control. Which of the following would demonstrate a creative strategy to implementing EBP? A. Adopting quality indicators for evaluating websites claiming to contain EBP B. Avoiding the issue of community politics C. Creating the role of a knowledge manager D. Making decisions on behalf of the community

A. Adopting quality indicators for evaluating websites claiming to contain EBP

A nurse is collecting data to identify health needs in the local community. Which of the following are examples of secondary data the nurse should review? (Select all that apply) A. Birth statistics B. Previous health survey results C. Windshield survey D. Community forum E. Health records

A. Birth statistics B. Previous health survey results E. Health records

Which of the following statements best explains the need for geologists, meteorologists, and chemists on the multidisciplinary team in environmental health? A. Earth sciences explain how pollutants travel in air, water, and soil B. Earth sciences help us understand the strength of the association between exposures and health effects in human populations. C.Earth scientists study the negative effects of chemical exposure. D.Earth scientists work with the community to coordinate services to meet the community's needs.

A. Earth sciences explain how pollutants travel in air, water, and soil

A nurse is conducting a community assessment. Which of the following data collection methods is the nurse using when having direct conversations with individual members of the community? A. Key informant interviews B. Participant observation C. Focus groups D. Health surveys

A. Key informant interviews

Implementing a program to notify individuals exposed to a communicable disease A nurse is using the I PREPARE mnemonic to assess a client's potential environmental exposures. Which of the following is an appropriate question for the nurse to ask to assess for "A in the mnemonic? A. What do you like to do for fun? B. What year was your residence built? C. What jobs have you had in the past? D. What industries are near where you live?

A. What do you like to do for fun?

When a community health nurse evaluates the completeness and accuracy of information made available to community residents regarding the impact of rezoning land parcels for industrial use, the nurse is: A. advocating for ethical choices B. Communicating risk C. controlling environmental damage D. volunteering for service on state boards

A. advocating for ethical choices

Which educational method has been shown to be most effective in fostering treatment adherence? a. Internet based education b. In-person counseling c. Telephone counseling d. Self-directed learning

A. internet based education

When applying the nursing process to environmental health, the community health nurse would examine criteria that include the immediate and long-term responses of the client to the planned interventions. Another important factor to consider in the evaluation process would be: A. recidivism of the problem for the client B. consideration of community policy and laws C.relationship between the disease and the environmental factors. D. coordination of actions to meet the client's needs.

A. recidivism of the problem for the client

Which of the following tools are used in analytic epidemiology? a. cohort study b. case-control study c.cross-sectional study d. clinical trials e.community trials

ABC

A nurse in community health in California has been working with a 6-year-old child that was rescued from a mudslide. The nurse will observe the child for which of the following stress effects? A. Bed-wetting episodes B. Desire to return to school C. Fantasies of denial D. Increased playfulness with peers E. Thumb sucking

ACE

Which of the following statements accurately describe the stress reaction phases a community may experience during a disaster response? A.Disillusionment and reconstruction is most associated with response efforts. B. During the Heroic phase, there is overwhelming need for people to do whatever they can to help others survive the disaster. C.In the Honeymoon phase, survivors may be rejoicing in that their lives and the lives of loved ones have been spared. D.Disillusionment is the longest phase in the stress reaction process. E.The Disillusionment phase occurs after time elapses and people begin to notice that additional help and reinforcement may not be immediately forthcoming.

B,C,E

A nurse is conducting health screening at a statewide health fair and identifies several clients who require referral to a provider. Which of the following statements by a client indicates a barrier to accessing health care? A. "I don't drive, and my son is only available to take me places in the mornings." B. "I can't take off during the day and the local after-hours clinic is no longer in operation." C. "Only one doctor in my town is a designated provider by my health maintenance organization." D. "I would like to schedule an appointment with the local doctor in my town who speaks Spanish and English."

B. "I can't take off during the day and the local after-hours clinic is no longer in operation."

Nurses in community health often use epidemiology because in the community it is often difficult to control the environment. Which of the following statements demonstrates an epidemiologic strategy for monitoring disease trends? A. A nurse in community health conducts an education class for clients newly diagnosed with diabetes. B. A nurse in community health investigates a breakout of whooping cough in a local middle school. C. A nurse in community health organizes a health fair at the community health center. D.A nurse in community health participates on a county school board that addresses student health issues.

B. A nurse in community health investigates a breakout of whooping cough in a local middle school.

A community health nurse is determining available and needed supplies in the event of a bioterrorism attack. The nurse should be aware that community members exposed to anthrax will need access to which of the following medications? A. Metronidazole (Flagyl) B. Ciprofoxacin (Cipro) C. Zanamivir (Relenza) D. Fluconazole (Diflucan)

B. Ciprofoxacin (Cipro)

Nurses should review which of the following reports to determine what pollutants have been found in the drinking water of a community? A. Point source report B. Consumer confidence report C. Material Safety Data Sheet D. Environmental standards report

B. Consumer confidence report

Following the attacks of 9/11, a nurse practitioner in a family clinic used opportunities at the clinic staff meetings to speak about her own feelings of loss and guilt. This strategy indicates that the nurse was aware of what phenomenon related to disasters? A. Anxiety B. Effects of stress on individuals C. Sense of urgency D. Scapegoating and blaming

B. Effects of stress on individuals

The monitoring and public reporting of air quality in a local community to alert individuals with asthma or other respiratory conditions would illustrate: A. Compliance and enforcement B. Environmental epidemiology C. secondary prevention D. toxicology

B. Environmental epidemiology

A nurse is interviewing for a position at the local health department. When preparing for the interview, the nurse should find that which of the following are responsibilities of this agency? (Select all that apply) A. Managing the women, infants and children program B. Providing education to achieve community health goals C. Coordinating directives from state personnel D. Reporting communicable disease to the CDC E. Licensing of registered nurses

B. Providing education to achieve community health goals C. Coordinating directives from state personnel

Four months after the disaster of 9/11 at the Pentagon, a local EMS worker complained of extreme exhaustion. The veteran EMS worker also stated that the pace of work at the squad was too slow. The occupational health nurse that is assessing the EMS worker recognizes the symptoms of: A. anger B. delayed stress reaction C. inability to concentrate D. insomnia

B. delayed stress reaction

The recovery phase of a disaster can take a very long time. Nurses need to be aware that despite effective disaster preparedness and response efforts: A. environmental hazards are minimal B. individuals must ultimately recover on their own C. the government provides economic support D. Religious organizations must bear the burden of the community

B. individuals must ultimately recover on their own

Nurses often participate on field assessment teams (surveillance) during a disaster response. These assessments are crucial to best help: A. encourage good intentions of those giving aid. B. match available resources to the population's emergency needs. C.separate casualties and allocate treatment. D. provide compassion and dignity.

B. match available resources to the population's emergency needs

What are the core competencies of the nurse participating in surveillance and investigation activities? a.Basic patient assessment skills b.Effective communication skills c.Ability to collaborate with community partners d.Advanced practice nurse with secondary science degree e. Leadership and systems thinking

BCE

Analytic epidemiology differs from descriptive epidemiology because it searches for: A. "when" of disease patterns. B. "where" of disease patterns. C. "why" of disease patterns. D. "who" of disease patterns.

C. "why" of disease patterns.

A nurse is conducting an environmental health history during a post-partum home visit. Residents in the home include the mother, her partner, a 1-week old infant, 2 year-old toddler, and 7-year old child. Which of the following questions would be important to ask the family? A. How much alcohol do you drink a day? B. Do you have a mother in town? C. Are there any industries or hazardous waste sites nearby? D. Do you drink milk with breakfast?

C. Are there any industries or hazardous waste sites nearby?

A tornado has touched down in a local small community, and you are the nurse responding to the crisis. Which of the interventions for disaster response should you be prepared to complete? A. Picking up trash on the roadside B. Contacting the U.S. President to ask for back-up C. Performing triage and directing disaster victims D. Packing cosmetics in your overnight bag

C. Performing triage and directing disaster victims

A community health nurse is educating the public on the agents of bioterrorism. Which of the following are Category A biological agents? (Select all that apply) A. Hantavirus B. Typhus C. Plague D. Tularemia E. Botulism

C. Plague D. Tularemia E. Botulism

A community health nurse is implementing health programs with several populations in the local area. In which of the following situations is the nurse using primary prevention? A. Performing a home safety check at a client's home B. Teaching healthy nutrition to clients who have hypertension C. Providing influenza immunizations to employees at a local preschool D. Implementing a program to notify individuals exposed to a communicable disease

C. Providing influenza immunizations to employees at a local preschool

The deliberate release of viruses, bacteria or other germs with the intent of causing illness or death is: a. event outbreak b. chemical terrorism c.biological terrorism d. surveillance

C. biological terrorism

The community health nurse asks a client, "Have you ever been exposed to any radiation or chemical liquids, dust, mists, or fumes?" The nurse is conducting an: A. environmental advocacy activity B. environmental compliance activity C. environmental health assessment D. Environmental risk communication

C. environmental health assessment

The Food Quality Protection Act of 1996 increased the protection of infants and children from pesticide exposure from multiple sources by establishing a new health-based standard of reasonable certainty of "no harm" that: A. considers the cumulative impacts of all pesticides that may share a common mechanism of action. B. establishes a 15-year renewal process for all pesticides. C. prohibits taking into account economic considerations when children are at risk. D. uses an additional tenfold margin of safety when there are adequate data indicating developmental risks.

C. prohibits taking into account economic considerations when children are at risk.

A nurse in community health who teaches a client with asthma to recognize and avoid exposure to asthma triggers and assists the family in implementing specific protection strategies such as removing carpets and avoiding pets is intervening at the level of: assessment. primary prevention. secondary prevention. tertiary prevention.

C. secondary prevention

Which of the following systems of surveillance is used to monitor trends in commonly occurring diseases? active passive sentinel syndromic

C. sentinel

A district health nurse is assigned to two rural counties in the state. To achieve the best outcomes possible in reducing the health disparities for the large number of frail older clients in the two counties, the nurse should consider using what community-oriented nursing skill? Assessment Case management Geriatrics Tertiary prevention

Case management

When final health care-related regulations are published, they often lead to changes in practice. After a period of draft review, public comment/hearing, further study if necessary, and then final redrafting, the regulations at both federal and state levels carry the weight of law and are published in the: a. ANA Code of Conduct. b. Code of Regulations. c. Patient Safety Act of 1997. d. Interstate Nurse Licensure Compact.

Code of Regulations.

