Chapter 10 and 12

1. A community health nurse leading a community group notes that the group has moved into the norming stage. Which action by the group does the nurse most anticipate at this time? A. Help to develop mutual trust among the members B. need for conflict management C. sharing ideas and opinions to achieve goals ability to work productively

Answer C during the norming stage, trust and openness are more apparent, and there is a sharing of ideas and opinions and creativity. The forming stage is characterized by members becoming oriented to one another period the storming stage involves conflict in competition with the group getting down to sharing more sensitive issues. The performing stage is characterized by the ability to work as a total group, subgroups, independently

The public health nurse recognizes that proper communication is vitally important to ensure successful results when educating the community about health concerns. Which aspect of communication is most important for the nurse to ensure? A period you eliminate distractions B. Renegotiate for clarity of message C. German the desired outcome D. Nonverbal expression

answer B a major component of the communication process is the feedback loop, which allows for both the sender and the receiver to check on the success of the transference of meaning and to renegotiate the message to for clarity and better understanding. Limiting the setting, such as limiting distractions, may or may not be appropriate. Although therapeutic communication is goal directed and involves nonverbal expressions, these are not parts of the communication, and they are not as important as making sure that the message has been understood correctly.

1. A public health nurse is organizing a group consisting of health care providers from other clinics and facilities in the community to address various challenges in providing adequate care to the community. The nurse recognizes that inadequate sharing of health records among the facilities can be addressed best by which solution? A. Using compatible software programs among facilities B. educating the public on the advantages of sharing information C. managing electronic health records by local information technology company D. encouraging each citizen to store their medical information in a portable electronic device to carry with them to share

Answer A A common obstacle is the use of various software programs that are incompatible. This can even occur within the same faculty or institution and delays the sharing of information. This will require permission from each citizen as well as follow HIPAA regulations to maintain the privacy of medical information. The use of local IT company would present legal challenges and would not be the first choice. Some older adults would be unable to provide a portable electronic device as they do not use computers and would be unable to maintain them

1. A public health nurse is reviewing information sent from various faculties and a large community and notes an unexpected increase in the case of lymes disease. Which resource is available to assist the nurse in planning an appropriate response? A. Electronic health records from each facility B. geographic information system C. emailing a survey to each client diagnosed with Lyme disease D. door to door survey of the affected neighborhoods

Answer B the use of GIS system will enable the nurse to quickly gather the necessary information, which is compiled from various sources of seemingly unrelated fax. It will give the nurse better understanding of the current situation, as well as plan for appropriate interventions and monitor the situation. The other choices would not provide a response that would be as quick or complete

1. The nurses discussing smoking cessation options with a client who's having difficulty pressures at work and with family and friends. Which statement used by the nurse displays active listening skills? A. I feel like you have shared a lot. Let me share with you what I think you said B. I am trying to determine why you are sharing this information C. it appears that you have a lot of peer influence in your life. Let's focus on prioritizing D. I can tell that you are engaged in your community

Answer A active listening involves a variety of interventions. In the correct response, the nurse prepares to summarize the key points the client has made. By doing so, the nurse demonstrates a desire to fully understand the clients concerns. This statement I am trying to determine why you're sharing this information does not reflect any active listening skills it may be viewed by the client as confrontational. Clients who feel criticize or judge may disengage from communication. Commenting that the client seems engaged in the community or should focus on prioritization is more a reflection of the nurses personal feelings then a therapeutic response. The nurse should only share ideas and feelings of the client has asked for advice or inputs.

