Final: Community (Questions)

Carolyn Mason uses technology to upload glucose readings to primary care providers to ensure that they are aware of trends. What are the most significant negative aspects of the use of new technology? Select all that apply: High cost of equipment Potential for privacy breach More convenient for providers Increased legal liability

*

BSN Nurses are

- more adequately prepared and can serve as leaders and enable others to have a smoother recovery during a disaster

When Planning a Health Program

- the number one thing is to assess the need

Report Cholera to what?

- to Health Department

Why is planning care a challenge today?

- we have multiple providers, multiple payers, insurance of different kinds, and settings need to be coordinated

A state health department wants to ensure that the local health departments are delivering quality client care and can demonstrate the degree of excellence attained. The principle that is best defined by this statement is: A. continuous quality improvement (CQI). B. quality assurance (QA). C. risk management. D. total quality management (TQM).

B

A multidisciplinary quality assurance team has reviewed an organization's stated philosophy and objectives and developed a conceptual model for appraisal that integrates peer review and client satisfaction. The quality assurance program component that should be addressed next would be: A. action. B. process. C. structure. D. outcome.

D

C -

Which of the following Medicaid clients would most likely receive case management? a. An elderly person b. A person receiving rehabilitation following an injury c. A person who has a high-cost chronic disease d. A person with acute illness

What is: the United Way, American Red Cross, Free clinics, Senior Center?

Examples of community-based organizations

A health care provider's refusal to accept Medicare or Medicaid

Health care rationing

What is: A specialty area of nursing practice that promotes optimal health and well-being for patients, their families, and caregivers within their homes and communities

Home health nursing

What does I PREPARE stand for?

Investigate potential exposures Present work Residence Environmental concerns Past work Activities Referrals and resources Educate

What is: Federal program to provide education to children about safety

Safe Kids Campaign

a condition including the promotion and maintenance of physical, mental, spiritual and social health for the family unit and for individual family members.

family health

first level of response is who

fire department, law enforcement, public health, and emergency services

assessing factors that determine or influence whether disease or other unhealthy results occur

health risk

highly prevalent problem that is commonly acquired early in life

holoendemic

this type of data includes death certificates, med examiner reports and birth certificates

morbidity data

based or oriented Teaching on water problems

oriented

increase in disease and or event from expected levels to levels that are clearly in excess of expected levels

outbreak

identifying an increase in frequency of disease

outbreak detection

this type of preparedness are disaster medical assistance teams that supplement local and state medical care needs

professional preparedness

the steps of program management are:

program, planning, evaluation

does not have a common source and spreads gradually from person to person

propagated outbreak

what are some men health concerns?

prostate cancer, testicular cancer, erectile dysfunction

client records are what:

provide the evaluator with information about the care given to the clients and the results of that care

reestablishment

reconstruction

A nurse is preparing an education program on disease transmission for employees at a local day care facility. When discussing the epidemiological triangle, the nurse should include which of the following factors as agents? (Select all that apply) Resource availability Ethnicity Toxins Bacteria Altered immunity

toxins bacteria

separating casualties and allocating treatment on the basis of the victims potential for survival

triage

School nurse working with an obese child

- involve entire family in care planning and teach about nutrition

based or oriented Pt comes up and asks about skin rash

based

Infectious diseases that are notifiable at the national level

- cholera, rabies animal, rabies human, smallpox/variola, tuberculosis

A community health nurse is educating the public on the agents of bioterrorism. Which of the following agents should the nurse include as Category A biological agents? (SATA) A. Hantavirus B. Typhus C. Plague D. Tularemia E. Botulism

- Answer: C, D, E

The idealized family portrayed in the media during the twentieth century consists of a working father, a mother who stays at home, and their children. Many families today compare their turbulent, hectic lives with those of its fictionalized past and find their situations wanted to be more idealized. Did the idealized version of the traditional family ever exist?

- Answer: No. The idealized version never existed. There have always been stressors that presented challenges for families. Although not as prominent in the past, differing family structures have always existed within the US society.

What is? Responsible for: - Lower respiratory tract infections in infants and children - SIDS - Buildup of fluid in the inner ear - Asthma flare ups

- Answer: Second hand smoke

What is ? Injuries sustained by accident: - Falls - Fires - Drowning - Suffocation - Poisoning - Sports - Motor vehicle accidents

- Answer: Unintentional injuries

What would be the most important elements to assess in the home environment?

- Do a physical assessment. - Walk through the important parts of house (bedroom, bathroom, kitchen, and hallways. Questions to ask: - Does the client have food in the house to eat? - Is there help with household activities? - Does the client live alone?

Medicare fraud and abuse include

- Inappropriate use of home health services - Inaccurate billing for services - Excessive administrative staff - Kickbacks for referrals - Billing for non-covered medical supplies

The home visit is the hallmark of nursing in home health and hospice. When a nurse enters a client's home, he or she is a guest and must recognize that the services offered can be accepted or rejected. The first visit sets the stage for success or failure. The initial assessment of the client, the support system, and environment is crucial. - What strategies would the nurse consider to develop a trusting relationship during the first visit?

- Respect the family's custom and space and use sensitivity regarding the timing of questions. - Be flexible and keep promises; this is even more important in the home. - Give the family a time range when making an appointment to allow for delays at other homes and for traffic. - Provide the client and family information about the referral, the purpose of the visit, what services are available, and how to contact the agency. - Deal first with the issue that is uppermost on the client's mind, not what is first on the nurse's agenda. This strategy will decrease client anxiety and improve the ability to understand and focus on what the nurse needs to tell them.

What should the nurse include in a client contract?

- Set short-term and long-term goals - Have a plan for every visit to progress toward the goals - Develop principles to facilitate care and encourage self-care - Plan for modifying care to allow as much independence as possible

What is: Parish nursing activities

- Sharing the joys of a new member in the family - Sharing the sorrows of losses in the family - Listening to the concerns of a youngster anticipating diagnostic procedures - Helping teens consider options when overwhelmed with serious life issues

What is: Goal of Omaha System

- To foster collaborative practice - To develop a structured and comprehensive system that could be understood and used by members of various disciplines

Planning effective health problem

- assess needs first!

Disaster Management planning begins

- before a disaster happens

Greatest population at risk after a disaster

- children and impoverished

12 statements that address the moral standards that delineate public health's values, goals, and obligations.

2002 Code of Ethics for Public Health

Nine statements that address the moral standards that delineate nursing's values, goals, and obligations.

2015 Code of ethics for Nurses

A client ask a community health nurse if there is a vaccine that protects against hepatitis infections. Which of the following might the nurse suggest? SATA A. Hepatitis B B. Hepatitis A C. HCV (hepatitis C) D. Immunoglobulin

A. Hepatitis B B. Hepatitis A

6. An underlying current throughout the special population groups with health disparities is: poverty. aging. minority groups. children.

A. Poverty Health disparities present political implications and influence government actions. Certain groups have been recognized as experiencing health disparities and have become a priority for policy efforts. Poverty is a strong and underlying current throughout all of the special groups.

A community health nurse is developing an education program on social factors that contribute to vulnerability. Which of the following factors should the nurse include? SELECT ALL THAT APPLY A. Stress B. Education C. Environment D. Nutrition

A. Stress B. Education C. Environment D. Nutrition

A nurse at a community clinic is conducting a well-child visit with a preschool-age child. The nurse should identify which of the following manifestations as a possible indication of child neglect? Select all that apply. A. Underweight B. Healing spiral fracture of the arm C. Genital irritation D. Burns on the palms of the hands E. Poor hygiene

A. Underweight B. Healing spiral fracture of the arm C. Genital irritation D. Burns on the palms of the hands E. Poor hygiene

2. When determining whether a geographic area is rural or urban, the nurse should recognize that: A. rural and urban areas, by relative nature, occur on a continuum. B. rural regions have fewer than six persons per square mile. C. rural residents feel isolated. D. rural areas are recreational, retirement, or resort communities.

A. rural and urban areas, by relative nature, occur on a continuum. Rural and urban residencies are not opposing lifestyles. Rather, they are a rural-urban continuum ranging from living

The occupational nurse conducts a walkthrough on a weekly basis in the automobile factory to: A.Assess for the presence of actual or potential hazards B.Ensure that employees are actually working C.Make sure the employees know someone is watching them D.Obtain knowledge about various roles to attain upward mobility

A.Assess for the presence of actual or potential hazards The nurse conducts assessments of the workplace. The purpose of this assessment, known as a worksite walkthrough or survey, is to learn the following: The work processes and materials The requirements of various jobs The presence of actual or potential hazards The work practices of employees

10.Which of the following statements accurately describe the stress reaction phases a community may experience during a disaster response? (Select all that apply.) A.Disillusionment and reconstruction is most associated with response efforts. B.During the Heroic phase, there is overwhelming need for people to do whatever they can to help others survive the disaster. C.In the Honeymoon phase, survivors may be rejoicing in that their lives and the lives of loved ones have been spared. D.Disillusionment is the longest phase in the stress reaction process. E.The Disillusionment phase occurs after time elapses and people begin to notice that additional help and reinforcement may not be immediately forthcoming.

B, C, E (The first two phases, the Heroic and Honeymoon phases, are most often associated with response efforts. The latter two phases, Disillusionment and Reconstruction, are most often linked with recovery. During the Heroic phase, there is overwhelming need for people to do whatever they can to help others survive the disaster. In the Honeymoon phase, survivors may be rejoicing in that their lives and the lives of loved ones have been spared. Survivors will gather to share experiences and stories. The Disillusionment phase occurs after time elapses and people begin to notice that additional help and reinforcement may not be immediately forthcoming. The last phase, Reconstruction, is the longest. Homes, schools, churches, and other community elements need to be rebuilt and reestablished.)

A school nurse is scheduling visits with a physical therapist for a child who has cerebral palsy. in which of the following roles is the nurse functioning? A. Direct caregiver B. Consultant C. Case manager D. Counselor

C. Case manager

A school nurse is scheduling visits with a physical therapist for a child who has cerebral palsy. In which of the following roles is the nurse functioning? A.Direct caregiver B.Consultant C.Case manager D.Counselor

C.Case manager In the role of the case manager, a school nurse coordinates comprehensive services for students who have complex health needs

What is the key purpose of health promotion in an occupational setting? A.To detect disease and initiate prompt treatment B.To restore health as fully as possible C.To maintain or enhance the well-being of individuals or groups D.To eliminate or reduce the risk of disease

C.To maintain or enhance the well-being of individuals or groups In the occupational health setting, the purpose of health promotion is to maintain or enhance the well-being of individuals or groups of employees and the company in general.

What are some US dept of health and wellness programs?

CMS, FDA, CDC, NIH

What is: An organized community approach designed to prevent disease, promote health, and protect populations

Public health

Traditional reimbursement methods that are fees for the delivery of health care services that are set after services are delivered.

Retrospective reimbursement

In 2012, 48 million people in the US were ...

Uninsured

based or oriented Nurse teaching a student who has asthma and meds

based

based or oriented Providing care to family with illness

based

The scope of occupational nursing

Worker and workplace assessment and surveillance Case management Health promotion Management and administration Business and finance skills Research

intentional release of hazardous chemicals into the environment to harm or kill.

chemical terrorism

A nurse is concluding a community assessment. Which of the following data collection methods is the nurse using when having direct conversations with individual members of the community? A. Key informant interviews B. Participant observation C. Focus Groups D. Health Surveys

- Answer: A.

Motor vehicle-related injuries and violence are the leading cause of morbidity and mortality for: A. Toddlers and preschoolers B. School-age children C. Adolescents

- Answer: C - Rationale: Risk taking becomes more conscious at this time, especially among boys. The injury death rates for boys are twice as high as those for girls. Adolescents are at the highest risk of any age group for motor vehicle deaths and fatal poisonings. Use of weapons and drug and alcohol abuse play an important role in injuries in this age group.

CASE STUDY Nurse Jones is the school nurse at Caseyville Middle School. The state requires all entering sixth-grade students to have a current immunization certificate on file prior to the student's enrollment. After reviewing the students' records, Nurse Jones finds that several students do not have current immunization certificates on file. Although the state law requires immunization, it does not specify the course of action in cases of noncompliance. Nurse Jones goes to her supervisor to discuss possible resolutions to the situation. Should they suspend the noncompliant students because the law states the certificate for immunization is required for enrollment? This solution could mean many missed days of valuable lessons for the students. Nurse Jones and her supervisor decide to contact each student and meet with each family individually. The meetings reveal that many of the parents have tried to get their child immunized but have not been able to do so because of the costs of the shots or the inability to make an appointment at the busy doctor's office. Nurse Jones works with those families to make appointments at the local health department to fulfill the immunization requirement. 1. The three types of law in the US that have particular importance to the community-oriented nurse are: (a) constitutional law, (b) legislation and regulation, and (c) judicial or common law. Describe how each of these types of laws affects Nurse Jones 2. What was the state's purpose when it made a law requiring immunizations prior to school enrollment? Which power was it invoking? 3. What can Nurse Jones do on the policy level to clear up some of the confusion about what to do when faced with students who are noncompliant regarding the immunization certificate policy for enrollment?

