Community Exam #2 (Ch. 7, 9-15, & 17)

B (Offering a smoking cessation counseling program to her patients)

A cardiovascular nurse working at a large medical center is examining the evidence on how to help her patients who smoke. Which of the following is an evidence-based behavioral level intervention aimed at reducing harm associated with tobacco use? A. Implementing a tobacco-free campus policy at the medical center B. Offering a smoking cessation counseling program to her patients C. Advocating for stricter package warnings on cigarette packages D. Asking the public health department to put up billboards near schools to promote prevention of smoking in adolescents

D (Consider a collaborative relationship with the public health department and fire and police departments.)

A nurse has seen an increase in infant injuries during motor vehicle crashes due to poor car seat installation. The nurse wants to consider upstream policies at the population level to address this issue but doesn't have the time to take on the project. How should the nurse proceed? A. Reconsider the project at a different time when the workload at his or her primary job lightens. B. Delegate some of the project tasks to an unlicensed assistive personnel (UAP). C. Quit the job to dedicate all of his or her time to the project. D. Consider a collaborative relationship with the public health department and fire and police departments.

B (Collective violence.)

A nurse has volunteered with an organization treating women who were the victims of rape as a weapon of war in the Congo. This violence is considered: A. Community violence. B. Collective violence. C. Stranger violence. D. Interpersonal violence.

B (Inform the public health department, the child's day care, and other caregivers so they can monitor for symptoms of the infection.)

A nurse is caring for a young child who is suspected of having meningitis. A spinal tap culture is pending. If it comes back positive for N. meningitidis, from a public health perspective it is important that the nurse: A. Provide his family with information about the disease in simple to understand language. B. Inform the public health department, the child's day care, and other caregivers so they can monitor for symptoms of the infection. C. Promptly admit the child to the ICU. D. Double the dose of antibiotics.

C (Men under the age of 45)

A nurse is educating new staff in the emergency department about the types of injuries and illness they might be treating. The nurse mentions that which population is at greatest risk for unintentional injuries? A. Women under the age of 45 B. Women over the age of 45 C. Men under the age of 45 D. Men over the age of 45

B (Health promotion.)

A nurse is looking to reduce the number of adolescents in her community that are using tobacco. The nurse implements a community-wide program to raise awareness about the dangers of nicotine use and creates a support group specifically aimed at teens looking to quit smoking. This is an example of: A. Health protection. B. Health promotion. C. Risk reduction. D. Tertiary prevention.

B (Hospital setting)

A nurse is planning specific interventions aimed at reducing the rate of complications due to uncontrolled blood sugar levels in the diabetes population with repeat admissions to hospital. The word population is primarily being used from the perspective of: A. Public health context. B. Hospital setting. C. Cultural context. D. None of the above.

A (Men)

A nurse is providing fire prevention education to families in the community. Which of the following groups in the United States is not at a higher risk for suffering burns from a fire at home? A. Men B. Women C. Children D. Older adults

D (All of the above)

A nurse is reviewing the safety procedures and protections in place at the community center. Which of the following show compliance with policies that were put in place to prevent fire-related deaths and injuries? A. Presence of two regular doors next to the revolving door B. Brightly lit exit signs C. Absence of flammable decorations on the walls D. All of the above

A, C, E (Proper labeling of all household chemicals and medications; Storing all cleaning materials and medications out of the reach of children; Informing parents not to share any medications with anyone for whom the medication is not prescribed)

A nurse is working with parents and community members to develop a chemical and medication safety class in their community. Techniques that they should discuss include which of the following? (Select all that apply.) A. Proper labeling of all household chemicals and medications B. Keeping household chemicals outside C. Storing all cleaning materials and medications out of the reach of children D. Encouraging disposal of medications into the toilet E. Informing parents not to share any medications with anyone for whom the medication is not prescribed

C (Marijuana)

A nurse manager of a primary care clinic providing care to an underserved population in a large urban setting wished to know more about the prevalence of substance use. She began with national statistics and found that the number one substance, other than tobacco and alcohol, used in the United States as of 2017 was: A. Cocaine. B. Hallucinogens. C. Marijuana. D. Nonmedical use of psychotherapeutics.

A (200)

A nurse studying harm associated with substance use learns that alcohol is a causal factor in more than ____ types of diseases and injuries. A. 200 B. 80 C. 60 D. 10

A (Alcohol, tobacco)

A public health nurse (PHN) researching risk factors for mortality found that ____ and ____ are leading causes of preventable deaths. A. Alcohol, tobacco B. Opioids, tobacco C. Cannabis, alcohol D. Opioids, cannabis

A (Universal level of prevention)

A school nurse working at a high school puts together a school-wide program to educate teens about the harm associated with alcohol use. What level of intervention is this? A. Universal level of prevention B. Selective level of prevention C. Indicated level of prevention D. None of the above

C (Both A and B: Review current alcohol SBI recommendations from the Joint Commission on Accreditation; Develop a plan to train health-care personnel on the use of the alcohol SBI.)

A team of nurses for a medical surgical unit has been assigned to develop an alcohol screening and brief interventions (SBI) program for their department. Which of the following steps should they take during the development stage? A. Review current alcohol SBI recommendations from the Joint Commission on Accreditation. B. Develop a plan to train health-care personnel on the use of the alcohol SBI. C. Both A and B. D. Conduct a process evaluation.