A nurse planning a smoking cessation clinic for adolescents in the local middle schools and high schools is providing: Community Oriented Care Community Based Care Secondary Care Tertiary Care

Community Oriented Care

The community health nurse performs an assessment of violence by observing which of the following community characteristics? Presence of social support networks Crime rates Levels of unemployment Presence of physical disabilities in individuals Presence of family violence

Crime rates Levels of unemployment

A recent movie release portrays a criminal as a black female drug user whose abusive boyfriend has two children by different women. She lives in the riot-torn inner city of a large metropolitan area. This best demonstrates what type of factor that influences poverty? Cultural Environmental Political Social

Cultural

A nurse educator who teaches at the local community college takes the time to read and understand her community's disaster plans and participates in community mock disasters as a leader of the triage team. The best description of the nurse's activities would be: A. ARC disaster training B. community preparedness C. personal preparedness D. professional preparedness

D

A nurse is planning a community health program. Which of the following should the nurse include as part of the evaluation plan? A. Determine availability of resources to initiate the plan B. Gain approval for the program for local leaders C. Establish a timeline for implementation of interventions D. Compare program impact to similar programs

D. Compare program impact to similar programs

A nurse is developing a community health education program for a group of clients who have a new diagnosis of diabetes mellitus. Which of the following learning strategies should the nurse include for clients who are auditory learners? A. Showing informational videos B. Providing equipment to practice hands-on skills C. Supplying outlines for note-taking D. Facilitating small group discussion

D. Facilitating small group discussion

One reason that nursing may be slow in developing evidence-based practice (EBP) in the community setting may be the lack of understanding about the links between EBP and: a. evidence gathering. b. research design. c. research funding. d. research use.

D. RESEARCH USE

In the event of a disaster, shelters are generally the responsibility of which of the following entities? A.Centers for Disease Control & Prevention (CDC) B. Federal Emergency Management Agency (FEMA) C.Public Health Service (PHS) D.Red Cross chapter

D. Red Cross chapter

The federal act that grants authority to the Environmental Protection Agency (EPA) which controls the generation, transportation, treatment, storage, and disposal of hazardous waste and ultimately called for the phaseout of land disposal of hazardous waste under a later amendment was the: A. Emergency Planning and Community Right to Know Act (EPCRA) B. National Environmental Policy Act (NEPA) C.Pollution Prevention Act (PPA) D. Resource Conservation and Recovery Act (RCRA)

D. Resource Conservation and Recovery Act (RCRA)

According to the Minnesota Model of Public Health interventions, what is the first step of surveillance for the public health nurse? a. organize the data b. analyze the data c. interpret and disseminate the data d. determine if surveillance is appropriate

D. determine if surveillance is appropriate

When applying the nursing process to environmental health, the community health nurse would: A.conduct a focused assessment on the presenting problem. B.coordinate interventions with the physician only. C.examine criteria that include only the client's immediate response. D. include outcome measures that mitigate and eliminate the environmental factors.

D. include outcome measures that mitigate and eliminate the environmental factors.

The major factor that has increased Florida's vulnerability to natural disasters in recent decades has been: A. El nino B. Geography C. trade winds D. urbanization

D. urbanization

To maintain effective disaster preparedness, nurses working in the community can play a critical role in providing an updated record of: A. immunizations B.active tuberculosis (TB) cases C. WIC enrollees D. Vulnerable populations

D. vulnerable populations

A nurse in community health that administers a local WIC program for women, infants, and children is participating in a federal-state collaborative program that receives oversight from the: a. Department of Agriculture (DOA). b. Department of Defense (DOD). c. Department of Health and Human Services (DHHS). d. Department of Labor (DOL).

Department of Agriculture (DOA).

The community health nurse is aware that African-American adults are more likely to be admitted to the hospital for which of the following conditions? a. Newly diagnosed HIV infection b. Diabetic patient with lower extremity wound c. Testicular cancer d. Psychiatric disorders

Diabetic patient with lower extremity wound

A nurse in community health conducting a home visit notices a 4-year-old girl sitting on a stool in an adjoining room. The girl is quiet and withdrawn, rarely makes eye contact, and does not leave the room. The nurse proceeds to ask about the child and attempts to engage the child in conversation. The nurse is assessing for what indicators of child abuse? Emotional abuse Emotional neglect Physical abuse Physical neglect

Emotional neglect

Which of the following are factors that may contribute to vulnerability? Exercise habits Crime Peeling lead paint Social isolation Illiteracy

Exercise habits Crime Peeling lead paint Social isolation Illiteracy

The historical figure whose work in providing care to poor people, primary prevention, and environmental health established that individual as nursing's first moral leader and community-oriented nurse was: Sister Mary Augustine. Florence Nightingale. William Rathbone. Lillian Wald.

Florence Nightingale.

The goal of deinstitutionalization was to improve the quality of life for people with mental disorders by providing services in the communities where they lived rather than in large institutions. At what program level did this change in locus of care fail? Assessment level Design level Evaluation level Implementation level

Implementation level

A nurse in community health located in Virginia is conducting an assessment on a Hispanic worker currently working in a local apple orchard for the season. The nurse determines that the worker originates from Florida and is living in temporary housing with other orchard workers. Based on this information, the nurse should integrate the special needs of what vulnerable population? Migrant farmworkers Seasonal farmworkers Underinsured Undocumented aliens

Migrant farmworkers

When using the health measure of death rates for working-age adults, the nurse could expect to find the highest rates in which areas? Large metropolitan areas Most rural and highly populated urban areas Most rural and suburban areas Small suburban and all urban areas

Most rural and highly populated urban areas

Implementing a community-level program, such as walking for exercise, to assist citizens in improving health behaviors is an example of which level of prevention? Primary prevention Secondary prevention Tertiary prevention Disease promotion

Primary prevention

A client diagnosed with human papillomavirus (HPV) states to the nurse, "I'm not concerned; I know the lesions disappear after a while." The nurse should counsel the client on which of the following? The link between HPV and cervical cancer The fact that HPV is a reportable disease The need to surgically remove tumors, if present The serious complications for men The lack of a cure

The link between HPV and cervical cancer The need to surgically remove tumors, if present The lack of a cure

What is the primary goal of total quality management? To confirm the high standards desired in patient care To discover and correct errors in task completion To eliminate problems before negative outcomes occur To enable organizations to publicize their quality approach to patient care

To eliminate problems before negative outcomes occur

Many families have financial resources that allow them to maintain themselves but limit the quality of their purchasing power. Food high in fat and calories may be affordable, whereas fresh fruits and vegetables may not be affordable. A federal program that attempts to promote healthier diets for vulnerable populations is: Medicaid Medicare Supplemental Security Income (SSI) Women, Infants, and Children (WIC)

Women, Infants, and Children (WIC)

A nurse in community health is conducting an assessment on a family of four. During the course of the assessment, the nurse collects information about previous generations of the family and siblings. The results are used to create a diagram for the family that displays the family unit across generations. Further discussions occur regarding the patterns of health and illness that relate to biological health risks. The diagram is called: an ecomap. a family plan. a genogram. a risk plot.

a genogram.

A 3-year smoking cessation program for teens has just concluded. The type of evaluation the staff will conduct is: a formative evaluation. an informal evaluation. an ongoing evaluation. a summative evaluation.

a summative evaluation.

What are some examples of programs which may be provided at the local health department level? a. Immunization clinics b. Health education c. Family planning services d. Licensing of health care professionals e. Quality and safety data

a,b,c

A nurse is conducting an in-service education session on the Centers for Disease Control and Prevention's (CDC's) updates for preventive services for a group of nurses in community health. The nurse would demonstrate the best understanding of the educational process by integrating which planning strategies? Use of films Small group interaction Use of games Session timing Session space

a,b,c,d,e

Which of the following barriers are specific to the educator? a. Fear of public speaking b. Low literacy c. Limited experience with the topic d. Lack of motivation e. Lack of experience with gaining participation

a,c,e

What are some of the effects of technology in the area of home health care? a. High technology equipment increases expense. b. Technology decreases legal liability. c. Technology has the potential for increased privacy. d. Technology quickly becomes outdated when newer developments occur. e. There is inconsistent quality of resources available on the Internet.

a,d,e

A nurse manager at a community agency is developing an orientation program for newly hired nurses. When discussing the differences between community-based and community oriented nursing, the nurse should include which of the following as examples of community-based nursing? (Select all that apply). a. A home health nurse performing wound care for a client who is immobile b. An occupational health nurse providing classes on body mechanics at a local industrial plant c. A school nurse teaching a student who has asthma about medications d. A parish nurse teaching a class on low-sodium cooking techniques e. A mental health nurse discussing stress management techniques with a support group

a. A home health nurse performing wound care for a client who is immobile c. A school nurse teaching a student who has asthma about medications

Which of the following factors have had an impact on the complex relationship among nursing practice, health policy, and politics? a. Categorical funding b. Death penalty c. Head Start d. Health fairs e. Statutory authority for the profession

a. Categorical funding c. Head Start e. Statutory authority for the profession

Several community-oriented nurses want to explore the problem of obesity in school-age children and assess their community school district health status related to that problem. When gathering information at a national level, they would begin with the: a. Centers for Disease Control and Prevention (CDC). b. Centers for Medicare and Medicaid Services (CMS). c. Health Resources and Services Administration (HRSA). d. National Institute of Nursing Research (NINR).

a. Centers for Disease Control and Prevention (CDC).

