Community Health Final

The community health nurse understands that events such as divorce, remarriage, or separation of parents have the potential to affect the family and individuals within the family. This demonstrates the nurse's understanding of which family theory? a. Structure-function family theory b. Family systems theory c. Family communication theory d. Developmental theory

. Developmental theory

It has been estimated that individual behaviors and environmental factors are responsible for what percentage of all premature deaths in the United States? a. 20% b. 40% c. 50%

50%

A goal set by Healthy People 2020 includes education to middle, junior, and senior high school students in priority areas. These areas include (Select all that apply.) a. lack of physical activity. b. poor nutrition. c. alcohol and drug use. d. poor organizational skills. e. injury and violence.

A goal set by Healthy People 2020 includes education to middle, junior, and senior high school students in priority areas. These areas include (Select all that apply.) a. lack of physical activity. b. poor nutrition. c. alcohol and drug use. e. injury and violence.

Which of the following theories is based on the assumption that individual needs and related activities are the focus of nursing care? A. Orem's self-care deficit theory B. The health belief model C. Milio's framework D. Critical social theory

A. Orem's self-care deficit theory

A microscopic approach to the community health problem of childhood obesity would focus on: A. asking an obese child and his or her parent(s) to complete a 24-hour food diary. B. analyzing aggregate Body Mass Indexes (BMIs) of school-age children in a school. C. advocating for a change in health policy related to school lunches. D. exploring changing cultural changes and societal values related to activity.

A. asking an obese child and his or her parent(s) to complete a 24-hour food diary.

Using theory to guide community health nursing practice serves to: (Select all that apply.) A. guide data collection and interpretation in a clear and organized manner. B. provide uniformity in community health nursing practice. C. improve community health nursing practice. D. validate traditional community health nursing beliefs. E. focus the student on factors that are critical to understanding the situation.

A. guide data collection and interpretation in a clear and organized manner. C. improve community health nursing practice. E. focus the student on factors that are critical to understanding the situation.

The composition of the family is an example of a. internal structure. b. external structure. c. subsystem. d. large system.

A. internal structure

Based on the Department of Housing and Urban Development (HUD) definitions of homelessness, which individual would be considered homeless? a. An individual whose residence lacks access to public water and electricity Incorrect b. An individual who has a permanent nighttime residence in the housing for mentally ill people c. An individual imprisoned or detained under an act of Congress or state law d. An individual who spends most nights at public or private places not designed for regular sleeping accommodations

An individual who spends most nights at public or private places not designed for regular sleeping accommodations

The use of theory in population-focused community health nursing encourages which of the following? (Select all that apply.) A. A reactive approach to care B. A proactive approach to care C. Development of population-focused programs D. Development of individual-focused health protocols for community use

B. A proactive approach to care C. Development of population-focused programs

A major limitation of the health belief model is that the burden of action related to health behaviors is exclusively on the aggregate. A. True B. False

B. False

In which historical age would people have had an increased risk for contracting salmonella, anthrax, Q fever, or tuberculosis from the proximity of domesticated animals and herds? A. Hunting and gathering stage B. Settled village stage C. Preindustrial cities stage D. Industrial cities stage

B. Settled village stage

A community health nurse explores a group of teenagers' beliefs about the seriousness of eating disorders and their related susceptibility. The nurse is applying principles from which theory? A. Orem's self-care deficit theory B. The health belief model C. Milio's framework D. Critical social theory

B. The health belief model

Receiving immunizations, regular health screenings, and physical exams is an example of: A. health promotion. B. health protection. C. secondary prevention. D. health maintenance.

B. health protection.

Which of the following nurse leaders formulated the first theory-based conceptual model for nursing care? A. Nancy Milio Incorrect B. Lillian Wald C. Florence Nightingale D. Dorthea Orem

C. Florence Nightingale

Which statement is not true about the "thinking upstream" model of community health nursing practice? A. It is a conceptual model to assist the nurse in community health planning. B. It helps to focus the time, energy, and programmatic resources available to community health nursing clients. C. It focuses the nurse on short-term, individual-based nursing interventions. D. It focuses the nurse on long-term, "bigger picture" issues related to community health practice, such as social justice or power.

C. It focuses the nurse on short-term, individual-based nursing interventions

The belief that health deficits result from an imbalance between the population's health needs and its health-sustaining resources is the premise of which theory? A. Orem's self-care deficit theory B. The health belief model C. Milio's framework D. Critical social theory

C. Milio's framework

Services provided in the private subsystem include all except: a. health promotion. b. disease prevention. c. heath care regulation. d. treatment of disease

C. health care regulation

The home health care industry has changed significantly in the past 20 years. Which is a factor that is responsible for the change in the home health care industry? a. Failure of traditional home health services to change to meet the needs of clients with new needs such as AIDS patients, terminally ill patients, and increasing numbers of elderly b. Advanced technology that resulted in new procedures and equipment not possible for use in the home Incorrect c. Changes in reimbursement that resulted from the implementation of the prospective payment system (PPS) for home health care, particularly for Medicare patients

Changes in reimbursement that resulted from the implementation of the prospective payment system (PPS) for home health care, particularly for Medicare patients

The home health care nurse is measuring the quality of the home health care patient's outcomes. Which elements are included when measuring structural outcomes? (Select all that apply.) a. Client b. Family c. Health status d. Health team e. Intervention

Client Family health team

Based on the common illnesses and risky health behaviors among farmers, the community health nurse should implement which health promotion activity? a. Partner with the local health department to offer smoking cessation classes for farmers and their spouses. b. Collaborate with health care providers and provide support and education for farmers with respiratory conditions and their families. c. Collaborate with health care providers to conduct skin assessments at a meeting of local farmers. d. Work with mental health consultations to outline a community-based program to address the high rate of suicide and depression among farmers. e. Plan, implement, and evaluate an outreach program designed to improve the cardiovascular status of farmers and their families.

Collaborate with health care providers and provide support and education for farmers with respiratory conditions and their families.

Which nursing intervention is the most appropriate as an initial intervention for a prison inmate? a. Manage a chronic illness through needed education. b. Administer the routine medication ordered. c. Complete the medical history and physical assessment.

Complete the medical history and physical assessment.

The community health nurse is teaching a prenatal class and includes the societal cost of fetal alcohol syndrome in one of the educational sessions. The nurse is demonstrating an understanding of: A. Orem's self-care deficit theory. B. the health belief model. C. Milio's framework. D. critical theoretical perspective.

D. critical theoretical perspective.

What official national organization provides financial housing assistance to low-income families? a. World Health Organization (WHO) Incorrect b. Federation of National Organizations Working with the Homeless (FEANTSA) c. Robert Wood Johnson Foundation d. Department of Housing and Urban Development (HUD)

Department of Housing and Urban Development (HUD)

Which statement is true concerning home health nursing? a. Home health nursing is a new nursing specialty originating with the inception of Medicare in the 1960s. b. Florence Nightingale is credited with creating the idea of home health nursing. c. Home health nursing has as a purpose to provide nursing care to individuals and clients in their homes.

Home health nursing has as a purpose to provide nursing care to individuals and clients in their homes.

Which action is inappropriate for a correctional nurse when testifying in court? a. Looking the jurors in the eye when answering questions b. Asking the attorney to repeat a question when not understood c. Practicing saying difficult medical terms before the court date d. Interrupting when necessary to verbalize correct medical information

Interrupting when necessary to verbalize correct medical information

What is the purpose of the Homeless Information Management System (HIMS)? a. Provides means to feed homeless people b. Obtains national data on homeless individuals c. Serves as a screening tool to obtain any history of criminal activity d. Provides homeless individuals with educational materials

Obtains national data on homeless individuals

A veteran was awarded VA disability compensation for a medical condition he contracted in 1965 while serving in Vietnam. Which condition did this veteran most likely have? a. Cardiac dysrhythmia b. Parkinson disease c. Diabetes type 1 Incorrect d. Irritable bowel syndrome

Parkinson disease

Agricultural workers are at high risk for occupational injuries and illnesses. To reduce the most common cause of fatalities among youth on farms, which is the most important strategy for the community nurse to implement? a. Planning a community media campaign advocating the use of helmets b. Partnering with the county extension agent to offer tractor safety classes c. Working with local health care providers to encourage use of personal protective equipment, such as hearing and respiratory protection d. Offering a class for local health care providers addressing the signs and symptoms of pesticide toxicity

Partnering with the county extension agent to offer tractor safety classes

A community health nurse is caring for a Native American client who often stares at the floor while the nurse is talking. The nurse knows this indicates which culturally appropriate behavior? a. The client is showing respect to the nurse. b. The client is listening carefully. c. The client's religion forbids him from making eye contact with women. d. The client is depressed.

b. The client is listening carefully.

The community health nurse is working with a client who has recently been diagnosed with diabetes. The physician has prescribed a diet and recommended adding an exercise regimen. Assessment reveals the client has been smoking two packs of cigarettes per day for approximately 30 years. Which statement most accurately reflects the appropriate approach for establishing health education priorities for this client? a. The nurse must assist the client to recognize that smoking cessation should be the highest priority. b. The nurse and client must partner in establishing health education priorities for the client. c. The client does not have his priorities in order and must be informed by the nurse as to the most important priority. d. The nurse should not discuss smoking cessation because this is not the client's most important health issue.

b. The nurse and client must partner in establishing health education priorities for the client.

