Community Health Practice Quiz

The nursing education coordinator is creating employee orientation materials for staff nurses who plan to work at a clinic that serves a lower socioeconomic neighborhood. What information should the educator include regarding the clinic's client population? (Select all that apply.) a.) Most of the clients are unemployed or disabled. b.) Access to mass transit may be an issue. c.) Clients will need reminders to bring insurance cards. d.) Basic physiologic needs of this population are often unmet. e.) Clients who are homebound will qualify for Medicaid. f.) Nonadherence to healthcare recommendations is likely.

- Most of the clients are unemployed or disabled. - Access to mass transit may be an issue. - Basic physiologic needs of this population are often unmet. Correct choices are (A, B, and D). The unemployed or disabled will likely comprise a majority of this clinic's clients (A); the lack of access to mass transit may affect the population's ability to keep health care appointments (B); and low-income clients are at risk for basic physiologic needs being left unmet (D). Most clients are not likely to have health insurance (C) because they lack the funds to pay the insurance premiums. Homebound status is not a defining qualification for public assistance, such as Medicaid (E). To state that a low-income population is more likely to be non-compliant with healthcare recommendations is an example of stereotyping (F).

A nurse working in a community health setting is performing primary health screenings. Which individual is at highest risk for contracting an HIV infection? a.) A 17-year-old who is sexually active with numerous partners. b.) A 45-year-old lesbian who has been sexually active with two partners in the past year. c.) A 30-year-old cocaine user who inhales the drug and works in a topless bar. d.) A 34-year-old male homosexual who is in a monogamous relationship.

A 17-year-old who is sexually active with numerous partners. (A) is at greatest risk for developing sexually transmitted diseases, including HIV, because the greater the number of sexual partners one has, the greater the risk for contracting STDs. (B) represents the group with the lowest number of infected persons because there is little transfer of body fluid during sexual acts. (C) would not be sharing needles, so contracting STDs is not necessarily a risk. A male homosexual in a monogamous relationship has a decreased risk of contracting HIV--as long as BOTH partners are monogamous and neither is infected (D).

Which example should the nurse identify as a significant outcome for the Leading Health Indicators of Healthy People 2020? a.) A community has adopted a no smoking policy. b.) A rural community has a public transportation system. c.) The high school drop out rate has decreased by 15%. d.) A county has decreased their divorce rate by 10%.

A community has adopted a no smoking policy. Environmental quality and tobacco are two of the 12 leading indicators of Healthy People 2020 that are addressed by a community that adopts a no smoking policy (A), which reduces secondary smoke exposure of children as well as impacting Air Quality Index (AQI). Although (B and C) are indirectly related to other indicators of Healthy People 2020 , such as access to health services and social determinants (high school graduation), the most significantly related outcome is a community wide no smoking policy. (D) is unrelated to Healthy People 2020 .

The nurse is teaching a community group about risks of cardiovascular disease. Several clients ask the nurse to determine their risk. Which client should the nurse identify as having the greatest risk for cardiovascular disease? a.) A male with a serum cholesterol level of 199 mg/dl b.) A female with a serum cholesterol level of 201 mg/dl c.) A male with a low-density lipoprotein (LDL) level of 200 mg/dl d.) A female with a low-density lipoprotein (LDL) level of 160 mg/dl.

A male with a low-density lipoprotein (LDL) level of 200 mg/dl. The risk factors for cardiovascular disease include nonmodifiable variables, such as gender, family history, and race, and modifiable variables, such as underlying diseases (hypertension, diabetes mellitus, hyperlipidemia, and obesity, smoking, sedentary lifestyle, and stress). Laboratory results that support these risk factors include elevated LDL and serum cholesterol levels, so (C), being male, has a higher risk than (D). (A and B) have borderline results.

