Community Exam #3

d.) Federally funded breakfast and lunch program. The school nurse has several federal resources available to assist children in need. The nurse must be able to recognize children and families that may be eligible for assistance. Options A, B, and C are not appropriate referrals for a child in the specified situation. NET focuses on healthy nutritional choices and health promotion and disease prevention topics in school and child care settings. The Youth Risk Behavior Surveillance System identifies and trends youth risk behavior. Adult and Child Protective Services assess and protect children from abuse.

A 10-year-old boy visits the nurse complaining of a headache and nausea. The nurse recognizes the boy from an earlier conference with a teacher about the boy's declining school performance. The nurse has been concerned because the boy's father and mother are recently divorced, and his mother works nights. An appropriate nursing intervention would be to investigate the boy's eligibility for a.) The Nutritional Education and Training Program (NET). b.) Youth Risk Behavior Surveillance System. c.) Adult and Child Protective Services. d.) Federally funded breakfast and lunch program.

b.) refer the child to an eye specialist. The role of the nurse in a school-based health center includes vision, hearing, and scoliosis screening and first-aid and medication administration, but the nurse should refer the individual to an appropriate specialist for diagnosis and treatment.

A 6-year-old child fails a routine vision screening on a Snellen chart at a school-based health center. The appropriate action by the nurse is to a.) rescreen the child in the following year. b.) refer the child to an eye specialist. c.) use a Rosenbaum chart instead of a Snellen chart. d.) do an internal ophthalmologic examination.

c.) physical examinations and comprehensive health history. The eight components of a comprehensive school health program are health education, physical education, health services, nutrition services, counseling, psychological and social services, healthy school environment, health promotion for staff and family, and community involvement. Physical examinations and comprehensive health history are not included.

A comprehensive school health program should include all except a.) health promotion for staff and health education. b.) health services and health education. c.) physical examinations and comprehensive health history. d.) nutrition services and counseling.

b.) displaced persons. Displaced persons are those who have to evacuate their home, school, or business as a result of a disaster. An indirect victim may be a family member or friend of the victim or a first responder. A mass casualty event is one in which 100 or more individuals are involved. Poverty is not considered a disaster classification.

A family of five people presented to a hospital after the flooding of their urban home. These family members are classified as a.) poverty victims. b.) displaced persons. c.) indirect victims. d.) mass casualties.

a.) lack of physical activity. b.) poor nutrition. c.) alcohol and drug use. e.) injury and violence. An objective of Healthy People 2020 sets a goal that middle, junior, and senior high schools provide health education courses in priority areas. Centers for Disease Control and Prevention (CDC) (2012a) identified six high-risk behaviors that need to be targeted in health education courses. The six behaviors identified by the CDC include (1) alcohol and drug use, (2) injury and violence (including suicide), (3) tobacco use, (4) poor nutrition, (5) lack of physical activity, and (6) sexual behavior that results in sexually transmitted diseases or unwanted pregnancies.

A goal set by Healthy People 2020 includes education to middle, junior, and senior high school students in priority areas. These areas include (Select all that apply.) a.) lack of physical activity. b.) poor nutrition. c.) alcohol and drug use. d.) poor organizational skills. e.) injury and violence.

b.) The student accepts a referral to a substance abuse counselor. Having a substance abuse problem does not mean that problems are always attributable to the addiction. An evaluation for other problems such as mental illness and depression should be conducted, with specialized attention involving a case management approach. Research demonstrates that treatment for substance abuse can be more effective than no treatment. The other goals may be appropriate but not the most desirable.

A high school student is referred to the school nurse for suspected substance abuse. After the nurse's assessment and interventions, what would be the most desirable outcome? a.) The student discusses conflicts over drug use. b.) The student accepts a referral to a substance abuse counselor. c.) The student agrees to inform his parents of the problem. d.) The student reports increased comfort with making choices.

b.) reservoir, mode of transmission A pathogen lives and multiplies in the reservoir and transfers from one host to another by a mode of transmission.

A pathogen lives and multiplies in a __________ and transfers from one host to another by a __________. a.) host, susceptible portal of entry b.) reservoir, mode of transmission c.) infectious agent, portal of exit d.) mode of transmission, reservoir

a.) schoolyard safety. Schoolyard injury accounts for 200,000 injuries yearly and is one of the greatest health concerns for elementary children. Motor vehicle safety should be included in programs for adolescents who are beginning to drive. Sports safety is particularly important among adolescents as participation in sports continues to grow, especially among girls. Immunization schedules are an important topic of education for parents of younger children and babies.