1. Constitutional law derives from federal and state constitution. It would provide guidance to the state for immunization certificate policies. Legislation is law that comes form the legislative branches of federal, state, or local government. Regulations are specific statements of law related to defining or implanting individual pieces of legislation. Nurse Jones is affected by legislation and regulation when she must adhere to and enforce the state's ruling to require current immunization certificated prior to sixth-grade enrollment. Judicial law is based on court or jury decisions. Nurse Jones and her supervisor could have reviewed judicial law to see whether any similar cases have occurred to aid in their decision-making process. 2. The state is acting to protect the health, safety, and welfare of their citizens. This power is called police power. 3. Nurse Jones can participate in a nursing organization, such as the American Nurses Association (ANA), to change the policy at the state level. Nurse Jones could also write to or meet with her legislator to express her concerns about the current immunization law.

A government agency is conducting an audit of all active clients in the local hospice program to ensure that hospice criteria for care are being applied appropriately. The type of tool being used in this specific approach to quality assurance is: A. concurrent audit. B. outcome audit. C. retrospective audit. D. peer review.

A

Given recent vaccine shortages for the flu, the local nurses in community health form a group to evaluate the process of scheduling and operating flu vaccination clinics in the community and review the community's complaints from the previous season. The activity best represents the principle of: A. total quality management (TQM) to achieve continuous quality improvement (CQI). B. quality assurance (QA) to achieve continuous quality improvement (CQI). C. risk management to achieve quality. D. continuous quality improvement (CQI) to achieve total quality management (TQM).

A

The Omaha System is a client classification system developed by the Visiting Nurses Association of Omaha, Nebraska, that has the potential to improve the delivery of care by: A. improving the description of care. B. minimizing the assessment required. C. predicting the outcome. D. decreasing the communication needs.

A

7.The nurse in community health identifies an elder abuse problem because of caregiver stress among families in the local community resulting from lack of caregiver support services. The next step in the community-oriented nursing process would be to: a.analyze the community problem. b.establish priorities. c.establish goals and objectives. d.identify intervention activities.

A (After the identification of the community problem(s), the planning phase of the community-oriented nursing process should begin with an analysis of the problem to seek clarification on the nature of the problem, its origins and effects, intervention points, interested parties/change agents, direct and indirect contributing factors, outcomes of the problem, and relationships between problems. Once high-priority problems are identified, relevant goals and objectives are developed, followed by the identification of intervention activities.)

4.The nurse engaging in formative program evaluation would most likely: A. conduct medical record audits for quality assurance. B. make a home visit before a client is discharged from the program. C.participate in new client evaluation. D.write policy for risk management.

A (Quality assurance audits are prime examples of formative program evaluation in health care delivery. The monitoring of program activities—such as hours of services, number of providers used, number of referrals made, and amount of money spent to meet the program objectives—provides an evaluation of the progress of the program. This type of evaluation is an example of formative evaluation of processes, which occurs on an ongoing basis while the program exists. Progress evaluation occurs primarily while implementing the program. The nurse who completes a daily or weekly log of clinical activities (e.g., number of clients seen in the clinic or visited at home, number of phone contacts, number of referrals made, number of community health-promotion activities) is contributing to progress evaluation of the nursing service.)

4.The hospital infection control practitioner reports new cases of tuberculosis to the public health department. Of what type of surveillance system is this an example? A.Passive B.Active C.Sentinel D.Special

A (Surveillance systems in use today are defined as passive, active, sentinel, and special. In the passive system, case reports are sent to local health departments by health care providers (i.e., physicians, nurses) or laboratory reports of disease occurrence are sent to the local health department. In the active system, the nurse, as an employee of the health department, may begin a search for cases through contacts with local health providers and health care agencies. In the sentinel system, trends in commonly occurring diseases or key health indicators are monitored. Special systems are developed for collecting particular types of data; these may be a combination of active, passive, and/or sentinel systems.)

B -

A nurse is using a case management plan to maximize patient care outcomes. Which of the following describes an important consideration that should be made by the nurse? a. Case management plans should be used only by nurses to manage care. b. Case management plans should be individualized for each client. c. Case managements plans provide additional expense to the client and family. d. Case management plans focus on the natural progression of the disease.

10.The public health nurse is most likely to use what types of surveillance systems? (Select 2 that apply.) Active Passive Sentinel Syndronic

A, B (Although all of the systems are important, the public health nurse is most likely to use the active or passive systems. A passive system may use the state reportable disease system to complete a community assessment or MAPPS. The active system is used when several schoolchildren become ill after eating lunch in the school cafeteria or at the local hot dog stand, to investigate the possibility of food poisoning, or to follow up the contacts of a newly diagnosed client with tuberculosis or a sexually transmitted infection (STI) at the local homeless shelter.)

A nurse is conducting surveillance for agents of Bioterrorism. What information must the nurse gather to answer the WHY of the surveillance system? SATA. A. Who? B. Where? C. How? D. When? E. How many? F. What?

A, B, D, F Page 460: Surveillance of Communicable Diseases: "When conducting surveillance you must gather the who, when, where, and what. These elements are then used to answer why."

Identification of the discrepancies between the quality standards of the agency and the actual practice of the health care professionals is part of the interpretation component of quality assurance programs. Other factors addressed during this stage are: (select all that apply) A. choices of possible courses of action. B. follow-up evaluation. C. strengths and weaknesses. D. taking action.

A, C

3. A nurse is planning a community health program. Which of the following actions should the nurse include as part of the evaluation plan? A. Determine availability of resources to initiate the plan. B. Gain approval for the program from local leaders. C. Establish a timeline for implementation of interventions. D. Compare program impact to similar programs.

A. The nurse should determine availability of resources to initiate the program as part of the assessment phase. However, when evaluating sustainability of the program, the nurse should determine whether resources are available for continuing the program. B. The nurse should gain approval for the program from local leaders as part of the preplanning phase because plans for the program should not move forward without adequate community support. C. The nurse establishes a timeline for implementation of interventions after determining and selecting the best strategies for meeting the program's goals and objectives. D. CORRECT: the nurse should include a comparison of program impact to similar programs as part of the evaluation plan. This comparison assists with determining the efficiency of the program.

A nurse at a community clinic is conducting a well‑child visit with a preschool‑age child. The nurse should identify which of the following manifestations as a possible indication of child neglect? (Select all that apply.) A. Underweight B. Healing spiral fracture of the arm C. Genital irritation D. Burns on the palms of the hands E. Poor hygiene

A. Underweight E. Poor hygiene

A newly hired occupational health nurse at an industrial facility is performing an initial workplace assessment. Which of the following information should the nurse determine when conducting a work site survey? A. Work practices of employees B. Past exposure to specific agents C. Past jobs of individual employees D. Length of time working in current role

A. Work practices of employees

An occupational health nurse is consulting with senior management of a local industrial facility. When discussing work-related illness and injury, the nurse should include which of the following factors as physical agents? (Select all that apply) A.Noise B.Age C.Lighting D.Viruses E.Stress

A.Noise Physical agent B.Age Host factor C.Lighting Physical agent D.Viruses Biological factors E.Stress Psychological factors

What kind of isolation precautions should a nurse utilize when caring for a client with HIV? A.Standard Precautions B.Contact Precautions C.Droplet D.Airborne

A.Standard Precautions

As a clinical project, the health department asked the community health nursing class at the university to develop a community message to air on local radio about the potential of a pandemic flu. What does the message need to contain to help the community prepare?

Answer: - The pandemic can come in waves and exposure to the flu could last for months. - It is important for families and businesses to be prepared. - There will be disruption in services, including hospitals, banks, schools, and post offices. - People may not be able to go to work; thus there may be a possible loss of income - There may not be any transportation - Support systems for individuals and families need to be developed.

The general approach to quality improvement known as licensure that grants control over who can enter into and who exists in a profession can best be described as a contract between the: A. consumers and the profession. B. legislature and the state board. C. profession and the state. D. public and the professional associations.

C

a nurse is planning measures to reduce the incidence of obesity. Which of the following interventions affect the environment, according to the epidemiological triangle? A) determine whether clients have a family history of obesity B) measure clients BMI C) provide low fat meal options at public schools D) ask affected adults to keep a diary of food intake

C-could help to reduce rates of obesity in the community

5. Elderly clients should be assessed for signs of abuse. The illegal use of a person for another person's profit is known as: neglect. incompetence. exploitation. self-determination

C. Exploitation Neglect refers to a lack of services that are necessary for the physical and mental health of an individual by the individual or a caregiver. Older persons can make independent choices with which others may disagree. Their right to self-determination can be taken from them if they are declared incompetent. Exploitation is the illegal or improper use of a person or their resources for another's profit or advantage. During the assessment process, nurses need to be aware of conflicts between injuries and explanation of cause, dependency issues between client and caregiver, and substance abuse by the caregiver.

8. A particular chronic health problem that adversely affects the aging experience for which it is difficult to estimate the number of individuals affected or the associated cost to manage is: iatrogenic drug reactions. immobility. incontinence. intellectual impairment.

C. Incontinence Urinary incontinence often contributes to institutional care and social isolation. For that reason it is difficult to estimate the number of individuals affected by and the cost associated with incontinence. It is important to address continence routinely in the assessment process, identify the type of incontinence, and intervene appropriately.

A community health nurse is developing strategies to prevent or improve mental health issues in the local area. In which of the following situations is the nurse implementing a tertiary prevention strategy? A. Providing support programs for new parents B. Screening a client whose partner recently died for suicide risk C. Teaching a client who has schizophrenia about medication interactions D. Discussing stress reduction techniques with employees at an industrial site

C. Teaching a client who has schizophrenia about medication interactions

A community health nurse is developing strategies to prevent or improve mental health issues in the local area. Which is a tertiary prevention strategy? A. Providing support programs for new parents. B. Screening a client whose partner recently died for suicide risk. C. Teaching a client who has schizophrenia about medication interactions. D. Discussing stress reduction techniques with employees at an industrial site.

C. Teaching a client who has schizophrenia about medication interactions.

Examples of chronic diseases include:

CV disease HTN stroke DM mental illness cancer weight control

Payment system whereby one fee is charged the client to pay for all services received or needed

Capitation

Definition of a population

Collection of individuals who share at least one common characteristic

A client is being seen who states they have been having flu-like symptoms including fever, muscle aches, and mouth sores. Which of the following STD may the client be experiencing? A. Chlamydia B. Genital herpes C. Gonorrhea D. HIV

D. HIV

Which of the following ethical theories are most appropriate to consider in dealing with the rural community (Select 2 that apply). Distributive justice and the allocation of benefits and burdens to members of society Beneficence as the obligation to perform those actions that maintain or enhance the dignity of other persons Autonomy, which requires that individuals be permitted to choose those actions and goals that fulfill their life plans unless those choices result in harm to another Virtue ethics, which enables persons to flourish as human beings

Distributive justice and the allocation of benefits and burdens to members of society Beneficence as the obligation to perform those actions that maintain or enhance the dignity of other persons

Governmental agencies important to nursing

Division of Nursing National Institute of Nursing Research Agency for Healthcare Policy and Research

Social science concerned with the problems of using or administering scarce resources in the most efficient way to attain maximum fulfillment of society's unlimited wants

Economics

What is the most important thing that community health nurses need to know?

It is the greatest good for the greatest number

What is: Responsible for implementing and enforcing local, state, and federal public health codes and ordinances while providing essential public health services.

Local public health department

Who coined the term public health?

Lillian Wald

Who est the Henry St Settlement?

Lillian Wald and Mary Brewster

Provides assistance to states and counties to pay for medical services for poor older adults, the blind, the disabled, and families with dependent children.

Medicaid

Provides hospital insurance and medical insurance to persons aged 65 and older, to permanently disabled persons, and to persons with end-stage renal disease.

Medicare

reducing risks to people and property from natural hazards before they occur (protecting building infrastructure, detect terrorists before they strike, immunizations

Mitigation (aka prevention)

What is: the professional body for school nurses

National Association of School Nurses (NASN)

Consultants, direct-care providers, researchers, teachers, supervisors, and program managers.

Nurses in state and local health departments.

Why is the issue of nursing scope of practice important to nurses in the community setting? The nurse practice act does not apply to community health nurses Nurses in the community setting have traditionally practiced with much autonomy Educational requirements for licensure are different in the community setting Nurses in the community setting do not have the same policies or procedures

Nurses in the community setting have traditionally practiced with much autonomy

What is: Responds to health and wellness needs of populations of faith communities and are partners with the church in fulfilling the mission of the health ministry

Parish Nursing

Reduced educational outcomes for children, poor nutrition, low productivity in the adult workforce, and unstable economic growth in a population, community, or nation.

Poorer health outcomes related to poverty

T or F: School nurses are mandated to tell the authorities about suspected cases of child abuse and neglect

T

TLC with family caregiving stands for:

T- training in care techniques, safe med use, recognition of abnormalities, and available resources L- leaving the care situation periodically to obtain relaxation and maintain their normal living needs C-care for themselves (the caregiver) through adequate sleep, rest, exercise, nutrition, socialization, solitude, support, financial aid, health management.

