FNP590 Final

Which form of managed care restricts providers to caring for individuals who are members of their organization?

Health maintenance organization (HMO)-The traditional HMO was a group or staff model in which a group of physicians and some specialty services provided care to its members. Providers generally spent all their time serving members of the HMO. Fee-for-service, IPAs, and PPOs are not restricted to serving clients for any one organization.

Which of the following statements is true with regard to health promotion?

Health promotion involves collaboration of many professional groups.-Health promotion is not the province of a single discipline but involves individuals, health care providers, and institutions working together to create a positive environment for health and to achieve health goals.

Which US report is considered a landmark document in creating a global approach to health:

Healthy People 2000

Which of the following is an example of a screenable population for hypertension?

High-level business executives attending an annual conference

A community is in the maintenance stage of change. Which of the following would be an appropriate intervention for the community health nurse?

Highlight past successes-In the maintenance stage of change, a community nurse should highlight past successes and future benefits. During the contemplation phase, the benefits of changing should be discussed. Developing strategies to prevent relapse should happen during the action phase. Providing information should occur during the precontemplation stage.

A nurse is counseling a person who has recently started to receive treatment for alcohol abuse. Which factor would most negatively influence the person's decision to stop abusing alcohol?

His wife recently died from breast cancer.

Which of the following was the fastest growing group in the US between 2000-2010?

Hispanic

A man is telling a nurse that he feels that his health is a gift from God. This statement most closely coincides with beliefs of which cultural group?

Hispanic-Hispanics define health as a gift from God.

Which of the following statements best defines the concept of holistic nursing care?

Holistic nursing care takes into consideration all aspects of a person's life.-Holistic nursing care takes into account all aspects of a person's life experiences including environmental, physical, social, spiritual, and psychological constructs.

A HCP is leading a community action coalition to address the problem of homelessness within the neighborhood. Which of the following statements would most likely be made by HCP?

Homelessness should be of concern to everyone in the neighborhood.

A nurse is planning a home visit for a family. Which of the following actions would be most appropriate for the nurse to take?

Study information regarding the family from agency records and other sources.-Part of planning the home visit is studying information regarding the family from agency records, referral forms, and other sources. Making a contract, identifying how the visit will be financed, and understanding the situation from the family's perspective are all part of the process of making the visit.

A nurse is determining which family assessment tool would be best to implement with a family when planning home visits for health promotion. Which of the following criteria should the nurse use to evaluate these tools?

The amount of involvement that the family has in completing the tool-Useful health-promotion family assessments involve listening to families, engaging in participatory dialogue, recognizing patterns, and assessing family potential for active, positive change.

A HCP is working with an African Am woman who has recently suffered a stroke and is homebound. She insists that she must get out of the house and attend Sun worship services. What is the most likely explanation for her insisting that she participate in this cultural practice?

The church serves as the social support for its members

A nurse is told by a colleague that an Asian American individual on home care is using complementary and alt med (CAM). Which of the following conclusions can accurately be drawn from this statement?

The client may be using meditation, acupuncture, or another therapy.

Which of the following best describes person-centered communication?

The client says to the nurse, "I think my husband is cheating on me." The nurse responds by saying, "You think your husband is cheating on you?"-The nurse recognizes that the person seeking care has some concerns that she would like to discuss and paraphrases her statement to give the person an opportunity to elaborate on thoughts that are important to him or her.

Which of the following statements about the current prevalence of obesity is accurate?

The current generation of children may be less healthy and have a shorter life expectancy than their parents.

A nurse is asked to provide an expert opinion about the development of an education program for newly diagnosed diabetics. In this scenario, the nurse is acting as a:

consultant

Adoption of a Canadian-style health care system in the United States has the potential to:

create further health disparities.-Canadians with private health insurance and higher incomes have access to greater health care services and more expedient health care. This translates to a two-tier system of health care, which can contribute to health disparities in health care access and quality.

The nurse recommended to a 50-yr old woman that she schedule a routine mammogram. Which of the following would be the most important factor in this woman's decision to schedule this exam?

cultural values

The study of a population is referred to as (a):

demography.-Demography is defined as the study of a population.

In contrast to holistic health care, Western or allopathic medicine focuses on the:

physical aspects of health deviations.-Holistic health care focuses on the whole person, mind, body, spirituality, and so forth. Western or allopathic medicine focuses mainly on physical aspects of disease.

A nurse is explaining the concept of "presence."The nurse should include that presence means that the person:

practices active listening and focuses on what is being said.

A nurse is counseling a teenager who smokes one pack of cigarettes a day. The teenager states he likes to smoke with his friends and does not recognize the connection between his smoking and his asthma. When planning an intervention for this person, the nurse must first recognize that the teenager is in the:

precontemplation stage of change.

A nurse is describing adults who are in the "sandwich generation." Which of the following provides the best description of this term?

Middle-aged adults who are caring for children and aging parents

The nurse is conducting community education about stress. Which of the following statements should be made by the nurse?

"A moderate amount of short-term stress can make a person more efficient and goal-focused."

A nurse is providing care to HIV positive clients living in sub-Saharan communities in Africa. When discussing prevention of the transmission of HIV, which of the following statements should be made by the nurse?

"Alternative practices to traditional sexual cleansing should be considered after the death of a spouse." Although traditional sexual cleansing can lead to further transmission of HIV is a true statement, it is not the most culturally sensitive response by the nurse. The nurse should respect the cultural practices of the clients living in the sub-Saharan community and discuss that alternative practices may be a better option to traditional sexual cleansing.

A nurse is defining stress to a person. Which of the following statements should the nurse should make?

"An event that requires any change in behavior in stressful."

A man states that he would like to change his dietary habits to decrease his risk of developing cancer in the future. Which of the following statements would be the best response for the nurse?

"Consume at least cups of fruits and vegetables each day."

The nurse conducted a community health education program about the benefits and limitations of alternative therapies. The nurse recognizes that learning has occurred when a participant makes which of the following statements?

"Herbal products must be used with caution because some can interact with prescription medications."

A nurse is counseling a person with heart disease. Which of the following statements made by the individual would require the nurse to provide additional education?

"I add salt to many of the food that I eat to enhance the flavor."

A nurse is demonstrating how to use effective communication when dealing with conflict. Which of the following statements would be most appropriate for the nurse to make?

"I feel anxious when you do not come home on time because I worry about your safety."

Which of the following statements can be identified as a method for clarifying a message?

"I get very upset when you talk to me in that tone."- Use of "I" statements is one technique that can be used for clarifying and qualifying messages.

A 37-year-old woman asks the nurse if she should take a daily nutritional supplement. Which of the following would be the best reply by the nurse?

"The best way to obtain nutrients is by eating a variety of foods."

The nurse is assisting an individual who is interested in music therapy. Which of the following statements made by the person indicates an understanding of this type of therapy?

"The music I choose may be different than what my spouse prefers."-Music selection is an individual choice. There is no one "best" type of music. Family members may also benefit from the positive effects of listening to music.

A nurse working at a holistic health center is asked by a person with severe rheumatoid arthritis if yoga would be a realistic therapy choice. Which of the following would be the best response by the nurse?

"There are many types of yoga that would be realistic for you to try. Let's talk about the types that would be suited to your needs."-There are many types of yoga that do not involve positioning, such as raja yoga, mantra yoga, and so forth. People should be informed about all of the choices and allowed to select the one most suited to their needs. Hatha yoga involves positioning, which might not be realistic for this individual.

An individual reveals to the nurse that he is having an affair with his wife's best friend. Which of the following statements will enhance effective therapeutic communication between him and the nurse?

"This affair seems to be troubling you."-The nurse is seeking to determine the client's own feelings about his affair. By seeking feedback, the nurse helps explain the meaning further. The nurse suspends judgment and responds in such a way as to encourage him to keep talking rather than make judgments about his behavior, which would shut down communication.

A client who is taking Coumadin tells the nurse that she has started taking a vitamin E supplement as she has heard that this will help decrease the likelihood of her developing cancer. Which of the following would be the most appropriate response by the nurse?

"Vitamin E can interfere with the actions of vitamin K and enhance the effects of Coumadin ."

A nurse is discussing resistance training with a 24-year-old woman. The woman is resistant to weight lifting because she does not want to get too muscular. She prefers a program that is strictly aerobic. Which of the following would be the most appropriate response from the nurse?

"Weight lifting has many purposes and benefits; can we talk about them?"

A nurse is working on values clarification with a person who has chosen to smoke during her pregnancy. Which of the following statements would be the most appropriate for the nurse to assist in this process? (select all that apply)

"What do you value most in life?" "Is your decision to smoke consistent with your values?"-Techniques to clarify values include assisting the person to identify her own values ("What is important to you?"), identify values conflicts or conflicts between values and actions ("Are your actions consistent with your values?"), and using reflection to restate the value and make it explicit.

Which of the following is an essential question that nurses should encourage individuals to ask at every health visit? (select all that apply)

"What is my main problem?" "Why is it important for me to do this?" "What do I need to do?"-Health literacy is the capacity to read, comprehend, and follow through on health information; it is a critical component of health promotion. To combat low health literacy, nurses can encourage individuals to ask three essential questions at every health visit: "What is my main problem?" "What do I need to do?" "Why is it important for me to do this?"

A nurse is working with a person to increase his daily exercise and activity. Which of the following statements by the nurse best demonstrates the use of reflection?