A priority health education topic for school-age children is a.) schoolyard safety. b.) motor vehicle safety. c.) sports safety. d.) immunization schedules.

a.) A flyer advertising an ice cream and pizza party for the student awards program School nurses facilitate positive student responses to normal development; promote health and safety, including a healthy environment; intervene with actual and potential health problems; provide case management services; and actively collaborate with others to build student and family capacity for adaptation, self-management, self-advocacy, and learning.

A school nurse evaluates the implementation of health promotion in a high school staff. Which indicates a need for more education? a.) A flyer advertising an ice cream and pizza party for the student awards program b.) Condoms being provided in all restrooms of the school c.) A decrease in missed days at school d.) The discontinuation of the availability of soft drinks and candy in vending machines during school instructional hours

b.) in an emergency. School health records are confidential, and without permission, releasing them is unethical and improper unless in an emergency.

A school nurse knows that under the Family Educational Rights and Privacy Act, a student's health record can be released a.) if the student is not a minor. b.) in an emergency. c.) to educators not involved in the student's education. d.) without the student's or guardian's permission.

b.) Vicodin. As of 2015, 4.4% high school seniors reported past-year nonmedical use of the prescription pain reliever hydrocodone (Vicodin), 3.7% reported abusing oxycodone (OxyContin), 7.7% reported use of amphetamines, and 7.5% reported misuse of Adderall—making these medications among the drugs most commonly abused by adolescents.

A survey done by The National Institute on Drug Abuse (NIDA) found that the most commonly abused prescription drug among high-school seniors is a.) OxyContin. b.) Vicodin. c.) Xanax. d.) codeine.

c.) frequent requests for a visit to the school nurse. Problems eating or sleeping, use of alcohol or other substances, problems making decisions, persistent angry or hostile feelings, inability to concentrate, increased boredom, frequent headaches or ailments, and inconsistent school attendance are all warning signs of stress. The nurse should be aware that these symptoms can negatively affect an adolescent's mental and physical health, and the student should be screened for depression and suicide.

A week before finals, a school nurse assesses a 15-year-old girl complaining of vague symptoms. All symptoms or behaviors should result in an immediate request for parent or guardian conference and referral to a physician for further evaluation except a.) problems eating or sleeping. b.) problems making decisions. c.) frequent requests for a visit to the school nurse. d.) inability to concentrate.

c.) youths and young adults. e.) international markets. The tobacco industry has now started targeting youths and dramatically increased international exports. Tobacco sales among American adults is down.

After the implementation of various policies to reduce tobacco use, the tobacco industry has begun targeting (Select all that apply.) a.) elderly people. b.) Hispanics. c.) youths and young adults. d.) African Americans. e.) international markets.

a.) a younger workforce. Escalating health care cost, increased women and minorities in the workforce, and a competitive international marketplace all contribute to the challenges of occupational health nursing practice. In addition, an aging workforce also presents a challenge.

All are challenges currently facing occupational health nursing practice except a.) a younger workforce. b.) escalating health care cost. c.) increased number of women and minorities in the workforce. d.) influence of a competitive international marketplace.

d.) the client is without a job. The diagnosis of substance abuse includes the continued use of a substance despite the consequences; putting oneself or others in danger because of substance use; or substance use interfering with one's major role obligations, such as family, work, and friends.

All outcomes may contribute to the diagnosis of substance abuse except a.) the substance use has placed someone in danger. b.) the individual uses the substance despite negative consequences. c.) the substance use interferes with the ability to function at work or at home. d.) the client is without a job.

a.) recognize the need to work as a part of an interdisciplinary team. As workplaces have continued to change over the past few decades, the role of the occupational health nurse had become even more diversified and complex. It is essential that the occupational health nurse functions as a part of an interdisciplinary team collaborating with workers, employers, and other professionals to identify health needs, prioritize interventions, develop and implement programs, and evaluate services delivered.