1. an instructor is role-playing with a group of students by negotiating a contract to determine the proper format. After the completion of the role-playing, which statement by the students indicates understanding of the process? A. The process is dynamic as it moves through various phases B. contracting involves an unidirectional client nurse relationship C. the process must move backward before it can move forward D. once the contract is developed it remains relatively stable

Answer A constructing is a dynamic process that moves through phases. It forms a reciprocal relationship between clients, nurses, other persons. The process moves forward, focuses on meeting client needs, and enables the collaborating group to facilitate ultimate achievement of the client goals

1. a client is surprised that the public health nurse does not ask many questions concerning the past medical history but appears to already know it. What is the best response for the nurse to address the client's concerns? A. The information is already available in the electronic health record B. the past medical history is not relevant to this visit C. the old records have been requested it will be reviewed when received D. the last nurse to see you shared your history with me

Answer A one of the most beneficial advantages of using EHR's is the ability to enter data once and reuse them multiple times period this capability reduces redundance and can reduce errors by providing the history from previous encounters. When an individual is readmitted, the previous data can be reviewed and updated with the goal of decreasing charting time and improving continuity of care. The past medical history should always be reviewed as there may be something relevant for the current visit. The nurse should not wait to review the past history but do a while with the clients so any questions can be addressed at that time period expecting a former nurse to provide the details will be unethical and inappropriate, since the chances are great that the nurse would not remember all of the details

1. A public health nurse is tasked with establishing a local health clinic in a rural community, which currently only has a small hospital that is struggling to adequately assist all in emergency department. Which goal should be a priority for the nurse? A. Address health literacy in the community B. apply for grants to help finance the new clinic C. form a partnership with the hospital to redirect clients to the clinic D. seek support from the local government to encourage the community to use the clinic's facilities

Answer A putting the emergency department as a walk in clinic for minor in or chronic conditions is often due to poor health literacy. The nurse can use various methods to educate the community such as local advertising, meeting with various groups to let them know what will be available, and mailing information describing what will be available. The other choices may be options that the nurse can utilize and inform the public; However, their priority would be to address the health literacy situation first

1. A community health nurse and a client are negotiating a contract for home health services. After agreeing on the shared goals, which statement/ question by the nurse will be most appropriate? A. Great now that we know our goals, let's decide on when we want to accomplish them B. OK so at the next appointment, we will see how well the plan is working C. So what else would you like to accomplish at these meetings D. is there anything you would like to change

Answer A setting a projected completion date would follow deciding on the shared goals, which is part of the planning stage. The evaluation stage would involve looking at the plan at the next appointment to determine if there needs to be any changes. Asking the client what he or she would like to accomplish would be part of establishing the goals. Renegotiating would occur after the plan has been in effect for a while, especially if the original plan is not working as expected

1. A public health nurse has been meeting with the group of clients who have recently been diagnosed with HIV. The nurse has noted improved appointment compliance among the group with which of the following techniques? A. Text messaging B. mail postcards C. monthly newsletters D. voice messages

Answer A text messages are the initial, simplest, most common type of mobile data service and are becoming a vital tool for the delivery of health information and engaging user to improve their health. It is a way of connecting quickly with the large population. The use of text messaging has been advocated for people living with HIV as a means of improving health quality and preventing complications. The other choices are not as effective

1. A public health nurse is preparing to work with the group of college students to help decrease the incidence of STI's. What is the best response from the nurse when asked why a contract is needed? A. It motivates each of us to achieve the intended outcomes B. the contract identifies what can happen if you don't follow the plan C. it provides documentation for requesting grants to cover the expenses for the group D. the contract is just a document outlining what we plan to do

Answer A the contract is not a binding agreement in the legal sense, but is a pledge of trust and dedication. It provides the motivation to see the contract through to completion. All parties feel responsible for keeping promises; All want to achieve the intended outcomes. A legal contract would specify the consequences if it is not fulfilled. It is also more than just a written plan, and it would not be used to request grants or funding

1. A public health nurse in the states health department notes the various facilities in a large community are reporting increased numbers of whooping cough. Which will be the nurses first response? A. Gather more information such as immunization records B. organize an immunization event for the community C. send the information to the CDC D. contact the local health facilities to encourage immunizations

Answer A the first step will be to gather more information to determine what the problem most likely would be. Use of big data from the area would allow the nurse to compare the number of cases against the number of individuals with current immunizations to determine if they're is truly a problem and a possible epidemic. After determining what the problem most likely is, it would be the time to organize an event and encourage immunizations. Whooping cough or pertussis is a reportable disease to the CDC; However, the nurse is responsible for the health of the community and just reporting the cases would not address the problem

