Community Final

8. A riverfront community builds a retaining wall to divert flood water away from the town. This is an example of: a. Mitigation b. A natural disaster c. Disaster reduction d. Disaster health

ANS: A Mitigation is defined as actions or measures that can either prevent the occurrence of a disaster or reduce the severity of the effects.

11. According to Leininger and Watson, the moral ideal of nursing is: a. Caring b. Advocacy c. Responsibility d. Accountability

ANS: A This conceptualization occurred as a response to the technological advances in health care science and the desire of nurses to differentiate nursing practice from medical practice.

21. The nurse labels a patient an alcoholic because of his ethnicity. This is called: a. Stereotyping b. Prejudice c. Racism d. Ethnocentrism

ANS: A This is an example of ascribing certain beliefs and behaviors about a given racial and ethnic group to an individual without assessing for individual differences.

3. A client who has been diagnosed with a substance abuse disorder and bipolar disorder has a: a. Disability b. Dual diagnosis c. Handicap d. Functional limitation

ANS: B A substance abuse disorder concurrent with a mental illness disorder is a dual diagnosis.

14. A nurse believes everyone is entitled to equal rights and equal treatment in society when applying: a. Distributive or social justice b. Egalitarianism c. Libertarian view of justice d. Communitarianism

ANS: B Egalitarianism is defined as the view that everyone is entitled to equal rights and equal treatment in society.

4. An orderly process that considers ethical principles, client values, and professional obligations is: a. Accountability b. Ethical decision making c. Moral principles d. Code for Nursing Practice

ANS: B Ethical decision making is defined as an orderly process that considers ethical principles, client values, and professional obligations.

24. A client shares that her grandparents immigrated to the United States from Germany. She has disclosed her: a. Multiculturalism b. Ethnicity c. Race d. Culture

ANS: B Ethnicity represents the identifying characteristics of culture, such as race, religion, or natural origin.

10. Which is considered a non-point source of pollution? a. Hazardous waste site b. Animal waste from wildlife c. Chlorine poured down a well d. Stagnant water

ANS: B Point source means a single place from which the pollutant is released into the environment, whereas non-point source implies a more diffuse source of pollution.

2. Which problem does a health department usually have the legal authority to investigate? a. Pandemics b. Unusual clusters of illness c. World trends of disease d. Cases of the common cold and pneumonia

ANS: B Powers of local government include surveillance of unusual clusters of illness.

2. To understand the causes of health and disease, epidemiology studies: a. Individuals b. Families c. Groups d. Populations

ANS: D Epidemiology monitors health of populations, understands determinants of health and disease in communities, and investigates and evaluates interventions to prevent disease and maintain health.

10. What information is shared among agencies when they collaborate to implement a quality surveillance system? a. How to use algorithms to identify which events should be investigated b. Who is to blame for a disease outbreak c. What shelters will be used and by whom d. How political action will be necessary to ensure public health

ANS: A Collaboration promotes the development of plans and a directory of emergency responses. How to use algorithms is a key type of information that is shared.

24. A study that uses information on current health status, personal characteristics, and potential risk factors or exposures all at once is called: a. Cross-sectional b. Ecological c. Case-control d. Cohort

ANS: A A cross-sectional study collects information on current health status, personal characteristics, and potential risk factors or exposures all at once.

17. A nurse considers an audience's ability to read, comprehend, and act on medical instructions while preparing health education materials. Which factor is the nurse considering? a. Health literacy b. Ethnicity c. Medical training d. Disparity

ANS: A A measure of a patient's ability to read, comprehend, and act on medical instructions is health literacy.

8. A visitor from Japan comes to the United States for a two-week vacation. This person is known as a: a. Non-immigrant b. Refugee c. Legal immigrant d. Lawful permanent resident

ANS: A A non-immigrant is admitted for a limited duration for a specific purpose.

17. Which role is being performed when the nurse speaks on behalf of others who are unable to speak for themselves? a. Advocate b. Caregiver c. Coordinator d. Collaborator

ANS: A A nurse speaking on behalf of others who are unable to speak for themselves is performing the role of advocate.

4. Which is an example of a human-made disaster? a. Structural collapse b. Communicable disease epidemics c. Mud slides d. Floods

ANS: A A structural collapse would be considered a human-made disaster.

16. A nurse is completing a disease investigation. Based on the clinical symptoms presented, it is assumed that the individual has measles. However, there has been no laboratory evidence documenting that this individual has the disease. What type of case is the nurse investigating? a. A suspected case b. A confirmed case c. A prolonged case d. An identified case

ANS: A A suspected case is a clinically compatible case of illness without isolation.

30. Research has shown that Asian men tend to have a greater sensitivity than white Europeans to codeine, and they experience significantly weaker effects from the drug. This is an example of cultural variations of: a. Biological variations b. Space c. Social organization d. Time perception

ANS: A Biological variations are the physical, biological, and physiological differences that exist between racial groups and distinguish one group from another.

7. A nurse is working in a temporary shelter for victims following a natural disaster. Which condition is the nurse most likely to encounter? a. Stress b. Communicable disease c. Chronic illness d. Injuries requiring first aid

ANS: A Causes can be the shock of the disaster itself, loss of personal possessions, fear of the unknown, living in close proximity to total strangers, and boredom.

20. A nurse executive would like to hire a neighborhood resident who is trained in community outreach to work at the nursing center. What would be the title of this position? a. Community health worker b. Support staff member c. Clinical specialist d. Specialty care provider

ANS: A Community health workers are typically neighborhood residents who are trained in community outreach, family case management, or on-site services.

11. To meet a client's needs, it is sometimes necessary to integrate into the client's care a culturally relevant practice that lacks scientific utility. This is known as cultural: a. Accommodation b. Brokering c. Preservation d. Repatterning

ANS: A Cultural accommodation refers to assistive, supportive, facilitative, or enabling nurse actions and decisions that help people of a particular culture to accept nursing strategies, or to negotiate with nurses to achieve satisfying health care outcomes.

23. Which statement is true about African American nurses in public health? a. Certificate and graduate education were more difficult to obtain. b. Cities were the major areas where they practiced. c. They often belonged to the Frontier Nursing Service. d. They were recruited heavily as military nurses.

ANS: A Due to segregation, certification and graduate education were more difficult to obtain.

20. The practice of a school nurse in the early twentieth century would have focused on: a. Investigating causes of absenteeism b. Teaching school as well as being a nurse c. Promoting nursing as an autonomous practice d. Providing medical treatment to enable children to return to school

ANS: A Early school nursing focused on investigating causes of absenteeism, not providing medical treatment. That was the responsibility of physicians.

20. A nurse believes that the best treatment for illness is the use of Western medicine and alternative therapies should not be used for healing. This is an example of: a. Ethnocentrism b. Cultural imposition c. Racism d. Stereotyping

ANS: A Ethnocentrism is the belief that one's own cultural group determines the standards by which another group's behavior is judged.

6. An example of an explicit cultural behavior is: a. Verbal communication b. Body language c. Use of titles d. Perception of health and illness

ANS: A Explicit behaviors are straightforward and do not leave room for misinterpretation of what the person wants to communicate, such as when using verbal communication. Implicit behaviors are less exact and may be difficult to interpret, including body language, use of titles, and perception of health and illness.

11. When working in a disaster, which attribute would be most important for the nurse to possess? a. Flexibility b. Training c. Experience d. Special interest

ANS: A Flexibility is an attribute. Training, experience, and special interest are all roles of a nurse working in a disaster.

1. Which statement about Florence Nightingale's ideas about ethics is correct? a. Nursing is a call to service, and the moral character of persons entering nursing is important. b. Ethical principles are based on the values of the individual nurse. c. Society will dictate the ethical principles to which nurses must adhere. d. Ethics are very important in times of war, such as in the Crimean War, when she set up public health centers.

ANS: A Florence Nightingale saw nursing as a call to service and viewed the moral character of persons entering nursing as important.

11. An example of a health disparity is: a. Childhood immunization rates b. High dropout rates c. Unemployment d. Income below poverty level

ANS: A High dropout rates, unemployment, and income below poverty level are social conditions that may lead to health disparities.

24. An example of the resourcefulness of a nurse during the time when the Rural Nursing Service was operating through the American Red Cross was: a. Using hot bricks, salt, or sandbags to substitute for hot water bottles b. Testing well water for pollutants c. Teaching school and developing curricula for rural nursing programs d. Providing post-surgical care

ANS: A In providing medical care, rural nurses were resourceful in finding alternatives when they did not have medical products that were available in urban areas.

9. A public health nurse is investigating an outbreak of salmonellosis in a community. Which type of surveillance system is being used? a. Active b. Passive c. Sentinel d. Special

ANS: A In the active system, a public health nurse begins to search for cases through contacts in the community. The nurse names the disease and gathers data about existing cases to try to determine the magnitude of the problem.

1. In the past, population-centered nurses have been called: a. District nurses b. Almshouse nurses c. Soldier nurses d. Sisters

ANS: A In the past, population-centered nurses have been called public health nurses, district nurses, visiting nurses, school nurses, occupational health nurses, and home health nurses.

6. John Snow is called the "father of epidemiology" because of his work with: a. Cholera b. Malaria c. Polio d. Germ theory

ANS: A John Snow investigated the spread of cholera in the mid-nineteenth century.

13. Examples of the benefits of distributive justice are: a. Basic needs, material and social goods, liberties, rights, and entitlements b. Taxes, military service, location of incinerators or power plants c. Entitlement to equal rights and equal treatment d. The right to private property and personal assets

ANS: A Justice requires that the distribution of benefits and burdens on a society be fair or equal. the third option refers to egalitarianism, and the last option refers to libertarianism. Taxes, military service, and location of incinerators or power plants are not benefits associated with justice.

18. Which of the trends in health issues in the United States between 1900 and 1955 is accurate? a. There was a rise in chronic disease such as heart disease and cancer. b. There was a rise in communicable disease. c. The crude mortality rate increased dramatically. d. The life span after diagnosis remained the same.

ANS: A Leading causes of death in 1955 were heart disease, cancer, and cerebrovascular disease, whereas in 1900 they were pneumonia, tuberculosis, and diarrhea/enteritis. The mortality rate decreased by 47%. There was a decrease in communicable disease, and the life span after diagnosis increased.

19. Local health departments were formed in urban areas in the late 1800s to: a. Target environmental hazards associated with crowded living conditions. b. Facilitate interdisciplinary efforts and promote "practical nursing." c. Provide immunizations and health care services to all citizens. d. Offer public health education to nurses who had finished basic training.

ANS: A Local health departments were formed to handle environmental issues in cities, including problems associated with crowded living conditions and dirty streets, and to regulate public baths, slaughterhouses, and pigsties.

18. Which statement is true about mortality rates? Mortality rates: a. Are informative only for fatal diseases b. Provide information about existing disease in the population c. Are calculated using a population estimate at year-end d. Reveal the risk of getting a particular disease

ANS: A Mortality rates are informative only for fatal diseases and do not provide direct information about the level of existing disease or the risk of getting a particular disease.

9. When providing care for a family who has a child with a disability, who would most likely to report high levels of stress, anxiety, and depression? a. Mother b. Father c. Teacher d. Home health nurse

ANS: A Mothers are most often the caregivers in families with a child with a disability.

16. A nurse applies the ethical principle of non-maleficence when: a. Administering medications using the "five rights" b. Allowing clients to be active participants in their care c. Providing patient privacy when delivering care d. Referring a client to a physical therapist

ANS: A Non-maleficence requires that one do no harm. It requires that health care professionals act according to the standards of due care, always seeking to produce the least amount of harm possible.