An essential strategy to deal with the complexities of the workplace and workforce is for the occupational health nurse to a.) recognize the need to work as a part of an interdisciplinary team. b.) seek legal counsel to stay informed of the legislative mandates influencing the workforce. c.) engage in political action in order to have input into the revision of the Healthy People 2020 document. d.) participate in program planning to develop a model to ensure advanced education for all workers.

a.) use of violence to handle disputes. Adolescents and children increasingly use violence to settle disputes. Children are often not taught peaceful ways of resolving differences and learn by what they observe at home, on television, in video games, and in movies. Consequently, schools have become a common site for violence. The reasons for violence are complicated and multilayered, but the most common reason cited is use of violence to handle disputes.

As a school nurse, you know the leading reason cited as the cause of school violence is a.) use of violence to handle disputes. b.) an unhappy home life. c.) overly protective parental situations. d.) poor communication with authority figures.

d.) remain outside if you hear sounds of fighting in a home. When approaching a home, as a community health nurse, you should notice the environment, animals, fences, activities, possible indicators of crime, and places you could go for assistance if necessary. Walk with confidence and maintain a professional attitude. Listen for signs of fighting before knocking. If you hear sounds of fighting, leave. Do not enter a home if you suspect an unsafe situation.

As a visiting community health nurse, you must take precautions to avoid unsafe situations. To avoid putting yourself in danger, you would a.) enter a house where a violent act is occurring and call 911. b.) expect the client to control angry family members. c.) always carry a concealed weapon. d.) remain outside if you hear sounds of fighting in a home.

Protective Factors: • Effective clinical care for mental, physical, and substance abuse disorders • Easy access to a variety of clinical interventions and support for help seeking • Family and community support (connectedness) • Support from ongoing medical and mental health care relationships • Skills in problem solving, conflict resolution, and nonviolent ways of handling disputes • Cultural and religious beliefs that discourage suicide and support instincts for self-preservation Risk Factors: • Family history of suicide • Family history of child maltreatment • Previous suicide attempt(s) • History of mental disorders, particularly clinical depression • History of alcohol and substance abuse • Feelings of hopelessness • Impulsive or aggressive tendencies • Cultural and religious beliefs (e.g., belief that suicide is noble resolution of a personal dilemma) • Local epidemics of suicide • Isolation, a feeling of being cut off from other people • Barriers to accessing mental health treatment • Loss (relational, social, work, or financial) • Physical illness • Easy access to lethal methods • Unwillingness to seek help because of the stigma attached to mental health and substance abuse disorders or to suicidal thoughts

BOX 25.3 Suicide: Protective Factors and Risk Factors?

Seek help as soon as possible by contacting a mental health professional or by calling the National Suicide Prevention Lifeline at 1-800-273-TALK if you or someone you know exhibits any of the following signs: • Threatening to hurt or kill oneself or talking about wanting to hurt or kill oneself • Looking for ways to kill oneself by seeking access to firearms, available pills, or other means • Talking or writing about death, dying, or suicide when these actions are out of the ordinary for the person • Feeling hopeless • Feeling rage or uncontrolled anger or seeking revenge • Acting reckless or engaging in risky activities—seemingly without thinking • Feeling trapped—like there's no way out • Increasing alcohol or drug use • Withdrawing from friends, family, and society • Feeling anxious, agitated, or unable to sleep or sleeping all the time • Experiencing dramatic mood changes • Seeing no reason for living or having no sense of purpose in life

BOX 25.4 Warning Signs of Suicide?

a.) reach almost 10 billion. The world's population soared to 4 billion between 1960 and 1974 and then to 5 billion between 1974 and 1987. In 1999, the world population was 6 billion; in 2016, it was 7.4 billion. The population is projected to reach 8 billion by 2025 and 9.8 billion by midcentury.

By the middle of the 21st century, the world population is expected to a.) reach almost 10 billion. b.) reach 8 billion. c.) be largely unchanged from the 20th century. d.) show a slight decline.

a.) weapons of mass destruction. Weapons of mass destruction refer to any weapon that is designed or intended to cause death or serious bodily injury through release, dissemination, or impact of toxic or poisonous chemicals or their precursors. Chemical warfare agents are classified as nerve agents, vesicants, pulmonary agents, and cyanides.

Chemical warfare agents such as pulmonary agents and cyanides are classified as a.) weapons of mass destruction. b.) computer-based attack weapons. c.) recovery agents. d.) prevention medications.

d.) neglect. Neglect is the failure of the responsible person to provide basic needs such as shelter, food, clothing, education, and access to medical care; permitting the child to use drugs/alcohol; and inattention to the child's emotional needs. The other options are types of abuse.