Which of the following best supports the concept of community-oriented nursing practice? a. Direct nursing care of individuals with tuberculosis (TB) b. Hospice home care for a terminally ill individual and family c. Nursing interventions to stop elder abuse d. Nutrition education programs for teenagers and their families e. Wound care for a homebound individual

a. Direct nursing care of individuals with tuberculosis (TB) c. Nursing interventions to stop elder abuse d. Nutrition education programs for teenagers and their families

A nurse is advocating for local leaders to place a newly approved community health clinic in an area of the city that has fewer resources than other areas. The nurse is advocating for the leaders to uphold which of the following ethical principles? a. Distributive justice b. Fidelity c. Respect for autonomy d. Veracity

a. Distributive justice

The nurse is preparing primary prevention activities for varied age groups. Which of the following are primary prevention activities? a. Educating about dental health b. Substance use prevention education c. Performing tuberculin skin tests d. Screening for lead exposure e. Discussing seat belt safety

a. Educating about dental health b. Substance use prevention education e. Discussing seat belt safety

A nurse is preparing to conduct a windshield survey. Which of the following data should the nurse collect as a component of this assessment? (Select all that apply) a. Ethnicity of community members b. Individuals who hold power within the community c. Natural community boundaries d. Prevalence of disease e. Presence of public protection

a. Ethnicity of community members c. Natural community boundaries e. Presence of public protection

What terms are used to describe healthy families? a. Families with strengths b. Dysfunctional c. Functional families d. Resilient families e. Resistant families

a. Families with strengths c. Functional families d. Resilient families

An occupational health nurse is consulting with senior management of a local industrial facility. When discussing work-related illness and injury the nurse should include which of the following as physical agents? (select all that apply) a. Noise b. Age c. Lighting d. Viruses e. Stress

a. Noise c. Lighting

A nurse is preparing an educational program on cultural perspective in nursing. The nurse should include that which of the following are influenced by an individual's culture? (Select all that apply.) a. Nutritional practices b. Family structure c. Health care interactions d. Biological variations e. Views about illness

a. Nutritional practices b. Family structure c. Health care interactions e. Views about illness

A nurse functioning in the role of a case manager performs which of the following functions in the care delivery process? a. Risk analysis b. Data mapping c. Provision of illness care d. Epidemiologic investigation of unexpected illnesses e. Counseling and education

a. Risk analysis b. Data mapping d. Epidemiologic investigation of unexpected illnesses

Which of the following interventions would be included when educating a family on environmental health? (select all that apply) a. Some plentiful sources of lead include playground equipment, vinyl mini-blinds, pottery, water, battery casings, and metal jewelry. b. Teach older children to wash hands when coming in from outside and prior to playing with the newborn. c. It is okay to keep toxic agents in an unlocked cabinet. d. Be certain to cook meats completely and to wash hands and sanitize countertops after preparing raw meats

a. Some plentiful sources of lead include playground equipment, vinyl mini-blinds, pottery, water, battery casings, and metal jewelry. b. Teach older children to wash hands when coming in from outside and prior to playing with the newborn. d. Be certain to cook meats completely and to wash hands and sanitize countertops after preparing raw meats

A nurse at a community clinic is conducting a well-child visit with a preschool-age child. The nurse should identify which of the following as a manifestation of child neglect? (Select all that apply) a. Underweight b. Healing spiral fracture of the arm c. Genital irritation d. Burns on the palms of the hands e. Poor hygiene

a. Underweight e. Poor hygiene

A newly hired occupational health nurse at an industrial facility is performing an initial workplace assessment. Which of the following should the nurse determine when conducting a work site survey? a. Work practices of employees b. Past exposure to specific agents c. Past jobs of individual employees d. Length of time working in current role

a. Work practices of employees

In giving care to the survivors of violence, the nurse should demonstrate respect and caring for all family members, insist that safety is the first priority, and demonstrate intolerance for violent behavior. Additionally, the nurse should be: a. absolutely honest about what will be reported and what the family can expect. b. authoritarian in approaching the problem. c. cautious in reporting unconfirmed reports of violence. d. sincere in concern for the victims.

a. absolutely honest about what will be reported and what the family can expect.

When applying evidence-based practice (EBP), community-oriented nurses are primarily obligated to ensure that evidence applied to practice is: a. acceptable to the community b. contains cost and reduces legal liability. c. applied as a universal remedy. d. limited to research findings.

a. acceptable to the community

The later years of life for many older adults mark a period of abruptly changing social dynamics over which the older adult has very little control. The nurse should understand that this phenomenon of later life challenges: a. adapting and coping responses. b. intellectual capacity. c. socioeconomic status. d. spiritual awareness.

a. adapting and coping responses.

A nurse coordinating care for undocumented minority workers with a high incidence of tuberculosis (TB) conducts a presentation before the local community health board to focus attention on the magnitude of the problem and its potential impact on the local community. The presentation stimulates the community to explore innovative solutions to increase screening for and treatment of TB cases. This scenario is an example of the relationship between: a. advocacy and case management. b. advocacy and continuity of care. c. care management and case management. d. care management and continuity of care.

a. advocacy and case management.

A nurse in community health is planning to begin a class to help mothers returning to work better cope with the stresses of multiple roles. The nurse would most likely use: a. an andragogical approach. b. a behavioral approach. c. an operational approach. d. a pedagogical approach.

a. an andragogical approach.

A neighborhood association group has asked the local nurse in community health for a class on environmental hazards. The nurse in community health has seen good information in the community health text and thinks about getting permission to copy some of the information. The most important thing the nurse should do before using copies of this material is to: a. assess the literacy level of the group. b. see how many plan to attend. c. see whether the group is ready to learn. d. secure a good space for a group meeting.

a. assess the literacy level of the group.

A community-based hospice nurse has an Asian male client with terminal stage cancer. The client complains that he is in continuous pain and receives no relief from the codeine prescribed by his primary care practitioner (PCP). The nurse contacts the client's PCP to discuss replacing the prescription of codeine with another pain-reducing non-codeine-based drug. The nurse is demonstrating knowledge of the cultural organizing factor of: a.biological variance. b.communication. c.space d. time perception

a. biological variance

Universal Precautions is a policy for all health care settings, where potential contact with blood or other body fluids exists, and requires that health care workers always perform hand hygiene and wear gloves, masks, protective clothing, and other indicated personal protective barriers. The underlying strategy for this policy requires that: a. blood and body fluids of all clients be handled as if infected. b. health care workers effectively use hand hygiene. c. health care settings are reservoirs of infection. d. effective infection control surveillance programs are in place.

a. blood and body fluids of all clients be handled as if infected.

A nurse in community health is following a pregnant teenager who attends school. The nurse plans to discuss self-care activities that will be important for the teen during her pregnancy. The discussion should include: a. carrying heavy book bags. b. changing to home education. c. decreasing fluid intake to avoid nausea. d. keeping up her grades.

a. carrying heavy book bags.

Identification of the discrepancies between the quality standards of the agency and the actual practice of the health care professionals is part of the interpretation component of quality assurance programs. Other factors addressed during this stage are: (select all that apply) a. choices of possible courses of action. b. follow-up evaluation. c. strengths and weaknesses. d. taking action.

a. choices of possible courses of action. c. strengths and weaknesses.

A multisystem approach to community disease control would include such interventions as: (select all that apply) a. community action programs. b. control of vectors. c. improved surveillance systems. d. legislation. e. provision of chemotherapy.

a. community action programs. b. control of vectors. c. improved surveillance systems. d. legislation. e. provision of chemotherapy.

The nurse engaging in formative program evaluation would most likely: a. conduct medical record audits for quality assurance. b. make a home visit before a client is discharged from the program. c. participate in new client evaluation. d. write policy for risk management.

a. conduct medical record audits for quality assurance.

Nurses in community health who understand the basis of their own behaviors and how those behaviors help or hinder the delivery of competent care to persons from cultures other than their own are demonstrating the cultural competence development process construct of: cultural awareness. cultural desire. cultural encounter. cultural skill.

a. cultural awareness

A nurse exclaims proudly to other nurses at the agency, "The care I provide is the same for everyone. I treat everyone the same." In fact, this nurse is demonstrating what inhibitor to developing cultural competence? Cultural blindness Cultural competence Cultural conflict Culture shock

a. cultural blindness

A breast cancer screening program screened 8000 women and discovered 35 women previously diagnosed with breast cancer and 20 women with no history of breast cancer diagnosed as a result of the screening. The prevalence proportion would reflect: a. current and past breast cancer events in this population of women. b. newly diagnosed cases of breast cancer in this population of women. c. past breast cancer events in this population of women. d.the population of women that had no evidence of breast cancer.

a. current and past breast cancer events in this population of women.

A strategy that may improve compliance with tuberculosis (TB) treatment is the: a. expansion of directly observed therapy. b. increased tuberculosis testing protocols. c. increased confirmatory testing protocols. d. treatment compliance education.

a. expansion of directly observed therapy.

Protecting the nation's food supply from contamination by all the virulent microbes is complex, costly, and time consuming. However, much foodborne illness, regardless of causal organisms, can be prevented through simple changes in: a. food preparation, handling, and storage. b. importation regulations. c. pesticide usage. d. animal breeding practices.

a. food preparation, handling, and storage.

The family nurse conducts the family nursing assessment with the family as a unit. Using a systematic process, family problems are identified and family strengths are emphasized as building blocks for interventions. Which of the following best completes the statement to demonstrate the importance of assessment to outcomes? Integrating the extended families: a. fosters equal family and provider commitment to success. b. facilitates outcomes-oriented family nursing research. c. decreases the need for nurse contact and intervention. d. removes barriers to needed services to achieve success.

a. fosters equal family and provider commitment to success.

A nurse who speaks only English has just gotten a new client for an intake interview. The client is a refugee who has very limited English proficiency (LEP). The nurse should: a. get an interpreter b. see whether another nurse, more comfortable with refugees, will work with the client. c. see what helpful information is on the Internet. d. try to communicate with hand gestures.

a. get an interpreter

The Omaha System is a client classification system developed by the Visiting Nurses Association of Omaha, Nebraska, that has the potential to improve the delivery of care by: a. improving the description of care. b. minimizing the assessment required. c. predicting the outcome. d. decreasing the communication needs.

a. improving the description of care.

The Patient Self-Determination Act of 1991 requires that providers receiving Medicare and Medicaid funds give clients written information regarding: a. legal options for treatment choices in the event the person becomes incapacitated. b. patient rights. c. the cost of services. d. patient privacy.

a. legal options for treatment choices in the event the person becomes incapacitated.

Ethical decision making is conducted in a generic framework. One step of ethical decision making is to place an ethical issue or dilemma within a meaningful context. The rationale for this step is: a. multiple factors affect the formulation and justification of ethical issues and dilemmas. b. the nature of ethical issues and dilemmas determines the specific ethical approach used. c. people cannot make sound ethical decisions if they cannot identify ethical issues and dilemmas. d. professional persons cannot avoid choice and action in applied ethics.

a. multiple factors affect the formulation and justification of ethical issues and dilemmas.

The hospital infection control practitioner reports new cases of tuberculosis to the public health department. Of what type of surveillance system is this an example? passive active sentinel special

a. passive

Provision 3 of the Code of Ethics for Nurses states, "The nurse promotes, advocates for, and strives to protect the health, safety, and rights of the patient." In applying this provision to practice, the public health nurse understands that: a. patient means the recipient of nursing care. b. the profession's integrity is at stake. c. rights of the individual supersede. d. this applies only to nursing in community health.

a. patient means the recipient of nursing care.