30. As a result of an outbreak of influenza in a community, a nurse encourages members of the community to receive the influenza vaccine. Which level of prevention is being used? a. Primary prevention b. Secondary prevention c. Tertiary prevention d. Multifactorial prevention

ANS: A Nurses are involved in epidemiologic surveillance by monitoring the potential for disease outbreaks. Primary prevention refers to interventions aimed at preventing the occurrence of disease, injury, or disability.

10. Nurses who strive to be culturally competent should: a. Respect individuals from different cultures and value diversity. b. Immerse themselves in different cultures. c. Design care for special ethnic groups. d. Give explicit instructions to avoid client decision making.

ANS: A Nurses who strive to be culturally competent respect individuals from different cultures and value diversity. The other answers are false.

4. Which characteristic is common among all nursing centers? a. Provision of community-based culturally competent care b. Services provided by physicians and health care providers c. Focus on the biological factors contributing to the development of disease d. Fee-for-service reimbursement model

ANS: A One characteristic that is common among all nursing centers is the provision of community-based culturally competent care that is accessible, acceptable, and responsive to the populations being served.

9. An example of a point source of air pollution is: a. A smoke stack b. The number of cars and trucks c. How much fossil fuel is consumed in a community d. Ground ozone levels

ANS: A Point sources of pollution are identifiable sources of air pollution, such as a smoke stack.

1. Why is it important for nurses to understand the premises of environmental health? a. Nurses should be able to assess risks and advocate for policies that support healthy environments. b. Toxicologists often consult nurses about environmental pollutants. c. Pollutant exposures such as lead are reported by nurses to the Environmental Protection Agency. d. Many Americans live in areas that do not meet current national air quality standards.

ANS: A Potential risks to health are concerns for professional nurses. It is the responsibility of the nurse to understand as much as possible about these risks: how to assess them, how to eliminate/reduce them, how to communicate and educate about them, and how to advocate for policies that support healthy environments.

12. A nurse is completing an exposure history using the mnemonic I PREPARE. What data would a nurse collect when asking questions about the first "P"? a. Present work b. Potential exposures c. Personal protective equipment use d. Problems with health

ANS: A Present work is the first "P".

19. A screening for diabetes revealed 20 previously diagnosed diabetics and 10 probable new cases, which were later confirmed, for a total of 30 cases. This is called: a. Prevalence b. Incidence c. Attack d. Morbidity

ANS: A Prevalence is the measure of existing disease in a population at a particular time.

10. A congressional mandate for the addition of folic acid to cereals in the United States to reduce neural tube defects in infants addresses which level of prevention? a. Primary prevention b. Secondary prevention c. Tertiary prevention d. Assessment

ANS: A Primary prevention refers to those interventions aimed at preventing the occurrence of disease, injury, or disability.

11. Immunization for measles is an example of: a. Primary prevention b. Secondary prevention c. Tertiary prevention d. Health promotion

ANS: A Primary prevention refers to those interventions aimed at preventing the occurrence of disease, injury, or disability.

15. Neighborhood centers that provided health care, education, and social welfare programs were called: a. Settlement houses b. Nursing care centers c. Nurse-managed clinics d. Public health services

ANS: A Settlement houses were neighborhood centers that provided health care, education, and social welfare programs. Nursing centers, nurse-managed clinics, and public health services are not necessarily in neighborhoods.

17. When making a final decision about establishing a nursing center, which factor is the most important for the nurse to consider? a. Legal and regulatory considerations b. Community involvement c. Nursing interest d. Potential grant funding

ANS: A Several essential areas must be explored before a final decision is made about establishing a nursing center, including legal and regulatory considerations.

3. What is the focus of a special care nursing center? a. A particular demographical group or those with special care needs b. An affiliation with a school of nursing c. Providing services while maintaining a not-for-profit status d. Providing fee-for-service care with designated HMO providers

ANS: A Special care centers focus on a particular demographical group or those with special needs. Examples are those that focus on persons with HIV/AIDS, adolescent mothers, and the frail elderly.

16. An example of tertiary prevention is: a. Rehabilitative job training b. Parenting education c. Testicular self-examination d. Family counseling

ANS: A Tertiary prevention includes those interventions aimed at disability limitation and rehabilitation from disease, injury, or disability.

16. A mental health nurse working in the 1960s received additional education to provide care for the severely mentally ill in the community because of which legislation? a. Community Mental Health Centers Act b. Stewart B. McKinney Homeless Act c. National Health Planning and Resource Development Act d. Patient Protection and Affordable Care Act

ANS: A The Community Mental Health Centers Act funded construction of community mental health centers and training of mental health professionals who provided community-based care for the severely mentally ill individuals who were discharged from state mental hospitals.

12. A 66-year-old woman is retired and no longer has health insurance through her place of employment. Which program would be appropriate for her health insurance needs? a. Medicare b. Medicaid c. Social Security d. Economic Opportunity Act

ANS: A The Social Security Act was amended to include health insurance benefits for the elderly, which is addressed through Medicare.

16. Which is an example of a bioterrorism and emergency readiness competency for a public health worker? a. Recognition of unusual events that might indicate an emergency b. Involvement in the chain of command c. Using a set of preplanned activities for every disaster d. Leaving communication to the authorities

ANS: A The ability to recognize unusual events that might indicate an emergency and describe appropriate action is a competency public health workers should possess.

11. A nurse is caring for a disabled individual and her family. The nurse recognizes that a potential effect on the family may include: a. High out-of-pocket expenses to receive necessary services b. Alteration of self-concept and self-esteem c. Compliance with necessary legislation to maintain services d. Provision of health care services by the health department

ANS: A The cost of caring for a child with a disability often affects the family's financial well-being. One-third of children with disabilities who have insurance lack adequate coverage to meet their needs. Alteration of self-concept and self-esteem may affect individuals in the family, but not the family. Compliance with legislation and provision of health care services may be potential effects on the community.

25. When working with an immigrant population, the first step the nurse should take is: a. Be aware of one's own culture. b. Become familiar with traditional practices of the immigrants. c. Try to see things from the immigrant's viewpoint. d. Learn to speak the language of the immigrant population.

ANS: A The first statement is the only one that is correct.

11. A nursing center is going to be placed in a rural community. Who has the most power and influence on model development and team composition? a. The rural community b. The mayor c. The nursing executive d. The center's staff

ANS: A The fundamental premise of any nursing center is that the community has the most power and influence.

15. What was the purpose of the CDC creating the first list of standard case definitions for notifiable diseases? a. Some diseases were under-reported and others were over-reported. b. There was no central office to collect data. c. Some people refused to notify officials when diseases were seen. d. No one knew where to report the information that was collected.

ANS: A The initial work was done by the CDC because diseases were over-reported or under-reported.

1. Which statement about the nursing workforce is true? a. The nursing workforce is overwhelmingly Caucasian. b. The number of minority nurses meets the needs of the country's demographics. c. The nursing workforce has many unauthorized immigrants. d. Refugees make up a large part of the nursing workforce in some areas.

ANS: A The nursing work force is 81.8% Caucasian. The other statements are false.

3. Which is a feature of public health surveillance? a. Sharing of the results with others b. Defining public health policy c. Evaluating interventions d. Planning national programs

ANS: A The other three options are the purposes of surveillance, not features.

14. What action would the nurse take when triaging victims following a disaster? a. Allocation of treatment based on the victim's potential for survival b. Assignment of tasks to the appropriate disaster response personnel c. Determination of the level of disaster and agency involvement d. Participation in community preparedness for the disaster response

ANS: A The triage process in disaster involves separating the casualties and allocating treatment based on the victim's potential for survival.

1. What is implied by the web of causation model? a. Variables interact resulting in higher probability of illness. b. One disease causes another, especially in vulnerable populations. c. The greater the poverty, the more likely people are to have diseases. d. Immunizations are necessary because vulnerable populations spread disease.

ANS: A The web of causation model implies that not only are there more variables, but the variables interact resulting in higher probability of illness. The relative risk for poor health is greater for vulnerable populations.

1. Which statement about disasters is true? a. They can be natural or human-made. b. They can be relieved without assistance. c. There is always injury and death when a disaster occurs. d. The timing of a disaster does not influence the types of injuries that will occur.

ANS: A There are natural and human-made disasters.

17. A nurse providing care using the idea of "servicing citizens, not customers" is applying the: a. Ethical tenets of policy development b. Basic concepts of the feminist theory c. Underlying premise of virtue ethics d. Components of distributive justice

ANS: A There are three tenets of both policy and ethics. The approach is based on the voice of the community as the foundation on which policy is developed.

3. When a nurse examines birth and death certificates during an epidemiologic investigation, what data category is being used? a. Routinely collected data b. Data collected for other purposes but useful for epidemiologic research c. Original data collected for specific epidemiologic studies d. Surveillance data

ANS: A These are examples of data collected routinely.

14. Which federal program created support for older and poor Americans? a. Social Security Act b. Medicare Amendment c. Medicaid Amendment d. Hill-Burton Act

ANS: A This act sought direct payments to eligible individuals to ensure a minimum level of support for people at risk of problems from inadequate financial resources.

14. A Mexican American mother insists on using special candles to help her daughter's ear infection. The nurse asks the mother if she would also give her daughter antibiotics. This is called cultural: a. Accommodation b. Repatterning c. Brokering d. Awareness

ANS: A This means that the nurse supports and facilitates the use of cultural practices with interventions from the biomedical health care system. Cultural accommodation refers to assistive, supportive, facilitative or enabling nurse actions and decisions that help clients of a particular culture accept nursing strategies, or negotiate with nurses to achieve satisfying health care outcomes.

12. To improve the health and wellness of persons with disabilities, what action should the nurse take? a. Treat the whole person, not just the disability. b. Focus on the disability and the related illnesses. c. Acknowledge the ability, not the disability. d. Ensure persons with disabilities have access to home health care.

ANS: A To improve the health and wellness of persons with disabilities, the former Surgeon General Carmona suggested that: health care providers should see and treat the whole person, educators should teach about disability, the public should focus on the person's abilities not just the disability, and the community should ensure accessible health care and wellness services.

4. The basic science applied to understanding the health effects associated with chemical exposures is: a. Toxicology b. Pharmacology c. Chemistry d. Environmental epidemiology

ANS: A Toxicology is the study of the health effects associated with chemical exposures.

3. A large portion of foreign-born residents of the United States: a. Work in service-producing and blue-collar sectors b. Reside in rural areas c. Have language barriers d. Are refugees and non-immigrants

ANS: A Two thirds of the foreign-born population lives in or around major metropolitan areas and works in mainly service-producing and blue-collar sectors. They are also more likely to be poorer. The majority of foreign born are legal immigrants (85%).

22. A nurse has recently completed a research study in a nursing center. Based on the historical pattern of research in nursing centers, what would likely have been the focus of this research? a. The development and characteristics of nursing centers b. The effects of nursing models of care in nursing centers c. Client outcomes d. Managed competition in nursing centers

ANS: A Typically, descriptive data has been collected about clients, types of services, the financial supports, and community relationships over the past three decades.

2. Which is a characteristic of a vulnerable population? a. Have worse health outcomes and an increased sensitivity to risk factors than the general population b. Have a single risk factor but experience worse health outcomes than the general population c. Have multiple risk factors but equal health outcomes than the general population d. Have worse outcomes with better access to health care than the general population

ANS: A Vulnerable population groups are more sensitive to risk factors and have worse health outcomes.