What is: Act that states workers must have a safe and healthful work environment

The Occupational Safety and Health Act of 1970

How is the U.S. Department of Agriculture (USDA) involved with providing services to a population of high-risk families? The USDA guides payment policy and delivery rules for services for poor, elderly, disabled, and unemployed individuals. The USDA is the lead federal agency charged with improving the quality, safety, efficiency, and effectiveness of health care for all Americans. The USDA administers food stamps and the WIC nutrition program. The USDA acquires new knowledge to help prevent, detect, diagnose, and treat disease and disability through food resources.

The USDA guides payment policy and delivery rules for services for poor, elderly, disabled, and unemployed individuals.

B -

The case manager explains to two disagreeing parties that coming to an agreement will save personnel costs for both of them. Which of the following terms best describes this action? a. Assertiveness b. Collaboration c. Cooperation d. Compromising

C -

The nurse suggests use of telehealth to assess how a client is progressing. Which of the following resources must be available for continuing care to be implemented? a. A physician who is willing to use wireless prescriptions and plans of care b. Family permission for the nurse to make home visits c. Long-distance telephone service or a computer with Internet access d. Willingness of the caregiver to drive the client to the nearest clinic

In considering the environmental concerns of the residents of the community, which of the following ethical questions would Lorraine need to consider? (Select all that apply) What actions should I perform? What are the funding options for the community? Am I adequately prepared to collect data on the population? What are my obligations to myself and the community I serve? How should I behave?

What actions should I perform? What are my obligations to myself and the community I serve? How should I behave?

B -

When acting as a mediator, the nurse advocate would: a. choose a new health plan for a client with limited funds. b. assist new parents in communicating with their health plan regarding well-baby coverage. c. provide health education to teens who need knowledge about sexually transmitted diseases. d. set up a doctor's appointment for an illiterate adult.

C (Case management, in contrast to the definition of care management, involves activities implemented with individual clients in the system.) -

Which of the following best describes case management? a. A tool of health maintenance organizations b. Targeted toward a specific segment of the population c. Implemented with individual clients d. Used to monitor the health status, resources, and outcomes for an aggregate

D -

Which of the following best describes the goal or priority of the nurse advocate? a. To gain organizational and governmental support for the promotion of nursing objectives b. To improve community service needs identified by research findings c. To integrate evidence-based practice guidelines in the provision of community nursing service d. To promote the client's rights and self-determination

D -

Which of the following best describes the primary problem that can result from health care today being given by many different care providers? a. Clients are not sure which provider to see first. b. Health care providers have to make referrals to other providers. c. Clients sometimes are not sure who their primary provider is. d. Overuse, underuse, or gaps in care may result.

What is: Important laws that govern the financial compensation of employees who suffer work-related health problems.

Worker's compensation acts

1.Migrant workers and their families who reside in a specific mobile home park during the summer months would best be classified as a: a.community. b.group. c.setting of practice. d. target population.

a (In most definitions the concept of community includes people, place/time, and function. Nurses in community health practice regularly need to examine how the personal, geographic, and functional dimensions of community shape their nursing practice with individuals, families, and groups. They can use both a conceptual definition and a set of indicators for the concept of community in their practice. The community is first the setting for practice for the nurse practicing health-promotion and disease-prevention interventions with individuals, families, and groups. Second, the community is the target of practice for the public health nurse whose practice is focused on the broader community rather than on individuals.)

this type of surveillance the nurse or health employees may begin search for cases and gather data to try to determine the magnitude of the problem

active system

The act of pleading for or supporting a course of action on behalf of a person, group, or community

advocacy

the epidemiological triangle includes what 3 things:

agents, hosts, environmental factor

the deliberate release of viruses, bacteria or other germs used to cause illness or death in people, animals or plants

biological terrorism

Planning of the community's health includes:

analyzing problems, prioritizing the, establishing goals*

what is the essential step in basic program planning?

assessing the clients need, identifying objectives for alternatives, choose solution

The core functions in public health that are all grounded in ethics

assessment, policy development, and assurance

The condition of being independent and free to make your own decisions

autonomy

2.A nurse in community health contacts three individuals who have had sexual encounters with an individual recently diagnosed with syphilis. The concept that is best described by this intervention is: a. community. b. community as client. c. individual as client. d. partnership.

b (When the community is the client, the results of nursing interventions should produce changes that affect the community as a whole, such as reducing the spread of sexually transmitted diseases (STDs). Although the nurse may work with individuals, families or other interacting groups, aggregates, institutions, or communities, or within a population, the resulting changes are intended to affect the whole community. The community health nurse is not providing care to an individual in this circumstance. It would be ideal if there were some form of partnership in this intervention.)

Stereotyping, Prejudice, Racism, Ethnocentrism, Cultural imposition, Cultural conflict, Cultural shock -- are all what?

barriers to providing culturally competent care

based or oriented Home health nurse provide wound care for an immobile patient

based

Action taken for the benefit of others, to help prevent or remove harms the situation of others.

beneficence

Affects social and environmental determinants of health, including clean air, safe drinking water, adequate food, and secure shelter.

climate change

group exposed to common noxious influence

common source outbreak

The local hospital emergency department has recently experienced an increase in gastroenteritis cases among migrant farmworkers. The local health department is informed of this rise in cases and schedules a case mapping of local: a. bars frequented by migrant workers. b. farm fields employing migrant workers. c. housing for migrant workers. d. restaurants frequented by migrant workers.

c. housing for migrant workers. Housing conditions greatly vary among states and localities. When housing costs are high, 50 farmworkers may live in one house, or three families may share one trailer. Some may live in cars or tents if necessary. Housing may lack individual sanitation, bathing, or laundry facilities. Poor-quality and crowded housing can contribute to such health problems as tuberculosis (TB), gastroenteritis, and hepatitis.

A nurse is preparing a community health program on communicable diseases. When discussing modes of transmission, the nurse should include which of the following illnesses as airborne? a. cholera b. malaria c. influenza d. salmonellosis

c. influenza

A nurse is preparing an education program on disease transmission for employees at a local day care facility. When discussing the epidemiological triangle, the nurse should include which of the following factors as agents? (SATA) a. resource availability b. ethnicity c. toxins d. bacteria e. altered immunity

c. toxins d. bacteria

The nurse supports and facilitates clients in their use of cultural practices when such cultural practices are not harmful to clients

cultural accomodation

The nurse's intrinsic motivation to provide culturally competent care

cultural desire

Involves the belief in one's own superiority, or ethnocentrism, and the act of imposing one's values on others.

cultural imposition

A set of beliefs, values, and assumptions about life that is widely held among a group of people and that is transmitted across generations

culture

control or reduce risk factors and minimize the incidence of associated disease and premature mortality; risk reduction is reflected in greater congruity between appraised and achievable age

health risk reduction

quantitative or qualitative measures used to describe the level of well-being or illness present in a defined population

health status indicators

this stress reaction is the overwhelming need for people to do whatever they can to help others survive

heroic

A nurse is developing a community health education program for a group of clients who have a new diagnosis of diabetes mellitus. Which of the following learning strategies should the nurse include for clients who are auditory learners? a. showing informational videos b. providing equipment to practice hands-on skills c. supplying outlines for note-taking d. facilitating small group discussions

d. facilitating small group discussions

any natural or human-made incident that cause disruption, destruction and or devastation requiring external assistance

disaster

the ongoing systematic collection, analysis and dissemination of health data. Used to monitor and reduce chronic disease and injuries

disease surveillance

this is where time elapses and realize that a return to previous norm is unlikely

disillusionment

a disease or event presently occurring in the population

endemic

a situation whereby the demands of the situation exceed the resources and coping capacity of the family

family crisis

Ex of a mandatory public health law

immunizations

this phase is where rapport is established

in-home phase

Mr. Smith has identified that 15% of the prisoners have acquired valley fever. What measure of epidemiology is most important to report to the medical director? Incidence rate Risk Attack rate Proportions

incidence rate

this phase in the home visit process clarifies the purpose and why you are going to see this

initiation phase

the 5 I's of chronic conditions=

intellectual impairement (dementia, depression, delerium) immbolity instability incontinence iatrogenic drug reactions

cases exposed over a period of days or weeks

intermittent source

What is an example of advocacy?

lobbying for healthcare

In a lower income retirement community, what is the community health nurse most concerned with regarding diabetes care and control of symptoms? Medication and diet compliance The use of complementary therapies Access to transportation Availability of general practitioners in the community

medication and diet compliance

outbreak with common source followed by secondary exposures related to person-to-person contact ( like spreading flu)

mixed outbreak

this type of data includes discharge reports, billing, sss

mortality data

destruction caused by nature

natural disasters

To do not harm, an obligation to not intentionally inflict harm

nonmalificence

Have the responsibilities to be informed consumers and to be advocates for citizens in their community regarding environmental issues.

nurses

Implementing of community health includes:

nurses role (social change process)

based or oriented Classes on body mechanics in an industrial place

oriented

based or oriented Looking at the water supply

oriented

based or oriented Providing classes on low fat techniques

oriented

epidemic spread of the problem over several countries or continents

pandemic

active participation and involvement of the community or its representatives in bringing about health change is______

partnership

type of surveillance: case reports/labs reports sent to local health departments by health care providers. They are summarized and sent to bigger health department who monitors the problems

passive system

this type of preparedness is having a personal checklist, emergency supplies kit, and red cross identification or FEMA

personal preparedness

Evaluation for intervention begins in which stage? (planning, implementing...etc)

planning

all persons become ill at the same time from one thing

point source

this phase is where the nurse documents, and plans for interventions

post-visit phase

this phase in the home visit process is the phase where a phone call is made and an appointment is scheduled

pre-visit phase

a family venogram made to assess health risks is what type of prevention

primary

this type of surveillance is developed to collect particular types of data

special system

irregular pattern of problems

sporadic

those involved in planning, funding and implementing the program are called

stakeholders

statistics (live births, infant mortality rates etc) are status, structure, or process

status

Identification of community health problems includes:

strengths and weaknesses of the community

services and resources of community such as hospitals, nursing homes, and schools is (status, structure, or process)

structure

Cultures are considered to be future, past, or present oriented

time oriented

What did the colonists do in regard to public health?

work on sanitation and vital records

A nurse is working with a client who has systemic lupus erythematosus and recently lost her health insurance. Which of the following actions should the nurse take in the implementation phase of the case management process? A. Coordinating services to meet the client's needs B. Comparing outcomes with original goals C. Determining the client's financial constraints D. Clarifying roles of interprofessional team members

- Answer: A

The nurse would like to create an ecomap for the Smith family as part of his assessment. Which of the following elements may be difficult to obtain? A. Financial risks B. Health risks C. Neighborhood and community resources D. Behavioral risks

- Answer: A - Rationale: Economic risk is a key predictor of health. Families often consider financial information private, and both the nurse and family may be uncomfortable when discussing finances. The nurse would only need to know actual family income to help the family determine if they are eligible for programs or benefits. It is helpful to know if the family's resources are adequate to meet their needs.

The most common cause of preventable disease, disability, and death among children are: A. Injuries and accidents B. Maintaining a healthy diet C. Physical activity D. Cardiovascular health

- Answer: A - Rationale: Injuries and accidents are the most common causes of preventable disease, disability, and death among children. Pg. 336

The Patient Self-Determination Act of 1990 requires that providers receiving Medicare and Medicaid funds give clients written information regarding: A. Legal options for treatment in the event the person becomes incapacitated B. Patient rights C. The cost of services D. Patient privacy

- Answer: A - Rationale: Pg. 343

The nurse is interested in initiating a wellness program for construction employees. What is the first step in the process? A. Define the problem and conduct a needs assessment B. Select the participants C. Create an educational plan D. Conduct a cost-benefit analysis

- Answer: A - Rationale: The initial and most critical step in health care planning is defining the problem and assessing client need. The target population, or client, to be served by any program must be identified and involved in designing the program to be developed. Program planners must verify that a current health problem exists and is being ignored or being treated unsuccessfully in a client group. Needs assessment is defined as a systematic appraisal of type, depth, and scope of problems as perceived by clients, health providers, or both.

An occupational health nurse is consulting with senior management of a local industrial facility. When discussing work0related illness and injury, the nurse should include which of the following factors as physical agents? (SATA) A. Noise B. Age C. Lighting D. Viruses E. Stress

- Answer: A & C

Family structures have: SATA A. Changed over time B. The speed of changes is increasing C. Not changed over time D. There is a typical model

- Answer: A, B - Rationale: Social norms have become more tolerant of a range of choices in relation to managing one's life. No typical model exists. An individual may have various life experiences, eg., experiencing some years in a single-parent family.

A public health nurse has determined that she will conduct a windshield survey using the public bus system. What windshield components can be assessed through utilizing public transportation? (SATA) A. What are the religious practices of the residents? B. How frequently is public transportation available? C. Are there common characteristics of the people on the bus? D. What are the socioeconomic characteristics of the residents? E. What are the goals and perceived needs of the residents?