D (The fact that there is no known treatment that can alter the progression of the disease)

A young woman presents to her primary care provider. Her mother has just been diagnosed with Huntington's disease, and several other members of her family have been diagnosed with the condition as well. She wants to know her options regarding testing to see if she is a genetic carrier. From an ethical perspective, what issue would be most important to discuss with the patient? A. The cost of Huntington's disease screening B. Whether the test is available at the local lab C. What will happen when her insurance finds out the results D. The fact that there is no known treatment that can alter the progression of the disease

A (Performing a discharge assessment before each patient leaves the hospital.)

At a large urban hospital, the nursing council is concerned with optimizing post-hospital discharge outcomes for patients. Which of the following actions would the nurses most likely recommend as standard of care? A. Performing a discharge assessment before each patient leaves the hospital. B. Performing a home health visit before the patient is discharged to assess if it is a safe environment. C. Making a referral for post-discharge home health visits for all patients who have been hospitalized. D. Making a referral to social services for all patients prior to discharge.

B (Focus on the full continuum of the disease.)

In caring for patients with noncommunicable diseases (NCD), nurses in a primary care clinic must not only understand the pathophysiology of the disease but also must primarily: A. Focus on the acute stage of disease. B. Focus on the full continuum of the disease. C. Focus on screening for disease. Conduct research related to treatment of the disease. D. Focus on primary prevention.

B (Major diagnostic categories (MDCs))

Megan is the nurse chair of the performance improvement committee for a small community hospital. She has been asked to work with the hospital's community health outreach program team with a focus on cardiovascular disease. Megan begins by reviewing hospital discharge data as part of the initial review of patients with cardiovascular disease. Because she wants to use a taxonomy that categorizes diagnoses into mutually exclusive groups, which taxonomy should she use? A. ICD10 codes B. Major diagnostic categories (MDCs) C. Recidivism rates D. ALOS statistics

D (Occurs when a person's current level of consumption puts them at risk for adverse health consequences.)

Nurses at a local trauma center were involved in evaluating their hospital's screening program for at-risk alcohol use. The nurses found that, for many of the health care workers, there seemed to be confusion as to what constituted a positive screen. As part of their staff training, they provided information on the levels of risk. They explained a positive screen: A. Occurs only with those who have an alcohol use disorder. B. Occurs with a blood alcohol concentration (BAC) to 0.08 grams percent or above. C. Occurs independent of other risk factors. D. Occurs when a person's current level of consumption puts them at risk for adverse health consequences.

A (Promoting and reinforcing selective protective factors.)

Sam, a PHN working in the maternal child division of an urban public health department, has been tasked with developing a child maltreatment home visitation prevention program. He has chosen to use the Nurse Family Partnership Model, which focuses on: A. Promoting and reinforcing selective protective factors. B. Identifying families at risk and referring for counseling. C. Building resilience in children. D. Improving the link between child protective services and the public health department.

C (Access to appropriate mental health services and quality)

The World Health Organization (WHO)'s Mental Health Improvements for Nations' Development (MIND) model includes four components. Which one of the following is not one of the components? A. Policy, planning, and service development B. Human rights and legislation C. Access to appropriate mental health services and quality D. Poverty and development

D (The population.)

The nurse at a community-based primary care organization is educating newly hired nurses about the process used at the clinic for developing public health programs aimed at benefitting community members whether they attend the clinic or not. The nurse explains that even though the primary care offered at the clinic focuses on caring for an individual, the health promotion activities that they are developing for the community are focused on: A. The family. B. The health-care provider. C. The health-care organization. D. The population.

D (All of the above)

When a community health nurse conducts an assessment of tobacco-related harm at the population level, she should include which of the possible indicators? A. Prevalence of childhood asthma B. Prevalence of chronic obstructive pulmonary disorders C. Prevalence of lung cancer D. All of the above

B (Access to health-care services)

When a nurse works with a patient diagnosed with heart disease to help build a plan for long-term management of the disease, which of the following is not one of the common behavioral level risk factors that the patient can modify? A. Tobacco use B. Access to health-care services C. Amount of exercise D. Nutrition

A (Methamphetamine)

A 20-year-old man presented to the emergency department (ED) with tactile hallucinations and appeared euphoric, tremulous, anorexic, and had dilated pupils. Based on these facts, the nurse concludes that the patient was most likely using which drug? A. Methamphetamine B. Cocaine C. Alcohol D. None of the above

A, B, C (Conduct a retrospective cohort study; Examine hospital discharge data; Examine cancer registry data.)

A PHN evaluating an increase in lung cancer cases in a certain area would conduct which of the following epidemiological studies to help understand the rising incidence in cases? (Select all that apply.) A. Conduct a retrospective cohort study. B. Examine hospital discharge data. C. Examine cancer registry data. D. Conduct a clinical trial to test the intervention chosen. E. Examine results of a health-related quality-of-life questionnaire.

D (All of the above.)