9. Which population is most likely to be affected by poverty? a. Women b. Men c. Two-parent families d. Adoptive families

ANS: A Women are more likely to be affected by poverty than other population groups.

2. Which organizations offer volunteer opportunities in disaster work for nurses? Select all that apply. a. American Red Cross b. Citizens Corps c. American Nurses Association d. National Public Health Training Centers

ANS: A, B American Red Cross and Citizens Corps offer volunteer opportunities. The American Nurses Association and National Public Health Training Centers offer education and training opportunities.

3. What factors should a nurse take into consideration when planning nursing interventions for disabled individuals living in poverty? Select all that apply. a. This population may have difficulty securing employment. b. This population may have less access to health care. c. This population is better able to use community resources. d. This population may make healthier lifestyle choices.

ANS: A, B Persons who are disabled and live in poverty are less likely to have the resources to provide for their own special needs. They often have difficulty securing employment and have barriers obtaining health insurance and accessing health care. This population is limited in their ability to access community resources and is at greater risk for disabling conditions resulting from lifestyle choices.

1. In which situation would a nurse use public surveillance? Select all that apply. a. When estimating the magnitude of an influenza outbreak b. When determining the geographical distribution of gonorrhea cases c. When detecting an epidemic of whooping cough d. When reducing the prevalence of obesity

ANS: A, B, C Estimating the magnitude of the problem, determining geographic distribution of an illness, and detecting epidemics are all uses of public surveillance.

2. A public health nurse working with a family living in poverty recognizes that they are more likely to be exposed to environmental hazards because they have (select all that apply): a. Limited funds to pay for health care b. Poor nutrition c. Homes located closer to hazardous waste sites d. Less education

ANS: A, B, C Families living in poverty are more likely to experience environmental justice issues such as disproportionate environmental exposures. Sub-standard housing, living closer to hazardous waste sites, working in more hazardous jobs, poorer nutrition, and less access to quality health care all contribute to this issue. Although limited education is related to poverty, it is not discussed as causing an increase in environmental exposure.

2. Which interventions are completed as a nurse "sets the stage" when assessing members of vulnerable population groups? Select all that apply. a. Creating a comfortable, non-threatening environment b. Providing culturally and linguistically competent assessment c. Collaborating with others as appropriate d. Providing financial and legal advice

ANS: A, B, C Nurses set the stage by creating a comfortable, non-threatening environment, providing culturally and linguistically competent assessment, and collaborating with others as appropriate. A nurse should not provide financial or legal advice.

1. Which populations are at greatest risk for disruption after a disaster? Select all that apply. a. Single-parent families b. Children c. Substance abusers d. Middle-class families

ANS: A, B, C Single-parent families, children, and substance abuses are all at greater risk for disruption after disaster than a middle-class family.

2. Which conditions may contribute to disability? Select all that apply. a. Violence b. Tobacco use c. Lack of access to health care d. Unsanitary living conditions

ANS: A, B, C, D Several conditions and inherited problems can cause disability: genetic disorders, acute and chronic illnesses, violence, tobacco use, lack of access to health care, as well as failure to eat correctly, exercise regularly, or manage stress effectively. Substance abuse, environmental problems, and unsanitary living conditions can cause disability.

1. Which would be an appropriate source for a nurse to look for financial support when developing a nursing center? Select all that apply. a. Grant funding b. Charitable organizations c. Private pledges d. Foundations

ANS: A, B, C, D Support for nursing centers can come from grants, charitable organizations, private pledges, and foundations.

1. A nurse is planning a refugee outreach clinic at the neighborhood health center. To provide culturally competent care, the nurse should consider that (select all that apply): a. Their own background, beliefs, and knowledge may be significantly different from those of the people receiving care. b. Language barriers may interfere with efforts to provide assistance. c. Certain risk factors may be present for a given population. d. Certain groups may use non-traditional healing practices.

ANS: A, B, C, D When working with immigrants it is important to be aware of one's own beliefs, realize that language barriers may exist, that different populations experience different risk factors and illnesses, and that non-traditional healing practices may be used.

1. Which trends are occurring among vulnerable populations? Select all that apply. a. Community-based care and interorganizational partnerships b. Outreach and case finding c. Elimination of disparities d. Culturally and linguistically appropriate care

ANS: A, B, D Elimination of disparities is not a trend related to caring for vulnerable populations.

1. The ethical tenets that underlie the core function of assessment are (select all that apply): a. Competency: the persons assigned to develop community knowledge are prepared to collect data on groups and populations b. Moral character: the persons selected to develop, assess, and disseminate community knowledge possess integrity c. Service to others over self: a necessary condition of what is "good" or "right" policy d. "Do no harm": disseminating appropriate information about groups and populations is morally necessary and sufficient

ANS: A, B, D Service to others over self is an ethical tenet of policy development. Competency, moral character, and "do no harm" are the ethical tenets of assessment.

2. A nurse is performing the role of researcher in a nurse center. Which type of data would most likely be collected by a nurse in this setting? Select all that apply. a. Client use of services b. Trends in community characteristics c. Staff compliance with HIPAA d. Client satisfaction

ANS: A, B, D Trends in health care services, client responses, and changes in community characteristics must be documented and summarized periodically. Outcome measurements such as client use of on-site services, childhood and adult immunization patterns, pregnancy outcomes, emergency department and hospital use, and other health indexes including client satisfaction and quality-of-life measures should also be collected. Staff compliance with HIPAA is a legal responsibility of staff and data should not need to be collected about this topic.

2. A staff nurse has demonstrated the ability to be competent as a participant in surveillance and investigation activities. What skills would you expect that nurse to possess? Select all that apply. a. The ability to identify appropriate data sources b. The ability to communicate effectively using written reports c. The ability to collaborate with community agencies d. The ability to create a budget

ANS: A, C, D The staff nurse must have analytic assessment skills, communication skills, and community dimensions of practice to be a participant in surveillance and investigation.

16. A nurse develops a plan to describe the development and direction of the nursing center and identifies how the center will meet its goals. This plan is called a(n): a. Feasibility study b. Business plan c. Strategic plan d. Organizational strategies

ANS: B A business plan describes the development and direction of the nursing center and how goals will be met.

5. What emotion would a nurse anticipate when working with an older person following a disaster? a. Anger b. Fear of loss of independence c. Violence d. Regression

ANS: B A common reaction of older persons experiencing disaster may be fear of loss of independence.

18. When examining the strengths, limitations, and capacity of an organization and the community to support the establishment and viability of a nursing center, a nurse is completing a: a. Data collection b. Feasibility study c. Focus groups d. Community forums

ANS: B A feasibility study reveals the strengths, limitations, and capacity of an organization and community to support the establishment and viability of a nursing center.

19. The nurse, with agreement from the family, arranges for families to see social workers on the same day that they bring their children for follow-up care in a pediatric cardiology clinic. The role being performed is: a. Caregiver b. Coordinator c. Collaborator d. Case finder

ANS: B A nurse arranging for families to see social workers on the same day that they bring children to be followed up in a pediatric cardiology clinic is performing the role of coordinator.

5. What type of services will a client receive when visiting a nursing center? a. Illness-oriented care b. Direct access to nursing services c. Free services d. Physician diagnosis of health problems

ANS: B A nursing center deemphasizes illness-oriented care, is reimbursed for services, and uses nurses to diagnose and treat.

17. The SARS (severe acute respiratory syndrome) outbreak was an epidemic that spread over several countries. By definition, this is considered a: a. Hyperendemic b. Pandemic c. Mixed outbreak d. Holoendemic

ANS: B A pandemic refers to the epidemic spread of the problem over several countries or continents.

13. Which vulnerable group would be most sensitive to adverse effects? a. Pregnant teenager living with her parents for financial support b. Poor, older woman with no means of transportation c. Two-year-old boy of underinsured parents d. Recently unemployed father of five

ANS: B A poor, older woman with no means of transportation has a combination of risk factors.

21. A set of actions one undertakes on behalf of another is: a. Social justice b. Advocacy c. Linguistically appropriate health care d. A waiver

ANS: B A set of actions one undertakes on behalf of another is advocacy.

23. The community leaders in a lesser-developed country decide not to tell the citizens of a small village about a chemical spill at a major industrial facility that could produce harmful effects. Which principle are they violating? a. Policy b. Advocacy c. Caring d. Virtue

ANS: B Advocacy requires that the community be properly informed, and this was violated in the above scenario.

9. Which is an example of an agent in the epidemiologic triangle? a. Human population distribution b. Salmonella c. Genetic susceptibility d. Climate

ANS: B An agent includes infectious organisms.

4. An epidemiologist wanting to know what caused severe diarrhea and vomiting in several people at a local banquet would be using: a. Descriptive epidemiology b. Analytic epidemiology c. Distribution d. Determinants

ANS: B Analytic epidemiology is directed toward understanding the etiology of the disease.

15. Which task would a nurse be most likely to perform while volunteering on a disaster medical assistant team? a. Set up immunization clinics. b. Assist in triaging disaster victims. c. Provide all the medical care for disaster victims. d. Complete a needs assessment of the community.

ANS: B As a first responder arriving on the scene, the plans for triaging of disaster victims should begin immediately.

19. Which core function supports the belief that all Americans should receive basic health care services? a. Assessment b. Assurance c. Policy development d. Advocacy

ANS: B Assurance purports that all persons should receive essential personal health services.

9. An example of a behavior that may be defined by culture is: a. Speaking a dialect of a language in a local region b. Standing when an older adult gets on the bus to give him a seat c. Immigrating to the United States seeking work d. An organizational structure of a cultural group

ANS: B Behaviors may be culturally determined as illustrated in the correct response. This behavior is based on the value of respect of elderly people.

5. According to the Social Security Administration, which individual would be considered disabled? a. A wheelchair-bound person b. A person unable to engage in any gainful activity because of a medical impairment c. A handicapped person d. A person who has had a stroke or has lost the use of a lower extremity

ANS: B By definition, the Social Security Administration defines a disabled person as a person unable to engage in substantial, gainful activity by reason of medically determinable physical or mental impairment.

17. An effect of providing care that is not culturally competent is: a. Enhancement of communication b. An increase in the cost of health care c. Achievement of health indicators d. Improvement in client compliance

ANS: B Care that is not culturally competent may increase health care costs and decrease positive client outcomes.

2. Environmental health is important to nurses because chemical, biological, and radiological materials are: a. A major cause of global warming b. Often found in the air, water, and products we use c. Frequently linked to the development of chronic illnesses d. Products that nurses work with on a daily basis

ANS: B Chemical, biological, and radiological pollutants are often found in the air we breathe, the water we drink, and the products we use.

6. A public health nurse is working with a migrant farm worker who has experienced an exposure to a pesticide. When researching pesticides, the nurse looks at the "family" of the chemical. What similarities are found among chemicals that have been placed in the same family? a. Route of entry into the body b. Actions and associated risks c. Effects that they have on the body d. Potency and toxicity

ANS: B Chemicals are grouped so it's possible to understand the actions and risks associated with each group.

18. If a person returns from overseas and it is determined that he has cholera, what must occur? a. This is not a disease that is on the notifiable list: nothing need be reported. b. The case must be reported to the state and local health departments. c. The patient must be isolated immediately. d. The patient will probably die, so it is not reportable.