- Answer: A, B, & C - Rationale: While driving a car or riding public transportation, the nurse can observe many dimensions of a community's life and environment through the windshield such as: Religious practices of the residents Common characteristics of people on the street Neighborhood gathering places Housing quality Geographic boundaries

What are the considerations for a nurse responding to a disaster? (SATA) A. Advance personal and family preparation can help ease some of the conflicts that arise and allow nurses to attend to clients sooner. B. The nurse assisting in disaster relief efforts must be as healthy as possible, both physically and mentally. C. Young children should not be involved in disaster preparedness because they might experience undue stress and anxiety. D. One way a nurse can ensure that her family is protected is by providing them with the skills and knowledge to help them cope with a disaster. E. The nurse maintains awareness that disaster drills are a requirement of the state and not a necessity.

- Answer: A, B, D - Rationale: Nurses who are disaster victims themselves and must provide care to others will experience considerable stress. Conflicts between family and work-related duties are inevitable. Advance personal and family preparation can help ease some of the conflicts that arise and help nurses to attend to client needs sooner. In addition, the nurse assisting in disaster relief efforts must be as healthy as possible, both physically and mentally, to serve clients, families and other disaster victims.

A nurse is collecting data to identify health needs in the local community. Which of the following examples should the nurse identify as secondary data? (SATA) A. Birth Statistics B. Precious health survey results C. Windshield Survey D. Community Forum E. Health Records

- Answer: A, B, E

A nurse is preparing to conduct a windshield survey. Which of the following data should the nurse collect as a component of this assessment? (SATA) A. Ethnicity of Community Members B. Individuals who hold power within the community C. Natural community boundaries D. Prevalence of Disease E. Presence of Public Protection

- Answer: A, C, E

Using the family systems theory, which interventions does the nurse put in place to help Stacy's family with their illness and coping? SATA A. Establish a mechanism for providing the family members with information on a regular basis B. Discuss ways to provide for everyday functioning when a family member is ill C. Teach the family about expected growth and development D. Help the family maintain routines and rituals E. Create an ecomap to display the ways the family interacts with outside sources

- Answer: A,B, D - Rationale: The family systems theory encourages nurses to view both the individual clients as participating members of a whole family. Interventions need to build on the strengths of the family to improve or support the functioning of the individual members and the whole family. Some nursing strategies based on a family systems theory include establishing a mechanism for providing families with information about their family members on a regular basis, helping the family maintain routines and rituals, and discussing ways to provide for everyday functioning when a family member becomes ill.

Reporting of national notifiable infectious diseases is essential for what reasons? SATA A. Accurately monitors trends B. Provides the basis for detecting disease outbreaks C. Alerts the hospital about a potential influx of patients D. Uses data to initiate prevention programs E. Uses data to identify potentials for bioterrorist attacks

- Answer: A,B,D - Rationale: Reporting of disease data by health care providers, laboratories, and public health workers to state and local health departments is essential if trends are to be monitored accurately.

A newly hired occupational health nurse at an industrial facility is performing an initial workplace assessment. Which of the following information should the nurse determine when conducting a work site survey? A. Work practices of employees B. Past exposure to specific agents C. Past jobs of individual employees D. Length of time working in current role

- Answer: A.

A nurse is developing a community health program is determining barriers to community resource referrals. Which of the following factors should the nurse include as an example of a resource barrier? A. Costs associated with services B. Decreased motivation C. Inadequate knowledge of resources D. Lack of transportation

- Answer: A.

Some people believe that American families are in decline, whereas others feel they are healthy. What do you think?

- Answer: According to a report from the National Commission on Children, people are both discouraged and encouraged about the status of America's families.

A nurse is completing a needs assessment and beginning analysis of data. Which of the following actions should the nurse take first? A. Determine health patterns within collected data B. Compile collected Data into a database C. Ensure data collection is complete D. Identify health needs of the local community

- Answer: B

A state health department wants to ensure that the local health departments are delivery quality client care and can demonstrate the degree of excellence attained. The principal that is best defined by this statement is: A. Continuous quality improvement (CQI) B. Quality assurance (QA) C. Risk management D. Total quality management (TQM)

- Answer: B - Quality assurance is the monitoring of the activities of care to determine the degree of excellence attained in the implementation of the activities.

What is the primary purpose of planning a well program in the occupational health setting? A. Provides a mechanism for marketing to attract new business for the corporation B. Provides a proactive means of promoting the health of the employees C, Reduces insurance and workers compensation premiums D. Provides job security for the nursing staff

- Answer: B - Rationale: A wellness program is an organized approach to meet the assessed needs of individuals, families, groups, or communities by reducing or eliminating one or more health problems.

Completion of a genogram and educating the family about the findings is an example of which level of prevention related to families? A. Disease management B. Primary prevention C. Secondary prevention D. Tertiary prevention

- Answer: B - Rationale: Completing a family genogram and assessing health risks with the family to contract for family health activities is an example of primary prevention. The nurse uses the information to prioritize interventions which will prevent disease from developing.

The nurse questions Stacy about her recent concerns with high blood pressure and asks if the recent diagnosis has affected her family. This is an example of which family nursing approach? A. Family as the client B. Family as the context or structure C. Family as a system D. Family as a component of society

- Answer: B - Rationale: Family as the context or structure has a traditional focus that places the individual first and the family second. The family as context serves as either a resource or a stressor to individual health and illness. A nurse using this focus might ask an individual client "How has your diagnosis of insulin-dependent diabetes affected your family?"

A home health nurse is discussing portals of entry with a group of newly hired assistive personnel. Which of the following locations should the nurse include as a portal of entry? (SATA) A. Respiratory secretions B. Skin C. Genitourinary tract D. Saliva E. Mucous Membranes

- Answer: B, C, E

A nurse is creating partnerships to address health needs within the community. The nurse should be aware that which of the following characteristics must exist for partnerships to be successful? (SATA) A. Being a leading partner with decision-making authority B. Flexibility among partners when considering new ideas C. Adherence of partners to ethical principles D. Varying goals for the different partners E. Willingness of partners to negotiate roles

- Answer: B, C, E

A community health nurse is determining available and needed supplies in the event of a bioterrorism attack. The nurse should be aware that community members exposed to anthrax will need access to which of the following medications? A. Metronidazole B. Ciprofloxacin C. Zanamivir D. Fluconazole

- Answer: B.

A newly hired public health nurse is familiarizing himself with the levels of disaster management. Which of the following actions is a component of disaster prevention? A. Outlining specific roles of community agencies B. Identifying community vulnerabilities C. Prioritizing care of individuals D. Providing stress counseling

- Answer: B.

A nurse is reviewing the various roles of a community health nurse. Which of the following actions is an example of a nurse functioning as a consultant? A. Advocating for federal funding of local health screening programs B. Updating state officials about health needs of the local community C. Facilitating discussion of a client's ongoing needs with an interprofessional team D. Performing health screening for high blood pressure at a local health fair

- Answer: B.

A school nurse is planning health promotion and disease prevention activities for the upcoming school year. In which of the following situations is the nurse planning a secondary prevention strategy? A. Placing posters with images of appropriate hand hygiene near restrooms B. Routinely checking students for pediculosis throughout the school year C. Implementing age-appropriate injury prevention programs for each grade level D. Working with a dietician to determine carbohydrate counts for students who have diabetes mellitus

- Answer: B.

One of the essentials for baccalaureate-prepared nurses to understand is disaster preparedness. What is the purpose of an adequately prepared nurse? A. It is a regulatory requirement that nurses participate in disaster planning B. Adequately prepared nurses can assist the public quickly so that they may return to their families C. Adequately prepared nurse can serve as leaders and enable others to have a smoother recovery phase D. Community health nurses do not mentor the community in a disaster.

- Answer: C - Rationale: One of the essentials for baccalaureate-prepared nurses to understand is disaster preparedness. Adequately prepared nurses can serve as leaders and enable others to have a smoother recovery phase.

A nurse is preparing a community health program on communicable diseases. When discussing models of transmission, the nurse should include which of the following illnesses as airborne? A. Cholera B. Malaria C. Influenza D. Salmonellosis

- Answer: C.

A school nurse is scheduling visits with a physical therapist for a child who has cerebral palsy. In which of the following roles is the nurse functioning? A. Direct Caregiver B. Consultant C. Case Manager D. Counselor

- Answer: C.

What is? An interdisciplinary process in which the client is the main focus.

- Answer: Case Management

What is? The systematic process of assessment, planning service coordination, referral, monitoring, and evaluation that meets the multiple service needs of clients.

- Answer: Case management

What is? Cure is not expected, so nursing care needs to be holistic

- Answer: Chronic Illness

A nurse is planning a community health program. Which of the following actions should the nurse include as part of the evaluation plan? A. Determine availability of resources to initiate the plan B. Gain approval for the program from local leaders C. Establish a timeline for implementation of interventions D. Compare program impact to similar programs

- Answer: D

A nurse is talking to a client who asks for additional information about hospice. Which of the following statements should the nurse make? A. "Clients who require skilled nursing care at home qualify for hospice care." B. "One function of hospice is to provide teaching to clients about life-sustaining measures." C. "Hospice assists clients to develop the skills needed to care for themselves independently." D. "A Component of hospice care is to control the client's manifestations."

- Answer: D

Which of the following assessment tools may provide a more accurate family assessment? A. Create a genogram and ecomap B. Interview the head of the household on behalf of each family member C. Individual assessments with each family member D. Conduct a home visit

- Answer: D - Rationale: Home visits give a more accurate assessment of the family structure, the natural or home environment, and behavior in the home environment. Home visits also provide opportunities to identify both barriers and supports for reaching family health promotion goals. The nurse can work with the client directly to modify interventions to match resources. Visiting the family in the home may also contribute to the family's sense of control and active participation in meeting its health needs.

A group of students become ill after their teacher uses dry-erase markers to demonstrate a math problem. The students have coughing, headaches, and itching throats. This is an example of which of the following patterns of occurrence? A. Point source outbreak B. Mixed outbreak C. Continuous source outbreak D. Common source outbreak

- Answer: D - Rationale: Patterns of occurrence can be identified when investigating a disease or event. These patterns are used to define the boundaries of a problem to help investigate possible causes or sources of the problem. A common source outbreak refers to a group exposed to a common noxious influence such as the release of noxious gases. In a point source, all persons exposed become ill at the same time during one time, during one incubation period. A mixed outbreak occurs with influenza when a victim of common source has person to person contact with others and spreads the disease. A continuous source case may be exposed over a period of days or weeks, as in food poisonings at a restaurant chain after purchase of contaminated onions.

A case management nurse at an acute care facility is conducting an initial visit with a client to identify needs prior to discharge home. After developing a working relationship with the client, the nurse is engaging in the referral process. Which of the following actions should the nurse take first? A. Monitor the client's satisfaction with the referral B. Provide the client information to referral agencies C. Review available resources with the client D. Identify referrals that the client needs

- Answer: D.

A nurse is scheduling visits with a physical therapist for an adult who has musculoskeletal injuries due to a MVA. In which of the following roles is the nurse functioning? A. Direct caregiver B. Consultant C. Mentor D. Case manager

- Answer: D. Case Manager

What is? Essential for healthy growth and development and influences disease prevention in later life

- Answer: Good Nutrition

How does a definition of family influence our care and society's support of families?

- Answer: How we ourselves define family will influence how we live, how we provide nursing care to families, and what health and welfare programs we are willing to support in society.

Poverty has the largest impact on

- health disparities among ALL populations

7.Local officials have requested a program evaluation of a comprehensive teen sex education program offered in the local schools in preparation for potential budget discussions. A nurse in community health conducts a program evaluation and determines that the teen pregnancy rate has gradually declined over the years that the program has been in place. The community is measuring the program's: efficiency. progress. relevance. sustainability.

A (A program evaluation may be able to determine whether a program provides better benefits at a lower cost than does a similar program or whether the benefits to the clients or number of clients served justifies the costs of the program. This is a measure of the efficiency of a program. A reduction in teen pregnancies can represent significant cost savings to the overall health of the community. The monitoring of program activities—such as hours of services, number of providers used, number of referrals made, and amount of money spent to meet the program objectives—provides an evaluation of the progress of the program. Evaluation of relevance is an important component of the initial planning phase. As money, providers, facilities, and supplies for delivering health care services are more closely monitored, the needs assessment done by the nurse will determine whether the program is needed. Sustainability is the continuation of a program when resources are adequate.)

9.A nurse in community health seeks a low-cost evaluation method to learn the perspectives of the largest number of persons regarding a proposed local safe haven program for unwanted infants. The best evaluation method to meet the criteria would be: community forums. focus groups. key informants. surveys.

A (Community forums have the advantage of being low in cost and capturing the perspectives of a large number of persons. Focus groups and key informant methods limit the number of persons expressing their perspectives. Surveys are expensive and technically demanding.)

9. The nurse in community health defines goals and measurable objectives during the planning phase of a community health intervention. This also marks the beginning of the: A.evaluation phase. B. implementation phase. C.needs assessment. D. problem analysis.