Clinical medicine and epidemiology differ from each other in the major aspect of: a.practice focus b. health monitoring c.determinants of health and disease d.evaluation of interventions

a. practice focus

A nurse in community health integrates new slides into a presentation that will be given to a local elementary school group regarding the techniques of proper hand washing. The new slides will repeat essential points during the presentation. This demonstrates the nurse's understanding of what principle? Repetition Integration Participation Sequencing

a. repetition

Twenty people attended a church picnic the previous weekend. By Monday, four individuals exhibited symptoms of food poisoning. On Tuesday, the nurse in community health records the addition of two new cases. The incidence rate would be: two new cases divided by 16 at risk. two new cases divided by 20. six cases divided by 20. four cases divided by 16.

a. two new cases divided by 16 at risk

Immunity to disease through vaccination is known as: natural immunity. resistance. acquired immunity. herd immunity.

acquired immunity.

The public health nurse is most likely to use what types of surveillance systems? (Select 2 that apply.) a.active b.passive c.sentinal d. syndromic

active and passive

A nurse in community health directly contacts a mammography clinic to arrange an appointment for a female migrant worker with limited English language abilities. The nurse communicates with the client through an interpreter to ensure that the client's appointment is scheduled to meet her needs and that the client understands the procedure to be performed. This strategy used with vulnerable populations can best be described as: advocacy. culturally competent care. partnership. social justice.

advocacy.

In applying the developmental theory, a family nurse determines the developmental stage of the family based on: age of the eldest child. family strengths. individual growth patterns. overall tasks of the family.

age of the eldest child.

An American takes a long-awaited vacation in sunny Mexico, spending days on the beach eating fresh raspberries from a nearby vendor and drinking bottled water. The tourist may be altering: agent-host-environment interaction. circadian rhythms. herd immunity. resistance.

agent-host-environment interaction.

The nurse in community health identifies an elder abuse problem because of caregiver stress among families in the local community resulting from lack of caregiver support services. The next step in the community-oriented nursing process would be to: analyze the community problem. establish priorities. establish goals and objectives. identify intervention activities.

analyze the community problem.

Nurses in community health conducting health education classes for populations vulnerable to HIV/AIDS should explain the natural history of the progression of human immunodeficiency virus (HIV). Of particular importance is the fact that the disease may go undetected during the primary infection phase because: antibody tests are typically negative. the immune system increases antibody production. the incubation period is prolonged. symptoms include myalgias, sore throat, and rash.

antibody tests are typically negative.

A parent involved in conflict resolution with her teenager says, "I know that some of your friends stay out until midnight, but I think it is best if you are in at 10 o'clock." This statement, a behavior seen in conflict situations, is an example of: negotiation. cooperation assertiveness aggressiveness.

assertiveness

A community-oriented nurse has identified obesity as a problem in the middle school. The next step in a population-focused practice is to make information available about the health of the middle school students. This describes the public health core function of: assessment. assurance. policy development. research.

assessment

The ethical question, "Are persons assigned to develop community knowledge adequately prepared to collect data on groups and populations?" is based on an ethical tenet that supports the community-oriented core function of: assessment. assurance. policy development. compliance.

assessment.

A state agency has received multiple complaints regarding the availability of elder transportation services to a specific county senior center. The state agency assigns a public health nurse to work with the community to evaluate its program for elder transportation services to publicly sponsored elder care programs. The public health core function applied is: assurance. policy development. primary prevention. public transportation.

assurance.

Evidence-based public health utilizes which of the following guidelines? a. Decision making for the community served b. Application of program planning frameworks c. Judicious use of the Internet for use of evidence d. Conducting evaluations e. Disseminating what has been learned

b, d, e

Primary care refers to personal health care for the most common needs of members of a community. Which of the following statements also differentiates primary care from primary health care? a. Primary care consists of a multidisciplinary team. b. Primary care is provided within the context of family and community. c. Primary care encourages self-care and self-management. d. Primary care provides first-contact, continuous, comprehensive, and coordinated care. e. primary care provides preventive, curative, and rehabilitative services.

b,d

A parent with two school-age children has just finished a family health assessment questionnaire. The parent asks the nurse why one of the questions asks whether there is a neighborhood playground. The nurse's best response would be: a. "Don't worry about it. We are going to talk about all this anyway." b. "It's important to good health to have adequate recreation resources." c. "We want to be able to report any dangerous playground equipment to the city." d. "We want to know what kind of neighborhood you're in so we can assess income."

b. "It's important to good health to have adequate recreation resources."

During a family nursing assessment, a parent questions whether God is punishing the family, because one of the children has just been diagnosed with leukemia. The most facilitative response by the nurse would be: a. "God is loving and doesn't punish people." b. "Tell me more about your family's spiritual beliefs." c. "That is not part of my religious belief system, so I don't know." d. "Why do you think your family needed to be punished?"

b. "Tell me more about your family's spiritual beliefs."

A nurse is completing a needs assessment and beginning analysis of data. Which of the following actions should the nurse take first? a. Determine health patterns within collected data b. Compile collected data into a database c. Ensure data collection is complete d. Identify health needs of the local community

b. Compile collected data into a database

A community-based HIV/AIDS clinic would be concerned about which aspects of the Public Health Code of Ethics? a. Autonomy of the professional b. Confidentiality when possible c. Funding d. Promoting advocacy for disenfranchised persons e. Respecting only community rights

b. Confidentiality when possible d. Promoting advocacy for disenfranchised persons

A nurse is caring for a client who is experiencing alcohol withdrawal. Which of the following findings is a manifestation of withdrawal? a. Decreased blood pressure b. Diaphoresis c. Pin-point pupils d. Bradycardia

b. Diaphoresis

A community-oriented nurse convenes a support group for teenage mothers. The nurse understands that this strategy fosters cohesiveness among members and allows the members to learn from one another. What other benefit specific to group teaching will be achieved? a. Cultural sensitivity b. Efficiency in client service c. Learning of new skills d. Distraction-free surroundings

b. Efficiency in client service

Family health can be defined as a dynamic, changing, relative state of well-being that includes the biological, psychological, sociological, cultural, and spiritual factors of a family system. This family health approach would best include which of the following underlying principles? a. Assessment of the individual's health does not determine the overall family system's health. b. Family functioning affects the health of individuals. c. Family system assessment specifically addresses the individual's health. d. The individual's health affects family functioning. e. Simultaneous assessment of individual family members and the family system as a whole is important to family health.

b. Family functioning affects the health of individuals. d. The individual's health affects family functioning. e. Simultaneous assessment of individual family members and the family system as a whole is important to family health.

Which of the following statements are true regarding the health-related vulnerabilities of men? a. More males die at birth. b. Fewer health services are offered to men. c. Men often put work ahead of their health needs. d. More males die from suicide. e. Men often incur more work related injuries than women.

b. Fewer health services are offered to men. c. Men often put work ahead of their health needs e. Men often incur more work related injuries than women.

A nurse is creating partnerships to address health needs within the community. The nurse should be aware that which of the following characteristics must exist for partnerships to be successful? (Select all that apply) a. A leading partner with decision-making authority b. Flexibility among partners when considering new ideas c. Adherence of partners to ethical principles d. Varying goals for the different partners e. Willingness of partners to negotiate roles

b. Flexibility among partners when considering new ideas c. Adherence of partners to ethical principles e. Willingness of partners to negotiate roles

Rural residents appear to have a more persistent, endemic level of depression. The factors that may contribute to this level of depression may be related to which of the following? a. Crisis intervention b. Gaps in continuum of mental health services c. Sufficient number of mental health services d. Tolerance for destructive coping behaviors e. Trust in the health care professionals

b. Gaps in continuum of mental health services d. Tolerance for destructive coping behaviors

A nurse is caring for a client who is from a different culture than himself. When beginning the cultural assessment, which of the following actions should the nurse take first? a. Determine the client's perception of his current health status b. Gather data about the client's cultural beliefs c. Determine how the client's culture may impact the effectiveness of nursing actions. d. Gather information about previous client interactions with the health care system

b. Gather data about the client's cultural beliefs

A newly hired public health nurse is familiarizing himself with the levels of disaster management. Which of the following actions is a component of disaster prevention? a. Outlining specific roles of community agencies b. Identifying community vulnerabilities c. Prioritizing care of individuals d. Providing stress counseling

b. Identifying community vulnerabilities

The primary reasons for delay, difficulty, or failure to access care include which of the following factors? a. The increase in safety net providers b. Inability to afford health care and a variety of insurance-related reasons c. Lack of transportation d. Refusal of services by providers e. Resolved nursing shortage

b. Inability to afford health care and a variety of insurance-related reasons c. Lack of transportation d. Refusal of services by providers

What is the purpose of using an algorithm in the surveillance process? a.Tells the nurse who to call in the event of an outbreak b.Provides the nurse with a step by step plan to identify events needing investigation c.Provides the nurse with a system for telephone triage in an outbreak d.It is a visual reminder of the epidemiologic triangle

b. Provides the nurse with a step by step plan to identify events needing investigation

A home health nurse is discussing portals of entry with a group of newly hired assistive personnel. Which of the following are portals of entry the nurse should discuss? (select all that apply) a. Respiratory secretions b. Skin c. Genitourinary tract d. Saliva e. Mucous membranes

b. Skin c. Genitourinary tract e. Mucous membranes

A nurse who questions whether a particular activity in her job description is within her scope of practice would look to which government jurisdiction or agency to seek the clarification? a. Federal system b. State system c. Department of Labor d. U.S. Department of Health and Human Services

b. State system

A nurse is reviewing the various roles of a community health nurse. Which of the following is an example of a nurse functioning as a consultant? a. Advocating for federal funding of local health screening programs b. Updating state officials about health needs of the local community c. Facilitating discussion of a client's ongoing needs with an interprofessional team d. Performing health screenings for high blood pressure at a local health fair

b. Updating state officials about health needs of the local community

A nurse doing a family assessment asks the client, "Have any of your blood relatives had mental illness?" The nurse is asking this question to: a. determine whether the family is stable. b. assess for biological risk factors. c. decide whether this family member needs medication. d. demonstrate open-mindedness about mental illness.

b. assess for biological risk factors.

When acting as a mediator, the nurse advocate would: a.choose a new health plan for a client with limited funds. b. assist new parents in communicating with their health c. plan regarding well-baby coverage. d. provide health education to teens who need knowledge about sexually transmitted diseases. e. set up a doctor's appointment for an illiterate adult.

b. assist new parents in communicating with their health plan regarding well-baby coverage.