ANS: B Cholera is on the notifiable list and must be reported to the state and local health departments.

2. Public health practice is an appealing specialty to nurses because of its: a. Interactions with wealthy contributors to secure funding b. Autonomy and independence of practice c. Ability to locate the source of diseases and cure patients d. Opportunities to meet a variety of people

ANS: B Community health nurses have a long history of autonomous practice, problem solving, and decision making. Community health care nurses engage in the other activities as well, but overall, they have been best known for autonomy of practice.

31. A nurse advocates and intervenes between the health care system and the client's cultural beliefs on behalf of the client. The nurse's action is called cultural: a. Accommodation b. Brokering c. Preservation d. Repatterning

ANS: B Culture brokering is advocating, mediating, negotiating, and intervening between the client's culture and the biomedical health care culture on behalf of clients.

4. Why does a nurse conduct surveillance? a. To eradicate a disease before it starts b. To establish a baseline rate of disease occurrence and patterns of spread c. To target populations for triage d. To reduce the incidence of heart disease in a community

ANS: B Disease surveillance helps establish baseline rates of disease occurrence and patterns of spread to make it possible to initiate a rapid response to an outbreak.

13. Florence Nightingale's contributions to public health included: a. Caring for the sick, poor, and neglected in institutions and at home b. Using a population-based approach that led to improved environmental conditions c. Writing the Elizabethan Poor Law to guarantee medical care for all d. Founding of the district nursing association to provide health care to needy people

ANS: B During the Crimean War, Nightingale progressively improved the soldiers' health by adopting a population-based approach that used simple epidemiological measures and greatly decreased mortality.

12. What is most likely to occur in the community during the Honeymoon Phase after a disaster? a. First responders work tirelessly to save others. b. Survivors share their stories. c. Medical personnel experience exhaustion. d. Community organizations rebuild the community.

ANS: B During the Honeymoon Phase, survivors rejoice for their survival and may share their experiences and stories. First responders work tirelessly to save others during the Heroic Phase. Medical personnel experience exhaustion during the Disillusionment Phase. The community begins to rebuild during the Reconstruction Phase.

3. A nurse in the 1960s would have referred to which code of ethics to guide ethical decision making? a. Nightingale Pledge b. Code for Professional Nurses c. Code of Ethics for Nurses with Interpretive Statements d. International Council of Nurses (ICN) Code of Ethics for Nurses

ANS: B Florence Nightingale lived in the 1800s. The Code for Professional Nurses was adopted in 1950, the Code of Ethics for Nurses with Interpretive Statements was adopted in 2001, and the International Council of Nurses (ICN) Code of Ethics for Nurses was adopted in 2000.

13. What was the overarching concept upon which Healthy People 2020 was built? a. Establish nursing centers for the purpose of health promotion. b. Create partnerships among individuals, communities, and systems. c. Eliminate disease in lesser-developed countries. d. Further the agenda of the World Health Organization.

ANS: B Healthy People 2020 builds upon shared responsibility to improve the nation's health. Powerful, productive partnerships among diverse people and groups and long-term commitments to community collaboration are needed to achieve these goals.

1. Which definition of disability is being used when a disability is considered to be a function of physical characteristics that place an individual at a disadvantage when compared to those without the characteristics? a. The Social Model of Disability b. The Medical Model of Disability c. The Webster Dictionary definition of disability d. The Social Security Administration definition of disability

ANS: B In the Medical Model of Disability, disability is considered to be a function of physical characteristics or conditions which place an individual at a disadvantage as compared to those without the characteristic or condition. This model emphasizes the disabled person and the need to modify the course of illness to give the disabled person a "normal" life.

8. A nurse practitioner reports a case of gonorrhea to the local health department. Which type of surveillance system is being used? a. Active b. Passive c. Sentinel d. Special

ANS: B In the passive system, case reports are sent to local health departments by health care providers.

5. Which is an example of an epidemic? a. "Bird" flu in China b. Adult obesity in the United States c. An isolated case of smallpox in Africa d. The nursing shortage in the United States

ANS: B It is estimated that 30% of the adults in the United States are obese. According to the CDC, this is an epidemic.

16. Which topic is most likely to have been discussed when Lillian Wald provided public health education? a. Taking and recording blood pressures accurately b. Safe and sanitary baby and child care c. Environmental pollutants and their effects on lung disease d. Time management: balancing factory work and the home

ANS: B Lillian Wald provided health care that included educating the community on health care matters.

25. A nurse working with Mary Breckinridge would have likely assisted with: a. Establishing the Henry Street Settlement b. Developing health programs geared toward improving the health care of the rural populations c. Blazing a nursing trail through the Rockies, providing nursing care to miners and their families d. Teaching birth control measures to large numbers of women in the South

ANS: B Mary Breckinridge developed health programs geared toward improving the health care of the rural and often inaccessible populations in the Appalachian regions of southern Kentucky. Lillian Wald established the Henry Street Settlement.

26. A nursing faculty member is discussing the importance of joining a professional organization as a registered nurse with a group of undergraduate students. Which statement would be most appropriate for the faculty member to include in this discussion? a. "All nurses should be members of the American Nurses Association." b. "Membership in a professional organization helps nurses organize around critical health issues." c. "Dues for professional organizations are expensive, so it is important to set aside money to pay these dues." d. "Membership in a professional organization will foster change in legislation."

ANS: B Membership in a professional organization helps nurses to organize around one or more critical health threats and strategize about what interventions work locally, regionally, and nationally. Membership in organizations should be based on interest, clinical and academic preparation, and employment. Dues for professional organizations vary, but most are not extremely expensive. One of the benefits of membership in a professional organization is that legislation can be influenced, however this in only one of the benefits of belonging to a professional organization.

8. Which statement about disabilities is true? a. Disability includes sickness. b. Almost everyone will experience disability at some time during life. c. Disabilities are limited to physical impairments. d. Most disabled individuals require assistance with activities of daily living (ADLs).

ANS: B Most men, women, and children of all ages, races, and ethnicities will experience disability at some time during their life. As a person ages, the likelihood of developing a disability increases.

5. An example of a vulnerable group experiencing multiple risk factors is: a. Smokers who use chewing tobacco as well as cigarettes b. Substance abusers who test positive for human immunodeficiency virus (HIV) c. Persons with limited access to care because they live in a rural area d. New mothers needing information about baby and child care

ANS: B Multiple risk factors are present in substance abusers, including contracting HIV and hepatitis B virus. Homelessness is another risk factor.

9. Which ethical principle requires "doing no harm"? a. Respect for autonomy b. Non-maleficence c. Beneficence d. Distributive justice

ANS: B Non-maleficence refers to doing no harm.

23. An outbreak of a gastrointestinal illness from a food-borne pathogen is an example of a(n): a. Attack rate b. Point epidemic c. Secular trend d. Event-related cluster

ANS: B One temporal and spatial pattern of disease distribution is the point epidemic. A point epidemic is most clearly seen when the frequency of cases is plotted against time. The sharp peak characteristic of such graphs indicates a concentration of cases in some short interval of time.

13. Which statement about physically compromised persons who are experiencing poverty is true? a. They are more likely to have access to needed services. b. They are at greater risk for more rapid progression of disease processes. c. Their care is usually better coordinated. d. They require more nursing in-home care than persons not living in poverty.

ANS: B People who are disabled and live in poverty are less likely to have the resources to provide for their own special needs.

10. Which statement fits the Liberal Democratic Theory of John Rawls? a. Rejection of any idea that societies, states, or collectives of any form can be the bearers of rights or can owe duties. b. Inequalities result from birth, natural endowment, and historic circumstances. c. Everyone has a right to private property. d. Government should be limited.

ANS: B Rawls acknowledges that inequities are inevitable in society, but he tries to justify them by establishing a system in which everyone benefits, especially the least advantaged. This is an attempt to address the inequalities that result from birth, natural endowments, and historic circumstances. The other choices relate to libertarianism.

17. The probability an event will occur within a specified period of time is called: a. Rate b. Risk c. Epidemiology d. Epidemic

ANS: B Risk is the probability an event will occur within a specified period of time.

12. Screening for hearing defects is an example of: a. Primary prevention b. Secondary prevention c. Tertiary prevention d. Health promotion

ANS: B Secondary prevention focuses on early detection and prompt treatment of disease, injury, or disability.

29. In which situation does the nurse need to be aware of the potential for selection bias? a. Determining the population to be studied b. Considering how the participants will enter the study c. Studying cause and effect relationships d. Documenting results of the study

ANS: B Selection bias is attributable to the way subjects enter a study. It has to do with selection procedures and the population from which subjects are drawn.

21. An employee who is blind is able to bring a service animal to work because of the provisions included in which legislation? a. The Rehabilitation Act of 1973 b. The Americans with Disabilities Act of 1990 c. The Individuals with Disabilities Education Act of 1975 d. The Developmental Disabilities Act and Bill of Rights Act of 2000

ANS: B Service animals are defined and protected under the Americans with Disabilities Act of 1990. Service animals are working animals that are individually trained to perform tasks for persons with disabilities. This legislation allows service animals to accompany a disabled person into all areas open to the general public.

8. Which health promotion topic would most likely be discussed in a class held at a nursing center? a. Advanced care of the chronically ill elderly at home b. Smoking cessation and weight management techniques c. How to provide primary services d. Providing financial support for nursing students

ANS: B Smoking cessation and weight management techniques focus on health promotion.

18. Which is an example of a social determinant of health? a. Ethnicity b. Income c. Gender d. Marital status

ANS: B Social determinants of health are such factors as economic status, education, environmental factors, nutrition, stress, and prejudice that lead to resource constraints, poor health, and health risk.

11. If a nurse wanted more information on indoor air quality, which website would be most helpful? a. The National Institutes of Health (NIH) b. The American Lung Association c. "Right to Know" d. The Occupational Safety and Health Administration (OSHA)

ANS: B Sources of information about air quality include the Environmental Protection Agency (EPA) and the American Lung Association.

2. The 1986 Immigration Reform and Control Act had what effect on illegal aliens living in the United States? a. Discriminated against individuals from Southern and Eastern Europe b. Allowed illegal aliens already living in the United States to apply for legal status c. Permitted foreign-born populations to set up communities in or around major metropolitan areas d. Allowed illegal aliens access to "green cards" that would allow them to work in the United States

ANS: B The 1986 Immigration Reform and Control Act permitted illegal aliens already living in the United States an opportunity to apply for legal status if they met certain requirements.

7. A public health nurse is compiling information about how to promote early detection of breast cancer in women. Which document would most likely provide useful information about this topic? a. The Future of Public Health b. Healthy People 2020 c. Patient Protection and Affordable Care Act d. Scope and Standards of Public Health Nursing Practice

ANS: B The Healthy People documents propose national strategies to improve significantly the health of Americans by preventing or delaying the onset of major chronic illnesses, injuries, and infectious diseases.

6. The original work of the National Organization for Public Health Nursing has influenced nursing practice today by: a. Requiring that public health nurses have a baccalaureate degree in nursing b. Standardizing public health nursing education c. Developing nursing cooperatives d. Opening the Henry Street Settlement

ANS: B The National Organization for Public Health Nursing sought to standardize public health nursing. The Henry Street Settlement was already in existence. The baccalaureate degree in nursing was not developed yet.