Which statement is true regarding the state level subsystem? a. States share central authority of the public health care system with the federal government. b. The organization and activities of public health services vary widely among the states. c. It is the role of the governor to direct most state health agencies. d. Compared with other state programs, state health programs usually have a small, specialized staff.

b. The organization and activities of the public health services vary widely among the states.

A high school student is referred to the school nurse for suspected substance abuse. After the nurse's assessment and interventions, what would be the most desirable outcome? a. The student discusses conflicts over drug use. b. The student accepts a referral to a substance abuse counselor. c. The student agrees to inform his parents of the problem. d. The student reports increased comfort with making choices.

b. The student accepts a referral to a substance abuse counselor.

A survey done by The National Institute on Drug Abuse (NIDA) found that the most commonly abused prescription drug among high-school seniors is a. OxyContin. b. Vicodin. c. Xanax. d. codeine.

b. Vicodin.

Which of the following sources of information about a community's health would give the community health nurse information about births, deaths, and marriages and aid in providing indicators of population growth or reduction? a. Census tracts b. Vital statistics c. National Health Survey data d. Needs assessment

b. Vital statistics

According to the American Nurses Association's (ANA) Scope and Standards of Home Health Nursing Practice, basic preparation for the generalist home health nurse is a. an associate degree in nursing. b. a baccalaureate degree in nursing (BSN). c.a diploma in nursing. d. a master of science degree in nursing.

b. a baccalaureate degree in nursing (BSN).

The nurse is aware that a risk factor for elder abuse is a. a caregiver with low income. b. an elder with urinary incontinence. c. an elder who is irritable and demanding. d. a caregiver with a strong need for control.

b. an elder with urinary incontinence.

Two unrelated heterosexual adults that share a housing unit with their three children is an example of a.nuclear family. b. cohabitation. c. internal structure. d. external structure.

b. cohabitation.

Which of the following groups is an example of a community of solution? A group: a. that lives within a specific geographic location. b. concerned with reducing teenage suicides. c. with the same ethnic background. d. in which all members enjoy hiking.

b. concerned with reducing teenage suicides.

A family of five people presented to a hospital after the flooding of their urban home. These family members are classified as a. poverty victims. b. displaced persons. c. indirect victims. d. mass casualties.

b. displaced persons.

A risk factor refers to a(n): a. probability that a specific event will occur in a given time frame. b. exposure that is associated with a disease. c. systematic way of distinguishing the risks posed by potentially harmful exposures. d. proactive process in which individuals participate in behaviors that enable them to react to actual or potential threats to their health.

b. exposure that is associated with a disease.

In preparing a presentation for seniors and supportive family members, the nurse includes safety information. This is in response to the knowledge that the leading cause of death because of injuries for seniors is a. fire. b. falls. c.heat or cold stress. d. motor vehicle accidents

b. falls

Epidemiologic data can be useful in the planning phase of the community assessment process because they: a. help discover the patterns of health and illness distribution in a population. b. help construct benchmarks to gauge achievement of program objectives. c. identify the aggregate at risk. d. explain the nature of the health problem.

b. help construct benchmarks to gauge achievement of program objectives.

Every 10 years, the U.S. Department of Health and Human Services publishes a national prevention initiative titled Healthy People. One of the new objectives for Healthy People 2020 is to a. achieve access to preventive services of all Americans. b. improve the nation's ability to prevent, prepare for, respond to, and recover from a major health incident. c. reduce health disparities among Americans. d. increase independence of older Americans.

b. improve the nation's ability to prevent, prepare for, respond to, and recover from a major health incident.

A school nurse knows that under the Family Educational Rights and Privacy Act, a student's health record can be released a. if the student is not a minor. b. in an emergency. c. to educators not involved in the student's education. d. without the student's or guardian's permission.

b. in an emergency.

According to the Health Belief Model, the inconvenience of driving to a gym to exercise is an example of a a. perceived susceptibility. b. perceived barrier. c. perceived benefit. d. cue to action.

b. perceived barrier.

In providing care for a client who recently had a liver transplant, a nurse case manager would focus attention on all of the following except: a. medication monitoring and management. b. provision of direct clinical skilled care (e.g., dressing changes, medication administration). c. identification of potential problems and notification of the physician. d. evaluation of progress to meeting projected outcomes or goals.

b. provision of direct clinical skilled care (e.g., dressing changes, medication administration).

A 6-year-old child fails a routine vision screening on a Snellen chart at a school-based health center. The appropriate action by the nurse is to a. rescreen the child in the following year. b. refer the child to an eye specialist. c. use a Rosenbaum chart instead of a Snellen chart. d. do an internal ophthalmologic examination.

b. refer the child to an eye specialist.

A pathogen lives and multiplies in a __________ and transfers from one host to another by a __________. a. host, susceptible portal of entry b. reservoir, mode of transmission c. infectious agent, portal of exit d. mode of transmission, reservoir

b. reservoir, mode of transmission

The school nurse is interviewing a student who has been assaulted by another student. Both students proclaim to be gang members. The nurse understands the reasons most youth give for joining a gang include the following: (Select all that apply.) a. financial gain. b. sense of belonging. c. peer pressure. d. relative is in a gang. e. need for respect.

b. sense of belonging. c. peer pressure. e. need for respect.

Migrant and seasonal farm workers constitute a high-risk population because of their low income and migratory status. These workers lack adequate access to preventive services. The most important role of the rural community health nurse in meeting the health care needs of this vulnerable population is to a. address the multiple communicable diseases of these farm workers. b. serve as an advocate working to gain health care access for these farm workers. c. participate in political activities with an emphasis on changing immigration laws. d. learn to speak Spanish to improve communication with this specific population.

b. serve as an advocate working to gain health care access for these farm workers.

The case manager reviews the chart of a patient to determine appropriateness and timeliness of medical care while the patient is in the hospital. This function of case management is referred to as: a. care coordination. b. utilization review. c. continuum of care. d. care management.

b. utilization review.

Posttraumatic stress disorder (PTSD) can develop due to (Select all that apply.) a. having recurring nightmares. b. viewing a dead body. c. having a history of mental illness. d. surviving a natural disaster. e. experiencing chronic pain.

b. viewing a dead body. c. having a history of mental illness. d. surviving a natural disaster.

Mary is a nursing student doing her senior project in community health. Part of her assignment is to conduct an activity that illustrates "social health" within a group in her community. The most appropriate activity for Mary to organize would be a a.neighborhood block party. b.food bank in a local church. c.community yard sale. d.school fundraiser for the school band.

b.food bank in a local church.

Which criteria is required in order for veterans to receive U.S. Department of Veterans Affairs(VA)benefits? (Select all that apply.) a. Serving in active duty for 24 consecutive months b. Serving for a half period of call in the Reserves Incorrect c. Committing to the Guard for 12 months d. Being separated under any condition other than dishonorable e. Being deployed overseas for 6 months

being separated under any condition other than dishonorable Serving in active duty for 24 consecutive months

The community health nurse is trying to encourage a client to attend Alcoholics Anonymous meetings. When the client asks the nurse what he must do to become a member, the nurse should respond a. "You must first stop drinking." b. "Your physician must refer you to this program." c. "Admit you are powerless over alcohol and that you need help." d. "You must bring along a friend who will support you."

c. "Admit you are powerless over alcohol and that you need help."

Which statement would indicate that the hospice patient's caregiver understood the nurse's instructions related to pain management? a. "I didn't wake him (the patient) up last night for the 2:00 AM dose because he was sleeping." b. "I gave him (the patient) the ordered medicine whenever he complained of pain." c. "I gave the pain medicine every 3 hours as we planned even when he (the patient) didn't complain of pain."

c. "I gave the pain medicine every 3 hours as we planned even when he (the patient) didn't complain of pain."

While caring for a client from a different culture, the community health nurse must assess the client's health-related beliefs. All of the following questions would be appropriate and would elicit the desired information except: a, "Are there certain foods you eat when you are sick?" b. "When do you know you are sick enough to visit a health care provider?" c. "Is it OK if I speak in English?" d. "What does health mean to you?"

c. "Is it OK if I speak English?"

A client who regularly participates in activities at the local senior center is celebrating his 65th birthday today. Without regard to gender, according to the U.S. average, how many additional birthdays can he anticipate celebrating? a. 10 b. 14 c. 19

c. 19

Which describes a NA-TECH (natural technological) type of disaster? a. A flood covering crops and recreational areas of a geographic area b. A terrorism attack causing major interruption of communication technologies c. A tornado resulting in flood and destruction of electrical systems for a community d. A nuclear accident at a power plant causing evacuation of people in an urban community

c. A tornado resulting in flood and destruction of electrical systems for a community

The wife of an alcoholic client is considering joining a support group to help her respond to her husband's condition in a healthy way. Where should the nurse refer this client? a. A psychiatrist for a referral to a suitable group b. Spouses Anonymous c. Al-Anon d. Alcoholics Anonymous

c. Al-Anon

Which is an example of "community health nursing" rather than "community-based nursing"? a. An RN assisting a doctor in a pediatrician's office b. An RN visiting a home-bound patient to monitor for congestive heart failure c. An RN reviewing school clinic records to determine which children are not up to date on their immunizations d. An RN dispensing medications in a nursing home

c. An RN reviewing school clinic records to determine which children are not up to date on their immunizations

Assisting the family of a special needs child through the complex health care system is an example of what type of case management? a. Disease-specific case management b. System-centered case management c. Client-centered case management d. Public health case management

c. Client-centered case management

While verifying compliance with immunization requirements, a school nurse notices that three students from the same family have not completed their immunizations. How should the nurse address this problem? a. Discuss with the principal the lack of immunizations. b. Expel the children from school. c. Contact the parents and educate them about the immunization requirements. d. Pull the students from class and immunize them.

c. Contact the parents and educate them about the immunization requirements.

