All
A school nurse suggests to teachers that they have a session on coping strategies and stress management techniques. The nurse also sets up a peer counseling program for teens. Which of the following is the school nurse most likely trying to prevent? a. Suicide b. Bullying c. Obesity d. Violence
a. Suicide
Which of the following addictive drugs is both legal and culturally acceptable throughout almost all of the United States? a. Beer b. Caffeine c. Cigarettes (nicotine) d. Mixed alcoholic beverages
b. Caffeine
A man is diagnosed with prostate cancer. Which of the following data should the nurse know to answer the man when he asks, "What are the chances I'll survive this thing?" a. Attack rate b. Case fatality rate c. Cause-specific morbidity rate d. Crude mortality rate
b. Case fatality rate
Which of the following is the number one cause of death worldwide? a. Chronic diseases (heart disease, cancer, stroke) b. Infectious diseases c. Injuries (accidental or purposeful) d. Terrorism
b. Infectious diseases
A community citizen reports to the public health nurse that the city water in one neighborhood has had an unusual taste for the past few months. Which of the following actions should the nurse take first? a. Check the most recent consumer confidence report. b. Consult the Centers for Disease Control and Prevention. c. Notify the Environmental Protection Agency (EPA). d. Place a call to the poison control center.
A
How did nursing education change in the 1950s? (Select all that apply.) a. Baccalaureate nursing programs typically included public health nursing concepts. b. Diploma schools of nursing continued to expand their student numbers. c. Junior and community colleges began offering nursing programs. d. Nurses were strongly encouraged to have a scientific basis for their practice.
A C
4. A nurse's family has moved to a rural area to be near her spouse's aging parents. Which of the following would the nurse most likely notice about the family's new environment? (Select all that apply.) a. It is very difficult to obtain continuing education, except for online programs. b. Neighbors seem to expect the nurse to know everything about all health care and illness conditions. c. Neighbors ask questions about health concerns any time they see the nurse, regardless of where they are. d. People come to the health clinic before their situation becomes relatively serious. e. Boundaries between personal and professional lives are blurred.
A,B,C,E
A community health nurse is beginning to work with a newly assigned community. Which of the following would be appropriate actions for the nurse to take to help ensure acceptance? (Select all that apply.) a. Asking those with whom the nurse interacts in the course of daily living their perception of the community (e.g., clerks in grocery stores or pharmacies) b. Attending community events such as festivals or fairs and interacting with participants c. Becoming involved in and contributing to volunteer community organizations d. Completing a comprehensive physical assessment on nearby neighbors e. Arranging to meet with the community's governing body
A, B, E
A school nurse was caring for an 8-year-old child who had been hurt on the school playground. During the nurse's assessment, the child admitted that her mother was working but didn't make much money, so the girl and her mother were living in their car. Based on this information, which of the following would the nurse most likely suspect? (Select all that apply.) a. Food insecurity b. Target of peer bullying c. Increased school absences d. Vision problems e. Depression
A, C, E
1. Which of the following factors may lead to increased violence? (Select all that apply.) a. Minimal social support b. Feelings of powerlessness c. Violence shown in the media d. Living in a crowded environment e. A history of depression
A,B,C,D
A nurse is working at a state health department. Which of the following duties would most likely be completed in this setting? (Select all that apply.) a. Administering the Medicaid program b. Assessing the health needs of the state's citizens c. Employing and supervising school health nurses d. Establishing and maintaining child immunization clinics e. Providing education regarding established health codes
ANS: A, B, E
The advanced practice nurse explains that the client has an upper respiratory infection (URI) and suggests several measures that might make the client more comfortable. Which of the following best describes why the nurse doesn't just prescribe antibiotics as the client repeatedly requests? (Select all that apply.) a. Antibiotics are expensive, whereas the support measures would be almost free of cost. b. Viral diseases are not affected by antibiotics. c. Clinics cannot afford to continually give antibiotics to anyone who asks for them. d. The more antibiotics are prescribed, the more infectious agents develop resistance to such drugs. e. Antibiotics are not particularly effective against coughs and nasal congestion.
B,D
A nurse is assessing potential environmental health risks in the community. Which of the following would be the first step that the nurse should take? a. Conduct health risk assessments of randomly selected individuals. b. Perform a windshield survey. c. Review facility permits and consumer confidence reports. d. Survey community members.
B
How did health care and its delivery change during the 1980s? (Select all that apply.) a. Funding to public health increased as funding for acute hospital care decreased. b. Laws began to be passed that discouraged the use of alcohol, drugs, and tobacco. c. Nurse practitioners were increasingly used to provide care. d. Public health programs suffered reduced political support, financing, and effectiveness.
B C D
A nurse who works at the local hospital asks a public health nurse what might be causing her hands to become very sore and sensitive. Which of the following statements would be the most appropriate response by the public health nurse? a. "Ask the staff in employee health if there have been any other complaints." b. "Call the local health department about any recent problems at the hospital." c. "Check the material safety data sheet on any chemicals you have used recently." d. "See the nurse's health care provider for a complete work-up."
C
A teenager who has just come in for her prenatal visit appears to be about 6 months pregnant. Which of the following best describes why the teenage girl has waited so long to come in for prenatal care? (Select all that apply.) a. Her friends were suggesting ways to make the problem go away. b. She knew she could not be pregnant because her boyfriend said he used a condom. c. She was afraid her parents would pressure her to terminate the pregnancy. d. She kept hoping the pregnancy would just go away. e. She dreads the gynecological examination.
C, D, E
A nurse wants to have a better understanding of the physiological effects of selected chemicals. Which of the following individuals would provide the most useful information to the nurse? a. Chemist b. Epidemiologist c. Pharmacologist d. Toxicologist
D
A public health nurse is working with a low-income population in Massachusetts. Which of the following assumptions can the nurse make about this population? a. They have difficulty accessing health care due to a shortage of primary-care providers. b. They most likely receive health insurance through Medicare. c. They are unable to access health care due to the implementation of the Affordable Care Act. d. They have access to affordable health care insurance.
D
A school nurse is administering medications at the school. Which of the following guidelines should be followed? a. A current drug reference should be available in case information is needed. b. The nurse should administer medications brought in from home by the child in a plastic bag. c. Medications cannot be administered without a physician order. d. Narcotics and controlled substances should be kept in a locked cabinet.
a. A current drug reference should be available in case information is needed.
The administration at a local medical center examines the trends in health problems when developing long-range plans for staffing and space allocation. Which of the following sources of information would be most helpful? a. Local data drawn from a professional survey in the city b. The National Health Interview Survey c. The National Hospital Discharge Survey d. The state's vital statistics
a. Local data drawn from a professional survey in the city
A nurse is concerned about stress related to the heavy caregiving burden assumed by adult children of older clients. Which of the following actions by the nurse demonstrates the use of secondary prevention to limit caregiver stress? a. Asking caregivers how they are doing and suggesting coping strategies b. Encouraging caregivers to periodically leave the house for a couple of hours c. Establishing support groups for caregivers of older parents d. Referring some activities to neighbors and friends
a. Asking caregivers how they are doing and suggesting coping strategies
Which of the following groups should the occupational health nurse devote the most time to regarding education and follow-up evaluation? a. New workers employed less than 1 year b. Older workers with chronic illnesses c. Older workers with diminished hearing d. Women in their childbearing years
a. New workers employed less than 1 year
Which of the following is generally considered to be nursing's first code of ethics? a. Nightingale Pledge b. Code for Professional Nurses c. Code of Ethics for Nurses d. Principles of the Ethical Practice of Public Health
a. Nightingale Pledge
Which interdisciplinary service member is most important to the achievement of autonomy for a client who experienced a lumbar located spinal cord injury? a. Occupational therapist b. Physical therapist c. Home health aide d. Social worker
a. Occupational therapist
A community health nurse would like to implement an intervention to increase lasting resilience among new immigrants. Which of the following actions should be taken by the nurse? a. Direct clients to English-as-second-language courses. b. Give immigrant clients money to help them get settled. c. Identify areas in the city where housing is less expensive. d. Solicit donations for food, clothing, and other needs.
a. Direct clients to English-as-second-language courses.
A nurse who works for a hospital in employee health notes that several nurses from one unit have missed work after contracting a communicable disease from a patient. Which of the following best describes the host factor? a. Each sick nurse b. The communicable disease c. The hospital d. The patient
a. Each sick nurse
Which of the following comments was most likely stated by a home health nurse? a. "Every time I see a client, it costs $80." b. "Health care costs are killing our economy." c. "I can't believe how much clients are charged for things." d. "Medicaid costs are such a large portion of our state's budget."
a. "Every time I see a client, it costs $80."
An employee in a laboratory drops a flask, resulting in a chemical splash into the employee's eyes, which in turn results in burns to the eyes. Which of the following would be considered the agent? a. The chemical b. The employee c. The flask d. The laboratory
a. The chemical
Two women seem to agree on almost everything from favorite music to favorite media stars to the best way to prepare a meal. Which of the following best explains this similarity in the two women? a. They are both members of the same birth cohort. b. They are close friends. c. They attended the same school. d. They both go to the same church.
a. They are both members of the same birth cohort.
Which of the following statements is the best explanation as to why some countries are more violent than others? a. Civilized societies are less violent than primitive societies. b. Geographical differences are the primary factor. c. Population differences are the main determinant—for example, having moremales than females. d. Violence is a learned behavior controlled or allowed by social norms.
d. Violence is a learned behavior controlled or allowed by social norms.
A nurse is assessing the status of a community's health. Which of the following will the nurse examine? a. Community awareness b. Health facilities c. Health care manpower d. Vital statistics
d. Vital statistics
1. Which of the following best describes why health professionals would be particularly concerned about the health needs of residents in rural areas? (Select all that apply.) a. 40% of rural children live in poverty. b. People in rural areas are especially susceptible to acute illnesses rather than chronic diseases. c. Diagnoses in rural areas are usually for physical injuries, not mental health concerns. d. The cost of healthcare is strain on rural families. e. Accessibility to healthcare is limited.
A, D, E
Which of the following activities are considered to be part of the core competencies for public health professionals? (Select all that apply.) a. Defining variables relevant to current public health problems b. Obtaining and interpreting information regarding risks and benefits to the community c. Implementing nursing care and subsequent evaluation outcomes d. Maintaining public health departments throughout the United States e. Focusing on health concerns of the individuals residing within the community
A,B
4. A client tells a nurse, "I know all about this already. I read about it on the Internet" and then begins to summarizes what he has learned. Because some of this information seems incorrect, what questions would be effective for the nurse to ask? (Select all that apply.) a. Were you able to find what you wanted easily on the website? b. Did the website say when the information was updated? c. Did the website state who was responsible for the information? d. Did you enjoy reading the material on the website? e. Did the information sound correct to you?
A,B,C
1. The parish nurse is working with the wellness committee to develop health programming for the congregation. Which of the following activities would the nurse most likely include? (Select all that apply.) a. Provide regular blood pressure screening for members of the congregation. b. Create a bulletin board to display information about the signs and symptoms of stroke. c. Implement a program to speak with adolescents about stress management. d. Research evidence-based approaches for chronic wound healing. e. Provide healthy recipes for holiday baking.
A,B,C,E
A mother is concerned that her daughter may be considering experimentation with drugs and alcohol. Which of the following strategies would the nurse suggest the mother implement? (Select all that apply.) a. Provide opportunities for her daughter to develop her talents. b. Provide realistic feedback to the daughter about her performance at school. c. Encourage her daughter to become involved in extracurricular activities. d. Encourage her daughter to develop new friendships.e. Encourage her to discuss her dreams for the future.
A,B,C,E
Which of the following activities are included in the Centers for Disease Control and Prevention's school health program? (Select all that apply.) a. Ensuring a healthy school environment b. Assisting teachers with education related to health c. Encouraging nutritious school meals d. Giving immunizations to students, staff, teachers, and their families e. Providing mental health counseling
A,B,C,E
Which of the following are the primary goals of case management? (Select all that apply.) a. To ensure that care coordination occurs across the continuum b. To emphasize evidence-based clinical decision-making c. To manage resource use and control expenses d. To stress the advantages and benefits of community-based care e. To reduce institutional care as a means of achieving wellness
A,B,C,E
1. Three nurses disagree over the appropriate treatment for a woman who is an excellent candidate for hospice care. The first nurse believes that deciding on care rather than cure is the woman's decision and no one else can decide for her. The second nurse says that it is the responsibility of the health care team to do good for the woman, and if the physician thinks there is still a possibility of cure, then the nurses should do everything they can to implement the treatment plan. The third nurse states that it isn't fair for the family members to expend all their resources on the woman, who is probably going to die anyway. Which of the following conclusions can be drawn from this dispute? (Select all that apply.) a. Ethical principles can conflict with one another. b. The nurses are each using different ethical approaches. c. The first nurse is correct because autonomy demands that the woman decide for herself. d. There is no single accepted approach for resolving such disagreements.
A,B,D
4. A home health client has been prescribed acetaminophen with codeine every 4 hours for pain following a hip arthroplasty. Which of the following statements made by a nurse to the client's primary health care provider indicates a need for further education on narcotics related to the goals of safe pain management? (Select all that apply.) a. "Please consider decreasing the time interval between doses to every 3 hours so that my client will maintain pain relief." b. "I'm really concerned my client will become addicted to the codeine." c. "Consider prescribing a different medication so that my client will achieve adequate pain relief." d. "My client needs a prescription for PRN medication for 'breakthrough' pain." e. "This medication is expensive; please prescribe something less costly."
A,B,D
3. A nurse is deciding which alternative interventions should be implemented. Which of the following factors must be considered by the nurse when making this decision? (Select all that apply.) a. The expected effect or outcome of each possible intervention b. How interested others are in helping in any particular intervention c. The nurse's own interest in implementing each intervention d. The likelihood that the intervention will resolve the problem e. Change process required to achieve stated objective
A,B,D,E
A case manager is concerned about exposure to possible lawsuits. Which of the following are appropriate actions to take to minimize this risk? (Select all that apply.) a. Assure clients they can appeal any decision. b. Carefully document client involvement and reasons for decisions. c. Share client information with the other involved providers and agencies. d. Confirm credentials and capabilities of providers or agencies to give care. e. Being mindful to maintain effective lines of communication with all clients.
A,B,D,E
A school nurse would like to improve the safety of everyone at the school by creating policies to decrease the likelihood that violence will occur. Which of the following actions would the nurse likely take to minimize risk of school violence? (Select all that apply.) a. Engaging parents in school activities b. Creating a zero tolerance police for weapons on school property c. Encouraging children to participate in the after-school program at a local community center d. Developing mentoring programs for at-risk youth e. Initiating a student hot line for discussing possible violence risks
A,B,D,E
An occupational health nurse should be aware of which of the following trends in the marketplace? (Select all that apply.) a. A majority of new jobs will be in service-oriented employment. b. Employees will often have longer hours within a compressed work week. c. Jobs are shifting from service to manufacturing. d. Many employees will be older and suffer chronic health problems. e. Reduced job security is common.
A,B,D,E
Which of the following are the major sources of air pollution in the United States? (Select all that apply.) a. Burning of fossil fuels b. Waste incineration c. Industrial plants d. Motor vehicles e. Coal-fired power plants
A,B,D,E
A nurse is helping a client's family prepare to have an intervention that hopefully will encourage the alcoholic father to realize the need for change. Which of the following instructions by the nurse to the client's family members would be most effective? (Select all that apply.) a. "Express your belief in him and his ability to change." b. "Point out that his behavior is his choice and his responsibility." c. "Let him know that you understand how much he loves being with his drinking pals." d. "Remind him that entering treatment is better than going to prison." e. "Let him know that he is loved by his family and friends."
A,B,E
Which of the following describes how occupational health nursing differs from other nursing specialties? (Select all that apply.) a. It is autonomous because the occupational nurse works independently. b. The major focus is on the environment. c. Nurses focus on health promotion and disease prevention. d. Nursing care is given in the community. e. A focus is directed toward restoration of health.
A,B,E
1. Which statements by a nurse demonstrate understanding of the unique needs of vulnerable groups? (Select all that apply.) a. "I always address the problem that the client believes is the most important." b. "I avoid asking clients for income or financial information, because this is an invasion of privacy." c. "I try to observe the client's cultural traditions as I complete my assessment." d. "I make sure to do a complete assessment, since we often don't know when the person will return to the clinic." e. "Understanding an individual's cultural experience is an important factor in meeting their needs."
A,C
The nurse is scheduled to teach carbohydrate counting to middle-aged adults newly diagnosed with diabetes. Which of the following actions will the nurse need to take when teaching this population? (Select all that apply.) a. Appeal to the need for autonomy and choice. b. Emphasize that anyone with diabetes must know this information. c. Explain how to cope with being a guest at a dinner. d. Recognize that this audience will depend on the instructor to set goals for learning. e. Reinforce learning with handouts.
A,C
Which of the following explains why contagious infections are becoming a central focus of public health? (Select all that apply.) a. Americans are fearful of terrorists using biological agents. b. Awareness of human susceptibility to animal diseases has been publicized. c. Drug-resistant strains of old diseases have evolved. d. Media coverage exaggerates the dangers of exposure to crowds. e. The American population has become more health conscious in the last 20 years.
A,C
A nurse believes a new mouth care procedure (MCP) is exacerbating a client oral tissue problems. Which of the following must be present for the nurse to go to administration with confidence that the MCP is causing problems? (Select all that apply.) a. A plausible explanation of how the new MCP could cause harm b. A strong feeling that the MCP is the cause c. Consistently seeing mouth inflammation in many of the patients who have received the MCP d. Documentation from patient records that mouth inflammation in clients did not occur until after the new procedure was implemented e. A less expensive option for appropriate oral care
A,C,D
Which of the following actions would a nurse take when serving as an advocate for the community? (Select all that apply.) a. Asking questions related to health implications at policy meetings b. Calling the local health department to report problems at the hospital c. Serving as a source of information at public meetings d. Volunteering to serve on health-related committees
A,C,D
Which of the following characteristics must a learner possess to successfully master psychomotor learning? (Select all that apply.) a. The necessary ability to perform the skill b. An open mind to learn the new skill c. A sensory image of how to perform the skill d. Opportunities to practice the skill e. Desire to learn the skill
A,C,D
Which of the following strategies would a nurse expect to be implemented by a typical state environmental agency? (Select all that apply.) a. Acting, through unannounced inspections, to ensure compliance b. Writing permits that help limit toxic hazards c. Monitoring hazardous substances to uphold established standards d. Obtaining and analyzing samples to confirm compliance e. Involvement in the permitting process established by the state
A,C,D, E
3. A nurse is developing a community-based activity aimed at preventing substance abuse in the community. Which of the following interventions would the nurse most likely implement? (Select all that apply.) a. Supporting an increase in the availability of recreational facilities b. Lobbying to state legislators to approve a higher cigarette tax c. Educating all middle school students about the long-term side effects of drugs and alcohol d. Providing general screenings for substance abusee. Identifying community-based resources that deal with substance abuse issues
A,C,D,E
3. A nurse tells her nursing supervisor that her family is moving from the urban area where they both live in a rural area to be near her spouse's parents, who are becoming less independent. Which of the following suggestions would the nursing supervisor provide to the nurse? (Select all that apply.) a. "Community members will probably hold you in higher regard and will look up to you." b. "Expect to have less autonomy in a small town than you have working as a nurse in a medical center." c. "You may feel like an isolated outsider, because the community may not immediately accept you." d. "You will have to be very sensitive about the differences in the rural lifestyle." e. "The church and school will be the centers for socialization."
A,C,D,E
What are examples of telehealth applications? (Select all that apply.) a. A cardiac client's heart function being monitored daily b. A client calling their provider's office to make an appointment c. A client discussing a skin reaction with a telephone triage nurse d. A surgeon accessing a client's electronic health record when a referral was made e. A "Zoom" meeting between an advanced practice nurse and mother regarding a well-baby visit
A,C,D,E
Which of the following emergency supplies or equipment should a nurse have available in the school health office? (Select all that apply.) a. Cervical spine collars b. Complete emergency kit that fulfills American Hospital Association requirements c. Epinephrine autoinjector kit d. Material for splints e. Supplemental oxygen
A,C,D,E
A community health nurse encourages members of the community to partner and assist in creating health programs. Which of the following best describes the rationale for this action? (Select all that apply.) a. Partnering results in increased effectiveness b. Involving community members results in contributions of time and money into the program c. Having many partners results in increased publicity for the program d. Participating in planning results in having a vested interest in the outcome e. Involving community partners ensures increased support by the populace
A,D
A community health nurse has been recently hired to work in an unfamiliar community. Which of the following persons would be the effective key informants for the nurse? (Select all that apply.) a. Community's immigrant group activist b. Federal senators and representatives c. Health board members d. The town mayor e. Local Clergy
A,D,E
A new student's parents had not yet submitted an immunization record, although the nurse had sent a reminder home with the student twice. Which of the following actions should be taken by the nurse to keep the child in school? (Select all that apply.) a. Call the parents or mail another reminder. b. Report the problem to the teacher and the principal. c. Send the child home with a note saying the child cannot return until the immunization record is received. d. Determine whether the family has health care insurance. e. Offer assistance in replacing a lost immunization record.
A,D,E
A nurse who is explaining to a client why it is important to take medication states, The medication takes a couple of weeks to be effective, but then you should feel better. When the client is next seen, no medication has been purchased. Which of the following is the most likely explanation? a.The nurse emphasized that eventually the client would feel better, but the client needed to feel better immediately so didnt bother with the drug. b.The medication required a trip to the pharmacy, and the client just hadnt had time to obtain the drug yet. c.The medication was too expensive for the clients family. d.The client really hadnt understood why the medication was important.
ANS: A Although any of the answers given is possible, if we look closely at what the nurse stated, there may have been a cultural disconnect based on time orientation. Many nurses are future oriented, whereas many families may place greater value on quality of life and view present time as being more important. When nurses discuss health promotion and disease prevention strategies with persons from a present orientation, they should focus on the immediate benefits these clients would gain rather than emphasizing future outcomes.
18. A nurse explained to a new mother that because she had tested positive for the hepatitis B virus, her newborn son would need the hepatitis B vaccine immediately and then also an immune globulin injection. Wait, said the new mother. Why is my son getting two shots? Which of the following statements would be the best response by the nurse? a. One injection protects your son, while the other encourages his body to build up immunity. b. One shot keeps your son from getting sick, while the other is a typical vaccine to prevent you from accidentally infecting him. c. Since youve already been infected with the virus, your son needs twice as much protection. d. The second shot is just to make sure the first one works.
ANS: A Because infected persons may not have any symptoms, all pregnant women should be tested for HBsAg. If the mother tests positive, her newborn needs hepatitis B immune globulin to provide passive immunity and thus prevent infection. In addition, the newborn is given the hepatitis B vaccine at birth, with two follow-up injections, to build active immunity to the infection.