Child maltreatment that allows the child to use drugs and alcohol is an example of a.) sexual abuse. b.) physical abuse. c.) psychological abuse. d.) neglect.

d.) Suffering chronic fatigue and tension When subject to repeated abuse, the victim experiences a variety of responses, including shock, denial, confusion, withdrawal, psychological numbing, and fear. He or she lives in anticipatory terror and experiences chronic fatigue and tension, disturbed sleeping and eating patterns, and vague gastrointestinal and genitourinary complaints. The other options are not symptoms of chronic violence.

Chronic stress characterizes the lives of people living with domestic violence. As the community health nurse, you recognize which as a long-term effect of violence? a.) Spontaneous disclosure of abuse to health care provider b.) Not complaining of physical symptoms c.) Having disturbed eating patterns, but sleeping well d.) Suffering chronic fatigue and tension

Schizophrenia -Most debilitating Depression -Most common illness Bipolar Disorders Anxiety Disorders Eating Disorders Attention-Deficit Hyperactivity Disorder Suicide

Common mental illnesses in community setting?

National Alliance for the Mentally Ill (NAMI)- advocacy group -Lobby on capitol hill big driver for mental health initiatives -Support them Substance Abuse and Mental Health Services Administration (SAMHSA) -Gov organization -Administer programs and provide funding to mental health organizations Mental Health America (MHA) -Don't need to know National Institute of Mental Health (NIMH) -Research gov organization -Specific departments related to alcohol and drug abuse U.S. Department of Veterans Affairs National Center for PTSD -Can be a significant issue in regards to mental illness -Research, funding, for PTSD

Community-based Mental Health?

Initiation: First use of the substance Exposure frequently occurs through family or friends Continuation: Continued, more frequent use of substance Usually social use only, with no detrimental effects Transition: Beginning of change in total consumption, frequency, and occasions of use More than just social use, with beginning of loss of control Abuse: Adverse effects and consequences of substance use -Rationalizations for continued use and denial of adverse effects present in user and significant others -Unsuccessful attempts at control of use Dependency and addiction: Physical or psychological dependency, or both, on the substance; marked by behavioral and cognitive changes -Preoccupation with the substance and its procurement, despite negative consequences -Narrowing of interests, social activities, and relationships to only those related to the substance use

Course of Addictive Illness: Table 27.2 Substance Abuse?

Legalization- fully legalizing illicit substances or changing controlled substance classification -No consequences at all; let everyone run free Decriminalization- stays illegal but criminal prosecution does not occur when caught with the substance -Still illegal but just not arresting and incarcerating people for it -Larger amounts still prosecute like for drug dealers Supporters- Reduction in crime and decrease stigma, taxes on sales -If legal can make money off of taxes Opposition- criminal penalties deter use, less access results in fewer new users

Debate: Legalization vs decriminalization?

d.) give the immunizations. A low-grade fever is not a contraindication to immunizations. The nurse should give the immunizations. It is not necessary to contact the child's pediatrician. Vaccination should be postponed in cases of moderate or severe febrile illness to avoid any confusion between a vaccine side effect and an unknown underlying cause.

Four-month-old Lucy is in for immunizations at the local health department. The Vaccine Information Sheet is given to Lucy's mother, and informed consent is obtained. However, the mother then states, "Lucy did have a temperature around 99.1 degrees the night of her last immunizations." After this statement, the nurse should a.) consult the child's pediatrician. b.) delay the immunizations. c.) do not give the immunizations because of the contraindication. d.) give the immunizations.

d.) cardiovascular accidents, stroke, and diabetes. Healthy People 2020 does not address cardiovascular accidents, stroke, or diabetes in its objectives for children and adolescents. The other options are addressed.

Healthy People 2020 addresses all goals for children and adolescents except a.) physical activity. b.) sex education and HIV prevention. c.) smoking prevention. d.) cardiovascular accidents, stroke, and diabetes.