1. the community health nurse working with the local community has found entering into a contract with clients to be very beneficial, and positive results are being achieved. Which concept does the nurse recognize to best explain this successful outcome? A. Encourages clients participation in the decision making process B. contributes to a trusting nurse client relationship C. decreases client stress during home visits D. reduces client's visit time by over 50%

Answer A the nurse and the client contributes to the formulations of the contract, thus fostering clients participation in decisions regarding the direction activities within the contract. Contracting also involves commitment, format, negotiation. Contributing to trust, decreasing client stress, reducing visit time or not considered benefits associated with contracting

1. A public health nurse is preparing a report for the town council concerning a specific health concern and is researching specific information to share. Which option will provide the nurse with the best information A. drill down the big data information B. sample surveys in the community C. drill up the big data information D. review EHR's from local clinics and offices

Answer A the use of big data makes it easier to drill down or view more detailed information, which will enable the nurse to see specifics about the situation that can be shared. Sample surveys may not provide enough information or accurate information if the wrong population is questioned period to drill up big data is to see the data in an aggregate view, which would possibly not provide enough specific information to make an informed decision. Reviewing the EHR may not provide enough information of the individual in question are using other facilities outside the local community being questioned

1. A public health nurse has been working with small community group for several months, and although things are progressing well, the nurse notes a subtle shift in the group with increasing lack of cooperation. After a recent meeting, the nurse recognizes which situation needs to be addressed to bring the group back to working successfully? A. Rejecting ideas before they are discussed B. determining what the problem is C. requesting For more information D. restating suggestions after group discussions

Answer A when someone in the group rejects the suggestion before it is even discussed, this can result in others not wanting to participate or cooperate to reach the stated goals for the group. Each individual should feel safe in suggesting ideas or possible solutions and each one should be thoroughly discussed before being rejected. The other choices are positive approaches or tasks that should be occurring in any group to ensure that the group achieves its goal

1. A group of student nurses is discussing the effect of health literacy on healthcare and how it may impact their future clients. Which key issues should these future nurses be most aware of? Select all that apply A. health literacy is characterized as critical to health promotions and disease prevention B. limited health literacy only effects those who have low educational levels C. poor health literacy skills can contribute to increased health care costs D. health literacy involves the ability to read, understand, and act on health information E. health literacy goes beyond the basic definitions of literacy

Answer A C D E help literacy is characterized as critical to health promotion and disease prevention. Limited health literacy affects people of all races, incomes, ages, educational levels. Poor health literacy skills have been associated with poorer health status and increased health care costs because people with a low literacy level are less knowledgeable about their health conditions and are less likely to seek preventative care. Health literacy involves the ability to read, understand, and act on health information. Health literacy goes beyond the basic definitions of literacy and includes cultural literacy, Computer literacy, scientific, media, technological literacy

1. The community health nurses is a member of collaborative partnership interdisciplinary team, which is working to improve health care to a rural community. As the group continues to work as a unit, which outcome does the nurse most anticipate? A. Secure more grants for funding educational outreaches B. each group member understands personal responsibilities C. each member can identify basic goals D. team members will easily identify who the leader is

Answer B The main goal of collaborative partnership of an interdisciplinary team should be 1 to benefit and improve the health of the local community that they serve. This team will be most effective when each member clearly understands their own responsibilities and can complete them. Identifying the basic goals and identifying the group leaders are important but do not benefit the community the most. Securing grants is also not a top priority and may not be something that every member of the group can accomplish

1. A public health nurse is seeking grants to assist with providing low to no cost influenza shots for a small rural community, which routinely experiences high rates of influenza each winter period which action by the nurse will help improve the chances of a grant being awarded to this community A. verify low income for the community B. documented collaboration with other local health facilities C. pledges from community members to accept flu shot if free D. agreement to be involved with a research project if chosen