When a community health nurse uses evidence-based practice (EBP) to evaluate effectiveness, accessibility, and quality of personal and population-based services, the nurse is addressing the core public health function of: a. assessment b. assurance c. policy development d. research

b. assurance

A nursing student prepares a treatment plan for a client that draws upon the student's understanding of pathophysiology and nursing practice theory learned in the student's coursework. This application of new information used in a different way demonstrates the educational principle of: a. affective domain. b. cognitive domain. c. events of instruction. d. principles of effective education.

b. cognitive domain

The concept of managed care is most often associated with processes such as utilization management, disease prevention, health promotion, wellness, and: a. ambulatory payment classes (APCs). b. consumer education. c. retrospective payment. d. third-party payer.

b. consumer education.

A family nurse is working with a married couple that has decided to remain child-free. The nurse recognizes this decision as a: a. biological necessity. b. contemporary family function. c. religious belief decision. d. threat to family survival.

b. contemporary family function.

A major evaluation source for a nurse to use to determine the effectiveness of a teen driver safety program is: a. Centers for Disease Control and Prevention (CDC) reports. b. epidemiologic data. c. recent census data. d. voter registration records.

b. epidemiologic data.

A mother brings her child to the nurse's office a few days before the first day of class for the new school year. The mother wants the child to begin school but says, "I'm going to take care of the immunizations tomorrow." The most important action the nurse should take is to: a. conduct a physical exam to determine whether the child is healthy. b. explain to the parent that all required immunizations must be given before the child will be allowed to enter school. c.let the child begin school but ensure that the school keeps the child separated from the other children. d. make sure the child does have an appointment for tomorrow.

b. explain to the parent that all required immunizations must be given before the child will be allowed to enter school.

A nurse volunteering at the free clinic in her community informs a client seeking treatment for hypertension that the family's children may qualify for enrollment in the State Children's Health Insurance Program (SCHIP). The nurse's intervention can reduce health disparities for these vulnerable children by making a referral to a program that provides: a. direct financial subsidies for children. b. funds to insure currently uninsured children. c. outreach efforts to enroll eligible children in Medicaid. d. prospective payments for child services.

b. funds to insure currently uninsured children.

A business executive develops symptoms of the flu 1 day after returning by air from a cross-Atlantic business trip that ran for 2 consecutive stressful 10-hour days. This individual's development of flu symptoms illustrates the relationship between: a. host and agent b. host, agent, and environment c. risk and casuality d. morbidity and disease

b. host, agent, and environment

The aging population is expected to affect health services more than will any other demographic factor. Another demographic population factor that affects health care costs can be related to: a. consumer demand. b. illnesses such as AIDS. c. marketing practices for new drugs. d. technology advancement.

b. illnesses such as AIDS.

Of the four major factors that affect health care—personal behavior/lifestyle, environmental factors (physical, social, economic), human biology, and the health care system—medical services are said to have the least effect. Yet, the U.S. health care system remains reactionary with high-cost, high-technology, and disease-specific "sickness care." This statement supports the need for increased investment in: a. managed care. b. primary prevention. c. secondary prevention. d. tertiary prevention.

b. primary prevention.

One of the basic concepts in epidemiology is the concept of risk. Risk refers to the: a.prevalence of an event occurring. b.probability that an event will occur within a specified time period. c.population most likely to develop a disease. d.rate of development of new cases.

b. probability that an event will occur within a specified time period

A nurse in community health is working with a single parent of three children, ages 4, 6, and 8. The 6-year-old has cerebral palsy. The 4-year-old has asthma. The maternal grandmother lives with the family and has diabetes. The nurse understands the importance of working within the context of the existing family structure and community resources because families are: a. resistive to outside intervention or involvement. b. responsible for providing/managing the care of their members c. unable to manage the stress of complex health needs. d. restricted in their ability to identify interventions.

b. responsible for providing/managing the care of their members

A nurse is concerned about the accuracy of the PPD test in identifying cases of TB exposure for follow-up chest x-ray. The nurse's concern is addressing the validity measure of: a. reliability b. sensitivity c. specificity d. variation

b. sensitivity

Politics is simply described as: a. the ability to fund a special project. b. the art of influencing others. c. business conducted in the senate. d. interaction between the policymakers and the public.

b. the art of influencing others.

A public health nurse has identified the need to make amendments in an existing law concerning the TB health assessment of individuals sentenced to serve jail terms on weekends only, based on the current criminal justice system practices and potential health risk to the free-living community. To raise this concern, the nurse has several paths to follow, but the amendment of any existing laws would ultimately be decided by: a. the executive branch of the government. b. the legislative branch of the government. c. local representatives. d. senate hearings.

b. the legislative branch of the government.

What are the purposes of disease surveillance in public health? a.Tries to identify terrorist attacks before they occur b.Provides a means for nurses to monitor disease trends c.Generates knowledge about disease or outbreak patterns d.Allows the nurse to advocate for policy changes e.Reduces morbidity and mortality and improves health through disease trend monitoring

bce

A case manager is concerned that some of the clients at the neighborhood clinic are getting fewer services because of their financial situations. The case manager is confronting the ethical principle of: justice. veracity. deontology. beneficence

beneficence

What are some of the benefits of an electronic medical record in the public health setting? a. Timely billing and financial reimbursement for services provided b. Improved public reporting of medication errors c. Coordination of referrals and facilitation of chronic disease management d. Improvement of quality measurement and monitoring e. Incorporation of protocol reminders for prevention, screening, and management of chronic disease

c,d,e

The public health nurse deals with the examination of a community setting to determine the community's health status. Which of the following activities should be considered in the assessment phase? a. Assisting communities to implement and evaluate plans and projects b. Building constituencies to work with the community c. Collecting, analyzing, and disseminating information d. Evaluating the social, economic, and environmental characteristics of the population e. Questioning the availability of health services to the community

c. Collecting, analyzing, and disseminating information d. Evaluating the social, economic, and environmental characteristics of the population e. Questioning the availability of health services to the community

A nurse is preparing a community health program on communicable diseases. When discussing modes of transmission, the nurse should include which of the following as an airborne illness? a. Cholera b. Malaria c. Influenza d. Salmonella

c. Influenza

The current-day definition of family refers to two or more individuals who depend on one another for emotional, physical, and/or financial support. Which of the following is the most important principle to support this broader definition? a. Families are defined by genetic ties. b. Family names are needed to confer status. c. Members of a family are self-defined. d. Traditional family functions have been redefined.

c. Members of a family are self-defined.

The nurse has developed a program to provide group therapy for clients with depression, which of the following issues for the vulnerable population are being addressed? a. Violence b. Poverty c. Mental health issues d. Homelessness

c. Mental health issues

A nurse in community health is participating in a community service board strategic team that is currently assessing the community's strengths, the local public mental health system, the community's mental health status, and other variables. This best describes what strategic program planning model used today in the public health arena? a. Assessment Protocol for Excellence in Public Health (APEXPH) b. Health Evaluation Data Information System (HEDIS) c. Mobilizing for Action Through Planning and Partnership (MAPP) d. Planning Approach to Community Health (PATCH)

c. Mobilizing for Action Through Planning and Partnership (MAPP)

Upon completing a community assessment, which of the following data WOULD NOT be included: a. Crime rate b. Curbside garbage pick up c. National statistics on prevalence of diabetes d. Public transportation

c. National statistics on prevalence of diabetes

A useful way to distinguish between Medicare Part A and Medicare Part B is to recognize that: (select all that apply) a. Part A covers outpatient hospital care. b. Part B covers limited skilled nursing care. c. Part A is hospital insurance. d. Part B is noninstitutional care insurance. e. Part B is a voluntary supplemental program.

c. Part A is hospital insurance. d. Part B is noninstitutional care insurance. e. Part B is a voluntary supplemental program.

A nurse working in the ED of a small rural hospital, discusses treatment over a secure video/audio line with a physician in a large city 2 hours away. This is an example of the use of: a. Occupational health nursing b. Informatics c. Telehealth d. Parish nursing

c. Telehealth

Administering medications to treat the chronic condition of asthma is a: a. Primary prevention activity b. Secondary prevention activity c. Tertiary prevention activity d. Nursing only function

c. Tertiary prevention activity

A nurse is preparing an education program on disease transmission for employees at a local day care facility. When discussing the epidemiological triangle, the nurse should include which of the following agents? (Select all that apply). a. Resource availability b. Ethnicity c. Toxins d. Bacteria e. Altered immunity

c. Toxins d. Bacteria

The nurse has just taught a client newly diagnosed with diabetes how to administer sliding-scale insulin. The most effective way to evaluate learning is to: a. provide an online test module. b. ask whether there are any questions. c. ask for a return demonstration. d. give a short paper-and-pencil quiz.

c. ask for a return demonstration.

A school nurse is working with the Parent Teacher Organization (PTO) to improve the health status of preschool students in a lower socioeconomic urban community. Given the demographics of the community, the nurse is aware that this population is at greatest risk for: a. asthma. b. attention deficit disorder (ADD). c. childhood obesity. d. poisoning.

c. childhood obesity.

An elementary classroom of 28 students has had 13 children who have developed chicken pox over the last 3 weeks. What is the pattern of occurrence? a.Common source outbreak b.Point source outbreak c.Continuous source d.Mixed outbreak

c. continuous source

he nurse who works in the community setting must ensure that the application of the best available evidence to improve practice is also: a. accessible and diverse. b. competent and compliant. c. culturally and financially appropriate. d. reasonable and deliverable in a timely fashion.

c. culturally and financially appropriate.

A Public Health Service nurse working for the Indian Health Service is working with a client diagnosed with cancer. The client uses sweat lodges to "cure the disease." The nurse understands that within the culture, disease is often perceived as disharmony with other forces, and clients may look to hot or cold treatments to resolve or cure a cancerous condition. The nurse is integrating her knowledge of the cultural organizing factor of: a.biological variations. b.communication. c.environmental control d.space.

c. environmental control

A nurse new to the community evaluates the resources available to a father that has sought help with his escalating abuse and threats of violence to his family. After making the referral, the nurse approaches the local newspaper about running a series on the nature and extent of human abuse in the community. This strategy would: a. advocate for government programs to treat survivors. b. demonstrate the provider's commitment to address the need for services. c. increase awareness of community resources to address violence and abuse. d. increase the number of individuals identified as perpetrators.

c. increase awareness of community resources to address violence and abuse.

If a small business employer desires to control company benefit expenditures by turning health care decision-making control over to the employees, the insurance reform effort that best addresses the shifting of responsibility, knowledge, and decision-making involvement to the individual receiving the care would be: a. health spending accounts (HSA). b. managed care. c. medical savings account (MSA). d. prospective payment.

c. medical savings account (MSA).