"You said that you have difficulty making time in your day for exercise."-Reflection is the restatement of what the individual has said in the same or different words. This technique can involve paraphrasing or summarizing the person's main point to indicate interest and to focus the discussion. It is the selective paraphrasing or literal repetition of the person's words to underscore the importance of what has been said, summarize a main concern or theme, or elicit elaborated information.

Which of the following demonstrates a nurse taking action to promote health and prevent disease:

Educating a person about the advantages of a heart-healthy diet during a home visit

A nurse is planning a comprehensive health promotion activity to provide community members with a better opportunity to manage their own risk. Which of the following activities would be most appropriate for the nurse to perform?

Obtaining blood pressures and discussing the importance of exercise during a screening

A 51-year-old woman has begun menopause. The nurse emphasizes the importance of a diet high in calcium and vitamin D as well as exercise for this woman.This recommendation is important because by the time the client is 56, she will have experienced another _____ bone loss.

15%

A nurse is monitoring the exercise of a 42-year-old woman. Which of the following would be the estimated maximum heart rate (MHR) for this woman?

178

A nurse believes that it is his responsibility to ensure the safety of the public by administering flu shots to everyone in the community. Which ethical theory is being used by the nurse?

Consequentialism theory-Consequentialism theory proposes that actions are good insofar as they are aimed at yielding the greatest amount of happiness or pleasure or cause the least amount of harm or pain to individuals and overall in society. Administration of flu vaccines proposes the best result for individuals and decreased risk for others in the community.

The school nurse has been asked to present a workshop on how to prevent CA-MRSA spread in the school. Which of the following interventions should be emphasized?

Using correct hand-washing technique

During an office visit, a nurse meets with a woman who states she does not have time to exercise. Which of the following actions should the nurse take next?

Provide her with information on the benefits of exercising

Which person is at highest risk for being uninsured?

27-year-old who attends college and works part time in a small pizza parlor-Young adults (27 years of age or older) are not eligible to be covered under their parents' insurance. Medicare is available for those over the age of 65 and for people who require dialysis. Medicaid and SCHIP are available for children whose families meet the financial requirements. This child would likely meet criteria for either Medicaid or SCHIP because the parents are considered working poor. Because health care insurance is so expensive, it would be difficult for a 27-year-old to afford his or her own plan. Young adults often go without insurance because of the high costs.

The goal for the educational session is for the individual to correctly demonstrate proper technique for checking blood sugar levels. Which of the following teaching strategies would be most effective?

Provide the individual with the opportunity to practice blood sugar monitoring.

The nurse has formulated a nursing diagnosis for a person with carpal tunnel syndrome of "Energy Field Disturbance r/t Slowing or Blocking of Energy Flow Secondary to Repetitive Motion Injury." Which of the following actions must the nurse take first when planning interventions for this person?

Explain healing touch therapy.-Before giving informed consent, the person must understand the proposed therapy.

A nurse is using a health education component when teaching about smoking cessation. Which of the following actions is the nurse implementing?

Providing education regarding the benefits of smoking cessation

According to the physical activity and fitness section of the Healthy People 2020report, what percentage of adults 18 years of age or older report no leisure-time physical activity?

36%

Which represents a disadvantage of screening?

Utilization of a test with low sensitivity

An Asian American family has recently immigrated to the US. Which of the following would provide an appropriate rationale when encouraging the family to send their child to school?

Exposure to different cultures in school will enhance socialization

In a family in which the mother and the father differ on how to spend and save money, the parents are constantly arguing with each other. Which of the following interventions should the nurse include in the plan of care for this couple?

Assist them to develop strategies that are congruent with their values.-When strategies are used that are congruent with each individual's values, the couple adjusts.

A nurse is speaking to a women's group in the community about the importance of completing mammography to screen for breast cancer. At which age should the nurse recommend that mammography begin?

40

To screen for colorectal cancer, colonoscopy should be conducted every 10 years beginning at age:

50.

A nurse is determining if children with severe acute malnutrition (SAM) should receive facility-based or community-based care. Which of the following children should receive care in the community?

6-month-old female who has a good appetite and no underlying medical conditions When a child has a good appetite with no medical conditions (hypoglycemia, hypothermia, dehydration, electrolyte imbalance, and/or infections), Ready-to-Use Therapeutic Foods (RUTF) under community-based care are appropriate. RUTF are special milk-based foods which are soft, crushable, and tasty nutrient- and energy-rich foods that can be consumed by children six months or older.

The nurse is working at a crisis hotline center. Which of the following callers would be most at risk for suicide?

A 50-year-old female who has a history of alcohol abuse Older adults have a greater risk of committing suicide than do younger people. Major factors contributing to suicide in Europe and North America include mental disorders especially depression and alcohol use disorders.

Which of the following women should be screened for breast cancer?

A 59-year-old woman with no children who still gets her period every month

Which of the following people is at greatest risk for a hip fracture secondary to osteoporosis?

A 66-year-old White woman

A nurse is using a genogram to represent a family. Which of the following statements is accurate?

A genogram can be used to make connections about family health patterns.-A genogram shows a variety of family structures and highlights family health patterns, which can be used for anticipatory health guidance. Significant diseases and disorders of the family members are highlighted on the genogram. Data on at least three generations are reported on a genogram. The genogram uses a variety of symbols to demonstrate connections but does not begin with a circle in the center of the page.

Which factor may have the most influence in changing the health behavior of a single, adult woman who smokes and is the care provider for her mother, her own children, and granddaughter?

A gift card for $10 to grocery store every week she is smoke free

A nurse is creating a hypertension screening program. Which of the following methods would be the best way to design a successful program?

A nurse is creating a hypertension screening program. Which of the following methods would be the best way to design a successful program?

When assessing a client's activity-exercise pattern, which subjective finding has implications for nursing practice?

A person's amount of leisure time-Although all findings are important in assessing the activity-exercise pattern, the only subjective finding is the amount of leisure time that the person reports having. All others are objective findings and can be validated with a physical exam.

A nurse is providing education about safe driving with a group of newly licensed teenagers. Which factor would most likely influence a teenager's decision to drive within the speed limit?

A previous traffic violation for speeding

A nurse has stated that the person she is working with demonstrates stress hardiness. Which of the following individuals is most likely being described?

Conducts Internet research to learn about the latest treatment options for a health deviation

A nurse is using a functional focus to assess a person. Which of the following the nurse be evaluating?

Ability to drive-Functional focus refers to the individual's performance level. Nurses assess how particular visual patterns affect lifestyle. The ability to drive would affect a person's lifestyle and might require a change in how the person functions.

Which of the following best describes the nurse's role in health promotion and disease prevention?

Acting as a role model for the family-The nurse's role in health promotion and disease prevention is best described as acting as a role model for the family. Implementing the nursing process, identifying areas for family improvement, and educating about home safety measures are all part of the nurse's role but do not describe the comprehensive role of the nurse.

A person asks the nurse to explain the difference between acupuncture and acupressure. Which statement would be the appropriate response by the nurse?

Acupressure stimulates meridian points by using pressing and stretching movements.-Massage oil is not used during acupressure therapy. Both acupressure and acupuncture have been shown to relieve nausea and vomiting. Acupressure involves pressing, knuckling, rubbing, squeezing, and stretching, not by applying pressure to needles inserted during acupuncture.

The nurse is asked to explain acupuncture to a person. Which of the following statements concerning acupuncture would the nurse include in the explanation?

Acupuncture can be used to either diagnose or treat a health deviation.-Acupuncture is accomplished by inserting fine needles into the skin, not subcutaneous tissue. This treatment modality is used to either treat illness or diagnose illness. Moxibustion describes using burning herbs to increase point stimulation.

Which of the following demonstrates the practice of transcultural nursing?

Adapting nursing care to meet the need of a person from an ethnic minority

A nurse is counseling a person who was recently diagnosed with diabetes about how to prevent the complications of this disease. Which of the following interventions would be stressed the most by the nurse?

Adhering to medical nutrition therapy

A nurse is assessing a community from both a developmental and risk perspective. Which of the following characteristics would be of most interest to the nurse?

Age-Community nurses use a developmental-age-correlated approach to identify health promotion and health protection activities. Age is an indication of development. Additionally, community nurses assess those risk factors in a community that can cause adverse health outcomes. Risk factors can vary from person to person but include age, gender, race, geographical location, and lack of health services. Age can thus be used to assess a community from both a developmental and a risk perspective.

The nurse is conducting a community health education program concerning alternative/complementary therapies. Which of the following should be included in the presentation?

Alternative/complementary therapy is used in both hospital and outpatient settings.-Alternative/complementary therapy is gaining popularity in both hospital and outpatient settings. It is used as an adjunct to traditional medicine and focuses on all aspects of being (e.g., environmental, spiritual), not just herbal products.

Which of the following ethnic groups has a disproportionately high death rate from unintentional injuries and suicide?

American Indian

A nurse is using the technique of mapping while implementing the nursing process in the community setting. The nurse is engaging in which aspect of the nursing process?

Analysis-Analysis refers to data categorization and pattern determination. The organization of data is used to determine patterns. Mapping is an organizational technique used in data analysis.

Which of the following information about anthrax is correct?

Anthrax can cause skin lesions or pneumonia.

A nurse discussing aromatherapy at a community health fair. Which of the following aspects of this technique should be stressed?