Which prospective payment method determined the amount of reimbursement that health care providers would receive for specific illnesses from Medicare? a. Current procedural terminology codes b. Actuarial classifications c. Diagnosis-related groups d. Medigap insurance

c. Diagnosis-related groups

A community health nurse is caring for a family that includes the husband, wife, children, and other blood relatives. This type of family is called a(n): a. Nuclear family. b. Communal family. c. Extended family. d. Nuclear dyad

c. Extended family

Which agency has a mission to support citizens and first responders to ensure that as a nation everyone works together to build, sustain, and improve the capacity to prepare for, protect against, respond to, recover from, and mitigate all? a. American Red Cross (ARC) b. National Institute for Health (NIH) c. Federal Emergency Management Agency (FEMA) d. Centers for Disease Control and Prevention (CDC)

c. Federal Emergency Management Agency (FEMA)

Which of the following methods of gathering data is most effective for remote and vulnerable segments of a community and for those communities with underdeveloped opinions? a. Interviewing community informants b. Community forum c. Focus groups d. Telephone surveys

c. Focus groups

Which educator is credited with developing the concept of empowerment and included activism on the part of the educator as a teaching methodology? a. Bandura b. Pender c. Freire d. Burris

c. Freire

Edwin Chadwick's Report on an Inquiry into the Sanitary Conditions of the Laboring Population of Great Britain greatly contributed to the development of the a. National Organization for Public Health Nursing. b. American Medical Association. c. General Board of Health for England. d. National Institute.

c. General Board of Health for England.

Which statement regarding sexually transmitted diseases (STDs) is correct? a. The rate of STDs is decreasing because of effective medication therapies. b. Women are less likely to use protection methods against STDs. c. Half of the STD rate in the United States falls within the 15 to 24 age range. d. Treatment for STDs in women is usually ineffective.

c. Half of the STD rate in the United States falls within the 15 to 24 age range.

Approaching health at the aggregate level is the initiative of which agency or document? a. Occupational Safety and Health Administration (OSHA) b. Clean Air for All c. Healthy People 2020 d. Centers for Disease Control and Prevention (CDC)

c. Healthy People 2020

The early Blue Cross and Blue Shield plan was an example of a/an: a. Health maintenance organization. b. Prospective payment plan. c. Indemnity plan. d. Cafeteria plan.

c. Indemnity plan

Identify the etiologic or causal statement component of the following community diagnosis: "There is an increased risk for undetected testicular cancer among young men related to insufficient knowledge about the disease and the methods for preventing and detecting it at an early stage as demonstrated by high rates of late initiation of treatment." a. Risk for undetected testicular cancer b. Young men c. Insufficient knowledge about the disease and methods of prevention d. High rates of late initiation of treatment

c. Insufficient knowledge about the disease and methods of prevention

Lemuel Shattuck, a Boston bookseller with an interest in public health, published the 1850 book Report of the Massachusetts Sanitary Commission. Which was not a recommendation of the report? a. Keeping a record of vital statistics b. Developing well-infant and well-child care programs c. Introducing modern family planning methods in the United States d. Beginning a system of vaccination and health education

c. Introducing modern family planning methods in the United States

In the 1850s, a researcher studied a cholera epidemic among people living in different sections of London. The researcher who used epidemiologic methods to study the epidemic and used rates as an epidemiologic tool was: a. Joseph Lister. b. William Farr. c. John Snow. d. Edward Jenner.

c. John Snow.

Which statement regarding military sexual trauma (MST) is true? a. MST is more common among male veterans. b. MST is always perpetrated by a stranger. c. MST is associated with diabetes.

c. MST is associated with diabetes.

The community health nurse is visiting the home of a known substance abuser. The client is talking excessively and is excited and aggressive. The nurse notes that the patient's heart rate is 158 beats/min. The nurse recognizes the client is most likely high on which substance? a. PCP b. Alcohol c. Methamphetamine d. Inhalants

c. Methamphetamine

An example of care provided under the local health department category of environmental health services is: a. Disease surveillance b. Immunizations c. Occupational health d. Nutrition services

c. Occupational health

Which model of care was developed to provide collaborative, quality-driven, safe, primary care? a. Community case management model b. Disease-specific case management model c. Patient-centered medical home d. Geriatric care management

c. Patient-centered medical home

A man has been smoking for 20 of his 40 years. He smokes a pack of cigarettes daily and states, "My dad smoked two packs a day and lived to be almost 90. Besides, I'm going to die from something anyway, so why quit"? He is in which "stage of change" in the transtheoretical model?a.Contemplation b. Maintenance c. Precontemplation d. Preparation

c. Precontemplation

Louisiana Health Care is a multistate home health organization consisting of 60 home health agencies. The company is a public company with stocks available on the open market. This is an example of what type of home health agency? a. Official agency b. Nonprofit agency c. Proprietary agency

c. Proprietary agency

Which entity strives to improve the health of all the public by promoting healthy lifestyles, preventing disease and injury, and protecting the health of communities? a. Managed care organizations (MCOs) b. Medicare c. Public health system d. Affordable Care Act

c. Public health system

How would a community health nurse use Executive Order 12898? a. Recognize that its focus is to decrease urban sprawl. b. Use its definition of sick building syndrome in completing an environmental assessment. c. Recognize that it would help achieve environmental justice. d. Cite it as a law to decrease carbon dioxide emissions for industries regulated by the Environmental Protection Agency.

c. Recognize that it would help achieve environmental justice.

.The health literature accessed by the community health nurse often addresses the probability of an adverse event. What term refers to the likelihood that healthy people exposed to a specific factor will experience a specific health condition? a. Prevalence b. Rates c. Risk d. Incidence

c. Risk

Learner assessment is an important aspect of health education. The assessment performed by the community health nurse includes questions about the client's age, family roles, social roles, and various responsibilities. Which of the following is the most important reason for obtaining this information? a. The nurse will need this information to plan the meetings with the client. b. The information will help the nurse to understand the client's desired outcomes. c. The client's developmental stage and roles have an impact on readiness to learn. d. The information is necessary to understand how much time the client will have.

c. The client's developmental stage and roles have an impact on readiness to learn.

Which statement differentiating hospice and traditional home health is not true? a. Hospice patients need not be homebound but must be certified as within the last months of life by a physician. b. Hospice services may be provided in the home, hospital, nursing home, or other health care site as appropriate. c. The type of hospice services are limited as in home health care to skilled nursing, social services, physical therapy, occupational therapy, and speech therapy.

c. The type of hospice services are limited as in home health care to skilled nursing, social services, physical therapy, occupational therapy, and speech therapy.

Which of the following was a result of the Patient Protection and Affordable Care Act of 2010? a. Social Security benefits were denied to selected aggregates. b. Third-party payers (e.g., preferred provider organizations and health maintenance organizations) use prospective payments systems to negotiate reimbursement. c. Value-based purchasing programs for hospitals were established. d. Health care providers received a fixed amount of money based on the relative cost of resources they use to treat Medicare patients within each diagnosis-related group.

c. Value-based purchasing programs for hospitals were established.

When chronic disease became a more important cause of death in developed countries, different epidemiologic models were developed to study the many factors involved in the development of these health conditions. Which of the following is an example of such a model? a. Person-place-time model b. Epidemiologic triangle c. Web of causation d. Wheel model

c. Web of causation

What group of homeless individuals is known for their involvement in survival sex? a. Young adult gay men b. Middle-aged women c. Young women

c. Young women

A 22-year-old college student explains to the nurse at the health clinic that she drinks four to five beers when she goes out with friends on Saturday nights. Otherwise, she rarely drinks during the week because of her classes, studying, and part-time job. This would be considered: a. age- and circumstance-appropriate behavior. b. alcoholism. c. binge drinking. d. excessive drinking.

c. binge drinking.

Transmission of an infectious disease can be efficiently controlled by a. breaking all links in the transmission chain. b. destroying all reservoirs of infectious agents. c. breaking only one link in the transmission chain. d. maintaining high levels of herd immunity.

c. breaking only one link in the transmission chain.

Family interviewing requires the community health nurse to understand or develop specific skills. All demonstrate appropriate family interviewing skills or techniques except a. introducing oneself by name and addressing the client appropriately, such as "Mr. Jones." b. planning the focus for the family visit in advance and engaging all family members present during the home visit. c. establishing the nursing goals based exclusively on the physician's orders.

c. establishing the nursing goals based exclusively on the physician's orders.