A nurse in community health has determined that there is a need for a program for teenage fathers who want to learn about child care. The next step in the program management process would be to: a. conduct a survey to determine how many children the fathers have. b. determine whether the fathers have benefited from this type of program before. c. meet with community members to form a planning body. d. provide the fathers with community resources.

c. meet with community members to form a planning body.

A community health nurse involved in care management would most likely: a. develop, conduct, and evaluate health teaching programs in primary care. b. manage the staff at a free clinic. c. monitor the health status, resources, and outcomes for an aggregate. d. provide immunizations to migrant workers.

c. monitor the health status, resources, and outcomes for an aggregate.

One member of an older couple has just retired. This is considered a: a. developmental stage that will help the family with stress reduction. b. nonnormative event that will have psychological impact on the family. c. normative event and can increase the family's risk for illness. d. normative event and will have little effect on the family' well-being.

c. normative event and can increase the family's risk for illness.

A nurse in community health is working in a rural setting. In planning for programs to address the population's needs, the nurse should be aware that, in general, rural populations: a. engage in physical activity during leisure time. b. engage in preventive behaviors. c. perceive their overall health as less favorable. d. use seat belts.

c. perceive their overall health as less favorable.

When health care providers in the community refuse to accept Medicare clients, this implies reduced access to care, potential decreases in acceptable quality of services offered, and a form of health care rationing. Health care rationing becomes a public health and nursing issue because: a. Medicare reimbursement needs to be higher. b. proactive primary prevention orientation is cost effective. c. public health systems and nurses must ensure that essential clinical services are available. d. sufficient resources are available in the public health system to meet the unmet need.

c. public health systems and nurses must ensure that essential clinical services are available.

An example of secondary prevention for infectious disease prevention is: a. malaria chemoprophylaxis. b. Pneumocystis carinii pneumonia (PCP) chemoprophylaxis for people with AIDS. c. quarantine. d. restaurant inspections.

c. quarantine.

The gold standard of evidence gathering in evidence-based practice is: a. clinical knowledge and judgment. b. expert opinions. c. randomized clinical trials. d. theories of practice.

c. randomized clinical trials

The 1989 changes to Medicaid required states to provide care for children younger than 6 years and to pregnant women under 133% of the poverty level. These changes also ensured adequate access to qualified providers by: a. adding coverage for the medically indigent. b. reimbursing early periodic screening, diagnosis, and treatment (EPSDT) for those younger than 21 years. c. reimbursing pediatric and family nurse practitioners. d. reimbursing skilled and intermediate nursing home care.

c. reimbursing pediatric and family nurse practitioners.

Parents can expect their children to be immunized for communicable diseases before entering kindergarten in the local school system because: a. primary care clinics focus on prevention. b. primary care clinics maintain adequate supplies of immunization. c. the public health system has mandates for immunization. d. the public health system provides good access to immunization clinics.

c. the public health system has mandates for immunization.

The community-oriented nursing care function of policy development is supported by the ethical tenet of: a. competency. b. do no harm. c. what is ethical is also good policy. d. to each person a fair share.

c. what is ethical is also good policy.

It is important that nurses understand the nontraditional healing practices of their clients because: a.folk practices are usually ineffective. b.nurses can refer clients to the appropriate local folk healers. c.safe, effective nontraditional healing methods can be blended with Western medicine. d.the nurse must understand them to help the client give them up.

c.safe, effective nontraditional healing methods can be blended with Western medicine.

A community health nurse is working with an uninsured family with two children. The nurse assists the parents in applying for SCHIP benefits and securing an appointment for the children with a community pediatrician that participates in SCHIP. The intervention can best be described as: care management. case management. continuity of care. disease management.

case management.

The nurse in community health is aware that HIV-infected children should attend school, because the benefit of attendance far outweighs the risk of transmitting or acquiring infections. School attendance should be reconsidered when there is evidence of: availability of homebound instruction. cases of measles. lack of handicapped access. prejudice of teachers and/or students.

cases of measles.

ccccc

cccccc

A nurse in community health is invited to work with a coalition of churches to address safety concerns for children in the local community. The nurse provides training in problem-solving skills, manages conflict, facilitates the process, and provides expertise in interpreting data. This nurse has chosen the implementation role of: change agent. change partner. group leader. data collector.

change partner.

Virtue ethics is distinctly different from moral justification via theories or principles because the emphasis of virtue ethics is practical reasoning applied to: character development. consequentialism distributive justice. egalitarianism.

character development.

To reach the desired goal of maximizing the full immunization rates for preventable communicable disease and increasing herd immunity levels, it is crucial for the nurse to: assume that the primary care physician has provided all appropriate immunizations. check an individual's immunization status at each and every visit. support parents who are reluctant to immunize their children. understand the difficulties in obtaining and maintaining immunization schedules.

check an individual's immunization status at each and every visit.

A nurse in community health is working with a parent whose spouse has been called up for active duty in the military reserve. The family is experiencing financial strain due to decreased income. The extended family lives at a distance. The parent is struggling to manage the family in the spouse's absence. The family consists of four children (three preschool and one preteen). In this situation, it would be important for the nurse to further explore the potential for: child abuse. depression. intimate partner abuse. parent's resentment of the preteen.

child abuse.

Health care costs are influenced by factors related to demographic changes, new technology, resource intensity, and: chronic illness. market practices. nursing shortages. professional competition.

chronic illness.

In case management, it is unlikely that any single professional has the expertise, knowledge, or skills required to achieve success. The synergy produced by all involved parties (client, providers, payers, family/significant others, and community organizations) can result in successful outcomes. This statement relates to the sequential process of: collaboration. communication. cooperation. negotiation.

collaboration.

A nurse in community health contacts three individuals who have had sexual encounters with an individual recently diagnosed with syphilis. The concept basic to community-oriented nursing practice that is best described by this intervention is: community. community as client. individual as client. partnership.

community as client.

A nurse in community health seeks a low-cost evaluation method to learn the perspectives of the largest number of persons regarding a proposed local safe haven program for unwanted infants. The best evaluation method to meet the criteria would be: community forums. focus groups. key informants. surveys.

community forums.

The major sources of information for program evaluation are: (select all that apply) community indicators. media reports. program clients. program providers. program records.

community indicators. program clients. program records.

A Hispanic outreach program works with the nurse in community health to train Hispanic health care workers in providing basic services and education within the local Hispanic community. The concept basic to community-oriented nursing practice that is best described by this intervention is: community. community client. community health. community partnerships.

community partnerships.

A nurse in a clinic that provides direct care services to clients with tuberculosis would be classified as practicing: community-based nursing. community-oriented nursing. institutional nursing. public health nursing.

community-based nursing.

Jennifer is a nurse in a family medicine clinic. Today she is assessing Jose, a 4-year-old who is being seen for an earache. The type of nursing Jennifer practices is: community-oriented nursing. community-based nursing. public health nursing. tertiary health nursing.

community-based nursing.

A school nurse teaches three middle school students with asthma conditions techniques to minimize their incidence of bronchial spasms. This is an application of: community-based nursing. community-oriented nursing. institutional nursing. public health nursing.

community-based nursing. community-oriented nursing. institutional nursing. public health nursing.

Migrant workers and their families who reside in a specific mobile home park during the summer months would best be classified as a: community. group. setting of practice. target population.

community.

A government agency is conducting an audit of all active clients in the local hospice program to ensure that hospice criteria for care are being applied appropriately. The type of tool being used in this specific approach to quality assurance is: concurrent audit. outcome audit. retrospective audit. peer review.

concurrent audit.

Factors that contribute to newly emerging or reemerging infectious disease can be related to microbial adaptation and changes made by the infectious agent. However, most of the emergence factors are related to environmental changes and: consequences of human activities/behaviors. increase in the number of vectors. industrialization and urbanization. unpredictable variances in the climate.

consequences of human activities/behaviors.

One specific approach to quality assurance is the use of Total Quality Management (TQM). A district public health department uses this approach and gives much attention to ensuring that studies are used to improve processes, remove management by objectives, and promote self-improvement. The major TQM guideline that would summarize these efforts would be: create, publish, and distribute aims and purposes. creating a strong customer-oriented philosophy that is process-driven. eliminate barriers to pride of work/performance. understand the purpose of inspection.

creating a strong customer-oriented philosophy that is process-driven.

A general approach to quality improvement where a qualified agent designates formal recognition to individuals or institutions that have met minimum standards of performance is best described as: accreditation. charter. credentialing. licensing.

credentialing.

Vulnerable populations may be exposed to more than one hazard at a time. This is known as: cumulative risk. disenfranchised populations. resilience. underserved populations.

cumulative risk.

A nurse is talking to a client who asks for additional information about hospice. Which of the following is an appropriate statement by the nurse? a. "Clients who require skilled nursing care at home qualify for hospice care." b. "One function of hospice is to provide teaching to clients about life sustaining measures." c. "Hospice assists clients to develop the skills needed to care for themselves independently." d. "A component of hospice care is to control the client's symptoms."

d. "A component of hospice care is to control the client's symptoms."

An intervention to improve access to health care for vulnerable populations would be: a. Create partnerships to provide free or reduced health care services b. Coordinate services at a central location c. Ensure the availability of translators with medical training d. All other options

d. All other options

Which of the following social science theories is used by public health nursing to describe how environments and systems outside of the family influence the development of a child over time? a. Life cycle theory b. Family developmental theory c. Family systems theory d. Bioecological systems theory

d. Bioecological systems theory

A nurse performing home hospice case management notes the increasing number of hospice clients that lack caregivers in the home environment. The nurse identifies the potential need for a hospice house facility to meet the needs of these clients. The case management process frequently reveals such larger picture issues as: (select all that apply) a. Community cost concerns b. Community conflict-resolution skills c. Community satisfaction d. Community weaknesses in quality of services e. Community weaknesses in quantity of services

d. Community weaknesses in quality of services e. Community weaknesses in quantity of services

The family systems theory encourages nurses to view both the individual clients as participating members of a whole family. What is the major weakness of the systems framework? a. Views families from both a subsystem and a suprasystem approach b. Defines the direction of interactions c. Views the family as an agent of change d. Focuses on the interaction of the family with other systems

d. Focuses on the interaction of the family with other systems

A case management nurse at an acute care facility is conducting an initial visit with a client to identify needs prior to discharge home. After developing a working relationship with the client, the nurse is engaging in the referral process. Which of the following should be the first action by the nurse? a. Monitor the client's satisfaction with the referral b. Provide client information to referral agencies c. Review available resources with the client d. Identify referrals that the client needs

d. Identify referrals that the client needs

A home health nurse receives a referral to educate an older adult client with diabetes in proper foot care. The nurse's assessment of the client determines that the client has poor eyesight that may affect the client's ability to learn and perform certain skills. Which educational principle is being examined? a. Cognitive domain b. Events of instruction c. Principles of effective instruction d. Psychomotor domain

d. Psychomotor domain

A nurse works in a free clinic for uninsured low-wage employees in the community. The free clinic setting operates in a primary health care (PHC) strategy. The nurse would most likely focus on: a. Incidence of the disease. b. Physician orders for the individual. c. Pathophysiology of the disease. d. Self-care/management.

d. Self-care/management.