For a bedridden Muslim patient, the nurse rearranges the room and moves the bed so that it faces toward Mecca for the patients daily prayers. Which of the following is the nurse demonstrating through these actions? a.Accommodation b.Awareness c.Brokering d.Imposition
ANS: A Cultural accommodation involves including aspects of the patients religious beliefs and/or folk practices in the traditional health care system to implement essential treatment plans. For this patient, daily prayer in the tradition of Islam is importantfrom the patients perspective, possibly more important than medical treatment.
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.
ANS: A Cultural competence in nursing includes adoption of culturally congruent behaviors. Culturally skillful nurses use appropriate touch during conversation, modify the physical distance between themselves and others, and use strategies to avoid cultural misunderstandings while meeting mutually agreed-upon goals. Nurses who strive to be culturally competent respect people from other cultures and value diversity, which helps them to provide more responsive care.
At a local hospital, postpartum care policy requires that nurses observe the mother during infant care to assess the mothers ability to care for the new baby and to promote bonding. A new mother expresses concern that in her country, all infant care is provided by other family members so that the mother can rest and recover. Which of the following actions would be taken by a culturally competent nurse? a.Allow family members to provide the newborns care and assess the mothers knowledge of child care through discussion. b.Reinforce the importance of bonding and that all good mothers gladly assume these responsibilities. c.Explain that the process of postpartum recovery does not require this much rest and require that she provide infant care. d.State that she must abide by hospital policy because documentation of the mothers ability to give the infant care is required for discharge.
ANS: A Culturally competent nursing care focuses on the specific patient, reflects the patients individual beliefs and values, and is provided with sensitivity.
A nurse says, Im not going to change the way I practice nursing based on where the client is from, because research shows that Western health care technology and research is best. Which of the following is being demonstrated by the nurses statement? a.Ethnocentrism b.Prejudice c.Racism d.Stereotyping
ANS: A Ethnocentrism, a type of cultural prejudice at the cultural population level, is the belief that ones own group determines the standards for behavior by which all other groups are to be judged. For example, some American nurses and providers may think, The way we do it is the only right way to provide this care.
6. A school nurse asks a class about the ways HIV can be transmitted. Which of the following comments by a student indicates a need for additional teaching? a. I wouldnt sit next to someone with HIV. b. Having unprotected sex with someone who is infected spreads HIV. c. Sharing needles when shooting up drugs spreads HIV. d. Transfusions of blood products that are contaminated can spread HIV.
ANS: A HIV can be transmitted through exposure to blood, semen, vaginal secretions, and breast milk and by sharing needles, syringes, and other equipment used to prepare injectable drugs. It can also be spread by perinatal transmission from mother to child through delivery or breastfeeding and by transfusions of contaminated blood. HIV is not transmitted through casual contact such as touching or hugging someone who has HIV infection. It is not transmitted by insects, coughing, sneezing, office equipment, or sitting next to or eating with someone who has HIV infection. Worldwide, the largest number of HIV infections result from heterosexual transmission.
Which of the following best describes most Americans attitude toward immigrants? a.Ambivalence because there are no clear solutions about how to address their needs b.Strongly negative because immigrants take jobs that native-born Americans could have instead c.Strongly positive because immigrants bring useful job skills and often join previous family members already in the United States d.Strong opposition to further immigration because of the increasing population in the United States
ANS: A Most Americans are ambivalent about immigration, recognizing both the positive and negative aspects involved and realizing that it is a complex issue that has no clear solutions.
When teaching a nutrition class to a student group with a large Hispanic population, the school nurse incorporates foods such as salsa and other healthy dishes familiar to Hispanic students into the presentation. Which of the following best describes the action taken by the nurse? a.Primary prevention b.Secondary prevention c.Tertiary prevention d.Both primary and secondary prevention
ANS: A Primary prevention involves activities such as health teaching to prevent a problem from occurring.
10. A male client visits the clinic office complaining of a yellow, green discharge from his penis. Which of the following STDs has the client most likely contracted? a. Gonorrhea b. Syphilis c. Herpes simplex virus 2 d. Human papillomavirus
ANS: A The symptoms for gonorrhea in a male include a burning sensation when urinating, or a white, yellow-green discharge from the penis. Some men may get swollen or painful testicles. In men, gonorrhea can cause epididymitis, a painful condition of the testicles that if untreated can lead to infertility.
13. Which of the following statements best explains why HSV-2 infection is more challenging for a client than gonorrhea infection? a. HSV-2 is a viral infection that is both chronic and incurable. b. HSV-2 is extremely expensive to treat. c. HSV-2, like HIV, is almost impossible to diagnosis in the early stages. d. Once a person has been treated for HSV-2, the person is immune to further outbreaks.
ANS: A Unlike gonorrhea, there is no cure for HSV-2 infection; it is considered a chronic disease.
Which of the following actions best represents public health nursing? a. Assessing the effectiveness of the high school health clinic b. Caring for clients in their home following their outpatient surgeries c. Providing care to children and their families at the school clinic d. Administering follow-up care for pediatric clients at an outpatient clinic
ANS: A A public health or population-focused approach would look at the entire group of children being served to determine whether available services are effective in achieving the goal of improving the health of the school population. Caring for clients and their families focuses on individuals and families and not on the entire population. Public health focuses on care of populations.
A registered nurse was just employed as a public health nurse. Which question would be the most relevant for the nurse to ask? a. "Which groups are at the greatest risk for problems?" b. "Which patients should I see first as I begin my day?" c. "With which physicians will I be most closely collaborating?" d. "With which nursing assistants will I partner the most?"
ANS: A Asking which groups are at greatest risk reflects a community-oriented perspective. The incorrect responses reflect a focus on individuals rather than a community-oriented perspective.
1. Which of the following best describes community-based nursing? a. A practice in which care is provided for individuals and families b. Providing care with a focus on the group's needs c. Giving care with a focus on the aggregate's needs d. A value system in which all clients receive optimal care
ANS: A By definition, community-based nursing is a setting-specific practice in which care is provided for "sick" individuals and families where they live, work, and attend school. The emphasis is on acute and chronic care and the provision of comprehensive, coordinated, and continuous care. These nurses may be generalists or specialists in maternal-infant, pediatric, adult, or psychiatric mental health nursing. Community-based nursing emphasizes acute and chronic care to individuals and families, rather than focusing on groups, aggregates, or systems.
Two nurses plan to walk under a huge downtown bridge where various homeless persons live. Why would the nurses go to such an unsafe area? a. To assess the needs of the homeless who live there b. To demonstrate their courage and commitment c. To distribute some of their own surplus clothes to those who can use them d. To share with various churches and other charities what is needed
ANS: A In most nursing practices, the client seeks out and requests assistance. In public health nursing, the nurse often reaches out to those who might benefit from a service or intervention, beginning with assessment of needs. The other answers reflect responses where the nurse is trying to give assistance to this population that may or may not be helpful or welcomed.
A public health agency is planning to implement the electronic health record. Which of the following is a benefit of this choice? a. Facilitation of interprofessional care b. Improved client compliance with medical regimens c. Cost savings to the agency d. Compliance with JCAHO standards
ANS: A The electronic medical record facilitates interprofessional care in chronic disease management and coordination of referrals; 24-hour availability of records with downloaded laboratory results and up-to-date assessments; incorporation of protocol reminders for prevention, screening, and management of chronic disease; improvement of quality measurement and monitoring; increased client safety; and decline in medication errors. DIF: Cognitive Level: Apply (Application) REF: p. 37
2. A woman and man who have come to the health clinic begin to argue loudly. You gave me an STD! the man yells. The woman screams back, Not me. I dont have an STD! Which of the following statements would be most appropriate for the nurse to say to them? (Select all that apply.) a. "Actually, you're very fortunate to have been tested, so you and your partner can begin treatment before more serious damage is done." b. "Some STIs may not have any symptoms, so you need to be tested for other conditions and treated if necessary." c. "Sometimes the test is inaccurate, so before getting too upset, you should ask to be tested again." d. "You may be able to get treatment from your pharmacist so you won't have to be embarrassed like this again." e. "Some STIs are spread in ways that are non-sexual in nature."
ANS: A, B, C Often cases of gonorrhea and chlamydia are asymptomatic, so treatment may not be sought and these infections are spread to others through sexual activity. Similarly, during latency, syphilis has no symptoms. It should be noted, however, that STD test results can sometimes be incorrect and the coexistence of other medical conditions may cause a false-positive test result. Having a partner retested, if the results were negative, would also suggest retesting the first person.
Which of the following actions demonstrate effective public health nursing practice in the community? (Select all that apply.) a. Epidemiologic investigations examine the environment for health hazards. b. New services are organized where particular vulnerable populations live. c. Partnerships are established with community coalitions. d. Staff members at the public health agency continue to increase in number.
ANS: A, B, C Evidence that public health nurses are practicing effectively in the community would include organizing services where people live, work, play, and learn; working in partnerships and with coalitions; and participating in epidemiologic studies. Increasing number of staff does not have a relationship to the effectiveness of public health nursing practice.
2. What do demographic figures suggest about the ways in which the population of the United States is changing? (Select all that apply.) a. Foreign-born immigrant population is increasing. b. Hispanics are the largest minority group population. c. Leading causes of death are from infectious diseases. d. Mortality for both genders in all age groups declined. e. Unintentional injuries are among the top 10 causes of death.
ANS: A, B, D, E
A nurse recognizes that although a patient speaks English, the patient is from a culture with which the nurse is unfamiliar. Therefore, a cultural assessment should be attempted. Which of the following questions should the nurse ask? (Select all that apply.) a.Can you tell me where your family is from? b.Do you practice a particular religious faith? c.Have you ever been in an American hospital before? d.Is there anything special we need to know about your food preferences? e. What do you think is causing your health problem?
ANS: A, B, D, E In a brief cultural assessment, nurses ask clients about their ethnic background, religious preference, family patterns, cultural values, language, education, politics and health practices. Nurses want to also ask about the clients perception of the health issue and what caused it and how it should be treated as well as the results they expect from the care they get. Such basic data help nurses understand the client from the clients point of view and recognize what is unique about the person, thus avoiding stereotyping.
Which of the following statements is accurate descriptions of current social and economic trends in the United States? (Select all that apply.) a. Citizens are appreciating the quality of life enjoyed in the United States. b. Enjoying life is not as important as the need to take care of oneself. c. People often spend a considerable amount of their own money on complementary therapies. d. The gap between the richest and poorest is widening. e. The composition of families and living patterns are changing..
ANS: A, C, D, E
Which of the following provides evidence that the U.S. health care system is in crisis? (Select all that apply.) a. Health insurance is an expensive benefit for employers to provide. b. Incompetent or negligent nurses are an ongoing source of medical errors. c. Long work hours and provider fatigue are a major factor in medical errors. d. More punitive measures must be taken to decrease provider errors. e. Consumers want lower costs and high-quality health care without limits.
ANS: A, C, E
An undocumented immigrant comes to a physicians office to receive care. Which of the following services can the client receive? (Select all that apply.) a.Treatment for tuberculosis b.Treatment for Type 2 diabetes c.Immunization for polio d.Physical examination e. Sutures for a laceration
ANS: A, C, E Undocumented immigrants or illegal aliens are individuals who have crossed a border into the United States illegally or whose legal permission to stay in the United States has expired. They are eligible only for emergency medical services, immunizations, treatment for the symptoms of communicable diseases, and access to school lunches.
Why are nurses increasingly providing care in clients' homes rather than in hospitals? (Select all that apply.) a. Home care is less expensive. b. It is much more efficient to give care in the home. c. Nurses prefer to give home care with individual attention. d. People prefer to receive care in their homes rather than in hospitals.
ANS: A,D An increasing number of clients are receiving care in the home because it is less expensive and clients prefer to receive care in familiar and comfortable settings. It is not more efficient nor more convenient, since travel time has to be considered. Nurses differ as to their preferred employment setting.
A Buddhist patient enters the hospital for diagnostic testing just before lunch time. The nurse tells the aide to give a meal tray to the new patient, because no tests will be done until later that evening. The aide gives the patient a meal of Salisbury steak, bread, green beans, and potatoes with brown gravy. The patient eats nothing but a slice of bread and the green beans. Which of the following considerations was omitted by the nurse? a.The patient should not be served any food until a physicians order is obtained. b.The patients Buddhist faith probably requires a vegetarian diet. c.The patient may be too frightened about the tests to want to eat very much. d.The patient may have diabetes or be allergic to some foods.
ANS: B Although it is always wise to check with a patient before sending in food, the meal given to this patient was offensive. Most Buddhists are vegetarians and dont eat meat.
8. Which of the following best explains why some health clinics allow clients to be tested for HIV anonymously with no record of the clients name, address, or contact information? a. Client doesnt actually ever have to be told the results of the test. b. Client may be engaged in illegal activities (drug use). c. Client plans on not paying for the test and collection agencies will not be able to harass them. d. Client wants to be sure care providers dont share results with their family.
ANS: B An advantage of anonymous testing may be that it increases the number of people who are willing to be tested, because many of those at risk are engaged in illegal activities. The anonymity eliminates their concern about the possibility of arrest or discrimination.
21. A mother felt very guilty that her baby was born HIV positive. When the nurse suggested the usual DPT and MMR immunizations, the mother was extremely upset. Dont you know HIV children are immunosuppressed? she exclaimed. Which of the following would be the nurses best response? a. All children have to have these immunizations before they can attend school. b. Being HIV positive, your child is more likely to catch an infection and be very ill if not immunized. c. Im so sorry; I forgot for a moment your child was HIV positive. d. The American Pediatric Association requires all health care providers to offer these immunizations to all parents; it is your choice whether or not to accept them.
ANS: B Because of impaired immunity, children with HIV infection are more likely to get childhood diseases and suffer serious consequences of the diseases. Therefore, DPT, IPV, and MMR vaccines should be given at regularly scheduled times for children infected with HIV. Other immunizations may also be recommended after medical evaluation. Many states do have a no shots, no school law, but exceptions can be made. The APA does recommend immunizations for most children, but this is not the best answer.
A nurse wishes to develop cultural competence. Which of the following actions should the nurse take first? a.Complete a survey of all the various ethnicities represented in the nurses community. b.Consider how the nurses own personal beliefs and decisions are reflective of his or her culture. c.Invite a family from another culture to join the nurse for an event. d.Study the beliefs and traditions of persons living in other cultures.
ANS: B Cultural awareness requires self-examination and an in-depth exploration of ones own beliefs and values as they influence behavior.
A nurse states, The best way to treat a client from another country is to care for them the same way we would want to be cared for. After all, we are all humans with the same wants and needs. What does this statement reflect in relation to culture? a.Awareness b.Blindness c.Knowledge d.Preservation
ANS: B Cultural blindness is the tendency to ignore differences between cultures and to act as if they do not exist. People from different cultures may have different expectations, wants, and needs.
15. Which of the following best describes the characteristic appearance of lesions of human papillomavirus (HPV)? a. Solitary growth with elevated borders and a central depression b. Elevated growths with a cauliflower appearance c. Thin-walled pustules that rupture to form honey-colored crusts d. Vesicles that ulcerate and crust within 1 to 4 days
ANS: B HPV causes genital warts that appear as textured surface lesions, with what is sometimes described as a cauliflower appearance. The warts are usually multiple and vary between 1 and 5 mm in diameter.
19. A client with tuberculosis (TB) asks why the nurse is required to watch the client swallow the medication each day. Which of the following statements is the best response by the nurse? a. Clients with TB are often noncompliant, so if I directly observe, you will be sure to take the drugs that have been ordered. b. This therapy is recommended to make sure that you receive the treatment you need and the infection doesnt become resistant to the drugs. c. This is to make sure you take your medication if your condition becomes so advanced that you do not have enough cerebral oxygenation to remember. d. Tuberculosis medications are very expensive so this method ensures that government money doesnt get wasted on those who will not take the drugs.
ANS: B It is important to be respectful to clients and to consider their perspective and psychological health while also responding truthfully. Directly observed therapy (DOT) programs for TB medication involve the nurse observing and documenting individual clients taking their TB drugs. When clients prematurely stop taking TB medications, there is a risk that the TB will become resistant to the medications. This can affect an entire community of people who are susceptible to this airborne disease. DOT ensures that TB-infected clients receive adequate medication. Thus, DOT programs are aimed at the population level to prevent antibiotic resistance in the community and to ensure effective treatment at the individual level. Many health departments have DOT home health programs to ensure adequate treatment.
12. Which of the following best explains why chlamydia is a major focus of public health efforts? a. It has more serious long-term outcomes than other STDs b. It can cause problems in infants born to infected mothers c. It is not frequently seen in the United States d. It is so difficult and expensive to treat
ANS: B Like gonorrhea and other STDs, chlamydia can cause neonatal complications in infants born to infected mothers, although it is rather easily treated with antibiotics. Chlamydia does have serious long-term outcomes for the client, but so do syphilis and other STDs. However, unlike syphilis, which in its later stages is rare in the United States, chlamydia is the most common reportable infectious disease in the United States and hence is a major focus of public health.
20. A nurse is concerned about the prevalence of tuberculosis among migrant farmworkers. Which of the following activities would be best to use when implementing tertiary prevention? a. Administer purified protein derivative (PPD) to contacts of those with tuberculosis. b. Initiate directly observed therapy (DOT) for tuberculosis treatment. c. Provide education about the prevention of tuberculosis to members of the migrant community. d. Use skin tests to screen migrant health workers for tuberculosis infection.
ANS: B Tertiary prevention is carried out among persons already infected with the disease. In this instance DOT ensures compliance with treatment to cure the disease and to prevent worsening or the development of secondary problems.
14. When a nurse discovers that a woman has been treated for cervical cancer, the nurse asks the woman whether she has ever been tested for HIV or other STDs. The woman is offended and asks why the nurse would ask her such a thing. Which of the following statements would be the best response from the nurse? a. Cervical cancer treatments may decrease immunity, so that it is easier to acquire STDs. b. Cervical cancer usually is caused by HPV, and often the presence of one STD is accompanied by other STDs. c. The presence of an STD in women with cervical cancer may lead to congenital defects in offspring. d. The presence of an STD in a woman with a history of cervical cancer has been associated with a relapse of the cancer after treatment.
ANS: B The link between HPV infection and cervical cancer has been established and is associated with specific types of the virus. In 80% to 90% of cases of cervical cancer, evidence of HPV has been found in the tumor. Additionally, HSV-2 infection is linked with the development of cervical cancer. Because the presence of an STD increases the risk for the presence of other STDs, it is essential to screen for this information.
Which of the following public health nurses most clearly fulfills the responsibilities of this role? a. The nurse who met with several groups to discuss community recreation issues b. The nurse who spent the day attending meetings of various health agencies c. The nurse who talked to several people about their particular health concerns d. The nurse who watched the city council meeting on local cable television
ANS: B Any of these descriptions might represent a nurse communicating, cooperating, or collaborating with community residents or groups about health concerns. However, the nurse who spent the day attending meetings of various health agencies is the most representative, because in public health, concerns are addressed from a broader perspective. In public health, broad concerns of the community should be addressed. Concerns are broader than recreation, individual concerns are not as important as aggregate priorities, and watching television (a one-way form of communication) is less effective than interacting with others.
African-American females have a higher mortality rate from breast cancer than White females. This is an example of: a. Projection b. Disparity c. Racism d. A sentinel event
ANS: B Disparities are racial or ethnic differences in the quality of health care, not based on access or clinical needs, preferences, or appropriateness of an intervention. DIF: Cognitive Level: Apply (Application) REF: p. 34
How does managed care attempt to control costs of care? a. By encouraging families to use the point of service list of individual practice associates b. By requiring families to choose a care provider from the MC network and not allowing access to other services without their provider's permission c. By moving Medicaid-eligible families onto state Medicare enrollment d. By refusing permission for families to use urgent care or emergency department services
ANS: B Managed care is a system in which care is delivered by a specific network of providers. Each provider serves as a gatekeeper who controls access to other providers and services. Cost is reduced because members cannot use specialists or seek hospital or other care without permission from their primary care providers. Thus, those enrolled in Medicaid managed care have restrictions that help keep costs down for government (and for taxpayers).
Which statement best describes ideal primary health care? a. Based on a multidisciplinary group of health care providers that work as a team b. Essential care available to all community members, which encourages self-management c. Focused on health promotion and disease prevention for everyone enrolled in the health center d. Local efforts to meet the Declaration of Alma Ata principles
ANS: B Primary health care is generally defined as essential care made universally accessible to individuals and families in a community with their full participation and at a cost that the community can afford. DIF: Cognitive Level: Understand (Comprehension) REF: p. 39
A nurse is developing a plan to decrease the number of premature deaths in the community. Which of the following interventions would most likely be implemented by the nurse? a. Increase the community's knowledge about hospice care. b. Promote healthy lifestyle behavior choices among the community members. c. Encourage employers to have wellness centers at each industrial site. d. Ensure timely and effective medical intervention and treatment for community members.
ANS: B Public health approaches could help prevent premature deaths by influencing the way people eat, drink, drive, engage in exercise, and treat the environment. Increasing knowledge of hospice care, encouraging on-site wellness centers, and ensuring timely treatment of medical conditions do not address the focus of improving overall health through health promotion strategies. This is the major method that is suggested to decrease the incidence of premature death.
Which of the following best describes why local, state, and federal governmental agencies have started to cooperate and collaborate more closely in the last few years? a. Increased administrative pressures to demonstrate outcomes b. Increased focus on emergency preparedness and response c. Increased taxpayers' complaints and general unhappiness d. Increased pressure to decrease overlap in services
ANS: B Since the tragedy of September 11, 2001, health departments have increasingly focused on emergency preparedness and response. In case of an emergency event, state and local health departments in the affected area will be expected to collect data and accurately report the situation, to respond appropriately to any type of emergency, and to ensure the safety of the residents of the immediate area, while protecting those just outside the danger zone. This goal—to enable public health agencies to anticipate, prepare for, recognize, and respond to terrorist threats or natural disasters—has required an unprecedented level of interstate and federal-local planning and cooperation among these agencies. DIF: Cognitive Level: Understand (Comprehension) REF: p. 45
1. Which of the following variables have led to a stronger commitment to population-focused services? (Select all that apply.) a. Economic turmoil and demand for high-technology care b. Emergence of new or drug-resistant infectious diseases c. Emphasis on overall health care needs rather than only on acute care treatment d. Threat of bioterrorism
ANS: B, C, D As overall health needs become the focus of care in the United States, a stronger commitment to population-focused services is emerging. Threats of bioterrorism, anthrax scares, and the emergence of modern-day epidemics have drawn attention to population-focused safety and services. Economic turmoil and demand for high-technology care have not contributed to a stronger commitment to population-focused services, rather it has occurred as overall health needs have become the focus of care.
3. The public health nurse comes to the hospital to see a client just diagnosed with hepatitis A. The nurse says, Im sorry to bother you when youre not feeling well, but I need to ask you a few questions. Which of the following questions would be most appropriate for the nurse to ask the client? (Select all that apply.) a. "Do you know how you got this infection?" b. "Who lives with you?" c. "Where are you employed?" d. "Where do you usually eat?" e. "Are you sexually active?"