A week before finals, a school nurse assesses a 15-year-old girl complaining of vague symptoms. All symptoms or behaviors should result in an immediate request for parent or guardian conference and referral to a physician for further evaluation except a. problems eating or sleeping. b. problems making decisions. c. frequent requests for a visit to the school nurse. d. inability to concentrate.

c. frequent requests for a visit to the school nurse.

Katie, a 2-year-old child, is brought to the doctor's office after 2 days of vomiting and diarrhea. Upon completion of the medical history, the mother tells the nurse that several of the other children at the daycare who played with the same toys as Katie have the same symptoms. The mode of transmission for the pathogen more likely was a. vector. b. direct. c. indirect. d. airborne.

c. indirect.

In long-range planning for community needs, the community health nurse considers that the fastest-growing segment of the senior population is the a. young-old (ages 65 to 74 years). b. middle-old (ages 75 to 84 years). c. old-old (ages 85 years and older).

c. old-old (ages 85 years and older).

A comprehensive school health program should include all except a. health promotion for staff and health education. b. health services and health education. c. physical examinations and comprehensive health history. d. nutrition services and counseling.

c. physical examinations and comprehensive health history.

Jennifer is a community health nurse in a large metropolitan area. According to the American Nurses Association's Code of Ethics (2015), community health nurses must align themselves with public health programs that promote and preserve the health of populations by influencing a. socioeconomic issues. b. psychosocial issues. c. sociocultural issues.

c. sociocultural issues.

When writing a community diagnosis, the community health nurse notes that the "among" phrase: a. presents a synthesis of all assessment data. b. provides the supporting data. c. specifies the aggregate that will benefit from the nurse's plan. d. describes the cause of the health problem and directs focus of interventions.

c. specifies the aggregate that will benefit from the nurse's plan.

The greatest promise for improving health outcomes for rural residents is a. the increase in health care providers migrating to rural areas. b. the expansion in Medicare services to rural hospitals and clinics. c. the increase in distribution of technology, providing more education and health services.

c. the increase in distribution of technology, providing more education and health services.

The home health nurse receives a referral for an evaluation visit for a patient. The nurse notes that the patient's primary diagnosis is end-stage lung cancer and that the patient is currently receiving daily palliative radiation treatments for pain management. This is not an appropriate home health referral because a. the patient is receiving palliative care. b. the patient's needs are too complex. c. the patient is not homebound

c. the patient is not homebound

The nurse is assisting Sargeant Earl in applying for VA benefits. Which statement made by Sargeant Earl indicates he understands VA benefits? a. "This is a wonderful health insurance program that will cover all of my health care needs." b. "I can see any provider I wish under the VA health insurance plan." c. "I still need to carry private insurance to assist with the most expensive treatments." d. "My primary care copay is $15 a visit and outpatient specialist copays are $50 per visit."

d. "My primary care copay is $15 a visit and outpatient specialist copays are $50 per visit."

A major cause for the rise in health care costs is: a. An increase in the specialization of physicians. b. A decrease in nonprofit hospitals. c. A shortage in the number of primary care physicians. d. A demand for complex and advanced services.

d. A demand for complex and advanced services.

Using critical theory when exploring issues of environmental health ultimately allows the nurse to: a. Develop a community diagnosis. b. Raise additional questions related to environmental health and safety. c. Design community health interventions. d. Alter the precursors of poor health.

d. Alter the precursors of poor health.

An epidemic is occurring in a public health nurse's community, and the nurse is working with the epidemiologist and other health professionals seeking to identify the causative agent. What phrase best describes such efforts? a. Cohort study b. Descriptive epidemiology c. Point prevalence study d. Analytic epidemiology

d. Analytic epidemiology

One of the first health insurance companies established in the 1930s to provide health care to subscribers was: a. Aetna Insurance. b. Woodmen of the World. c. Humana Health Maintenance Organization. d. Blue Cross and Blue Shield.

d. Blue Cross and Blue Shield

What element of a community disaster plan investigates the citizen's reliance on telephone systems or cell phones during disasters? a. Authority b. Logistical c. Rescue d. Communication

d. Communication

An elderly client expresses the following concerns to the community health nurse. Which of these concerns is a physiological change associated with the aging process? a. Increased saliva b. Decreased pain threshold c. Increased nightly sleep time d. Difficulty remembering new names

d. Difficulty remembering new names

Personal care provided by physicians is delivered by various basic models. The following is an example of an integrated health maintenance model: a. Dr. Jones is a family practitioner. He has his own practice in his own office. He covers all of his own expenses. b. Dr. Cohen and Dr. Bernard are cardiologists who share a practice. They divide the expenses, income, and offices. c. Dr. Davis is a general surgeon, Dr. Brown is an orthopedic surgeon, and Dr. Burnett is a vascular surgeon. They share the practice, along with all of their expenses, income, and offices. d. Dr. Smith is an internist, Dr. Gregory is a pediatrician, and Dr. Stanley is a family practitioner. They are paid a monthly salary by an organization to see all of its patients.

d. Dr. Smith is an internist, Dr. Gregory is a pediatrician, and Dr. Stanley is a family practitioner. They are paid a monthly salary by an organization to see all of its patients

A community health nurse is concerned about reducing the fatal injuries to America's rural children. To address this problem, the nurse organizes a community of solution (see Chapter 1). For this group, it would be important to have representatives from all groups or organizations: (Select all that apply.) a. The Department of Public Highway and Safety b. Emergency department staff (both doctors and nurses) from local hospitals c. Teachers and coaches from area schools d. Area employers e. City or county government

The Department of Public Highway and Safety Emergency department staff (both doctors and nurses) from local hospitals Teachers and coaches from area schools City or county government

Which statement regarding the impact of managed care on rural public health departments is true? a. Managed care has expanded the safety-net role of many local health departments by funding primary care services. b. Medicaid's importance for rural areas is likely to decrease. c. The role of rural public health departments may increasingly narrow into areas that are currently without any type of reimbursement

The role of rural public health departments may increasingly narrow into areas that are currently without any type of reimbursement

A 10-year-old boy visits the nurse complaining of a headache and nausea. The nurse recognizes the boy from an earlier conference with a teacher about the boy's declining school performance. The nurse has been concerned because the boy's father and mother are recently divorced, and his mother works nights. An appropriate nursing intervention would be to investigate the boy's eligibility for a. The Nutritional Education and Training Program (NET). b. Youth Risk Behavior Surveillance System. c. Adult and Child Protective Services. d. Federally funded breakfast and lunch program.

d. Federally funded breakfast and lunch program.

The first visiting nurse in the United States was a. Lillian Wald. b. Mary Brewster. c. Florence Nightingale. d. Francis Root.

d. Francis Root.

The nurse at the disaster site is using the SMART triage system. What color triage tag would be provided to an ambulatory individual with a superficial cut on the left elbow and bruise to the right hand? a. Red b. Yellow c. Black d. Green

d. Green

Which was not a public health service provided by the Romans? a. A supervisor of the public baths b. Street cleaners c. Supervision of the sale of food d. Housing for the indigent population

d. Housing for the indigent population

The home care nurse is caring for a client recently diagnosed with inoperable cancer. Which best expresses the nurse's role related to end-of-life issues? a.Monitoring for the client to express interest in talking about these issues b. Asking the client whether an advance directive has been completed c. Exploring end-of-life issues with the client's family d. Initiating discussion and education

d. Initiating discussion and education

Over 13% of residents in the United States were born in other countries. More than half (52%) of these individuals were born in: a. Asia. b. Europe. c. Africa. d. Mexico and Latin America.

d. Mexico and Latin America

Which is classified as a vector of disease? a. Humans b. Door handles c. Water and food d. Mosquitoes

d. Mosquitoes

What is the most common chemical dependence in the United States? a. Alcohol b. Cocaine c. Marijuana d. Nicotine

d. Nicotine

Veterans with a substance use disorder (SUD) are most likely to suffer from a. TBI b. MST c. VHA d. PTSD

d. PTSD

Which is true of adolescents who have been convicted and incarcerated in adult facilities rather than in a juvenile facility? a. They are less likely to be sexually assaulted. b. They are usually not attacked by other inmates. c. They are more likely to commit suicide.

They are more likely to commit suicide.

Forensic nursing is best defined as a. a field of legal nursing in which the nurse works with or for lawyers. b. a field of correctional nursing in which the nurse works with inmates. c. investigational nursing in which the nurse works with law enforcement. d. a link among the health care system, the investigative process, and courts of law.

a link among the health care system, the investigative process, and courts of law.

Public health efforts focus on prevention and promotion of population health. The local level of the health care system provides direct services to community members through community and personal health services. An example of a health service that targets the larger community, rather than individuals, is (Select all that apply.) a. providing well-infant care. b. a mobile immunization clinic. c. condemning or repairing unsafe housing. d. encouraging family planning. e. airing a weekly public service announcement to remind women to do breast self-examination.

a mobile immunization clinic condemning unsafe housing airing a weekly public service announcement to remind women to do breast self exam

Which statement indicates that further teaching is needed for a patient involved in family planning? a. "I can't get human papilloma virus (HPV) from my boyfriend because we're not having intercourse." b. "I need to use condoms to prevent transmission of sexually transmitted diseases." c. "Even though I have no signs or symptoms, I still may have Chlamydia." d. "I can give my unborn baby warts during childbirth."

a. "I can't get human papilloma virus (HPV) from my boyfriend because we're not having intercourse."