Influences on alcohol use- drinking increased during World Wars, decreased during Great Depression and Prohibition, legal drinking age went from 21 to 18(60-70s) back to 21 (late 80s), criminal activity- driving under the influence, federal agencies- National Institute on Alcohol Abuse and Alcoholism, Bureau of Alcohol, Tobacco, Firearms and Explosives -Criminal alcohol use- drinking and driving --Blood alcohol level to operate certain machinery; federal government implemented and threatened to withhold funding for road improvement if all states didn't put a BAC % in each state Influences on illicit drug use- 70s counterculture- avoided alcohol used hallucinogens, marijuana and heroin instead, Anti-Drug Abuse Acts of 1986 and 1988 increased funding for treatment and eradication efforts (AKA War of Drugs), current funding for research and enforcement to multiple federal agencies- SAMHSA, National Institute on Drug Abuse, Drug Enforcement Agency -War on drugs disparity: much larger portion of african american males who are caught with marijuana and institutionalized for it SAMHSA also helps drug abuse with mental health

History Lesson on Alcohol/Illicit Drug use?

b.) Betty Moulder was employed by a group of companies to care for coal miners and their families. c.) Ada Mayo Stewart was hired by the Vermont Marble Company to care for the company's workers. d.) A nursing service was established for employees of the Frederick Loeser department store in Brooklyn, New York. e.) Anna B. Duncan was employed by the John Wanamaker Company to visit sick employees at home. Occupational health nursing dates to the late 1800s with the employment of Betty Moulder by a coal mining company and Ada Mayo Stewart by a marble company. After that, the Fredrick Loeser department store hired a nursing service for employees and Anna B. Duncan was employed by the John Wanamaker Company to visit sick employees at home. Lillian Wald was instrumental in the development of public health nursing.

Important historical events leading to the development of occupational health nursing as a specialty practice include: (Select all that apply.) a.) Lillian Wald, the first public health nurse, established the Visiting Nurse Service of New York. b.) Betty Moulder was employed by a group of companies to care for coal miners and their families. c.) Ada Mayo Stewart was hired by the Vermont Marble Company to care for the company's workers. d.) A nursing service was established for employees of the Frederick Loeser department store in Brooklyn, New York. e.) Anna B. Duncan was employed by the John Wanamaker Company to visit sick employees at home.

Prevention: -What community factors promote starting substance use -Resources available to put primary prevention strategies in place -Fiscal resources to law enforcement, crop eradication, punitive laws for drug users and manufacturers Treatment- Harm Reduction- approaches to treatment of substance abuse that are not aimed at abstinence -Incremental changes -Elimination of harmful effects- infection, unwanted pregnancy, overdose, death -Examples- methadone for heroin, needle exchanges, dispensing naloxone, breathalyzer to activate care, special license plates for DUI --Safe consumption spaces, party plates- license plates for DUI can let police pull them over at any time with no probable cause

Interventions for Substance Abuse?

b.) Secondary prevention Secondary prevention includes the investigation of contacts to sexually transmitted disease cases. Secondary prevention includes activities to ensure early detection of infection and effective treatment of persons who are infected. Not only does this prevent progression of the infectious disease, but it also prevents transmission of the pathogen to others. Primary prevention of communicable diseases involves measures to prevent transmission of an infectious agent and to prevent pathology in the person exposed to an infection. Tertiary prevention includes activities involved in caring for persons with an infectious disease to ensure that they are cured or that their quality of life is maintained.

Investigating all contacts of a person infected with a sexually transmitted disease is an example of what? a.) Primary prevention b.) Secondary prevention c.) Tertiary prevention d.) Initial prevention

c.) indirect. The stem of the question indicates that the children played with the same toys. This would indicate the indirect mode of transmission. The other modes of transmission do occur through the sharing of toys.

Katie, a 2-year-old child, is brought to the doctor's office after 2 days of vomiting and diarrhea. Upon completion of the medical history, the mother tells the nurse that several of the other children at the daycare who played with the same toys as Katie have the same symptoms. The mode of transmission for the pathogen more likely was a.) vector. b.) direct. c.) indirect. d.) airborne.

Community health nurses will encounter many clients that have mental illness. 50% of the U.S. population will have a mental illness during their lifetime. -Big issue!! Access to mental health treatment is important to the health of a community. -Access is key to the health of the community The community health nurse must be familiar with common mental disorders to ensure they can assess the community and plan for needed services. -Have to know different disorders, symptoms, treatment -To make sure have right services in place -Clinic: weekly injections? Need to know if they need transportation Community health nurses may provide a variety of prevention strategies to prevent or mitigate mental disorders in various aggregates. -Primary, secondary, tertiary Community health nurses must be aware of organizations and resources to assist community members in managing mental illness.

