Population Health Exam 2 Book and PCA Questions

A community health nurse is determining available and needed supplies in the event of a bioterrorism attack. The nurse should be aware that community members exposed to anthrax will need access to which of the following medications? a. Metronidazole (Flagyl) b. Ciprofloxacin (Cipro) c. Zanamivir (Relenza) d. Fluconazole (Diflucan)

b. Ciprofloxacin (Cipro)

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

An unusual illness in a population

If you were a nurse employed in an industry, which of the following federal laws would affect you the most? A. National Child Abuse Act B. Freedom of Information/Privacy Act C. Occupational Safety and Health Act (OSHA) D. Patient Self-Determination Act

C. Occupational Safety and Health Act (OSHA)

When health care providers in the community refuse to accept Medicare clients, this implies reduced access to care, potential decreases in acceptable quality of services offered, and a form of health care rationing. Health care rationing becomes a public health and nursing issue because: A. Medicare reimbursement needs to be higher. B. proactive primary prevention orientation is cost effective. C. public health systems and nurses must ensure that essential clinical services are available. D. sufficient resources are available in the public health system to meet the unmet need.

C. public health systems and nurses must ensure that essential clinical services are available.

The 1989 changes to Medicaid required states to provide care for children younger than 6 years and to pregnant women under 133% of the poverty level. These changes also ensured adequate access to qualified providers by: A. adding coverage for the medically indigent. B. reimbursing early periodic screening, diagnosis, and treatment (EPSDT) for those younger than 21 years. C. reimbursing pediatric and family nurse practitioners. D. reimbursing skilled and intermediate nursing home care.

C. reimbursing pediatric and family nurse practitioners.

A community-based HIV/AIDS clinic would be concerned about which aspects of the Public Health Code of Ethics? Select all that apply. Autonomy of the professional Confidentiality when possible Funding Promoting advocacy for disenfranchised persons Respecting only community rights

Confidentiality when possible Promoting advocacy for disenfranchised persons

For the nurse to evaluate why people at the picnic became sick, what questions should she ask the people who brought the food? A. Cooking time and how they cooked the food B. Hygiene of their equipment C. Sources of the water used in cooking the food D. All of the above

D. All of the above

Which domain(s) of learning did Ms. Fields use to teach the importance of hand washing to her fourth-grade students? A. Affective B. Cognitive C. Psychomotor D. All of the above

D. All of the above

The nurse epidemiologist at the health department develops a line list to organize the data. The line list includes the information reported by the student health nurse. What is the term used to describe the type of epidemiology associated with time, place, and person? A. Descriptive B. Analytic C. Scientific D. Environmental

A. Descriptive

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

A. Distributive justice

A model that helps to explain complex relationships among host, agent and environment.

Epidemiologic triangle

Which of the following systems of surveillance is used to monitor trends in commonly occurring diseases? Active Passive Sentinel Syndronic

Sentinel

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

exploitation.

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

"It's important to good health to have adequate recreation resources."

A nurse demonstrates cultural competence by using statements such as: "I know how you feel." "Tell me about your health care beliefs." "Let me show you the way you should do this." "You can do things in a more modern way now."

"Tell me about your health care beliefs."

Analytic epidemiology differs from descriptive epidemiology because it searches for: "when" of disease patterns. "where" of disease patterns. "why" of disease patterns. "who" of disease patterns.

"why" of disease patterns.

Since 1998, nurse practitioners (NPs) and clinical nurse specialists (CNSs) are reimbursed by Medicare Part B at a rate that is what percent of physician rates for the same service? 50% 70% 85% 95%

85%

Nurses in community health often use epidemiology because in the community it is often difficult to control the environment. Which of the following statements demonstrates an epidemiologic strategy for monitoring disease trends? A nurse in community health conducts an education class for clients newly diagnosed with diabetes. A nurse in community health investigates a breakout of whooping cough in a local middle school. A nurse in community health organizes a health fair at the community health center. A nurse in community health participates on a county school board that addresses student health issues.

A nurse in community health investigates a breakout of whooping cough in a local middle school.

A nurse manager at a community agency is developing an orientation program for newly hired nurses. When discussing the differences between community-based and community-oriented nursing, the nurse should include which of the following as examples of community-based nursing? (Select all that apply.) A. A home health nurse performing wound care for a client who is immobile B. An occupational health nurse providing classes on body mechanics at a local industrial plant C. A school nurse teaching a student who has asthma about medications D. A parish nurse teaching a class on low-sodium cooking techniques E. A mental health nurse discussing stress management techniques with a support group

A. A home health nurse performing wound care for a client who is immobile C. A school nurse teaching a student who has asthma about medications

Several community-oriented nurses want to explore the problem of obesity in school-age children and assess their community related to this problem. They would begin: A. Centers for Disease Control and Prevention (CDC) B. Centers for Medicare and Medicaid Services (CMS) C. Health Resources and Services Administration (HRSA) D. National Institute of Nursing Research (NINR)

A. Centers for Disease Control and Prevention (CDC)

Several community-oriented nurses want to explore the problem of obesity in school-age children and assess their community school district health status related to that problem. When gathering information at a national level, they would begin with the: A. Centers for Disease Control and Prevention (CDC). B. Centers for Medicare and Medicaid Services (CMS). C. Health Resources and Services Administration (HRSA). D. National Institute of Nursing Research (NINR).

A. Centers for Disease Control and Prevention (CDC).

The nurse applies the ethical principal of non-maleficence when: A. Completing MORSE fall scale to assess fall risk B. Encouraging patients to be active participants in their care C. Providing privacy during a dressing change D. Asking the physician for a referral for physical therapy on the patient's behalf.

A. Completing MORSE fall scale to assess fall risk

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

A. Coordinating services to meet the client's needs

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

A. Costs associated with services

Based on the data analysis, the nurse epidemiologist determines that the fresh vegetable tray is associated with illness. She also learns that two of the food handlers were not feeling well during the event. What measures should she take at this point to control the outbreak? (Select all that apply.) A. Obtain stool specimens from the catering staff. B. Educate catering and serving staff about safe food preparation. C. Encourage food service staff not to prepare or serve food when they are ill with gastrointestinal symptoms. D. Call the Better Business Bureau.

A. Obtain stool specimens from the catering staff. B. Educate catering and serving staff about safe food preparation. C. Encourage food service staff not to prepare or serve food when they are ill with gastrointestinal symptoms.

The system that refers to "organized community efforts designed to prevent disease and promote health" is which of the following? A. Public health system B. Primary health care system C. Managed care system D. Primary care system

A. Public health system

A nurse is using the I PREPARE mnemonic to assess a client's potential environmental exposures. Which of the following questions should the nurse ask when assessing the A in the mnemonic? A. What do you like to do for fun? B. What year was your residence built? C. What jobs have you had in the past? D. What industries are near to where you live?

