Community Chapter 5

A)Give rewards for a lower blood sugar level and a food diary that reflects moderate dietary compliance.

10. The nurse decided to use a learning model based on Skinner with a client with diabetes to improve compliance with dietary and blood glucose assessment requirements. Which would be the best way to implement this program? A)Give rewards for a lower blood sugar level and a food diary that reflects moderate dietary compliance. B)Eliminate the reward and punish the client when she fails to comply with dietary guidelines. C)Demonstrate positive reinforcement by decreasing dietary guidelines and blood sugar parameters. D)Institute a strict timeline to accomplish goals.

A,B,C

11.The nurse decides to use the health belief model for a wellness walking program for older adults. The walk is to begin each day at 8 PM. Each day a different participant is to start a chain of phone calls to other participants to remind all to attend. The nurse informs the clients in the clinic that walking will improve their overall health and well-being. Two older adults show up the first night and none the second. Which information should the nurse gather to explain the failure of the program? (Select all that apply.) A)The severity of the physical challenge related to the client population B)What stands in the way of taking action toward the goal of health promotion C)The presence or absence of cues needed for the program to achieve success D)The presence or absence of a strong team leader among the participants E) The need to increase persuasion when implementing the program

A) An enhanced ability to meet his goals on the basis of his intention and behaviors

13.A 34-year-old client is recovering from a below-the-knee amputation secondary to a motor vehicle accident. The nurse meets with the client to update his care plan, and client states that he knows that he will walk again. He asks for physical therapy schedules and timelines for prosthetics on the basis of his healing process. On the basis of knowledge of the theory of reasoned action, the client's behavior reflects: A)An enhanced ability to meet his goals on the basis of his intention and behaviors B)Goal setting that is unrealistic and irrational based on the client's diagnosis and behaviors C)A depression that will complicate the healing process D)Denial of the injury and part of the healing process

D)Relapse prevention model

14. A 47-year-old client and three members of his neighborhood have had their homes robbed and belongings scattered. The client contacts the police and, with their assistance, develops a neighborhood watch. The watch is organized and 24 families have been recruited to participate. The watch will be active throughout vacation months and as needed. This organization is representative of: A)Transtheoretical model B)Theory of reasoned action C)Social learning D)Relapse prevention model

B,D,E

15. A 27-year-old client comes from a background of physical and sexual abuse. Violence victimization continued with her partners until recently. She is currently in a support group for victims of abuse. The client's social background places her at risk for: (Select all that apply.) A)Increased safe sex behaviors B)Decreased safe sex behaviors C)Decreased risk for HIV/AIDS D)Increased risk for HIV/AIDS E)Increased risk of depression

A,B,E

16. A 19-year-old client is diagnosed as HIV positive. Which behaviors might be indicators of noncompliance with her drug regimen and require further assessment? (Select all that apply.) A)Depression B)Indifference to self-advocacy in sexual relationships C)Goal-oriented attitude toward treatment plan D)Client's expression of concern for the health and well-being of her children E)Client's expression of concern regarding the ability to pay for her medications

C)Inability to advocate for herself

17. A 32-year-old African-American client is diagnosed with HIV. She is at her 6-month appointment following diagnosis and treatment. The client states that she has not revealed her diagnosis to her boyfriend because she is afraid that he will leave. She expresses feelings of anger because she must put her feelings and illness aside or be abandoned. The client's behaviors reflect: A)Denial of her disease process B)Noncompliance with her drug regimen C)Inability to advocate for herself D)Fear of financial insolvency

B)"You will not be protected against other strains of HIV or sexually transmitted infections (STIs)."

18. A woman arrives at the clinic for a routine appointment. She has been HIV positive for 3 years and states she is doing well. She currently is involved in a relationship with a man who is HIV positive. She states that she is not consistent with safe sex practices due to her significant other's preferences and feels uncomfortable asking him to wear a condom. Which is the nurse's best response to promote the client's health? A)"You won't become pregnant as long as you are taking your drug cocktail." B)"You will not be protected against other strains of HIV or sexually transmitted infections (STIs)." C)"You will both be safe because you both already have HIV." D)"Let's have you both tested for STIs."

C)Posttraumatic stress disorder

20. A 43-year-old African-American client is HIV positive. She has a personal history of abuse, which ended when her husband died 2 years ago. When counseling the client about adherence to her treatment plan, the nurse finds her intelligent and goal oriented. In addition to her need for education and follow-up regarding her HIV diagnosis and treatment, which associated condition should the nurse most consider when caring for this client? A)Cardiac tamponade B)Chronic obstructive pulmonary disease C)Posttraumatic stress disorder D)Cirrhosis of the liver

B)Selective screening

21. The nurse works at community clinic that provides various types of health screenings for members of the community. One day, the nurse provides tuberculin tests for a group of new hospital employees. Which type of screening procedure is this? A)Mass screening B)Selective screening C)Multiphasic screening D)Case finding

A)Develop an asthma education and surveillance program that addresses students, families, and faculty members.