Key Points for Mental Health Chapter?

b.) Occupational Safety and Health Act. The Occupational Safety and Health Act was enacted in 1970. The general clause of the Act states that employers must "furnish a place of employment free from recognized hazards that are causing or likely to cause death or serious physical harm to employees." The Act also identified the role of various government agencies such as the Occupational Safety and Health Administration under the jurisdiction of the Department of Labor.

Legislation passed in 1970 that requires employers to provide a place of employment free from recognized hazards to the employees is correctly referred to as the a.) Americans with Disabilities Act. b.) Occupational Safety and Health Act. c.) Workers' Compensation Act. d.) Occupational Health and Safety Administration.

1960s- Community Mental Health Centers Act- deinstitutionalization 1980s- States develop plans to care for serious mental illness -More funding, crisis centers become available 1999- Mental illness acknowledged as disease 2008- Insurance coverage for mental health and substance use conditions -People might have medical insurance but might not get mental help with it -Supposed to have same coverage for 2010- ACA- provides protection for preexisting conditions Proposed legislation- H.R.7666 - Restoring Hope for Mental Health and Well-Being Act of 2022 Passed house 6/22/22

Mental Health Care History?

Goal: Improve mental health Increase the proportion of people with substance use and mental health disorders who get treatment for both — MHMD‑07 -Screened for depression Increase the proportion of primary care visits where adolescents and adults are screened for depression — MHMD‑08 -Once we have identified the illness, need to provide support Increase the proportion of adolescents with depression who get treatment — MHMD‑06 Increase the proportion of children with mental health problems who get treatment — MHMD‑03 Increase the proportion of children and adolescents who get preventive mental health care in school — EMC‑D06 -Teaching coping mechanisms, life skills, stress reduction

Mental Health- Healthy People 2030?

c.) Most mental illnesses are caused by genetic factors; therefore, problems associated with them persist across generations and among certain racial and ethnic groups. Although genetic factors most likely contribute to some mental illnesses and in some individuals there is little information linking a specific gene to a specific disorder. Rather, the major psychiatric disorders are complex, and mental illnesses appear to result from a very complex interaction among neurochemical and metabolic changes and environmental and situational factors. The other statements are all true.

Mental illnesses adversely affect achievement of social justice. Which statement related to marginalization of some populations because of mental illness is false? a.) About half of all inmates in jails and prisons have mental health problems. b.) Mental illnesses can lead to employment difficulties, which adversely affects access to health insurance, thereby limiting treatment options. c.) Most mental illnesses are caused by genetic factors; therefore, problems associated with them persist across generations and among certain racial and ethnic groups. d.) Both natural and human-made disasters can adversely affect mental health; those with limited resources appear to be more directly impacted, and the effects persist longer.

b.) "Mental illness is a disease with biopsychosocial causes that are not the patient's fault." Mental illness is a medical condition that is caused by biopsychosocial attributions that are not the patient's fault nor caused by the patient's behavior.

Mr. B has been diagnosed with a severe mental illness. He tells the nurse that his family says his disorder is his own fault and is because of his laziness. Which reply by the nurse is accurate? a.) "Lazy people are more prone to mental illness." b.) "Mental illness is a disease with biopsychosocial causes that are not the patient's fault." c.) "Most people are unsupportive of family members with mental illness." d.) "It would really help your situation if you got over the stigma associated with mental illness."

c.) Behavioral therapy Behavioral therapy uses learning principles to change thought patterns and behaviors systematically; it is used to encourage the individual to learn specific skills to obtain rewards and satisfaction. Individual therapy focuses on the client's current life and relationships within the family, social, and work environments. Couple therapy is used to develop the relationship and minimize problems through understanding how individual conflicts are expressed in the couple's interactions. Family therapy involves problem-solving sessions with members of a family.

Mr. H is a patient in the primary care center where you work as a staff nurse. He tells you that he is currently participating in a type of therapy that helps patients change behaviors. You know that Mr. H is describing which type of therapy? a.) Individual therapy b.) Couple therapy c.) Behavioral therapy d.) Family therapy

b.) depression. Depression is often a complication of serious physical disorders such as heart attack, stroke, diabetes, and cancer. The other options are usually not complications of other physical disorders.