The federal agency most responsible for improving the health status of the American people is the: a. Office of Health Preparedness. b. Office of Global Affairs. c. Food and Drug Administration. d. U.S. Department of Health and Human Services.

d. U.S. Department of Health and Human Services.

Caring and the ethic of care is a core value of nursing in community health. This ethical view was developed in the mid-1980s and early 1990s in response to the technical advances in health care science and the desire of nurses to: a. apply gender-related voices to moral judgment. b. apply principles of utilitarianism. c. differentiate distributive justice from beneficence. d. differentiate nursing practice from medical practice.

d. differentiate nursing practice from medical practice.

In caring for a young adult from West Africa, the community nurse is introduced to another individual who is referred to as "auntie." A culturally competent nurse who is aware of the basic organizing factor of culture related to social organization would: a. assess the competence of the "auntie" to care for the young adult. b. assume that the "auntie" is related to one of the young adult's parents. c. declare that the young adult is capable of making personal health decisions. d. find out who is considered to be a member of the family.

d. find out who is considered to be a member of the family.

The nurse in community health is meeting with staff to systematically plan for a new outreach program. Doing so helps them to: a. assess the needs of potential outreach clients. b. recognize the special needs of vulnerable people in the area. c. identify how the problems of similar programs will not be repeated. d. identify the resources and activities that will help them meet their program objectives.

d. identify the resources and activities that will help them meet their program objectives.

In applying Ethical Principles for Effective Advocacy, the ethical principle that empowers the client (groups or communities) to make knowledgeable decisions is: a. act impartially and offer frank, independent advice. b. act in accordance with the client's wishes and instructions. c. act in the client's best interest. d. keep the client properly informed.

d. keep the client properly informed.

A disease outbreak of severe acute respiratory syndrome has occurred and has spread over several countries outside the United States. This level of occurrence is said to be: hyper-endemic sporadic. epidemic. pandemic.

d. pandemic

The purpose of record keeping in public health agencies is to maintain complete information on clients served and the extent and quality of service provided to those clients. The records also provide information for education and research. Another important use of the records is to: a. determine raises for personnel. b. explain cost overruns. c. foster independence in clinical practice. d. resolve legal issues in malpractice suits.

d. resolve legal issues in malpractice suits.

The school nurse is interested in providing an antismoking program in a local middle school and is aware that programs are more effective for this age group when they focus on short-term versus long-term effects of smoking. Besides including health risks and cosmetic effects, the nurse should also consider: a. behavior modification techniques. b. effects on the environment. c. laws regarding tobacco sales to minors. d. social skills instruction to resist pressure to smoke.

d. social skills instruction to resist pressure to smoke.

A population-level tertiary prevention intervention typically performed by nurses and aimed at controlling communicable diseases is: a. HIV test counseling. b. needle-exchange program. c. partner notification. d. standard precautions teaching.

d. standard precautions teaching.

A nurse in community health seeks to determine whether the visit with an older adult Asian woman is successful. The nurse has not encountered many clients from this culture. An effective way to judge whether a cultural encounter has been effective would include the nurse's sense that the visit was successful, the nurse and client experience little or no stress, and: a. the client says "thank you." b. the client nods frequently. c. the client's family does not complain. d. tasks are done efficiently.

d. tasks are done efficiently.

A public health nurse employed by the Department of Health is working on a team developing local health policy. The nurse recognizes which of the following about policy development? a. It is based on Socratic method. b. It is important that the policy has been approved by the American Nurses Association. c. It is primarily up to politicians to plan for health care. d. It is very similar to the nursing process.

d.It is very similar to the nursing process.

While conducting a community health assessment, a nurse in community health meets with local religious leaders to understand the values, norms, perceived needs, and influence structures within the community. This process of data collection can best be described as: data gathering. data generation. data interpretation. problem identification.

data generation.

It is estimated that one in 15 males becomes a father during his teen years. The nurse should be aware that many young men facing paternity have specific challenges such as: (select all that apply) acting as though they are interested when they are disinterested. avoiding prenatal care involvement. desiring and needing to be involved with their children. being rejected by the young woman's family. rejecting their role as a father.

desiring and needing to be involved with their children. being rejected by the young woman's family.

A case management nurse for a locally funded program for special-needs children is increasingly concerned about a recent referral for a 1-year-old child with a congenital illness residing in a poverty-stricken community. The nurse knows that this child may be at higher risk for the most harmful effects of poverty, including: developmental delays. ear infections. frequent colds and infections. irritability.

developmental delays.

The nurse at the adult day care center notices bruises on the wrists of a 90-year-old client. Besides the physical assessment of the client, the nurse should: confront the daughter when she arrives to pick the father up. discuss the findings with the caregivers to determine the cause of the injuries. educate the staff about indications of elder abuse. make a referral to the primary care provider for follow-up.

discuss the findings with the caregivers to determine the cause of the injuries.

Society bears the burden of infectious disease. That burden includes the effects of morbidity and mortality as well as the staggering: economic burden. fear burden. incidence burden. vulnerability burden.

economic burden.

Local officials have requested a program evaluation of a comprehensive teen sex education program offered in the local schools in preparation for potential budget discussions. A nurse in community health conducts a program evaluation and determines that the teen pregnancy rate has gradually declined over the years that the program has been in place. The community is measuring the program's: efficiency. progress. relevance. sustainability.

efficiency.

The nurse in community health defines goals and measurable objectives during the planning phase of a community health intervention. This also marks the beginning of the: evaluation phase. implementation phase. needs assessment. problem analysis.

evaluation phase.

Elderly clients should be assessed for signs of abuse. The illegal use of a person for another person's profit is known as: neglect. incompetence. exploitation. self-determination.

exploitation.

true or false The "do-nothing" solution to a problem is always the decision that will pose the least risk to the client

false

true or false Fragmentation of services affects the process of case management in a limited way

false

true or false Systematic planning for meeting client needs is only of benefit to the agency sponsoring the program

false

true or false The facilitator role involves provided a formal communication link among all parties concerning plan of care

false

true or false The most critical step in planning for a health program is comparison of alternative methods to arrive at problem resolution

false

The nurse in community health uses information about family structure, household composition, marriage, divorce, birth, death, adoption, and other family life events to forecast and predict stresses and developmental changes experienced by families and identify possible solutions to family challenges. This best describes the study of: family demographics. family functions. family health. family resilience.

family demographics.

A father brings his stepdaughter to the family clinic for an immunization update before the new school year. The nurse notices the interaction between the young girl and her stepfather. The child appears tense and cautious and wraps her arms around herself in a protective manner. The child startles when touched by the stepfather and pulls away. The stepfather is overheard saying, "I'll leave you here if you don't behave and act nice." In this scenario, it would be important for the nurse to explore in her assessment the possibility of: child neglect. family secrets. father-daughter incest. impaired family functioning.

father-daughter incest.

A school nurse is asked to assess a 13-year-old child because of excessive drowsiness and inattention in class. The nurse determines that this is a child of migrant workers on a local produce farm. Based on the nurse's knowledge of migrant worker families, the nurse should first explore the child's potential involvement in: delinquent behavior. drug use. field work. Migrant Education Program.

field work.

An undocumented migrant farmworker has been diagnosed with tuberculosis (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 to 12 months. A major challenge that the client may face related to ongoing treatment for TB is: affordable care. discrimination. fragmented services. language barriers.

fragmented services.

Violence is a major public health problem in our communities that causes premature mortality and lifelong disability. Violence-related morbidity is a significant factor in: community deterioration. health care costs. juvenile delinquency. population density.

health care costs.

A poor, older Native Alaskan woman lives in a small, remote village near the Canadian border. She has been diagnosed with hypertension and diabetes but rarely makes it to the regional clinic in a distant town for checkups. This woman is most at risk for: disenfranchisement. health disparities. loss of independence. resilience.

health disparities.

Health education is often used as a strategy in working with vulnerable populations. The benefits of health education can be greatly affected by: dependency cycle. health literacy. income level. race and ethnicity.

health literacy.

A client presents at the local clinic with acute symptoms of fever, nausea, lack of appetite, malaise, and abdominal discomfort. During the course of the assessment, the nurse determines that the client is a health care aide working at a day care center. These facts are important because: acute hepatitis B is self-limiting. hepatitis A outbreaks are common in facilities where staff change diapers. hepatitis C is the "silent stalker." persons with chronic liver disease are at greater risk for hepatitis A.

hepatitis A outbreaks are common in facilities where staff change diapers.

All adults should be assessed for violence in their primary intimate relationships. The abuse of female partners has the most serious community health ramifications because of the greater prevalence, the more serious long-term emotional and physical consequences, and the greater potential for: fleeing to a shelter. homicide. possessive behavior. spontaneous abortion.

homicide.

The local hospital emergency department has recently experienced an increase in gastroenteritis cases among migrant farmworkers. The local health department is informed of this rise in cases and schedules a case mapping of local: bars frequented by migrant workers. farm fields employing migrant workers. housing for migrant workers. restaurants frequented by migrant workers.

housing for migrant workers.

A particular chronic health problem that adversely affects the aging experience for which it is difficult to estimate the number of individuals affected or the associated cost to manage is: iatrogenic drug reactions. immobility. incontinence. intellectual impairment.

incontinence.

In a federally funded preschool program such as Head Start, nursing services that include conducting developmental-level screening for cognitive and psychomotor development of individual children would most likely be considered community-oriented nursing care when: individual results are compared with established standards for children of the same age group. program characteristics are assessed for their effectiveness in making the school population healthier. referral is provided for a child identified with delayed psychomotor development. treatment is initiated for a child with an identified learning disability.

individual results are compared with established standards for children of the same age group.