A (Evaluation begins in the planning phase, when goals and measurable objectives are established and goal-attaining activities are identified. After implementing the intervention, only the accomplishment of objectives and the effects of the intervention activities have to be assessed. The nurse will evaluate whether the objectives were met and whether the intervention activities were effective.)

D -

A case manager advocates for a client by helping an insurer understand the client's needs and desires and by helping the client understand programs and benefits offered by the insurer. What role is the nurse? a. Arbitrator b. Counselor c. Mediator d. Negotiator

C -

A case manager implements a primary prevention activity. Which of the following actions would the nurse most likely complete? a. Advocating for the client whose values conflict with those of the medical service provider b. Collaborating between nursing and occupational health personnel c. Educating a group regarding community services that are available if ever needed d. Resolving conflict between a primary care clinic and a tertiary health care facility

A B D -

A case manager is concerned about his exposure to possible lawsuits. Which of the following are appropriate actions to take to minimize this risk? (Select all that apply.) a. Assure clients they can appeal any decision. b. Carefully document client involvement and reasons for decisions. c. Share client information with the other involved providers and agencies. d. Confirm credentials and capabilities of providers or agencies to give care.

D -

A case manager is concerned that some of the clients at the neighborhood clinic are getting fewer services because of their financial situations. The case manager is confronting the ethical principle of: a. justice. b. veracity. c. deontology. d. beneficence.

C -

A client spends a great deal of his time on the Internet or reading articles related to diabetes and its long-term effects. One day the client asks why the nurse has not suggested a life care plan. Which of the following would be the best response by the nurse? a. "Life care plans are only for young persons who are newly diagnosed." b. "Life care plans are primarily used to determine long-term financial needs for legal reasons." c. "You are receiving appropriate care for your diabetes without serious side effects, so a life care plan isn't really appropriate." d. "I was waiting for you to express interest in having a life care plan."

C -

A community health nurse involved in care management would most likely: a. develop, conduct, and evaluate health teaching programs in primary care. b. manage the staff at a free clinic. c. monitor the health status, resources, and outcomes for an aggregate. d. provide immunizations to migrant workers.

B -

A community health nurse is working with an uninsured family with two children. The nurse assists the parents in applying for SCHIP benefits and securing an appointment for the children with a community pediatrician that participates in SCHIP. The intervention can best be described as: a. care management. b. case management. c. continuity of care. d. disease management.

A -

A nurse coordinating care for undocumented minority workers with a high incidence of tuberculosis (TB) conducts a presentation before the local community health board to focus attention on the magnitude of the problem and its potential impact on the local community. The presentation stimulates the community to explore innovative solutions to increase screening for and treatment of TB cases. This scenario is an example of the relationship between: a. advocacy and case management. b. advocacy and continuity of care. c. care management and case management. d. care management and continuity of care.

A B D -

A nurse functioning in the role of a case manager performs which of the following functions in the care delivery process? Select all that apply. a. Risk analysis b. Data mapping c. Provision of illness care d. Epidemiologic investigation of unexpected illnesses e. Counseling and education

C -

A nurse is completing a case management advocacy activity which corresponds to the implementation phase of the nursing process. Which of the following activities would the nurse most likely use? a. Asking the client what is most important b. Seeking appropriate referrals for the client c. Assuring the client that his wishes will be supported d. Determining the order in which actions will occur

B -

A nurse is using the problem identification phase of the case management process. To which of the following phases of the nursing process does this correspond? a. Assessment phase b. Diagnosis phase c. Planning phase d. Implementation phase

D E -

A nurse performing home hospice case management notes the increasing number of hospice clients that lack caregivers in the home environment. The nurse identifies the potential need for a hospice house facility to meet the needs of these clients. The case management process frequently reveals such larger picture issues as: (select all that apply) Select all that apply. a. Community cost concerns b. Community conflict-resolution skills c. Community satisfaction d. Community weaknesses in quality of services e. Community weaknesses in quantity of services

B -

A nurse reviews with the client what the client can expect during the next 3 days, as well as how the client should expect to feel each of those days. The client laughs and says, "You've got my care all mapped out." Which of the following tools is the nurse using to determine what will happen when? a. Care planning b. Critical pathway c. Demand management d. Use management

D -

A nurse working with a Hispanic client explains the referral options available for the client to receive a mammogram. One option is free and has limited Spanish language resources. The other option has a nominal fee and comprehensive Spanish language resources. The nurse supports the client's decision to choose the provider that the client feels would best meet her needs. This advocacy role is best described as: a. intercessor. b. mediator. c. obstructer. d. promoter.

C -

A nurse, client, family, and other care providers meet to discuss what will be the best approach to use to continue care. Which of the following best describes why the nurse suggests changing the goal from obtaining appropriate long-term care placement to ensuring that the client's convalescence is beneficial and safe? a. To consider all possible consequences of long-term care placement b. To encourage the group to review the client outcomes in the different settings c. To expand the goal so that different solutions can be generated and considered d. To help the group focus on the critical aspects the client's family considered most important

C -

A parent involved in conflict resolution with her teenager says, "I know that some of your friends stay out until midnight, but I think it is best if you are in at 10 o'clock." This statement, a behavior seen in conflict situations, is an example of: a. negotiation. b. cooperation. c. assertiveness. d. aggressiveness.

10.*Which of the following best supports the concept of community-oriented nursing practice? (Select all that apply.)* a. Direct nursing care of individuals with tuberculosis (TB) b. Hospice home care for a terminally ill individual and family c. Nursing interventions to stop elder abuse d. Nutrition education programs for teenagers and their families e. Wound care for a homebound individual

A, C, D (Nurses who have a community orientation are often considered unique because of their target of practice. When the location of practice is the community and the focus of practice is the individual or family, the client remains the individual or family, and the nurse is practicing in the community as the setting; this is an example of community based nursing practice. Community-oriented nursing interventions should result in changes that are intended to affect the whole community.)

10.The major sources of information for program evaluation are: (select all that apply) A community indicators. B media reports. C program clients. D program providers. E program records.

A, C, E (Major sources of information for program evaluation are program clients, program records, and community indicators. The program participants, or clients of the service, have a unique and valuable role in program evaluation. Whether the clients, for whom the program was designed, accept the services will determine to a large extent whether the program achieves its goal. Thus their reactions, feelings, and judgments about the program are important to the evaluation.)

9.A nurse in community health in California has been working with a 6-year-old child that was rescued from a mudslide. The nurse will observe the child for which of the following stress effects? (Select all that apply.) A.Bed-wetting episodes B.Desire to return to school C.Fantasies of denial D.Increased playfulness with peers E.Thumb sucking

A, C, E (The effects of disasters on children can be especially disruptive. They can resort to regressive behaviors such as sucking their thumb, wetting their bed, crying, and clinging to parents or have nightmares and fantasies that the disaster never occurred. School-related problems may also develop, and the child may not be able to concentrate or may even refuse to attend school.)

A progression in drug use patterns and related problems warns about the possibility of addiction of which denial is a primary symptom. Which of the following is NOT a method of denial? A. Addressing one's emotional difficulties B. Intellectualizing C. Using humor D. "Going with the flow"

A. Addressing one's emotional difficulties

5. A nurse is collecting data to identify health needs in the local community. Which of the following examples should the nurse identify as secondary data? (Select all that apply.) A. Birth statistics B. Previous health survey results C. Windshield survey D. Community forum E. Health records

A. CORRECT: Birth statistics are an example of secondary data the nurse should review. B. CORRECT: Previous health survey results are an example of secondary data the nurse should review. C. Windshield surveys are a method of collecting direct data. D. Community forums are a method of collecting direct data. E. CORRECT: Health records are an example of secondary data the nurse should review

4. A nurse is conducting a community assessment. Which of the following data collection methods is the nurse using when having direct conversations with individual members of the community? A. Key informant interviews B. Participant observation C. Focus groups D. Health surveys

A. CORRECT: informant interviews are direct conversations with individual community members for the purpose of obtaining ideas and opinions. B. Participant observation is observing formal or informal community activities and does not involve direct conversations with individual community members. C. Focuses groups are directed talks with a representative sample of a community, and do not involve direct conversations with individual community members. D. Surveys are specific questions asked in a written format and do not involve direct conversations with individual community members.

1. A nurse is preparing to conduct a windshield survey. Which of the following data should the nurse collect as a component of this assessment? (Select all that apply.) A. ethnicity of community members B. individuals who hold power within the community C. natural community boundaries D. Prevalence of disease E. Presence of public protection

A. CORRECT: the nurse should identify the ethnicity of the people visible in the community as a component of a windshield survey. B. Individuals who hold power are identified through formal and informal observations of community activities as a participant observer. C. CORRECT: the nurse should identify natural community boundaries as a component of a windshield survey. D. Prevalence of disease is incorrect. Disease prevalence is a component of secondary data and is identified through morbidity rates of the community. E. CORRECT: the nurse should identify the presence of public protection, such as police, fire, and animal control, as a component of a windshield survey.

A nurse at an urban community health agency is developing an education program for city leaders about homelessness. Which of the following groups should the nurse include as the fastest‑growing segment of the homeless population? A. Families with children B. Adolescent runaways C. Intimate partner abuse survivors D. Older adults

A. Families with children

A nurse at an urban community health agency is developing and education program for city leaders regarding homelessness. The nurse knows that this population is the fastest growing segment of the homeless population? A. Families with children B. Adolescents runaways C. Intimate partner abuse survivors D. Older adults

A. Families with children

2. A nurse is completing a needs assessment and beginning analysis of data. Which of the following actions should the nurse take first? A. Determine health patterns within collected data. B. Compile collected data into a database. C. Ensure data collection is complete. D. Identify health needs of the local community.

A. In order to determine health patterns within collected data, the nurse must take another action first. B. CORRECT: in order to adequately and appropriately analyze collected data, the nurse must first compile collected data into a database. C. In order to ensure data collection is complete, the nurse must take another action first. D. In order to identify health needs of the local community, the nurse must take another action first.

3.The most important causes of preventable disease, disability, and death among children are: injuries and accidents. maintaining a healthful diet. physical activity. cardiovascular health.

A. Injuries and Accidents Injuries and accidents are the most important causes of preventable disease, disability, and death among children. Unintentional injuries are any injuries sustained by accident such as falls, fires, drowning, suffocation, poisoning, sports, recreation, or motor vehicle accidents. Because of their size, growth and development, inexperience, and natural curiosity, children and teens are especially at risk for injury.

An occupational health nurse is consulting with senior management of a local industrial facility. When discussing work‑related illness and injury, the nurse should include which of the following factors as physical agents? (Select all that apply.) A. Noise B. Age C. Lighting D. Viruses E. Stress

A. Noise C. Lighting

Which of the following are community factors that can encourage violence and human abuse? Select all that apply. A. Organized religion B. Social support networks C. Work D. The media E. Neighborhood block parties

A. Organized religion B. Social support networks C. Work D. The media E. Neighborhood block parties

Emerging infections remains a 21st century public health challenge because of: A.Drug-resistant organisms B.Shortage of antibiotics C.Welfare reform and health care spending D.Behavioral influences

A.Drug-resistant organisms A major 21st century public health challenge is emerging infections resulting from drug-resistant organisms. The widespread, often inappropriate, use of antimicrobial drugs has resulted in a loss of effectiveness for some community-acquired infections such as gonorrhea, pneumococcal infections, and tuberculosis and in increasing rates of drug resistance in community-acquired pathogens such as Streptococcus pneumonia, E-Coli, and Salmonella. The nurse can influence this trend by objecting to inappropriate use of antibiotics by providers and educating individuals, families, health care providers, and the community about the dangers of misuse and overuse of antibiotics.

7.The later years of life for many older adults mark a period of abruptly changing social dynamics over which the older adult has very little control. The nurse should understand that this phenomenon of later life challenges: A.adapting and coping responses. B.intellectual capacity. C.socioeconomic status. D.spiritual awareness.

A.adapting and coping responses. Eighty-five percent of all elderly people live in homes alone, with spouses or other family or friends. For many families the caregiving experience is a positive, rewarding, and fulfilling one. Nursing intervention can facilitate good health for older persons and their caregivers and contribute to meaningful family relationships during this period.

4.The Patient Self-Determination Act of 1991 requires that providers receiving Medicare and Medicaid funds give clients written information regarding: A.legal options for treatment choices in the event the person becomes incapacitated. B.patient rights. C.the cost of services. D.patient privacy.

A.legal options for treatment choices in the event the person becomes incapacitated. The Patient Self-Determination Act of 1991 (PL 103-43) requires that providers receiving Medicare and Medicaid funds give clients written information regarding their legal options for treatment choices if they become incapacitated. A routine discussion of advance medical directives can help ease the difficult discussions faced by health care professionals, family, and clients. The nurse can assist an individual to complete a values history instrument. These instruments ask questions about specific wishes regarding different medical situations.