A. What do you like to do for fun?

Health care costs are influenced by factors related to demographic changes, new technology, resource intensity, and: A. chronic illness. B. market practices. C. nursing shortages. D. professional competition.

A. chronic illness.

In this situation, the rule of confidentiality is: A. superseded by the duty to protect the infant's welfare. B. adhered to in order to maintain the nurse-client relationship. C. important in maintaining Ms. White and Mr. Smith's right to privacy. D. superseded by the principle of justice when housing is involved.

A. superseded by the duty to protect the infant's welfare.

The principle of utility, when applied to this situation, would involve the nurse: A. weighing the potential benefits of not informing Child Protective Services versus the potential harm of leaving the baby with his mother. B. informing Ms. White of her rights in regard to personal freedom. C. deciding what aspects of this situation should be recorded in the chart. D. telling Ms. White that he would be calling Child Protective Services.

A. weighing the potential benefits of not informing Child

The nurse decides to educate all staff about the organism, including how it is transmitted and prevention strategies. This level of prevention is: A. primary. B. secondary. C. tertiary.

ANS: A

Aids in disaster response on a local or national level. Volunteers from all areas of licensed and unlicensed personnel can be involved

ARC/MRC

A community health nurse is educating the public on the agents of bioterrorism. Which of the following are Category A biological agents? (Select all that apply.) a. Hantavirus b. Typhus c. Plague d. Tularemia e. Botulism

c. Plague d. Tularemia e. Botulism

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

Active Passive

The Clean Air Act of 1970 was amended in 1990 to meet unaddressed or insufficiently addressed problems that included which of the following? Select all that apply. Addressing acid rain Addressing excessive noise and heat or cold extremes Addressing ground-level ozone Addressing stratospheric ozone depletion Tracking 75,000 industrial chemicals

Addressing acid rain Addressing ground-level ozone Addressing stratospheric ozone depletion

Finding resources to implement evidence-based practice (EBP) in community health will continue to be a challenge because of the emphasis on quality care, equal distribution of health care resources, and cost control. Which of the following would demonstrate a creative strategy to implementing EBP? Adopting quality indicators for evaluating websites claiming to contain EBP Avoiding the issue of community politics Creating the role of a knowledge manager Making decisions on behalf of the community

Adopting quality indicators for evaluating websites claiming to contain EBP

A nurse in the community is planning to begin a class to help mothers returning to work better cope with the stresses of multiple roles. The nurse would most likely use: An andragogical approach A behavioral approach An operational approach A pedagogical approach

An andragogical approach

Evidence-based public health utilizes which of the following guidelines? Decision making for the community served Application of program planning frameworks Judicious use of the Internet for use of evidence Conducting evaluations Disseminating what has been learned

Application of program planning frameworks Conducting evaluations Disseminating what has been learned

Which of the following major problems in the health care system was most evident in this situation? A. Escalating costs B. Access to care C. Fragmentation of services D. Quality of care

B. Access to care

The nurse epidemiologist notes that the infections are clustered in time, place, and person. She interviews all of the ill nursing students and learns that all of them attended the open house at the Dean's home. What should the nurse do next? A. Close the nursing school. B. Arrange to collect stool specimens. C. Contact the Dean. D. Quarantine all of the open house attendees.

B. Arrange to collect stool specimens.

A nurse is caring for a client who is from a different culture than himself. When beginning the cultural assessment, which of the following actions should the nurse take first? A. Determine the client's perception of his current health status. B. Gather data about the client's cultural beliefs. C. Determine how the client's culture can affect the effectiveness of the nursing process. D. Gather information about previous client interactions with the health care system

B. Gather data about the client's cultural beliefs.

A nurse is conducting health screenings at a statewide health fair and identifies several clients who require referral to a provider. Which of the following statements by a client indicates a barrier to accessing health care? A. I don't drive, and my son is only available to take me places in the morning. B. I can't take off during the day, and the local after-hours clinic is no longer in operation. C. Only one doctor in my town is designated provider by my health maintenance organization. D. I would like to schedule an appointment with the local doctor in my town who speaks SPanish and English.

B. I can't take off during the day, and the local after-hours clinic is no longer in operation.

A nurse is reviewing information about the local health department to prepare for an interview. Which of the following services should the nurse expect the local health departments to provide? A. Managing the WIC program B. Providing education to achieve community health goals. C. Coordinating directives from state personnel. D. Reporting communicable diseases to the CDC. E. Licensing of RN.

B. Providing education to achieve community health goals. C. Coordinating directives from state personnel.

A nurse practice act can be found in which of the following sources? A. Federal procedure B. State laws C. Judicial opinions D. State regulations

B. State laws

A nurse who questions whether a particular activity in her job description is within her scope of practice would look to which government jurisdiction or agency to seek the clarification? A. Federal system B. State system C. Department of Labor D. U.S. Department of Health and Human Services

B. State system

The nurse epidemiologist decides to interview everyone (ill and well) who attended the open house. This type of study is called a: A. case-control study. B. cohort study. C. longitudinal study. D. case study.

B. cohort study.

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

B. flexibility among partners when considering new ideas C. adherence of partners to ethical principles E. Willingness of partners to negotiate roles

Of the four major factors that affect health care—personal behavior/lifestyle, environmental factors (physical, social, economic), human biology, and the health care system—medical services are said to have the least effect. Yet, the U.S. health care system remains reactionary with high-cost, high-technology, and disease-specific "sickness care." This statement supports the need for increased investment in: A. managed care. B. primary prevention. C. secondary prevention. D. tertiary prevention.

B. primary prevention.

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

B. updating state officials about health needs of the local community

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

Bed-wetting episodes Fantasies of denial Thumb sucking

When does disaster management begin? Before the disaster occurs During the disaster Immediately following the disaster During the recovery period

Before the disaster occurs

Which of the following social science theories is used by public health nursing to describe how environments and systems outside of the family influence the development of a child over time? Life-cycle theory Family developmental theory Family systems theory Bioecological systems theory

Bioecological systems theory

You are a nurse called to the scene of the mock disaster. Triage the following clients you see at the disaster site: A. 60-year-old man with a broken wrist and a history of heart disease. B. 30-year-old woman with "road burn" lacerations on her forearms and thighs. C. 12-year-old boy with third-degree burn marks over 40% of his body.

C. 12-year-old boy with third-degree burn marks over 40% of his body. Highest priority is always given to victims who have life-threatening injuries but also have a high probability of survival once stabilized. Therefore you would first attend to the 12-year-old boy with third-degree burn marks over 40% of his body, because he needs severe wound care and pain management. Second priority is given to victims with injuries that have systemic complications that are not yet life threatening and could wait 45 to 60 minutes for treatment. So, you would next treat the 60-year-old man with a broken wrist and a history of heart disease. Last priority is given to those victims with local injuries without immediate complications and who can wait several hours for medical attention. That would apply to the 30-year-old woman with "road burn" lacerations on her forearms and thighs, because her injuries are not life threatening and can wait.