3.Absenteeism due to illness has increased recently in the local middle school. The increase is noted to be related to exacerbation of asthma symptoms in the student population. Which would be the most effective approach in decreasing absenteeism among this population? A)Develop an asthma education and surveillance program that addresses students, families, and faculty members. B)Develop a policy to exclude students with a diagnosis of asthma from admission to the school. C)Create an asthma prevention plan within the school environment, based in the school nurse's office. D)Create an education program for faculty related to the prevention of exacerbation of asthma systems.

C)Interview members of the neighborhood to determine why they do not use the clinic.

4. Multiple family units in an underserved neighborhood have children who have not been vaccinated per health guidelines. The nurse researches the problem and establishes a well-child clinic within walking distance to the neighborhood. The clinic is poorly attended. Which would be the nurse's best action to revise the program and improve attendance to the clinic? A)Determine whether the location of the clinic is not conducive to attendance. B)Discuss the problem of attendance at the next community council meeting. C)Interview members of the neighborhood to determine why they do not use the clinic. D)Discuss the problem with the local minister and request him to discuss the clinic at the next prayer service.

A) Primary

5. The local clinic is dedicated to the well adult and child. It has evening hours and offers varied programs for the community. The programs include immunizations and classes on fire safety, health education, and car safety, to name a few. How would the nurse explain the level of prevention used in this setting to your colleagues? A)Primary B)Secondary C)Tertiary D)Quaternary

A,B,D

7. The nurse works in a facility that provides hospice care for clients with cancer diagnoses. The nurse recognizes that the care provided in this facility is tertiary in nature. The nurse develops a plan for the clients that would include the tenets of tertiary prevention. The plan would include: (Select all that apply.) A)Palliative care B)Pain control C)Isolation D)Supportive spiritual development E)Diminished involvement of significant others

A,C,E

1.Health People 2020 (HP 2020) is a guidepost for nurses and interdisciplinary teams in community and public health. New focal areas for HP 2020 include: (Select all that apply.) A)Adolescent health B)Diabetes C)Genomics D)Nutrition and weight status E)Social determinants of health

B)Preparation

12. The committee has established the need for a sick child clinic in an impoverished neighborhood. The demographic data have been collected, and the committee is ready to meet with a group of local businesspeople who are willing to support the project financially. The plan is for the committee and group to combine to facilitate the establishment of the clinic. Using a transtheoretical model, which level of readiness has the committee achieved? A)Contemplation B)Preparation C)Action D)Relapse

A,C,E

19. Secondary HIV prevention or positive prevention is used when caring for African-American women living with HIV by addressing which behavioral risks? (Select all that apply.) A)Interpersonal mistrust B)Alcoholism C)Poor adherence to treatment D)Smoking E)Compromised self-advocacy in sexual relationships

B)Develop a plan to meet the costs and promote the benefits of the project

2. The nurse identifies the specific indicators and focal areas needed to establish immunization and well-child clinics in a low-income neighborhood. What actions are needed to meet the health outcomes of the project? A)Identify the need in the community for the clinic on the basis of subjective data. B)Develop a plan to meet the costs and promote the benefits of the project. C)Consider the identified neighborhood's need for healthcare compared with that of other low-income neighborhoods by interviewing the members of the neighborhood. D)Assume that the neighborhood will welcome the institution of a well-child and immunization clinic.

B)The hospital can more easily implement programs of care for the clients.

6. Using the tenets of secondary prevention, the committee seeks to establish an HIV/AIDS clinic. The nurse states that it is important for the location of the clinic to be associated with the local hospital. The committee states that the cost of the clinic associated with the hospital is higher than one that is free standing. Which presents the best rationale for the nurse's suggestion? A)Third-party insurance will reimburse the clinic visits only if the clinic is attached to the hospital. B)The hospital can more easily implement programs of care for the clients. C)The hospital will cover the clients only if the clinic is approved by the hospital governance board. D)The hospital will have a vested interest in the success of the clinic.

B)Developing culturally relevant and gender-sensitive interventions

8. An immigrant from Guatemala, age 47, is admitted to the coronary care unit with congestive heart failure. This is the fourth admission for this client, and the physician believes that the client's inability to adhere to his diet and medication regimen is the reason for his frequent admissions. The physician refers the client to the local community health nurse, on discharge from the hospital. Which would be most appropriate for the nurse to include in this client's plan of care? A)Insisting that the client adhere to his diet B)Developing culturally relevant and gender-sensitive interventions C)Teaching the family to adapt their cultural dietary plans to the client's diagnosis D)Assessing the client's financial needs and obtaining financial assistance as needed

C)Encourage the group to participate in the decision making

9. The nurse conducts a class on the basics of nutrition to a group of obese adults. The nurse counsels the audience, telling them that they need to change their behaviors. By the end of the class, the nurse has lost the audience. To enhance audience participation and learning in the next class, the nurse should: A)Use consistent methods of persuasion B)Offer advice while the participants are passive C)Encourage the group to participate in the decision making D)Encourage the group to continue ambivalent behaviors