Access to health care is determined by the circumstances of the individual that obstruct the means to obtain desired health care. Which is not a barrier to health care access? a. Preexisting conditions b. Nonparticipating physician c. Inability to communicate d. Personal avoidance of a health problem

d. Personal avoidance of a health problem

Which of the following "determinants of health" refers to factors that are experienced with the senses-things that can be seen, touched, heard, and smelled? a. Biology b.Behaviors c. Social environment d. Physical environment

d. Physical environment

Which statement about intimate partner violence (IPV) is true? a. It occurs only in poor, uneducated, minority households. b. It only occurs in heterosexual relationships. c. Victims can change the abusers' behavior. d. Professional intervention is needed to change the abusers' behavior.

d. Professional intervention is needed to change the abusers' behavior.

Which intervention would be the most appropriate to implement for a community that has a high risk for environmental health hazards? a. the evaluation of ongoing community health interventions. b. Document participation levels of families in environmental issues. c. Involve citizens in decision-making processes about proposed activities that could pose an environmental threat. d. Screen at-risk populations for asthma and test blood levels for air pollutants.

d. Screen at-risk populations for asthma and test blood levels for air pollutants.

Knowledge of various learning theories is important for community health nurses involved in health education. Enhancing self-confidence and self-efficacy are important aspects of which learning theory? a. Cognitive learning theory b. Humanistic learning theory c. Behavioral learning theory d. Social learning theory

d. Social learning theory

Rural residents in the United States compose more than _____% of the nation's poor. a. 50 b. 35 c. 20 d. 18

a. 50

A school nurse evaluates the implementation of health promotion in a high school staff. Which indicates a need for more education? a. A flyer advertising an ice cream and pizza party for the student awards program b. Condoms being provided in all restrooms of the school c. A decrease in missed days at school d. The discontinuation of the availability of soft drinks and candy in vending machines during school instructional hours

a. A flyer advertising an ice cream and pizza party for the student awards program

There are many ways the community health nurse can be engaged in health education in the community. Which of the following are frequent roles or activities that the nurse can be expected to fulfill? (Select all that apply.) a. Advocate b. Consultant c. Diagnostician d. Collaborator e. Mediator

a. Advocate b. Consultant d. Collaborator e. Mediator

Which minority group hit an all-time low high school drop-out rate in 2013? a. African Americans b. Chinese Americans c. Polish Americans d. Italian Americans

a. African Americans

The community health nurse is working in an emergency shelter with displaced families. Which clients have risk factors for posttraumatic stress disorder (PTSD)? (Select all that apply.) a. An 18-year-old client with a previous gunshot wound b. A 50-year-old client who saw people die in the disaster c. A 23-year-old client experiencing extreme fear d. A 60-year-old client who had little social support before the event e. A 35-year-old client with a history of schizophrenia

a. An 18-year-old client with a previous gunshot wound b. A 50-year-old client who saw people die in the disaster c. A 23-year-old client experiencing extreme fear e. A 35-year-old client with a history of schizophrenia

Cost containment incentives include (Select all that apply.) a. Capitated reimbursement. b. Limited access to care. c. Fee-for-service billing. d. Health care rationing. e. Carve-out services.

a. Capitated reimbursement. b. Limited access to care. d. Health care rationing.

Which characteristics are demonstrated by healthy or energized families? (Select all that apply.) a. Communication is appropriate and clear. b. Support and respect are evident and appreciated. c. Roles are static and change only in times of crisis. d. Common beliefs and values are shared. e. Members play and share leisure time appropriately.

a. Communication is appropriate and clear. b. Support and respect are evident and appreciated. d. Common beliefs and values are shared. e. Members play and share leisure time appropriately.

The phrase "All Chinese people like rice" is an example of: a. Cultural stereotyping b. Culture-bound syndrome. c. Cultural imposition. d Ethnocentrism.

a. Cultural stereotyping

The public health nurse is working with a specific population and is preparing to participate in a descriptive epidemiology study. Which of the statements apply to descriptive epidemiology? (Select all that apply.) a. Descriptive epidemiology seeks to answer questions about the amount of disease in a given population. b. Descriptive epidemiology seeks to answer questions about the cause of disease in a given population. c. Descriptive epidemiology seeks to answer questions about the cure for disease in a given population. d. Descriptive epidemiology seeks to answer questions about the distribution of disease in a given population

a. Descriptive epidemiology seeks to answer questions about the amount of disease in a given population. d. Descriptive epidemiology seeks to answer questions about the distribution of disease in a given population

Which statement best describes the demographics of rural America? a. Despite the shrinking number of family farms and full-time farmers, agriculture continues to be an important part of the rural and U.S. economy. b. There has been a shift in the economic base of rural America as more communities are dependent on income generated from mining and construction. c. There has been a decline in diversity in rural America, with more Hispanics and youth moving to urban areas rather than rural communities and small towns. d. There are more positive health behaviors (e.g., less smoking, obesity, and drug use) among residents of rural America when compared with urban America.

a. Despite the shrinking number of family farms and full-time farmers, agriculture continues to be an important part of the rural and U.S. economy.

For an RN to apply for certification for case management through the Case Management Society of America (CMSA), the nurse must perform essential activities of case management. Which is not one of the required activities? a. Diagnosis b. Coordination c. Evaluation d. Outcomes e. Assessment

a. Diagnosis

The community health nurse assesses the family as a system within the context of their environments using which approach? a. Ecological framework b. Social network framework c. Transaction model d. General systems theory

a. Ecological framework

Which communicable diseases found in prison inmates is of ongoing concern? (Select all that apply.) a. HIV b. Hepatitis c. Tuberculosis d. Bronchitis e. Chlamydia

a. HIV Correct b. Hepatitis Correct c. Tuberculosis Correct

When assisting specific aggregates, which should be included in the community health nurse's outcomes? a. Helping people learn from their own experiences and analyzing the world with the intention to change it. b. Honesty, fairness, and mutuality in the interactions c. Intervening in mutual exchanges with community members and citing the current literature d. Asking critical questions of the aggregates involved

a. Helping people learn from their own experiences and analyzing the world with the intention to change it.

The community health nurse is caring for a client who abstains from eating any form of meat. This dietary preference is commonly practiced by members of which faith? a. Hinduism b. Mormonism c. Judaism d. Islam

a. Hinduism

Which factors cause primary vaccine failure? (Select all that apply.) a. Inefficient storage b. An intramuscular vaccine injection given subcutaneously c. Waning immunity in immunocompromised patients d. Light-sensitive vaccines exposed to light e. Seroconversion

a. Inefficient storage b. An intramuscular vaccine injection given subcutaneously d. Light-sensitive vaccines exposed to light e. Seroconversion

The report requested by Congress that recommended a more systematic approach to promote quality in government-funded programs was: a. Leadership by Example b. Crossing the Quality Chasm. c. To Err is Human, Building a Safer Health System. d. Health Professions Education.

a. Leadership by Example

A client meeting with a community health nurse inquires about diabetes education classes. The client's health records reveal the diagnosis of diabetes was made a little over 1 year ago. The client reports partial compliance with diet, gradual improvement in her exercise program, and a 15-pound weight loss. The client reports that she takes her medication as prescribed but rarely monitors her blood glucose level. Which statement best reflects the impact of initial diabetes education on this client? a. Learning occurred, but additional support and education are needed. b. It is apparent that the diabetic education was totally inadequate. c. It is not possible to draw any conclusions about the education. d. The education did not work because this client is noncompliant.

a. Learning occurred, but additional support and education are needed.

When making health-related decisions, clients from different cultural backgrounds depend on relationships. One type of relationship involves the client seeking assistance from other members of the family and allowing a relative to make decisions about important health-related issues. This relationship is a(n): a. Lineal relationship b. Collateral relationship c. Cultural relationship d. Individual relationship

a. Lineal relationship

Provisions of the Patient Protection and Affordable Care act included (Select all that apply.) a. Mandating that all citizens obtain health insurance. b. Reducing Medicaid eligibility. c. Subsidizing insurance premiums for all citizens. d. Prohibiting denial of coverage for preexisting conditions. Correct e Establishing health insurance exchanges.

a. Mandating that all citizens obtain health insurance d. Prohibiting denial of coverage for preexisting conditions. Correct e Establishing health insurance exchanges.

Enacted in 1965 as part of the Social Security Act, __________ was intended to provide health care to the population of U.S. citizens 65 years of age and older. a. Medicare b. Medicaid c. Social Security d. Blue Cross/Blue Shield

a. Medicare

Which statement about homicide in the United States is false? a. Most homicides are caused by stabbings. b. Homicide is the third leading cause of death for 1- to 4-year-old children. c. Blacks are more likely to be the victims of homicide than whites. d. Over 50% of homicide victims are killed by someone they knew.

a. Most homicides are caused by stabbings.