Aromatherapy can cause an allergic reaction in some people.-Aromatherapy uses aromatic plant materials and the essential oils of plants to treat physical imbalances, as well as to achieve psychological and spiritual well-being through inhalation, external application or ingestion. The use of aromatherapy without professional clinical training is strongly discouraged. Individuals must have this training to know the specific warnings and contraindications for each oil, as oils may cause allergic reactions or other undesirable side effects.

Which of the following actions demonstrates a health care prof providing culturally comp care?

Asking the person to describe his folk healing methods

A client reports that her family will be moving because her husband is taking a new job in another state. She is very unhappy about the decision and doesn't want to move. What action should the nurse take next?

Assess the client's and family's coping mechanisms in handling stress.-The family's ability to cope with demands of everyday living determines its level of success. The nurse needs to assess how the family usually copes with stressful situations to find ways that might be available to the family now to cope with the current situation.

A nurse distributes a demographic questionnaire to attendees of a weight management program. Which step in the teaching-learning process is being implemented?

Assessment

Which of the following illustrates that the objectives of health education and counseling have been met?

Asthmatic who has a decrease in emergency department visits

A 24-year-old man with severe cognitive impairment, and no relatives participating in his care, needs to make a decision about removal of a brain tumor that will render him totally dependent for completion of all activities of daily living. The nurse participates in ethical decision making on his behalf, knowing that the client is unable to benefit from which of the following ethical concepts?

Autonomy-Because the client is cognitively delayed and is unable to understand explanations of treatment that would be given to him, the client is unable to be autonomous in making a decision regarding neurosurgery.

A nurse is counseling a person with a dysfunctional sleep pattern. Which of the following recommendations would the nurse most likely give the person?

Avoid fluids after 7 PM.-Etiological factors of most dysfunctional patterns often lie within another pattern or patterns. Outcomes and plans are based on probable cause. Exercising before bed, watching television, and reading in bed are not considered appropriate sleep hygiene. Frequent urination may be the cause of his dysfunctional sleep pattern and, if so, avoiding fluids before bed would be an appropriate plan.

A school nurse is using height and weight measurements to calculate the body mass index (BMI) of the students. How will the nurse use these data?

BMI can be used to determine if a child is obese or underweight.

A family has recently become homeless. Which of the following factors likely contributed to this situation?

Being unable to find affordable housing

Which of the following concepts of ethics is described as the "duty to maximize the benefits of actions while minimizing harm"?

Beneficence-Beneficence governs actions taken to further the overall health or well-being of an individual or society. "Beneficence" means doing good.

A nurse is assessing a low-income population in a community. Which of the following would be most appropriate for this population?

Blood pressure screening

A 45-year-old man has been diagnosed with metabolic syndrome. Which of the following characteristics would this man exhibit?

Blood pressure: 146/88 mm Hg

A woman is going for a 2-hour hike in the Grand Canyon and she asks the nurse how much fluid she should take along with her. Which of the following recommendations should be given by the nurse?

Bring at least 72 ounces of sports drink.

The school nurse has been asked to present a workshop on CA-MRSA for high school teachers. Which of the following information would the nurse most likely include?

CA-MRSA is a potentially fatal skin infection that is difficult to treat

A nurse is conducting a health promotion assessment for a family with a 9-month-old. Which of the following should be of most concern to the nurse?

The age of the house in which the family lives-A typical 9-month-old is beginning to crawl. Houses built before 1974 may contain lead-based paint, to which a crawling baby might have access. Lead causes neurological damage and anemia.

A nurse is performing therapeutic touch with a person. Which of the following would be the first action that the nurse would take?

Centering-The first step in therapeutic touch therapy is for the therapist to become centered, so full attention can be paid to the person receiving the therapy. The second step is to assess for disturbances by moving the hands above the body. The last step involves the actual treatment techniques.

Which of the following is the first step in the valuing process?

Choosing freely-The seven-step valuing process involves (1) choosing freely, (2) choosing from alternatives, (3) choosing after careful consideration of potential outcomes of each alternative, (4) cherishing and being happy with personal beliefs and actions, (5) affirming the choice in public, when appropriate, (6) acting out the choice, and (7) repeatedly acting in some type of pattern.

Which functional health pattern provides information about problem-solving and decision-making within communities?

Cognitive-perceptual pattern-The cognitive-perceptual pattern provides information about problem-solving and decision making within communities.

A nurse is collecting data for a family assessment using Gordon's functional health patterns. The nurse learns that the family has no books in the home to read to the preschool-age children. To which of the following functional health patterns does this information pertain?

Cognitive-perceptual-The cognitive-perceptual pattern identified characteristics of language, cognitive skills, and perception that influence desired or required family activities. The availability of books in the home for preschool age children impacts this functional health pattern.

A nurse is making a final home visit with a family to evaluate the nursing care plan. Which of the following actions would the nurse most likely complete during this visit?

Collect data similar to that which was collected at the initial visit for comparison.-The purpose of evaluation is to determine how the family has responded to the planned interventions and whether these interventions were successful. The family's baseline data are used as comparative criteria in evaluation; thus, it would be worthwhile to collect data similar to that collected at the initial visit to see if any changes have occurred. The nurse reassesses the situation and compares the new information with that on the original assessment to determine whether change has occurred.

Which of the following is the leading cause of death among women?

Coronary artery disease-The leading cause of death in women is coronary artery disease.

A nurse is working with a community that is experiencing an alteration in its values-beliefs pattern. Which of the following is most likely to result because of a disturbance in this functional health pattern?

Coronary artery disease-The values-beliefs pattern identifies the community values and beliefs. Values underlie decisions regarding prevention programs. A lack of primary prevention methods (e.g., exercise and a healthy diet) can lead to coronary artery disease.

A nurse is educating a group of community members about how hypertension screening is effective in reducing the rate of cardiovascular disease, thus reducing the expenses that are spent on management of this disease. Which of the following ratios is being described?

Cost-benefit ratio analysis

A person states, "My grandmother is the decision maker in our family." Which of the following is being described by the person?

Culture

A nurse assesses the cognitive-perceptual pattern of a Type 1 diabetic client. Which finding has implications for the individual's nursing plan of care?

Decreased visual acuity-Assessment parameters in the cognitive-perceptual pattern include hearing, vision, smell, and taste. A person with Type 1 diabetes mellitus requires insulin injections. A decrease in visual acuity will make it difficult for the individual to draw up his or her medication and therefore will influence the nurse's plan of care.

Which of the following types of ethical theories tells us how people act toward each other and their environments and what they believe are good or moral actions?

Descriptive value theories-Descriptive theories do not tell us what actions we ought to take. They are not directive; they tell us how people act toward each other and their environments and what they seem to believe are good or moral actions.

An overweight woman is in the preparation stage of change. Which of the following interventions would be the most appropriate for the nurse to implement?

Develop a low-calorie/low-fat diet with her so she can follow it at home.

A nurse is caring for a man who states he is ready to start exercising. Which of the following actions should the nurse take next?

Develop an exercise prescription with him.

A nurse plans to use lectures, handouts, and a video to teach a group of teenagers the importance of safe sex practices. Which step in the teaching-learning process is the nurse demonstrating?

Development

A nurse is assessing how a family will transition and adapt after their youngest child leaves for college. By using this framework, which of the following perspectives is the nurse implementing?

Developmental-Duvall and Miller identified stages of the family life cycle and critical family developmental tasks, through a developmental perspective. This conceptual model helps to anticipate family events and discusses how families complete basic family tasks as they transition through these events.

Which of the following illustrates that the objectives of health education and counseling are being met?

Diabetic who starts taking his medications regularly

A nurse is caring for a family with an adolescent child. Which of the following problems would the nurse anticipate that the family would report?

Difficulty with open communication with the child-Open communication with parents is often difficult during the adolescent stage, partly because of the differing developmental tasks of adolescents and adults. Concerns about exposure to environmental hazards and parents finding fulfillment with raising the child typically are concerns with families with younger children. Concerns about career decisions are typically problematic for families with older children/young adults.

A nurse is working at a clinic in a third world country and suspects a child has severe acute malnutrition (SAM). Which of the following assessment findings would be expected?

Distended abdomen

A nurse is providing health education for a group of older adults about the risks of developing coronary heart disease. Which of the following group members is at highest risk?

Doesn't participate in any form of regular physical activity

The school nurse is planning a workshop for high school students about interpersonal violence (IPV). Which of the following information would the nurse discuss as risk factors for IPV?

Drug and alcohol abuse Risk factors for IPV may include a victim's low self-esteem, low self-control, and personality/conduct disorders. Other risk factors are reported to be lack of social support, dysfunctional family structure, family history of violence, and drug and alcohol abuse.

A home care nurse is planning an intervention with a family focusing on decreasing susceptibility. Which of the following nursing interventions would be most appropriate to implement?

Education about hand hygiene-Four types of nursing interventions appear in health-promotion and disease-prevention planning: increasing knowledge and skills; increasing strengths; decreasing exposure; and decreasing susceptibility. Decreasing susceptibility means educating families about prevention principles. Examples include education about hand hygiene and how diseases are spread from person to person and by other factors in the environment.

The person known as the father of British and American public health is:

Edwin Chadwick is known as the father of British and American public health.

A nurse is caring for a person who has experienced a minor injury following a fall. Which of the following physiological responses to stress would the nurse anticipate?