Which of the following factors have had an impact on the complex relationship among nursing practice, health policy, and politics? Select all that apply. Categorical funding Death penalty Head Start Health fairs Statutory authority for the profession

Categorical funding Head Start Statutory authority for the profession

A nurse is working with her church to develop a new outreach program aimed at providing support services for recovering substance abusers in the local community. What agency might the nurse contact to secure federal funding for the program? Center for Faith-Based and Neighborhood Partnerships Office of Global Affairs Office of Public Health Preparedness The National Health Services Corp

Center for Faith-Based and Neighborhood Partnerships

Several community-oriented nurses want to explore the problem of obesity in school-age children and assess their community school district health status related to that problem. When gathering information at a national level, they would begin with the: Centers for Disease Control and Prevention (CDC). Centers for Medicare and Medicaid Services (CMS). Health Resources and Services Administration (HRSA). National Institute of Nursing Research (NINR).

Centers for Disease Control and Prevention (CDC).

Which is one of the most common chronic diseases in the United States? Chronic obstructive pulmonary disease (COPD) Asthma Stroke Crohn's disease

Chronic obstructive pulmonary disease (COPD)

When final health care-related regulations are published, they often lead to changes in practice. After a period of draft review, public comment/hearing, further study if necessary, and then final redrafting, the regulations at both federal and state levels carry the weight of law and are published in the: ANA Code of Conduct. Code of Regulations. Patient Safety Act of 1997. Interstate Nurse Licensure Compact.

Code of Regulations.

Which of the following tools are used in analytic epidemiology? Select all that apply. Cohort study Case-control study Cross-sectional study Clinical trials Community trials

Cohort study Case-control study Cross-sectional study

Nurses should review which of the following reports to determine what pollutants have been found in the drinking water of a community? Point source report Consumer confidence report Material Safety Data Sheet Environmental standards report

Consumer confidence report

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

Continuous source

What are some of the benefits of an electronic medical record in the public health setting? Select all that apply. Timely billing and financial reimbursement for services provided Improved public reporting of medication errors Coordination of referrals and facilitation of chronic disease management Improvement of quality measurement and monitoring Incorporation of protocol reminders for prevention, screening, and management of chronic disease

Coordination of referrals and facilitation of chronic disease management Improvement of quality measurement and monitoring Incorporation of protocol reminders for prevention, screening, and management of chronic disease

A nurse exclaims proudly to other nurses at the agency, "The care I provide is the same for everyone. I treat everyone the same." In fact, this nurse is demonstrating what inhibitor to developing cultural competence? Cultural blindness Cultural competence Cultural conflict Culture shock

Cultural blindness

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

D. Identify referrals that the client needs.

The traditional reimbursement method for health care services is which of the following? A. Capitation B. Contracting C. Prospective D. Retrospective

D. Retrospective

The federal agency most responsible for improving the health status of the American people is the: A. Office of Health Preparedness. B. Office of Global Affairs. C. Food and Drug Administration. D. U.S. Department of Health and Human Services

D. U.S. Department of Health and Human Services

Which of the following federal agencies is most directly involved with the health and welfare of Americans? A. Department of Agriculture B. Department of Justice C. Department of Commerce D. U.S. Department of Health and Human Services E. Department of Defense

D. U.S. Department of Health and Human Services

The nurse epidemiologist suspects an outbreak and launches an investigation because: A. the situation is an unusual problem. B. there is a potential risk to the public. C. there is a causal pathway. D. all of the above.

D. all of the above.

The principle of autonomy is not applicable because of: A. Tommy's chronological age. B. Ms. White's mental illness, now untreated. C. Mr. Smith's criminal record. D. both A and B. E. all of the above.

D. both A and B.

The nurse epidemiologist discovers that all of the infected inmates have their wound dressings changed on the same day of the week in the same treatment room. She notices there is no sink or evidence of hand sanitizer in the treatment room. She recommends the following strategies EXCEPT: A. install hand hygiene stations in convenient locations in treatment rooms. B. clean and disinfect examination tables after each inmate is seen. C. perform medical procedures in the jail. D. recommend antibiotics for all inmates and staff

D. recommend antibiotics for all inmates and staff

A nurse who is interested in disaster training through the Community Emergency Response Team (CERT) program would look to which government jurisdiction or agency to seek the certification? Local system State system Department of Homeland Security US Department of Health and Human Services

Department of Homeland Security

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

Determine if surveillance is appropriate.

The nurse epidemiologist decides to visit the jail. Based on what she knows about the transmission of A. baumannii, what information could she collect? A. Underlying infections and chronic diseases of inmates B. Medical procedures performed in the jail C. Number of air exchanges in the jail D. All of the above E. A and B only

E. A and B only

The nurse epidemiologist notifies the student health nurse that all the stool specimens were positive for norovirus. Based on the incubation period for norovirus (12-48 hours) and the dates of onset of symptoms, the nurse epidemiologist suspects the students were exposed to the virus at or around the same time. She hypothesizes that the nurses contracted norovirus from a contaminated item consumed at the open house event. She makes arrangements to meet with the Dean to discuss the situation and gather additional information. What information would be useful to the nurse epidemiologist? A. A list of items served at the event. B. A list of persons who prepared and served the refreshments. C. A list of students, faculty, and staff who attended the event. D. A list of faculty and student absences. E. All of the above.

E. All of the above.

There are many barriers that affect the actual implementation of evidence-based practice (EBP) in a nursing environment. Which statements reflect the most significant concerns of nurses in the community-focused setting? Select all that apply. EBP requires compliance by the client. EBP requires little support. EBP demands change. EBP questions long-standing nursing practice. Lack of resources

EBP requires compliance by the client. EBP questions long-standing nursing practice. Lack of resources

Which of the following statements best explains the need for geologists, meteorologists, and chemists on the multidisciplinary team in environmental health? Earth sciences explain how pollutants travel in air, water, and soil. Earth sciences help us understand the strength of the association between exposures and health effects in human populations. Earth scientists study the negative effects of chemical exposure. Earth scientists work with the community to coordinate services to meet the community's needs.

Earth sciences explain how pollutants travel in air, water, and soil.

What are the core competencies of the nurse participating in surveillance and investigation activities? Select all that apply. Basic patient assessment skills Effective communication skills Ability to collaborate with community partners Advanced-practice nurse with secondary science degree Leadership and systems thinking

Effective communication skills Ability to collaborate with community partners Leadership and systems thinking

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

Effects of stress on individuals

A community-oriented nurse convenes a support group for teenage mothers. The nurse understands that this strategy fosters cohesiveness among members and allows the members to learn from one another. What other benefit specific to group teaching will be achieved? Cultural sensitivity Efficiency in client service Learning of new skills Distraction-free surroundings

Efficiency in client service

Which of the following methods for providing healthy nutrition education to Jefferson County will be most efficient? Which will be the most effective method? A. Hold morning and evening educational sessions at the nearby community center. B. Set out informational pamphlets in the nursing clinic waiting room. C. Provide in-home, one-on-one education, demonstration, and follow-up with high-risk individuals already being followed at the center.