20. If a bioterrorism attack was to occur in the United States, which program would be used to provide large quantities of medication to the American public? a. Cities Readiness Initiative b. Strategic National Stockpile (SNS) c. Public Health Information Network (PHIN) d. Project BioShield

ANS: B The Strategic National Stockpile has the capacity to provide large quantities of medicine and medical supplies to protect the American public in a public health emergency. The Cities Readiness Initiative aids cities in increasing their capacity to deliver medicines and medical supplies during a public health emergency. The Public Health Information Network helps ensure information access and sharing. Project BioShield is a program to develop and produce new drugs and vaccines against potential bioweapons.

6. Which is the correct way to refer to someone with a disability? a. A handicapped person b. A person with an amputation c. An amputee d. A wheelchair-bound afflicted person

ANS: B The correct way to refer to someone with a disability is as a "person with" and not to label the person according to the disability.

3. The differential vulnerability hypothesis refers to the: a. Resistance of certain groups to risk factors b. Increased susceptibility to cumulative risk factors among vulnerable groups c. Variability in the effects of stressors according to socioeconomic status d. Increased sensitivity of the very young and the very old to risk factors

ANS: B The differential vulnerability hypothesis refers to the possession of and/or an increased susceptibility to multiple cumulative risk factors in vulnerable groups.

12. When applying the Minnesota Model of Public Health Interventions: Applications for Public Health Nursing Practice steps of surveillance, what initial action would the nurse take? a. Analyze data. b. Consider whether surveillance as an intervention is appropriate to the situation. c. Evaluate the impact of the surveillance. d. Collect data.

ANS: B The first step in this model considers whether the surveillance was appropriate.

22. The most important predictor of overall mortality is: a. Race b. Age c. Gender d. Income

ANS: B The mortality curve by age drops sharply during and after the first year of life to a low point in childhood, then begins to increase through adolescence and young adulthood and then increases sharply through middle and older ages.

4. Current threats to health in the United States that community health nurses are faced with include: a. Diphtheria, cholera, and hepatitis b. HIV, H1N1 influenza, and bioterrorism c. Avian flu, tuberculosis, and radiation d. Polluted water and air

ANS: B The newest threats to health that public health nurses are involved in are HIV, H1N1 influenza, and bioterrorism. Hepatitis is also a current threat, but diphtheria and cholera are not concerns in the United States. Avian flu may be a threat, but radiation and tuberculosis are ongoing. Environmental pollution has been reduced; however, there are pollution issues that do raise concerns.

21. What is anticipated to happen in the future with disaster management? a. Vague and unorganized future because constant emergence of new disasters b. Increasing sophistication in technology and surveillance c. Lack of involvement by national and state officials d. Decreasing need for public health workers to provide care

ANS: B The terrorist event of September 11, 2001, and the anthrax cases have increased the awareness for the need to plan for disasters. Technology and surveillance will continue to advance.

22. When would it be appropriate for a nurse to use a Geographic Information System (GIS)? a. Recording client data collected at a foot clinic b. Determining neighborhoods that have an increased incidence of lead poisoning c. Evaluating effectiveness of a farm safety program d. Scheduling health promotion programs in the community

ANS: B The use of a Geographic Information System (GIS) allows the public health nurse to apply the principles of epidemiology into practice. GIS allows nurses to code data so that it is related spatially to a place on earth and is helpful in determining concentrated areas for incidence of disease and illness.

2. The use of weapons of mass destruction or natural disasters, such as earthquakes, will often have more casualties because: a. They cause the most widespread destruction. b. Victims have little time to make evacuation preparations. c. Those with chronic conditions cannot escape in time. d. The early warning systems are not effective.

ANS: B The use of weapons of mass destruction or natural disasters, such as earthquakes, will often have more casualties because victims have little time to make evacuation preparations. The other answers are false.

17. Nurses who provided care to people in their homes and provided that care to several people at a time were called _____ nurses. a. Private duty b. Visiting c. Public health d. Community staff

ANS: B The visiting nurse cared for several families in a day and helped to make care of the sick poor at home economical, whereas a private duty nurse may live with a family of clients receiving care and was to be available 24 hours a day.

7. The wide variations in health services and health status between certain population groups are called: a. Priority population groups b. Health disparities c. Disadvantaged populations d. Risk markers

ANS: B The wide variations in health services and health status between certain population groups are called health disparities.

21. Why would a nurse refer to the Code of Ethics for Nurses or the Public Health Code of Ethics? a. To provide answers for ethical dilemmas b. To guide professional practice related to ethics c. To increase moral leadership in ethics d. To find a framework for ethical decision making

ANS: B These codes provide general ethical principles and guide personnel in thinking about the underlying ethics of the profession.

8. A major provision of the Social Security Act of 1935 was the establishment of: a. The Frontier Nursing Service to provide nursing service to rural communities b. State and local community health services and training of personnel c. District nursing to provide home health care to sick people d. Community-based settlement houses

ANS: B Title VI of the Social Security Act provided funding for expanded opportunities for health protection and promotion through education and employment of public health nurses. Nurses completed educational programs in public health and funds were provided to assist states, counties, and medical districts in the establishment and maintenance of adequate health services.

6. A client would like to enroll in a smoking cessation program. Which type of nursing center would be most likely to provide this type of programming? a. Academic Nursing b. Wellness c. Comprehensive Primary Care d. Special Care

ANS: B Wellness centers focus on health promotion, disease prevention, and management programs.

7. An example of an ethical dilemma is: a. Whether or not to set up a community health center in a rural area b. Allocating resources in a natural disaster c. Deciding to withdraw care on a hospice patient d. Applying the principles of Florence Nightingale in Bangladesh

ANS: B When resources are scarce, a dilemma may exist as to how to allocate them.

1. The impact of World War I on public health nursing included (select all that apply): a. Many communicable diseases were eradicated. b. The depletion of the ranks of public health nurses to the war. c. The feeling that the greatest patriotic duty was to stay at home. d. Expanding nursing services in the community was limited by lack of funding.

ANS: B, C, D Both World Wars I and II depleted the public health nurse population as nurses went off to war. The feeling of patriotism extended to the idea that patriotic duty could also be served on the home front.

3. Which are the objectives of a disease investigation? Select all that apply. a. To enhance the knowledge of the nurse working in public health b. To control and prevent disease and death c. To identify factors that contribute to the disease outbreak/even occurrence d. To implement measures to prevent occurrences

ANS: B, C, D Enhancing the knowledge of the nurse working in public health is not an object of an investigation.

2. Nurses incorporate epidemiology into their practice and function in epidemiologic roles through (select all that apply): a. Policy making and enforcement b. Collection, reporting, analysis, and interpretation of data c. Environmental risk communication d. Documentation on patient charts and records

ANS: B, C, D The 2nd, 3rd, and 4th options are examples of the use of epidemiology in practice. The first option does not apply to epidemiology.

1. Which approach(s) can a nurse use when assessing environmental health risks? Select all that apply. a. Ask legislators to provide a list of environmental pollutants in the area. b. Develop a list of exposures associated with urban, rural, or suburban settings. c. Assess the risk by medium such as air, water, soil, or food. d. Divide the environment into functional locations: home, school, workplace, and community.

ANS: B, C, D The 2nd, 3rd, and 4th options are ways a nurse can assess the environment.

1. Which individuals would meet the definition of work disability as defined by the United State Census Bureau? Select all that apply. a. An individual who has resigned from a position because of discrimination b. An individual who has retired or left a job for health reasons c. An individual who did not work because of long-term mental illness d. An individual who did not work in the past 12 months because of illness

ANS: B, C, D Work disability includes a person who has a problem or disability that prevents him or her from working, has a service-connected disability, has retired or left a job for health reasons, did not work because of long-term physical or mental illness, or did not work in the past 12 months because of illness or disability.

1. Epidemiologic studies of diseases conducted by nurses during the twentieth century were influenced by the (select all that apply): a. Increasing rate of poverty b. Declining child mortality rates c. Overcrowding in major cities d. Development of new vaccinations

ANS: B, D Factors contributing to the development and application of epidemiologic methods in the twentieth century were: improved nutrition, new vaccines, better sanitation, the advent of antibiotics and chemotherapies, and declining infant and child mortality and birth rates. A rise in the standard of living occurred for many following the Great Depression and World War II.

2. A nurse will be using an interpreter during a client encounter. What considerations should be made by the nurse? Select all that apply. a. It is appropriate to use family members as interpreters. b. Written materials should be available in the client's primary language. c. Observe the interpreter's gestures to assure client understanding. d. The gender, age, and educational level of the interpreter should be evaluated.

ANS: B, D Family members should be used with caution. The client's gestures and non-verbal messages should be observed to assure understanding. Written materials should be available in the client's primary language. The gender, age, educational level, socioeconomic status, religion, and dialect should all be considered when selecting the proper interpreter.

2. How can a community health nurse apply the Ethical Principles for Effective Advocacy? Select all that apply. a. Act in the health care provider's best interest. b. Keep the client (group, community) properly informed. c. Maintain client confidentiality. d. Carry out instructions with diligence and competence.

ANS: B,C,D Keep the client (group, community) properly informed, maintain client confidentiality, and carry out instructions with diligence and competence are ethical principles for effective advocacy.

25. The type of epidemiologic study that is used to describe a group of persons enrolled in a study who share some characteristic of interest and who are followed over a period of time to observe some health outcome is a(n): a. Case control study b. Cross-sectional study c. Cohort study d. Experimental study

ANS: C A cohort study is the type of epidemiologic study that is used to describe a group of persons enrolled in a study who share some characteristic of interest and who are followed over a period of time to observe some health outcome.

3. Which is an example of a natural disaster? a. Transportation accident b. Pollution c. Communicable disease epidemic d. Fire

ANS: C A communicable disease epidemic would be considered a natural disaster.

20. A college student goes to the Student Health Center with an extremely swollen neck. The advanced practice nurse determines that he has mumps. His roommate also is experiencing malaise and a sore throat. These two students by definition are considered a: a. Mixed outbreak b. Common source c. Point source d. Propagated outbreak

ANS: C A point source outbreak involves all persons exposed becoming ill at the same time, during one incubation period.

27. A nurse is considering joining the American Public Health Association. What information about this organization should be considered when making this decision? a. APHA focuses on the public health concerns of the medical profession. b. APHA represents concerns of nursing specialty practices. c. APHA provides a forum for nurses to discuss their public health concerns. d. APHA focuses on providing health promotion education to the public.

ANS: C APHA was formed to facilitate interprofessional efforts and promote the "practical application of public hygiene." The Public Health Section within APHA provides nurses with a forum to discuss their concerns and strategies. It also serves as a focus of leadership and policy development for community/public health nursing.

15. When using the principles of virtue ethics in decision making, a nurse would: a. Provide efficient and effective nursing care. b. Identify the meaningful facts in the situation. c. Seek ethical community support to enhance character development. d. Plan ways to restructure the social practices that oppress women.

ANS: C According to Aristotle, virtues are acquired and include interest in the concept of the good, including benevolence, compassion, trustworthiness, and integrity. One part of the process is seeking ethical community support to enhance character development.

13. A large amount of data related to hypertension rates is collected in a community. The data is analyzed. What is the next step in the surveillance process? a. Collecting data from multiple valid sources b. Evaluating the impact on the surveillance system c. Interpreting the data and disseminating it to decision makers d. Asking political officials to finance a hypertension clinic

ANS: C After data is collected and analyzed, the findings must be disseminated.

13. What is the first action a nurse should take when assessing persons arriving at a shelter following a disaster? a. Limit the amount of equipment and medications brought into the shelter. b. Determine if the person has a psychological condition requiring special attention. c. Assess whether this type of facility is appropriate for the person. d. Provide medical care for persons as if they were in a hospital.