Strengthening individuals and families so that they can cope more effectively with the demands in their lives is an example of which type of nursing care? A. Violence prophylaxis B. Tertiary prevention C. Community violence sanctions D. Primary prevention

D. Primary prevention

One specific approach to quality assurance is the use of Total Quality Management (TQM). A district public health department uses this approach and gives much attention to ensuring that studies are used to improve processes, remove management by objectives, and promote self-improvement. The major TQM guideline that would summarize these efforts would be: A. create, publish, and distribute aims and purposes. B. creating a strong customer-oriented philosophy that is process-driven. C. eliminate barriers to pride of work/performance. D. understand the purpose of inspection.

B

process of identifying and analyzing an individuals prognostic characteristics of health and comparing them with those of a standard age-group. providing a prediction of a person's likelihood of prematurely developing the health problems that have high morbidity and mortality in this country. a. health risk b.health risk appraisal c. health risk reduction d.family health

B

5. A major evaluation source for a nurse to use to determine the effectiveness of a teen driver safety program is: A.Centers for Disease Control and Prevention (CDC) reports. B. epidemiologic data. C.recent census data. D.voter registration records.

B (A major source of evaluation is epidemiologic data. Mortality and morbidity data measuring health and illness indicators are probably cited more frequently than any other single index for program evaluation. Incidence and prevalence are valuable indexes used to measure program effectiveness and impact, and these data are readily available on the Internet. Major sources of information for program evaluation are program clients, program records, and community indexes.)

2. What is the purpose of using an algorithm in the surveillance process? A.Tells the nurse who to call in the event of an outbreak B.Provides the nurse with a step by step plan to identify events needing investigation C.Provides the nurse with a system for telephone triage in an outbreak D.It is a visual reminder of the epidemiologic triangle

B (A quality surveillance system requires collaboration among a number of agencies and individuals: federal agencies, state and local public health agencies, hospitals, health care providers, medical examiners, veterinarians, agriculture, pharmaceutical agencies, emergency management, and law enforcement agencies, as well as 911 systems, ambulance services, urgent care and emergency departments, poison control centers, nurse hotlines, school, and industry. The type of information shared includes the use of an algorithm to identify which events should be investigated (i.e., using a precise step-by-step plan outlining a procedure that in a finite number of steps helps to identify the appropriate event).)

6.Nurses often participate on field assessment teams (surveillance) during a disaster response. These assessments are crucial to best help: A.encourage good intentions of those giving aid. B.match available resources to the population's emergency needs. C.separate casualties and allocate treatment. D.provide compassion and dignity.

B (Assessment is a major nursing role during a disaster. The acute needs of populations in disaster turn the community assessment into rapid appraisal of a sector or region's population, social systems, and geophysical features. Elements of a rapid needs assessment include determining the magnitude of the incident, defining the specific health needs of the affected population, establishing priorities and objectives for action, identifying existing and potential public health problems, evaluating the capacity of the local response including resources and logistics, and determining the external resource needs for priority actions.)

8.A nurse in community health is invited to work with a coalition of churches to address safety concerns for children in the local community. The nurse provides training in problem-solving skills, manages conflict, facilitates the process, and provides expertise in interpreting data. This nurse has chosen the implementation role of: a. change agent. b change partner. c. group leader. d. data collector.

B (Content-focused roles often are considered change agent roles, whereas process roles are change partner roles. Change partner roles include enabler-catalyst, teacher of problem-solving skills, and activist advocate. Different roles may be required if the community lacks problem-solving skills or has a history of unsuccessful change efforts. The nurse may have to focus on developing problem-solving capabilities or on making one successful change so that the community becomes empowered to take on the job of promoting change on its own behalf.)

5.While conducting a community health assessment, a nurse in community health meets with local religious leaders to understand the values, norms, perceived needs, and influence structures within the community. This process of data collection can best be described as: a.data gathering. b.data generation. c.data interpretation. d.problem identification.

B (Data generation in a community health assessment is the process of developing data that do not already exist through interaction with community members, individuals, families, and groups, such as community knowledge and beliefs, values, goals, perceived needs, norms, problem-solving processes, power, leadership, and influence structures. This activity parallels the assessment phase of the nursing process. Data gathering is the process of obtaining existing, readily available data. Data interpretation is conducted in the analysis phase. All of the steps will assist the nurse in problem identification.)

7.Four months after the disaster of 9/11 at the Pentagon, a local EMS worker complained of extreme exhaustion. The veteran EMS worker also stated that the pace of work at the squad was too slow. The occupational health nurse that is assessing the EMS worker recognizes the symptoms of: A.anger. B.delayed stress reaction. C.inability to concentrate. D.insomnia.

B (Delayed stress reactions, or those that occur once the disaster is over, include exhaustion and an inability to adjust to a slower pace at work or at home. Workers may be disappointed if family members and friends do not show sufficient interest in what they have been through and if coming back home, in general, does not live up to expectations. Also, they may feel frustration and conflict if their needs seem inconsistent with those of their family and co-workers or if they have left the disaster site thinking that so much more could have been done.)

2.A nurse doing a family assessment asks the client, "Have any of your blood relatives had mental illness?" The nurse is asking this question to: A.determine whether the family is stable. B.assess for biological risk factors. C.decide whether this family member needs medication. D.demonstrate open-mindedness about mental illness

B (Healthy People 2020 (U.S. Department of Health and Human Services, 2010) identified the following major categories as being: inherited biological risk, including age-related risks, social and physical environmental risks and behavioral risks as well as health care risks. Although single risk factors can influence outcomes, the combined effect of several risks has greater influence.)

8.The recovery phase of a disaster can take a very long time. Nurses need to be aware that despite effective disaster preparedness and response efforts: A.environmental hazards are minimal. B.individuals must ultimately recover on their own. C.the government provides economic support. D.religious organizations must bear the burden of the community.

B (Recovery is about returning to the new normal with the goal of reaching a level of organization that is as near the level before the disaster as is possible. This is often the hardest part of the disaster. During the recovery period all involved agencies pull together to restore the institutions and properly rebuild. In the end, all of the nurses and organizations in the world can only provide partnerships with the victims of disaster. Ultimately, it is up to the individuals to recover on their own.)

1.During a family nursing assessment, a parent questions whether God is punishing the family, because one of the children has just been diagnosed with leukemia. The most facilitative response by the nurse would be: A "God is loving and doesn't punish people." B "Tell me more about your family's spiritual beliefs." C."That is not part of my religious belief system, so I don't know." D "Why do you think your family needed to be punished?"

B (The focus of the Neuman Systems Model would be to assess the family's ability to adapt to this stressful change. Assessment of spirituality is an important variable in assessing family strengths and weaknesses. The Neuman Systems Model is a wellness-oriented model in which the nurse uses the strengths and resources of the family to maintain system stability while adjusting to stress reactions that may lead to health change and affect wellness. In other words, this model focuses on family wellness in the face of change.)

4.A parent with two school-age children has just finished a family health assessment questionnaire. The parent asks the nurse why one of the questions asks whether there is a neighborhood playground. The nurse's best response would be: A. "Don't worry about it. We are going to talk about all this anyway." B. "It's important to good health to have adequate recreation resources." C. "We want to be able to report any dangerous playground equipment to the city." D. "We want to know what kind of neighborhood you're in so we can assess income."

B (The importance of social risks to family health is gaining increased recognition. A family's health risk increases if they are living in high-crime neighborhoods, communities without adequate recreation or health resources, in communities with major noise pollution or chemical pollution, or in other high-stress environments.)

5.Following the attacks of 9/11, a nurse practitioner in a family clinic used opportunities at the clinic staff meetings to speak about her own feelings of loss and guilt. This strategy indicates that the nurse was aware of what phenomenon related to disasters? A.Anxiety B.Effects of stress on individuals C.Sense of urgency D.Scapegoating and blaming

B (The stress response of individuals following a disaster may be experienced as rumination about the disaster, immense fear of everything, survivor guilt, sense of great loss, and hesitation to express feelings. Key actions by the nurse can assist others with dealing with the stress, help people cope, allay concerns and fears, identify feelings that they may be experiencing, assist others to think positively and move to the future, and prepare nursing personnel to be effective in a crisis/emergency situation.)

10.The problem of the working poor and uninsured places a major burden on the current health care system that affects those families and the community in general. Nurses in community health see this as a major: (select all that apply) A.behavioral issue. B.policy issue. C.health risk issue. D.social issue. E.nursing issue.

B, C, D (Economic risk is one of the foremost predictors of health. It is useful to know whether families' resources are adequate to meet their needs. The standard of living they are comfortable with is not the measure of risk. If the main wage earner is employed but receives no medical benefits, and the salary is not sufficient for health promotion or illness-related care, the family may qualify for available government-sponsored programs. This is a major policy issue of concern to nurses.)

Which of the following statements are true regarding the health-related vulnerabilities of men? (Select all that apply.) A.More males die at birth. B.Fewer health services are offered to men. C.Men often put work ahead of their health needs. D.More males die from suicide. E. Men often incur more work related injuries than women.

B, C, E Although health policies, campaigns, and community health organizations offer services for men, women's health is more often emphasized. Treadwell and Marguerite (2008) noted that virtually no health services were offered to men, especially to men at the lowest socioeconomic levels or to those unable to work. Men often put work ahead of their own health needs. Large numbers of men do not receive the health screenings intended to prevent and identify disease. Men are more often employed in dangerous jobs and incur more work-related injuries than women.

8.What are the purposes of disease surveillance in public health? (Select all that apply.) A.Tries to identify terrorist attacks before they occur B.Provides a means for nurses to monitor disease trends C.Generates knowledge about disease or outbreak patterns D.Allows the nurse to advocate for policy changes E.Reduces morbidity and mortality and improves health through disease trend monitoring

B, C, E (Surveillance is a critical role function for nurses practicing in the community. It is important because it generates knowledge of a disease or event outbreak patterns (including timing, geographic distribution, and susceptible populations). Surveillance provides a means for nurses to monitor disease trends to reduce morbidity and mortality and to improve health. Although surveillance was initially devoted to monitoring and reducing the spread of infectious diseases, it is now used to monitor and reduce chronic diseases and injuries as well as "environmental and occupational exposures" and personal health behaviors. Surveillance systems help nurses and other professionals monitor emerging infections and bioterrorist outbreaks.)

9.What are the core competencies of the nurse participating in surveillance and investigation activities? (Select all that apply.) A.Basic patient assessment skills Incorrect B.Effective communication skills Correct C.Ability to collaborate with community partners D.Advanced practice nurse with secondary science degree E.Leadership and systems thinking

B, C, E (The national core competencies for public health nurses were developed from the work of the Council on Linkages Between Academia and Public Health Practice (Core Competencies for Public Health Professionals, 2010) and by the Quad Council of Public Health Nursing Organizations (2009). To be a participant in surveillance and investigation activities, the staff nurse must have the following: · Analytic assessment skills · Ability to provide effective oral and written reports · Community dimensions of practice · Basic public health science skills · Leadership and systems thinking)

A nursing is reviewing the spread of foodborne illnesses with a new graduate. Which if the following comments indicate that the new graduate needs further teaching about how to prevent the spread of foodborne illnesses? A. "It is important to wash hands and surfaces frequently." B. "The same knife and cutting board should be used to prepare raw foods." C. "Fruits and vegetables should be washed thoroughly before consumption." D. "Cooked foods should not be left on the counter for longer than 2 hours."

B. "The same knife and cutting board should be used to prepare raw foods." According to the "Five Keys To Safer Food" by the World Health Organization, to prevent foodborne illnesses raw foods should be prepared with separate cutting boards and knives then cooked foods, especially for meats, hands and surfaces should be cleaned frequently, fruits and vegetables should be cleaned before they are consumed, and cooked food should not be left on the counter for longer than 2 hours. Chapter 26 pg. 468 BOX 26.3

A community health nurse is determining available and needed supplies in the event of a bioterrorism attack. The nurse should be aware that community members exposed to anthrax will need access to which of the following medications? A. Metronidazole B. Ciprofloxacin C. Zanamivir D. Fluconazole

B. Ciprofloxacin Community members exposed to anthrax will need access to ciprofloxacin. This medication is used for the prophylactic treatment of anthrax. ATI Chapter 28 Emergency Preparedness, Page 75 Bioterrorism

9. The community health nurse is aware that African-American adults are more likely to be admitted to the hospital for which of the following conditions? Newly diagnosed HIV infection Diabetic patient with lower extremity wound Testicular cancer Psychiatric disorders

B. Diabetic patient with lower extremity wound Hospital admissions for lower extremity amputations in clients with diabetes and lack of prenatal care for pregnant women in the first trimester are the largest disparities for African Americans. For African Americans, large disparities remain in new AIDS cases despite significant decreases in other groups. The proportion of new AIDS cases was 9.4 times as high for African Americans as for whites. Although addressing these disparities is complex, the goal is to close the gap with regard to the health disparities in adults of color while at the same time preserving and respecting the richness and unique influences of various cultures.