Efficiency refers to producing maximal output, such as a good or service, using a given set of resources, such as labor, time, and available money. The most efficient means would be A (Hold morning and evening educational sessions at the nearby community center), because this would provide the information in a teaching style that would have the most likely effect for those who attended the meeting, in a format that saves labor, money, and time. Effectiveness refers to the extent to which a health service meets a stated goal or objective, or how well a program or service achieves what is intended. The most effective means would be C (Provide in-home one-on-one education, demonstration, and follow-up with high risk individuals already being followed at the center), because those who receive one-on-one education and follow-up will be more likely to change their behavior than those who simply want to learn about nutrition.

National comprehensive government organization responsible for disaster management

FEMA

What terms are used to describe healthy families? Select all that apply. Families with strengths Dysfunctional Functional families Resilient families Resistant families

Families with strengths Functional families Resilient families

Family health can be defined as a dynamic, changing, relative state of well-being that includes the biological, psychological, sociological, cultural, and spiritual factors of a family system. This family health approach would best include which of the following underlying principles? Select all that apply. Assessment of the individual's health does not determine the overall family system's health. Family functioning affects the health of individuals. Family system assessment specifically addresses the individual's health. The individual's health affects family functioning. Simultaneous assessment of individual family members and the family system as a whole is important to family health.

Family functioning affects the health of individuals. The individual's health affects family functioning. Simultaneous assessment of individual family members and the family system as a whole is important to family health.

Which of the following barriers are specific to the educator? Select all that apply. Fear of public speaking Low literacy Limited experience with the topic Lack of motivation Lack of experience with gaining participation

Fear of public speaking Limited experience with the topic Lack of experience with gaining participation

Which of the following statements are true regarding the health-related vulnerabilities of men? Select all that apply. More males die at birth. Fewer health services are emphasized for men. Men are less likely to be honest about their symptoms. More males die from suicide. Men do not participate in health care at the same level as women.

Fewer health services are emphasized for men. Men are less likely to be honest about their symptoms. Men do not participate in health care at the same level as women.

The historical figure whose work in providing care to poor people, primary prevention, and environmental health established that individual as nursing's first moral leader and community-oriented nurse was: Sister Mary Augustine. Florence Nightingale. William Rathbone. Lillian Wald.

Florence Nightingale.

The family systems theory encourages nurses to view both the individual clients as participating members of a whole family. What is the major weakness of the systems framework? Views families from both a subsystem and a suprasystem approach. Defines the direction of interactions. Views the family as an agent of change. Focuses on the interaction of the family with other systems.

Focuses on the interaction of the family with other systems.

What are some of the effects of technology in the area of home health care? Select all that apply. High technology equipment increases expense. Technology decreases legal liability. Technology has the potential for increased privacy. Technology quickly becomes outdated when newer developments occur. There is inconsistent quality of resources available on the Internet.

High technology equipment increases expense. Technology quickly becomes outdated when newer developments occur. There is inconsistent quality of resources available on the Internet.

How can evidence-based practice help Ms. Lee plan a successful program? How can she learn about current studies being done in occupational health promotion programs?

How can evidence-based practice help Ms. Lee plan a successful program? How can she learn about current studies being done in occupational health promotion programs?

Which educational method has been shown to be most effective in fostering treatment adherence? Internet-based education In-person counseling Telephone counseling Self-directed learning

Internet-based education

A public health nurse employed by the Department of Health is working on a team developing local health policy. The nurse recognizes which of the following about policy development? It is based on Socratic method. It is important that the policy has been approved by the American Nurses Association. It is primarily up to politicians to plan for health care. It is very similar to the nursing process.

It is very similar to the nursing process.

What are some examples of programs which may be provided at the local health department level? Select all that apply. Immunization clinics Health education Family planning services Licensing of health care professionals Quality and safety data

Immunization clinics Health education Family planning services

The primary reasons for delay, difficulty, or failure to access care include which of the following factors? Select all that apply. The increase in safety net providers Inability to afford health care and a variety of insurance-related reasons Lack of transportation Refusal of services by providers Resolved nursing shortage

Inability to afford health care and a variety of insurance-related reasons Lack of transportation Refusal of services by providers

Which of the following factors has influenced the implementation of evidence-based practice in health care? Select all that apply. Increased expectations of consumers Advances in technology Nursing shortages Increases in lawsuits Implementation of electronic health records

Increased expectations of consumers Advances in technology Increases in lawsuits

The current-day definition of family refers to two or more individuals who depend on one another for emotional, physical, and/or financial support. Which of the following is the most important principle to support this broader definition? Families are defined by genetic ties. Family names are needed to confer status. Members of a family are self-defined. Traditional family functions have been redefined.

Members of a family are self-defined.

major category related to air pollution; includes vehicles, water (i.e. cars, trucks, buses, toxic algae bloom)

Non-point sources

A useful way to distinguish between Medicare Part A and Medicare Part B is to recognize that: Select all that apply. Part A covers outpatient hospital care. Part B covers limited skilled nursing care. Part A is hospital insurance. Part B is noninstitutional care insurance. Part B is a voluntary supplemental program.

Part A is hospital insurance. Part B is noninstitutional care insurance. Part B is a voluntary supplemental program.

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

Passive

The community health nurse is aware that lesbian, gay, bisexual, and transgender (LGBT) adults are more likely to experience which of the following conditions? Cardiovascular disease Poor mental health Obesity Poverty

Poor mental health

Primary care refers to personal health care for the most common needs of members of a community. Which of the following statements also differentiates primary care from primary health care? Select all that apply. Primary care consists of a multidisciplinary team. Primary care is provided within the context of family and community. Primary care encourages self-care and self-management. Primary care provides first-contact, continuous, comprehensive, and coordinated care. Primary care provides preventive, curative, and rehabilitative services.

Primary care is provided within the context of family and community. Primary care provides first-contact, continuous, comprehensive, and coordinated care.

Implementing a community-level program, such as walking for exercise, to assist citizens in improving health behaviors is an example of which level of prevention? Primary prevention Secondary prevention Tertiary prevention Disease promotion

Primary prevention

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

Provides a means for nurses to monitor disease trends. Generates knowledge about disease or outbreak patterns. Reduces morbidity and mortality and improves health through disease trend monitoring.

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

Provides the nurse with a step by step plan to identify events needing investigation.