A PHN follows which of these guiding principles on harm reduction when helping clients who are substance users? A. Clients are responsive to culturally competent, nonjudgmental services delivered in a manner that demonstrates respect for individual dignity, personal strength, and self-determination. B. Service providers are responsible to the wider community for delivering interventions, which attempt to reduce the economic, social, and physical consequences of drug- and alcohol-related harm and harms associated with other behaviors, or practices that put individuals at risk. C. Because those engaged in unsafe health practices are often difficult to reach through traditional service venues, the service continuum must seek creative opportunities and develop new strategies to engage, motivate, and intervene with potential clients. D. All of the above.

B (Intersectoral strategies.)

A PHN is currently working in a community with a high poverty rate as part of a team to help address the increasing prevalence of serious mental illness especially among adolescents. During a team meeting, the members of the community begin talking about the need to engage more stakeholders including government agencies, grass roots groups, nonprofits, and businesses. Invitations are extended, and many of these stakeholders agree to send representatives who will work in tandem with the team during their planning phase. This interrelationship is called: A. Indicated prevention. B. Intersectoral strategies. C. Health-Related Quality of Life. D. Institute of Medicine Model of Prevention.

A (Deinstitutionalization)

A PHN is helping develop an outreach treatment program for adults in the community who have been diagnosed with a mental health disorder. She understands that the burden of treatment was shifted to the community through which of the following: A. Deinstitutionalization B. The Affordable Care Act C. Health reform at SAMSHA D. Title XIX of the Social Security Act

B (Both A and C: Is a perception that risky substance use is a personal choice and consequences are self-inflicted; Continues to be a barrier for entrance into treatment for the person with a substance use disorder.)

A PHN preparing a proposal on prevention of overdose deaths for the community is worried about the stigma attached to those who use drugs. She understands that stigma: A. Is a perception that risky substance use is a personal choice and consequences are self-inflicted. B. Both A and C. C. Continues to be a barrier for entrance into treatment for the person with a substance use disorder. D. Encourages persons with a drug use disorder to seek treatment.

A (National Violent Death Reporting System)

A PHN working at a large urban public health department is reviewing motor vehicle-associated mortality data to compare the city's mortality rate (MR) with state and national MRs. Which of the following would provide the most comprehensive database of information? A. National Violent Death Reporting System B. Vital Statistics C. Department of Motor Vehicles D. Department of Transportation

D (All of the above)

A PHN, concerned about the increase in NCDs in a community, could include in his/her assessment of the community which of the following? A. Socioeconomic risk B. Genetic predispositions C. Behavioral factors D. All of the above

D (Data they obtained using their community health survey on Health-Related Quality of Life (HRQoL))

A community health group focused on optimizing the health of a large urban community decides to include mental health as a priority. However, they have limited data on mental health. What would be an example of primary data on the mental health of the community that would help them further determine if it is indeed a priority? A. Discharge rates for persons with mental health disorder diagnoses from local hospitals B. Violent crime rate trends over the past year C. Data from available national surveys such as the National Health Interview Survey, and Behavioral Risk Factor Surveillance System D. Data they obtained using their community health survey on Health-Related Quality of Life (HRQoL)

B, C, A, D (Develop a goal statement and determine what will be measured during this process; Proceed with ventilator care process using standard hospital protocols; Study the process from start to finish; Make changes to the processes as determined by results of the study)

A group of nurses is looking to reduce the number of cases of ventilator-associated pneumonia in their hospital. The nurses decide to use the IHI model as their guiding process. Place the following steps in the order in which they should be performed (A-D): _____ A. Study the process from start to finish. _____ B. Develop a goal statement and determine what will be measured during this process. _____ C. Proceed with ventilator care process using standard hospital protocols. _____ D. Make changes to the processes as determined by results of the study.

A (Mental Health Parity Act)

A nurse considering a career in behavioral health learns that the ____ mandates that group health plans of 50 or more persons, which cover mental health and substance use disorders, must provide benefits equivalent to or better than those benefits provided for medical or surgical benefits. A. Mental Health Parity Act B. Community Mental Health Centers Act C. Affordable Care Act D. None of the above

12

A nurse decides to use a Haddon Matrix to evaluate factors that may contribute to patient falls on the medical units of the hospital. What is the minimum number of boxes that should be drawn on the grid to be filled out? ____________________

C (Go to the nearest emergency department.)

A nurse is answering telephone calls from a triage line. A call comes in from a 62-year-old woman who has complaints of unusual fatigue, abdominal pain, and nausea. She denies eating anything unusual that day. What should the nurse advise her to do? A. Rest and take an antacid. B. Call her physician in the morning. C. Go to the nearest emergency department. D. Schedule an appointment with a cardiologist next week.

C (They can figure out what works on the large scale fairly quickly.)

A nurse is looking to develop a new policy to address the rising rate of central line infections in their medical ICU. The nurse speaks with the nurse manager about utilizing the Plan-Do-Study-Act (PDSA) approach instead of simply developing new ICU protocols. Which of the following is not a benefit of using this system? A. New protocols can be tested before implementing them throughout the hospital ICUs. B. The staff can work with manufacturers of the medical equipment to determine how the central line trays can be arranged more efficiently. C. They can figure out what works on the large scale fairly quickly. D. The nurses can figure out what other processes need to be addressed with the new policy changes.