Elevated heart rate

Which is an example of asymptomatic pathogenesis?

Elevated prostate-specific antigen (PSA)

A nurse is assessing a community's exposure to pollutants by examining contaminated soil, air, water, and food. Which functional health pattern is being assessed by the nurse?

Elimination pattern-The elimination pattern identifies factors including exposure to pollutants in the community through contaminated soil, water, air, and food.

A nurse would like to assist Americans in improving their health. Which strategy would be most beneficial to improve the health of the American public?

Encourage Americans to stop smoking.

A nurse is caring for a person who has a diagnosis of "Sleep disturbance related to stress as evidenced by excessive daytime fatigue." Which of the following nursing interventions would most likely to assist this person

Encourage a consistent sleep-wake schedule.

A nurse is helping a man restructure his eating, sleeping, exercise, and thinking patterns to reduce stress. Which of the following nursing interventions would be most effective for this person?

Encourage writing in a journal on a daily basis.

A nurse is developing a primary prevention strategy to address the problem of obesity. Which of the following interventions is being created?

Encouraging an active lifestyle during childhood years

A nurse would like to include holistic nursing care in her nursing practice. Which of the following actions must the nurse take first?

Engage in self-exploration.-The first step to providing holistic care is an exploration of self. Each of the other steps follows that step.

A teenager, who lives at home with her parents and school-aged brother, has been diagnosed with anorexia nervosa. Which of the following would be the most appropriate teaching goal for this teenager?

Enhanced self-esteem

A nurse has started admitting a new person on home care and is beginning to establish a relationship. Which of the following would be the most important thing for the nurse to do?

Establish open communication-Communication is the foundation for any professional relationship. It is the cornerstone of a positive nurse-person relationship. It refers to a set of strategies and actions to enhance reciprocity, mutual understanding, and decision making.

A nurse weighs a person who has been diagnosed with a dysfunction in the nutritional-metabolic pattern. Which aspect of the nursing process is being performed?

Evaluation-The nursing process consists of assessment, diagnosis, planning, implementation, and evaluation. A person who has been diagnosed with a dysfunction has already been assessed. The process of analyzing changes experienced by a person after a plan has been implemented occurs in the evaluation phase. In this question, a weight will determine whether or not the person is moving toward her goals of weight loss.

A nurse is using the four-step public health approach to address violence in the community. Which of the following actions would the nurse take first?

Examine risk factors that have contributed to the violence.

A nurse reflects on previous experiences with minority populations and considers how these interactions have influenced her present care to these populations. Which part of values clarification and reflection has the nurse used?

Examine the influence of beliefs.-It is important for the nurse to think about the influence that beliefs and values have on his or her practice. An understanding of how personal beliefs and values are either congruent, or are liable to interfere, with the task at hand is crucial to ethical problem solving.

A nurse using the four-step public health approach to respond to violence. Which of the following actions would occur as the nurse identifies risk and protective factors?

Examining characteristics in the community where violence has not occurred A "risk factor" is defined as "a characteristic that increases the likelihood of a person becoming a victim or perpetrator of violence," and a "protective factor" as "a characteristic that decreases the likelihood of a person becoming a victim or perpetrator of violence." Knowing risk and protective factors can help responsible organizations and personnel to estimate violence magnitudes and devise appropriate prevention measures.

A nurse is providing care to a 15-year old female who has recently been diagnosed with a sexually transmitted infection (STI). Which of the following actions should the nurse take next?

Facilitate interaction between the adolescent and her parents/guardians.-Federal and state laws generally serve to protect the privacy and autonomy of adolescents. Responsibilities of the nurse include helping an adolescent to grasp his or her authentic options and rights, facilitating interaction between the adolescent and parents or guardians, maintaining trust, and preserving confidentiality.

A nurse uses ethical reasoning to solve an ethical dilemma. Why would the nurse use this process?

Facilitates gathering of the most important information to solve the problem-The purpose of ethical inquiry is to gain clarity on actual or potential moral issues arising in the context of health-promotion endeavors and to understand what is expected of the health-promotion agent viewed as a moral agent. Ethical reasoning can facilitate appropriate and in-depth data gathering, permit the uncovering of hidden agendas and interests, and focus on the most salient aspects of a particular problem.

Considering the provider and client perspective, which of the following is the most autonomous form of insurance?

Fee-for-service plan-In the fee-for-service plan, a provider provides a service and bills the individual's insurance company. The individual is also allowed to choose his or her provider.

What is the most effective policy a staff nurse can implement to help decrease medical errors on the unit?

Foster a collaborative working environment on the unit.-Health care systems are the basic cause of medical errors. Organizational and workforce management, work design, and organizational culture are problem areas that contribute to medical errors. Creating a collaborative working environment helps improve organizational culture, thereby reducing the chance of medical errors.

The country with the highest life expectancy for women in 2011 was:

France-France was the country with the highest life expectancy for women (85 years of age) in 2011.

Which of the following statements best explains priorities related to preventative health care?

Global initiatives have been developed to respond to health care needs around the world. Health care initiatives have a global focus and involve developing as well as developed countries. Nurses play a major role in this initiative.

Who authored the framework which provides the foundation for nursing assessment and diagnosis using the functional health patterns?

Gordon-Gordon's framework provides the foundation for most NANDA nursing diagnoses using the functional health pattern. Nurses use the framework to combine assessment skills with subjective and objective data to construct patterns.

The nurse is discussing an exercise prescription with a person. To help him determine the appropriate intensity, the nurse tells him that he should monitor his rate of perceived exertion. Which of the following should the nurse tell the man he should experience while exercising?

Having mild musculoskeletal discomfort

A Hispanic mother tells the nurse that she has been using home remedies for her child's asthma. Which home remedy might this mother be using?

Hot tea-In the Hispanic population, asthma is viewed as a cold disease (hot-cold imbalance) and thus is treated with warm therapies. Diet is often used to maintain equilibrium. Thus, warm tea added to the child's diet might be used to restore equilibrium between hot and cold in this child who has asthma.

A nurse who is using Gordon's functional health patterns is planning to assess its roles-relationships pattern. Which of the following questions would be most appropriate for the nurse to ask?

How are problems in the family resolved?-How problems in the family are resolved relates to assessment of the roles-relationships pattern. The family's philosophy of health relates to the health perception-health management pattern. What the family does to have fun relates to the activity-exercise pattern. The decision concerning when and how children go to sleep relates to the sleep-rest pattern.

A nurse is assisting a client in values clarification. Which of the following actions should the nurse assist the client to complete first?

Identify what is meaningful in one's life.

After the 2010 Dietary Guidelines were released, a community health nurse updated a nutrition presentation that was being used to educate various community groups about healthy eating habits. Which of the following information would have been added to the presentation?

Impact of the environment on the public's food, drink, and activity choices

A teenager, who lives at home with her parents and school-aged brother, has been diagnosed with anorexia nervosa. Which of the following would be the most appropriate teaching goal for this family?

Improved coping

A woman reports that she has strong spiritual practices. Which of the following is she most likely to experience?

Improved coping skills and social support

Which of the following would be described as a family structural component?

Income earner of the house-Structural components of the family refer to family roles and relationships.

A nurse has implemented a smoking cessation program for teenagers and is now evaluating the rate of teenage smoking in the community. Which of the following functions is being demonstrated by the nurse?

Independent function-Evaluating nursing activities such as health promotion and health education is an independent function. In this case, the nurse is evaluating the nursing activity (smoking cessation program), and therefore it is an independent function.

Which of the following is a major factor limiting health care services in the United States?

Lack of funding-The lack of nurses may prevent health care providers from offering health promotional education activities. The cost of health care and prescription drugs is a major limitation to health care services. The United States has the highest proportion of population with no health insurance, thereby limiting health care services available to Americans.

A major cause of death in the early twentieth century was:

Infections

Which of the following represents a method of primary prevention?

Informational session about healthy lifestyles

A client is scheduled to have open-heart surgery. His physical condition is such that he is at high risk to experience complications during the procedure, but he has not been advised of this possibility. Which of the following ethical concepts has been ignored in rendering care for this client?

Informed consent-The client is able to "substantially understand" his care. Ethical care ensures that a person has all of the appropriate information necessary to make an autonomous decision about his or her care. This client has not been informed of his chances of dying during the surgery.

A nurse is counseling a 19-year-old person who has recently been diagnosed with Type 1 diabetes mellitus. The person asks if there is anything specific that should be done before going to play tennis with a friend. Which of the following instructions should the nurse give the person to avoid hypoglycemia?

Inject the insulin into the abdomen.

A nurse responded to a natural disaster and used expressive writing as a means of coping with the stress related to this experience. Which of the following benefits of expressive writing should the nurse expect?

Insight into the personal meaning of the experience

A young couple is deciding if they should get married and start a family. Which of Erikson's life stages are they experiencing?

Intimacy vs. isolation-During early adulthood individuals experience Erikson's life stage of intimacy vs. isolation. Examples of life events in this stage include committing to a mate and family responsibilities and selecting a career. Identity vs. role confusion occurs during adolescence. Intimacy vs. isolation occurs during middle adulthood. Ego integrity vs. despair occurs during maturity.

A parish nurse is concerned about the number of parishioners who smoke. How would the parish nurse best address this issue?