A home health nurse receives a referral to educate an older adult client with diabetes in proper foot care. The nurse's assessment of the client determines that the client has poor eyesight that may affect the client's ability to learn and perform certain skills. Which educational principle is being examined? Cognitive domain Events of instruction Principles of effective instruction Psychomotor domain

Psychomotor domain

Which of the following domains are used in evaluating the strength of evidence? Select all that apply. Quality Quantity Cost effectiveness Consistency Usefulness

Quality Quantity Consistency

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

Tell me more about your family's spiritual beliefs

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

Red Cross chapter

A nurse in community health integrates new slides into a presentation that will be given to a local elementary school group regarding the techniques of proper hand washing. The new slides will repeat essential points during the presentation. This demonstrates the nurse's understanding of what principle? Repetition Integration Participation Sequencing

Repetition

The federal act that grants authority to the Environmental Protection Agency (EPA) which controls the generation, transportation, treatment, storage, and disposal of hazardous waste and ultimately called for the phaseout of land disposal of hazardous waste under a later amendment was the: Emergency Planning and Community Right-to-Know Act (EPCRA). National Environmental Policy Act (NEPA). Pollution Prevention Act (PPA). Resource Conservation and Recovery Act (RCRA).

Resource Conservation and Recovery Act (RCRA).

What is the Federal Emergency Management Agency (FEMA)? What other agencies assist FEMA in emergency management, and how do they help?

The Federal Emergency Management Agency (FEMA) is the federal authority on disaster preparedness, response, and recovery. When the President declares a state of emergency, FEMA assists with recovery efforts. The American Red Cross and other volunteer organizations assist FEMA by operating shelters, providing services to victims, acting as advocates, and seeking and accepting donations from people wanting to help.

What was the state's purpose when it made a law requiring immunizations prior to school enrollment? Which power was it invoking?

The state is acting to protect the health, safety, and welfare of their citizens. This power is called police power.

The federal agency most responsible for improving the health status of the American people is the: Office of Health Preparedness. Office of Global Affairs. Food and Drug Administration. US Department of Health and Human Services.

US Department of Health and Human Services.

A nurse is conducting an in-service education session on the Centers for Disease Control and Prevention's (CDC's) updates for preventive services for a group of nurses in community health. The nurse would demonstrate the best understanding of the educational process by integrating which planning strategies? Select all that apply. Use of films Small group interaction Use of games Session timing Session space

Use of films Small group interaction Use of games Session timing Session space

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

Women, Infants, and Children (WIC).

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

a genogram.

A nurse is caring for a client of another culture. Which of the following actions would be most appropriate for the nurse to take? a. Alter personal nonverbal behaviors to reflect the cultural norms of the client. b. Keep all behaviors culturally neutral to avoid misinterpretation. c. Rely on friendly gestures to communicate caring for the client. d. Avoid any pretense of prejudice by treating the client in the same way as any other client.

a. Alter personal nonverbal behaviors to reflect the cultural norms of the client.

A nurse has decided to increase the evidence base of current nursing practice in an agency. Which of the following describes a barrier that could be encountered by the nurse? (SELECT ALL THAT APPLY.) a. Colleagues who don't know how to search the literature or critique research. b. Dedication to the history and tradition of the agency c. Little or no research published in the clinical area of concern d. Several meta-analyses in the literature with inconsistent results

a. Colleagues who don't know how to search the literature or critique research. c. Little or no research published in the clinical area of concern

The ethical question, "Are persons assigned to develop community knowledge adequately prepared to collect data on groups and populations?", is based on an ethical tenet that supports the community-oriented core function of: assessment. assurance. policy development. compliance.

assessment.

A nurse is preparing an educational program on cultural perspectives in nursing. The nurse should include that which of the following are influenced by an individual's culture? (SELECT ALL THAT APPLY) a. Nutritional practices b. Family structure c. Health care interactions d. Biological variations e. Views about illness

a. Nutritional practices b. Family structure c. Health care interactions e. Views about illness

A nurse is educating a local elementary school group on proper hand washing. He will repeat some of the slides that have essential points on them during the presentation. This demonstrates the nurse's understanding of what principle? a. Repetition b. Integration c. Participation d. Sequencing

a. Repetition

When a community health nurse uses evidence-based practice (EBP) to evaluate effectiveness, accessibility, and quality of personal and population-based services, the nurse is addressing the core public health function of: assessment. assurance. policy development. research.

assurance.

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

adapting and coping responses.

A nurse is preparing an educational program on cultural perspectives in nursing . the nurse should include which of the following factors are influenced by an individual's culture? select all that apply a. nutritional practices b. family structure c. health care interactions d. biological variation e. views about illness

a. nutritional practices b. family structure c. health care interactions e. views about illness

When a community health nurse evaluates the completeness and accuracy of information made available to community residents regarding the impact of rezoning land parcels for industrial use, the nurse is: advocating for ethical choices. communicating risk. controlling environmental damage. volunteering for service on state boards.

advocating for ethical choices.

In applying the developmental theory, a family nurse determines the developmental stage of the family based on: age of the eldest child. family strengths. individual growth patterns. overall tasks of the family.

age of the eldest child.

A nurse in community health is planning to begin a class to help mothers returning to work better cope with the stresses of multiple roles. The nurse would most likely use: an andragogical approach. a behavioral approach. an operational approach. a pedagogical approach.

an andragogical approach.

The nurse has just taught a client newly diagnosed with diabetes how to administer sliding-scale insulin. The most effective way to evaluate learning is to: provide an online test module. ask whether there are any questions. ask for a return demonstration. give a short paper-and-pencil quiz.

ask for a return demonstration.

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

assess for biological risk factors.

A neighborhood association group has asked the local nurse in community health for a class on environmental hazards. The nurse in community health has seen good information in the community health text and thinks about getting permission to copy some of the information. The most important thing the nurse should do before using copies of this material is to: assess the literacy level of the group. see how many plan to attend. see whether the group is ready to learn. secure a good space for a group meeting.

assess the literacy level of the group.

When applying evidence-based practice (EBP), community-oriented nurses are primarily obligated to ensure that evidence applied to practice is: acceptable to the community. contains cost and reduces legal liability. applied as a universal remedy. limited to research findings.

acceptable to the community.

A nurse wants to find information about environmental threats that are present in the community. Which of the following would be the best source of data for the nurse? a. CINAHL b. National Library of Medicine c. State health department d. Closest local library

b. National Library of Medicine

When a community health nurse uses EBP to evaluate effectiveness, accessibility, and quality of personal and population-based services, the nurse is addressing the core public health function of: a. Assessment b. Assurance c. Policy development d. Research

b. Assurance

A nurse planned a presentation about the latest trends in disaster planning for the senior nursing students at the local college. However, when the nurse began to share the information, the students were talking to one another and essentially ignoring the nurse. Which of the following actions should be taken by the nurse? a. Ask the students why they are being so rude. b. Explain why the information is crucial to their current clinical practice. c. Nothing; let the instructor of the course handle the problem d. Tell a joke to get the students' attention.

b. Explain why the information is crucial to their current clinical practice.