ANS: B, C, E The nurse should ask about sexual contacts and ask who (if anyone) lives with the client because the named individuals will need to have immune globulin administered to hopefully prevent the spread of hepatitis A and a community epidemic. The nurse should also ask about the clients place of employment because certain settings warrant special considerations. For example, in restaurants, hospitals, daycare centers, or other institutions, the lack of careful hand-washing by an infected worker can result in contamination of many others.
1. In which of the following cases would the school nurse be correct to advise the parents of an HIV-infected child to keep the child home from school? (Select all that apply.) a. The child develops allergies with sneezing. b. The child is unable to control body secretions. c. The nurse is not comfortable with being responsible for the child. d. There is an outbreak of chickenpox in the school. e. The child persists in biting behavior.
ANS: B, D, E Not attending school may be advisable if cases of childhood infections, such as chickenpox or measles, occur in the school, because the immunosuppressed child is at greater risk for suffering complications. Alternative arrangements, such as homebound instruction, might be instituted if a child is unable to control body secretions or displays biting behavior. HIV-positive children are encouraged to obtain routine immunizations, because their immune systems are compromised and they are more susceptible to such infections. To date, no cases of HIV infections being transmitted in a school setting have occurred in the United States. Strong disapproval by parents of well children is an opportunity to teach these persons how HIV is transmitted.
In the United States, which group is most affected by a new HIV diagnosis? a. Women having heterosexual relationships b. White IV drug abusers c. Young Black gay and bisexual men d. Men who have sex with other men
ANS: C
The nurse practitioner (NP) discovered that an immigrant client is not taking the penicillin prescribed because his illness is hot and he believes that penicillin, a hot medicine, will not provide balance. Which of the following terms best describes the action taken by the NP when the clients prescription is changed to a different yet equally effective antibiotic? a.Cultural awareness b.Cultural brokering c.Cultural knowledge d.Cultural skill
ANS: C
. A 40-year-old Bosnian, Muslim woman who does not speak English presents to a community health center in obvious pain. She requests a female health care provider. Through physical gestures, the woman indicates that the pain is originating in either the pelvic or genital region. Which of the following interpreters would be the most appropriate in this situation? a.A Bosnian male who is certified as a medical interpreter b.A female from the clients community c.A female who does not know the client d.The clients 20-year-old daughter
ANS: C Although having experience in medical interpretation is important, in many cultures it is inappropriate to have a male interpreter for females. This client has specifically requested a female provider; therefore, one might anticipate that the client will not be as forthcoming with a male interpreter. Regardless of certification and ability, the interpreter cannot interpret information the client may withhold because she feels it inappropriate to discuss private matters in front of a male. This client may also feel it inappropriate to have private matters interpreted by her daughter (especially if they are of a sexual nature or if they involve infidelity). Additionally, to avoid a breach of confidentiality, the nurse should avoid using an interpreter from the same community as the client.
1. Which of the following sexually transmitted diseases can be prevented through immunization? a. Chlamydia b. Gonorrhea c. Hepatitis B d. Herpes
ANS: C At the time of this writing, HBV infection can be prevented by immunization; vaccines for the remaining options are not yet available.
9. A nurse is providing education to a client about the use of PrEP. Which of the following statements would the nurse include as part of this teaching? a. Side effects of PrEP include extreme lethargy and joint pain. b. PrEP has been shown to be effective in preventing transmission of the disease from sharing needles. c. The effectiveness of PrEP will depend on your adherence to the medication regimen. d. PrEP will prevent you from contracting HIV and Hepatitis B.
ANS: C Pre-exposure prophylaxis, or PrEP, is a new HIV prevention method for people who do not have the infection but would like to reduce their risk of becoming infected. PrEP requires taking a pill to prevent the HIV virus from getting into the body. It has been shown to be effective for people at very high risk for HIV infection through sex; the results about its effectiveness with injection drug users are not yet available. This prevention method requires strict adherence to taking the medication and having regular HIV testing; it is also used in combination with other HIV prevention methods rather than in isolation (CDC: PrEP, 2012b).
A client is crying softly and saying, What did I do to deserve this punishment, Lord? Which of the following responses by the nurse would be the most appropriate? a.God doesnt punish people. Youre sick just because of bad luck. b.I can call the hospital chaplain to help you talk about these feelings c.What can I do to be helpful to you right now? d.Would you like to confess your sins and repent so this illness will go away?
ANS: C Some clients may view their illness as punishment for misdeeds and may have difficulty accepting care from nurses who do not share their beliefs. Because the nurse may not be a member of the clients religious faith group, an open-ended response showing caring is the most appropriate statement.
A nurse gives detailed information on how to apply for Medicaid to a new mother who moved to the United States from Russia about 10 years ago. The nurses next client is an African-American mother of newborn twins who worked until the children were born. The nurse knows the woman is eligible to maintain her insurance after her employment was lost and does not discuss insurance options at all. Which of the following errors is being made by the nurse? a.Covert intentional prejudice b.Covert unintentional prejudice c.Overt intentional prejudice d.Overt unintentional prejudice
ANS: C The nurse may have assumed that the African-American mother knew the available resources and could negotiate for assistance on her own and that the immigrant Russian woman had no experience negotiating government programs and thus needed the nurse to advocate for her and inform her of the programs available to her. The nurse, not knowing the health-seeking behaviors of either client, stereotyped both women and intentionally used her informational power to help one client while denying assistance to the other client.
2. Which of the following provides the best explanation as to why people do not immediately seek medical treatment when they first become ill with HIV? a. They are afraid to get tested for fear results will be positive. b. They avoid the problem (maybe it will go away). c. They dont recognize their symptoms as possibly being due to HIV. d. It is too expensive to get an HIV test.
ANS: C When HIV enters the body, it can cause a flu-like syndrome referred to as a primary infection or acute retroviral syndrome. This may go unrecognized. The symptoms are similar to flu or a bad cold including sore throat, lethargy, rash, fever, and muscle pain. An antibody test at this stage is usually negative. So the person or a medical provider may not recognize the illness as HIV.
Which of the following best defines aggregate? a. A large group of persons b. A collection of individuals and families c. A collection of people who share one or more characteristics d. Another name for demographic group
ANS: C An aggregate is defined a collection of people who share one or more personal or environmental characteristics. Members of a community can be defined in terms of either geography (e.g., a county, a group of counties, or a state) or a special interest (e.g., children attending a particular school). These members make up a population. The term population may be used interchangeably with the term aggregate. A large group of persons, a collection of individuals and families, and another name for demograhpic group are not accurate definitions of the term aggregate.
Making sure that essential community-oriented health services are available defines which of the core public health functions? a. Policy development b. Assessment c. Assurance d. Scientific knowledge-based care
ANS: C Assurance includes making sure that essential community-oriented health services are available in the community. The definition does not fit the terms assessment, policy development. Scientific knowledge-based care is not a core function of public health. Assessment is systematic data collection on the population, monitoring the population's health status, and making information available about the health of the community. Policy development refers to efforts to develop policies that support the health of the population, including using a scientific knowledge base to make policy decisions.
A nurse is explaining the health care system in the United States to a group of physicians visiting from South America. How would the nurse best describe the current health care system? a. "It is a logical, rational approach to meeting expressed needs while still trying to control costs." b. "It is a system in the process of reform as problems have become increasingly apparent." c. "It is divided primarily into two components: private health care and public health care." d. "It is the best in the world with outstanding research and high-technology care available to all."
ANS: C Health care in the United States consists of a personal care system and a public health system, with overlap between the two.
Which of the following is responsible for the dramatic increase in life expectancy during the 20th century? a. Technology increases in the field of medical laboratory research b. Advances in surgical techniques and procedures c. Sanitation and other population-based prevention programs d. Use of antibiotics to fight infections
ANS: C Improvements in control of infectious diseases through immunizations, sanitation, and other population-based prevention programs led to the increase in life expectancy from less than 50 years in 1900 to more than 78 years in 2013. Although people are excited when a new drug is discovered that cures a disease or when a new way to transplant organs is perfected, it is important to know about the significant gains in the health of populations that have come largely from public health accomplishments.
Which of the following is a basic assumption of public health efforts? a. Health disparities among any groups are morally and legally wrong. b. Health care is the most important priority in government planning and funding. c. The health of individuals cannot be separated from the health of the community. d. The government is responsible for lengthening the life span of Americans.
ANS: C Public health practice focuses on the community as a whole, and the effect of the community's health status (resources) on the health of individuals, families, and groups. The goal is to prevent disease and disability and promote and protect the health of the community as a whole. Public health can be described as what society collectively does to ensure that conditions exist in which people can be healthy. The basic assumptions of public health do not judge the morality of health disparities. The focus is on prevention of illness not on spending more on illness care. Additionally, individual responsibility for making healthy choices is the directive for lengthening life span not the role of the government.
An 80-year-old woman comes to the community health care facility with a large bag of medications. She tells the nurse she can no longer afford these medications because her only income is Social Security. Which statement is the best response by the nurse? a. "Let's go through these medications and see which ones we can delete." b. "You can get these medicines at this clinic for free." c. "Let's see if we can get some help from Medicare to help you pay for these medications." d. "These medications are important. Do your best to pay for them."
ANS: C This elderly patient probably is eligible for benefits through Medicare Part D. Medicare Part D has been added to Medicare to help cover the cost of prescriptions. DIF: Cognitive Level: Analyze (Analysis) REF: p. 40
4. A student asks the nurse at the student health clinic how AIDS is diagnosed. Which of the following statements would be the best response by the nurse? a. A diagnosis of AIDS is made when a screening test called an enzyme-linked immunosorbent assay (ELISA) is confirmed by the Western blot test. b. A diagnosis of AIDS is made when antibodies to HIV are detected about 6 weeks to 3 months following possible exposure. c. A diagnosis of AIDS is made when antibodies to HIV reach peak levels of 1000/ml of blood. d. A diagnosis of AIDS is made when CD4 T lymphocytes drop to less than 22 cells/mm.
ANS: D AIDS is defined as a disabling or life-threatening illness caused by HIV; it is diagnosed in a person with a CD4 T-lymphocyte count of less than 200/ml with or without documented HIV infection. The HIV antibody test (usually the EIA) is the most commonly used screening test for determining whether the antibody to HIV is present but does not confirm AIDS. Positive results with the EIA are tested further with the Western blot test. However, false-negative results are frequent between 6 weeks and 3 months following exposure.
17. Which of the following statements best explains why many health care providers are more afraid of getting hepatitis B than HIV? a. Everyone would assume the person infected with hepatitis B is a drug user. b. Having HBV would mean no further employment in health care. c. The fatality rate is higher and occurs sooner with HBV. d. There is no treatment for HBV, which can be a very serious illness.
ANS: D Both HBV and HIV are blood-borne pathogens. Health care workers may be exposed to either from needle stick injuries and mucous membrane splashes. However, HBV remains alive outside the body for a longer time than does HIV and thus has greater infectivity. The virus can survive for at least 1 week dried at room temperature on environmental surfaces, and therefore infection control measures are crucial in preventing transmission. There is no treatment for hepatitis B, and although some persons never have symptoms and others fight off the disease, many suffer from chronic hepatitis B, a very serious illness. Others may become chronic carriers of the disease.
A Spanish-speaking family comes to the public health department. No one in the family speaks English, and nobody at the health department speaks Spanish. Which of the following actions should be taken by the nurse? a. Attempt communication using an English-Spanish phrase book. b. Call the local hospital and arrange a referral. c. Emphatically state, "No hablo Español" (I don't speak Spanish). d. Obtain an interpreter to translate.
ANS: D Communication with the client or family is required for a careful assessment. When nurses do not speak or understand the clients language, they should obtain an interpreter. The nurse must use strategies that will allow effective communication with the client. The client has the right to receive effective care, to judge whether the care was appropriate, and to follow up with appropriate action if the expected care was not received.
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 clients 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
ANS: D Cultural skill is the effective integration of cultural knowledge and awareness to meet client needsin this case, the clients need to not be offended by having the bottom of the nurses foot or shoe in view of the clients face. The nurse using cultural skill makes sure nonverbal communication techniques take into consideration the clients use of body language and space. Cultural accommodation involves negotiation with clients to include aspects of their folk practices with the traditional health care system to implement essential treatment plans. Cultural imposition is the process of imposing ones values on others. Cultural repatterning is working with clients to make changes in their health practices if cultural behaviors are harmful or decrease their well-being.
22. A nurse was reading PPD tests 24 hours after another nurse had administered them. Which of the following findings would cause the nurse to interpret the test as positive? a. 15 mm of erythema in a client with HIV infection b. 5 mm of induration in an immigrant from a country where TB is endemic c. A 5-mm ruptured pustule with purulent drainage in a homeless client d. 10 mm of swelling and increased firmness in a client recently released from a correctional facility
ANS: D Erythema alone does not indicate a positive finding. For a PPD test to be positive, induration (swelling with increased firmness) must be present. A diameter of 10 mm induration would be a positive finding in an immigrant from a region with high TB infection. A small pustule in a homeless client undoubtedly is an infection but may not be due to the PPD test.
5. The correctional health nurse is doing a quick assessment on a newly admitted inmate who is HIV positive. Which of the following diseases should the inmate receive screening for immediately? a. Herpes zoster b. Hepatitis B c. Hepatitis C d. Tuberculosis
ANS: D HIV-infected persons who live near one another, such as in correctional facilities, must be carefully screened and deemed noninfectious before admission to such settings. A person with HIV is more susceptible to opportunistic infections, the most common of which is TB.
11. A client is being treated for secondary syphilis. Which of the following signs and symptoms would the nurse anticipate the client would exhibit? a. Chancre at the site of entry b. Jaundice c. Difficulty coordinating muscle movements d. Skin rash without itching
ANS: D Secondary syphilis occurs when the organism enters the lymph system and spreads throughout the body. Signs include skin rash on one or more areas of the body and do not cause itching. Other symptoms may include fever, swollen lymph glands, sore throat, patchy hair loss, headaches, weight loss, muscle aches, and fatigue.
A health care worker tells a nurse, It does no good to try to teach those Medicaid clients about nutrition because they will just eat what they want to no matter how much we teach them. Which of the following is being demonstrated by this statement? a.Cultural imposition b.Ethnocentrism c.Racism d.Stereotyping
ANS: D Stereotyping occurs when someone attributes certain beliefs and behaviors about a group to an individual without giving adequate attention to individual differences. In this instance, the health care worker makes the assumption that clients with low incomes are not educable. The health care worker is guilty of making another assumption as well: noncompliance among other Medicaid clients the worker has known may have been related to an inability to afford nutritious food.
23. A high school student is planning to volunteer at the hospital after school, so she needs to have a Mantoux test before beginning. Which of the following information should the nurse provide to the new volunteer? a. I will be using tiny tines to administer the TB antigen to the skin on your arm. b.Notify the clinic immediately if you experience any redness or itching at the test site. c. The areas should be kept dry until you return; cover it with plastic wrap when bathing. d. You will need to return in 2 to 3 days to have any reaction interpreted.
ANS: D The Mantoux test is a TB skin test that involves a 0.1-ml injection containing 5 tuberculin units of PPD tuberculin (not tines as in the TB tine test). The site should be examined for a reaction 48 to 72 hours (2 to 3 days) after injection. Only induration should be measured, and the results should be recorded in millimeters.
16. A client who is very upset says to the nurse, But we always used a condom! How could I have genital warts? Which of the following would be the best response by the nurse? a. Are you positive you always used a condom? b. Condoms dont always work. c. The condom might have had a tear in the latex. d. "Contact may have occurred outside the area that the condom covers."
ANS: D The challenge of HPV prevention is that condoms do not necessarily prevent infection. Warts may grow where barriers, such as condoms, do not cover, and skin-to-skin contact may occur.
3. A client was clearly very relieved when an HIV test came back negative. Thank goodness. Ive had sex several times without a condom, and when one of my friends said he was sick, I think I panicked. Which of the following would be most important to emphasize to the client immediately? a. Abstinence is the only way to be certain you are HIV-free. b. Sex should be restricted to one partner. c. The test could be wrong and the client might still have an HIV infection. d. The test would not cover any recent infection, so if the client has had recent unprotected sex, the test should be repeated in 3 months.
ANS: D The client needs to understand that the test cannot identify infections that may have been acquired within the previous 3 months before the test. Appearance of the HIV antibody can take up to 12 weeks. All persons who have an STD test should be counseled about risk-reduction activities before and after the test is done.
7. Which of the following actions would most likely be performed by a public health nurse? a. Asking community leaders what interventions should be chosen b. Assessing the community and deciding on appropriate interventions c. Using data from the main health care institutions in the community to determine needed health services d. Working with community groups to create policies to improve the environment
ANS: D Although the public health nurse might engage in any of the tasks listed, he or she works primarily with members of the community to carry out core public health functions, including assessment of the population as a whole and engaging in promoting health and improving the environment. The interventions of asking community leaders which interventions should be chosen, asessing the community and deciding on appropriate interventions, and using data from health care institutions do not demonstrate the engagement of the community when making decisions about what the community actually wants and needs.
A nurse is determining which health care services must be offered at a local public health clinic. Which of the following factors is most important for the nurse to consider? a. Data available from the most recent community assessment b. Suggestions from community members about what is needed c. Recommendations of Healthy People 2020 d. Services mandated by the state government
ANS: D At the local level, health departments provide care that is mandated by state and federal regulations. DIF: Cognitive Level: Apply (Application) REF: p. 40
Which of the following best describes community-oriented nursing? a. Focusing on the provision of care to individuals and families b. Providing care to manage acute or chronic conditions c. Giving direct care to ill individuals within their family setting d. Having the goal of health promotion and disease prevention
ANS: D By definition, community-oriented nursing has the goal of preserving, protecting, or maintaining health and preventing disease to promote the quality of life. All nurses may focus on individuals and families, give direct care to ill persons within their family setting, and help manage acute or chronic conditions. These definitions are not specific to community-oriented nursing.
The public health nurse has a clear vision of what needs to be done and where to begin to improve the health of the community. Why would the nurse spend time meeting with community groups to discuss the most important task to be addressed first? a. To increase the group's self-esteem b. To maintain communication links with the groups c. To make the groups feel good about their contribution d. To work with the groups, not for the groups
ANS: D Historically, health care providers have been accused of providing care for or to people without actually involving the recipients in the decisions. Public health nursing is a "with the people"—not a "to the people" or "for the people"—approach to planning. The purpose of meeting with community groups is not to increase their self-esteem or make them feel good about their contribution, rather it is to allow them to act for themselves to solve the problems they are facing. The first task of working with the group should occur before addressing maintaining communication links.
Which of the following is the primary focus of public health nursing? a. Families and groups b. Illness-oriented care c. Individuals within the family unit d. Health care of communities and populations
ANS: D In public health nursing the primary focus is on the health care of communities and populations rather than on individuals, groups, and families. The goal is to prevent disease and preserve, promote, restore, and protect health for the community and the population within it. Community-based nurses deal primarily with illness-oriented care of individuals and families acorss the life span. The aim is to amanage acute and chronic health conditions in the community, and the focus of practice is on individual or family-centered illness care.
When talking to a women's group at the senior citizens' center, the nurse reminded them that the only way the center would be able to afford to provide transportation services for them would be for them to continue to write letters to their local city council representatives requesting funding for such a service. What was the nurse trying to accomplish through this action? a. Ensure that the women did not expect the nurse to solve their problem. b. Demonstrate that the nurse understood the women's concerns and needs. c. Express empathy, support, and concern. d. Help the women engage in political action.
ANS: D Public health nurses engage themselves and others in policy development and encourage and assist persons to communicate their needs to those with the power to take action. The nurse is demonstrating the role of advocate through this action, it goes beyond merely understanidng the women's concern, and instead mobilizes them to take action. This action does not demonstrate the nurse showing empathy rather the nurse is empowering these women.
14. The nurse often has to make resource allocation decisions. Which of the following best describes the criterion the nurse should use in such cases? a. The specific moral or ethical principle related to the situation b. The cheapest, most economical approach c. The most rational probable outcome d. The needs of the aggregate rather than a few individuals
ANS: D The dominant needs of the population outweigh the expressed needs of one or a few people. All of the choices represent components of a decision that the nurse might consider in determining the needs of the aggregate.
A nurse working with Mary Breckinridge would have likely assisted with: (Select all that apply.) a. Establishing the Henry Street Settlement b. Developing health programs geared toward improving the health care of the rural populations c. Blazing a nursing trail through the Rockies, providing nursing care to miners and their families d. Ensuring positive outcomes for pregnancies among women in the Appalachian region
B D
How did Florence Nightingale help bring about community health nursing? (Select all that apply.) a.She convinced socially prominent wealthy women to volunteer to give care. b. She focused on all soldiers and their environment. c. She interacted with each individual person, assessing his or her needs and acting to meet those needs. d. She kept careful records on what was done and what were the results.
B D
. A nurse is concerned about a teenage mother who does not seem to know how to play with an infant. Which of the following behaviors would the nurse want to role-model as good parenting behaviors? (Select all that apply.) a. Allow the baby to cry for 10 or 15 minutes before reacting so that the infant can learn to self-soothe. b. Cuddle the baby often. c. Teach the mother to keep her face about 4 or 5 inches from the baby and to gently blow on the infant's face. d. Sing to baby with different melodies until baby seems to listen and shows a preference for certain tunes. e. During the assessment, smile and gaze into the baby's eyes.
B, D, E
3. Which of the following strategies should be used when providing educational programs for children? (Select all that apply.) a. Emphasize how to build learning from previous experiences. b. Use simple words to enhance understanding. c. Use objects to help increase their attention. d. Emphasize the importance of the long-term consequences. e. Use concrete examples to reinforce learning
B,C,E
A nurse is caring for Mexican migrant farmworkers. Which of the following conditions are of greatest importance for the nurse to assess? (Select all that apply.) a. Tuberculosis b. Hepatitis c. High blood level of lead d. Malaria e. Diabetes
B,C,E
An occupational health nurse wants to know the NAICS code of a prospective employer. Which of the following best explains why the nurse would be interested in this information? (Select all that apply.) a. To assess how others have rated the company in relation to employment there b. To compare the prospective employer's injury rate with similar employers' rates c. To learn more about the usual processes and products of the company as well as typical hazards d. To learn how employees feel about their employer e. To identify useful information about the employer
B,C,E
6. A child has multiple disabilities, and caring for the child has been both expensive and time consuming for the school. Once the child turns 16, which of the following actions is the school responsible for? (Select all that apply.) a. None, since the child is no longer eligible for school services b. Continuing to provide needed appropriate education for the child c. Excluding the child from selected extracurricular activities d. Continuing to prepare an updated individualized education plan e. Arranging for reimbursement for services provided
B,D
A nurse is concerned about the high incidence of sexually transmitted infection (STIs) in the community college population and sets up a special STI screening. Which of the following groups of students would be encouraged to attend? (Select all that apply.) a. Sexually active students currently receiving treatment for an STI b. Sexually active students who had been screened the previous year c. Students who are not sexually active and do not plan to become sexually active d. Students who are sexually active but never "go all the way" e. Students who are freshmen or new transfers
B,D
A nurse is planning to host a health screening at a large urban mall. Which of the following variables will help the nurse determine which screenings should be included? (Select all that apply.) a. Adequate space for persons to lie down after testing until side effects are reduced b. Health problems for which the specific population is at risk c. Whether adequate privacy can be obtained for the invasive or embarrassing procedures d. Whether health care providers are available to follow up on any positive screening results e. Ability to provide the individual health screenings free to the public
B,D
A nurse wants to use the principles of risk and outrage to improve an environmental hazard in the community. To accomplish this, which of the following actions would be taken by the nurse? (Select all that apply.) a. Advertise in the media throughout the entire surrounding area. b. Communicate the correct information in a timely fashion. c. Share all the data found on the community assessment. d. Talk to those affected or those worried about the situation. e. Conduct a community-based survey to identify risks.