ANS: C Any person who comes to a special needs shelter must be assessed by a nurse to determine whether this type of facility is appropriate.

18. When the nurse maintains current information about agencies whose services are of potential use to the disabled and directs clients to the resources that can meet their needs, which role is being demonstrated? a. Educator b. Caregiver c. Referral agent d. Advocate

ANS: C As a referral agent, the nurse directs clients to the resources that can meet their needs.

13. A nurse fulfills the environmental health competency of "assessment and referral" when: a. Advocating for public policy changes b. Understanding policy framework and major pieces of legislation c. Completing an environmental health history d. Describing the scientific principles about environmental health

ANS: C Assessment is always an important element of the nursing process. The third option is an example of the assessment phase of the nursing process.

18. Public health administrators in a community provide a health department to serve an indigent population of immigrants providing translators on certain days of the week. This is an example of: a. Policy b. Quality c. Assurance d. Libertarian philosophy

ANS: C Assurance refers to the role of public health in making sure that essential community-oriented health services are available, which may include providing essential personal health services for those who would otherwise not receive them.

21. What action can a nurse take on an individual level to reduce pollution in the environment? a. Provide a tax incentive to factories that do not pollute. b. Make laws related to allowed levels of pollution in the area. c. Choose a less-polluting car. d. Move to an area with less pollution.

ANS: C Citizens can reduce air pollution by doing their part, which can include choosing less-polluting cars.

26. A nurse wants to obtain information on the alternative methods of health care her 45-year-old female client uses. Who is the best person to ask about this? a. The husband of the client b. A community leader of the ethnic group c. The client herself d. The religious leader of the ethnic group

ANS: C Clients provide a rich source of information about their own cultures.

18. The tendency to ignore all differences between cultures and to act as though the differences do not exist is defined as cultural: a. Conflict b. Shock c. Blindness d. Imposition

ANS: C Cultural blindness occurs when people state that everyone is treated the same, regardless of their cultural orientation.

15. When a nurse supports the use of traditional home remedies in conjunction with Western medicine to promote healthy behaviors, the nurse is using cultural: a. Accommodation b. Brokering c. Preservation d. Repatterning

ANS: C Cultural preservation refers to assistive, supportive, facilitative, or enabling nurse actions and decisions that help the clients of a particular culture to retain and preserve traditional values, so they can maintain, promote, and restore health.

22. A nurse resigns from a position in a hospital to accept a job in a community setting. After starting the new job, the nurse feels helpless and confused, wondering if this was the right career choice. This nurse is likely experiencing cultural: a. Conflict b. Relativism c. Shock d. Brokering

ANS: C Culture shock can happen to individuals within their own culture when they are having experiences such as starting a new job or career. Culture shock is brought on by anxiety from losing familiar signs and symbols of social interaction. Feelings associated with culture shock are helplessness, discomfort, and disorientation.

11. What does each state do with the information that it receives about notifiable diseases? a. Keeps its own records for surveillance purposes b. Reports the information to the local branch of the World Health Organization c. Transmits the data electronically, weekly, to the CDC d. Does nothing with the information

ANS: C Data is transmitted weekly to the CDC through the National Electronic Telecommunications System for Surveillance.

5. Epidemiology: a. Is a science that studies the poisonous effects of chemicals b. Explains the association between learning disabilities and exposure to lead-based paint at the cellular level c. Helps nurses understand the strength of the association between exposure and health effects d. Is a method for tracking the prevalence of a disease

ANS: C Epidemiology studies the incidence and prevalence of disease, helping nurses understand the strength of the association between exposure and health effects.

21. In which situation would a nurse be using the Health Insurance Portability and Accountability Act (HIPAA)? a. When counseling an employee that his insurance will remain the same after changing jobs b. When supervising staff to ensure that all work has been completed c. When adhering to client confidentiality when providing care d. When an employee takes additional time off of work to care for a sick family member

ANS: C HIPAA also states that staff must monitor and keep client records secure, and have mechanisms to transfer client information securely and appropriately.

7. A nurse executive reports that the nursing center receives reimbursement through contracted rates. What type of reimbursement mechanism is being used? a. Fee-for-service b. Federally Qualified Health Center (FQHC) c. HMO provider d. Third-party reimbursement

ANS: C HMO providers pay at contracted rates.

19. A nurse caring for a homeless population recognizes that those who are homeless: a. Need more nursing care than other vulnerable groups b. Have no desire to seek medical care c. Have even fewer resources than poor people who have adequate housing d. Are living in despair with no hope or resilience

ANS: C Homeless and marginally housed people must struggle with heavy demands as they try to manage daily life because their resources are limited.

1. What occurs during biological terrorism? a. The intentional release of hazardous chemicals into the environment b. Environmental and occupational exposure to biological toxins c. Immunity to toxins related to repeated exposures d. An intentional release of viruses, bacteria, or their toxins

ANS: D An intentional release of viruses, bacteria, or their toxins would be described as biological terrorism.

5. Why would a hospital use surveillance? a. To protect the public against isolated patients b. To eliminate pathogens from the environment c. To improve quality of care and outcomes d. To decrease the incidence of ventilator-acquired pneumonia

ANS: C Hospital surveillance is used to improve quality of care and outcomes. An example is an infection that occurs in patients who had procedures at that facility. Reduction of the incidence of ventilator-acquired pneumonia is one reason why a hospital uses surveillance, but it does not address the entire issue.

4. Which statement about race is true? a. In the United States, children of biracial parents are usually assigned the race of the father. b. Ethnicity and race are synonymous terms. c. Individuals may be of the same race but of different cultures. d. No social significance is usually placed on race.

ANS: C It is often a misconception that persons of the same race have the same culture. For example, African Americans may have been born in Africa, the Caribbean, North America, or elsewhere and have very different cultures.

10. When studying chronic disease, the multifactorial etiology of illness is considered. What does this imply? a. Genetics and molecular structure of disease is paramount. b. Single organisms that cause a disease, such as cholera, must be studied in more detail. c. Focus should be on the factors or combinations and levels of factors contributing to disease. d. The recent rise in infectious disease is the main focus.

ANS: C Multifactorial etiology implies a focus on combinations and levels of factors.

22. Which nursing action demonstrates advocacy? a. Offering a smoking cessation program b. Screening for hypertension c. Lobbying for health care reform d. Conducting home visits

ANS: C Nurses should participate in implementing new directions for health care and help envision these new directions. Nurses can be an important voice in advocating for access to consistent, effective, efficient health care for all.

10. How can a nursing center best be responsive to the needs of the community? a. Having staff examine the needs of the community b. Determining the services to be established by the center c. Involving the community in assessing its own needs d. Addressing the problems in the community

ANS: C Nurses work in close partnership with the communities. As the community and center work together, a multilevel approach is needed. For comprehensive community health improvement, strategies are needed at organizational, community, and sociopolitical levels. Thus, it is important to involve the community in the planning of a nursing center.

6. There are two medically indigent clients in the clinic who have come to get their monthly supply of free insulin. There is only enough for one client. Which action does the nurse take first? a. Identify all options. b. Make a decision. c. Gather additional information. d. Act and assess decisions made.

ANS: C One must have all information before looking at options and making a decision.

7. A nurse is using surveillance to collect outcome data. What information would most likely be collected? a. Number of clinic services which use evidence-based protocols b. Proportion of the population vaccinated against influenza c. Incidence of breast cancer in the population d. Probability of a bioterrorism attach occurring in the community

ANS: C Outcome data focus on change in health status; incidence rates are one example of this type of information.

10. A nurse operates a school-based clinic in a local school, making it easier for children to access health care. This is an example of: a. Case finding b. Wrap-around services c. Outreach d. Comprehensive services

ANS: C Outreach is an approach to making health care more readily available to certain populations.

17. A nurse is addressing the problem of air pollution in the community. The first step in the process of controlling the pollution would be: a. Setting standards b. Monitoring c. Permitting d. Compliance

ANS: C Permitting is a process by which the government places limits on the amount of pollution emitted into the air or water.

15. A client is self-employed as a mechanic and has limited health insurance coverage. This client is considered: a. Poor b. Near poor c. Medically indigent d. Uninsured

ANS: C Persons who are self-employed but have inadequate health insurance are considered medically indigent.

15. A nurse implements a health promotion education programs for physically compromised adults. What is the most important reason to provide programming for this population? a. Health promotion interventions are similar among those with disabilities. b. Establishment of health-promoting behaviors is difficult. c. Information and counseling is needed to prevent other health problems. d. Community resources can be accessed through these presentations.

ANS: C Physically compromised clients need information and counseling for health-promoting behaviors and for prevention of the progression of a condition or pathology. Primary prevention is the most important strategy so that other conditions do not occur.

27. The proportion of persons with positive test results who actually have a disease, interpreted as the probability that an individual with a positive test result has the disease, is the: a. Sensitivity b. Specificity c. Positive predictive value d. Negative predictive value

ANS: C Positive predictive value refers to the proportion of persons with positive test results who actually have the disease, interpreted as the probability that an individual with a positive test result has the disease.

14. An example of primary prevention is: a. Pap smear b. Blood pressure screening c. Diet and exercise d. Physical therapy

ANS: C Primary prevention refers to those interventions aimed at preventing the occurrence of disease, injury, or disability.

4. Which is an example of a priority population group? a. People earning more than $100,000/year b. People earning less than $100,000/year c. Residents of remote rural areas of Canada d. African American physicians

ANS: C Priority population groups are those targeted by national governments for special emphasis in health care goals because they have particularly poor health status.

16. A nurse implements nursing interventions considering the uniqueness of the person's culture. The practice is called cultural: a. Diversity b. Knowledge c. Competence d. Awareness

ANS: C Providing care based on the uniqueness of the client's cultural norms and values is one of the four guiding principles of culturally competent nursing care.

12. A nurse is developing a one-stop service to meet the needs of a vulnerable group. Which is an example of this type of service? a. Wrap-around services where mental services are linked b. Giving all immunizations on a single clinic visit c. Providing multiple services during a single clinic visit d. Providing free services to the medically indigent

ANS: C Providing multiple services during a single clinic visit makes services more responsive to the combined effects of social and economic stressors.

5. A person's skin color is an example of: a. Multiculturalism b. Ethnicity c. Race d. Culture

ANS: C Race is primarily a social classification that relies on physical markers.

19. Segregation is an example of: a. Prejudice b. Cultural imposition c. Racism d. Stereotyping

ANS: C Racism is a form of prejudice that occurs through the exercise of power by individuals and institutions against people who are judged to be inferior in, for example, intelligence, morals, beauty, and self-worth.

7. A 35-year-old man from Russia comes to the United States seeking asylum because of religious persecution in his native country. This type of immigrant is known as a(n): a. Legal immigrant b. Lawful permanent resident c. Refugee d. Unauthorized immigrant

ANS: C Refugees are people who seek protection in the United States because of fear of persecution in their homeland.

14. Which level of prevention is being used when a community conducts blood lead screenings on a regular basis for children under 6 years old? a. Tertiary prevention b. Primary prevention c. Secondary prevention d. Health education

ANS: C Secondary prevention often involves screening. Primary prevention involves education.