Answer B outside funding agencies comma both government and nonprofit, are increasingly looking for proof of effective collaboration and coalition building before approving grants or government funding. Being able to demonstrate fiscal responsibility and evidence based outcomes will assist community health nurses in sustaining health promotion efforts on a long term basis, and this may be facilitated by collaborative partnerships. The other choices would not demonstrate the collaboration and coalition building desired

1. A community health nurses remaining calm and firmly reassuring when dealing with a family and acute crisis. The nurse recognizes this as the best defense against which barrier to communication? A. Filtering information B. emotional influence C. language barrier D. selective perception

Answer B the nurse is avoiding emotional influence that is, how a person feels at the time a message is sent or received, which can influence its meaning. Senders can distort messages and receivers can interpret messages incorrectly when emotions cloud their perception. Emotions can interfere with the rationale and objective reasoning, those blocking communication. Filtering information means manipulating information by the sender to influence the receiver's response. Language barriers involve the different interpretations of words by people. Select the perception involves the receivers interpreting a message through their own perceptions, which are influenced by their own experiences, interest, values, motivations, expectations

1. A community health nurse is concerned that certain members of the local community do not comprehend the educational material due to low literacy. The nurse recognizes which approach to this problem is the most appropriate? A. Make the message as basic and simple as possible because the client likely has low intelligence B. best to use simple written materials for clients who have low literacy C. very important for clients with low literacy to have ample opportunity to provide feedback D. health literacy is not a very important factor in mortality and morbidity

Answer C it is very important for clients who have low literacy to have ample opportunity to provide feedback that will demonstrate understanding. Communication with low literacy, high risk groups should be simplified and easy to read materials. At the same time, there is the danger of making the communication so simple that the reader feels insulted. It has been well documented that most health information pamphlets, brochures, other materials cannot be read or comprehended by adults who have low literacy. Those who have the lowest literacy levels have the highest mortality and morbidity

1. A collaborative community health group working with the teenage population is to improve health draws on the expertise of school nurses and others working with adolescents to develop a plant. The group is demonstrating which characteristic of collaboration? A. Shared goals B. mutual participation C. maximize use of resources D. clear responsibilities

Answer C maximizing the use of community resources involves drawing on the expertise of those who are most knowledgeable and in the best position to influence a favorable outcome. In this case, it would be school nurses and others working with adolescents. Shared goals are demonstrated by recognition of the specific reasons for entering into the relationship, that is, the improved health of adolescence. Mutual participation involves the reciprocal exchange among team members, with all team members contributing and receiving mutual benefit. Clear responsibilities involve each member playing a specific role with related task

1. A new graduate nurse is expressing frustration with the supervisor concerning the apparent lack of clients taking conversations seriously or following care plans. Which skill will be most important for the supervisor to evaluate? A. Active listening B. Paraphrasing C. nonverbal messages D. rapport

Answer C two main channels to send messages are nonverbal and verbal messages. Active listening and paraphrasing are involved with receiving skills. Rapport t is an interpersonal skill

1. a public health nurse is responsible for teaching school aged children how to live with type one diabetes. The nurse has utilized various approaches and techniques that help these young clients learn and cope with their challenges. The nurse recognizes which video game can be very effective to achieve this goal? A. Snow world B. Bronkie the bronchiasuraus C. Packy and marion D. Spiro game

Answer C video games are providing a unique method to teach clients how to deal with their chronic conditions, especially in the younger population. Packy and marion Is a video game designed to encourage children to correctly manage their insulin levels and food intake to win at the game period snow world is a game used for burn pain to provide a distraction during wound care. Bronkie the bronchiasuraus Is a video game for children with asthma. SpiroGame Is for preschool children with compromised lung function

1. The public health nurse is often involved with leading community groups and recognizes leading a successful group involves going through various stages. Which statements best describe some of these stages? Select all that apply A. all groups eventually reach the performing stage B. the storming stage is detrimental to group development C. loss of group affiliation often occurs with adjourning D. the group begins to focus more on maintenance rather than just tasks during the norming stage conflict is inherent in the forming stage

Answer C D during the adjourning stage, the group must disengage, and this may cause feelings of loss period the group begins to focus more on maintenance rather than just tasks during the norming stage. Not all groups do reach the performing stage. The storming stage is necessary to allow group members to identify rules, expectations, and get a feel of how the group will work together. Conflict is to be avoided at the forming stage but most occur at the storming stage

1. A public health nurse working with young mother is concerned the mother is not providing accurate information during the assessment. What is the best response by the nurse in this situation? A. What I'm seeing is not matching what you're telling me B. OK let's try this again. Tell me what happened C. let's try some simple yes and no type questions D. I'm sorry, there seems to be some misunderstanding. Let's try this again, OK?