Rural residents appear to have a more persistent, endemic level of depression. The factors that may contribute to this level of depression may be related to which of the following? SATA A. Crisis intervention B. Gaps in continuum of mental health services C. Sufficient number of mental health services D. Tolerance for destructive coping behaviors E. Trust in the health care professionals

B. Gaps in continuum of mental health services There appears to be a more persistent, endemic level of depression among rural residents. Factors that relate to this level of depression are high rate of poverty, economic difficulties, economic recession, geographic isolation, insufficient number of mental health professionals, delays in seeking treatment, tolerance of destructive coping behaviors, lack of trust in mental health professionals, and gaps in the continuum of mental health services. D. Tolerance for destructive coping behaviors There appears to be a more persistent, endemic level of depression among rural residents. Factors that relate to this level of depression are high rate of poverty, economic difficulties, economic recession, geographic isolation, insufficient number of mental health professionals, delays in seeking treatment, tolerance of destructive coping behaviors, lack of trust in mental health professionals, and gaps in the continuum of mental health services

A school nurse is planning health promotion and disease prevention activities for the upcoming school year. In which of the following situations is the nurse planning a secondary prevention strategy? A. Placing posters with images of appropriate hand hygiene near restrooms B. Routinely checking students for pediculosis throughout the school year C. Implementing age‑appropriate injury prevention programs for each grade level D. Working with a dietitian to determine carbohydrate counts for students who have diabetes mellitus

B. Routinely checking students for pediculosis throughout the school year

A nurse is receiving a report on a patient admitted for tuberculosis, the nurse learns that the patient is a migrant worker that works in farms in a rural area. After learning this information the nurse knows that this patient is part of what aggregate? A. Rural population B. Vulnerable population C. Millennial population D. Agricultural population

B. Vulnerable population Rationale: Pg. 358 Box 21.1

The home health nurse is focusing on symptomatic management at the end of life of a client. Which of the following models of care is being used? A.Hospice care B.Palliative care C.Personal care D.Transitional care

B.Palliative care Palliative care is concerned with symptomatic care at the end of life.

A school nurse is planning health promotion and disease prevention activities for the upcoming school year. In which of the following situations is the nurse planning a secondary prevention strategy? A.Placing posters with images of appropriate hand hygiene near restrooms B.Routinely checking students for lice throughout the school year C.Implementing age-appropriate injury prevention programs for each grade level D.Working with a dietitian to determine carbohydrate counts for students who have diabetes mellitus

B.Routinely checking students for lice throughout the school year

A general approach to quality improvement where a qualified agent designates formal recognition to individuals or institutions that have met minimum standards of performance is best described as: A. accreditation. B. charter. C. credentialing. D. licensing.

C

1.The deliberate release of viruses, bacteria or other germs with the intent of causing illness or death is: event outbreak. chemical terrorism. biological terrorism. surveillance.

C (Biological terrorism is the deliberate release of viruses, bacteria, or other germs (agents) used to cause illness or death in people, animals, or plants. Chemical terrorism is the intentional release of hazardous chemicals into the environment for the purpose of harming or killing. Surveillance is a critical role function for nurses practicing in the community. It is important because it generates knowledge of a disease or event outbreak patterns (including timing, geographic distribution, and susceptible populations).)

7.A nurse in community health is conducting an assessment on a family of four. During the course of the assessment, the nurse collects information about previous generations of the family and siblings. The results are used to create a diagram for the family that displays the family unit across generations. Further discussions occur regarding the patterns of health and illness that relate to biological health risks. The diagram is called: an ecomap. a family plan. a genogram. a risk plot.

C (Genogram is a drawing that shows the family unit of immediate interest and includes several generations, using a series of circles, squares, and connecting lines. Basic information about the family, relationships in the family, and patterns of health and illness can be obtained by completing the genogram with the family.)

5.Which of the following systems of surveillance is used to monitor trends in commonly occurring diseases? A.Active B.Passive C.Sentinel D.Syndronic

C (In the sentinel system, trends in commonly occurring diseases or key health indicators are monitored. Special systems are developed for collecting particular types of data; these may be a combination of active, passive, and/or sentinel systems. In the passive system, case reports are sent to local health departments by health care providers (i.e., physicians, nurses) or laboratory reports of disease occurrence are sent to the local health department. In the active system, the nurse, as an employee of the health department, may begin a search for cases through contacts with local health providers and health care agencies.)

3.One member of an older couple has just retired. This is considered a: A.developmental stage that will help the family with stress reduction. B.nonnormative event that will have psychological impact on the family. C.normative event and can increase the family's risk for illness. D.normative event and will have little effect on the family' well-being.

C (Life events can increase the risk for illness. Normative events are those that are generally expected to occur at a particular stage of development or the life span. If the event is normative, families may be able to identify needed resources, make plans to cope with the change, learn new skills, and prepare for the event and its consequences. This kind of anticipatory preparation can increase the family's coping ability and decrease stress and negative outcomes. However, when the event is nonnormative, or unexpected, families have little or no time to prepare and the outcome can be increased stress, crisis, or even dysfunction.)

8. A nurse in community health is participating in a community service board strategic team that is currently assessing the community's strengths, the local public mental health system, the community's mental health status, and other variables. This best describes what strategic program planning model used today in the public health arena? A.Assessment Protocol for Excellence in Public Health (APEXPH) B.Health Evaluation Data Information System (HEDIS) C.Mobilizing for Action Through Planning and Partnership (MAPP) D.Planning Approach to Community Health (PATCH)

C (MAPP is the newer approach to program planning in the public health arena. It is a strategic planning model that helps the community health workers be facilitators, as communities establish priorities in their public health issues and identify resources to address the issues. APEXPH addresses the three core competencies of public health: assessment, assurance, and policy development. PATCH is a health education model and HEDIS is not associated with program planning.)

7.An elementary classroom of 28 students has had 13 children who have developed chicken pox over the last 3 weeks. What is the pattern of occurrence? Common source outbreak Point source outbreak Continuous source Mixed outbreak

C (Patterns of occurrence can be identified when investigating a disease or event. These patterns are used to define the boundaries of a problem to help investigate possible causes or sources of the problem. Intermittent or continuous source cases may be exposed over a period of days or weeks, as in the recent food poisonings at a restaurant chain throughout the United States as a result of the restaurant's purchase of contaminated green onions. A common source outbreak refers to a group exposed to a common noxious influence such as the release of noxious gases. In a point source outbreak all persons exposed become ill at the same time, during one incubation period. A mixed outbreak (which was described while investigating a foodborne gastroenteritis caused by a Shigella sonnei virus) is a common source followed by secondary exposures related to person-to-person contact, as in the spreading of influenza.)

1.A nurse in community health has determined that there is a need for a program for teenage fathers who want to learn about child care. The next step in the program management process would be to: A.conduct a survey to determine how many children the fathers have. B.determine whether the fathers have benefited from this type of program before. C.meet with community members to form a planning body. D.provide the fathers with community resources.

C (The program management process is like the nursing process. Program management consists of assessing, planning, implementing, and evaluating a program. One is applied to a program, whereas the other is applied to clients. Following the assessment, planning for the program should occur.)

A nurse is talking to a new grad nurse about strategies that help eliminate disparities in vulnerable populations, the nurse should correct the new grad nurse when they state which of the following? A. "I need to be honest and create a trusting environment for the patient, if I don't know the answer I should tell them and then let them know that I will find them the answer." B. "I should put my assumptions aside, no two people or groups are alike." C. "My focus as a nurse in our community should be correction." D. "I should develop a strong support network for myself, I think I'll pick up poetry as a new hobby."

C. "My focus as a nurse in our community should be correction." Rationale: Pg. 368-369 Jasmine

Which of the following major psychoactive drug categories is described as causing lower overall energy level, reduced sensitivity to outside stimulation, and, in high doses, induces sleep? A. Stimulant B. Inhalant C. Depressant D. Hallucinogen

C. Depressant

1.A school nurse is working with the Parent Teacher Organization (PTO) to improve the health status of preschool students in a lower socioeconomic urban community. Given the demographics of the community, the nurse is aware that this population is at greatest risk for: asthma. attention deficit disorder (ADD). childhood obesity. poisoning.

C. childhood obesity. Obesity among the youth of the nation has reached epidemic proportions. Many factors contribute to the likelihood that a child will become overweight or obese. Factors include genetics, family eating, and physical activity patterns and time spent inactive while viewing television, playing computer games, or using other electronic devices. The environment in which children live influences obesity.``

A retirement community in a small town reported to the local health department 24 cases of severe gastrointestinal illness that had occurred among residents and staff of the facility during the past 24 to 36 hours. It was determined that the ill clients became sick within a short, well-defined period and that most recovered within 24 hours without treatment. The communicable disease outbreak team, composed of nurses, public health physicians, and an environmental health specialist was called to respond to this possible epidemic. How should they respond? A.Call the CDC and ask for help with surveillance B.Send all the ill persons to the hospital C.Evaluate the agent, host, and environment relationships to determine the cause of the problem D.Close the dining hall and find another source to provide food to the residents

C.Evaluate the agent, host, and environment relationships to determine the cause of the problem The team was organized to develop the case definition, plan the interview questions and sampling, and organize the specimen collection. Interviews were used to determine characteristics of the illness and to attempt to identify the source by dietary recall and living arrangements. The dietary recall was focused on the food consumed during the three meals before illness onset.

The purpose of record keeping in public health agencies is to maintain complete information on clients served and the extent and quality of service provided to those clients. The records also provide information for education and research. Another important use of the records is to: A. determine raises for personnel. B. explain cost overruns. C. foster independence in clinical practice. D. resolve legal issues in malpractice suits.

D

6. A nurse in community health becomes aware that a teen smoking cessation program offered at the health department is a demonstration project. In evaluating this program, the nurse would be concerned with the program's: A. efficiency. B. impact. C. relevance. D. sustainability.

D (A program can be continued if there are resources for it. Programs funded as a demonstration project or through outside sources require ongoing funding to survive after the initial funding or timeframe for the demonstration project has ended. If the reason for the evaluation is to examine the efficiency of a program, it may occur on an ongoing basis as a formative evaluation. If the evaluation of impact is the goal, long-term effects such as changes in morbidity and mortality must be investigated. Evaluation of relevance is an important component of the initial planning phase. As money, providers, facilities, and supplies for delivering health care services are more closely monitored, the needs assessment done by the nurse will determine whether the program is needed.)

3.The nurse in community health reviews the monthly and year-to-date health service use report for the local community to monitor trends as correlates of the community's health. The nurse is viewing community health through the dimension of: a.partnership. b.process. c.status. d.structure.

D (Community health has three dimensions: status, structure, and process. The dimension of structure would define the community's health in terms of community characteristics such as services and resources. Community health in terms of status, or outcome, is the most well-known and accepted approach; it involves biological, emotional, and social parts. The view of community health as the process of effective community functioning or problem solving is well established. In population-centered practice, the nurse and community seek healthful change together.)

4.A Hispanic outreach program works with the nurse in community health to train Hispanic health care workers in providing basic services and education within the local Hispanic community. The concept that is best described by this intervention is: a.community. b.community client. c.community health. d.community partnerships.

D (Community partnership is necessary because when there is community partnership lay community members have a vested interest in the success of efforts to improve the health of their community. Most changes must aim at improving community health through active partnerships between community residents and health workers from a variety of disciplines. Partnership, as defined here, is a concept that is as essential for nurses to know and use as are the concepts of community, community as client, and community health.)

5.A nurse in community health decides to form a contract with a family. The contract states that the family will designate one night as a family night. The nurse is most likely using the contract to: A.make sure the family does what is expected. B.Encourage the family to put plans in writing. C.let the family know that this is a legal agreement. D.shift the responsibility so that it becomes a shared effort

D (Contracting involves a shift in responsibility and control toward a shared effort by the client and professional as opposed to an effort by the professional alone. The premise of contracting is family control. It is assumed that when the family has legitimate control, its ability to make healthful choices is increased. Contracting is a strategy aimed at formally involving the family in the nursing process and jointly defining the roles of both the family members and the health professional.)

9.Nursing interventions and approaches for helping individuals and families to assume an active role in their care should focus on empowerment rather than on enabling. The underlying principle to empowerment is: client dominance. decreased competence. professional dominance. professional-client partnership.

D (Empowerment's underlying assumption is one of partnership between the professional and the client, as opposed to one in which the professional is dominant. Families are assumed to be either competent or capable of becoming competent. For families to become active participants, they need to feel a sense of personal competence and a desire for and willingness to take action.)

6.Two nurses in community health schedule a day to ride through a low-income community to better understand the community and its boundaries, trends, rhythm, stability, and changes that can affect the health of that community. This direct data collection method is often referred to as: a.composite database. b.participant observation. c.secondary analysis. d. windshield survey.

D (Five useful methods of data collection are informant interviews, participation observation, windshield survey, secondary analysis of existing data, and surveys. Windshield surveys are the motorized equivalent of simple observation. While driving a car or riding public transportation, the nurse can observe many dimensions of a community's life and environment through the windshield. A basic method is participant observation, the deliberate sharing, if conditions permit, in the life of a community. In secondary analysis, the nurse uses previously gathered data, such as minutes from community meetings.)