A community health nurse participating in planning programs for the coming year considers incidence rates to better understand the needs of the community. Which statement below is the most accurate explanation of incidence rates? a. New cases of a disease or condition in a community over a period of time are included in incidence rates. b. The number of all cases of a specific disease or condition in a population at a given point in time relative to the population at the same point in time is included in incidence rates. c. Incidence rate refers to the number of new cases of a disease in those exposed to the disease. d. The term incidence rate refers to the percentage of deaths in a specific period of time from a specific cause.

a. New cases of a disease or condition in a community over a period of time are included in incidence rates

A female veteran has just given birth to her first child. Which resource is most appropriate for this veteran at this time? a. PC3 b. VHA c. CHAMPVA d. TRICARE

a. PC3

Which of the following are principles of a patient-centered medical home? (Select all that apply.) a. Physician-led, team based care b. Value-based purchasing c. Integration and coordination of care d. Improved access to care e. Quality and safety

a. Physician-led, team based care c. Integration and coordination of care d. Improved access to care e. Quality and safety

Through epidemiologic investigations, effective prevention measures are often identified. When the nurse is engaged in providing prevention for the community before disease has developed, the prevention activities meet the definition for what level of prevention? a. Primary b. Secondary c. Tertiary d. Pathogenic

a. Primary

You teach a community disaster preparedness class on how to find shelter during and after a disaster situation. This is an example of what kind of prevention? a. Primary b. Secondary c. Tertiary d. Disaster

a. Primary

The percentage of deaths resulting from a specific cause provides the nurse with information about areas in which public health programs might make significant contributions in reducing deaths. Select the statistic often used for this purpose. a. Proportionate mortality rate b. Crude death rate c. Age-adjusted death rate d. Standardized mortality rate

a. Proportionate mortality rate

The report Health Professions Education identified core competencies that apply to all health care professions. These competencies include (Select all that apply.) a. Provide patient-centered care. b. Prioritize hands-off communication. c. Use evidence-based practice. d. Apply quality improvement. e. Use informatics

a. Provide patient-centered care. c. Use evidence-based practice. d. Apply quality improvement. e. Use informatics

Which of the following is a goal of case management? (Select all that apply.) a. Providing high-quality care b. Decreasing fragmentation of health services c. Containing cost of health care d. Integrating specialty care e. Enhancing quality of life for clients

a. Providing high-quality care b. Decreasing fragmentation of health services c. Containing cost of health care e. Enhancing quality of life for clients

Which activites are performed by psychiatric forensic nurses? (Select all that apply.) a. Sanity and competency evaluations b. Parole and probation considerations c. Sexual predator screening d. Assessment of prison health clinics e. Evaluation of prison nurses

a. Sanity and competency evaluations Correct b. Parole and probation considerations Correct c. Sexual predator screening Correct

The nurse is meeting with a client who has been referred for assistance with smoking cessation. During their first meeting, the client states he is very doubtful about his ability to stop smoking. In the health belief model, the client's belief that actions can be performed to achieve the desired outcome is referred to by which of the following terms? a. Self-efficacy b. Perceived susceptibility c. Perceived benefits d. Cues to action

a. Self-efficacy

Which model supports upstream thinking with the purpose to improve homelessness through reduction of structural conditions contributing to homelessness? a. Social justice b. Market justice c. Physical justice d. Mental justice

a. Social justice

Which statement about adolescent substance abuse is false? a. Teen use of cigarettes and smokeless tobacco is increasing. b. Alcohol use among youth declined increased between 2010 and 2015. c. Most of the movement in teen substance abuse has been in the downward direction. d. Marijuana use among teens is decreasing.

a. Teen use of cigarettes and smokeless tobacco is increasing.

Which assessment findings by the community health nurse would suggest that an elderly client may be the survivor of physical abuse by a caregiver? (Select all that apply.) a. The client has a laceration on her forehead that was sutured. b. The client has a flat affect. c. The client has bruises on her forearms in various stages of healing. d. The client withdraws from soft touch. e. The client is not sexually active but has a diagnosis of Chlamydia.

a. The client has a laceration on her forehead that was sutured. c. The client has bruises on her forearms in various stages of healing. e. The client is not sexually active but has a diagnosis of Chlamydia.

While caring for a client from an Asian culture, the community health nurse might expect which behaviors? (Select all that apply.) a. The client is quiet and compliant, asking few questions. b. The client asks many questions related to the health problem and the nurse's instructions. c. The client may avert his or her eyes during the conversation. d. Folk healers and complementary health care providers may also be present. e. The client may provide the nurse with the answers he or she thinks the nurse wants to hear.

a. The client is quiet and compliant, asking few questions. c. The client may avert his or her eyes during the conversation. e. The client may provide the nurse with the answers he or she thinks the nurse wants to hear.

In the United States today, where are most personal health care services provided? a. The private sector b. The public c. The nonprofit d. The community health sector

a. The private sector

Seven cases of hepatitis A are diagnosed in a community over a period of 2 weeks. An investigation results in a determination that all of the infected individuals ate at a local restaurant. Which statement explains the possible connection between hepatitis A and a restaurant? a. The route of transmission for hepatitis A is fecal-oral. b. A food worker likely coughed on the customers. c. A food worker may have a bleeding wound. d. Hepatitis A is transmitted where people congregate.

a. The route of transmission for hepatitis A is fecal-oral.

When building a collective strategy by framing an environmental problem, the community health nurse should ask which question? a. Who is affected by the problem? b. What individual should I talk to? c. What nursing diagnosis is involved? d. What is my role?

a. Who is affected by the problem?

A community health nurse would include which in her assessment of environmental health? (Select all that apply.) a. Work-related exposures b. Atmospheric quality c. Families d. Job availability e. Radiation risks

a. Work-related exposures b. Atmospheric quality e. Radiation risks

The U.S. Department of Education defines a homeless child as a. a child abandoned in a hospital. b. a child in foster care. c. a child in a group home. Incorrect d. a child living with a grandparent.

a. a child abandoned in a hospital.

One dimension of a community, which looks at personal characteristics and risks of a group, is called: a. aggregate of people. b. location in space and time. c. social system. d. census tract.

a. aggregate of people.

On discharge after treatment for alcoholism, a client plans to take disulfiram (Antabuse) as prescribed. When teaching the client about this drug, the nurse emphasizes the need to a. avoid all products containing alcohol. b. adhere to concomitant vitamin B therapy. c. return for monthly blood drug level monitoring. d. limit alcohol consumption to a moderate level.

a. avoid all products containing alcohol.

Which "determinants of health" would include predisposition to prostate cancer and a history of depression? a. biology b. Behaviors c. Social environment d. Physical environment

a. biology

When nonindustrial cultures adopt Western customs and transition into urban environments, Western diseases begin to appear. Epidemiologic studies suggest that common risk factors that contribute these health conditions include: (Select all that apply.) a. changes in diet. b. environmental alterations. c. economic changes. d. increased population density. e. occupational hazards

a. changes in diet. b. environmental alterations. d. increased population density. e. occupational hazards

Personality traits associated with an increased risk of alcohol abuse include (Select all that apply.) a. impulsive. b. shy. c. withdrawn. d. disinhibited. e. aggressive.

a. impulsive. d. disinhibited.

Modern community health nursing requires the nurse to __________, which empowers people to understand and address their health issues and disease. a. practice from a population focus b. adopt a medical model of care c. return to earlier models of prevention d. focus on the individual and family

a. practice from a population focus

A priority health education topic for school-age children is a. schoolyard safety. b. motor vehicle safety. c. sports safety. d. immunization schedules.

a. schoolyard safety.

A single white male veteran served two tours in Afghanistan. The veteran has returned home from Afghanistan where he lives alone, begins drinking alcohol daily around 11 am, and watches television from rising until bedtime. This veteran is at high risk for a. suicide. b. cognitive impairment c. chronic pain Incorrect d. unresolved conflict

a. suicide.

As a school nurse, you know the leading reason cited as the cause of school violence is a. use of violence to handle disputes. b. an unhappy home life. c. overly protective parental situations. d. poor communication with authority figures.

a. use of violence to handle disputes.

Chemical warfare agents such as pulmonary agents and cyanides are classified as a. weapons of mass destruction. b. computer-based attack weapons. c. recovery agents. d. prevention medications.

a. weapons of mass destruction.

Nurses, including public health nurses, are at increased risk for workplace violence. Risk factors for violence in the workplace include all except a. working in pairs. b. access to medications. c. increased number of mentally ill patients. d. inadequate security.

a. working in pairs.

The steps in the community assessment process for community health nurses are: (Select all that apply.) a. writing a community diagnosis. b. evaluating the outcomes. c. collecting assessment data. d. identifying the cause of the problem. e. planning community interventions

a. writing a community diagnosis. b. evaluating the outcomes. c. collecting assessment data. e. planning community interventions

Which of these statements is true regarding income insufficiency in the United States? a.The poverty rate from 2010 to 2015 did not differ statistically b. People who make minimum wage would not be categorized as impoverished. Incorrect c. Alcoholism is the major reason for lack of employment. d. The median household income in 2015 was around $40,000

a.The poverty rate from 2010 to 2015 did not differ statistically

The number one health concern identified by the majority of rural health care leaders is a.lack of health insurance b. limited access to health care. c. increase in communicable diseases. d. social isolation of rural dwellers.

a.lack of health insurance

Disease prevention activities protect people from disease and the effects of disease. An example of primary disease prevention is a.teaching people with diabetes how to prevent complications. b. administering vaccines to children before kindergarten. c. checking the skin of farm workers for signs of skin cancer. d. identifying and testing individuals exposed to someone with tuberculosis.

administering vaccines to children before kindergarten.