After accepting the position of the school nurse in an public elementary school, what strategy is best for the nurse to use to obtain an overview understanding of the student body? a.) Review all of the health records of the students presently registered for classes. b.) Talk with the current officers of the parent-teacher association c.) Send home a survey form to parents of third grade students. d. Conduct a windshield survey of the geographic areas served by the school

Conduct a windshield survey of the geographic areas served by the school The windshield survey (the nurse drives through neighborhoods viewing homes, stores, churches, air quality, etc.) (D) gives the nurse the best initial overview of the children and a sense of their community. (A, B, and C) provide information about some of the children and parents, but are not as comprehensive as the windshield survey.

What action is best for the community health nurse to take if the nurse suspects that an infant is being physically abused? a.) Follow agency protocols to report suspected abuse. b.) Report suspicions to the local child abuse reporting hotline. c.) Educate the child's caregivers about growth and development issues. d.) Call the police department to have the child removed from the home.

Follow agency protocols to report suspected abuse. Nurses are mandated to report all suspected cases of child abuse and neglect, and it is best to follow agency protocols to protect the nurse and child's safety (A). (B) is available for the general public, but in this case it is best for the community health nurse to follow the agency policy. While (C) can contribute to abuse and neglect, the situation warrants immediate action to protect the child and follow the law. (D) could jeopardize the safety of the nurse, the child, or others in the home.

A young women tells the public health nurse that a friend was recently diagnosed with Hep. B and she is concerned about getting the disease during the assessment interview. Which question is most important for the nurse to ask this woman? a.) Did you drink after or use any utensils that your friend used? b.) Have you noticed any yellowish tinge to the whites of your eyes? c.) Have you shared any needles or had sex with your friend? d.) How long ago was your friend diagnosed with Hep. B?

Have you shared any needles or had sex with your friend? Hepatitis B virus is transmitted by sharing needles or unprotected sex, so (C) is the most important question for the nurse to ask this young woman. Hepatitis A is transmitted by (A). The incubation period for Hepatitis B is 75 days, so (B and D) are not priority questions at this time.

The home health nurse is admitting a client with Parkinson's disease to the home healthcare service. In planning care for this client, which nursing diagnosis has priority? a.) Impaired physical mobility related to muscle rigidity and weakness b.) Ineffective coping related to depression and dysfunction due to disease progression. c.) Ineffective breathing pattern related to respiratory muscle weakness. d.) Fear related to constant possibility of experiencing seizures

Impaired physical mobility related to muscle rigidity and weakness. Parkinson's disease is a progressive neurologic disorder affecting the brain centers that are responsible for control and regulation of movement. The chief clinical manifestations are impaired movement, muscular rigidity, resting tremor, muscle weakness, and loss of postural reflexes (A). Depression and dysfunction are appropriate nursing diagnoses but are not the primary diagnosis (B). Client's with Parkinson's usually do not experience (C or D).

A nurse organizes a community action group to help resolve health problems in a low income neighborhood with a large population of recent immigrants from Africa. What problem should the nurse address first? a.) High rate of unemployment. b.) Low immunization rate of children. c.) Provision of substandard health care. d.) Access to bilingual care providers.

Low immunization rate of children. In the early phase of a community group, it is important for the group to experience success in resolving a problem so that they feel encouraged and empowered to continue working together. (B) is the problem easiest to tackle. While (A and C) are important, they are complex problems to address, and it is crucial for the group to experience success on a smaller scale issue so that they will be encouraged to attempt resolving more complex problems in the future. (D) is important, particularly with Hispanic immigrant populations, but not as important as initial group success to this non-Hispanic majority.

The nurse administers a booster dose of DTaP (diphtheria, tetanus, and pertussis) vaccine to an infant. Which level of prevention is the nurse implementing? a.) Primary prevention. b.) Tertiary prevention. c.) Secondary prevention. d.) Primary nursing.

Primary prevention. Primary prevention (A) involves activities that focus on reducing the potential for illness before it occurs, such as immunizations. Tertiary prevention (B) minimizes the consequences of a disorder or illness through aggressive management or rehabilitation. Secondary prevention (C) includes early diagnosis and implementing interventions aimed at a cure or reducing the progress of a disease. Primary nursing (D) describes a method of nursing management and nursing care assignments, not a healthcare strategy.