8.Many families have financial resources that allow them to maintain themselves but limit the quality of their purchasing power. Food high in fat and calories may be affordable, whereas fresh fruits and vegetables may not be affordable. A federal program that attempts to promote healthier diets for vulnerable populations is: Medicaid Medicare Supplemental Security Income (SSI) Women, Infants, and Children (WIC)

D (Nutritious diets are important in preventing illness and promoting health. A U.S. Department of Agriculture (USDA) study examined the effects of its Women, Infants, and Children (WIC) nutrition program. The study found that children who participated in WIC were more linked to the health care system than children who were not. Children in WIC were more likely to receive both preventive and curative care more often than children not participating in WIC.)

6.A disease outbreak of severe acute respiratory syndrome has occurred and has spread over several countries outside the United States. This level of occurrence is said to be: A.hyperendemic. B.sporadic. C.epidemic. D.pandemic.

D (Pandemic refers to the epidemic spread of the problem over several countries or continents (such as severe acute respiratory syndrome [SARS] outbreak). If a problem is considered hyperendemic, there is a persistently (usually) high number of cases. Sporadic problems are those with an irregular pattern with occasional cases found at irregular intervals. Epidemic means that the occurrence of a disease within an area is clearly in excess of expected levels (endemic) for a given time period.)

2.A nurse educator who teaches at the local community college takes the time to read and understand her community's disaster plans and participates in community mock disasters as a leader of the triage team. The best description of the nurse's activities would be: A.ARC disaster training. B.community preparedness. C.personal preparedness. D.professional preparedness.

D (Preparedness can take place at three levels: personal, professional, and community. The nurse who is professionally prepared is aware of and understands the disaster plans at the workplace and in the community. Adequately prepared nurses can serve as leaders and assist others to have a smoother recovery phase.)

4.In the event of a disaster, shelters are generally the responsibility of which of the following entities? A.Centers for Disease Control & Prevention (CDC) B.Federal Emergency Management Agency (FEMA) C.Public Health Service (PHS) D.Red Cross chapter

D (Shelters are generally the responsibility of the local Red Cross chapter, although in massive disasters the military may set up "tent cities" or bring in trailers for the masses who need temporary shelter. Nurses, because of their comfort with delivering aggregate health promotion, disease prevention, and emotional support, make ideal shelter managers and team members. Each person who comes to the shelter is assessed to determine what type of facility is most appropriate. Although initially physical health needs are the priority, especially among older adults and the chronically ill, many of the predominant problems in shelters revolve around stress. The shock of the disaster itself, the loss of personal possessions, the fear of the unknown, living in proximity to total strangers, and even boredom can cause stress.)

3.A 3-year smoking cessation program for teens has just concluded. The type of evaluation the staff will conduct is: a formative evaluation. an informal evaluation. an ongoing evaluation. a summative evaluation.

D (Summative evaluations assess program outcomes or are a follow-up of the results of the program activities and look at the end result. Formative evaluations are used to evaluate the progress of a program. An evaluation of program effectiveness may help the nurse evaluator determine both client and provider satisfaction with the program activities, as well as whether the program met its stated objectives.)

2. The nurse in community health is meeting with staff to systematically plan for a new outreach program. Doing so helps them to: A.assess the needs of potential outreach clients. B.recognize the special needs of vulnerable people in the area. C.identify how the problems of similar programs will not be repeated. D.identify the resources and activities that will help them meet their program objectives.

D (Systematic planning for meeting client needs assists in identifying the resources and activities that are needed to meet the objectives of client services. Today this type of planning is referred to as strategic planning and it involves the successful matching of client needs with specific provider strengths and competencies and agency resources.)

3.According to the Minnesota Model of Public Health interventions, what is the first step of surveillance for the public health nurse? A.Organize the data. B.Analyze the data. Incorrect C.Interpret and disseminate the data. D.Determine if surveillance is appropriate

D (The Minnesota Model of Public Health Interventions: Applications for Public Health Nursing Practice (Centers for Public Health Nursing 2001, pp. 15, 16) suggests that surveillance is one of the interventions related to nursing practice in public health. The model provides seven basic steps of surveillance for nurses to follow: 1. Consider whether surveillance as an intervention is appropriate for the situation. 2. Organize the knowledge of the problem, its natural course of history, and its aftermath. 3. Establish clear criteria for what constitutes a case. 4. Collect sufficient data from multiple valid sources. 5. Analyze the data. 6. Interpret and disseminate the data to decision makers. 7. Evaluate the impact of the surveillance system.)

1.The major factor that has increased Florida's vulnerability to natural disasters in recent decades has been: A.El Niño. B.geography. C.trade winds. D. Urbanization

D (The urbanizing and the overcrowding of cities have increased the danger from natural disasters because communities have been built in areas that are vulnerable to disasters, such as in known hurricane, flood, and tornado zones. Increases in population and developing for habitation of areas vulnerable to natural disasters have led to major increases in insurance payouts in the United States in every decade. Projections suggest that by 2050, at least 46% of the world's population will live in areas vulnerable to natural floods, earthquakes, and severe storms.)

6.A nurse in community health is conducting a parenting class for prospective parents that will focus on the development of new skills, identification of needed resources, planning, and other preparations for the arrival of a newborn. This intervention is addressing a potential risk associated with: biology. behavior. environment. transitions.

D (Transitions, or the movement from one stage or condition to another, are times of potential risk for families. Age-related or life event risks often occur during transitions from one developmental stage to another. They require families to learn new skills; change behaviors, schedules, or patterns of communication; identify needed resources; and make plans.)

3.To maintain effective disaster preparedness, nurses working in the community can play a critical role in providing an updated record of: A.immunizations. B.active tuberculosis (TB) cases. C.WIC enrollees. D.vulnerable populations.

D (When calamity strikes, disaster workers must know what kinds of populations they are attempting to assist. Accurate information regarding the location of a retirement village, nursing home, childcare center, rehabilitation center, individuals cared for in the home who are dependent on critical medical equipment, or locations with special populations is crucial.)

A nurse is talking to a client who asks for additional information about hospice. Which of the following statements should the nurse make? A. "Clients who require skilled nursing care at home qualify for hospice care." B. "One function of hospice is to provide teaching to clients about life‑sustaining measures." C. "Hospice assists clients to develop the skills needed to care for themselves independently." D. "A component of hospice care is to control the client's manifestations."

D. "A component of hospice care is to control the client's manifestations."

A community health nurse is developing a program on substance abuse use disorders for a group of adolescents. Which of the following should the nurse include when teaching about nicotine & smoking? A. Smoking is the fifth-most preventable cause of death in the U.S. B. Nicotine is a CNS depressant. C. Withdrawal effects from smoking are minimal. D. Tolerance to nicotine develops quickly.

D. Tolerance to nicotine develops quickly.

A community health nurse is developing an education program on substance use disorders for a group of adolescents. Which of the following information should the nurse include when discussing nicotine and smoking? A. Smoking is the fifth‑most preventable cause of death in the united States. B. Nicotine is a central nervous system depressant. C. Withdrawal effects from smoking are minimal. D. Tolerance to nicotine develops quickly.

D. Tolerance to nicotine develops quickly.

What is the primary symptom of addiction? A.) Tachycardia B.) Fatigue C.) Dilated pupils D.) Denial

D.) Denial

When the public health nurse noted an issue with asthma exacerbations in the local student population, she worked with the school nurses and air pollution board to develop a community-wide alert program. What public health role was exhibited in this instance? A.Assessment B.Management C.Counseling D.Advocacy

D.Advocacy On the basis of their assessment and in partnership with the community, nurses advocate for evidence-based intervention to respond to negative health status indicators. Nurses provide the link for people who need personal health services and ensure health care when it is needed and not available elsewhere.

2.The school nurse is interested in providing an antismoking program in a local middle school and is aware that programs are more effective for this age group when they focus on short-term versus long-term effects of smoking. Besides including health risks and cosmetic effects, the nurse should also consider: behavior modification techniques. effects on the environment. laws regarding tobacco sales to minors. social skills instruction to resist pressure to smoke.

D.social skills instruction to resist pressure to smoke. Antismoking programs directed toward children and teenagers are more successful if the focus is on short-term effects rather than long-term effects. Developmentally, children and teenagers cannot visualize the future to imagine the consequences of smoking. Teaching should include how advertising puts pressure on people to smoke.

this phase is where the nurse and client plan for future visits

termination phase

P, S, or T prevention Implementing a program for a client who has already been exposed to a communicable disease

tertiary

developing a contract with family to change nutritional patterns to reduce further complications is what type of prevention

tertiary

A -

In case management, it is unlikely that any single professional has the expertise, knowledge, or skills required to achieve success. The synergy produced by all involved parties (client, providers, payers, family/significant others, and community organizations) can result in successful outcomes. This statement relates to the sequential process of: a. collaboration. b. communication. c. cooperation. d. negotiation.

B -

Which of the following best describes why planning care for an individual is so challenging in today's health care system? a. Because today's clients have high expectations of the health care system b. Because multiple providers, payers, and settings have to be coordinated c. Because of the new high technology constantly being created and used for client treatment d. Because so many different health care providers are in the acute care setting today

A -

Which of the following best explains why every client doesn't receive care from a case manager? a. Case management time is demanding; thus it is restricted to complex cases. b. Many health agencies do not employ case managers. c. Most clients would not benefit from case management. d. Most nurses do not know how to function as case managers.

A B C -

Which of the following is the primary goal of case management? (Select all that apply.) a. To ensure that care coordination occurs across the continuum b. To emphasize evidence-based clinical decision making c. To manage resource use and control expenses d. To stress the advantages and benefits of community-based care

B -

Which of the following public health nurse applicants is the least qualified for a position of case manager in a rural county? a. A 24-year-old who has a master's degree in public health b. A 34-year-old who will be moving from a large city c. A 44-year-old who was born and raised in the community d. A 54-year-old who, until recently, was a member of the community's school board

Permitted illegal aliens already living in the United States to apply for legal status if they met certain requirements

the 1986 Immigration Reform and Control Act

group of people living in a defined geographical area that share a common culture, value, norms, beliefs, arranged according to relationships developed over time

community

this type of preparedness involves national health security strategy and disaster and mass casualty exercises

community preparedness

this type of data assessment involves getting usable information about the community and health

data collection and interpretation

Assessment of a community includes:

data collection, gathering, generating it

this type of data assessment involves age gender, race vital statistics

data gathering

this type of data assessment involves developing data that doesn't exist

data generation

A nurse is advocating for local leaders to place a newly approved community health clinic in an area of the city that has fewer resources than other areas. The nurse is advocating for the leaders to uphold which of the following ethical principles? Distributive justice Fidelity Respect for autonomy Veracity

distributive justice

Concept that applies that some people are worthy to have a roof over their heads and others are not

distributive justice

An environmental assessment is conducted which reveals that the population is being exposed to toxic drinking water. Which of the following ethical tenets is related to dissemination of information? Do no harm Virtue ethics Moral character Competency

do no harm

what are some women health concerns?

eating disorders reproductive health gestational diabetes menopause breast cancer osteoperosis (eat diet rich in vitamin D)

occurrence of disease within an area

epidemic

The science that helps us understand the strength of the association between exposures and health effects in human populations.

epidemiology

Shared feeling of peoplehood among a group of individuals and relates to cultural factors such as nationality, geographical region, culture, ancestry, language, beliefs, and traditions

ethnicity

Evaluating the Intervention for community health includes:

evaluating whether implementations worked or not.

occurrence of a phenomenon of health that can be discretely characterized (environmental, occupational, biological, naturally occurring)

event

in chronic conditions, cure is not expected so nursing activities are geared to be more ______

holistic

this is when survivors rejoice for their life and the lives of others that were spared

honeymoon

Where is the majority of healthcare $$ spent?

hospital care

destruction caused by humans (transportation accidents, chemical, nuclear, radiologic, biological, explosive)

human-made disaster

persistently high number of cases

hyperendemic

based or oriented Teaching class on the RF of smoking

oriented

Involves interventions to reduce incidence of disease by promoting health and preventing disease processes from developing

primary prevention

commitment to community health, effective functioning or problem solving is status structure or process

process

returning to the new normal with the goal of reaching a level of organization that is as near the level prior to the disaster as is possible. Often the hardest part of the disaster

recovery

shelter management is the responsibility of

red cross

One of the first things we need to do when we are thinking about cultural competence

reflect on self

use a behavioral health risk survey to identify the factors leading to health problems such as obesity

secondary

Community care settings can include:

senior centers adult day health home health hospice assisted living long-term care and rehab

something that happened that should not have happened (amputating the wrong limb). Also monitors commonly occurring disease

sentinel

program evaluation has the purpose of:

showing whether the program is meeting its purpose

The way in which a cultural group structures itself around the family to carry out role functions

social organization

this type of special surveillance is developed to monitor illness syndromes or events

syndromic surveillance systems

Which of the sciences would be used to study the poisonous effects of chemicals in the community? Toxicology Epidemiology Chemistry Pharmacology

toxicology