C (Community-wide CPR instruction.)

A nurse is looking to implement new preventative measures to address the rate of drowning in young children in the community. All of the following policies are examples of primary prevention, except: A. Swimming instruction for every child. B. Mandatory installation of locked child-safety fences around all community and private pools. C. Community-wide CPR instruction. D. Mandatory use of life jackets for all children on boats.

C (Call the landlord directly to ensure the timely repair of the window guards and encourage the woman to keep the windows closed in the meantime.)

A nurse is performing a home visit for a young mother that lives in the projects in Brooklyn, New York. There is a young child who is 3 years old living in the apartment as well. The nurse notices that the window guards on the bedroom window are hanging off the building. Which of the following is the best approach to addressing the safety issue? A. Encourage the woman to call the landlord after the nurse leaves. B. Call Child Protective Services to report an unsafe living situation. C. Call the landlord directly to ensure the timely repair of the window guards and encourage the woman to keep the windows closed in the meantime. D. Call the city to report a bad landlord and complete the paperwork to support evidence of the event.

A (Conducting a screening program at local senior centers to help identify persons who may have early stages of heart failure.)

A nurse is reviewing the Healthy People objectives related to cardiovascular disease and stroke and decides to develop an intervention to reduce hospitalizations of older people with heart failure. Which of the following is an example of an intervention at the level of secondary prevention? A. Conducting a screening program at local senior centers to help identify persons who may have early stages of heart failure. B. Developing a family-based discharge program for heart failure patients with a history of readmissions in less than thirty days. C. Having patients who have been diagnosed with heart failure complete a chronic disease self-management program once they have been discharged from the hospital. D. Conducting a good nutrition and exercise program at the local older adult housing complex.

A, B, C (Use of rapid response teams; Central line infections; Ventilator-assisted pneumonia)

A nurse is reviewing the hospital's statistics in comparison with the Institute for Healthcare Improvement (IHI) "100,000 Lives Campaign" to see what the facility could do to improve safety within the organization. What statistics should the nurse look at? (Select all that apply.) A. Use of rapid response teams B. Central line infections C. Ventilator-assisted pneumonia D. Pressure ulcers/wounds E. Number of falls

C (To charge a nominal fee if the patient can afford to pay but provide services regardless.)

A nurse is speaking with her accountant about opening a free clinic as a 501(c)(3) organization. The accountant advises the nurse: A. To charge patients his or her regular fees. B. To waive her professional fees but charge for testing and more advanced care. C. To charge a nominal fee if the patient can afford to pay but provide services regardless. D. To charge a small fee, usually around 25% of the service value.

B, A, C, D (Assess the patient, Chest compressions, Clear the airway, Administer breaths)

A nurse is teaching a CPR course for non-medical professionals. Place the following steps for performing CPR on an adult in the order in which they should be performed (A-D): _____ A. Chest compressions. _____ B. Assess the patient. _____ C. Clear the airway. _____ D. Administer breaths.

A, B, C (Age between 15 and 44; Poor mental health; Substance use)

A nurse is teaching a class about emergency preparedness and violence. Which of the following factors are associated with an increased risk of being the victim of violence or intentional harm? (Select all that apply.) A. Age between 15 and 44 B. Poor mental health C. Substance use D. Male gender E. Low socioeconomic status

D (Age)

A nurse is teaching water safety at the local community pool and mentions that which of the following is the most significant risk factor for drowning? A. Gender B. Income C. Education D. Age

C (Inform the school psychologist immediately and notify the boyfriend's parents.)

A nurse is working at a high school when a young woman comes down to the nursing office concerned about her boyfriend whom she states is making suicidal comments. How does the nurse proceed? A. Counsel the young woman about relationship issues. B. Call the young woman's parents about her concerns. C. Inform the school psychologist immediately and notify the boyfriend's parents. D. Call the young man down to the nurse's office for a mental health evaluation.

A (A means or a plan to commit suicide, including whether he has access to a weapon, such as a gun.)

A nurse is working at a suicide prevention hotline and receives a call from a man threatening to end his life. The most important thing for her to determine is whether the man has: A. A means or a plan to commit suicide, including whether he has access to a weapon, such as a gun. B. Been diagnosed with a mental illness. C. A substance use disorder and is currently using alcohol or drugs. D. None of the above.

C (Actively encouraging patients diagnosed with type 2 diabetes to have foot, eye, and hemoglobin A1C screening tests every 3 months.)

A nurse is working with a community center that primarily serves a nearby Native American tribe. The nurse knows that many of the tribe members suffer from type 2 diabetes. Which of the following interventions is an example of a tertiary prevention? A. Teaching school-aged children healthy exercise. B. Conducting a blood glucose screening for program for the adults in the community. C. Actively encouraging patients diagnosed with type 2 diabetes to have foot, eye, and hemoglobin A1C screening tests every 3 months. D. Publishing a culturally grounded guide about preventing diabetes using input from the tribal leaders and distributing it to all persons who come to the clinic.