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

b. Identifying community vulnerabilities

A home health nurse is discussing portals of entry with a group of newly hired assistive personnel. Which of the following are portals of entry the nurse should discuss? (Select all that apply.) a. Respiratory secretions b. Skin c. Genitourinary tract d. Saliva e. Mucous membranes b, c, e

b. Skin c. Genitourinary tract e. Mucous membranes

A community is experiencing the Honeymoon phase following a disaster. Which of the following is most likely to occur in the community? a. First responders work tirelessly to save others b. Survivors share their stories c. Medical personnel experience exhaustion d. Community organizations rebuild the community

b. Survivors share their stories

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

biological terrorism.

A community-based hospice nurse has an Asian male client with terminal stage cancer. The client complains that he is in continuous pain and receives no relief from the codeine prescribed by his primary care practitioner (PCP). The nurse contacts the client's PCP to discuss replacing the prescription of codeine with another pain-reducing non-codeine-based drug. The nurse is demonstrating knowledge of the cultural organizing factor of: biological variance. communication. space. time perception.

biological variance.

A nurse is providing an educational program about testicular self-examination (TSE). Which of the following would be the best learning objective for this program? a. Each participant will state why TSE is important and explain how to do it b. Each participant will describe how to do TSE and discuss the dangers of testicular cancer. c. 90% of the men will correctly demonstrate testicular self-examination. d. 100% of the men will do a testicular examination correctly on a model.

c. 90% of the men will correctly demonstrate testicular self-examination.

The community health nurse asks a client "Have you ever been exposed to any radiation or chemical liquids, dust, mists, or fumes?" The nurse is conducting an: a. Environmental advocacy activity b. Environmental compliance activity c. Environmental health assessment d. Environmental risk communication

c. Environmental health assessment

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

c. Taking "Spanish for Healthcare" classes in the evening at a local college.

A nurse advises a client with cardiovascular disease to reduce the amount of sodium in their diet to daily. Which of the following levels of prevention is being used by the nurse? a. Primary prevention b. Secondary prevention c. Tertiary prevention d. Treatment, but not prevention

c. Tertiary prevention

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

c. influenza

a community health nurse is implementing health programs with several populations in the local area. in which of the following situation is the nurse using primary prevention? a. preforming a home safety check at a clien'ts home b. teaching health nutrition to clients who have HTN c. providing influenza immunizations to employees at a local preschool d. implementing a program to notify individuals exposed to a communicable disease

c. providing influenza immunizations to employees at a local preschool

a nurse is preparing an education program on disease transmission for employees at a local day care facility. When discussing the epidemiologica ltrigangle, the nurse should include which of the following factors as agents? Select all that apply a. resource availability b. ethnicity c. toxins d. bacteria e. altered immunity

c. toxins d. bacteria

Virtue ethics is distinctly different from moral justification via theories or principles because the emphasis of virtue ethics is practical reasoning applied to: character development. consequentialism. distributive justice. egalitarianism.

character development.

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

childhood obesity.

Health care costs are influenced by factors related to demographic changes, new technology, resource intensity, and: chronic illness. market practices. nursing shortages. professional competition.

chronic illness.

A nursing student prepares a treatment plan for a client that draws upon the student's understanding of pathophysiology and nursing practice theory learned in the student's coursework. This application of new information used in a different way demonstrates the educational principle of: affective domain. cognitive domain. events of instruction. principles of effective education.

cognitive domain.

Laboratory confirmed clinical specimen that meets the diagnostic criteria of a specific disease / disorder

confirmed case

Also known as Right to Know reports; report that discloses results of drinking water testing to consumers

consumer confidence report

The concept of managed care is most often associated with processes such as utilization management, disease prevention, health promotion, wellness, and: ambulatory payment classes (APCs). consumer education. retrospective payment. third-party payer.

consumer education.

A family nurse is working with a married couple that has decided to remain child-free. The nurse recognizes this decision as a: biological necessity. contemporary family function. religious belief decision. threat to family survival.

contemporary family function.

Nurses in community health who understand the basis of their own behaviors and how those behaviors help or hinder the delivery of competent care to persons from cultures other than their own are demonstrating the cultural competence development process construct of: cultural awareness. cultural desire. cultural encounter. cultural skill.

cultural awareness.

The nurse who works in the community setting must ensure that the application of the best available evidence to improve practice is also: accessible and diverse. competent and compliant. culturally and financially appropriate. reasonable and deliverable in a timely fashion.

culturally and financially appropriate.

A breast cancer screening program screened 8000 women and discovered 35 women previously diagnosed with breast cancer and 20 women with no history of breast cancer diagnosed as a result of the screening. The prevalence proportion would reflect: current and past breast cancer events in this population of women. newly diagnosed cases of breast cancer in this population of women. past breast cancer events in this population of women. the population of women that had no evidence of breast cancer.

current and past breast cancer events in this population of women.

The nurse has been reading everything she can find on a particular clinical problem, using both the closes medical library and the Internet. Which of the following would be the most helpful source? a. A journal with a whole issue devoted to research on that clinical problem. b. A randomized controlled clinical trial related to that clinical problem. c. A researcher who has built a career on studying that clinical problem. d. A systematic review related to the clinical problem

d. A systematic review related to the clinical problem

Several small communities have applied for grant funding from the state department of health to help decrease their teenage pregnancy rate. Which of the following communities should the nurse suggest receive funding first? a. Community A - with 23 single teenage pregnancies in a city of 500 b. Community B - with 45 single teenage pregnancies in a city of 1000 c. Community C - with 90 single teenage pregnancies in a city of 2000 d. Community D - with 90 single teenage pregnancies in a city of 1500

d. Community D - with 90 single teenage pregnancies in a city of 1500

A male nurse had a habit of sitting with the lower part of one leg resting over the knee of his opposite leg when collecting a client's history. He stopped doing this around Muslim clients after being told that Muslims were offended when he exposed the sole of his foot (shoe) to their face. Which of the following was exhibited by the nurse when he changed his behavior? a. Cultural accommodation b. Cultural imposition c. Cultural repatterning d. Cultural skill

d. Cultural skill

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

d. Identifying community vulnerabilities

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

d. facilitating small group discussions

A nurse is concerned about the accuracy of the PPD test in identifying cases of TB exposure for follow-up chest x-ray. The nurse's concern is addressing the validity measure of: reliability. sensitivity. specificity. variation.

sensitivity.

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

delayed stress reaction.

Descriptive epidemiology

describes the distribution of disease, death, and other health outcomes in the population according to person, place, and time, providing a picture of how things are or have been: the who, where, and when of disease patterns.

A particular chronic health problem that is a serious public health challenge and results in health complications that double medical costs is: stroke. hypertension. diabetes. cardiovascular disease.

diabetes.

A nurse overhears the doctor saying, "Do not give him milk; he is from Africa." The nurse reflects on the comment and determines that the: Select all that apply. doctor is culturally competent. doctor is prejudiced. doctor should have called an interpreter. doctor's ability to assess nutritional practices based on culture may be limited. doctor is planning care based on racial enzymatic differences.

doctor is culturally competent. doctor is planning care based on racial enzymatic differences.