Mr. S was recently hospitalized for a stroke. While in the hospital, he was also diagnosed with diabetes. As his nurse, you know he is at risk for a.) panic disorder. b.) depression. c.) schizophrenia. d.) bipolar disorder.

a.) Schizophrenia Diagnostic criteria for schizophrenia are two or more of (each present for a significant portion of a 1-month period): delusions, hallucinations, disorganized speech (e.g., frequent derailment or incoherence), grossly disorganized or catatonic behavior, or negative symptoms (e.g., affective flattening, alogia, avolition).

Mr. T has been admitted to the mental health floor for evaluation. You, the nurse, note that he has displayed hallucinations, disorganized thinking and speech, and bizarre behavior. He has a flat affect, lack of energy, and poor attention. You know that these are symptoms of what disorder? a.) Schizophrenia b.) Depression c.) Anxiety d.) Panic disorder

a.) "My medication will cure me of my depression." Psychotherapeutic medications do not cure mental illness; rather, they act by controlling symptoms. The other statements are correct.

Ms. L is being treated for depression. Which statement by her indicates a need for further education? a.) "My medication will cure me of my depression." b.) "A side effect of my medication (Prozac) may be gastrointestinal upset." c.) "I need to keep my follow-up appointment for medication management." d.) "I should not stop taking my medication without checking with my doctor first."

b.) attention-deficit disorder/attention-deficit hyperactivity disorder (ADD/ADHD). The reported symptoms best fit ADD/ADHD, although the young woman should also be screened for depression and substance abuse, which can accompany ADD/ADHD.

Ms. W, 18 years old, presents at a community clinic describing vague symptoms. She explains that she recently dropped out of high school and is having trouble keeping a job. She notes that she has difficulty concentrating and has used drugs (i.e., marijuana and alcohol) when riding motorcycles with friends. When conducting the initial assessment, the RN should include questions and tools that would screen for a.) depression. b.) attention-deficit disorder/attention-deficit hyperactivity disorder (ADD/ADHD). c.) posttraumatic stress disorder. d.) obsessive-compulsive disorder.

a.) working in pairs. Risk factors for violence in the workplace include increasing number of acute and chronically mentally ill patients, working alone, availability of drugs at worksite, low staffing levels, poorly lit parking areas and corridors, long waits for service, inadequate security, increasing number of substance abusers, and access to firearms.

Nurses, including public health nurses, are at increased risk for workplace violence. Risk factors for violence in the workplace include all except a.) working in pairs. b.) access to medications. c.) increased number of mentally ill patients. d.) inadequate security.

Self-assessment is important to prevent providing biased care -Knowing how you feel about substance use is important Non-judgmental approach Routinely assess substance use patterns during client history Home visits paint a picture- empty pill or liquor bottles Increase awareness when the client is in denial Involve the client's social network Know community resources- treatment programs, help groups and transportation Every client will have an individualized treatment plan

Nursing Perspectives for Substance Abuse?

b.) promoting, preventing, and restoring health within the context of a safe and healthy environment. Occupational health nursing is a specialty practice that focuses on promoting, preventing, and restoring health within the context of a safe and healthy environment. The other options limit the scope of the practice role.

Occupational health nursing is best described as a specialty practice that focuses on a.) providing comprehensive health care service to workers and their families. b.) promoting, preventing, and restoring health within the context of a safe and healthy environment. c.) preventing adverse effects from occupational and environmental hazards at the workplace. d.) planning, implementing, and evaluating safety programs for workers at the workplace.

a.) avoid all products containing alcohol. Disulfiram, when combined with any alcohol, produces the classic disulfiram-ethanol reaction of flushing, tachycardia, nausea, headache, chest tightness, and chest pain. Adhering to concomitant vitamin B therapy and returning for monthly blood drug level monitoring are not necessary when taking Antabuse.

On discharge after treatment for alcoholism, a client plans to take disulfiram (Antabuse) as prescribed. When teaching the client about this drug, the nurse emphasizes the need to a.) avoid all products containing alcohol. b.) adhere to concomitant vitamin B therapy. c.) return for monthly blood drug level monitoring. d.) limit alcohol consumption to a moderate level.

d.) lack of interest in health issues and health care. In developing countries, people are more likely to be exposed to communicable diseases as a result of a number of factors, including high population density, lack of accessible health care and treatment, and poor or limited sanitation. In addition, although tobacco use is decreasing in most developed countries, it is increasing in many underdeveloped ones. Although people in developed countries often lack resources and information, they are nonetheless interested in health promotion, disease prevention, and many aspects of health care delivery.