D (Use of disposable gloves, hand washing, the use of a disposable gown if washing or turning the patient, or changing diapers)

A nurse manager is presenting an in-service to the rest of the nurses on the floor. They are discussing the recent spread of vancomycin-resistant enterococci (VRE) within the hospital and how to prevent transmission on their floor. Which of the following are recommended procedures for reducing transmission? A. Use of disposable gloves, negative pressure rooms, the use of a disposable gown if washing or turning the patient, or changing diapers B. Use of disposable gloves, hand washing, reverse isolation C. Use of masks, hand washing, the use of a disposable gown if washing or turning the patient, or changing diapers D. Use of disposable gloves, hand washing, the use of a disposable gown if washing or turning the patient, or changing diapers

A (Manual, cognitive, and visual)

A nurse who has worked in a large urban emergency department for the past 20 years is precepting a new hire. She explains that there has been an increase in admissions due to motor vehicle crashes (MVC) and that there two of the main risk factors for MVC are driving while impaired and distracted driving. What are the three types of distracted driving? A. Manual, cognitive, and visual B. Behavioral, environmental, and manual C. Cognitive, behavioral, and environmental D. Manual, situational, and visual

D (Reporting of wars and war crimes has increased.)

A nurse who is about to travel as part of an outreach medical team to a country that has experienced civil war does some research on the nature of war to better understand the context of the violence that has occurred due to war in this country. She learns that war has changed in the last few decades. Which of the following statements is correct? A. There are more wars currently than in the past. B. War-related deaths have increased in the past decade. C. Fewer countries have weapons of mass destruction due to increased world condemnation of such weapons. D. Reporting of wars and war crimes has increased.

C (Adherence to medication regimen)

A nurse working in a community clinic understands that lack of access to health care can increase the risk for morbidity and mortality related to NCD. Which of the following is not associated with access to care? A. Available transportation to services B. Adequate health insurance C. Adherence to medication regimen D. Number of health-care providers in the community

B (Perform a problem- or health-issue-based assessment beginning with an assessment of sources of healthy foods such as supermarkets and farmers markets available in the community.)

A nurse working in an inner-city community health clinic is concerned that her patient education efforts related to achieving a healthy lifestyle are not resulting in any substantial changes in her patients. When she discussed this with one mother whose children are struggling with obesity, the mother explained that she is unable to find fresh fruits and vegetables in their neighborhood and resorts to the use of fast food. This information makes the nurse wonder if this is true for other families. What should she do next? A. Ask families she sees to keep a food journal to see what food substitutions could be made. B. Perform a problem- or health-issue-based assessment beginning with an assessment of sources of healthy foods such as supermarkets and farmers markets available in the community. C. Arrange for free bussing from the community center to the closest supermarket. D. Refer them to the local supplemental nutrition assistance program (SNAP) office to help them obtain benefits.

C (Both A and B: Low birth weight; Increased risk for sudden infant death syndrome (SIDS))

A nurse working on a maternity unit became concerned when one of the pregnant patients indicated that she was currently smoking cigarettes. Which of the following adverse effects might eventually affect her unborn child? A. Low birth weight B. Increased risk for sudden infant death syndrome (SIDS) C. Both A and B D. Lower rates of asthma

A (Healthcare Cost and Utilization Project)

A nurse working on a medical surgical unit in a large urban hospital is evaluating the hospital's discharge rate for congestive heart failure and wants to see how it compares with national statistics. Which national resource is available that specifically tracks hospital discharge data? A. Healthcare Cost and Utilization Project B. Healthy People 2020 C. Centers for Disease Control and Prevention D. Institutional Review Board

B (≥30)

A nurse working with adult patients diagnosed with diabetes noted that most of them were obese and that this is a risk factor not only for developing the disease but for morbidity and mortality associated with the disease. The nurse knows that a body mass index of ____ indicates a person is obese. A. 25-29.9 B. ≥30 C. 18.5-24.9 D. ≥40

A (Case-control study, cohort study)

A public health nurse (PHN) employs which two type of studies to help determine whether specific risk factors are associated with the development of disease? A. Case-control study, cohort study B. Cohort study, cross-sectional survey C. Cross-sectional study, case-control study D. Clinical trial, cross-sectional survey

C (Present the proposal to the hospital Institutional Review Board for review and obtain permission from them prior to doing the study.)

Adam is writing a proposal for a performance improvement study related to care of adolescent patients presenting in the emergency department (ED) with suicidal ideation. As part of his study, he wishes to conduct chart reviews for all adolescent patients seen in the ED over the past 6 months. How should he proceed? A. Obtain the records from the EMR or the medical records department as required by the hospital. B. Inform the physicians caring for the patients why he needs to review the records prior to conducting the medical record review. C. Present the proposal to the hospital Institutional Review Board for review and obtain permission from them prior to doing the study. D. The nurse is not able to use the records because it is a violation of HIPAA.

A, B (High crime rate; High poverty rate)

At her new job at the state department of health in Pennsylvania, Janice is tasked with overseeing a new mental health outreach program. Her last step at the beginning of her assessment was to identify the greatest risk based on community-level risk factors. What community-level risk factors might she include? (Select all that apply.) A. High crime rate B. High poverty rate C. Lack of mental health services D. Family instability

A, B, C (Hormonal imbalance; Physical trauma; Malnutrition)

At her new job at the state department of health in Pennsylvania, Janice is tasked with overseeing a new mental health outreach program. Janice researched what factors at the individual level might be associated with increased risk for developing a SMI. Which of the following are specifically individual-level risk factors that may contribute to the development of mental disorders? (Select all that apply.) A. Hormonal imbalance B. Physical trauma C. Malnutrition D. Limited educational opportunities

D (All of the above.)