Invite local experts to participate in a health fair at the parish.-Nurses interact with communities to promote health. They supply educational information to at-risk groups to develop health-oriented skills as well as encourage behavior change. As such, nurses act as advocates collaborating with other disciplines and agencies. The success of health promotion programs depends on support from prominent community members. Therefore, arranging for a health fair and inviting local experts to participate is the best way for the nurse to address the smoking issue at her parish.

A nurse is providing education about safety precautions for people to take when using complementary/alternative medicine (CAM). Which of the following information would be included in this presentation?

It is important to research and understand the treatment before starting to use it.-It is important to take time to research and understand the treatment and ensure it is appropriate for the individual and the purpose. Treatments may not be covered by insurance. The U.S. Food and Drug Administration regulates dietary supplements, but does not always regulate their quality. There may be interactions between the treatment prescribed by allopathic and holistic practitioners so both providers should know about the care and treatment provided by the other.

A community health nurse is using the Dietary Reference Intakes (DRIs) as a guide while developing an education presentation about nutrition for a community group. How will the use of the DRIs be helpful in developing this presentation?

It serves as an overall guideline for the population.

A nurse is planning to offer a depression screening at a local community center. Which of the following should be considered prior to implementation of the program?

Limited referral sources in the community

A nurse is providing education about improving self-awareness to a small group of women who have been victims of domestic violence. Which of the following should the nurse recommend the clients do first to improve their self-awareness?

Listen to oneself and pay attention to emotions, thoughts, and reactions.-To achieve a high self-awareness, three steps must be taken. The first step is listening to oneself and paying attention to emotions, thoughts, memories, reactions, and impulses. The second step is listening to and learning from others. The third step is using self-disclosure to share aspects of self.

Which of the following demonstrates the nurse using subjective data to indicate a health concern in the health-perception-health-management pattern?

Listening to community members discuss the high smoking rate among teenagers-Subjective data is based on the perceptions of individuals in the community. Interviewing provides a way to learn how members perceive their communities and their perceptions of health. Therefore, the high smoking rates among teenagers reported by community members indicates subjective data. The others are forms of objective data.

A nurse is implementing a test that screens for hypercholesterolemia. Which of the following parameters should this test have?

Low cutoff point

Which of the following statements about exercise is true?

Low-level physical activity may have a protective effect on gastric and pancreatic cancer.

A community health nurse is educating a community group about the 2010 Dietary Guidelines for Americans. Which of the following information would be included in this presentation?

Make at least half of your grains whole grains.

Which of the following statements best describes the application of moral or ethical theory to the practices involved in health promotion?

Making ethical decisions regarding human health involves the consideration of multiple factors.-Making moral or ethical decisions about human health is not an easy task and requires assessing various criteria or theories.

For which of the following is Type 2 diabetes mellitus screening recommended?

Man with hypertension

A pregnant woman with 2 toddlers living at less than 135% of the federal poverty level would be eligible for:

Medicaid-state Medicaid programs must cover all pregnant women and children up to 6 years of age with a family income of less than 133% of the federal poverty level. States Children's Health Insurance Program provides insurance coverage to children whose family income is below 200% of the federal poverty level or whose income is 50% higher than the state's Medicaid eligibility threshold. In this case, the woman is pregnant, her children are under the age of 6, and they meet the financial criteria for Medicaid but not SCHIP.

When providing an educational session about the Arab American population, which of the following information would be included?

Members of the Arab American pop are more likely to have college degrees than Americans

A nurse is discussing exercise intensity with a client. Which of the following medications that the client is taking may limit the usefulness of heart rate as an indicator of exercise intensity?

Metoprolol (Toprol)

A person states to the nurse, "The guidelines for what we should eat as Americans is constantly changing, just when I got used to using MyPyramid they changed it to MyPlate. I wonder what will be next and if they really know what they are doing with all of this change." Which of the following would be the best response from the nurse?

MyPlate serves as a better visual aid, reminding Americans what a healthy 'plate' looks like."

Which cultural group defines illness as a price that is being paid for the past or the future?

Native American-American Indians define illness as a price that is being paid for the past or the future.

A health care professional is offering an educational session about providing culturally congruent care. Which of the following information would be included in the presentation?

Native Americans are present oriented, taking one day at a time.

Which of the following complementary/alternative therapies involves emphasizing healthy lifestyle, strengthening and cleansing the body, and noninvasive treatments?

Naturopathy-Naturopathy is guided by the healing power of nature. Practitioners do not use prescription drugs, injections, x-rays, or surgery, but instead use a variety of complementary and alternative medicine (CAM) modalities, emphasizing healthy lifestyle, strengthening and cleansing the body, and noninvasive treatments.

A community health nurse is educating health care providers in a local clinic about steps to take to help their clients improve their health-related behaviors. Which of the following would be included as the nurse teaches about the acronym LEARN?

Negotiate an agreement.

Which addition to a community best demonstrates the concept of the Healthy People 2020 report?

New recreational health center-The Healthy People 2020 report promotes health care, not illness care. A hospital, ICU, and rehabilitation center emphasize episodic care after an illness. The recreation health center serves to preserve health in the community and helps meet the goals of the Healthy People 2020 report.

Which of the following statements about nonverbal communication is true?

Nonverbal behavior is culturally and situationally bound.-Cultural exposure and situational impact are essential components of interpreting nonverbal communication and must be taken into consideration in attempts to interpret nonverbal communication.

A nurse is providing care for a 10-year-old child with a BMI at the 80th percentile. Which of the following best describes this child?

Normal weight

A nurse includes the statement, "Treat others the way you would like to be treated." when teaching a group of adolescents about bullying. Which type of ethical theory is being used in this example?

Normative theory-Normative theories are concerned with ensuring good actions. They are reasoned explanations of the moral purpose of human interactions, or they are divinely "revealed" truths about good action (religious ethics).

A nurse whose religious beliefs prohibit abortion has been asked to participate in a termination of the pregnancy of a 16-year-old victim of date rape. According to the revised American Nurses Association's (ANA's) Code of Ethics for Nurses, which of the following actions should the nurse take next?

Notify her supervisor about her beliefs and request a change in assignment..-In the immediacy of the situation, the ANA Code of Ethics provides for the right of nurses to refuse to participate in procedures that violate their own values, but the nurse's ethical behavior must ensure that arrangements for the care of the client are provided.

A community planning committee is working on the development of a community nursing center. Which of the following essential components should be included in this center?

Nurse as chief manager-The essential components of a community nursing center include a nurse as chief manager, a nursing staff that is accountable and responsible for care and professional practice, and nurses as the primary providers of care.

Which is a violation of the Health Insurance Portability and Accountability Act of 1996?

Nurse discussing the person's case with his or her school nurse-The Health Insurance Portability and Accountability Act of 1996 (HIPAA) is a federal privacy standard that requires safeguards to protect the security and confidentiality of health information. Disclosures without individual authorization are allowed only to public health authorities authorized by law to collect and receive information for the purpose of preventing or controlling disease, injury, or disability. Before speaking to the school nurse, the nurse must obtain authorization from the client's parents.

Which nurse is functioning as a care manager?

Nurse working with a family to coordinate care after their child experiences a second hospitalization for an asthma exacerbation-Care managers help determine what medical care is necessary, monitor care, and arrange for individuals to receive the most cost-effective care in the most appropriate settings. They must collaborate with providers and with the client/family. Care managers are especially helpful following a client after discharge and clients with complex needs. A nurse working with a family to coordinate service after a hospitalization is a good example of services provided by a care manager.

A woman tells the nurse that she is very nervous about their meeting today. Which of the following relationship stages are the nurse and woman most likely experiencing?

Orientation phase-The orientation phase begins when the nurse and individual meet. This meeting typically involves some feeling of anxiety because neither party knows what to expect.

A hurricane has just caused extensive damage within a local community. Which of the following are community members at risk to experience?

Outbreaks of acute respiratory infection Victims of natural disasters tend to have limited access to essential infrastructures for survival related to food, water, shelter, and sanitation. Infection outbreaks commonly diagnosed after natural disasters include diarrhea, acute respiratory infections, viral hepatitis, and snail and trematode infections.

A nurse working with a Hispanic family is explaining the plan for managing a child's asthma to the child's mother, father, and grandmother. To whom should the nurse direct the education?

Parents and grandmother-Culturally competent care is delivered with understanding of and sensitivity to cultural factors influencing health behaviors. Nurses provide culturally competent care when they identify and use cultural norms and values. In the Hispanic population, the male figure is usually the decision maker, and the family elders are highly respected. However, assumptions about cultural norms should not be made. As a result, the nurse should direct education to all three adults because they may all have an impact on the child's health care needs.

A nurse would like to improve his cultural competence. Which of the following is the best strategy to use?

Participate in contributing education programs about cultural diversity.

Over the last week, a person has had finger stick glucose levels of 127, 132, 140, 138, 143, 145, and 140. This information allows the nurse to characterize the person's function pattern by utilizing which area of focus?

Pattern-Pattern focus implies that the nurse explores patterns or sequences of behavior over time. Pattern recognition occurs during information collection. Functional health patterns then provide structure to analyze factors.

Which health care provider represents a primary care provider?

Pediatric nurse practitioner-A primary care provider serves as a gatekeeper, coordinating care of individuals by determining the need for referrals and procedures. A primary care provider can be a physician, physician's assistant, or advanced practice nurse in a primary care setting. The primary care provider provides basic and routine care usually in an office or a clinic. A pediatric nurse practitioner is an example of a primary care provider.