23. How can nurses promote social justice? a. By contacting lawmakers about environmental health issues b. By assisting at homeless shelters c. By advocating for policies to improve social conditions d. By serving on a local coalition to prevent obesity

ANS: C Social justice refers to providing equitable care and social supports for the most disadvantaged members of society. Nurses can function as advocates for policy changes to improve social, economic, and environmental factors that predispose vulnerable populations to poor health.

27. Hispanics tend to believe that the needs of the family take priority over those of the individual. This is an example of cultural variations of: a. Communication b. Space c. Social organization d. Environmental control

ANS: C Social organization refers to the way in which a cultural group structures itself around the family to carry out role functions.

28. A nurse is told that a screening test has high specificity. This means that the test: a. Provides precise and consistent readings b. Accurately identifies those with the condition or trait c. Accurately identifies those without the trait d. Has a high level of false positives

ANS: C Specificity refers to the test accurately identifying those without the trait.

9. Individuals, families, groups, organizations, policy makers, and staff who are involved in community collaboration are known as: a. Nursing Center workers b. Policy makers c. Stakeholders d. Diversity

ANS: C Stakeholders offer diversity in perspective in community collaborative efforts.

15. Which term addresses the multiple levels of intervention required for bringing about and sustaining change? a. Community collaboration b. Community assessment c. Strategic planning d. Partnership

ANS: C Strategic planning addresses the multiple levels of intervention required for bringing about and sustaining change.

24. What is an appropriate role for a nursing student to engage in while working in a nursing center? a. Leader b. Follower c. Advocate d. Researcher

ANS: C Students most often play the role of advocate in a nursing center. Students have the opportunity to promote social justice while engaging in community service learning activities with underserved, vulnerable populations. A student needs to be a leader, but with supervision. A student can collect data, but is not yet a researcher.

13. Vocational rehabilitation of a person with a neuromuscular disease is an example of: a. Primary prevention b. Secondary prevention c. Tertiary prevention d. Health promotion

ANS: C Tertiary prevention includes those interventions aimed at disability limitation and rehabilitation from disease, injury, or disability.

22. A nurse works with a group of abused women to enhance their levels of self-esteem. Which level of prevention is being performed? a. Primary level of prevention b. Secondary level of prevention c. Tertiary level of prevention d. Health promotion

ANS: C Tertiary prevention includes those interventions aimed at disability limitation and rehabilitation from disease, injury, or disability.

15. Which environmental law sets basic structure for regulating pollutants to United States waters? a. Safe Drinking Water Act b. Toxic Substance Control Act c. Clean Water Act d. Pollution Prevention Act

ANS: C The Clean Water Act sets basic structure for regulating pollutants to United States waters.

26. Which client would have been most likely to receive care from the Frontier Nursing Service? a. An injured soldier b. A homebound, elderly male c. A woman in labor d. A child with measles

ANS: C The Frontier Nursing Service nurses were trained in nursing public health and midwifery and provided care to rural and inaccessible areas, which led to reduced mortality.

17. What is the purpose of the National Response Framework? a. Create a new branch of government that deals with bioterrorism. b. Establish a way for the Red Cross to carry out its mission. c. Develop a nationwide all-hazards approach to domestic incident management. d. Extend presidential power to act quickly upon weapons of mass destruction.

ANS: C The National Response Framework is a unified, all-discipline, all-hazards approach to domestic incident management. It is built upon scalable, flexible, and adaptable coordinating structures to align key roles and responsibilities linking all levels of government and organizations.

3. The Elizabethan Poor Law of 1601 is similar to which current law? a. Welfare b. Food Stamps c. Medicaid d. Medicare

ANS: C The Poor Law guaranteed medical care for poor, blind, and "lame" individuals, similar to Medicaid.

13. A nurse demonstrates cultural desire to provide culturally competent care by: a. Relying on a textbook for information about an ethnic group b. Bringing a translator to the local community clinic c. Taking Spanish classes in the evening at a local college d. Judging others using his or her own cultural values

ANS: C The activity that suits the definition of cultural desire is one that a nurse would want to do instead of being directed to do so, referring to the intrinsic motivation of the nurse.

8. Which example contains the components necessary to form an epidemiologic triangle? a. Pesticides, water, food b. Lead, mercury, soil c. Trichloroethylene, water, infants d. Children under 12, elderly, temperature

ANS: C The epidemiologic triangle consists of an agent (chemical), host (community consisting of several variants), and environment (air, water, soil, etc.).

20. Which question would a nurse ask during the first phase of a risk assessment? a. Has the chemical been released into the environment? b. How much and by which route of entry can the chemical enter the body? c. Is the chemical known to be associated with a negative health effect? d. What is the prediction for potential harm?

ANS: C The first phase is determining if a chemical is known to be associated with negative health effects (in animals or humans).

7. What is the most common disability occurring in the United States in persons aged 18 years and older? a. Diabetes b. Stroke c. Arthritis d. Cancer

ANS: C The most common disability found in the United States in persons aged 18 years and over is arthritis.

8. Public health professionals refer to three levels of prevention as tied to specific stages in the: a. Epidemiologic triangle b. Web of causation c. Natural history of disease d. Surveillance process

ANS: C The natural history of disease is the course of the disease process from onset to resolution. The three levels of prevention provide a framework commonly used in public health practice to depict this process.

8. The steps of the ethical decision making process are similar to the steps of: a. Healthy People 2010 b. Deontology c. The nursing process d. Advocacy

ANS: C The nursing process involves the same basic steps: assessment, diagnosis, planning, implementation, and evaluation.

5. A colonist working in the public health sector in early colonial North America would likely have focused on: a. Establishing schools of nursing b. Developing vaccines to administer to large numbers of people c. Collecting vital statistics and improving sanitation d. Developing public housing and almshouses

ANS: C The other choices are events that happened after the colonial period.

8. What is the primary cause of vulnerability? a. Race b. Age c. Poverty d. Illness

ANS: C The primary cause of vulnerability is poverty.

2. Which type of nursing center operates under a service model? a. Free-standing center b. Affiliated center c. Comprehensive primary care center d. Community center

ANS: C The service model includes comprehensive primary care centers, wellness centers, and special care centers.

26. Voters have recently decided to have fluoride added to the city water system. Epidemiologists wanting to study the effect of fluoride on dental caries would be conducting a(n): a. Ecological study b. Double-blind study c. Community trial d. Screening

ANS: C This is similar to clinical trials, but the issue is often health promotion and disease prevention rather than treatment of existing disease.

22. The document, Visiting Nurses in the United States, highlighted the fact that: a. Nurses were trained by Boards of Education. b. Trained nurses adequately covered less densely populated areas. c. Visiting nurse services were concentrated in the northeastern United States. d. Nurses were curing diseases such as tuberculosis and typhoid fever.

ANS: C This report emphasized the fact that visiting nurse services were concentrated in the northeast, which underscored the need for rural health.

16. Employees working with hazardous chemicals have the "right to know" about the chemicals they are working with through the creation of the: a. Material Safety Data Sheet b. Consumer Confidence Report c. Hazard Communication Standard d. Environmental Protection Agency

ANS: C This standard requires employers to maintain a list of all hazardous chemicals that are used on site.

14. The greatest single source of air pollution in the United States is from: a. Waste incineration b. Power plants c. Motor vehicles d. Molds

ANS: C Waste incineration and power plants are major contributors after motor vehicles. Molds contribute to poor indoor air quality.

20. The nurse organizes developmental vision and hearing screening of young children to identify those with disabilities. The nurse is performing which role? a. Caregiver b. Coordinator c. Collaborator d. Case finder

ANS: D A nurse as a case finder identifies individuals with disabilities who need services.

19. Which essential step of program evaluation is completed when a nurse executive publishes information about the effectiveness of a prenatal program? a. Focusing on design b. Engaging stakeholders c. Ensuring use and sharing lessons learned d. Gathering credible evidence

ANS: D A nurse executive providing materials on the effectiveness of a prenatal program is an example of gathering credible evidence.

1. Which type of nursing center actively integrates service, education, and research in its model? a. Special care b. Freestanding organization c. Fee-for-service d. Academic

ANS: D Academic nursing centers actively integrate service, education, and research in their model.

12. Which factor is the most important for the nurse to consider when facilitating successful collaboration? a. Focus of the group b. Planned change that will occur c. Decisions made by executive director d. Open and frequent communication

ANS: D Although the focus of the group and its planned change are important, they are not the most important factor for the nurse to consider. To accomplish anything with the group open and frequent communication is necessary.

18. An acceptable level of emissions or a maximum contaminant level allowed is an example of which environmental protection strategy? a. Controlling pollution b. Waste minimization c. Land use planning d. Environmental standard

ANS: D An example of an environmental standard is an acceptable level of emissions or a maximum contaminant level allowed.

9. An example of community preparedness for a disaster is: a. Assembling emergency supplies b. Understanding the workplace disaster plan c. Taking a disaster training course d. Developing an evacuation plan to remove individuals from danger

ANS: D Assembling emergency supplies is an example of individual preparedness. Understanding the workplace disaster plan is an example of preparedness in the workplace within the community. Taking a disaster training course is an example of professional preparedness.

20. An example of an attack rate is the: a. Number of cases of cancer recorded at a medical center b. Number of people who died of cholera in India in a given year c. Number of beef cattle inoculated against mad-cow disease on a farm d. Proportion of people becoming ill after eating at a fast-food restaurant

ANS: D Attack rates are often specific to exposures, such as food-specific attack rates.

20. Which demonstrates the removal of a barrier to health care? a. Discrimination against certain groups b. Treatment of pets at the same facility c. Provision of free food at a food bank d. Providing services for a rural population by using a mobile clinic

ANS: D Barriers to access are policies and financial, geographic, or cultural features of health care that make services difficult to obtain or so unappealing that people do not want to seek care. Examples of removing barriers include providing extended clinic hours, low-cost or free health services for people who are uninsured or underinsured, transportation, mobile vans, and professional interpreters which can help improve access to care.

2. When nurses apply the knowledge and processes of ethics to the examination of ethical problems in health care, they are using: a. Values b. Morality c. Ethics d. Bioethics

ANS: D Bioethics applies the knowledge and processes of ethics to the examination of ethical problems in health care.

5. The growing multiculturalism of American society can contribute to ethnicity conflicts when: a. Cultural standards are congruent with professional standards. b. Cultural traditions within an ethnic group align with those of the community. c. Ethnic groups overburden the health care system. d. The greater community's values are jeopardized by specific ethnic values.

ANS: D Callahan offered perspectives on judging diversity and suggests a thoughtful tolerance and some degree of moral persuasion (not coercion) for ethnic groups to alter values so that they are more in keeping with what is normative in American culture.

14. When working with low-income disabled families who have young children, the nurse recognizes that the children who are at greatest risk for abuse have: a. Physical disabilities b. Developmental delays c. Mental retardation d. Cognitive disabilities

ANS: D Children with cognitive disabilities under the age of six and from low-income families are at the highest risk for abuse or neglect. Children who have developmental delays, mental retardation, or physical disabilities are not at increased risk.

1. The factors, exposures, characteristics, and behaviors that determine patterns of disease are described using: a. Descriptive epidemiology b. Analytic epidemiology c. Distribution d. Determinants

ANS: D Determinants may be individual, relational, social, communal, or environmental.

2. Developmental disabilities, which continue throughout a person's lifetime, start before which age? a. 7 b. 12 c. 17 d. 22

ANS: D Developmental disabilities start before age 22.