Latisha, a recent graduate nurse working in a large urban medical center in the emergency department (ED), noticed that a number of the patients coming in were adolescents who had attempted suicide. The patients she was particularly concerned about were those who identified as LGBTQ+. Latisha requested permission from the nurse manager to conduct a quality improvement project with a focus on screening all adolescent patients that might be at risk for depression. For a comprehensive screening program, which of the following would be included in the program? A. All adolescent patients will be screened for depression when they are admitted to the ED. B. Patients with positive screens are referred for further evaluation. C. Before being discharged, all adolescents will complete a questionnaire specific to depression symptoms and the nurse will notify appropriate persons (for example, a social worker) for those with positive screens. D. All of the above.

D (Stigma and culture)

Latisha, a recent graduate nurse working in a large urban medical center in the emergency department, noticed that a number of the patients coming in were adolescents who had attempted suicide. The patients she was particularly concerned about were those who identified as LGBTQ+. Latisha reviews current data on prevalence of suicide and suicide attempts and brings the evidence to her nurse manager that LGBTQ+ adolescents are at greater risk for suicide than their peers and suggests that the most likely community risk factors contributing are _________ and _______ . A. Stigma and shame B. Family disapproval and shame C. Culture and family disapproval D. Stigma and culture

A (No need to address this—the average door-to-balloon time is well within the desired guidelines.)

Megan is the nurse chair of the performance improvement committee for a small community hospital. She has been asked to work with the hospital's community health outreach program team with a focus on cardiovascular disease. Megan's report to the performance improvement committee at the hospital results in the decision to examine whether a specific protocol is needed for the care of women presenting to the emergency department (ED) with atypical symptoms of a heart attack. The nurse finds that the average door-to-balloon time - the interval that starts with the patient's arrival in the emergency department and ends when a catheter guidewire crosses the culprit lesion in the cardiac catheter lab - in their hospital is 64 minutes with the longest time being 84 minutes. How does Megan proceed? A. No need to address this—the average door-to-balloon time is well within the desired guidelines. B. Perform a hospital and ED assessment to see where these patients are being held up. C. Mandate EKGs for every patient who comes into the emergency room. D. Create a separate wing of the ED especially for suspected cardiac patients.

D (All of the above.)

Megan is the nurse chair of the performance improvement committee for a small community hospital. She has been asked to work with the hospital's community health outreach program team with a focus on cardiovascular disease. The team finds that a major issue is treatment of women especially those who present with atypical symptoms. The team asks Megan to partner with the local television station to create a public service announcement (PSA) discussing heart disease in women. Megan incorporates into the PSA the fact that women often experience the symptoms of a heart attack differently than men. These symptoms can include: A. Abdominal pain. B. Nausea. C. Difficulty breathing. D. All of the above.

C (Further assessment, appropriate referrals, and discussion of a safety plan)

Michelle is conducting a routine well baby visit in the home. As part of her visit, she uses the DOVE tool to screen the mother for possible Intimate Partner Violence (IPV). The mother discloses that she is a victim of IPV. What actions are Michelle required to perform? A. Further assessment, report to the physician, and discussion of a safety plan B. Provide her with pamphlets on escaping domestic violence, appropriate referrals, and discussion of a safety plan C. Further assessment, appropriate referrals, and discussion of a safety plan D. Referral to a shelter for victims of IPV, and report to the physician

D (All of the above.)

Nurses at a local trauma center were involved in evaluating their hospital's screening program for at-risk alcohol use. Which of the following steps was part of their plan? A. Review files on patients admitted with a possible alcohol-related injury. B. Evaluate the current screening system in use on their unit. C. Review current screening techniques used in other hospitals. D. All of the above.

B (How to get genetic testing)

Nurses working on a medical unit focused on treatment of patients with cardiovascular disease (CVD) decide to put together a program to reduce risk for the development of CVD and reduce morbidity in persons who have already been diagnosed with CVD. They include in their program all but which of the following? A. How to incorporate healthy eating habits into their daily menu B. How to get genetic testing C. How to self-manage CVD D. How to increase their amount of daily exercise

A, B, C (It cannot be prevented by a vaccination, It cannot be cured by a medication, It requires long-term management)

Nurses working with diabetes patients know that this noncommunicable chronic disease (NCD) has which of the following characteristics? (Select all that apply.) A. It cannot be prevented by a vaccination. B. It cannot be cured by a medication. C. It requires long-term management. D. It is not affected by weight. E. It does not require lifestyle changes such as regular exercise.