Which of the following statements concerning enjoying healthy activities is true?

People who have hobbies are better able to handle stress than those without hobbies.

A nurse is using the health belief model as a framework when developing a community action campaign to increase the percentage of the population who receives the influenza vaccine. Which of the following considerations will need to be made?

Perceived susceptibility in the community about getting influenza

A nurse is investigating an outbreak of a food-borne illness occurring at a local school. Which of the following would contribute to a chemical contamination resulting in food-borne illness?

Pesticide on the fresh fruit

A nurse is providing care to a person who has lower back pain. Which of the following exercises would the nurse recommend to assist with pain reduction?

Pilates

A community is considering banning smoking in all schools. Based on the community's current stage of change, which action should the nurse take next?

Point out positive outcomes associated with banning smoking such as maintenance of lung function.-A community that is considering implementing a smoking ban is in the contemplation stage of change. In this stage, interventions should be focused on discussing the risks of not changing and the benefits of changing. Maintaining the lung function of children is a benefit of the ban the community members are considering and thus an appropriate intervention for the nurse to utilize.

A person wishes to participate in a therapy involving energy utilization and dietary design. Which of the following therapies would the nurse recommend to the person?

Polarity therapy-Reiki, Qi gong, and pranic healing are all forms of touch therapy. Polarity therapy utilizes touch therapy and dietary restructuring.

After assessing the community, the nurse concludes that the community is having difficulty meeting its nutritional-metabolic pattern. Which of the following findings would the nurse most likely have discovered during the assessment?

Poor nutritional habits-The nutritional-metabolic pattern identifies data relevant to community eating habits. These habits are the result of decreased availability of grocery stores, lack of subsidized food programs, and inadequate knowledge. The habits are also influenced by a community''s culture. Therefore, the end results of health concerns in the nutritional-metabolic pattern of a community are poor nutritional habits.

Which of the following is a health plan consisting of hospitals and physician providers providing health care services to plan members (usually at a discounted rate) in return for expedited claims payment?

Preferred provider org (PPO)-A health plan consisting of hospitals and physician providers providing health care services to plan members (usually at discounted rates) in return for expedited claims payment is known as a preferred provider organization (PPO).

Influenza occurs among Americans at a rate of 36 per 100 people annually. Which type of rate is this statement describing?

Prevalence rate

When providing preoperative teaching for a client who will be undergoing total knee arthroplasty, the nurse asks the client questions to assess his understanding of the surgery. Which type of ethics is the nurse implementing?

Preventive ethics-Preventive ethics aims to forestall ethical problems before they develop. Preventive ethics is an important requirement of health-promotion endeavors that includes individual action by the nurse, as well as social and political activism with other nurses or professional nursing organizations. Assessing the client's understanding of what is going to happen during a surgical procedure before the client signs the consent for the procedure makes sure the client understands the information and should help prevent ethical problems.

Which concept is aimed at interrupting potential ethical problems before they develop?

Preventive ethics-Preventive ethics is a requirement of health promotion in which practitioners envision potential problems and institute actions that stop their development.

A community nurse develops a plan to address the problem of teenage pregnancies. Which of the following actions should the nurse take next?

Provide educational programs at local schools regarding pregnancy prevention.-Plans guide nursing actions. Implementation of the nursing process begins based on the health promotion/health protection plan. Providing education is an action item in a plan and thus should be the next step. Determining the rate occurs before diagnosis. Determining which factors require intervention occurs during the planning phase.

A nurse is caring for a person with a potential dysfunction in the health-perception-health-management pattern. Which of the following nursing interventions would most likely be performed?

Providing education regarding the dangers of smoking-Potential problems are risk states. Nursing interventions are directed toward risk reduction through education. Health promotion requires the individual to participate in his own care, and he cannot do this if he does not recognize his susceptibility to an impending health problem. Providing education addresses the risk and provides the person with information needed to change beliefs. The other options make the person a passive participant rather than an active one.

A nurse is employed by a local health department. Which of the following would be one of her primary responsibilities?

Providing education to the community about prevention of the flu-The role of the community health nurse is to promote the health of the population. It is not limited to any particular individual or group of individuals. It is important that the nurse view the community structure as a population and consider existing health services. Therefore, the primary responsibility of this nurse is to the community she serves by providing education about flu prevention.

A nurse is encouraging members of the community to advocate for the prevention of premature deaths in children under the age of 5 at the international level. Which of the following interventions would most likely be discussed by the nurse?

Providing nutritional supplements Protein-energy malnutrition can be severely harmful to the mental and physical development of individuals, especially young children under the age of 5. Worldwide, one out of two deaths among children younger than 5 years old stems from protein-energy malnutrition.

A nurse is working with UNAIDS to fight against HIV/AIDS at the global level. Which of the following activities would the nurse most likely be involved in?

Providing treatment access for all HIV-positive individuals who need medication

A person has just been admitted to the hospital. In talking with the person, the nurse is able to elicit from her that the reason for her hospitalization is that her husband beat her up. Which characteristic of the therapeutic relationship is being demonstrated?

Purposeful communication-The nurse focuses communication for a particular aim: to obtain information to be used in care of the person.

A nurse is examining the incidence, prevalence, and mortality rates of colon cancer in the community. Which of the following measures of life is being investigated?

Quantity of life

The devaluing of beliefs, values, and customs of others is known as:

Racism

A nurse is counseling a person on how to effectively deal with stress. Which of the following actions would the nurse recommend the person take first?

Recognize signs of stress.

The nurse has just discussed reflexology with an individual. Which of the following statements would the person make that demonstrates that learning has taken place?

Reflexology uses pressure applied to specific hand and foot areas to relieve tension.-Reflexology is a hand pressure technique applied to the hands or feet. It does not involve massage, squeezing, or stretching like acupressure.

A health care professional is caring for an Arab American individual. Which of the following cultural practices is this ethnic minority should be considered when planning care?

Religion plays an important role in this culture

An 18-year-old woman in whom a sexually transmitted disease (STD) was recently diagnosed asks the nurse not to tell her mother that she has an STD. Her mother asks the nurse what is causing her daughter's vaginal discharge. Which of the following actions should the nurse take?

Respect the principle of confidentiality and support the client's request not to tell her mother the diagnosis.-The Health Insurance Portability and Accountability Act (HIPAA) guarantees client confidentiality. The client is the only person who can inform her mother of the diagnosis and the only person who can give the nurse permission to inform her mother of the diagnosis. The nurse could appropriately respond to the mother by saying, "I cannot share that information with you because of client confidentiality legislation. You might ask your daughter to share that information with you."

A nurse is collecting data regarding the number of crosswalks within a community. Which perspective is being used to gather this data?

Risk-factor perspective-One way to assess a community is from a risk-factor perspective. Risk factors associated with community diseases, illness, and death rates play a role in predicting the likelihood of adverse health conditions. Risk factors include a combination of demographic, psychological, physiological, or environmental characteristics. Select groups may be at risk based on shared risks. Knowing which risk factors are present assists community nurses in developing action plans for health promotion and disease prevention.

A nurse is providing follow-up care for a family who has recently had a baby. Which of the following topics should the nurse anticipate discussing with the family?

SIDS-Families in the beginning childbearing stage need education about the risk of SIDS for their infant. After the birth of the child, it is most likely that they do not need education about fetal alcohol syndrome, unless there were issues with alcohol use during the prenatal period. Discussion about communicable diseases and potentially Type 1 diabetes would be more common with families with school-aged children.

A nurse is educating a person about the process of cognitive restructuring. Which of the following actions should be taken at the end of this process?

Select a realistic alternative thought.

Within a community there is an elevated high-school dropout rate and its high school students are experiencing a decreased sense of self-worth. Based on this data, the community is at highest risk to experience an alteration in which of the following functional health patterns?

Self-perception-self-concept pattern-The elevated high-school dropout rate is a risk factor in the values-beliefs pattern, and the decreased sense of self-worth is a risk factor in the self-perception-self-concept pattern. Risk factors from several pattern areas may form clusters of risks for certain groups. Elevated high-school dropout rates and a decreased sense of self-worth may lead to crimes that the community cannot adequately control or cope with.

A nurse is discussing holistic health care with an individual. Which of the following explanations should the nurse include in this discussion?

Self-reports of stress relief related to alternative/complementary therapy are numerous.-Empirical research related to the effectiveness of alternative/complementary therapy has been mixed. Some research studies have verified positive physiological reaction to this type of therapy.

The nurse has determined that a person has a dysfunction in the nutritional-metabolic pattern. Which action would be the next step for the nurse to take?

Set a goal weight with the person.-The individual's goals and the determined diagnosis provide the basis for planning. Before developing a plan, a goal must be set. Clarity of the goals and diagnosis is critical to the development of an effective plan. In this case, the diagnosis has already been established and thus assessment of this pattern has occurred (weight, favorite foods). The next step before developing a plan is to set a goal weight with the client.

A nurse is reviewing the chart of a 15-year-old girl who has been sexually active since the age of 12. Which of the following findings would be of most concern?

She has never had a Pap test.