Persistent (usual) presence of a disease with low to moderate numbers of cases

endemic

A Public Health Service nurse working for the Indian Health Service is working with a client diagnosed with cancer. The client uses sweat lodges to "cure the disease." The nurse understands that within the culture, disease is often perceived as disharmony with other forces, and clients may look to hot or cold treatments to resolve or cure a cancerous condition. The nurse is integrating her knowledge of the cultural organizing factor of: biological variations. communication. environmental control. space.

environmental control.

The monitoring and public reporting of air quality in a local community to alert individuals with asthma or other respiratory conditions would illustrate: compliance and enforcement. environmental epidemiology. secondary prevention. toxicology.

environmental epidemiology.

The community health nurse asks a client, "Have you ever been exposed to any radiation or chemical liquids, dust, mists, or fumes?" The nurse is conducting an: environmental advocacy activity. environmental compliance activity. environmental health assessment. environmental risk communication.

environmental health assessment.

Occurrence of a disease within an area is in excess of expected levels

epidemic

A mother brings her child to the nurse's office a few days before the first day of class for the new school year. The mother wants the child to begin school but says, "I'm going to take care of the immunizations tomorrow." The most important action the nurse should take is to: conduct a physical examination to determine whether the child is healthy. explain to the parent that all required immunizations must be given before the child will be allowed to enter school. let the child begin school but ensure that the school keeps the child separated from the other children. make sure the child does have an appointment for tomorrow.

explain to the parent that all required immunizations must be given before the child will be allowed to enter school.

True or False: The timing of a disaster does not influence the types of injuries that will occur.

false

The nurse in community health uses information about family structure, household composition, marriage, divorce, birth, death, adoption, and other family life events to forecast and predict stresses and developmental changes experienced by families and identify possible solutions to family challenges. This best describes the study of: family demographics. family functions. family health. family resilience.

family demographics.

In caring for a young adult from West Africa, the community nurse is introduced to another individual who is referred to as "auntie." A culturally competent nurse who is aware of the basic organizing factor of culture related to social organization would: assess the competence of the "auntie" to care for the young adult. assume that the "auntie" is related to one of the young adult's parents. declare that the young adult is capable of making personal health decisions. find out who is considered to be a member of the family.

find out who is considered to be a member of the family.

The family nurse conducts the family nursing assessment with the family as a unit. Using a systematic process, family problems are identified and family strengths are emphasized as building blocks for interventions. Which of the following best completes the statement to demonstrate the importance of assessment to outcomes? Integrating the extended families: fosters equal family and provider commitment to success. facilitates outcomes-oriented family nursing research. decreases the need for nurse contact and intervention. removes barriers to needed services to achieve success.

fosters equal family and provider commitment to success.

A nurse who speaks only English has just gotten a new client for an intake interview. The client is a refugee who has very limited English proficiency (LEP). The nurse should: get an interpreter. see whether another nurse, more comfortable with refugees, will work with the client. see what helpful information is on the Internet. try to communicate with hand gestures.

get an interpreter.

A business executive develops symptoms of the flu 1 day after returning by air from a cross-Atlantic business trip that ran for 2 consecutive stressful 10-hour days. This individual's development of flu symptoms illustrates the relationship between: host and agent. host, agent, and environment. risk and causality. morbidity and disease.

host, agent, and environment.

analytic epidemiology

how and why of the illness outbreak (looking for which foods were causing the illness and what caused bacteria to grow in those foods)

The aging population is expected to affect health services more than will any other demographic factor. Another demographic population factor that affects health care costs can be related to: consumer demand. illnesses such as AIDS. marketing practices for new drugs. technology advancement.

illnesses such as AIDS.

Number of new cases or events in a population at risk during a specified time

incidence

When applying the nursing process to environmental health, the community health nurse would: conduct a focused assessment on the presenting problem. coordinate interventions with the physician only. examine criteria that include only the client's immediate response. include outcome measures that mitigate and eliminate the environmental factors.

include outcome measures that mitigate and eliminate the environmental factors.

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

individuals must ultimately recover on their own.

A community-oriented nurse is interested in studying the hospital discharge data for facilities that typically provide services to members of the community where the nurse practices. The nurse accesses the National Hospital Discharge Survey database of the Department of Health and Human Services (DHHS) to identify data at national, regional, and local levels for comparison purposes. The government health care function being used by the nurse is: direct services. financing. information. policy setting.

information.

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

injuries and accidents.

In applying Ethical Principles for Effective Advocacy, the ethical principle that empowers the client (groups or communities) to make knowledgeable decisions is: act impartially and offer frank, independent advice. act in accordance with the client's wishes and instructions. act in the client's best interest. keep the client properly informed.

keep the client properly informed.

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

legal options for treatment choices in the event the person becomes incapacitated.

A nurse in community health is visiting with an older adult Asian woman for the first time. The nurse has not encountered many clients from this culture. An effective way to ensure client-centered care is performed is to: explain to the client how the nurse intends to fix the problem. focus on the differences between the two cultures. tell the client how Western medicine will fix her problem. listen to the client's perceptions of the problems.

listen to the client's perceptions of the problems.

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

match available resources to the population's emergency needs.

If a small business employer desires to control company benefit expenditures by turning health care decision-making control over to the employees, the insurance reform effort that best addresses the shifting of responsibility, knowledge, and decision-making involvement to the individual receiving the care would be: health spending accounts (HSA). managed care. medical savings account (MSA). prospective payment.

medical savings account (MSA).

How often a disease (that is generally fatal) occurs in a specific area or period of time; Can include attack rate (proportion of persons exposed who develop disease

morbidity

Death rate of a disease in a population during a specific time

mortality

Ethical decision making is conducted in a generic framework. One step of ethical decision making is to place an ethical issue or dilemma within a meaningful context. The rationale for this step is: multiple factors affect the formulation and justification of ethical issues and dilemmas. the nature of ethical issues and dilemmas determines the specific ethical approach used. people cannot make sound ethical decisions if they cannot identify ethical issues and dilemmas. professional persons cannot avoid choice and action in applied ethics.

multiple factors affect the formulation and justification of ethical issues and dilemmas.

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

normative event and can increase the family's risk for illness.

Epidemic spread of the problem over several countries or continents

pandemic

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

pandemic.

The most significant commonalities between the ANA's Scope and Standards of Public Health Nursing Practice and the Public Health Code of Ethics assert that advocacy is conducted in the: assertiveness arena. education arena. litigation arena. policy arena.

policy arena.

The problem of the working poor and uninsured places a major burden on the current health care system that affects those families and the community in general. Nurses in community health see this as a major: Select all that apply. behavioral issue. policy issue. health risk issue. social issue. nursing issue.

policy issue. health risk issue. social issue.

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

poverty.

Clinical medicine and epidemiology differ from each other in the major aspect of: practice focus. health monitoring. determinants of health and disease. evaluation of interventions.

practice focus.