A community-oriented nurse is interested in studying the hospital discharge data for facilities that typically provide services to members of the community where the nurse practices. The nurse accesses the National Hospital Discharge Survey database of the Department of Health and Human Services (DHHS) to identify data at national, regional, and local levels for comparison purposes. The government health care function being used by the nurse is: direct services. financing. information. policy setting.

information.

The most important causes of preventable disease, disability, and death among children are: injuries and accidents. maintaining a healthful diet. physical activity. cardiovascular health.

injuries and accidents.

A nurse participates with a community planning board addressing housing strategies and future community needs. The nurse is aware that the community has a population of homeless families served by local churches. The nurse is also aware that this agricultural community relies on migrant workers during seasonal harvesting of local produce. The nurse is concerned that these disenfranchised populations may be: complicated to address. costly to serve. invisible to the community. resilient to the community.

invisible to the community.

For the homeless, health care is usually crisis oriented and sought in emergency departments. The most difficult challenge for nurses treating this vulnerable population is to recognize the client's: limitations in following treatment protocols. limited number of transient treatment facilities. transition to persistent poverty. use and abuse of tobacco, alcohol, and illicit drugs.

limitations in following treatment protocols.

A nurse in community health working in an inner city clinic with high poverty and unemployment rates recognizes the need for programs for pregnant women because these women often receive late or no prenatal care and deliver: at home. full term. identical twins or triplets. low-birthweight babies.

low-birthweight babies.

For the nurse to fully understand the threat associated with the release of biological agents and participate in an appropriate response, the Centers for Disease Control and Prevention (CDC) has stated that the biological agents most likely to be employed are those that both have a potential for high mortality and can be easily disseminated to produce: immediately severe symptoms. major panic and social disruption. multisyndrome effect. person-to-person transmission.

major panic and social disruption.

Within a state, counties designated as Health Professional Shortage Areas (HPSAs) tend to have a high proportion of racial minorities and fewer specialists. This factor may explain conflicting data within a state related to: adult immunization rates. chronic respiratory illness rates. maternal/infant morbidity rates. obesity rates.

maternal/infant morbidity rates.

A hospice nurse is working with a cancer client and his family. The client's 7-year-old son has developed recent school and peer problems. Understanding the risk for disruption of normal development, the nurse plans to first screen the child for: developmental disorders. mental health problems. parental neglect. violence potential.

mental health problems.

A multidisciplinary quality assurance team has reviewed an organization's stated philosophy and objectives and developed a conceptual model for appraisal that integrates peer review and client satisfaction. The quality assurance program component that should be addressed next would be: action. process. structure. outcome.

outcome.

A young female client visits a local clinic, seeking treatment for a urinary tract infection (UTI). During the assessment, the nurse conducts an extensive sexual history/activity screening to determine the risk for a sexually transmitted disease and potential complication of: genital warts. herpes simplex virus 1. pelvic inflammatory disease (PID). primary syphilis.

pelvic inflammatory disease (PID).

The most significant commonalities between the ANA's Scope and Standards of Public Health Nursing Practice and the Public Health Code of Ethics assert that advocacy is conducted in the: assertiveness arena. education arena. litigation arena. policy arena.

policy arena.

The problem of the working poor and uninsured places a major burden on the current health care system that affects those families and the community in general. Nurses in community health see this as a major: (select all that apply) behavioral issue. policy issue. health risk issue. social issue. nursing issue.

policy issue. health risk issue. social issue.

Public health nursing is a specialty with a distinct focus and scope of practice and requires a special knowledge base different from other specialty areas of nursing. A public health nurse would first be interested in: drug treatments for diabetes. populations with the highest rate of diabetes. educational materials for individuals with diabetes. new technology for diabetic care.

populations with the highest rate of diabetes.

An underlying current throughout the special population groups with health disparities is: poverty. aging. minority groups. children.

poverty.

The general approach to quality improvement known as licensure that grants control over who can enter into and who exists in a profession can best be described as a contract between the: consumers and the profession. legislature and the state board. profession and the state. public and the professional associations.

profession and the state.

Nursing interventions and approaches for helping individuals and families to assume an active role in their care should focus on empowerment rather than on enabling. The underlying principle to empowerment is: client dominance. decreased competence. professional dominance. professional-client partnership.

professional-client partnership.

A nurse working with a Hispanic client explains the referral options available for the client to receive a mammogram. One option is free and has limited Spanish language resources. The other option has a nominal fee and comprehensive Spanish language resources. The nurse supports the client's decision to choose the provider that the client feels would best meet her needs. This advocacy role is best described as: intercessor. mediator. obstructer. promoter.

promoter.

During the last stage of AIDS, many opportunistic infections proliferate in persons with weakened immune systems. HIV-infected individuals who live near one another in long-term care facilities, drug treatment facilities, and prisons should be carefully screened before admission because they are at greater risk for acquiring: fungal disease. invasive cervical cancer. oral candidiasis. pulmonary tuberculosis (TB).

pulmonary tuberculosis (TB).

A state health department wants to ensure that the local health departments are delivering quality client care and can demonstrate the degree of excellence attained. The principle that is best defined by this statement is: continuous quality improvement (CQI). quality assurance (QA). risk management. total quality management (TQM).

quality assurance (QA).

A nurse in community health that speaks out in a public hearing in support of changes to existing requirements for reporting any long-term effects of structural or organizational changes within the community's health care organizations would be demonstrating: legislative action. health policy. regulatory action. regulatory monitoring.

regulatory action.

When determining whether a geographic area is rural or urban, the nurse should recognize that: rural and urban areas, by relative nature, occur on a continuum. rural regions have fewer than six persons per square mile. rural residents feel isolated. rural areas are recreational, retirement, or resort communities.

rural and urban areas, by relative nature, occur on a continuum.

Many behaviors place individuals of all ages, genders, ethnicities, or any other factors at greater risk for sexually transmitted diseases (STDs). The nurse should include primary prevention interventions in all client encounters through the discussion of: partner notification. safer sex. standard precautions. STD testing.

safer sex.

The primary prevention of hepatitis C virus (HCV) includes: counseling and follow-up of infected clients. routine testing for health care workers. screening of blood products. testing of high-risk individuals.

screening of blood products.

A nurse in community health decides to form a contract with a family. The contract states that the family will designate one night as a family night. The nurse is most likely using the contract to: a. make sure the family does what is expected. b. encourage the family to put plans in writing. c. let the family know that this is a legal agreement. d. shift the responsibility so that it becomes a shared effort.

shift the responsibility so that it becomes a shared effort.

A nurse in community health may have state-granted personal immunity for particular practice areas such as giving immunizations. If the state legislature has granted personal immunity to nurses employed by public agencies to cover all aspects of their practice, the legal theory that applies is: case law. respondeat superior. sovereign immunity. worker's right to know.

sovereign immunity.

The nurse in community health reviews the monthly and year-to-date health service use report for the local community to monitor trends as correlates of the community's health. The nurse is viewing community health through the dimension of: partnership. process. status. structure.

structure.

A nurse in community health becomes aware that a teen smoking cessation program offered at the health department is a demonstration project. In evaluating this program, the nurse would be concerned with the program's: efficiency impact. relevance. sustainability.

sustainability.

In a community clinic that screens and treats individuals for cardiovascular disorders, the nurse practicing public health/population-focused nursing would most likely ascertain: a holistic treatment plan. a specific clinical diagnosis. individual dietary interventions for cardiovascular disorders. the prevalence rate of cardiovascular disorders among various groups.

the prevalence rate of cardiovascular disorders among various groups.

Given recent vaccine shortages for the flu, the local nurses in community health form a group to evaluate the process of scheduling and operating flu vaccination clinics in the community and review the community's complaints from the previous season. The activity best represents the principle of: total quality management (TQM) to achieve continuous quality improvement (CQI). quality assurance (QA) to achieve continuous quality improvement (CQI). risk management to achieve quality. continuous quality improvement (CQI) to achieve total quality management (TQM).

total quality management (TQM) to achieve continuous quality improvement (CQI).

A nurse in community health is conducting a parenting class for prospective parents that will focus on the development of new skills, identification of needed resources, planning, and other preparations for the arrival of a newborn. This intervention is addressing a potential risk associated with: biology. behavior environment transitions.

transitions.

true or false A program is an organized approach to meet the assessed needs of individuals, families, groups, or communities by reducing or eliminating one or more health problems

true

true or false Care management is a monitored systematic process that monitors the health status, resources, and outcomes for aggregates

true

true or false Case management nust use risk analysis and data monitoring for deviations from the norm

true

true or false Nurse case managers can serve as third parties in attempting to provide assistance for clients who may be experiencing a conflict in obtaining something they desire

true

true or false Strategic planning involves the successful matching of client needs with specific provider strengths and competencies, as well as agency resources

true

true or false Telehealth is an approach to managing healthcare that include triage, advice, counseling, and referrals for selected clients

true

A nurse in community health conducts quarterly mental health-promotion and depression-screening programs at the local senior center. The nurse is aware that older adults are at increased risk for developing depression. Using such an intervention also addresses the older adults': dependence on their primary care provider. normal sensory losses. reduced social contacts. underutilization of the mental health system.

underutilization of the mental health system.

The most critical strategy that can be used by nurses in community health to improve the health status of migrant workers that spend only a few months in a geographic location is to: conduct a comprehensive assessment and formulate a plan for treatment. establish a long-term trust relationship to prevent disappointment. schedule appointments for appropriate immunizations for the children. use every opportunity to teach about preventive health care.

use every opportunity to teach about preventive health care.

A young adult with a history of prior parental abuse recently has been diagnosed with a stress-related illness. The individual works at a local convenience store, earning a little more than the federal poverty level, but receives no health benefits. This individual is predisposed to the development of: poverty. resilience. risk. vulnerability.

vulnerability.

A city uses the local media (radio, television, and newspapers) to post ratings of air quality on days when the air quality is poor. This notification is directed toward older adults, very young members of the community, and those with chronic breathing problems. These groups are an example of: disenfranchised populations. disadvantaged populations. vulnerability. vulnerable populations.

vulnerable populations.

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Two nurses in community health schedule a day to ride through a low-income community to better understand the community and its boundaries, trends, rhythm, stability, and changes that can affect the health of that community. This direct data collection method is often referred to as: composite database. participant observation. secondary analysis. windshield survey.

windshield survey.

A large industrial plant has recently laid off a significant portion of its workforce because of scalebacks in production. The occupational health nurse proposes education sessions with the remaining employees about effective strategies for managing stress during economic downturns. This suggestion to management is based on the nurse's understanding that increases in aggression and violence at home and work may be triggered by: competition. unemployment. survivor guilt. work-related stress.

work-related stress.