A nurse is in the process of establishing a therapeutic relationship with a person. Which of the following techniques should be used by the nurse? (select all that apply)

Show interest in the person's concerns. Define the parameters of the relationship with the person.-Purposeful communication should be an aim of the therapeutic relationship. Social chitchat, communication without a goal, should not make up the bulk of the therapeutic interaction. The amount of space between communicators varies from culture to culture, so sitting close to the person may not be culturally appropriate. Building rapport by showing the person that his or her concerns interest the nurse is important. Also, trust can be built with the person by clearly defining the relationship parameters and expectations.

Which of the following describes a nurse who is "being with" the client?

Silently prays with a client when requested to do so-Performing one's duty or completing a task allows a nurse to "be there" with the client, but entering the client's world and praying with him or her when requested to do so exemplifies truly "being with" the client.

A nurse is providing health education about the importance of dental health to Latino residents in a community. Which of the following considerations should be made to promote health literacy within this program?

Speak slowly and distinctly.

A nurse is interviewing members of a substance abuse unit at a local Veterans Administration (VA) hospital. Which of the following parts of a community is the nurse assessing?

Subsystem of a community-Structural parts of a community form subsystems within a larger supra system. A substance abuse unit of a local VA hospital is a subsystem of a larger system (the VA hospital and family of hospitals). The structure of a community system or subsystem forms a formal or informal arrangement of parts. As a result, because interviewing is a form of assessment, the nurse in this example is assessing the subsystem (substance abuse unit of a local VA hospital) of a community (the VA hospital and family of hospitals).

The nurse is assisting a person to develop a positive attitude toward exercise. Which of the following nursing interventions would be most successful when working with this person?

Suggest that the person walk at a moderate pace for 30 minutes a day, 5 days a week for improvement in physical and psychological health.

A community health nurse is working with a low-income family who is experiencing food insecurity. To assist the family in getting nutritious foods in their home, the family should be referred to which of the following programs?

Supplemental Nutrition Assistance Program (SNAP)

Which of the following projects would most likely be administered by International Micronutrient Malnutrition Prevention and Control (IMMPaCT) Program?

Surveying various populations about consumption patterns IMMPaCt provides its skills and resources toward working to eradicate vitamin and mineral deficiencies around the globe. The IMMPaCT program's activities include conducting surveys; providing micronutrients to infants, young children, and women of childbearing age; and monitoring and evaluating intervention systems

The country with the lowest infant mortality rate in 2011 was:

Sweden-Sweden had the lowest infant mortality in 2011 with a mortality rate of 2.74 per 1000 live births.

Which of the following theories is an attempt to explain families as a set of interacting individuals with patterns of living that influence health decisions?

Systems theory-Systems theory is an attempt to explain patterns of living among the individuals who make up the family system.

A nurse is advocating for improved disease prevention and health promotion within the local community. Which of the following interventions would the nurse most likely implement?

Talk with a state legislator about improved access to health care for the uninsured and underinsured. In order to be advocates for newly emerging priorities for disease prevention and health promotion, nurses in the twenty-first century need to participate in policy development for health promotion as the health care of individuals in acute settings shifts from hospitals to home and community settings, influence public expectations about health promotion, and promote equitable access to preventive health care. Talking with a state legislator about improving access to health care for the uninsured and underinsured is the only example that demonstrates the nurse in the role of an advocate working in one of these priority areas.

A person reports that she has been seeking care from an acupuncturist to help relieve the chronic pain that she has been experiencing. Which of the following statements would be the most appropriate response from the nurse?

Tell me more about your treatments from the acupuncturist.

Which classification system fulfills needs that are exclusive to nursing?

The International Nursing Diagnoses Classification (NANDA-I)-The NANDA-I system includes diagnostic criteria, and related etiologies in addition to the description. The NANDA-I fulfills needs that are exclusive to nursing.

A primary care clinic is being established in a rural county that recently experienced a hurricane severely damaging its infrastructure for medical care. Which of the following considerations would be the priority when planning for this clinic?

The ability to provide mental health services to community members The priority in planning should be the ability to provide mental health services to the community members. In 2007, the Inter-Agency Standing Committee developed its Guidelines on Mental Health and Psychosocial Support in Emergency Setting. It emphasizes the importance of primary care clinics being able to provide mental health services to victims of the disaster.

An individual asks the nurse to explain yoga. Which of the following statements would be made by the nurse?

There are many different types of yoga.-Not all forms of yoga involve physical activity. There are many forms of yoga, some of which involve meditation and others that involve movement.

A Medicare client reports to the home care nurse that he is receiving care through an accountable care organization (ACO). Which of the following considerations should be made when delivering care to this individual?

The focus of care is prevention and management of individuals with chronic disease.-The focus of care of accountable care organizations (ACOs) is to focus on prevention and management of individuals with chronic disease out of the hospital. In an ACO, physicians accept the responsibility for the quality of care provided and overall costs of delivering care to a defined population of patients. Accountable care organizations are composed of physicians, specialists, and hospitals, so a specialist will be able to be seen within the ACO. Individuals who are part of concierge care pay a membership fee in return for enhanced health care services or amenities. Health savings accounts are used in conjunction with high deductible health insurance plans and are not related to the use of ACOs.

A nurse is developing learning objectives for an individual who has been placed on a low-fat, low-cholesterol diet. Which is an example of an appropriately written cognitive learning objective?

The individual will correctly identify and purchase low-fat, low-cholesterol foods.

A nurse is developing learning objectives for an individual who has been recently diagnosed with asthma. Which is an example of an appropriately written psychomotor learning objective?

The individual will demonstrate proper use of the inhaler.

A nurse is developing learning objectives for an individual who is becoming more physically active. Which of the following is an example of an appropriately written affective learning objective?

The individual will verbalize the importance of daily exercise.

Which of the following health concerns should the nurse have as a priority when planning care for a community?

The lack of grocery stores within walking distance identified by the community-As a community liaison, the nurse establishes priorities for programming and matches resources with needs determined by a community-needs assessment. The goal is to maintain the community's vision. Nurses' concerns should be based on the community's concerns. Therefore, the lack of grocery stores identified by the community should take first priority.

The nurse shares with her client the news that she, the nurse, is going to be married soon and tells the client about her wedding plans. Which of the following best describes the nurse's actions?

The nurse is exhibiting a communication technique called self-disclosure.-Sharing aspects of the self enriches interpersonal life and is a use of the technique labeled self-disclosure.

During a health history, a person reports getting 5 hours of sleep a night. What does this information indicate to the nurse?

The nurse must ask additional questions.-The single most important factor assessed in the sleep-rest pattern is probably the perception of adequacy of sleep and relaxation. The objective when assessing the sleep-rest pattern is to describe the effectiveness of the pattern from the person's perspective. Wide variation in sleep time does not necessarily affect functional performance. Different individuals require different amounts of sleep. Thus, without further subjective data, the nurse is not able to make a diagnosis in this functional pattern.

A health care professional is searching for a funding source to develop a colorectal cancer screening program for ethnic and racial minorities in the community. Which of the following federal agencies would most likely be able to assist with this initiative?

The office of minority health

A HCP i caring for an individual who is homeless. Which of the following considerations should be made?

The percentage of the population who has health insurance is much lower among the homeless than the general public

A nurse is collecting health assessment data about a person's coping mechanisms in relation to stressors. Who would provide the best source of this information?

The person

The nurse is caring for a person who is obese, sedentary, and has recently been diagnosed with Type 2 diabetes mellitus. Which of the following goals for the person is correctly stated?

The person will walk one-quarter mile a day, 5 days a week.

When assessing a person's nutritional-metabolic pattern, which objective finding would have implications for nursing intervention?

The person's dentition-Although all of the assessment parameters listed have implications for nursing diagnosis and planning for this client, the only objective measure is the client's dentition. It is the only one that can be validated with a physical exam.

The ecomap of a client's family has slashed lines drawn from the son to the family church. Based on this information, what conclusion can the nurse make?

The son has a stressful relationship with the church.-Slashed lines on an ecomap signify stressful relationships.

A blended family has six children, ages 2, 4, 4, 5, 7, and 10. During a visit to the home, the nurse notices that the 7-year-old seems quiet and withdrawn, whereas the other children are playing loudly in the garage. Which of the following conclusions can the nurse make from this observation?

This child is one of multiple children closely spaced in age.-Risks associated with role relationships in blended families include multiple closely spaced children, which limits the parents' time for interaction to meet individual children's needs.

A community health nurse is providing education about the "Dietary Approaches to Stop Hypertension" (DASH) eating plan to people attending cardiac rehabilitation. Which of the following recommendations would be included in this presentation?

This dietary plan includes eating greater amounts of fruits and vegetables.

The nurse makes sure that the distance between himself and the client is at least 6 feet before he begins to ask questions related to the client's health history. Which of the following statements is true?

This distance is too far for the nurse to build a therapeutic relationship while obtaining the information.-Personal space of 18 inches to 4 feet is appropriate for close relationships in which touching may be involved and good visualization is desired.

A nurse is working with a family that is experiencing food insecurity. Which of the following statements best describes this family?

This family's access to adequate food is limited by lack of money.

The nurse is teaching imagery as a method to reduce anxiety in preoperative individuals. Which of the following aspects should the nurse stress when teaching this technique?

This technique promotes a sense of well-being.-Imagery is a gentle but powerful technique that focuses and directs the imagination in order to promote a sense of well-being and help people relax. Imagery is an individual exercise and does not include a prayer circle.