A, B, C (Takes into account what impact the disease will have on the community as a whole; Provides an overview of the disease's social and economic impact; Helps determine promotion and prevention efforts targeting most common NCDs)

Nurses working with patients who have a noncommunicable disease (NCD) consider it important to know about the burden of disease associated with a specific disease primarily because it does which of the following? (Select all that apply.) A. Takes into account what impact the disease will have on the community as a whole B. Provides an overview of the disease's social and economic impact C. Helps determine promotion and prevention efforts targeting most common NCDs D. Does not take into account the cost of treatment E. Is specific to disease only and does not include injury

B (Poor nutrition, low physical activity, tobacco use, and alcohol use.)

Nurses working with patients who have chronic noncommunicable disease (NCDs) assess them based on specific risk factors. The four common modifiable risk factors that account for much of the NCDs in the U.S. are: A. Poor nutrition, low physical activity, medication adherence, and tobacco use. B. Poor nutrition, low physical activity, tobacco use, and alcohol use. C. Low physical activity, tobacco use, illicit drug use, and poor nutrition. D. Age, tobacco use, poor nutrition, and low physical activity.

A, B (Length of stay before onset of the disease; Multiple drug-resistant pathogens.)

One of the concerns at a large urban hospital is the increase in Ventilator Associated Pneumonia (VAP) and the hospital board has asked the Infection Control Committee to look into it. Major risk factors for VAP that the infection control nurse states must be included in their initial assessment of the problem include: (Select all that apply.) A. Length of stay before onset of the disease. B. Multiple drug-resistant pathogens. C. Type of ventilator equipment used at the institution. D. Patient-nurse ratio.

D (Both A and B: Patient Health Questionnaire 2; Center for Epidemiological Studies Depression Scale (CESD-10))

The nurse wishes to choose a reliable screening tool to help identify patients in her clinic who may have depression. Which of the following tools are used to screen for depression? A. Patient Health Questionnaire 2 B. Center for Epidemiological Studies Depression Scale (CESD-10) C. Brief Symptom Checklist-18 of the My Mood Monitor (M-3) D. Both A and B

B (A primary prevention approach focused on health protection.)

The public health department (PHD) is concerned about an outbreak of measles that has occurred in a country adjacent to theirs. Although there are currently no reported cases, as one of their actions the PHD reaches out to all the primary care providers to encourage all of their unvaccinated patients to get vaccinated and to encourage the parents of unvaccinated children to get their vaccinations up to date. Such a public health initiative is an example of: A. A secondary prevention approach related to screening. B. A primary prevention approach focused on health protection. C. A primary prevention approach focused on health promotion. D. A primary prevention approach focused on screening.

C (Both A and B: Provide patients counseling options; Review options for medications used for smoking cessation.)

To help patients who report current tobacco use, a nurse knows which of the following evidence-based approaches for smoking cessation strategies is the most effective? A. Provide patients counseling options. B. Review options for medications used for smoking cessation. C. Both A and B. D. None of the above.

D (Increasing the presence of law enforcement officers skilled in working with adolescents.)

Together with members of the community, a PHN is helping to complete a community assessment of an inner-city neighborhood. One of the issues that has surfaced is the rising level of youth violence. The assessment team decides to work on the establishment of a program aimed at promoting youth development. Areas included in this approach according the CDC guide include: A. Promoting family environments that support healthy development. B. Creating protective community environments. C. Connecting youth to caring adults and activities. D. Increasing the presence of law enforcement officers skilled in working with adolescents.

B (Both A and C)

When developing a program to address drug use in the schools, the school nurse wants to make sure that she includes all types of psychoactive substances. In addition to stimulants, inhalants, depressants, and cannabis, psychoactive substances also include which of the following? A. Dissociative anesthetics B. Both A and C C. Hallucinogens D. Non-narcotics

A (The individual/family)

When providing care within the context of primary health care, the most important person(s) is/are: ______________. A. The individual/family B. The population C. The primary-care physician D. The medical specialist

D (All of the above.)

When screening a patient for NCD risk, a nurse reviews the social determinants of health, including which of the following? A. The social gradient B. Early life C. Work life D. All of the above

C (Focused on long-term management of disease.)

When the nurse is applying the chronic care model when seeing patients, she or he is: A. Focused on treating an acute care phase of the NCD. B. Focused on short-term management of the disease. C. Focused on long-term management of disease. D. Focused on a primary prevention framework.

D (Both A and C: Strong social networks; Safe place to work and live.)

When working with a community assessment team, the PHN stresses that it is important to assess the mental health as well as the physical health of the community. An indicator or indicators of mental health in the community that could be included in the assessment include: A. Strong social networks. B. Availability of behavioral health services. C. Safe place to work and live. D. Both A and C.