Answer D Filtering is the manipulation of information by the sender to make it seem more favorable to the receiver. It leads to miscommunication and misinterpretation. Filtering can be intentional or unintentional and may be used by clients or nurses. Clients sometimes are using filtering during a needs assessment process comma giving only partial or distorted information because they think this is what health professionals want to hear period the other choices would be inappropriate as they either belittle the client or suggest the client as possibly lying about the situation

1. a public health nurse has noticed a trend in the number of clients with low compliance and routine health maintenance from a certain area in the state. Which resource can the nurse use to best justify the creation of a new public health clinic? A. School district immunization records B. use of telemedicine by clients C. client load and wait times at the surrounding emergency department D. geographic information system data

Answer D public health uses of GIS include tracking child immunizations, evaluating the spread and clustering of diseases, conducting health Policy Research, and establishing services areas in districts. Medical information is significantly more useful when combined with knowledge of the environmental factors associated with clients, location, conditions. A health system utilizing GIS technology will provide a more precise understanding of the link between an individual's health and where they reside, work, play. The other choices may be included in the GIS information

1. A community health nurse is meeting with a group of clients and notes that some clients are misinterpreting the information. What does the nurse recognize as the most likely barrier to communication for this group A. the nurses sharing of complete and accurate information with the clients B. the clients use of medical terminology in the discussion C. the clients offering a feedback to allow the nurse to learn what the client understands D. the client's interpretation of the message through their own perception

Answer D selective perception is the interpretation of a message through their own perceptions and projections this on to the communication process as they decode the message. Sharing complete and accurate information, clients use of medical terminology, and offering of feedback are important skills of effective communication

1. Which is the first step in active listening? A. Using reflection B. summarizing the key points C. conveying a non judgmental attitude D. being observant and aware

Answer D the first step in active listening is being observant and aware. The nurse must be attentive when the client speaks and mindful of what the client is communicating through words or body language. The next step is conveying a non judgmental attitude by keeping an open mind that arguing and then demonstrating understanding to the client by paraphrasing key points and asking for clarification of anything not understood. After waiting patiently for the client to finish speaking, the nurse will summarize the main ideas the client has presented to keep the conversation focused and ensure mutual understanding. The nurse may have the opportunity to share feelings and ideas, but only if the client feels comfortable and understood, and has asked for feedback

1. A public health nurse is meeting with student nurses to discuss the importance of effective communication. Which aspects of communication should the nurse indicate are under the most control of the nurse? Select all that apply A. The decoding B. the message C. the channel D. the feedback loop E. the encoding

answer B C E the community health nurse who is serving as the sender in the communication process has the most control over the sender, the message, the channel (the medium through which the center conveys the message), and the encoding (the sender decides which specific signals or codes such as language, words, gestures, body language to use). The community health nurse does not have much control over the receiver, the decoding (the receivers interpretation of the message), or the feedback loop (away for the sender and receiver to check on the success of the transference of meaning and to renegotiate the message to allow for clarity and better understanding), all of which are controlled by the receiver

1. A group of students is discussing the various parts of effective communication with the nurse at a health care organization in the community. The nurse recognizes that the students understand the discussion when they correctly identify an e-mail request to the local health department is which part of communication a. sender B. Message C. Decoding D. Channel

answer D the channel is the medium through which the sender conveys the message. It may be written, spoken, nonverbal. Sending an e-mail as an example. The sender is the person conveying the message. The message is the expression of the purpose of the communication. Decoding is the translation of the message into an understandable form by the receiver