Measure of an existing disease in a population at a particular time

prevalence

Of the four major factors that affect health care—personal behavior/lifestyle, environmental factors (physical, social, and economic), human biology, and the health care system—medical services are said to have the least effect. Yet, the US health care system remains reactionary with high-cost, high-technology, and disease-specific "sickness care." This statement supports the need for increased investment in: managed care. primary prevention. secondary prevention. tertiary prevention.

primary prevention.

One of the basic concepts in epidemiology is the concept of risk. Risk refers to the: prevalence of an event occurring. probability that an event will occur within a specified time period. population most likely to develop a disease. rate of development of new cases.

probability that an event will occur within a specified time period.

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

professional preparedness.

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

professional-client partnership.

The Food Quality Protection Act of 1996 increased the protection of infants and children from pesticide exposure from multiple sources by establishing a new health-based standard of reasonable certainty of "no harm" that: considers the cumulative impacts of all pesticides that may share a common mechanism of action. establishes a 15-year renewal process for all pesticides. prohibits taking into account economic considerations when children are at risk. uses an additional tenfold margin of safety when there are adequate data indicating developmental risks.

prohibits taking into account economic considerations when children are at risk.

When health care providers in the community refuse to accept Medicare clients, this implies reduced access to care, potential decreases in acceptable quality of services offered, and a form of health care rationing. Health care rationing becomes a public health and nursing issue because: Medicare reimbursement needs to be higher. proactive primary prevention orientation is cost effective. public health systems and nurses must ensure that essential clinical services are available. sufficient resources are available in the public health system to meet the unmet need.

public health systems and nurses must ensure that essential clinical services are available.

The gold standard of evidence gathering in evidence-based practice is: clinical knowledge and judgment. expert opinions. randomized clinical trials. theories of practice.

randomized clinical trials.

When applying the nursing process to environmental health, the community health nurse would examine criteria that include the immediate and long-term responses of the client to the planned interventions. Another important factor to consider in the evaluation process would be: recidivism of the problem for the client. consideration of community policy and laws. relationship between the disease and the environmental factors. coordination of actions to meet the client's needs.

recidivism of the problem for the client.

A nurse in community health that speaks out in a public hearing in support of changes to existing requirements for reporting any long-term effects of structural or organizational changes within the community's health care organizations would be demonstrating: legislative action. health policy. regulatory action. regulatory monitoring.

regulatory action.

The 1989 changes to Medicaid required states to provide care for children younger than 6 years and to pregnant women under 133% of the poverty level. These changes also ensured adequate access to qualified providers by: adding coverage for the medically indigent. reimbursing early periodic screening, diagnosis, and treatment (EPSDT) for those younger than 21 years. reimbursing pediatric and family nurse practitioners. reimbursing skilled and intermediate nursing home care.

reimbursing pediatric and family nurse practitioners.

One reason that nursing may be slow in developing evidence-based practice (EBP) in the community setting may be the lack of understanding about the links between EBP and: evidence gathering. research design. research funding. research use.

research use.

A nurse in community health is working with a single parent of three children, ages 4, 6, and 8. The 6-year-old has cerebral palsy. The 4-year-old has asthma. The maternal grandmother lives with the family and has diabetes. The nurse understands the importance of working within the context of the existing family structure and community resources because families are: resistive to outside intervention or involvement. responsible for providing/managing the care of their members. unable to manage the stress of complex health needs. restricted in their ability to identify interventions.

responsible for providing/managing the care of their members.

It is important that nurses understand the nontraditional healing practices of their clients because: folk practices are usually ineffective. nurses can refer clients to the appropriate local folk healers. safe, effective nontraditional healing methods can be blended with Western medicine. the nurse must understand them to help the client give them up.

safe, effective nontraditional healing methods can be blended with Western medicine.

A nurse in community health who teaches a client with asthma to recognize and avoid exposure to asthma triggers and assists the family in implementing specific protection strategies such as removing carpets and avoiding pets is intervening at the level of: assessment. primary prevention. secondary prevention. tertiary prevention.

secondary prevention.

A nurse works in a free clinic for uninsured low-wage employees in the community. The free clinic setting operates in a primary health care (PHC) strategy. The nurse would most likely focus on: incidence of the disease. physician orders for the individual. pathophysiology of the disease. self-care/management.

self-care/management.

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

shift the responsibility so that it becomes a shared effort.

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

social skills instruction to resist pressure to smoke.

A nurse in community health may have state-granted personal immunity for particular practice areas such as giving immunizations. If the state legislature has granted personal immunity to nurses employed by public agencies to cover all aspects of their practice, the legal theory that applies is: case law. respondeat superior. sovereign immunity. worker's right to know.

sovereign immunity.

signs and symptoms a person is exhibiting are consistent with a particular disease

suspected case

Politics is simply described as: the ability to fund a special project. the art of influencing others. business conducted in the senate. interaction between the policymakers and the public.

the art of influencing others.

A public health nurse has identified the need to make amendments in an existing law concerning the TB health assessment of individuals sentenced to serve jail terms on weekends only, based on the current criminal justice system practices and potential health risk to the free-living community. To raise this concern, the nurse has several paths to follow, but the amendment of any existing laws would ultimately be decided by: the executive branch of the government. the legislative branch of the government. local representatives. senate hearings.

the legislative branch of the government.

Parents can expect their children to be immunized for communicable diseases before entering kindergarten in the local school system because: primary-care clinics focus on prevention. primary-care clinics maintain adequate supplies of immunization. the public health system has mandates for immunization. the public health system provides good access to immunization clinics.

the public health system has mandates for immunization.

Caring and the ethic of care is a core value of nursing in community health. Femenist ethics is pertinent to public health because: gender-related voices to moral judgment are applied. principles of utilitarianism are applied. differentiate distributive justice from beneficence. the role of political and social structures in health are recognized.

the role of political and social structures in health are recognized.

Provision 1 of the Code of Ethics for Nurses addresses practicing with compassion and respect for the person being cared for regardless of the person's status, attributes, or the nature of the health problem. In applying this provision to practice, the public health nurse understands that: there are times when individual rights may be limited because of public health concerns. the profession's integrity is at stake. the nurse's primary commitment is to the individual being cared for. this applies only to nursing in community health.

there are times when individual rights may be limited because of public health concerns.

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

transitions.

Twenty people attended a church picnic the previous weekend. By Monday, four individuals exhibited symptoms of food poisoning. On Tuesday, the nurse in community health records the addition of two new cases. The incidence rate would be: two new cases divided by 16 at risk. two new cases divided by 20. six cases divided by 20. four cases divided by 16.

two new cases divided by 16 at risk.

The major factor that has increased the danger of natural disasters is: El Niño. geography. trade winds. urbanization.

urbanization.

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

vulnerable populations.

The community-oriented nursing care function of policy development is supported by the ethical tenet of: competency. do no harm. what is ethical is also good policy. to each person a fair share.

what is ethical is also good policy.