A nurse is working at a women's health clinic and is asked by a client when she should return for her next Pap smear. Which of the following resources would the nurse use to find the most current recommendations?

U.S. Preventive Services Task Force (USPSTF) website

Which of the following scenarios best describes a nurse using metacommunication?

Understanding that an individual needs a break before proceeding-Metacommunication refers to a message about the message. It is the relationship aspect of communication. In a sense, it involves reading between the lines or going past the surface content of the message to glean nuances of meaning.

A nurse is working with a group of individuals to start an exercise program. Which of the following would require the most attention and assistance?

Unemployed, obese Hispanic woman

A liver for which two people are tissue-typed has become available after the death of a donor in a car accident. Client A is a 45-year-old substance abuser whose liver is damaged as a result of his use of alcohol. Client B is a 16-year-old adolescent in need of a liver transplant because of a birth abnormality. Which of the following would be useful for a nurse in giving input as to which of the two should receive the liver?

Use a guided set of moral principles in decision-making before advocating for either.-Systematically using a set of moral principles in making ethical decisions assists the nurse in resolving ethical dilemmas such as that described.

The nurse is caring for a family who has 2-year-old twins. Which of the following health promotion advice would be included in the nurse's plan of care for this couple?

Use caution around the family swimming pool.-Two-year-olds are prone to wandering to where water is and could fall into a swimming pool without being noticed.

A nurse has developed a family nursing diagnosis. Which of the following best describes the purpose of this action?

Validates health problems with the family-Writing a family nursing diagnosis helps families promote health throughout the life cycle and prevents disease through decreasing risk-taking behaviors. Nurses derive diagnoses from assessed validated data. The nursing diagnosis describes and validates potential or actual health problems with families. The diagnosis provides direction for outcomes and interventions first identifying what the problem is.

The nurse is examining the ability of a phenylketonuria (PKU) screening test to distinguish correctly between newborns who have and who do not have the disease. Which of the following measures of accuracy of the instrument is being evaluated?

Validity

Which of the following statements about values is true?

Values evolve over time; they are not static.-Values take time to develop, and they may change with education, experience, exposure, or a combination of these.

A nurse is counseling someone who has recently been diagnosed with diabetes. The nurse says, "Tell me more about how this diagnosis has affected your daily activities." Which of the following best describes the type of communication the nurse is using?

Verbal communication-Verbal communication is the transmission of messages using words, spoken or written. Nonverbal communication encompasses all messages that are not spoken or written. Metacommunication refers to a message about the message, the relationship aspect of communication.

During an office visit, a nurse provides counseling to a 70-year-old woman with osteoporosis who is otherwise very healthy. Which of the following information should the nurse provide to the woman?

Walk with a partner at least 30 minutes a day 5 days a week.

A nurse is educating a 35-year-old woman about the best exercises to engage in to prevent bone loss. Which of the following exercises would the nurse recommend?

Walking

A school nurse is preparing to discuss food safety practices with high school students enrolled in a family and consumer science "foods" course. Which of the following information would be included in the presentation?

Wash hands thoroughly with running warm water with soap for 30 seconds.

A nurse is developing an exercise program for a person with moderate osteoarthritis of the knees. Which of the following forms of exercise would the nurse include in this program?

Water aerobics

A nurse is using a sweat test to screen people for cystic fibrosis. Which of the following results demonstrates poor sensitivity?

When 6 out of every 10 sweat tests performed are negative, but the six individuals actually have cystic fibrosis

A nurse is working in the emergency department (ED). Which of the following situations would cause the nurse to suspect bioterrorism?

When thirteen people, aged 24 to 33, come to the ED with ascending flaccid muscle paralysis

Which of the following individuals would be at greatest risk to develop Type 2 diabetes?

White, 50-year-old woman, obese, second child weighed 10 pounds at birth

A nurse states that many community members are concerned about the increasing number of natural disasters that have been occurring in the United States. Which of the following would the community members be referring to?

Wildfires and hurricanes

Which scenario indicates a potentially dysfunctional pattern?

Woman who lost her job-A pattern is potentially dysfunctional when sufficient evidence exists or enough risk factors are present to indicate that a pattern of dysfunction will likely occur if interventions are not instituted. A dysfunctional pattern is a problem when it represents a deviation from established norms or from the individual's previous condition or goal. The woman who lost her job indicates a potential dysfunction pattern because the stress of losing her job places her at risk for ineffective coping. The other scenarios are not potentially dysfunctional; by definition, they aredysfunctional.

A nurse is helping a person reduce stress-disinhibition related to poor dietary choices. Which of the following nursing interventions would be most appropriate?

Work with the person to develop a plan to slowly replace high-fat, high-calorie foods with more healthy choices.

Which nurse is at risk of making a medical error?

Working overtime-Health care systems are the basic cause of medical errors. Organizational and workforce management, work design, and organizational culture are problem areas that contribute to medical errors. Poor management leads to increased nurse turnover, the need for increased client-to-nurse ratios, increased need for overtime, and decreased number of nurses, all of which can lead to medical errors. A nurse working overtime is at risk of making a medical error.

Which of the following represents a method of secondary prevention?

Yearly mammograms

A nurse complies with the Patient Self-Determination Act when asking:

a person upon admission to the hospital if he or she has an advanced directive-The Patient Self-Determination Act is designed to increase individual involvement in decisions about life-sustaining treatments. The nurse must ensure that advanced directives are available to physicians at the time the medical decision is being made. Therefore, the nurse complies with the act when she asks a person upon admission to the hospital if he or she has an advanced directive.

During a home visit, a nurse assists an individual to complete an application for disability services. The nurse is acting as an:

advocate

Activity that uses large muscle groups in a repetitive, rhythmic fashion over an extended period to improve the efficiency of the oxidative energy producing system and improve cardiorespiratory endurance is known as:

aerobic activity.

In reviewing a person's medical claims, a nurse realizes that the individual with moderate persistent asthma has had several emergency dept. visits and is not on inhaled steroids as recommended by NHLBI asthma management guidelines. The nurse discusses this with the person's primary care provider. In this scenario, the nurse is acting as a:

care manager

The primary objective of social marketing is to

change behavior.

Any combination of planned experiences based on sound theories that provide individuals, groups, and communities the opportunity to acquire the information and skills needed to make quality health decisions is known as health:

education.

During a home visit, a nurse discuss the dangers of smoking with an individual. In this scenario the nurse is acting as an:

educator

A nurse is planning to deliver an educational program to individuals with diabetes. Which of the following should be the initial action taken by the nurse to ensure the success of the program?

establish teacher-learner goals

An emergency department provides care for all individuals regardless of circumstances and ability to pay. This is an example of:

ethic of justice.-The ethic of justice is impartial and nondiscriminatory. An ethic of care, however, requires an understanding of situational particularities, ensuring that we try to understand a given individual's needs in the context of his or her life.

Assuming that an individual's own perspective is correct and shared by others is known as:

ethnocentrism

A nurse who uses findings from a randomized, controlled trial on the care of Foley catheters to change practice at an institution is practicing:

evidenced-based medicine

The process of dynamic change with adaptation in the system's parts, and how community systems and subsystems interact is known as:

function of a community.-The function of a community is defined as the process of dynamic change with adaptation in the system's parts and how community systems and subsystems interact.

A state of physical, mental, spiritual, and social functioning that realizes a person's potential and is experienced within a developmental context is known as:

health

Partnering with school-based clinics and local pediatric dentists so that children can have access to preventive dental care is an example of a(n):

interdependent function.-Collaboration with community members and interdisciplinary teamwork functions crucial to effective community health are considered interdependent functions. Partnering with school-based clinics and local dentists is a collaborative effort to improve the community's health.

The interrationship of poverty and healthcare dollars spent by Blacks and other minorities is affected greatly by:

lack of access to preventive health care services

Building a partnership with an obese individual who is trying to lose weight requires the nurse to:

learn about the methods of weight loss.

A nurse and a man are involved in a conversation. When the person folds his arms across his chest, the nurse almost simultaneously folds her arms across her chest. This behavior is recognized as:

reciprocity.-The patterning of similar activities within the same interval by two people can facilitate communication. This patterning is known as reciprocity.

A nurse administers the T-ACE test to a pregnant woman. The woman's responses result in a score of 3. This score indicates that the woman:

requires interventions for problem drinking.-The T-ACE provides a sensitive measure of alcohol-intake pattern in pregnant women. A score of 2 or more indicates evidence of problem drinking. This client had a score of 3, which would require an intervention for problem drinking.

The proportion of people with a condition who correctly test positive when screened is known as:

sensitivity.

Which of the following is most influenced by social and economic environment of a community?

social health policies

An example of a Hispanic American nurse promoting cultural competency is:

taking a class about hisp american culture

A system used to evaluate the necessity, appropriateness, and efficiency of the use of the health care system, the purpose of which is to lower costs by discouraging unnecessary treatments is know as:

utilization review-A system used to evaluate the necessity, appropriateness, and efficiency of the use of the health care system, the purpose of which is to lower costs by discouraging unnecessary treatments, is known as utilization review.

A nurse and her client are engaged in meaningful conversation when suddenly there is silence between the two. To facilitate effective client-centered communication, the nurse should:

wait quietly to give the person time to reflect where he wants to lead the conversation.-Silence allows the person to reflect on what is being discussed or experienced and lets him or her know that the nurse is willing to wait until he or she is ready to say more.