ch. 12, 26, 27
3. Enacted in 1965 as part of the Social Security Act, __ was intended to provide health care to the population of U.S. citizens 65 years of age and older. A. Medicare B. Medicaid C. Social Security D. Blue Cross/Blue Shield
A
6. Which of the following statements about homicide in the United States is false? A. Most homicides are caused by stabbings. B. Homicide is the third leading cause of death for 1- to 4-year-old children. C. Blacks are more likely to be the victims of homicide than whites. D. Over 50% of homicide victims are killed by someone they knew.
A
7. Nurses, including public health nurses, are at increased risk for workplace violence. Risk factors for violence in the workplace include all of the following except: A. working in pairs. B. access to medications. C. increased number of mentally ill patients. D. inadequate security.
A
8. As a school nurse, you know the leading reason cited as the cause of school violence is: A. use of violence to handle disputes. B. an unhappy home life. C. overly protective parental situations. D. poor communication with authority figures.
A
7. On discharge after treatment for alcoholism, a client plans to take disulfiram (Antabuse) as prescribed. When teaching the client about this drug, the nurse emphasizes the need to: A. avoid all products containing alcohol. B. adhere to concomitant vitamin B therapy. C. return for monthly blood drug level monitoring. D. limit alcohol consumption to a moderate level.
A Disulfiram, when combined with any alcohol, produces the classic disulfiram-ethanol reaction of flushing, tachycardia, nausea, headache, chest tightness, and chest pain. Adhering to concomitant vitamin B therapy and returning for monthly blood drug level monitoring are not necessary when taking Antabuse.DIF: Cognitive level: KnowledgeREF: Page 532
3. Which of the following statements about adolescent substance abuse is FALSE? A. Teen use of cigarettes and smokeless tobacco is increasing. B. Alcohol use among youth declined between 2010 and 2011. C. Most of the movement in teen substance abuse has been in the downward direction. D. Marijuana use among teens is increasing.
A Teen use of cigarettes and smokeless tobacco has declined. The rate of current alcohol use among youths age 12 to 17 was 13.6% in 2010, which was lower than the 2009 rate (14.7%). In fact, although most drug and alcohol use continues to decline or hold steady, marijuana is almost the only licit or illicit drug showing significant 5-year increases.DIF: Cognitive level: KnowledgeREF: Page 524
2. Cost containment incentives include which of the following? Select all that apply. A. Capitated reimbursement B. Limited access to care C. Fee-for-service billing D. Health care rationing E. Carve-out services
A, C, D
2. Which of the following individuals should be evaluated for intimate partner violence (IPV)? Select all that apply. A. The 24-year-old white woman with low self-esteem B. The 33 year-old black divorced single mother C. The 18-year-old Hispanic gay man with multiple sexual partners D. The 50-year-old Asian man who is addicted to methamphetamine E. The 48-year-old black woman who was recently hospitalized for depression
A, C, D, E
9. Which of the following assessment findings by the community health nurse would suggest that an elderly client may be the survivor of physical abuse by a caregiver? Select all that apply. A. The client has a laceration on her forehead that was sutured. B. The client has a flat affect. C. The client has bruises on her forearms in various stages of healing. D. The client withdraws from soft touch. E. The client is not sexually active but has a diagnosis of Chlamydia.
A, C, E
1. Personality traits associated with an increased risk of alcohol abuse include: Select all that apply. A. impulsive. B. shy. C. withdrawn. D. disinhibited. E. aggressive.
A, D Two broad personality dimensions are also associated with an increased risk for alcohol abuse. Impulsivity and ease of disinhibition add to the risks for substance abuse. Being prone to anxiety and depression is also a risk, and these comorbidities are not well understood. The other options are not associated with a risk for alcohol abuse.DIF: Cognitive level: KnowledgeREF: Page 519
9. Provisions of the Patient Protection and Affordable Care act include: Select all that apply. A. mandating that all citizens obtain health insurance. B. reducing Medicaid eligibility. C. subsidizing insurance premiums for all citizens. D. prohibiting denial of coverage for preexisting conditions. E. establishing health insurance exchanges.
A, D, E
6. During World War II, faced with a decrease in the number of workers, employers added a health insurance plan to employee's benefits. These plans were called: A. health maintenance organizations. B. prospective payment plans. C. indemnity plans. D. cafeteria plans.
C
3. Which of the following clients is at highest risk for elder abuse? A. A 75-year-old nursing home client who is alert and has osteoporosis B. A 70-year-old client being with dementia cared for at home C. A 65-year-old client who has just had a hip replacement D. A 72-year-old client on a rehabilitation unit with bilateral above-the-knee amputations
B
7. In a managed care organization, physicians are responsible for the approval or referral of some services. In this position, they are referred to as: A. enforcers. B. gatekeepers. C. carriers. D. distributors.
B
9. A high school student is referred to the school nurse for suspected substance abuse. After the nurse's assessment and interventions, what would be the most desirable outcome? A. The student discusses conflicts over drug use. B. The student accepts a referral to a substance abuse counselor. C. The student agrees to inform his parents of the problem. D. The student reports increased comfort with making choices.
B Having a substance abuse problem does not mean that problems are always attributable to the addiction. An evaluation for other problems such as mental illness and depression should be conducted, with specialized attention involving a case management approach. Research demonstrates that treatment for substance abuse can be more effective than no treatment. The other goals may be appropriate but not the most desirable.DIF: Cognitive level: ApplicationREF: Page 541
5. A survey done by The National Institute on Drug Abuse (NIDA) found that the most commonly abused prescription drug among high-school seniors is: A. OxyContin. B. Vicodin. C. Xanax. D. codeine.