A terrorist attack has occurred and several people have inhaled Ricin. Which intervention should the emergency department nurse implement when caring for these clients? a.) Administer the antibiotic streptomycin, IV STAT. b.) Provide all clients with the Ricin antidote. c.) Implement strict respiratory isolation immediately. d.) Provide supportive nursing care until antitoxin is available.

Provide supportive nursing care until antitoxin is available. Production of the Ricin antitoxin involves immunizing sheep with inactive ricin, which results in the production of antibodies that are harvested to produce a freeze-dried product for reconstitution and injection for victims exposed to Ricin poisoning. Although the antitoxin is ready to be manufactured, full licensing is likely in 5 years (2014).There is no known cure or treatment for Ricin exposure so supportive care (D) should be provided until the antitoxin is available. (A) may be administered for secondary infections but is not a treatment for Ricin exposure. (B) does not exist at this time. Ricin does not have person-to-person transmission, so (C) is not necessary.

During a home health visit, a male client reports to the nurse that he felt a solid testicular mass during self-exam, but that it wasn't painful. What instruction should the nurse provide the client? a.) Continue to monitor the mass until the next scheduled annual medical exam. b.) Notify the healthcare provider if the mass becomes soft, painful, or starts to drain. c.) Schedule an appointment with the healthcare provider for prompt evaluation. d.) Testicular nodules are of concern only if they feel matted or are not easily movable.

Schedule an appointment with the healthcare provider for prompt evaluation. A painless testicular mass is an abnormal finding, and the nurse should instruct the client to obtain prompt medical evaluation (C). (A, B, and D) place the client at risk, since they do not emphasize prompt medical evaluation.

The home health nurse is planning a visit with a client who has been discharged home after a hospitalization. Which action should the nurse implement? a.) Avoid creating barriers by wearing a name tag in the home. b.) Schedule home visits that take place during the daylight hours. c.) Ensure HIPAA laws are observed by avoiding visits with other home care providers. d.) Use a duplicate copy of the client's record to provide concurrent services.

Schedule home visits that take place during the daylight hours. To ensure safety of the client and the nurse, home visits should be scheduled during daylight hours (B). The nurse practice act requires the nurse to wear an identification name tag during client care which also provides clear role expectations (A) for the client. Making visits with another home care provider (B) provides an opportunity for the nurse to evaluation and coordinate care (C). (D) is not necessary.

A home health nurse knows that a 70-year-old male client who is convalescing at home following a hip replacement, is at risk for developing decubitus ulcers. Which physical characteristic of aging contributes to such a risk? a.) 16% increase in overall body fat. b.) Reduced melanin production. c.) Thinning of the skin with loss of elasticity. d.) Calcium loss in the bones.

Thinning of the skin with loss of elasticity. Thin, non-elastic skin (C) is an important factor in decubitus formation. Proportion of body fat to lean mass increases with age (A), and might help decrease ulcer tendency. (B) results in grey hair. (D) can contribute to broken bones, but it is probably not a factor in decubitus formation.

The nurse is planning a community-based project to reduce obesity in a school-aged population. Which outcome statement best supports the goal for this population? a.) Increase in exercise will decrease obesity in children with a sedentary life style. b.) Students with a body mass index above the 95 percentile will decrease. c.) Within 2 years, students with a body mass index greater than 95% will be reduced by 50%. d.) In the target population, 30% of students will be below the 95 percentile in weight

Within 2 years, students with a body mass index greater than 95% will be reduced by 50%. Goals are intended to be expressed in specific outcomes that provide direction toward interventions and determine change in measurable terms. Outcome statements include past or present events with specific quantitative expectations with a time frame, so (C) supports these specific terms. (A, B, and D) are not as specific as (C).