B,D
Which of the following best explains why the federal government is beginning to fund school-based health centers? (Select all that apply.) a. These centers help young children avoid becoming addicted to drugs while still in elementary school. b. Attendance and learning are higher in schools with health clinics. c. These centers help keep children in school longer by distributing birth control and thus avoiding pregnancies. d. Many children have no other source of health care services. e. To ensure parents are compliant with meeting the health needs of their children.
B,D
1. Five students order meals at a local restaurant. Which of the following students are at highest risk for illness? (Select all that apply.) a. The first student asks for a salad with chicken strips and dressing on the side. b. The second student asks for a hamburger, very rare. c. The third student orders a tuna salad sandwich with extra mayonnaise. d. The fourth student orders a breakfast meal with two very soft-poached eggs and toast. e. The fifth student asks for a vegetable platter and a side of hummus.
B,D,E
4. A nurse wants to determine whether health problems have been improved and interventions have been appropriate and successful over a period of time. Which of the following data should the nurse examine? (Select all that apply.) a. Changes in staffing patterns in the health agency b. Demographic data c. Education and school statistics d. Environmental factors e. Utilization of health services
B,D,E
4. Which of the following are the primary reasons that employers have increasingly focused on ensuring a healthy and safe environment for workers? (Select all that apply.) a. To fulfill their ethical and moral responsibility b. To avoid the cost of liability suits, workers' compensation, etc. c. To maintain good public relations d. To meet enacted legislated standards e. To avoid significant penalties for noncompliance
B,D,E
Which of the following is the most common vector-borne disease is a result of travelers introducing the disease to the United States? a. Dengue b. Malaria c. Onchocerciasis (river blindness) d. Yellow fever
B. Malaria
A family is concerned about the medical bills of their father, age 63, who is unemployed and has almost no savings. Which of the following statements by the nurse accurately explain how Medicaid and Medicare would work in this family's situation? (Select all that apply.) a. "All your father's medical bills will be paid by whichever program is appropriate." b. "Choose any physician and just show them your Medicare or Medicaid card." c. "Your father must be homebound to qualify for Medicare assistance but less so for Medicaid." d. "Medicare is a federally funded program, but Medicaid is administered by your state." e. "Your father's age disqualifies him from both programs."
C,D
Which of the following aspects of a home health agency would most likely be examined during the accreditation process? (Select all that apply.) a. Cost of each service rendered b. Credentials of each employee c. Organizational structure d. Outcomes of caree. History of clients
C,D
3. Which of the following explains why some occupational health specialists are very concerned about chemicals in the workplace? (Select all that apply.) a. All chemicals are inherently dangerous to humans. b. Chemicals are often used when natural substances are equally effective. c. Effects of chemicals can be cumulative. d. Interactions of chemicals are typically unknown. e. It is difficult to accurately predict the reaction of chemical contact.
C,D,E
A parish nurse has been using pastoral activities when providing care to clients. Which of the following interventions is the nurse most likely using? (Select all that apply.) a. Helping families plan healthy nutritious meals and get plenty of rest b. Giving health education classes to the congregation c. Using hymns and scripture as a source of guidance and comfort d. Helping identify spiritual strengths that may assist in coping e. Visiting home-bound parishioners
C,D,E
A public health nurse is assisting the community in dealing with the effects of lead paint poisoning. Which of the following activities would the nurse most likely complete? (Select all that apply.) a. Administering medications to those with signs of lead poisoning b. Assessing community members for any health problems c. Setting up a blood screening program with the local health department d. Encouraging local landlords to improve the condition of their housing e. Educating the public on the dangers of lead paint
C,D,E
Which of the following symptoms suggests smallpox as opposed to the more common and much less dangerous chickenpox? (Select all that apply.) a. Child appears only mildly ill until late stages in smallpox. b. Lesions appear in various stages in the same area of the body rather than all at once. c. Rash lesions are most abundant on the face and extremities, not on the trunk. d. Rash occurs 2 to 4 days after sudden onset of fever rather than with the fever. e. Vesicles do not collapse when punctured.
C,D,E
An immigrant who takes metamizole (banned in the United States) for pain may experience life-threatening agranulocytosis. Which of the following actions would be taken by a nurse who employs cultural re-patterning? A. Complete a cultural assessment to identify any other dangerous medications that the client may be taking. B. Put this into perspective by considering that many drugs used in the United States cause agranulocytosis. C. Explain the harmful effects of metamizole and recommend an alternative medication for pain. D. Recognize that taking metamizole is common among persons living in Mexico and accept this as a cultural tradition.
C. Explain the harmful effects of metamizole and recommend an alternative
The mother of a high school student newly diagnosed with a condition that will require special health care services is concerned that the student will be required to be homeschooled away from the friends he has developed. Which of the following would be the most appropriate response by the school nurse? a. "Federal legislation requires that the school make provisions for those with various challenges, so your child will be able to remain in school as long as he is able." b. "I realize that this will be a difficult adjustment, but homeschooling has improved over recent decades and the Internet will allow your child to connect with friends." c. "Whether your child can remain in school will depend on state funding for those with disabilities. You might want to contact your congressman on this issue." d. "Your child may remain in school as long as he can manage the course requirements and doesn't flunk out."
a. "Federal legislation requires that the school make provisions for those with various challenges, so your child will be able to remain in school as long as he is able."
Which of the following statements, made by a caregiver of an older client, should alert the nurse to assess for evidence of elder abuse? a. "Mom is always into something and can't seem to stay still, so I've been giving her half a Valium to get her to relax so I can get some rest." b. "Mom wanted to stay at her home, but we were scared for her safety, so we moved some of her personal things into our home and brought her to live with us." c. "She has not been having incontinence problems since we have been taking her to the toilet every 2 to 3 hours when she is awake." d. "We have to feed Mom baby food now because she has trouble chewing and swallowing regular food."
a. "Mom is always into something and can't seem to stay still, so I've been giving her half a Valium to get her to relax so I can get some rest."
A nurse has invited community members to participate as full partners in creating changes to improve the health of the community. Which of the following may be an unexpected consequence of this action? a. A change in the distribution or redistribution of power and influence b. An increase in awareness of the importance of health c. Continued ongoing interest in community health activities d. Improved family functioning and involvement in health activities
a. A change in the distribution or redistribution of power and influence
A client is using a primary prevention strategy to prevent infectious disease. Which of the following actions is the client most likely taking? a. A client receives a tetanus booster every 10 years. b. A client receives a tetanus booster after stepping on a nail. c. A client receives tetanus immunoglobulin after stepping on a nail. d. A client with tetanus is given antibiotics and is placed on seizure precautions.
a. A client receives a tetanus booster every 10 years.
A client requests help to stop smoking. Which of the following methods would be the best for the nurse to suggest to the client? a. A combination of interventions, beginning with changing the environment b. Acupuncture to reduce the nicotine cravings c. Behavior modification through hypnosis d. Nicotine replacement products
a. A combination of interventions, beginning with changing the environment
Statistics clearly demonstrate that there are significantly more cases of a disease in one particular neighborhood than in all the rest of the city. Assuming all else is the same, which of the following is the most likely explanation for a single neighborhood having such a different pattern of illness? a. A cultural or ethnic concentration in the neighborhood b. The geographic location of the neighborhood within the city c. A statistical fluke without meaning d. The time of year the different statistics were collected throughout the city
a. A cultural or ethnic concentration in the neighborhood
The board of directors is examining various submitted reports concerning its home health agency. Which of the following reports represents an example of benchmarking? a. A report by the administrator regarding how the home health agency's performance compares with that of other local and national home health agencies b. A report by the chief financial officer regarding a cost-benefit analysis related to technological advances c. A report by the chief nursing officer regarding client outcomes d. A report by the medical director regarding implementation of evidence-based practice into standards of care
a. A report by the administrator regarding how the home health agency's performance compares with that of other local and national home health agencies
Which of the following persons is most likely to be assaulted? a. A young man b. A young woman c. An older man d. An older woman
a. A young man
In addition to those barriers faced by many residents in rural areas, what additional barrier to health care is a Hispanic migrant farmworker likely to encounter? a. Absence of culturally competent care b. Availability of specialists c. Distance of health care facilities from the place of residence d. High cost of health care
a. Absence of culturally competent care
Which of the following is the most probable cause of the increase in new emerging infectious diseases? a. Activities or behavior of humans, including changes in the environment b. Increasing urbanization and growth in new housing materials c. New infectious agents are evolving throughout the world d. Overpopulation in many areas, creating a need to reduce global population
a. Activities or behavior of humans, including changes in the environment
A group of teenagers with diabetes become upset and angry because they cannot agree on whether or not to have meetings during summer vacation. Which of the following should the nurse do to be effective in helping the teenagers resolve the conflict? a. Admit that it is difficult for everyone to agree on everything; then ask whether the group can try to decide how to agree on the issue. b. Assume adult authority and announce that meetings will be suspended until fall. c. Recognize that most of the teenagers want to have the meetings, but two are being stubborn; ask the two deviant members to leave the group. d. Suggest that the group avoid discussing it further but rather think about it over the next week and try to discuss the situation more rationally next week.
a. Admit that it is difficult for everyone to agree on everything; then ask whether the group can try to decide how to agree on the issue.
A 13-year-old resident in a rural community has been diagnosed with asthma. Which of the following providers will most likely provide care to this client? a. Advanced nurse practitioner b. Allergist c. Pediatrician d. Pulmonologist
a. Advanced nurse practitioner
Which of the following best describes the primary difference between parish nursing and all other nursing positions? a. Affiliation with a church or congregation b. Incorporation of spiritual aspects into nursing care c. Provision of holistic nursing care d. Residence within the community of service
a. Affiliation with a church or congregation
Three female clients were brought to the emergency department by ambulance after a two-car accident at a busy intersection. Which of the following tests should automatically be done under such circumstances? a. Alcohol blood level b. Cardiac workup c. Pregnancy test d. STI tests
a. Alcohol blood level
A nurse is providing care to a pregnant teenager. Which of the following principles is the most important for the nurse to consider when providing care? a. All teen pregnancies are considered high risk. b. Limited self-care knowledge can lead to pregnancy complications. c. Pregnant teens are likely to receive prenatal care late in the pregnancy. d. Pregnant teens may have limited financial resources to pay for care.
a. All teen pregnancies are considered high risk.
Which of the following biological warfare agents poses the greatest bioterrorism threat to a community? a. Anthrax b. Botulism c. Smallpox d. Tularemia
a. Anthrax
A nurse makes the suggestion that the 2-week shift rotations should be set up so that the next rotation in shifts is later rather than earlier. Which of the following is the nurse attempting to prevent through this suggestion? a. Anxiety, depression, and exhaustion b. Family turmoil c. Physical illnesses d. Sleeping disorders
a. Anxiety, depression, and exhaustion
A nurse would like to increase the accessibility to health care services for mentally ill homeless clients in the community. Which of the following actions should be taken by the nurse? a. Apply for a grant to fund a mobile clinic to take health care to the clients. b. Distribute flyers to the homeless that detail the location of various types of health care services. c. Refer homeless clients to areas that provide temporary housing. d. Solicit donations for food and clothing to be distributed to the homeless.
a. Apply for a grant to fund a mobile clinic to take health care to the clients.
The nurse learns that a family has declined an elective medical intervention for a health care problem because paying for the care would drastically reduce the family's resources and ability to meet the needs of other family members. Ethically, which of the following actions should be taken by the nurse? a. Appreciate that the family has made the decision that it feels is best and take no further action if it is clear the family has made an informed choice. b. Stress that each individual in society has a right to health care and the family will have to create some way to raise funds for the needed treatment. c. Talk to the media to see whether a campaign to raise funds for the family can be created. d. Try to convince the agency to give the care for free, even if it means economic stress for the agency, because the medical need is obvious.
a. Appreciate that the family has made the decision that it feels is best and take no further action if it is clear the family has made an informed choice.
Which of the following places best describes where the incidence of Vancomycin-resistant Staphylococcus aureus (VRSA) and methicillin-resistant S. aureus (MRSA) is currently rising? a. Areas where people share dressing or bathing facilities b. Daycare centers and schools c. Long-term care facilities d. Senior citizen centers
a. Areas where people share dressing or bathing facilities
Nursing students have been assigned to set up a health fair for the homeless population in a large urban setting. Without any funds to pay for space, where should the health fair be located, assuming that all of the following sites are available at no cost? a. At the city's homeless shelter, which is, by policy, vacant during the day b. At a large medical center, where the students could get permission to use an empty clinic in the evening c. At the largest inner city police station, where there was a large empty space available d. At the local community college, where there are plenty of tables and chairs
a. At the city's homeless shelter, which is, by policy, vacant during the day
A nurse is considering accepting the parish nursing position within their congregation. Which of the following educational preparation is crucial for the nurse to have received? a. Baccalaureate education including community health nursing experience b. Graduate education in community health nursing c. Passing the national certifying examination for parish health nursing d. Worship experiences for the process of ministry
a. Baccalaureate education including community health nursing experience
A group of nursing students are scheduled to present a program on healthy hearts to various community groups, with a day care center being the first location. What of the following advice should be given to them by their instructor? a. Base the program on the audience's development and maturity. b. Bring (borrow if necessary) a model of the heart to help explain its functioning. c. Focus on entertaining the learners. d. Have lots of handouts to reinforce the lesson.
a. Base the program on the audience's development and maturity.
A nurse is working as a case manager with a vulnerable population. Which of the following actions should the nurse do when providing care? a. Be willing to enter into a long-term relationship with families. b. Direct and control the client's care because the nurse knows what is most needed. c. Encourage families to become self-sufficient and less dependent on nursing personnel for advice and referrals. d. Rotate assignments periodically to prevent attachment and codependency.
a. Be willing to enter into a long-term relationship with families.
A homeless family brought their father to the public health clinic after he reported bleeding when he went to the bathroom. Which of the following nursing actions would be most appropriate? a. Begin tests to determine the cause of the bleeding while asking about other family concerns from nutrition to shelter for the night. b. Refer the man to a urologist to address the urinary bleeding. c. Suggest that the family take him to an urgent care center immediately. d. Treat the urinary infection and give the man medication to take to prevent the recurrence of infection.
a. Begin tests to determine the cause of the bleeding while asking about other family concerns from nutrition to shelter for the night.
Which of the following best represents an example of infectious disease spreading via a vector? a. Being bitten by an infected mosquito b. Disease spreading from infected mother to infant via the placenta c. A group of partygoers hugging and shaking hands d. Two persons, one of whom is infected, sharing a glass of soda
a. Being bitten by an infected mosquito
Which of the following best describes why it is helpful to be a member of a faith community? a. Belief and traditions help with coping. b. Members can ask others in the group for help. c. It is a social outlet. d. Members are able to get others to contribute to the causes they support.
a. Belief and traditions help with coping.
A pregnant teen asks the school nurse to provide information on abortion and a list of health care providers who offer such services. If the school nurse has very strong personal beliefs against abortion, which of the following actions should be taken by the nurse? a. Call in another nurse to care for this client. b. Explain, from the nurse's perspective, all the reasons that abortion should be made illegal. c. Offer the student a combination of oral contraceptives to induce spontaneous abortion. d. Provide information on alternatives to abortion and give the client information on adoption agencies.
a. Call in another nurse to care for this client.
A nurse is caring for a migrant farm worker who has been working in the agricultural industry for the past 10 years. When questioned about environmental hazards, the client reports regular exposure to pesticides. Which of the following disorders is the client most at risk to develop? a. Cancer b. Memory loss c. Skin rashes d. Headaches
a. Cancer
A nurse who is providing diabetes screening at a community clinic discovers that a new client has type 2 diabetes mellitus. The nurse provides counseling, refers the client to an endocrinologist for initial assessment and treatment, arranges for the client to see someone regarding financial assistance, contacts the mobile van to arrange transportation, and sets up a follow-up appointment. Which of the following types of service does these actions represent? a. Case management b. Client advocacy c. Holistic care d. Wrap-around services
a. Case management
Which of the following best explains why every client doesn't receive care from a case manager? a. Case management time is demanding; thus it is restricted to complex cases. b. Many health agencies do not employ case managers. c. Most clients would not benefit from case management. d. Most nurses do not know how to function as case managers.
a. Case management time is demanding; thus it is restricted to complex cases.
Which of the following actions represents the use of secondary prevention to reduce environmental health risks? a. Collecting blood specimens from preschool children to check for lead levels b. Meeting with local government officials to request that the city clean up a hazardous vacant lot c. Referring a child with toxic lead levels to a neurologist d. Teaching parents of a 2-year-old about the dangers of lead-based paint in older homes
a. Collecting blood specimens from preschool children to check for lead levels
A nurse would like to maximize autonomy in their parish nursing practice. Which of the following models would most likely be preferred by the nurse? a. Congregation-based model b. Institution-based model c. Teamwork model d. Partnership model
a. Congregation-based model
Which of the following statements regarding the Health Belief Model is accurate? a. Cues to action are an important component of the model. b. Multiple methods of education should be used when implementing this model. c. The first stage experienced in this model is the pre-contemplation stage. d. To successfully implement this model, ongoing maintenance of the behavior must be considered.
a. Cues to action are an important component of the model.
A nurse would like to implement a primary prevention effort to decrease the leading cause of death among children and teenagers. Which of the following actions would the nurse most likely take? a. Educate students about injury prevention measures. b. Provide free condoms to sexually active students. c. Screen for signs and symptoms of cancer. d. Invite a guest speaker to talk about living with HIV.
a. Educate students about injury prevention measures.
When evaluating an educational program, the nurse discovers that only 25% of community members met the learning objectives. Which of the following parts of the program should be improved? a. Educator b. Content c. Learners d. Objectives
a. Educator
A migrant farmworker has been injured while working on the farm. Which of the following would provide assistance to care for this injury? a. Emergency department for immediate care b. Migrant Health Act clinics c. OSHA, because the man was injured by farm machinery d. Workers' Compensation, because injury was at work
a. Emergency department for immediate care
A city has announced its plans to build a city dump near a community of poor and predominantly African-American citizens. Which of the following principles would the nurse be using when vocalizing opposition for this plan? a. Environmental justice b. Equal rights c. Primary prevention d. Risk protection
a. Environmental justice
A nurse is examining all of the various factors which can lead to disease. Which of the following models would the nurse most likely use? a. Epidemiologic triangle b. Health promotion c. Levels of prevention d. Natural history of disease
a. Epidemiologic triangle
A Mexican immigrant mother tells the nurse she is concerned that people in the community will give her daughter mal de ojo. To which of the following folk illnesses is the nurse referring? a. Evil eye b. Fallen fontanel c. Fright d. Indigestion
a. Evil eye
Which of the following hospital employees are most at risk for being exposed to and possibly developing active drug-resistant TB? a. Housekeeping staff b. Medical staff c. Nursing staff d. Ward clerks
a. Housekeeping staff
Which of the following would have been the focus of a school nurse in the early 20th century? a. Investigating causes of absenteeism b. Teaching school as well as being a nurse c. Promoting nursing as an autonomous practice d. Providing medical treatment to enable children to return to school
a. Investigating causes of absenteeism
A nurse is considering applying for a position as a public health nurse. Which of the following would be a reason this position would be appealing? a. Its autonomy and independence b. Its focus on acute care and immediately visible outcomes c. Its collaboration with other health care professionals d. Its flexibility and higher wages
a. Its autonomy and independence
The school health nurse has enlisted the assistance of high school role models in the areas of sports and scholarship to provide an antidrug presentation to their peers. Which of the following levels of prevention is being implemented? a. Primary b. Secondary c. Tertiary d. Both primary and secondary
a. Primary
A nurse established an ongoing group meeting of teenagers with diabetes. In the early stages, the nurse was very directive in arranging location, providing low-carbohydrate drinks and snacks, steering the discussion, and trying to meet all the teenagers' needs. After the group had been meeting for about 3 months, the nurse noticed that the group members no longer simply accepted everything the nurse suggested. Instead, the teenagers began making decisions themselves, and eventually, the nurse no longer controlled the group. Which of the following most likely happened to cause this shift? a. The group became cohesive enough to share leadership tasks. b. Teenagers don't like feeling dependent on adults with power. c. Teenagers often rebel against adult authority. d. The nurse was overwhelmed and lost control of task process.
a. The group became cohesive enough to share leadership tasks.
Which statement made by the nurse best confirms the achievement of goals related to the Omaha System conceptual model? a. The nurse confirms to the client that, "Your appointment can be rescheduled." b. The occupational therapist emails the nurse confirming, "I got the client's files." c. The client thanks the nurse saying, "I appreciate knowing what the procedure will cost." d. The pharmacist calls the client to say, "Your prescription is going to be delayed by one day."
a. The nurse confirms to the client that, "Your appointment can be rescheduled."
Why did American citizens become interested in establishing government-controlled boards of health? a. They were afraid of infectious diseases such as yellow fever. b. The government could force the poverty-stricken to accept care. c. Such boards could tax and thereby ensure adequate funds to pay for care. d. Such a system would allow for accurate records of births and deaths.
a. They were afraid of infectious diseases such as yellow fever.
A nurse just accepted a position in community health and has been assigned to a neighborhood very close to where she lives. Which of the following best describes the rationale for this assignment? a. To allow participant observation by the nurse b. To ensure that the nurse would care about her intervention outcomes c. To maximize convenience and minimize commuting time for the nurse d. To save gasoline in these difficult economic times
a. To allow participant observation by the nurse
From an ethical standpoint, what is the problem with the belief that everyone should receive his or her fair share, that life should always be fair, and that everyone should make his or her own decisions? a. With this belief, the needs of society as a whole are ignored. b. Insufficient resources exist to give everyone a fair share. c. This belief leads to a propensity for some people to like to be taken care of. d. Some people think they deserve more than others.
a. With this belief, the needs of society as a whole are ignored.