B The NIDA Monitoring the Future survey found that about one in 12 high school seniors reported past-year nonmedical use of the prescription pain reliever Vicodin in 2010, and one in 20 reported abusing OxyContin, making these medications among the most commonly abused drugs by adolescents. The three classes of most commonly abused prescription drugs are: (1) opioids, (2) central nervous system depressants, and (3) stimulants.DIF: Cognitive level: KnowledgeREF: Page 522
1. The school nurse is interviewing a student who has been assaulted by another student. Both students proclaim to be gang members. The nurse understands the reasons most youth give for joining a gang include the following: Select all that apply. A. financial gain. B. sense of belonging. C. peer pressure. D. relative is in a gang. E. need for respect.
B, C, E
4. Currently, the state with the highest rate of adult smoking is: A. Tennessee. B. Indiana. C. Kentucky. D. Ohio.
C
8. Which of the following prospective payment methods determined the amount of reimbursement that health care providers would receive for specific illnesses from Medicare? A. Current procedural terminology codes B. Actuarial classifications C. Diagnostic-related groups D. Medigap insurance
C
6. The community health nurse is trying to encourage a client to attend Alcoholics Anonymous meetings. When the client asks the nurse what he must do to become a member, the nurse should respond: A. "You must first stop drinking." B. "Your physician must refer you to this program." C. "Admit you are powerless over alcohol and that you need help." D. "You must bring along a friend who will support you."
C As a nonprofessional ongoing source of assistance, Alcoholics Anonymous is viewed as an invaluable resource to the community. The first step of the 12-step program is the admission of defeat and surrender to a higher power. The other options are false.DIF: Cognitive level: AnalysisREF: Page 533
4. The community health nurse is visiting the home of a known substance abuser. The client is talking excessively and is excited and aggressive. The nurse notes that the patient's heart rate is 158 beats/min. The nurse recognizes the client is most likely high on which substance? A. PCP B. Alcohol C. Methamphetamine D. Inhalants
C Short-term effects of methamphetamine are increased heart rate, insomnia, excessive talking, excitation, and aggressive behavior. PCP is known for its violent dissociative and anesthetic effect. Alcohol intoxication causes euphoria, disinhibition, and sedation. Inhalants cause euphoria.DIF: Cognitive level: KnowledgeREF: Page 524
10. The wife of an alcoholic client is considering joining a support group to help her respond to her husband's condition in a healthy way. Where should the nurse refer this client? A. A psychiatrist for a referral to a suitable group B. Spouses Anonymous C. Al-Anon D. Alcoholics Anonymous
C Substance abuse has been called a family disease because it affects the entire family system and holds potential adverse psychological and physical consequences for the family members in addition to the abuser. Al-Anon and Alateen are support groups for family members of substance abusers. A psychiatrist's referral is not necessary. Alcoholics Anonymous is focused more on the substance abuser than their families.DIF: Cognitive level: ApplicationREF: Page 533
CHAPTER 12
CHAPTER 12
CHAPTER 26
CHAPTER 26
CHAPTER 27
CHAPTER 27
1. A major cause for the rise in health care costs is: A. an increase in the specialization of physicians. B. a decrease in nonprofit hospitals. C. a shortage in the number of primary care physicians. D. a demand for complex and advanced services.
D
10. Child maltreatment cases are most frequently attributed to: A. sexual abuse. B. physical abuse. C. psychological abuse. D. neglect.
D
10. One of the first health insurance companies established in the 1930s to provide health care to subscribers was: A. Aetna Insurance. B. Woodmen of the World. C. Humana Health Maintenance Organization. D. Blue Cross and Blue Shield.
D
5. Access to health care is determined by the circumstances of the individual that obstruct the means to obtain desired health care. Which of the following is NOT a barrier to access to health care? A. Preexisting conditions B. Nonparticipating physician C. Inability to communicate D. Personal avoidance of a health problem
D
5. Chronic stress characterizes the lives of people living with domestic violence. As the community health nurse, you recognize which of the following as a long-term effect of violence? A. Spontaneous disclosure of abuse to health care provider B. Not complaining of physical symptoms C. Having disturbed eating patterns, but sleeping well D. Suffering chronic fatigue and tension
D
8. When a client regularly takes a drug that is a central nervous system (CNS) stimulant, such as cocaine, what symptoms would the nurse expect to see when the client abstains from this substance? A. The client will have symptoms of CNS stimulation. B. The client will experience anxiety, insomnia, and tremors. C. Common symptoms include hallucinations and seizures. D. The client will feel depressed, somnolent, and lethargic.
D Symptoms of withdrawal from CNS stimulants are depression, apathy, lethargy, and sleepiness. The client may experience signs of CNS stimulation while high on the CNS stimulant. The client withdrawing from opioids may experience anxiety and tremors. The client withdrawing from alcohol may experience hallucinations and seizures.DIF: Cognitive level: KnowledgeREF: Page 526
2. All of the following outcomes may contribute to the diagnosis of substance abuse except: A. the substance use has placed someone in danger. B. the individual uses the substance despite negative consequences. C. the substance use interferes with the ability to function at work or at home. D. the client is without a job.
D The diagnosis of substance abuse includes the continued use of a substance despite the consequences; putting oneself or others in danger because of substance use; or substance use interfering with one's major role obligations, such as family, work, and friends.DIF: Cognitive level: KnowledgeREF: Page 525
4. As a visiting community health nurse, you must take precautions to avoid unsafe situations. To avoid putting yourself in danger, you would do which of the following? A. If you enter a house where a violent act is occurring, call 911 and wait inside for the police to arrive. B. Expect the client to control angry family members. C. Repeat the reason for your visit and stay and continue your task. D. Do not enter a home if you hear sounds of fighting.
D.