C (Resilience)

A student nurse is studying stress and mental health. The student nurse learns that ____ is based on an individual's ability to access protective factors that exist at different levels to withstand chronic stress or recover from traumatic life events. A. Intervention B. Support C. Resilience D. Therapy

A (Post-traumatic stress disorder)

A young woman presents to a community clinic. She states that she is having severe anxiety and insomnia after suffering an acquaintance rape at school last year. She is unable to go back to college, and her grades are suffering as a result. What does the nurse suspect that this young woman is suffering from? A. Post-traumatic stress disorder B. Generalized anxiety disorder C. Major depression D. Personality disorder

B (Both A and C: The DAST-10; The National Institute on Drug Abuse (NIDA) ASSIST tool)

An emergency department (ED) nurse wants to put together a comprehensive screening program for substance use. When choosing a screening tool for drug use, which of the following might she suggest to the team? A. The DAST-10 B. Both A and C C. The National Institute on Drug Abuse (NIDA) ASSIST tool D. The AUDIT

D (All of the above)

Assessment of risk associated with substance use includes determining which of the following? A. Quantity consumed B. Frequency of consumption C. Duration of use D. All of the above

C (Those reporting two or more races)

At her new job at the state department of health in Pennsylvania, Janice is tasked with overseeing a new mental health outreach program. She begins with an assessment of the population at greatest risk. Based on 12-month prevalence of serious mental illness (SMI) at the national level, which group would be at greatest risk for SMI among those aged 18-44? A. Males B. Females C. Those reporting two or more races D. American Indian/Alaska Natives

D (There is no centralized method of conducting surveillance of mental health disorder.)

At her new job at the state department of health in Pennsylvania, Janice is tasked with overseeing a new mental health outreach program. She found it challenging to estimate the prevalence of mental disorders in the U.S. primarily due to what issue? A. There is no consensus on what constitutes a mental disorder. B. HIPAA laws prevent review of medical records. C. There are no health surveys that include data related to mental health. D. There is no centralized method of conducting surveillance of mental health disorder.

C (Both A and B: High blood pressure; An inactive lifestyle.)

Cardiovascular nurses know that more than a third of adults have two or more risk factors for heart disease and stroke, which may include: A. High blood pressure. B. An inactive lifestyle. C. Both A and B. D. Normal body weight.

C (Both A and B: Depressants; Stimulants)

During a class lecture, a nursing student learned that which of the following are considered psychoactive substances? A. Depressants B. Stimulants C. Both A and B D. Antidepressants

B (Sepsis/bacteremias, pneumonia, and urinary tract infections)

During her orientation, a new graduate nurse is attending a lecture by the Infection Control Nurse on the prevention of health care-associated infections (HAI). She learns that the following are the major issues related to HAIs: A. Pneumonia, urinary tract infections, and ventilator-associated infections B. Sepsis/bacteremias, pneumonia, and urinary tract infections C. Sepsis/bacteremias, pneumonia, Clostridium difficile infections D. Pneumonia and urinary tract infections

C (10-20)

During the past decade, the morbidity and mortality rate of serious mental illnesses (SMIs) has increased, showing that persons diagnosed with an SMI die ____ years earlier than those in the general population. A. 5-10 B. 25-35 C. 10-20 D. 10-15

C (Major depressive disorder (MDD))

More than 6% of the U.S. adult population is affected by ____ each year. It is the leading cause of disability for people ages 15 to 44 and is more prevalent in women than men. A. Postpartum depression (PPD) B. Schizophrenia C. Major depressive disorder (MDD) D. Posttraumatic stress disorder (PTSD)

A, B, D, E (Meet the demands of everyday life; Function in society; Adapt to change; Cope with challenges.)

Persons who are emotionally healthy are able to: (Select all that apply.) A. Meet the demands of everyday life. B. Function in society. C. Experience alterations in thinking. D. Adapt to change. E. Cope with challenges.

C (Tertiary)

Susan has been assigned a 56-year-old patient in the intensive care unit who is recovering from bypass cardiac surgery. She is primarily providing what level of prevention? A. Primary B. Secondary C. Tertiary D. Selected

A (Overall disability and premature death in the population.)

Suzanne, a PHN, has taken on an internship with the World Health Organization. She is working with a team focused on reducing heart disease in low-income countries. She is aware that the life expectancy is lower but was not familiar with other measures to help understand the burden of disease. She learns that the further analysis of the burden of disease examines how much the disease, injury, or risk factor contribute to: A. Overall disability and premature death in the population. B. Overall capacity in the country to prevent disease and premature death in the population. C. Overall premature death in the population and infrastructure capacity to prevent disease in the country. D. Overall capacity with the country to prevent and treat disease.

D (Both A and C: The five leading causes of death in the United States are NCDs; Prevention occurs across the continuum starting with primary prevention during the perinatal period through tertiary prevention measures such as chronic disease self-management (CDSM) programs.)

To educate their patients about the risks of developing NCDs, nurses might share which of the following facts? A. The five leading causes of death in the United States are NCDs. B. Risk for NCD is not affected by individual behaviors, the environment, and socioeconomic factors. C. Prevention occurs across the continuum starting with primary prevention during the perinatal period through tertiary prevention measures such as chronic disease self-management (CDSM) programs. D. Both A and C.

A (Indicated)

To help best use limited resources, the PHN has developed a ____ prevention program for specific subgroups at highest risk for development of a mental disorder or those that are showing early signs of a mental disorder. A. Indicated B. Selective C. Universal D. Both A and B

B (The first Surgeon General's report on smoking and health)

Which of the following influenced policy-level interventions that led to reduction in tobacco use in the United States? A. World War II B. The first Surgeon General's report on smoking and health C. The Great Depression D. All of the above

B (Stigma)

____ is a combination of personal attributes and societal stereotypes related to human characteristics viewed as unacceptable and results in social disapproval. A. Indicated prevention B. Stigma C. Risk factors D. Transinstitutionalization