Public health policy in the United States is influenced by two types of justice, market justice and social justice. Examples of market justice include (Select all that apply.) a. all people are entitled to the status they create for themselves. b. all people are entitled to a livable minimum wage. c. all people are entitled to happiness if they put forth enough effort. d. all people are entitled to the income they work for. e. all people are entitled to access to health care.

all people are entitled to the status they create for themselves all people are entitled to happiness if they put forth enough effort. all people are entitled to the income they work for.

A public health nurse is surveying a population of coal miners. Which question would elicit information about related risk to a miner's children? a. "Do you wear a respirator?" b. "How close do you live to your workplace?" c. "How many accidents has the mine had this year?" d. "Do you have a good rapport with your boss?"

b. "How close do you live to your workplace?"

Which client is at highest risk for elder abuse? a. A 75-year-old nursing home client who is alert and has osteoporosis b. A 70-year-old client with dementia who is cared for at home c. A 65-year-old client who has just had a hip replacement d. A 72-year-old client on a rehabilitation unit with bilateral above-the-knee amputations

b. A 70-year-old client with dementia who is cared for at home

A 16-year-old young woman arrives at the local emergency department (ED) early Sunday morning and states, "I was on a date last night, and the last thing I remember was eating dinner with my boyfriend." She comments that she woke up in her bed with her clothes "messed up" and states, "I just don't feel right down there" as she points to her genital area. She appears medically stable. Which health care provider would be most appropriate to conduct the physical examination? a. An experienced obstetrical nurse because the patient could be pregnant b. A SANE (sexual assault nurse examiner) c. The physician on call in the ED department d. An emergency nurse

b. A SANE (sexual assault nurse examiner)

A community health nurse often provides health education for individual clients. Her office has a play center because some clients bring small children with them. She routinely offers her clients bottled water, juice, or soda. She works with her clients at a small table rather than at her desk. Which statement below best sums up her approach? a. Clients enjoy hospitality, but her approach has no support in learning theory. b. Adults learn better in a facilitative and nonrestrictive environment. c. The nurse's approach simply takes the clients' minds away from their troubles. d. This approach is too informal and contrary to most learning theories.

b. Adults learn better in a facilitative and nonrestrictive environment.

The nurse working in the community is aware that there are different models for studying the epidemiology of a health condition in a population. One model of investigation of the interrelationships and characteristics of disease is the epidemiological triangle. This model analyzes what three elements? a. Incidence, prevalence, and etiology b. Agent, host, and environment c. Person, place, and time d. Virus, bacteria, and fungus

b. Agent, host, and environment

Certification for registered nurses in the field of case management is provided through which professional organization? (Select all that apply.) a. American Nurses Association b. American Nurses Credentialing Center c. American Hospital Association d. Case Management Society of America e. National Association for Healthcare Quality

b. American Nurses Credentialing Center d. Case Management Society of America

Which of the following is an example of a modifiable risk factor? (Select all that apply.) a. Air pollution b. Cigarette smoking c. Gender d. Sexual practices e. Diet

b. Cigarette smoking d. Sexual practices e. Diet

What is the process used when conceptual differences, which impact the provision of health care, exist between the client and the nurse? a. Cultural diversity b. Cultural negotiation c. Cultural competence d. Cultural imposition

b. Cultural negotiation

A smoking cessation class stresses increased lung function, money saved that is not spent on cigarettes, and smelling clean and fresh as benefits to quitting smoking. These support which of the following concepts? a. Perceived barriers b. Decisional balance c. Precontemplation d. Contemplation

b. Decisional balance

A primary role of the community health nurse in facilitating community participation and partnership is: a. Solving environmental health problems. b. Educating about environmental health hazards. c. Altering individual behaviors. d. Implementing solutions to environmental racism.

b. Educating about environmental health hazards.

Key messages from the report To Err Is Human (Institute of Medicine, 1999) include all except: a. The magnitude of harm that results from medical errors is greater than the number of deaths from breast cancer. b. Errors result largely from individuals' failures, not system failures. c. Health care systems must focus on error prevention. d. Processes must be improved to promote patient safety.

b. Errors result largely from individuals' failures, not system failures.

Studies indicate that which lifestyle behaviors can prevent many chronic illnesses? (Select all that apply.) a. Consuming a sugar-free diet b. Exercising regularly c. Maintaining an optimal body weight d. Reducing stress e. Decreasing smoking

b. Exercising regularly c. Maintaining an optimal body weight d. Reducing stress

A client provides information regarding medical and health history. This is an example of which assessment tool? a. Genogram b. Family health tree c. Ecomap d. Ancestry mapping tool

b. Family health tree

In a managed care organization, physicians are responsible for the approval or referral of some services. In this position, they are referred to as: a. Enforcers b. Gatekeepers c. Carriers d. Distributors

b. Gatekeepers

Which phase of the community response to disaster includes medical personnel contributing long hours of volunteer work helping unfamiliar people after a disaster? a. Honeymoon phase b. Heroic phase c. Reconstruction phase d. Disillusionment phase

b. Heroic phase

Which does not accurately describe home health nursing as "officially" defined by the U.S. Department of Health and Human Services (USDHHS)? a. Home health care is a system of comprehensive health care for people in their homes. b. Home health care is provided to homebound or disabled people in any residence or medical facility. c. Home health care has as its purpose to promote, maintain, or restore a client's health. d. Home health care requires a coordinated plan of care provided by professional health care providers.

b. Home health care is provided to homebound or disabled people in any residence or medical facility.

Lillian Wald and Mary Brewster's Henry Street Settlement was a model of modern health care. Which services were provided to people living in the Lower East Side of New York City by the Henry Street Settlement nurses? (Select all that apply.) a. Emergency care and first aid b. Home visits to ill mothers and children c. School health services d. Industrial health services to local workers e. Support programs for immigrants

b. Home visits to ill mothers and children c. School health services d. Industrial health services to local workers e. Support programs for immigrants

An emergency department nurse assesses a 25-year-old patient with tachycardia, headache, and nausea. The patient denies drug use, heart problems, and smoking. She works from her house and states that everyone in her house has had the "flu" but that she is the only one who has not been feeling better. The nurse notices that the patient lives in the historic section of the town. What environmental hazard should the nurse be primarily concerned about? a. Food quality b. Housing quality c. Water quality d. Occupational risks

b. Housing quality

A community nurse is reviewing health statistics to gain a better understanding of a population's health needs. Crude rates are available for several health occurrences. What statement accurately describes crude rates? a. In calculating a crude rate, the numerator is the size of the population at risk. b. In calculating a crude rate, the average population size may be used as denominator. c. The denominator in a crude rate represents the population at risk for the event. d. Crude rates are used frequently because they avoid bias in interpretation

b. In calculating a crude rate, the average population size may be used as denominator.

The scope of health services at the federal level subsystem targets all major health areas mentioned except: a. The general population b. Individual families c. Special populations d. International health

b. Individual families

Smoking cessation programs often are provided to adults who meet in small groups. Educational sessions include both formal and informal activities. Sharing of experiences of the members of the group is sometimes encouraged. Which of the following statements is most reflective of Knowles' assumptions about adult learners? a. Members of the group may enjoy sharing sessions about the smoking cessation experiences of others, but such sessions are not health education. b. Members may benefit from hearing about the smoking cessation experiences of others in the group, and sessions may provide health education. c. Members will likely perceive sharing sessions about smoking cessation experiences as a waste of time and drop out of the group. d. Members, unless trained in group dynamics, will not be able to fully benefit from sharing sessions about smoking cessation experiences.

b. Members may benefit from hearing about the smoking cessation experiences of others in the group, and sessions may provide health education.

In which case management setting is the nurse responsible for providing primary prevention to employees to keep the work force healthy? a. High-risk clinic setting b. Occupational health setting c. Home health and hospice setting d. Public health clinic setting

b. Occupational health setting

Local health department service categories fall into all except: a. Community health services b. School health services c. Personal health services d. Mental health services

b. School health services

Investigating all contacts of a person infected with a sexually transmitted disease is an example of what? a. Primary prevention b. Secondary prevention c. Tertiary prevention d. Initial prevention

b. Secondary prevention

A variety of health indicators are used by health providers, policy makers, and community health nurses to measure the health of the community. Indicators that illustrate the health status of a community and may be useful in analyzing health patterns over time include (Select all that apply.) a. morbidity. b. mortality. c. birth rates. d. life expectancy. e. cancer incidence rates.

morbidity mortality life expectancy cancer incidence rate

Joanne, a 37-year-old incarcerated woman, is reluctant to seek medical attention for a routine Pap smear. The correctional nurse knows a. this is usual; women do not seek health services as much as men in this setting. b. other factors may be influencing Joanne's hesitancy in seeking medical attention. c. Joanne is delaying the visit because she probably has a sexually transmitted disease or HIV. d. because she is not sexually active, Joanne is not in need of a Pap smear at this time.

other factors may be influencing Joanne's hesitancy in seeking medical attention.

Early public health nurse Lillian Wald and her associates were successful in addressing health and disease in the immigrant community by a. supporting political activities to improve social and environmental conditions of immigrant families. b. administering bedside nursing care to immigrants and their families. c. teaching the immigrant family members to provide health care in the home. d. obtaining and administering medications to the immigrants and their family members.

supporting political activities to improve social and environmental conditions of immigrant families.