Which population is best protected against pertussis by the DTaP vaccine? a. Young children b. The pre-teen c. The teen d. Adult
a. Young children
A nurse is working with Mexican immigrants. Which of the following behaviors would most likely lead to a positive interaction for the nurse? a. Avoiding touching the client except when necessary as part of the physical examination b Calling the client by name, socializing before addressing the problem, and being very respectful c. Keeping all interactions direct, to the point, and targeted on the reason for presentation d. Maintaining a nonconfrontational relationship by avoiding any disagreement even if the nurse does disagree with what the client is saying
b Calling the client by name, socializing before addressing the problem, and being very respectful
A group of parish nurses affiliated with a number of faith-based communities located in different regions across the state are attending a quarterly meeting. Which of the following statements made by one of them indicates a lack of understanding of parish nursing? a. "I always make sure to have new clients sign a release of information form to obtain their health record from their previous parish nurse." b. "Because I work for and within the church, I am immune from civil laws." c. "The pastor and I work together for the spiritual health of the community." d. "Yes, I am happy to pray with my clients and help them worship."
b. "Because I work for and within the church, I am immune from civil laws."
Which of the following statements by the client indicates the client is experiencing a learner-related barrier to new information about type 2 diabetes management? a. "I know about diabetes; my sister has it." b. "I Don't like to read' just tell me what I need to know." c. "It won't change my life; it's type 2 diabetes." d. "It can't be that hard to learn; I don't have to take shots."
b. "I Don't like to read' just tell me what I need to know."
During a group counseling session for perpetrators of intimate partner violence, which of the following statements made by a client indicates a lack of insight into his violent behavior? a. "I have been taking out my frustrations with work on my girlfriend." b. "I love my girlfriend and didn't want to hurt her; it was an accident." c. "It might be a good idea for me to temporarily leave the house when I feel myself becoming angry." d. "When I drink alcohol, I become more abusive toward my girlfriend."
b. "I love my girlfriend and didn't want to hurt her; it was an accident."
Which of the following statements by a parent indicates a need for increased learning regarding appropriate (nonabusive) discipline of a child? a. "I have stopped using a switch on my child, and I am learning to count to 10 before reacting." b. "I never spank or hit; I yell at them to stop being stupid, and if they don't, I tell them no one is ever going to love them if they act like that." c. "I use time-outs when my child acts out or is naughty. Sometimes my child doesn't cope well with this, but I am persistent." d. "When my child misbehaves, I distract him and focus his attention on other things. If he throws a tantrum, I have been known to just pick him up and leave from wherever we are."
b. "I never spank or hit; I yell at them to stop being stupid, and if they don't, I tell them no one is ever going to love them if they act like that."
An upset mother calls the school nurse and says, "How dare you say my child has lice? My child is clean and I keep a clean house! You've obviously made an error." Which of the following would be the best response by the nurse? a. "I'm sorry you're upset, but your child cannot return to school until this problem is addressed." b. "Most lice are found in clean hair. Children often share combs. Let me tell you how to fix the problem." c. "You may have been traveling. Lice are often found in motels." d. "I'm sure you're correct; one of my volunteers probably made an error. I'll recheck."
b. "Most lice are found in clean hair. Children often share combs. Let me tell you how to fix the problem."
A school health nurse presents a program on preventing teen pregnancy to a group of parents. Following the presentation, which of the following comments by a parent would cause concern? a. "I do not know if my son is sexually active; however, I have decided I'm going to talk to him about it." b. "My daughter is too intelligent to get involved with boys, even if her friends do sleep around." c. "My daughter and I have often discussed sexuality, and when she's ready, I'll pay for her birth control pills." d. "I have spoken to my son about birth control. He says he's not ready to be a father and support a baby. He wants to go to college."
b. "My daughter is too intelligent to get involved with boys, even if her friends do sleep around."
A new nurse states to a nursing colleague, "But why do I have to be involved in politics? I just want to be the very best clinical nurse I can." Which of the following would be the best response from the nursing colleague? a. "As long as you pay your membership fee to the American Nurses Association, you have participated in the profession's political endeavors." b. "Political action is the way you try to fulfill your ethical responsibilities to clients." c. "You're absolutely right; if you are good clinically, you have fulfilled your obligation." d. "When you've completed your clinical orientation, then you'll have time to be involved in politics."
b. "Political action is the way you try to fulfill your ethical responsibilities to clients."
Which of the following statements by a parish nurse exhibits a lack of understanding of the concept of pastoral care? a. "By working with my clients to help them identify their spiritual strengths, I am drawing on pastoral care aspects of practice." b. "To incorporate pastoral care, I should involve the pastor in ministering to the members of the congregation." c. "I use pastoral care when I emphasize the spiritual dimension of nursing when providing care." d. "When I lend support to my clients during times of joy, as well as during their times of sorrow, it illustrates an important aspect of pastoral care."
b. "To incorporate pastoral care, I should involve the pastor in ministering to the members of the congregation."
A student reports to the college health nurse that her academic work has been going downhill because of lack of sleep. "My 3-year-old probably misses her babysitter since she has started going to the big daycare center. She hasn't been sleeping well and keeps scratching her bottom. Hopefully, she'll adapt to daycare soon." Which of the following information should the nurse provide to the student? a. "Dry skin in winter weather can cause itchiness; try to put on lotion before bedtime." b. "Your daughter may have pinworms; let me teach you how to check for this." c. "Perhaps your child is not developmentally ready for group play." d. "Try to arrange more one-on-one time with your 3-year-old."
b. "Your daughter may have pinworms; let me teach you how to check for this."
According to the Federal Register, which of the following is the minimum income needed by a family of four to meet the basic needs for healthy living (that is, an income below this amount is considered insufficient to provide the food, shelter, and clothing needed to preserve health)? a. $16,020 b. $26,200 c. $36,580 d. $40,890
b. $26,200
Which of the following clients is most likely to experience a high incidence of poverty? a. A 65-year-old woman b. A 14-year-old male c. A 79-year-old male d. A 19-year-old female
b. A 14-year-old male
Which of the following clients is most at risk for suicide involving firearms? a. A 15-year-old female b. A 20-year-old male c. A 56-year-old female d. A 36-year-old male
b. A 20-year-old male
Which of the following public health nurse applicants is the least qualified for a position of case manager in a rural county? a. A 24-year-old who has a master's degree in public health b. A 34-year-old who will be moving from a large city c. A 44-year-old who was born and raised in the community d. A 54-year-old who, until recently, was a member of the community's school board
b. A 34-year-old who will be moving from a large city
Which of the following should be the minimum requirement for a nurse to be prepared for home health nursing? a. An RN license and a baccalaureate degree in a health-related field b. A baccalaureate degree in nursing and RN licensure c. An associate degree in nursing and RN licensure d. Eligibility for certification as a home health nurse
b. A baccalaureate degree in nursing and RN licensure
Which of the following bills would the nurse lobbyist, who believes strongly in social justice, encourage legislators to support? a. A bill that establishes policies requiring all persons to pay the same cost for services regardless of income b. A bill that promotes universal health insurance coverage c. A bill that requires all health care providers to give care to uninsured persons without charge d. A bill that requires health care workers to report undocumented immigrants who present for treatment
b. A bill that promotes universal health insurance coverage
A school health nurse is asked by a parent group to explain risk factors for alcoholism. Which of the following information should the nurse include? a. Alcoholism is determined primarily by the family environment. b. Alcoholism is determined partly by genetic factors. c. Persons who are alcoholics are usually women. d. Persons born with fetal alcohol syndrome are alcoholics from birth.
b. Alcoholism is determined partly by genetic factors.
The nurse is making a postpartum visit to a teenage mother and her month-old infant. Which of the following assessments would be most important? a. Assessing for mother's ability to fulfill her own growth and development tasks b. Assessing for mother's knowledge about normal infant growth and development c. Assessing how much the teenage mother's own mother is helping her cope with childcare d. Assessing whether the baby's father is being helpful to the mother
b. Assessing for mother's knowledge about normal infant growth and development
Which of the following is the leading cause of children being absent from school because of a chronic illness? a. Allergies b. Asthma c. Diabetes d. Upper respiratory infections
b. Asthma
Which of the following best describes the primary reason that school health nurses spend so much time on educational programs that teach children the importance of water and fire safety, using a seatbelt in the car and wearing a helmet when biking or skateboarding? a. Because children won't know if someone doesn't tell them b. Because injuries are the leading cause of death in children and most injuries are preventable c. Because it is a dangerous world and someone has to warn children about the dangers d. Because teaching is easy and more fun than passing out bandages and documenting care
b. Because injuries are the leading cause of death in children and most injuries are preventable
Which of the following best describes why planning care for an individual is so challenging in today's health care system? a. Because today's clients have high expectations of the health care system b. Because multiple providers, payers, and settings have to be coordinated c. Because of the new high technology constantly being created and used for client treatment d. Because so many different health care providers are in the acute care setting today
b. Because multiple providers, payers, and settings have to be coordinated
A nurse is using a case management plan to maximize patient care outcomes. Which of the following describes an important consideration that should be made by the nurse? a. Case management plans should be used only by nurses to manage care. b. Case management plans should be individualized for each client. c. Case management plans provide additional expense to the client and family. d. Case management plans focus on the natural progression of the disease.
b. Case management plans should be individualized for each client.
Which of the following statements about children and environmental hazards is correct? a. The prevalence of autism is directly related to the increase in environmental toxins. b. Children are more susceptible to environmental toxins because of their smaller size. c. The prevalence of asthma among children has been decreasing. d. Children are more susceptible to cancer if they have a family history of the disease.
b. Children are more susceptible to environmental toxins because of their smaller size.
The case manager explains to two disagreeing parties that coming to an agreement will save personnel costs for both of them. Which of the following terms best describes this action? a. Assertiveness b. Collaboration c. Cooperation d. Compromising
b. Collaboration
Which of the following statements best describes how workers' compensation legislation has changed employer behavior? a. Employers have improved safety of working conditions because safety data is now public information. b. Companies have improved safety of working conditions because workers' compensation insurance premiums are now based on previous claims. c. Employers were legally required to implement safety changes. d. Companies have become more involved in the legislative process.
b. Companies have improved safety of working conditions because workers' compensation insurance premiums are now based on previous claims.
Which of the following is most important for school nurses to master in order to prepare for health care delivery in the future? a. Complementary and alternative therapies b. Computer and technology use c. Psychoanalytical techniques d. Self-defense techniques
b. Computer and technology use
A school health nurse is requested by the board of education to assist in choosing new playground equipment for an elementary school that meets safety standards. Which of the following best describes the nurse's role in this scenario? a. Case manager b. Consultant c. Counselor d. Health educator
b. Consultant
A disaster has occurred in the community. Which of the following actions should be taken by the school nurse? a. Continue activities as much as possible as if nothing had happened. b. Continue to assess for shock and stress. c. Help teachers discuss the disaster with their class. d. Maintain school routines and activities.
b. Continue to assess for shock and stress.
Which of the following is a potential advantage of hospital-based home health agencies over other types of home care agencies? a. Administration and management benefits are gained from the expertise of two boards of experts. b. Continuity of care is enhanced. c. Health promotion and illness prevention concerns take precedence over acute care and rehabilitation. c. They are eligible for tax exemptions through affiliated agencies.
b. Continuity of care is enhanced.
A nurse reviews with the client what can be expected during the next 3 days, as well as how the client should expect to feel each of those days. The client laughs and says, "You've got my care all mapped out." Which of the following tools is the nurse using to determine what will happen when? a. Care planning b. Critical pathway c. Demand management d. Use management
b. Critical pathway
Which of the following best describes a principle of care that the nurse should abide by when working with abusive families? a. Confront the abuser and shame him into penitence and a desire to change. b. Demonstrate respect for all family members, including the abuser. c. Exclude the abuser from family meetings because the abuser is the one creating problems. d. Notify the abuser's clergyman, boss, and others who can exert pressure for change.
b. Demonstrate respect for all family members, including the abuser.
Which of the following is considered the most important goal in nursing today? a. Adapting to technological advances such as electronic medical records b. Demonstrating caring as the basis of nursing practice c. Distinguishing nursing care from medical care d. Seeking evidence-based outcomes to demonstrate nursing's contribution to care
b. Demonstrating caring as the basis of nursing practice
A nurse is using analytic epidemiology when conducting a research project. Which of the following projects is the nurse most likely completing? a. Reviewing communicable disease statistics b. Determining factors contributing to childhood obesity c. Analyzing locations where family violence is increasing d. Documenting population characteristics for healthy older citizens
b. Determining factors contributing to childhood obesity
The wife of an abusive husband reports to the nurse that her husband has been increasingly more abusive over the past year. Which of the following should be the first action that is taken by the nurse? a. Arrange for the couple to attend marital counseling. b. Develop a plan for the wife's escape if the violence starts again. c. Teach the client how to avoid initiating her husband's anger. d. Work with the client on development of self-esteem.
b. Develop a plan for the wife's escape if the violence starts again.
A nurse is working to ensure long-term positive health outcomes of poor pregnant teens and their children. Which of the following actions would the nurse most likely take? a. Assist teen mothers to learn about their body changes during pregnancy. b. Develop programs that allow teen mothers to complete their education. c. Offer courses in proper care of babies and how to be a parent. d. Monitor pregnant teens to detect early problems with pregnancy.
b. Develop programs that allow teen mothers to complete their education.
A nurse is using the problem identification phase of the case management process. To which of the following phases of the nursing process does this correspond? a. Assessment phase b. Diagnosis phase c. Planning phase d. Implementation phase
b. Diagnosis phase
Which of the following components of the epidemiologic triangle contributes most to a female client developing a vaginal infection caused by fungi after successful treatment of her strep throat with antibiotics? a. Agent b. Environment c. Host d. Agent and host
b. Environment
A parish nurse is evaluating health programs that provide holistic care across the life span. Which of the following methods would be the most appropriate approach? a. Bringing families together to plan programs to meet the needs of individuals b. Establishing a wellness committee to assist in the evaluation process c. Matching financial resources with program objectives and goals d. Revisiting assessment data to be certain that planning reflects actual problems observed
b. Establishing a wellness committee to assist in the evaluation process
A nurse is employed as a nurse epidemiologist. Which of the following activities would most likely be completed by the nurse? a. Eliciting the health history of a client presenting with an illness b. Evaluating the number of clients presenting with similar diseases c. Performing a physical examination of an ill client d. Providing treatment and health education to a client with a disease
b. Evaluating the number of clients presenting with similar diseases
How can nurses know whether they have been effective in assessing the community and planning and implementing appropriate interventions? a. Ask community leaders for their opinion of the interventions. b. Examine the morbidity and mortality rate of the community. c. Reassess the community to determine whether obvious needs have been met. d. Systematically survey community residents regarding their perception.
b. Examine the morbidity and mortality rate of the community.
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.
Which of the following best describes services that are offered at a school-based health center? a. Employee care at a discounted cost at the school b. Family-centered care for preK-12 grade students c. Sex education, birth control, family planning, and care throughout pregnancy d. Referral and networking with other health care services in the community
b. Family-centered care for preK-12 grade students
With which of the following ethical approaches are Gilligan and Noddings associated? a. Distributive justice approach b. Feminine ethic c. Principlism approach d. Virtue ethics
b. Feminine ethic
Which of the following is the most likely reason for a man to rape a woman? a. Because the woman was asking for it b. For power and control c. Provoked by the woman's dress and behavior d. Sexual pleasure and release
b. For power and control
Which of the following approaches has research suggested is the most effective way to approach drug addiction? a. Criminal justice system b. Harm reduction c. Punishment approach d. Substance abuse education
b. Harm reduction
Nurses at a homeless clinic are concerned that homeless clients rarely return to have the nurses assess the findings of their tuberculosis (TB) skin tests. Which of the following is the most appropriate policy for the clinic to have regarding the screening test findings? a. Call all homeless clients 48 hours after TB skin testing to remind them to return to the clinic for test interpretation. b. Have homeless individuals read their TB skin test, if necessary, and mail in results on a postage-paid card coded to protect privacy. c. Readminister the TB skin test if the client returns later than scheduled for test interpretation. d. Routinely refer all homeless clients for chest X-rays.
b. Have homeless individuals read their TB skin test, if necessary, and mail in results on a postage-paid card coded to protect privacy.
A nurse was shocked when late one night she saw a former high school friend going through a trash bin outside a fast-food restaurant and pulling out half-eaten food. Which of the following is the most likely explanation for a healthy young adult engaging in such behavior? a. He ate his meal but wanted more and had no more money. b. He had full-time employment, but with such a low salary it was inadequate to meet basic expenses. c. A friend had thrown his meal away, and he thought he could find his friend's untouched food. d. He was doing this to fulfill an obligation of fraternity initiation at the college.
b. He had full-time employment, but with such a low salary it was inadequate to meet basic expenses.
To help congregation members better meet their nutritional needs, the parish nurse organized members to participate in activities that focused on fellowship while providing healthy meals to homebound members and serving "healthy heart" church suppers. Which of the following activities is being completed? a. Holistic care b. Health ministries c. Partnerships d. Pastoral care practices
b. Health ministries
A public health nurse is compiling information about how to promote early detection of breast cancer in women. Which document would most likely provide useful information about this topic? a. The Future of Public Health b. Healthy People 2020 c. Patient Protection and Affordable Care Act d. Scope and Standards of Public Health Nursing Practice
b. Healthy People 2020
A nurse is assessing a community's openness to change. Which of the following variables indicate that the community is ready? a. Commitment to current processes and policies b. High socioeconomic status in the community as a whole c. Long history of dependence on the community health agency and its staff d. Minimal level of social participation by community members
b. High socioeconomic status in the community as a whole
Which of the following statements best describes the most essential difference between home health care and acute client care? a. Acute client care is individualized for the client and family. b. Home health care is provided in the client's environment. c. Reimbursement for home health care varies from that of care provided in institutions. d. The focus of acute client care is on community health.
b. Home health care is provided in the client's environment.
A nurse has just received word that Medicaid will reimburse for care provided to a homeless man with schizophrenia who is afraid to come to the clinic to receive health care. Which of the following best describes this type of nursing? a. Community-oriented nursing b. Home health nursing c. Hospice nursing d. Private duty nursing
b. Home health nursing
Which of the following statistics is used by countries to compare the success of their health care systems? a. Attack rate b. Infant mortality rate c. Proportionate mortality ratio d. Cause-specific mortality rate
b. Infant mortality rate
A student comes to the college health clinic with typical cold symptoms of fever, sneezing, and coughing, but the nurse also notes small white spots on the inside of the student's cheeks. Which of the following actions should be taken by the college health nurse? a. Inform all students, staff, and faculty of a possible rubella epidemic. b. Inform all students, staff, and faculty of a possible measles epidemic. c. Reassure the student that it is just a bad cold and will soon pass. d. Tell the student to take two acetaminophen and drink lots of fluids.
b. Inform all students, staff, and faculty of a possible measles epidemic.
Which of the following conditions of the rural environment provides increased opportunities for teaching? a. Increased interaction among residents due to neighbors visiting neighbors on the family farms b. Involvement in rural community activities provides more contact with community residents than in urban areas c. Nursing responsibilities in these areas stress the importance of primary, secondary, and tertiary preventions d. Increased illnesses and injuries of rural residents require that they see nurses more often
b. Involvement in rural community activities provides more contact with community residents than in urban areas
The nurse gives a very informative and engaging presentation and then gives everyone in the audience a handout that outlines the presentation. Later, the nurse discovers that many of the handouts were thrown away before the audience left the building. Which of the following educational principles has the nurse forgotten? a. Audiences expect PowerPoint or video presentations, not lectures. b. Many Americans do not have a high reading level. c. People want photographs and images, not wordy outlines. d. The nurse gave them too much information too fast for them to want to cope with it all.
b. Many Americans do not have a high reading level.
Which of the following statements accurately describes why methadone is used to treat heroin addiction? a. Addicts come to prefer methadone instead of heroin. b. Methadone blocks the effects of heroin and reduces the craving. c. Methadone prevents further dependence on drugs. d. Methadone gives an enjoyable high, so addicts continue treatment.
b. Methadone blocks the effects of heroin and reduces the craving.
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
Which of the following objectives is most appropriate for the development of a community-oriented nursing care plan? a. All monitored patients will receive abortive therapy for lethal dysrhythmias within 3 minutes of dysrhythmia recognition. b. Of mothers receiving nutrition counseling, 80% will identify five sources of calcium by the end of class. c. 95% of children will be immunized by 1 year of age. d. There will be a 25% reduction in health disparities by 2015.
b. Of mothers receiving nutrition counseling, 80% will identify five sources of calcium by the end of class.
The nurse who works at a homeless clinic wants to improve healing of chronic wounds in clients living on the streets. Which of the following would be the best action to take to improve client outcomes? a. Provide antibiotics to all homeless persons with chronic, nonhealing wounds. b. Offer daily access to a room with soap, water, and bandages. c. Hand out free bandaging supplies following each clinic visit. d. Perform regular monitoring of the client's wound condition.
b. Offer daily access to a room with soap, water, and bandages.
Which of the following is an accurate concern about the marijuana? a. Strength of most available marijuana is weaker than in the past. b. Paranoia is a known side effect of marijuana use. c. Marijuana has no effect on a fetus. d. Psychological and physiological dependence are seldom experience with marijuana use.
b. Paranoia is a known side effect of marijuana use.
A parish nurse is using the institution-based model to plan care for a client with a chronic illness. Which of the following activities would the nurse most likely implement? a. Bringing in family members to work with the client and nurse in decision making b. Partnering with outlying health care centers for coordinating optimal care c. Pulling from the collective strengths of faith-based community members for social support for the client d. Relying on congregational prayer as a component of healing
b. Partnering with outlying health care centers for coordinating optimal care
A parish nurse is implementing a primary prevention measure related to obesity among the school-age members of the church. Which of the following activities is most likely being used by the nurse? a. Establishing a walking program that is sufficiently challenging yet not too strenuous for those who are obese b. Partnering with youth camp cooks to ensure that food is nutritious c. Supervising height and weight measurements taken by clinic assistants d. Working with parents of obese children to implement family lifestyle changes
b. Partnering with youth camp cooks to ensure that food is nutritious
A nurse is working toward an objective to "increase to at least 90% the proportion of all pregnant women who receive first trimester prenatal care." During which of the following phases of the nursing process would determination of the objective occur? a. Assessment phase b. Planning phase c. Implementation phase d. Evaluation phase
b. Planning phase
In the agency, one of the nurses spent all available time visiting a group of persons with mental health problems who were trying to remain functional in the community. Which of the following types of assignments did the nurse most likely have? a. Home-based primary care b. Population-focused home care c. Proprietary home care d. Transitional care
b. Population-focused home care
A school nurse was talking to the teacher of an 8-year-old child who was living with her mother in their car. Which of the following concerns would lead the nurse to talk to the teacher concerning the child's academic progress? a. Protentional abuse risk b. Possible developmental delays c. Food insecurity d. Susceptibility to infections
b. Possible developmental delays
Which of the following is the primary cause of vulnerability to health problems? a. Breakdown of family structures b. Poverty c. Prejudice d. Social isolation
b. Poverty
The occupational health nurse continually reminds employees to wear their safety goggles and ear plugs. Which of the following levels of prevention is being implemented? a. Both secondary and tertiary prevention b. Primary prevention c. Secondary prevention d. Tertiary prevention
b. Primary prevention
The school nurse has arranged for volunteers to help assess each child's hearing and vision. Any child that the volunteers feel did not "pass" will be sent to the nurse for follow-up. The nurse will then send a note to the parents that a physician should be seen. Which of the following levels of prevention is being implemented? a. Primary b. Secondary c. Tertiary d. Both primary and secondary
b. Secondary
A nurse offers homeless clients yearly tuberculosis (TB) screening and free treatment for those who test positive for TB. Which of the following levels of prevention is being used? a. Primary prevention b. Secondary prevention c. Tertiary prevention d. Secondary and tertiary prevention
b. Secondary prevention
A school health nurse is conducting drug screening to detect drug use by students before serious problems develop. Which of the following levels of prevention does this action represent? a. Primary prevention b. Secondary prevention c. Tertiary prevention d. Primary and secondary prevention
b. Secondary prevention
An occupational health nurse periodically conducts spirometry testing of employees who work around hazardous gases. Which of the following levels of prevention is being implemented? a. Primary prevention b. Secondary prevention c. Tertiary prevention d. Tertiary care prevention
b. Secondary prevention
Which of the following actions by Florence Nightingale demonstrates her role as an epidemiologist? a. She convinced other women to join her in giving nursing care to all the soldiers. b. She demonstrated that a safer environment resulted in decreased mortality rate. c. She obtained safe water and better food supplies and fought the lice and rats. d. She met with each soldier each evening to say goodnight, thereby giving psychological support.
b. She demonstrated that a safer environment resulted in decreased mortality rate.