4. A client has a developmental disability. The nurse would anticipate limited functioning in which areas? a. Dependent living, education, and finances b. Race, gender, and ethnicity c. Care giving, dependence, and limitation d. Self-help, language, and learning

ANS: D Disabilities limit functioning in at least three of seven areas, including self-help, language, learning, mobility, self-direction, independent living, and economic self-sufficiency.

10. What would most likely occur during the preparedness stage of disaster management? a. Heightened inspection and increased security in the community b. Incorporation of provision of pets into local disaster plans c. Purchase of personal protective equipment for all citizens d. Assembly of disaster kits for the home, workplace, and car

ANS: D Disaster kit assembly for the home, workplace, and car, especially by nurses occurs during the preparedness phase. The other answers are false or describe the other stages.

14. What information is included in a case definition? a. The precise point of contact b. Laboratory confirmation c. Source of contamination d. Clinical symptoms

ANS: D Each case has a unique set of criteria based on what is known about the particular disease. It may include clinical symptoms, laboratory values, and epidemiologic criteria.

21. When comparing the practices of industrial and occupational health nurses, it is noted that: a. Industrial nurses invented new machines to streamline production of medical goods, whereas occupational health nurses provide care to employees. b. Industrial nurses investigated industrial injuries to improve work conditions, whereas occupational health nurses demonstrate proper body mechanics. c. Industrial nurses treated work related-injuries, whereas occupational health nurses care for families in their homes. d. Industrial nurses provided care for workers in their homes, whereas occupational health nurses care for work-related injuries.

ANS: D Early occupational health nursing did not provide care for work-related injuries, but instead focused on the care of employees and their families in the home. Contemporary occupational health nurses provide care for work-related injuries.

29. Asians may perceive illness as disharmony with other forces and that medicine is only able to relieve the symptoms rather than cure the disease. They may look to naturalistic solutions and acupuncture to resolve or cure health problems. This is an example of cultural variations of: a. Communication b. Space c. Social organization d. Environmental control

ANS: D Environmental control refers to the ability of individuals to control nature and to influence factors in the environment that affect them.

19. An inspection of a facility after a permit is obtained for the purpose of observing whether the plans submitted in the permit application are being implemented as approved is an example of which environmental protection strategy? a. Controlling pollution b. Waste minimization c. Land use planning d. Environmental monitoring

ANS: D Environmental monitoring would be an inspection of a facility after a permit is obtained to observe whether the plans submitted in the permit application are being implemented as approved.

12. Which statement about feminist ethics is correct? a. Feminists include only women in their worldview. b. Persons who ascribe to feminist ethics are passive and wish to pursue their ideals through the legislative process. c. Feminists believe that men should not be nurses. d. Women's thinking and moral experiences are important and should be taken into account.

ANS: D Feminist theory ascribes to the idea that women's thinking and moral experiences are important and should be considered.

10. A neighborhood health center is researching its origins. Which of the legislative acts most likely provided funds for its development? a. Emergency Maternity and Infant Care Act of 1943 b. Medicaid legislation c. Social Security Act of 1935 d. Economic Opportunity Act

ANS: D Funding for neighborhood health centers, Head Start, and other community action programs began in 1964 with the Economic Opportunity Act.

16. How does Healthy People 2020 address persons with disabilities? a. Suggests specific therapies and techniques for working with this population b. Recognizes disabled individuals as productive citizens c. Recommends the development of community health centers d. Emphasizes increased access to services for this population

ANS: D Healthy People 2020 has a greater emphasis on increasing access to services that can increase independence and foster community living.

12. An example of a cultural encounter is: a. Sharing significant assessment findings with members of a racial minority b. Visiting the native land of the clients served at a community health center c. Telephoning the priest at a Latino church to discuss the health issues of a client d. Learning about traditional healing practices from an American Indian client

ANS: D Learning about traditional healing practices is an example of a direct cultural encounter. This occurs when a nurse engages in cross-cultural interactions.

14. Lillian Wald's major contribution to public health nursing was: a. Founding the American Nurses Association b. Developing the New York Training Hospital for Nurses c. Creating the Public Health Service d. Establishing the Henry Street Settlement

ANS: D Lillian Wald established the Henry Street Settlement.

3. How have nurses historically learned to identify a possible relationship between environmental chemical exposures and their potential harm? a. Extrapolation by toxicologists b. Biomonitoring c. Completing chemistry courses d. Observing signs and symptoms in clients

ANS: D Nurses have historically made discoveries related to chemical exposure when people presented with signs and symptoms related to known chemical toxicity. The first two options are modern methods.

21. Which would be considered a serious epidemic of influenza? a. 50 cases b. 100 cases c. 500 cases d. Unable to determine

ANS: D One cannot tell the degree of seriousness without a denominator, which represents the total population.

6. A community coalition monitors the increasing obesity rate of children in their schools. Based on this data, they consider a variety of programming options which may possibly help decrease this trend. What was the purpose of conducting this surveillance? a. Protect the children from diseases that affect obese children. b. Teach parents that obesity will not be tolerated in this community. c. Educate children on surveillance techniques. d. Demonstrate that new clinical and effective protocols need to be developed.

ANS: D Ongoing surveillance in a community can lead to new clinical and effective protocols to address an issue.

11. What task would have been a responsibility of a nurse who was employed by the Marine Hospital Service? a. Setting policy on quarantine legislation for immigrants b. Establishing hospital-based programs to care for the sick at home c. Identifying and improving environmental conditions d. Providing health care for merchant seamen

ANS: D Providing health care to seamen was an early effort by the federal government to improve public health. The purpose of the Marine Hospital Service was to secure its maritime trade and seacoast cities.

20. Which statement is discussed in the Code of Ethics for Nurses with Interpretive Statements? a. The profession of nursing is responsible for making political statements and supporting nurse-friendly candidates for office. b. The nurse's primary focus is on acute bedside nursing, followed by community health care to promote seamless care. c. The nurse owes duty primarily to the physician to strive to protect health, safety, and the rights of the patient. d. The profession of nursing is responsible for articulating nursing values, for maintaining the integrity of the profession, and for shaping social policy.

ANS: D Provision 9 of the Code of Ethics for Nurses with Interpretive Statements discusses the need for the nursing profession to address national and global health concerns as well as be involved with shaping policies through political action.

9. Public health nurses are involved in health care reform because reform should: a. Promote the nursing profession. b. Increase funding for public health nursing. c. Address the concerns of nurses. d. Improve health care access and reduce health care costs.

ANS: D Public health nurses have been involved in health care reform for several years. An emphasis of reform is that health promotion and disease prevention appear to yield reduction in costs and illness/injury incidence while increasing years of healthy life.

19. Following a disaster, what is the priority of the disaster response? a. Clean up the environment. b. Handle the stress reaction of the victims. c. Bring in as many aid workers and nurses as possible. d. Reestablish sanitary barriers and focus on basic needs.

ANS: D Reestablishing sanitary barriers and focusing on water, food, waste disposal, vector control, shelter, and safety are the first goals.

25. A nurse is presenting information to community members about the potential development of a retail care clinic in the neighborhood. What information would the nurse include in this presentation? a. These clinics are typically staffed by physicians. b. These clinics are usually located in community centers. c. These clinics focus on providing information related to health promotion. d. These clinics are many times owned by for-profit organizations.

ANS: D Retail care clinics are typically staffed by nurse practitioners, located in a high volume retail business, and provide a limited scope of care including immunizations, routine school physicals, and care for common acute problems. The majority of retail clinics are owned by for-profit organizations and its management does not consider the clinics as nurse-managed health centers.

7. A public health nurse is organizing a multidisciplinary team to address the issue of water pollution in the community. The most likely members that would be invited to address this issue would be: a. Physicians, water sanitation workers, and occupational therapists b. Pharmacologists, radiologists, and epidemiologists c. Nurse practitioners, pharmacologists, and environmentalists d. Geologists, meteorologists, and chemists

ANS: D Scientists who study how pollutants travel in air, water, and soil are geologists, meteorologists, and chemists.

15. An example of secondary prevention is: a. Rehabilitation b. Avoidance of high-risk behaviors c. Immunization d. Mammogram

ANS: D Secondary prevention focuses on early detection and prompt treatment of disease, injury, or disability.

28. A nursing student during World War II would likely join which group? a. The Public Health Service of New York City b. The Marine Nurse Corps c. The Frontier Nursing Service d. The Cadet Nurse Corps

ANS: D The Bolton Act of 1943 established the Cadet Nurse Corps during World War II, which increased enrollment in schools of nursing at undergraduate and graduate levels.

18. Which organization would a nurse collaborate with when developing and coordinating an emergency response plan for a community? a. American Red Cross (ARC) b. Stress Management in Disaster Program (SMID) c. Centers for Disease Control and Prevention (CDC) d. Emergency Management Agency (EMA)

ANS: D The EMA is responsible for developing and coordinating emergency response plans in a defined area.

7. The interaction between an agent, a host, and the environment is called: a. Natural history of disease b. Risk c. Web of causality d. The epidemiologic triangle

ANS: D The epidemiologic triangle consists of the interaction between an agent, a host, and the environment.

23. A nurse executive is managing a nursing center. What would be an expected responsibility of a nurse in this role? a. Managing the business operations b. Managing the data systems c. Providing patient care and referral d. Overseeing contracts and grants

ANS: D The nurse executive has many leadership roles and responsibilities including responsibility for overseeing contracts and grants, annual reports, development of the advisory board, and hiring and retention of highly qualified staff.

19. Which source would a nurse use to collect morbidity data? a. Vital statistics reports b. Birth records c. Death certificates d. Specialized disease registries

ANS: D There are many sources of morbidity data (rate of disease incidence). The other three options do not provide morbidity data.

24. Which is the most appropriate action for a nurse when planning and implementing care for vulnerable populations? a. Setting up multiple clinics in a wide geographic area b. Advising legal consultants on a variety of issues c. Making laws to protect the homeless d. Teaching vulnerable individuals strategies to prevent illness and promote health

ANS: D These are some of the multiple roles nurses perform with vulnerable populations.

23. A client comes into the clinic and tells the nurse he goes to an acupuncturist for pain. The nurse says he should take pain medication instead. This would be called cultural: a. Conflict b. Blindness c. Relativism d. Imposition

ANS: D This is an example of cultural imposition—the act of imposing one's cultural beliefs, values, and practices on individuals from another culture.

28. In the Vietnamese culture, individuals may focus on wishes and memories of their ancestors and look to them to provide direction for current situations. This is an example of cultural variations of: a. Communication b. Space c. Social organization d. Time

ANS: D This is the duration or period between successive events, where some cultures assign greater or lesser emphasis to events that occur in the past, present, or future.

21. A nurse is investigating a potential bioterrorism attack. What evidence would a nurse most likely find if a bioterrorism attack occurred? a. A large number of cases of influenza b. A case of cholera in a local politician following a trip to India c. Dengue fever in a group of students who just returned from a mission trip d. An unusual illness in a population

ANS: D Unusual illness in a population should trigger an investigation.

6. In which situation would a nurse experience vicarious traumatization? a. When sustaining an injury during the disaster b. When exhausted and unable to adjust to the pace at home c. When frustrated about the response time during the disaster d. When listening to survivors' stories about traumatic events

ANS: D Vicarious traumatization can be a response to listening to survivors' stories about traumatic events. Mental health workers need to assist nurses as well as the public.

6. A 17-year-old pregnant cocaine addict who is homeless is considered: a. At risk b. A special population c. A Healthy People 2020 target group d. A vulnerable individual

ANS: D Vulnerable individuals often have multiple risk factors.