It is vital that the forensic psychiatric nurse be knowledgeable about mental illnesses and personality disorders because a. the nurse will be diagnosing many of the illnesses. b. the nurse will work in psychiatric facilities. c.the nurse may be an expert witness in court.

the nurse may be an expert witness in court.

In the role of advocate, the community health nurse recognizes that compared with men in the same age range, women age 65 years and older are most at risk for a. divorce. b. widowhood. c. social isolation. d. criminal victimization (e.g., robbery, burglary, assault).

widowhood

In reviewing research related to client actions that may retard the aging process, the nurse is aware that such research is based on stochastic theories of aging. Why? a. Stochastic theories state that normal cells divide a specific number of times and the number of cell divisions is proportional to the life span of the species. b. Stochastic theories state that aging is a programmed decline in the functioning of the nervous, endocrine, and immune systems. c. Nonstochastic theories propose that aging is a result of a loss of self-regulation between the body and cells, resulting in an immune response that is not reversible or decelerating. d. Stochastic theories explain aging as the accumulation of random events over time; nonstochastic explain aging as a predetermined process and therefore not modifiable through individual actions.

d. Stochastic theories explain aging as the accumulation of random events over time; nonstochastic explain aging as a predetermined process and therefore not modifiable through individual actions.

Chronic stress characterizes the lives of people living with domestic violence. As the community health nurse, you recognize which as a long-term effect of violence? a. Spontaneous disclosure of abuse to health care provider b. Not complaining of physical symptoms c. Having disturbed eating patterns, but sleeping well d. Suffering chronic fatigue and tension

d. Suffering chronic fatigue and tension

A 71-year-old man is brought to the emergency department by his daughter and states that he has fallen and appears to have a broken arm. He is alert and oriented and walks alone without difficulty. Which nursing intervention is most appropriate after he is seen and treated by the physician? a. Talk with the daughter about nursing home placement for the patient. b. Discuss the dietary needs and regimen with patient and family. c. Review the patient's current medications. d. Talk with the patient alone and question the possibility of elder abuse.

d. Talk with the patient alone and question the possibility of elder abuse.

When a client regularly takes a drug that is a central nervous system (CNS) stimulant, such as cocaine, what symptoms would the nurse expect to see when the client abstains from this substance? a. The client will have symptoms of CNS stimulation. b. The client will experience anxiety, insomnia, and tremors. c. Common symptoms include hallucinations and seizures. d. The client will feel depressed, apathetic, and lethargic.

d. The client will feel depressed, apathetic, and lethargic.

What discovery by Edward Jenner resulted in one of the greatest medical advances of the 18th century? a. The benefits of isolation in the control of communicable disease such as bubonic plague b. The discovery that cholera was transmissible through contaminated water c. The identification of modern epidemiologic principles, such as agent-host-environment d. The development of the smallpox vaccination that resulted in immunity after inoculation with the cowpox virus

d. The development of the smallpox vaccination that resulted in immunity after inoculation with the cowpox virus

A community health nurse is asked to review a draft of a brochure developed for distribution to clients. The nurse finds the brochure generally well designed but suggests replacing several words with simpler words that have fewer syllables and are more commonly used. What is the best explanation for the nurse's recommendation? a. The nurse assumes the clients are uneducated because they have low income. b. The nurse knows that English may not be the primary language of many clients. c. The nurse is assuming that most of the client's will read at a third-grade level. d. The nurse knows that more difficult words will pose a barrier to some clients.

d. The nurse knows that more difficult words will pose a barrier to some clients.

Which is the purpose of the staging area in a disaster plan? a. A triage area outside the hospital, supplying first aid and transport to medical facilities b. A stage for entertainment to cheer up disaster victims c. To provide sheltered area for displaced victims to sleep, eat, and bathe d. To act as command station for disaster responders to report to and get assignments

d. To act as command station for disaster responders to report to and get assignments

Which description does not reflect a current definition of family? a. A social unit interacting with the larger society b. Individuals living together related by kinship, marriage, or choice c. Mother, father, and children interacting with extended family d. Two or more persons living together who share common interests

d. Two or more persons living together who share common interests

A veteran is a person who has served in the military. Which statement about veterans is correct? a. There are 5 million veterans in the United States today. b. Employees of the National Aeronautics and Space Administration (NASA) are considered veterans. c. People who were honorably discharged from the military are still considered veterans. d. Veterans include those that have served in the active military, naval, or air service

d. Veterans include those that have served in the active military, naval, or air service

According to the vulnerability index, the individual at highest risk for death is a. a 46-year-old person who has been homeless for 2 months and has HIV. b. a 22-year-old person who lives in a homeless shelter and is addicted to heroin. c. a 65-year-old person who is being evicted from his home after living there for 25 years. Incorrect d. a 60-year-old person who has been homeless for 9 months.

d. a 60-year-old person who has been homeless for 9 months.

Healthy People 2020 addresses all goals for children and adolescents except a. physical activity. b. sex education and HIV prevention. c. smoking prevention. d. cardiovascular accidents, stroke, and diabetes.

d. cardiovascular accidents, stroke, and diabetes.

A community health nurse in the assessment phase of the nursing process conducted research to identify the distribution pattern of breast cancer within a population and the associated risk factors. This is called a. statistical analysis. b. needs assessment. c. census collection. d. epidemiology.

d. epidemiology.

Four-month-old Lucy is in for immunizations at the local health department. The Vaccine Information Sheet is given to Lucy's mother, and informed consent is obtained. However, the mother then states, "Lucy did have a temperature around 99.1 degrees the night of her last immunizations." After this statement, the nurse should a. consult the child's pediatrician. b. delay the immunizations. c. do not give the immunizations because of the contraindication. d. give the immunizations.

d. give the immunizations.

A client is having difficulty performing his activities of daily living. This means he is having difficulty with a. expressive functioning. b. affective functioning. c. emotional functioning. d. instrumental functioning.

d. instrumental functioning.

Child maltreatment that allows the child to use drugs and alcohol is an example of a. sexual abuse. b. physical abuse. c. psychological abuse. d. neglect.

d. neglect.

As a visiting community health nurse, you must take precautions to avoid unsafe situations. To avoid putting yourself in danger, you would a. enter a house where a violent act is occurring and call 911. b. expect the client to control angry family members. c. always carry a concealed weapon. d. remain outside if you hear sounds of fighting in a home.

d. remain outside if you hear sounds of fighting in a home.

All outcomes may contribute to the diagnosis of substance abuse except a. the substance use has placed someone in danger. b. the individual uses the substance despite negative consequences. c. the substance use interferes with the ability to function at work or at home. d. the client is without a job.

d. the client is without a job.

One of the first steps in community assessment may involve the community health nurse driving or walking through an area and making observations about such things as environmental layout and location of agencies, hospitals, industries, and so forth. This is called a(n): a. census survey. b. needs survey. c. informant survey. d. windshield survey.

d. windshield survey.

In contrast to people who live in urban areas, rural residents frequently describe their health by their ability to a. avoid hospitalizations. b. maintain social connections. c. perform activities of daily living. d. work and be productive.

d. work and be productive.

A community health nurse needs to understand that most families in today's society can be described as a. blended. b. nuclear. c. extended. d. defined by its members.

defined by its members.

The primary purpose of hospice care is to a. provide anticipatory grief support to the patient and family. b. improve the quality of life for the terminally ill patients c. decrease the cost of traditional home health services. d. coordinate the services reimbursed by Medicare for terminally ill patients.

improve the quality of life for the terminally ill patients

The Brown family is being evicted from their home and will be moving into a homeless shelter in 3 days. Under the Department of Housing and Urban Development (HUD) definition, the Brown family is a. literally homeless. b. in imminent risk of homelessness c. homeless under other federal statutes. d. fleeing or attempting to flee intimate partner violence

in imminent risk of homelessness

The community health nurse is reviewing the Healthy People 2020 objectives. She understands a primary goal for the elderly population is a. decrease the proportion of older adults who have diabetes. b. increase the proportion of older adults with reduced physical or cognitive function who engage in light, moderate, or vigorous leisure-time physical activities. c. increase the proportion of older adults who qualify for Medicare benefits. d. increase the proportion of older adults who seek medical care for chronic conditions

increase the proportion of older adults with reduced physical or cognitive function who engage in light, moderate, or vigorous leisure-time physical activities.

The nurse is facilitating a support group for caregivers of parents with dementias. She discusses strategies to ensure safety of the client who wanders. These strategies include (Select all that apply.) a. inform the local police of the potential problem. b. keep current pictures of the client available. c. consider restraining the client when left alone. d. place bells on doors. e. use childproof doorknobs.

inform the local police of the potential problem. keep current pictures of the client available. place bells on doors. use childproof doorknobs.

During the Renaissance period, much was learned about health and disease. The Elizabethan Poor Law was enacted during this time to a. govern personal and community hygiene such as contagion, disinfection, and sanitation. b. make local parishes responsible for caring for the poor in the community c. enforce hygienic codes from Leviticus and establish leper houses. d. legislate social reform, addressing issues such as child welfare and factory management.

make local parishes responsible for caring for the poor in the community