A nurse is reviewing the original work of the National Organization for Public Health Nursing. Which of the following accomplishments of today was started within this organization? a. Requiring that public health nurses have a baccalaureate degree in nursing b. Standardizing public health nursing education c. Developing nursing cooperatives d. Opening the Henry Street Settlement
b. Standardizing public health nursing education
Which client may be able to safely detoxify and manage their withdrawal symptoms with only minimal medical supervision? a. A 50-year-old who uses diazepam to "manage my anxiety" b. The 30-year-old reporting a "weekend cocaine habit" c. A 60-year-old who takes a secobarbital "most nights to help me sleep" d. A 70-year-old who usually drinks "3-4 beers in the evening"
b. The 30-year-old reporting a "weekend cocaine habit"
In a particular community, several high school students were diagnosed with diabetes mellitus type 2 during the annual high school health fair. Over the next few years, the nursing staff developed and implemented educational programs about the risk factors for diabetes mellitus type 2 and proper nutrition. Which of the following would be the most useful for the nurses to use to determine if they are having any impact? a. The epidemic of diabetes in the high school is gradually ending. b. The incidence of diabetes is slowly decreasing during screening events. c. The prevalence of diabetes is slowly decreasing during screening events. d. The risk for diabetes is slowly increasing over time.
b. The incidence of diabetes is slowly decreasing during screening events.
The nursing staff has attempted to screen the entire African-American population in the community for diabetes. Which of the following would provide immediate verification of the success of the nursing staff's efforts? a. An epidemic of diabetes will be recognized. b. The incidence of diabetes will increase in the community. c. The prevalence of diabetes will decrease in the community. d. The risk for diabetes in the community will increase.
b. The incidence of diabetes will increase in the community.
Earlier in the week, a nurse carefully taught a patient from a different culture exactly how much medication to take and emphasized the importance of taking the correct amount. However, the patient is back in the hospital today with symptoms of an overdose although the patient denies taking more than the label indicated. Which of the following is the most likely explanation? a. The patient was taking more mediation in the hope of getting well faster. b. The patient was also taking folk medicines that had many of the same effects and perhaps some of the same ingredients as the prescribed medication. c. The patient truly did not understand and thought the dose being taken was correct. d. The patient had a unique response to the medication and should have a smaller dose ordered.
b. The patient was also taking folk medicines that had many of the same effects and perhaps some of the same ingredients as the prescribed medication.
A woman is sitting in a corner of the clinical waiting room, crying audibly. The nurse asks, "What's wrong? Can I help?" The woman responds, "They just told me I have a positive mammogram and I need to see my doctor for follow-up tests. I know I'm going to die of cancer. How can I tell my family?" Which of the following information does the nurse need to know in order to help the woman cope with this finding? a. The negative predictive value of mammography b. The positive predictive value of mammography c. The reliability of mammography d. The validity of mammography
b. The positive predictive value of mammography
A nurse sees the father of a newborn baby push his wife in a wheelchair out onto the patio. The man and woman each smoke a cigarette while the baby sleeps in the mother's arms. Which of the following information should the nurse share with the parents? a. Fetal nicotine syndrome may cause complications in the newborn. b. The sidestream smoke that the baby is exposed to is more dangerous than the mainstream smoke that the parents are inhaling themselves. c. The baby will eventually develop tolerance to tobacco smoke. d. The parents should switch to chewing tobacco as long as the child lives in the home.
b. The sidestream smoke that the baby is exposed to is more dangerous than the mainstream smoke that the parents are inhaling themselves.
Which of the following best describes the purpose of local health departments making unannounced inspections of local restaurants? a. To enforce local laws and regulations b. To ensure compliance c. To provide exposure to oversight d. To monitor employee safety
b. To ensure compliance
Which of the following best describes the mission of OSHA? a. To create an inspection system to avoid preventable loss of life b. To ensure safe and healthful working conditions c. To establish rules for employee safety d. To share factory illness and injury rates with the public
b. To ensure safe and healthful working conditions
Which of the following best describes the current goal in relation to communicable diseases? a. To control political borders so diseases cannot spread further b. To exterminate specific infectious agents one by one c. To expand health care facilities to improve infectious disease treatment d. To achieve worldwide immunization to control new cases
b. To exterminate specific infectious agents one by one
An occupational health nurse is working with the manager to change the assignment of an employee from working with heavy metal to using machinery to assist with loading and unloading boxes at the truck dock. Which of the following best explains the rationale for this change? a. To prevent injury b. To limit disability c. To provide primary prevention d. To provide tertiary prevention
b. To limit disability
Which of the following is the most rapidly growing group experiencing poverty? a. Hispanic families b. Women older than 65 c. African-American families d. Single men of all ages
b. Women older than 65
Minority nurses represented about 30.1 percent of the RN population. What is this an example of? a. Projection b. Disparity c. Racism d. A sentinel event
b. disparity
A woman has just delivered a baby and is lamenting that the baby's father is not with her. She shares with you that he became involved with drugs and is now in prison for theft. The new mother says, "It's so sad. He's clearly no good." Which of the following would be the best response by the nurse while demonstrating empathy? a. "I'm so sorry to hear that. Is your mother able to be with you?" b. "It's good that you and the baby are safe from him." c. "Is there anyone to help you with the baby until the baby's father can be released and encouraged to get treatment for his addiction?" d. "You must hate him for leaving you alone with a new baby!"
c. "Is there anyone to help you with the baby until the baby's father can be released
Which of the following public health actions has been particularly instrumental in reducing childhood infectious diseases in the United States? a. Answering parents' questions about the safety and importance of vaccines today b. Educational campaigns to all health care providers about the importance of immunizations whenever a child is seen c. "No shots, no school" legislation, which legally requires children be immunized before school d. Offering all immunizations to all children free of any charge
c. "No shots, no school" legislation, which legally requires children be immunized before school
A man loudly protests his increased property tax bill right after the public health department has made a plea for more funds. "Why," he asks, "should my tax dollars be used to pay for their children to be immunized?" Which of the following would be the best response by the nurse? a. "Immunizations are required by law, and if their parents can't afford it, you and I will have to pay for it." b. "It's just the right thing to do." c. "Only by making sure most kids are immunized can we stop epidemics that might hurt all of us." d. "We're a religious God-fearing community, and we take care of each other."
c. "Only by making sure most kids are immunized can we stop epidemics that might hurt all of us."
The principal of a school was upset over a rumor that one of the children had engaged in a violent activity that injured a younger sibling. The principal asked the nurse who the children were so that the involved teachers could both support the injured child and guard other children from the violent child. Which of the following would be the best response by the nurse? a. "I'll get the names to you and the involved teachers immediately." b. "Let me get the parents' consent, and then I'll get you the names." c. "Rumors are often inaccurate; let me follow up and see what happened and what needs to be done." d. "Why don't we coordinate a school-wide program on preventing accidents instead?"
c. "Rumors are often inaccurate; let me follow up and see what happened and what needs to be done."
An instructor is reviewing Salmonella infections with her class. Which of the following comments indicates that the student needs further review on how Salmonella is spread? a. "Certain pets and farm animals may be Salmonella carriers." b. "It is possible to transmit Salmonella by person-to-person contact." c. "Salmonella may be spread by spores that form once contaminated blood is exposed to the air." d. "Salmonella outbreaks are usually due to contaminated meat, poultry, and eggs."
c. "Salmonella may be spread by spores that form once contaminated blood is exposed to the air."
A nurse is completing a basic health assessment. Which of the following questions should be asked by an environmentally aware nurse? a. "Is anyone else in your family having these symptoms?" b. "Can you tell me about your house or apartment?" c. "What jobs have you held longest?" d. "Where do you live?"
c. "What jobs have you held longest?"
A client spends a great deal of time on the Internet or reading articles related to diabetes and its long-term effects. One day, the client asks why the nurse has not suggested a life care plan. Which of the following would be the best response by the nurse? a. "Life care plans are only for young persons who are newly diagnosed." b. "Life care plans are primarily used to determine long-term financial needs for legal reasons." c. "You are receiving appropriate care for your diabetes without serious side effects, so a life care plan isn't currently appropriate." d. "I was waiting for you to express interest in having a life care plan."
c. "You are receiving appropriate care for your diabetes without serious side effects, so a life care plan isn't currently appropriate."
A staff member is orienting a new nurse to a health clinic that serves primarily vulnerable populations. Which of the following statements indicates a need for additional staff education? a. "If a client who does not speak English comes in, you must obtain an interpreter right away." b. "We try to take care of as many problems as possible in one visit, so when you interview the client, ask about additional concerns." c. "You will like working with Hispanic immigrants because they all have close-knit family structures." d. "You will need to assist the client by scheduling any referral or follow-up appointments around their work schedules."
c. "You will like working with Hispanic immigrants because they all have close-knit family structures."
A public health nurse found that out of the 70 people who ate the potato salad at a school picnic, 63 developed symptoms of food poisoning. Which of the following best describes the attack rate? a. 63% b. 70% c. 90% d. 100%
c. 90%
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.
A public health nurse is hosting an informational meeting for young parents about how to balance their multiple responsibilities. Which of the following parents in attendance would be most at risk for abusing his or her own child? a. A new mother who has joined a parents' support group b. A father who is overwhelmed and exhausted by overtime work c. A depressed father who was laid off from work and is missing his work colleagues d. A mother who is missing her career challenges and friends but enjoying being home with her baby
c. A depressed father who was laid off from work and is missing his work colleagues
Which of the following Medicaid clients would most likely receive case management? a. An elderly person b. A person receiving rehabilitation following an injury c. A person who has a high-cost chronic disease d. A person with acute illness
c. A person who has a high-cost chronic disease
Which of the following is the most accurate description of a migrant farmworker? a. A person who does farm work as the primary means of employment, although other work may be done when the seasonal work ends b. A person who immigrates to the United States to "follow the crops" in performing seasonal farm work c. A person who moves from place to place to earn money performing seasonal agricultural work d. A person who specializes in the development of rural land for the purpose of farming
c. A person who moves from place to place to earn money performing seasonal agricultural work
A new nurse is overwhelmed with the needs of the community. Which of the following should be the first priority of the nurse? a. A problem that affects the most disadvantaged residents in the community b. A problem that is very easy and inexpensive to address c. A problem that is of high concern to the community d. A problem in an area in which the nurse has a great deal of expertise
c. A problem that is of high concern to the community
Which of the following best describes a health professional shortage area (HPSA)? a. An area with inadequate health care facilities for residents b. An isolated area of underserved populations within an urban region c. A region with insufficient numbers of health care providers d. A rural region of the United States with a population density of less than 10,000
c. A region with insufficient numbers of health care providers
Which client would have been most likely to receive care from the Frontier Nursing Service? a. An injured soldier b. A homebound, elderly male c. A woman in labor d. A child with measles
c. A woman in labor
A nurse is considering joining the American Public Health Association. What information about this organization should be considered when making this decision? a. APHA focuses on the public health concerns of the medical profession. b. APHA represents concerns of nursing specialty practices. c. APHA provides a forum for nurses to discuss their public health concerns. d. APHA focuses on providing health promotion education to the public.
c. APHA provides a forum for nurses to discuss their public health concerns.
Which of the following is the leading cause of disability for adult Americans? a. Accidents b. Arthritis c. Anxiety disorders d. Workplace injuries
c. Anxiety disorders
A nurse is completing a case management advocacy activity which corresponds to the implementation phase of the nursing process. Which of the following activities would the nurse most likely use? a. Asking the client what is most important b. Seeking appropriate referrals for the client c. Assuring the client that his wishes will be supported d. Determining the order in which actions will occur
c. Assuring the client that his wishes will be supported
How are ethics and public policies similar? a. Both are abstract principles that often differ in actual practice. b. Both are best achieved by persons in high political office who can effect change. c. Both strive for the public good. d. Both use general principles in making decisions.
c. Both strive for the public good.
A migrant farmworker brings his daughter to the clinic with severe heat stroke from being out in the sun. The nurse explains the danger signs and stresses staying cool and drinking lots of water. The man seems to know this already. Which of the following best describes the most likely reason that this happened? a. It was a rare occurrence, which probably won't be repeated. b. The daughter either disobeyed her father and went out to play in the sun or just did not realize how hot she was. c. Children may work on small farms because the family may need the additional income. d. The parents were busy working and didn't realize the child was outside so long.
c. Children may work on small farms because the family may need the additional income.
Which of the following types of study should the nurse researcher choose if the goal is to identify the long-term benefits and risks of a particular nursing intervention for senior citizens living in the community? a. Cross-sectional study b. Ecological study c. Clinical trial d. Retrospective analysis
c. Clinical trial
A colonist is working in the public health sector in early colonial America. Which of the following activities would have likely been completed? a.Establishing schools of nursing b.Developing vaccines to administer to large numbers of people c. Collecting vital statistics and improving sanitation d. Developing public housing and almshouses
c. Collecting vital statistics and improving sanitation
What example of information sharing is most important when managing a client's transition from acute care to home care? a. Working directly with the client's insurance provider b. Arranging for emotional support for both client and caregivers. c. Communication between acute care and home health agency staff d. Providing the client with information regarding available community resources
c. Communication between acute care and home health agency staff
Which of the following would be the best way for the school nurse to fulfill his or her responsibilities in an emergency situation? a. Tell all staff to call 911 if the nurse is not in the building. b. Arrange to always be available, even if only by phone. c. Create and share an emergency plan with all teachers and staff. d. Wear a pager so that the nurse can come as soon as humanly possible.
c. Create and share an emergency plan with all teachers and staff.
A nurse is administering a tuberculosis (TB) skin test to a client who has acquired immune deficiency syndrome (AIDS). Which of the following results should the nurse anticipate when using this screening test? a. Decreased positive predictive value b. Decreased reliability c. Decreased sensitivity d. Decreased specificity
c. Decreased sensitivity
Some nurses are debating about the appropriate action to take in relation to a particular family. The father is ill, and the other family members have chosen to continue working rather than take time off to care for the ill family member. One nurse states, "It is a wife's responsibility to care for an ill husband." Which of the following ethical approaches is being used by this nurse? a. Consequentialism b. Communitarianism c. Deontological ethics d. Principlism
c. Deontological ethics
A community health nurse is implementing a tertiary prevention activity related to tuberculosis. Which of the following interventions is the nurse most likely completing? a. Administration of skin tests to identify persons who have been infected with tubercle bacilli b. Assessing for signs and symptoms of active tuberculosis c. Directly observing clients with active tuberculosis as they take their antitubercular medications d. Interpretation of tuberculosis skin test findings
c. Directly observing clients with active tuberculosis as they take their antitubercular medications
Which of the following actions would a nurse take to reduce the high incidence of coronary artery disease (CAD) in a community? a. Introduction of a heart-healthy curriculum beginning in the first grade, presentations on diet and exercise for the community at large, and special education sessions for high-risk populations b. Provision of online activities related to prevention of cardiac disease, smoking reduction programs, and blood pressure screenings c. Distribution of handouts, including age-appropriate games, self-assessments, and education on heart-healthy lifestyles; availability of community screenings for hyperlipidemia in persons age 35 and older; and walking programs for those affected with CAD d. Enrollment of clients with CAD into cardiac rehabilitation programs, routine evaluation of effectiveness of CAD treatment regimens, and participation in clinical trials that evaluate interventions for those diagnosed with CAD
c. Distribution of handouts, including age-appropriate games, self-assessments, and education on heart-healthy lifestyles; availability of community screenings for hyperlipidemia in persons age 35 and older; and walking programs for those affected with CAD
The staff cannot reach an agreement on what is the right thing to do in relation to a specific patient. Which of the following approaches should the nurse use in personally deciding what is right? a. Do whatever will not get the nurse in trouble with employer. b. Do whatever is supported by an ethical expert, such as the hospital chaplain. c. Do whatever the nurse would recommend to anyone in a similar situation. d. Do whatever the nurse supervisor would feel comfortable reporting to administration.
c. Do whatever the nurse would recommend to anyone in a similar situation.
A community health nurse drives through an assigned community before visiting the community groups scheduled for the day. The nurse then drives through the community again that evening before going home. Which of the following best describes the nurse's reason for driving through the community twice in the same day? a. On the second trip, the nurse can carefully confirm the results of the first assessment. b. Repeating the experience ensures that the nurse absorbed all the relevant details. c. Driving through twice allows the nurse to see the community when many residents are at work or at school and then again when most are at home. d. When leaving in the evening, the nurse has more time to write down the results of the earlier assessment.
c. Driving through twice allows the nurse to see the community when many residents are at work or at school and then again when most are at home.
A man who takes a prescribed narcotic for pain on a regular basis reports that he does not like the way the medicine makes him feel. He has tried to change to an alternate analgesic but experienced withdrawal symptoms when he stopped taking the narcotic. Which of the following problems is the man experiencing? a. Drug abuse b. Drug addiction c. Drug dependence d. Substance abuse
c. Drug dependence
A case manager implements a primary prevention activity. Which of the following actions would the nurse most likely complete? a. Advocating for the client whose values conflict with those of the medical service provider b. Collaborating between nursing and occupational health personnel c. Educating a group regarding community services that are available if ever needed d. Resolving conflict between a primary care clinic and a tertiary health care facility
c. Educating a group regarding community services that are available if ever needed
A public health nurse is working with a client who does not have health insurance. Where will the nurse most likely direct the client to in order to receive care? a. Managed care b. Community health center c. Emergency department d. Physician office
c. Emergency department
In which of the following settings have nurses most often reported being the victims of violence, especially by patients and their families? a. Acute care inpatient settings b. Community clinics and physicians' offices c. Emergency departments and psychiatric units d. In homes during home health visits
c. Emergency departments and psychiatric units
A nurse reports that in comparison to all the children in a particular school, the children who are members of the Cub Scouts have 0.3 risk for obesity before entering the sixth grade. Which of the following recommendations would the nurse make to the new parents of two boys who had just moved into this school's neighborhood? a. Discourage the parents from enrolling their sons in Cub Scouts because of the risk. b. Don't say anything about Cub Scouts, because it isn't relevant to nursing care. c. Encourage the parents to enroll their sons in Cub Scouts. d. Share the finding and let the parents draw whatever conclusions they feel appropriate.
c. Encourage the parents to enroll their sons in Cub Scouts.
How can ethics be applied to public health nursing practice? a. Ethics and actual nursing practice are not related. b. Knowing ethics allows nurse to recognize the source of most problems. c. Ethics is constantly involved in nurses' clinical decisions. d. Although ethics is important, political and legal responsibilities are more important in practice.
c. Ethics is constantly involved in nurses' clinical decisions.
A member of a community weight-loss group has maintained a healthy weight for 2 years through healthy eating and daily exercise. Which of the following steps of the affective domain is this participant demonstrating? a. Analysis b. Application c. Evaluation d. Knowledge
c. Evaluation
Which of the following would most likely be one of the first steps taken in employer disaster planning? a. All employees are invited to attend sessions on disaster planning. b. Employers stress the importance of disaster drills and encourage active participation. c. Exhaustive inventory of chemicals and industrial hazards is completed. d. Written disaster plans are distributed to each employee and each worksite.
c. Exhaustive inventory of chemicals and industrial hazards is completed.
A public health nurse is determining what type of programming should be developed for the community. Which of the following is the most crucial factor that will influence program development? a. Comprehensive assessment and planning done in the community b. Documented needs of the local community c. Federal funding for priority diseases or groups d. Nursing staff's expertise and skills
c. Federal funding for priority diseases or groups
Which of the following activities are expectations for a school health nurse? a. Ensuring that children with health problems are accepted by their peers b. Driving children home if parents can't pick them up c. Giving emergency care in the school or during school events d. Giving medications as needed if children are ill
c. Giving emergency care in the school or during school events
What was the outcome of the Shattuck Report? a. Efforts to control alcohol and drug abuse, as well as tobacco use, were initiated. b. Environmental sanitation efforts became an immediate priority. c. Guidelines for modern public health organizations were eventually developed. d. Local and state governments established boards of health after its publication.
c. Guidelines for modern public health organizations were eventually developed.
Which of the following interventions regarding worker safety would be the least effective? a. Using job rotation and workplace monitoring b. Designing equipment so that employee exposure to hazards is minimized c. Having employees use safety measures and personal protective equipment d. Designing the environment to encourage employees to follow workplace procedures
c. Having employees use safety measures and personal protective equipment
A nurse is concerned about the possibility of suicide in a teenage boy. Which of the following characteristics has the boy most likely displayed? a. He has threatened harm to his school peers. b. He is between the ages 15 and 19. c. He is depressed and has a history of being sexually abused. d. He has been accused of abusing an animal.
c. He is depressed and has a history of being sexually abused.
Which statement best describes the cost of health care in the United States? a. Health care costs are kept low, and the indicators of health are among the best worldwide. b. Health care costs are low which has resulted in poor health outcomes. c. Health care costs are the highest in the world, but the indicators of health are not the best worldwide. d. Health care costs and indicators of health are the highest in the world.
c. Health care costs are the highest in the world, but the indicators of health are not the best worldwide.
A faith community nurse is partnering with a local public health department to develop programs for primary, secondary, and tertiary prevention activities. Which of the following should be used as the primary guide for development? a. Contemporary articles in nursing journalsb. Evidence-based practice guidelines for treatment of disease c. Healthy People 2030 goals and objectives d. Preferences of partners who are funding the programs
c. Healthy People 2030 goals and objectives
A nurse is assessing a young, single pregnant woman. Which of the following findings would be of most concern to both mother and fetus? a. Elevated blood pressure b. First prenatal visit at 5 months' gestation c. Homelessness d. Positive STD test
c. Homelessness
A nurse is investigating a bacterial illness that has caused a health problem in the community. Only some of the people exposed to the bacteria have become ill. Which of the following factors best explains why this would have happened? a. Chemical agent factors b. Environmental factors c. Host factors d. Physical agent factors
c. Host factors
A nurse is working to improve personal self-awareness in order to provide better client-centered care to clients living in poverty. Which of the following questions should the nurse self-reflect upon? a. What would I do if I lived in poverty? b. What can be done to get poor people motivated to work? c. How have the media images of poor persons shaped my image of poverty? d. How can community resources assist those living in poverty?
c. How have the media images of poor persons shaped my image of poverty?
Which of the following is the first and most crucial step in a generic ethical decision-making process? a. Assess the context or environment in which the decision must be made. b. Consider the various ethical principles or theories. c. Identify the ethical issues and dilemmas. d. Make a decision and act on it.
c. Identify the ethical issues and dilemmas.
A home health nurse asks a client diagnosed with arthritis to attend a demonstration in which an assistive device is used to put on shoes. Which phase of the nursing process is the nurse's current focus? a. Outcome identification b. Planning c. Implementation d. Evaluation
c. Implementation
Which of the following best describes case management? a. A tool of health maintenance organizations b. Targeted toward a specific segment of the population c. Implemented with individual clients d. Used to monitor the health status, resources, and outcomes for an aggregate
c. Implemented with individual clients
A nurse is focusing on the process dimension of a community's health. Which of the following interventions will the nurse most likely implement? a. Assessing the health care services available in a community b. Establishing screening programs to diagnose diseases as early as possible so that the treatment can begin c. Implementing health promotion activities such as education programs d. Planning for new programs to be developed based on identified needs
c. Implementing health promotion activities such as education programs
Which of the following data would most likely be collected in a syndromic surveillance system? a. Incidence of bioterrorism attacks b. Number of air travelers c. Incidence of school absenteeism d. Number of influenza vaccines administered
c. Incidence of school absenteeism
A nurse practitioner has established a mobile clinic to vaccinate noninstitutionalized adults against influenza. Which of the following phases of the nursing process is being implemented? a. Assessment b. Planning c. Intervention d. Evaluation
c. Intervention
Which of the following events led to the emphasis on home care nurses caring for acutely ill clients and the increased demands for extensive documentation? a. Advances in medical technology and pharmacology b. Increased number of lawsuits for substandard care c. Introduction of Medicare d. Social Security Act of the 1930s
c. Introduction of Medicare
Which of the following statements describes how nursing in the community is more challenging than nursing in an acute care setting? a. There is limited access to information useful to the nurse in giving care in the community. b. More paperwork and forms are required when giving care in the home. c. It is more challenging to control the environment in the community. d. Specialization isn't possible in the community setting.
c. It is more challenging to control the environment in the community.
Which of the following statements best describes how clients and parish nurses typically perceive spiritual health? a. It exists at the point that cure is attained. b. It has a tangential relation to well-being. c. It is part of an ongoing dynamic process. d. It is usually unchanging across the life span.
c. It is part of an ongoing dynamic process.
A man says, "I just can't get myself to leave the house and go for a 30-minute walk each day. I wish I could think of some way to motivate myself." Which of the following would be the best action for the nurse to take? a. Establish a written contract between him and his employer that states walking is required each day. b. Recognize the reasons why 30 minutes of walking each day is one of the best health promotion activities he can choose. c. Join a group that walks early each morning. d. Set up rewards, such as a nice snack after he gets back from walking.
c. Join a group that walks early each morning.
A nurse didn't know what to do when faced with a particular ethical dilemma because an option that would have a good outcome didn't seem possible. The nurse decided to talk to the agency supervisor and decide what action to take. Which of the following best describes the nurse's actions? a. Appropriate, because the supervisor is responsible for the nurse's choices. b. Intelligent, because the supervisor has access to resource persons (clergy, physicians, administrators) who might know of options the nurse hadn't considered. c. Justified, because this provides an opportunity to discuss the issue but the nurse maintains responsibility for the decision. d. Wise, because the supervisor would be more knowledgeable concerning agency priorities and traditional practices.
c. Justified, because this provides an opportunity to discuss the issue but the nurse maintains responsibility for the decision.
A teacher asks the school health nurse to assess a child for neglect. Which of the following assessment findings could indicate neglect? a. Bruises in various stages of healing b. Failure of parent to attend parent-teacher conferences or return teacher phone calls c. Lack of weight gain and wearing dirty clothes d. Lice in the hair
c. Lack of weight gain and wearing dirty clothes
Which of the following nurses is famous for creating public health nursing in the United States? a. Florence Nightingale b. Frances Root c. Lillian Wald d. Mrs. Solomon Loeb
c. Lillian Wald
A nurse is implementing a primary prevention strategy to address abuse in the community. Which of the following actions is the nurse most likely taking? a. Encouraging others to interfere when they see children hit or hurt in a public place b. Referring caregivers to community respite centers if abuse is beginning to occur c. Lobbying for passage of legislation to outlaw physical punishment in schools d. Screening each pregnant woman privately for intimate partner abuse
c. Lobbying for passage of legislation to outlaw physical punishment in schools
The nurse suggests use of telehealth to assess how a client is progressing. Which of the following resources must be available for continuing care to be implemented? a. A primary care provider who is willing to use wireless prescriptions and plans of care b. Family permission for the nurse to make home visits c. Long-distance telephone service or a computer with Internet access d. Willingness of the caregiver to drive the client to the nearest clinic
c. Long-distance telephone service or a computer with Internet access
Which of the following is the most common vector-borne disease in the United States? a. Babesiosis b. Ehrlichiosis c. Lyme disease d. Rocky Mountain spotted fever
c. Lyme disease
The leader of an Alzheimer's support group surveys the members of the group to determine the best time for the group to meet. Which of the following norms is being supported through this action? a. Group norms b. Task norms c. Maintenance norms d. Reality norms
c. Maintenance norms
The Elizabeth Poor Law of 1601 is similar to which current law? a. Welfare b. Food stamps c. Medicaid d. Medicare
c. Medicaid
Which of the following statements best explains why many school nurses are not able to ensure that all children receive needed health care in the schools? a. There is a shortage of baccalaureate-prepared nurses with national school health nurse certification. b. Most nurses prefer to be employed in hospitals giving direct care. c. Most school districts are unable to afford a nurse in every school. d. School districts and taxpayers see no need for nurses in schools.
c. Most school districts are unable to afford a nurse in every school.
A young woman had been away from home several years before she returned home sick and disheartened. Her mother called a nurse to help. Which of the following behaviors would suggest that the caregiver who arrived was a parish nurse? a. Advanced nursing practice education and skills b. Compassionate, skilled, dedicated touch c. Offered a prayer with the daughter and mother d. Willingness to do whatever was needed by mother or daughter
c. Offered a prayer with the daughter and mother
Which of the following types of home health agencies emphasizes health promotion and illness prevention? a. Combination agencies b. Hospital-based agencies c. Official agencies d. Proprietary agencies
c. Official agencies
A nurse just finished teaching breast self-examination to a large group of women at a professional conference. During the session, the nurse distributed literature and used culturally appropriate visual aids. However, the session was not as effective as it could have been. Which of the following was the most important thing omitted by the nurse? a. Time for audience members to ask questions and clarify the information b. Explanation of why culturally appropriate images are more acceptable c. Opportunity for the women to practice what they learned d. Use of simple language instead of printed material
c. Opportunity for the women to practice what they learned
A nurse is trying to identify the risk for mental health problems among older adults. Which of the following interventions should the nurse implement initially? a. Provide information on mental health resources in the community. b. Teach the elderly to self-monitor for signs and symptoms of depression. c. Organize screening programs offered at senior centers. d. Teach older clients to focus on their strengths rather than their weaknesses.
c. Organize screening programs offered at senior centers.
A man entered the emergency department bleeding profusely and screaming, "I've got to see a doctor right now! I've got a right to see a doctor! I'm hurt. You have to take care of me!" Which of the following premises would ethically justify such a demand for immediate attention? a. All hospitals receive federal money and all capable employed adults pay taxes, so all adults have a right to what their tax money has purchased. b. Saving an individual's life improves society and upholds tradition. c. Our society believes that all persons should be treated equally and that basic needs, such as not dying if death can be avoided, should be met. d. The man has a property right to his own body, and the government is responsible to ensure that property rights are protected.
c. Our society believes that all persons should be treated equally and that basic needs, such as not dying if death can be avoided, should be met.
When meeting with a client and family, the home health nurse says, "We have discussed your health problems and limitations. Now tell me what level of health and function you hope to achieve." In which of the following phases of the nursing process is the nurse engaging? a. Assessment b. Diagnosis c. Outcome identification d. Planning
c. Outcome identification
A nurse uses lecturing as the primary method of educating clients. Which part of the education process is missing? a. Evaluation b. Experience c. Participation d. Understanding
c. Participation
A community mental health nurse is working within the community to help prevent youth violence. Which of the following interventions would most likely be implemented by the nurse? a. Distributing literature that associates violence with a lack of intelligence b. Explaining to youth why youth violence is detrimental to society c. Partnering with associations to provide alternative activities that improve social skills d. Recommending increased funding to prosecute and jail teens associated with violent activity
c. Partnering with associations to provide alternative activities that improve social skills
A nurse completes a self-assessment of performance as part of the home health nurse's annual evaluation. Which of the following terms best describes this activity? a. Collaboration b. Quality of care c. Performance appraisal d. Resource utilization
c. Performance appraisal
A migrant farmworker presents to the clinic reporting an acute onset dizziness, intense thirst, vomiting, fatigue, and headache with difficulty concentrating. Which of the following conditions would cause such symptoms? a. Appendicitis b. Bacterial gastroenteritis c. Pesticide poisoning d. Viral illness
c. Pesticide poisoning
This year 600 of 8000 young women age 17 to 20 years at a university health center tested positive for a sexually transmitted infection (STI). Which of the following terms best describes this data? a. An epidemic b. Incidence c. Prevalence d. Risk
c. Prevalence
Which of the following is a common factor typically found in those who abuse others? a. Fear and belief that others are "out to get them" b. Poor self-esteem and unawareness of alternatives c. Previous observations of violent behaviors to manage conflict d. Difficulty keeping commitments
c. Previous observations of violent behaviors to manage conflict
Some nurses are debating about the appropriate action to take in relation to a particular family. One member of the family is ill, and the other family members have chosen to continue working rather than take time off to care for the ill family member. One nurse states, "But it doesn't have to be an either/or situation. Perhaps each family member could take a turn calling in sick just 2 or 3 days. That way they could all take a turn at helping and yet not upset their employers. Wouldn't that be fair?" Which of the following ethical approaches is being used by this nurse? a. Communitarianism b. Deontology c. Principlism d. Utilitarianism
c. Principlism
Some nurses are debating about the appropriate action to take in relation to a particular family. One member of the family is ill, and the other family members have chosen to continue working rather than take time off to care for the ill family member. One nurse states, "It's not up to us; it's the family's decision. They know what is best for them." Which of the following ethical approaches is being used by this nurse? a. Communitarianism b. Deontology c. Principlism d. Utilitarianism
c. Principlism
Which of the following is the primary focus of hospice care? a. Curing or controlling the client's chronic disease b. Decreasing the waste of acute care (hospital) resources c. Providing palliative care to maintain comfort until death d. Teaching the client and family how to care for themselves
c. Providing palliative care to maintain comfort until death
A nurse wants to help keep the community environment safe. Which of the following is the most appropriate action for the nurse to take? a. Conserve water by bathing less often. b. Downsize to a smaller living space. c. Reduce, reuse, and recycle. d. Replace all his appliances with new energy-efficient ones.
c. Reduce, reuse, and recycle.
An occupational health nurse is removing a foreign body from a patient's eye. Which of the following levels of prevention is being implemented? a. Injury prevention b. Primary prevention c. Secondary prevention d. Tertiary prevention
c. Secondary prevention
A nurse is practicing in the community but also has the community as the target of practice. Which of the following best describes the activities of this nurse? a. Providing care to an active caseload of 50 families in the neighborhood b. Inviting all the parents of asthmatic children in the school to meet together for mutual support c. Sharing assessment findings and health goals with every community group that will listen d. Writing articles for the local newspaper highlighting the various programs and services of the local health department
c. Sharing assessment findings and health goals with every community group that will listen
Which of the following best describes why it is more challenging for most nurses to meet the needs of a dying child and his or her family than to meet the needs of a dying adult? a. Children don't understand what it means to die. b. A child's death is harder for anyone to accept. c. Society does not expect death to occur in children. d. Families are not prepared to deal with death.
c. Society does not expect death to occur in children.
Which of the following principles is central to the role of the parish nurse? a. Advanced nursing practice education and skills b. Faith consistent with the community and its leadership c. Spiritual dimension of care d. Willingness to serve anyone in need
c. Spiritual dimension of care
A home health nurse is caring for a client who has right-sided paresis secondary to a stroke. Which of the following would be the best approach for the nurse to take? a. Arrange for private duty nurses to assist the client with daily needs. b. Assist the client with activities of daily living. c. Teach the client to participate in self-care activities. d. Teach the family how to care for the client.
c. Teach the client to participate in self-care activities.
An occupational health nurse at a local factory is using primary prevention strategies to reduce the environmental health risks among the employees. Which of the following activities would the nurse most likely implement? a. Checking radiation detectors to monitor for unsafe levels of radiation exposure b. Irrigating the eyes of an employee who has had a chemical splash to the face c. Teaching new employees who will work outdoors about the signs and symptoms of heat-related illness d. Using spirometry to rule out obstructive or restrictive lung disease for workers who will be wearing mask respirators
c. Teaching new employees who will work outdoors about the signs and symptoms of heat-related illness
A school nurse is demonstrating the use of a peak flow meter to help children with chronic asthma recognize when they need to use a rescue inhaler. Which of the following levels of prevention is being used by the nurse? a. Primary b. Secondary c. Tertiary d. Both primary and secondary
c. Tertiary
A nurse advises a client with osteoporosis to have three servings of milk or dairy products 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 school nurse has developed a special class for pregnant teens to teach them everything from anticipated body changes to methods for managing common pregnancy-associated problems. The classes also allow the nurse to be in close frequent contact with the students to monitor their health status. Which of the following levels of prevention is being used by the nurse? a. Primary prevention b. Secondary prevention c. Tertiary prevention d. Both primary and secondary prevention
c. Tertiary prevention
A movie shows a woman and a man having a contest to see who can drink more shots of whiskey. Who is more likely to "win" the drinking contest when and one is unable to continue drinking? a. If their alcohol consumption is the same size, they'll both pass out about the same time. b. Whoever has food in their stomach will probably vomit and be unable to continue drinking. c. The man will likely win because of an inborn tendency to greater alcohol tolerance. d. The woman will likely win due to the tendency to have more adipose tissue.
c. The man will likely win because of an inborn tendency to greater alcohol tolerance.
A nursing staff has successfully screened for diabetes in the community. Which of the following might best persuade the health board to increase funding for diabetic clinics in this community? a. An epidemic of diabetes is now recognized and must be addressed. b. The incidence of diabetes is now higher than previously recognized in the community. c. The prevalence of diabetes is now higher than previously recognized in the community. d. The risk for diabetes in the community could decrease if funding is received.
c. The prevalence of diabetes is now higher than previously recognized in the community.
Persons in an auditorium may have been exposed to a disease. If they are infected, it is crucial that they receive immediate treatment and not take the disease home to their families. Which of the following characteristics would be most important to consider when selecting the screening test to be used? a. The negative predictive value b. The positive predictive value c. The sensitivity of the test d. The specificity of the test
c. The sensitivity of the test
Which statement made by the nurse best describes the effect vaccines have had on tuberculosis (TB)? a. Tuberculosis is no longer a threat in most of the world. b. Tuberculosis has developed resistance to the all antibiotics. c. The treatment has helped greatly reduce the incidence of TB in the United States. d. The incidence of TB has remained constant since the 20th century.
c. The treatment has helped greatly reduce the incidence of TB in the United States.
Which of the following is the top risk factor for intimate partner homicide? a. There is a gun in the house. b. The husband has made threats against wife before. c. The wife has previously reported being physically abused. d. The woman's young daughter also lives with them.
c. The wife has previously reported being physically abused.
A nurse keeps ongoing documentation of all the clients seen at the community health clinic. The nurse enters the demographic data and the primary diagnoses into the computer to have a comprehensive perspective of the clinic's clients. Which of the following best explains why the nurse is collecting this data? a. This data will be useful in a research study the nurse is conducting. b. This data will provide evidence of clinic resources being wasted on minor health problems. c. This data will help identify patterns in the risk factors associated with a particular subgroup. d. This data can be used to show trends that can be included in the next grant proposal for further funding.
c. This data will help identify patterns in the risk factors associated with a particular subgroup.
A nurse, client, family, and other care providers meet to discuss what will be the best approach to use to continue care. Which of the following best describes why the nurse suggests changing the goal from obtaining appropriate long-term care placement to ensuring that the client's recovery is beneficial and safe? a. To consider all possible consequences of long-term care placement b. To encourage the group to review the client outcomes in the different settings c. To expand the goal so that different solutions can be generated and considered d. To help the group focus on the critical aspects the client's family considered most important
c. To expand the goal so that different solutions can be generated and considered
Which of the following statements best explains the primary reason why violence is so high among young male parents? a. Men tend to be more violent than women. b. They are young and thus lack maturity. c. Unemployment is higher in this population. d. Violent tendencies are transferred genetically along racial lines.
c. Unemployment is higher in this population.
A school nurse wants to decrease the incidence of obesity in elementary school children. Which of the following describes a secondary prevention intervention that the nurse could implement? a. Giving a presentation on the importance of exercise and physical fitness b. Designing a game in which students select healthy food choices c. Weighing students to identify those who are overweight d. Putting students on a diet if they weigh greater than 20% of their ideal weight
c. Weighing students to identify those who are overweight
How did the Industrial Revolution result in previous caregiving approaches, such as care by families, friends, and neighbors, becoming inadequate? a. Economic and political wars resulted in frequent death and injuries. b. Incredible plagues consistently and constantly swept the European continent. c.Migration and urbanization resulted in increased demand for care. d.Caregivers could easily find other employment, so they demanded to be paid.
c.Migration and urbanization resulted in increased demand for care.
A nurse is reviewing with a client the importance of the diabetic diet to maintaining control of blood glucose levels. The client states, "I went to the classes and learned how to count carbohydrates. I have even started to write down what I eat for each meal." Which of the following would be most appropriate response from the nurse? a. "I'm so glad you're beginning to recognize the need to control your blood sugar." b. "Now you just have to make sure you don't give that habit up!" c. "Sounds like you're not ready to really plan your eating yet." d. "That is great. You've started to take action and make changes."
d. "That is great. You've started to take action and make changes."
A family shared their concerns, including sexual issues, in strictest confidence with a faith community nurse. When the nurse returned to the church office, the pastor asked why the family wanted to see the nurse. Which of the following statements would be the best response by the nurse? a. "Because you are my supervisor, I will summarize what was said for you." b. "I will include that information in my report to our church's wellness committee." c. "They just wanted me to assess their health needs and make some suggestions." d. "The family had some issues they wanted to discuss in confidence, which I will keep in confidence."
d. "The family had some issues they wanted to discuss in confidence, which I will keep in confidence."
A nurse invited all the teenagers who were newly diagnosed with diabetes to a group meeting to discuss issues they all had in common. One teenager replied, "I don't know if I want to share all the problems I'm having with strangers." Which of the following is the best nurse response? a. "Don't share anything with anyone until you're comfortable doing so." b. "I can understand what you are saying." c. "No one will require you to do anything you don't want to do." d. "The purpose of the group is to have a safe place to share problems with others who may be having similar problems."
d. "The purpose of the group is to have a safe place to share problems with others who may be having similar problems."
A nurse is completing a health history on a client during a routine physical examination. Which of the following questions, which is often omitted, should be asked by the nurse? a. "How is your family doing?" b. "What problems have you been having?" c. "What health concerns do you have today?" d. "Where do you work and what do you do there?"
d. "Where do you work and what do you do there?"
A nurse is interviewing a person who has stated on their entry health form that they are retired. Which of the following is the most crucial question for the nurse to ask? a. "Have you had any problems since leaving your employment?" b. "How do you spend your time now?" c. "What has retirement been like for you?" d. "Where were you previously employed and what did you do there?"
d. "Where were you previously employed and what did you do there?"
A mother and her son are in the emergency department seeking care after the son had become so angry that he put his hand through a glass window and had to have stitches. The emergency care provider suggested a psychiatric consult. Now the mother asks, "Do you think my son is crazy?" Which of the following is the most appropriate response by the nurse? "a. Absolutely not. But a psychiatrist can help your son realize more appropriate ways of displaying anger." b. "Have you had other reasons to think your son is crazy? Perhaps the psychiatrist can reassure you that your son is just an adolescent coping with hormones." c. "Your son is having problems coping with anger. And naturally you're upset. Let the psychiatrist determine whether your son is crazy or not." d. "Your son is having problems with behavior, which is distressing all of you. A psychiatrist may be able to help your son cope with life in a more acceptable way."
d. "Your son is having problems with behavior, which is distressing all of you. A psychiatrist may be able to help your son cope with life in a more acceptable way."
Which individual has the greatest risk for becoming a member of the vulnerable population of the local community? a. A male diagnosed with a cardiac issue who recently moved in with his adult child b. A single mother who is studying for a law degree at the local university c. A 50-year-old married female who has worked as a server in local restaurants for her entire adult life d. A single male who has a history that includes a learning disability and a parent diagnosed with type 2 diabetes
d. A single male who has a history that includes a learning disability and a parent diagnosed with type 2 diabetes
Which of the following is the best brief definition of community? a. A geographic area or political division under common leadership b. A group sharing a common bond such as a profession or occupation c. A group working together to confront a common problem d. A social group with common goals within a geographic area
d. A social group with common goals within a geographic area
Research as shown that vaping increases an individual's risk of contracting what disease five-fold? a. Gingivitis b. Mouth cancer c. Oral herpes d. COVID-19
d. COVID-19
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 parish nurse organizes the annual health fair for the congregation, inviting community agencies to attend the event and display the health resources that are available in the community. What function of the parish nurse is being demonstrated? a. Health advocate b. Referral agent c. Health educator d. Coordinator of volunteers
d. Coordinator of volunteers
Which of the following best describes one of the outcomes of the incentives and pressures for cost control and improved health outcomes? a. Expansion in alternative health care agencies b. Improvements in client teaching materials c. Public pressure to improve health professionals' education d. Development and increased use of telehealth technology
d. Development and increased use of telehealth technology
The nurse is examining blood lead levels in school-age children 1 year after a community-wide education intervention. Which of the following phases of the nursing process is being implemented? a. Assessment b. Diagnosis c. Intervention d. Evaluation
d. Evaluation
There is great concern in the nurse's community over three local cases of West Nile virus. Which of the following actions should the nurse take to get the community involved in addressing this problem? a. Ask the state department of health for assistance. b. Demand that everyone over age 65 become immunized immediately. c. Encourage immunization of all children under 12. d. Have an educational campaign to remove any containers of standing water.
d. Have an educational campaign to remove any containers of standing water.
Why did the Metropolitan Life Insurance Company establish and retain for several years the first community nursing health program for policyholders? a. Creating such a service was the morally correct thing to do. b. Employing nurses directly was less expensive than paying taxes to the city for the same purpose. c. Having the company's nurses make home visits increased worker morale. d. Having public health nurses visit policyholders and their families led to a decline in policyholder deaths, thus lowering costs for the insurance company.
d. Having public health nurses visit policyholders and their families led to a decline in policyholder deaths, thus lowering costs for the insurance company.
Which of the following infectious disease interventions best represents the use of secondary prevention? a. Clients with HIV infection are encouraged to use condoms to protect sexual partners. b. Clients with HIV infection are given medications to improve immunological response. c. Health care workers are encouraged to receive annual vaccinations for influenza. d. Health care workers are required to have a tuberculosis skin test or chest X-ray.
d. Health care workers are required to have a tuberculosis skin test or chest X-ray.
A nurse is asked to meet with a family who recently immigrated from Botswana (Africa). After the physician tells the husband the wife's diagnosis of breast cancer, the family thanks the physician and starts to leave. Ethically, which of the following is the nurse's most important action? a. Emphasizing that the family must set up a surgical appointment for the wife immediately b. Assessing the family's current living situation, including insurance and other assets c. Educating the family concerning the usual treatment and the prognosis of breast cancer d. Interviewing the family concerning their perspective of the threat to the family's well-being
d. Interviewing the family concerning their perspective of the threat to the family's well-being
Which of the following is the primary reason that large companies are becoming more involved in their employees' personal health and well-being? a. It is an ethical and moral responsibility. b. It improves public relations within the community. c. It allows managers to better understand their employees. d. It provides a cost savings to the company.
d. It provides a cost savings to the company.
A school nurse stops a student in the hall and expresses concern that, "Your eyes look rather red and dry." The student yawns and denies eye problems but does mention having gained 15 pounds since smoking "special cigarettes." Which of the following is the student most likely smoking? a. Tobacco b. Crack cocaine c. Ice methamphetamine d. Marijuana
d. Marijuana
Which of the following statements best describes why health care of the homeless is so expensive to the community? a. Health conditions of the homeless require increased preventive services. b. Homeless clients typically make more clinic visits for multiple health problems. c. Homeless people are a major source of spread for contagious diseases. d. Most care to homeless people takes place in hospital emergency departments.
d. Most care to homeless people takes place in hospital emergency departments.
A case manager advocates for a client by helping an insurer understand the client's needs and desires and by helping the client understand programs and benefits offered by the insurer. What role is the nurse? a. Arbitrator b. Systems allocator c. Mediator d. Negotiator
d. Negotiator
A school nurse listens as one student talks about another student being upset because his father frequently spanks him with a leather belt that leaves big marks on the student's back. But the student begs the nurse not to tell anyone because he promised the friend that the information would never be shared. Which of the following actions should be taken by the nurse? a. Ask the student if abuse has occurred. b. Call in the named student and ask him to remove his shirt. c. Discuss the conversation with the student's parents. d. Notify the legal authorities.
d. Notify the legal authorities.
Which of the following best explains why school nurses are involved in helping teachers with the task of teaching children how to practice problem solving, communication, and other life skills? a. Teacher shortages have required nurses to be increasingly involved in teaching life skills. b. Because so many nurses want to be employed in schools, this responsibility was assumed to increase employment opportunities. c. States are requiring nurses to screen and to teach life skills. d. Nurses have been enlisted in this role to help reduce risk factors for future health problems in schoolchildren.
d. Nurses have been enlisted in this role to help reduce risk factors for future health problems in schoolchildren.
Why were nurses so unprepared for public health nursing in the early twentieth century? a. Community health nursing had not yet been created as a field. b. No one would teach the nurses how to engage in public health activities. c. Nightingale's textbook did not include content on public health nursing. d. Nurses were educated in diploma schools, which focused on hospital nursing.
d. Nurses were educated in diploma schools, which focused on hospital nursing.
A high school student considering a job in the restaurant industry after graduation asks a nurse about workplace safety issues. Which of the following acts would the nurse most likely discuss with the student? a. Chemical Safety Information, Site Security, and Fuels Regulatory Act b. Comprehensive Environmental Response, Compensation, and Liability Act c. Food Quality Protection Act d. Occupational Safety and Health Act
d. Occupational Safety and Health Act
Which of the following best describes when the home health nurse must document required Outcome and Assessment Information Set (OASIS-C2) data? a. Before any episode of hospitalization b. After each home health visit c. For all incidences of error or mistake in care d. On first admission to home health care
d. On first admission to home health care
Which of the following best describes the primary problem that can result from health care today being given by many different care providers? a. Clients are not sure which provider to see first. b. Health care providers have to make referrals to other providers. c. Clients sometimes are not sure who their primary provider is. d. Overuse, underuse, or gaps in care may result.
d. Overuse, underuse, or gaps in care may result.
During an outbreak of hepatitis A, nurses are giving injections of hepatitis A immunoglobulin to selected susceptible persons. Which of the following best describes the type of immunity that will follow the administration of these injections? a. Active immunity b. Acquired immunity c. Natural immunity d. Passive immunity
d. Passive immunity
At a town meeting with public health officials to discuss a communicable disease outbreak, a nurse is asked to explain what is meant by the phrase "a virulent organism." The nurse explains that this means the organism causing the disease is able to do which of the following? a. Bypass normal immunological response mechanisms b. Invade major organ systems c. Produce toxins and poisons that weaken the body d. Produce very severe physical reactions
d. Produce very severe physical reactions
At a county board meeting, a nurse reports statistics related to the increasing problem of substance abuse in the county . The nurse then requests funding for an after-school recreation program that promotes age-appropriate fun activities and sports. Which of the following objectives is the nurse attempting to meet through this action? a. Help prevent obesity and boredom. b. Offer alternatives to being "on the streets." c. Prevent children from getting in trouble before their parents get home from work. d. Promote healthy lifestyles with physical activity.
d. Promote healthy lifestyles with physical activity.
A family member asks a home health nurse to explain the concept of hospice care. Which of the following would the nurse need to include as the fundamental underlying philosophy of hospice? a. Enabling the client to die at home b. Ensuring that the client's living will is upheld c. Placing experts in the position of power of attorney d. Providing comfort measures before death
d. Providing comfort measures before death
A nurse was employed by the Marine Hospital Service in 1800. Which of the following interventions would the nurse most likely have completed? a. Setting policy on quarantine legislation for immigrants b. Establishing hospital-based programs to care for the sick at home c. Identifying and improving environmental conditions d. Providing health care for merchant seamen
d. Providing health care for merchant seamen
The occupational health nurse makes certain all employees have and know how to use personal protective equipment (PPE). Which of the following factors will most likely determine how effective the PPE is in keeping employees safe? a. Comfort level of the PPE b. Effectiveness of the nurse's teaching c. Knowledge level of the employee d. Psychosocial norms of the setting
d. Psychosocial norms of the setting
A father confides to the parish nurse that his wife has been hurting their 3-year-old daughter. The nurse examines the daughter and finds evidence of physical abuse. In the parish nurse role, which of the following actions should the nurse take first? a. Contact the pastor for guidance in handling this situation. b. Recommend that the family be removed from the faith community. c. Refer the family to pastoral services for counseling. d. Report the findings to child protective services.
d. Report the findings to child protective services.
A mother confides to the nurse that her live-in boyfriend knocked down her 2-year-old child because he was crying too much. She begs the nurse not to tell anyone because her boyfriend has agreed to take anger management classes. Which of the following actions should be taken by the nurse? a. Abide by the mother's wishes because this information was provided in confidence. b. Arrange for counseling for the boyfriend at the earliest possible availability. c. Encourage the mother to take the child and find alternate housing right away. d. Report the incident to child protective services or other appropriate legal authority.
d. Report the incident to child protective services or other appropriate legal authority.
At the annual community health fair, the school health nurse displays a science booth that examines the hazards of ineffective hand washing. Which of the following best describes the nurse's role in this scenario? a. Consultant b. Community outreach c. Counselor d. Researcher
d. Researcher
A principal comments to the school nurse that it seems there are a lot more problems with asthma among the students than there were before the school was remodeled a couple of years ago. The nurse investigates the principal's observation by reviewing all the school records to determine visits to the health office because of asthma by week and month for the past 5 years. Which of the following best describes the type of study the nurse is conducting? a. Descriptive epidemiological study b. Ecological study c. Prospective cohort study d. Retrospective cohort study
d. Retrospective cohort study
Which of the following statements suggests that faith community nursing is a nationally recognized specialty of nursing? a. Academic programs now offer a clinical specialty in parish nursing. b. Faith community nurses are increasingly receiving salaries for their efforts. c. Faith community nursing is being adapted in other countries and to non-Christian faiths. d. Scope and standards of faith community practice have been developed and revised.
d. Scope and standards of faith community practice have been developed and revised.
A mother cannot understand why her daughter ran away from home. When the police locate the daughter, she complains of a severe headache, so the police take both of them to the emergency department for assessment. Which of the following potential problems should be assessed by the nurse? a. The daughter's inability to do well in school b. Intimacy problems with the daughter's boyfriend c. The mother's abuse of the daughter over a long period of time d. Sexual abuse by the father
d. Sexual abuse by the father
Which of the following factors predisposes many migrant farm workers to disenfranchisement? a. Being a minority group member b. Inability to attend religious services because of work requirements c. Previous experiences of physical abuse d. Short length of time in the community
d. Short length of time in the community
Persons often point out that smokers choose to light their cigarettes; alcoholics lift the glass to their mouth, and drug addicts inject or ingest their drugs. Which of the following statements best describes why nurses don't simply focus on helping persons who engage in poor health behaviors to behave appropriately? a. Addicts don't have the willpower to change their behavior. b. It is too rewarding to continue the behavior for a person to be able to change. c. Laws and policies must reward good healthy behaviors and punish unhealthy behaviors to help individuals recognize the importance of change. d. Society must offer healthy choices, offer support, and practice helpful policies.
d. Society must offer healthy choices, offer support, and practice helpful policies.
A nurse is working with a family to reduce the incidence of home violence. Which of the following actions by the nurse would most likely have a positive effect? a. Being assertive and taking control of decisions because family members cannot be expected to have this ability b. Focusing attention on family weaknesses that need to be fixed before healing can begin c. Pointing out things that victims should do differently to avoid antagonizing the abuser d. Soliciting ideas from the family regarding what they feel will improve their situation
d. Soliciting ideas from the family regarding what they feel will improve their situation
Which of the following is the most common disabling condition when measured by days away from work? a. Bruises b. Cuts and lacerations c. Mental illnesses d. Sprains and strains
d. Sprains and strains
The nurse is trying to determine if a disease occurrence needs to be reported to the state health department. Which of the following resources should the nurse use to answer this question? a. Centers for Disease Control and Prevention Weekly Report b. Communicable Diseases Weekly Report c. Nationally notifiable infectious diseases on the CDC website d. State health department website
d. State health department website
A large financial grant was being offered to whichever health facility wanted to accept the responsibility for giving care to local vulnerable populations. Which of the following actions would most likely be taken by the local medical centers? a. Agree to collaboratively apply for the funds in a cooperative proposal. b. Individually compete eagerly for the additional funds now available. c. Reach out enthusiastically to this previously underserved population group. d. Strongly consider not applying, because this population will be expensive to treat.
d. Strongly consider not applying, because this population will be expensive to treat.
Which of the following would confirm that the nurse's advocacy has been truly successful or effective? a. Audiences agree with the nurse who is serving as advocate. b. Legislators discuss appropriate legislation to better allocate resources. c. People verbalize that the disenfranchised should be better treated. d. Systematic social changes are made to improve quality of life.
d. Systematic social changes are made to improve quality of life.
A nurse is meeting to discuss problems and solutions with a group of teenagers who have been newly diagnosed with diabetes. One teenager states, "My mom found this particular brand of popcorn that has only 15 carbohydrates in the whole giant bag." Which of the following best describes the group purpose that is being served by the teenager's statement? a. Maintenance function of encouraging everyone to continue the discussion b. Maintenance function of helping everyone feel comfortable talking about food c. Task function of resolving problems about what to nibble during movies d. Task function of sharing information and resources
d. Task function of sharing information and resources
During which of the following activities is the nurse in community health acting as a partner in change? a. Administering vaccinations to preschoolers b. Analyzing community problems to determine the best interventions c. Establishing an elder-care center for older adults living with family members who work d. Teaching anger management skills to a group of teens in a halfway house
d. Teaching anger management skills to a group of teens in a halfway house
An IV drug abuser admits to the nurse he has no desire to stop using drugs, so rather than lecture the individual on the dangers of drug addiction, the nurse provides information how to sterilize his needles. Which of the following prevention efforts is the nurse attempting to achieve? a. Primary prevention by educating about safe injections b. Primary prevention by avoidance of future legal complications c. Secondary prevention to reduce the risk for infection or other complications d. Tertiary prevention to reduce the transmission of blood-borne diseases
d. Tertiary prevention to reduce the transmission of blood-borne diseases
A nursing student during World War II would likely join which group? a. The Public Health Service of New York City b. The Marine Nurse Corps c. The Frontier Nursing Service d. The Cadet Nurse Corps
d. The Cadet Nurse Corps
Which of the following do community-based nurses typically use to organize, sort, and document pertinent client data? a. NANDA b. NIC & NOC c. Nursing Diagnosis Taxonomy d. The Omaha System
d. The Omaha System
Students at first-day orientation at the local community college are discussing alcohol and drug abuse with their freshmen advisor. During a break, some students go outside for soft drinks and snacks. Soon after, the advisor walks by and notices several of these students smoking cigarettes. Based on this, which of the following topics of the drug and alcohol orientation would be most important for the advisor to reemphasize after the break? a. A discussion of which drugs are commonly used on campus b. How students can learn to "just say no" when offered drugs or drinks c. How to recognize and overcome peer pressure to continue bad habits d. The fact that tobacco smoking causes more premature deaths than any other behavior
d. The fact that tobacco smoking causes more premature deaths than any other behavior
Between 2010 and 2015, 1000 of 10,000 young women age 17 to 20 years at a university tested positive for a sexually transmitted infection (STI). Of the 1000 diagnosed STIs, 300 were gonorrhea and 500 were chlamydia. Which of the following statements best summarizes these findings? a. The proportion of cases of gonorrhea to all STIs was 300:1300. b. The proportion of cases of gonorrhea to chlamydia was 300:500. c. The proportion of cases of gonorrhea to all STIs was 50%. d. The proportion of STIs to the total population was 100:1000.
d. The proportion of STIs to the total population was 100:1000.
In which of the following scenarios is a family member enabling an individual to continue to abuse alcohol? a. The husband asks the nurse to explain why his wife's continued drinking is dangerous. b. The son threatens to leave home because he finds the father's behavior embarrassing. c. The teenage daughter of an alcoholic turns to a favorite teacher for emotional support. d. The wife tells her husband's boss that her husband is sick when he is actually inebriated.
d. The wife tells her husband's boss that her husband is sick when he is actually inebriated.
An occupational health nurse sees the various injuries and diseases that persons can acquire from employment. Which of the following recommendations would the nurse most likely provide about safety in the workplace? a. Find employment in physical labor; at least your body will be in good condition. b. Professional positions are the safest choice for employment. c. White collar positions provide the least risk for injury. d. There is no "safe" occupation or profession.
d. There is no "safe" occupation or profession.
An employer provides a migrant farm family the day off to visit the health clinic in a nearby community and tells them to take all of the time they need. However, the family arrives at the clinic appearing very stressed. In addition to the health issue, which of the following would most likely be a fear experienced by the family? a. Their personal belongings may be stolen while they are at the clinic. b. Immigration officials will send them back to their home country. c. The clinic personnel will look down on them and be biased against them. d. They weren't getting paid for that day, and continued employment is nevercertain.
d. They weren't getting paid for that day, and continued employment is nevercertain.
A teacher recommends that surveys to obtain data on drug use be given to high school students when they meet for various school organizations. Which of the following best describes why the nurse would reject this suggestion? a. This method of data collection would result in classification bias. b. This method of data collection would result in confounding bias. c. This method of data collection would result in personal bias. d. This method of data collection would result in selection bias.
d. This method of data collection would result in selection bias.
A nurse is planning an educational program about cardiovascular disease. Which of the following would be the optimal time for the nurse to elicit feedback from program participants? a. At the beginning of the program b. At the program midpoint c. Immediately following program completion d. Throughout the program
d. Throughout the program
A hospital nurse wants to know why home health nurses often take more time with assessment than nurses do in the hospital. Which of the following is the best explanation for this? a. Home care assessment includes not only the client but also the supplies and equipment the family may have available for use. b. The home environment is less organized and equipped for the nurse's use. c. Family members must also be assessed for possible problems that could interfere with the primary client's recovery. d. To be effective, the home health nurse must earn the family's trust and work in partnership with them.
d. To be effective, the home health nurse must earn the family's trust and work in partnership with them.
The occupational health nurse suggests that an employee work only half-days for three weeks and then return to full-time employment. Which of the following best describes the rationale for this suggestion? a. To provide an example to other employees to ensure future cooperation with safety measures b. To enforce an economic penalty for not obeying nurse's instructions regarding safety measures c. To ensure that all employees keep their positions during an economic downturn d. To continue employment and income with limited duty as a rehabilitation effort after an injury
d. To continue employment and income with limited duty as a rehabilitation effort after an injury
During the assessment phase, the nurse compiles and interprets available data and draws conclusions as to the community's strengths and concerns. Which of the following best describes why the nurse would also conduct interviews with key informants? a. To ensure that others agree with the nurse's plans for interventions b. To confirm the nurse's initial findings and conclusions c. To encourage community partners to feel they "own" the data d. To generate non-statistical data such as values, beliefs, and perceived needs
d. To generate non-statistical data such as values, beliefs, and perceived needs
A public health nurse is involved in health care reform. Which of the following best explains why the nurse is involved in these efforts? a. To promote the nursing profession b. To increase funding for public health nursing c. To address the concerns of nurses d. To help improve health care access
d. To help improve health care access
As the single occupational health employee at a company, a nurse is busy with safety programs and first aid when employees are hurt. However, the nurse still finds time to walk through the entire facility once a day. Which of the following best explains the rationale for this action by the nurse? a. To document employee efficiency and effectiveness at their jobs b. To look for evidence of personal protective equipment being torn or destroyed c. To observe whether employees are taking their rest periods as scheduled and drinking adequate fluids during the day d. To observe effectiveness of safety education and equipment
d. To observe effectiveness of safety education and equipment
Which of the following best describes the goal or priority of the nurse advocate? a. To gain organizational and governmental support for the promotion of nursing objectives b. To improve community service needs identified by research findings c. To integrate evidence-based practice guidelines in the provision of community nursing service d. To promote the client's rights and self-determination
d. To promote the client's rights and self-determination
Before beginning to survey the community to assess its health needs and strengths, the nurse reviews various documents, including local statistical data and the minutes of the previous meeting of the health care agency. Which of the following best explains why the nurse would start with this activity? a. To avoid confronting the community until the nurse is thoroughly oriented b. To become familiar with previous goals and priorities of the agency c. To help get a better understanding of the assigned community d. To save time and effort and perhaps have new insights
d. To save time and effort and perhaps have new insights
A new client has just been released from the hospital after intensive treatment for multiple injuries following a motorcycle accident. Which of the following types of care will the client most likely receive? a. Home-based primary care b. Population-focused home care c. Proprietary home care d. Transitional care
d. Transitional care
A nurse is implementing a tertiary prevention strategy related to pesticide exposure. Which of the following activities would the nurse complete? a. Observe farmworkers for evidence of unsafe handling of pesticides. b. Provide teaching on how to handle pesticides to avoid or decrease exposure. c. Teach farmworkers how to recognize signs and symptoms of pesticide poisoning. d. Treat a client who has pesticide exposure to prevent complications.
d. Treat a client who has pesticide exposure to prevent complications.
A nurse is assessing the structure of a community's health. Which of the following data will the nurse examine? a. The community's commitment to health b. Health-risk profiles of selected aggregates c. Statistics of morbidity and mortality in comparison with similar communities d. Treatment and service use patterns from local health agencies and care providers
d. Treatment and service use patterns from local health agencies and care providers
Which of the following is the dominant issue in ethical debate around an issue such as continuing or withdrawing treatment in acute health care? a. Doing what is best for the community b. Doing what is best for the family c. Obeying legal mandates d. Upholding ethical principles
d. Upholding ethical principles
Some nurses are debating about the appropriate action to take in relation to a particular family. One member of the family is ill, and the other family members have chosen to continue working rather than take time off to care for the ill family member. One nurse states, "The whole family is being affected and will fall apart if they don't focus on their family's needs first before anything else." Which of the following ethical approaches is being used by this nurse? a. Communitarianism b. Deontology c. Principlism d. Utilitarianism
d. Utilitarianism
A nurse has only a regular blood pressure cuff when conducting a health screening for all of the residents of a community. Which of the following may be lacking when obtaining blood pressure readings? a. Reliability b. Sensitivity c. Specificity d. Validity
d. Validity
A nurse is counseling a woman following a rape. Which of the following feelings is the woman most likely to state she felt while being raped? a. Confusion b. Satisfaction c. Sexual release d. Victimization
d. Victimization
A health care provider refuses to order pain medication for a drug addict who has been severely injured in a car accident. When reminded by nurses that pain medication has not been ordered, the provider merely replies that the patient's suffering from the pain of his injuries will build character and that the addicted patient needs to get off drugs. Which of the following ethical theories is being using (or misusing)? a. Consequentialism b. Communitarianism c. Deontological ethics d. Virtue ethics
d. Virtue ethics
Which of the following terms is used to describe aggregates who are at high risk for having poor health outcomes because of limited resources? a. Disadvantaged families b. Multi-problem families c. Resilient populations d. Vulnerable populations
d. Vulnerable populations
A nurse is examining the various factors that lead to disease and suggesting several areas where nurses could intervene to reduce future incidence of disease. Which of the following models would the nurse most likely use? a. Epidemiologic triangle b. Health promotion c. Levels of prevention d. Web of causality
d. Web of causality
A nurse orienting to the home health role states, "I don't understand why we have to collaborate with so many other disciplines; this conflicts with the concept of nurses providing all direct care to the client in the home?" Which of the following would be the best response? a. The nurse still provides direct care for the client; however, interdisciplinary collaboration is necessary to prevent fragmentation of care. b. Direct nursing care is a concept applied to care in tertiary facilities, such as hospitals, where materials are centrally located in one facility. In home health, this is not possible. c. Even though home health nursing does not provide as much direct care as other nursing specialties in the community, each discipline contributes to client needs from its special knowledge base. d. Yes, it does create conflict, but Medicare mandates interdisciplinary collaboration.
d. Yes, it does create conflict, but Medicare mandates interdisciplinary collaboration.