People who live in developing countries are at risk for a variety of health threats as a result of all factors except a.) limited sanitation facilities. b.) increased chance of exposure to communicable diseases, including AIDS, tuberculosis, and hepatitis B. c.) higher rates of tobacco use compared with most developed countries. d.) lack of interest in health issues and health care.

a.) impulsive. d.) disinhibited. Two broad personality dimensions are also associated with an increased risk for alcohol abuse. Impulsivity and ease of disinhibition add to the risks for substance abuse. Being prone to anxiety and depression is also a risk, and these comorbidities are not well understood. The other options are not associated with a risk for alcohol abuse.

Personality traits associated with an increased risk of alcohol abuse include (Select all that apply.) a.) impulsive. b.) shy. c.) withdrawn. d.) disinhibited. e.) aggressive.

c.) increased incidence of disease. Overcrowding leads to pollution, stress, disease, and violence. Mortality rates are increased, and quality of life decreases.

Population overcrowding can result in a.) increased productivity. b.) improved education. c.) increased incidence of disease. d.) decreased mortality.

Primary Prevention: -Increase public awareness, especially youth -Encourage development of life skills -Assist in formation of awareness groups- MADD, DFCoA (MADE locally) --Mothers against drunk driving Secondary Prevention: -Screen individuals for substance use disorders -Identify at-risk individuals and assist to reduce stress (consider social services referral) --Increase stress: Unemployment, death, homelessness Tertiary Prevention: -Assist client to develop plan to avoid high-risk situations and enhance coping --Narcan available -Refer to community groups- AA, NA Monitor pharmacological management- nicotine replacement therapy and medication assisted therapy -Support to those in recovery and families

Prevention Strategies for Substance Abuse?

Teach clients, families and community members to identify mental illness symptoms and suicide risk factors -People might not recognize the problem, especially the family members Assess- direct questions or observations -Are you having thoughts of killing yourself? Work settings- crisis housing program, supportive employment programs, Assertive Community Treatment (ACT) teams, Crisis Intervention Teams (CIT), medication management programs, community case management programs -Homeless shelter, Occupational health at a job facility, People who have difficulty managing medications Provision of services- access, cost and disparity -What providers? Can they have transportation? Do they have insurance? Recognize that individuals have more difficulty accessing care? (Homeless, minorities, children (don't know to ask for help or don't realize they're in a bad situation), Old people rely on other people) Navigating systems- healthcare, social service, legal -Applying for gov assistance, job training programs, childcare (job and family services) -Community health nurses need to know how to navigate the legal system because a lot of people in jail are crazy and have mental health issues --Need to know how to teach others

Role of Community Mental Health Nurse?

a.) The route of transmission for hepatitis A is fecal-oral. Hepatitis A is transmitted by fecal-oral route. Coughing or bleeding would not transmit hepatitis A. Option D does not have enough information to form a conclusion about hepatitis A transmission.

Seven cases of hepatitis A are diagnosed in a community over a period of 2 weeks. An investigation results in a determination that all of the infected individuals ate at a local restaurant. Which statement explains the possible connection between hepatitis A and a restaurant? a.) The route of transmission for hepatitis A is fecal-oral. b.) A food worker likely coughed on the customers. c.) A food worker may have a bleeding wound. d.) Hepatitis A is transmitted where people congregate.

Social consequences- role in crime (steals, assaults), need for money to buy substances, theft of drugs, irreversible health consequences from use Continued availability of the substance and social support system that enables use may maintain addiction -Infection, Hepatitis, HIV, physical changes with methadone (lose teeth), cirrhosis of the liver from chronic alcohol use -Enabling behavior: giving them money to go buy drugs, allowing to bring in and do drugs in the home, and lets them maintain the addiction People use multiple substances or have cross addictions more than in past -Some people use drug of convenience (smoking, drinking) Government typically takes a criminalization approach -Typically fined, put in jail -Concerns related to that: Jail overcrowding, spreading infection in crowded environments, paying for medical care as taxpayers for these people in jail, having to pay government facilities (police workforce) to arrest them, etc.

Sociocultural and Political Aspects of Substance Abuse?

Primary Prevention: Educate populations about mental health issues --AWARENESS; need to recognize illness and need to know when to seek help Teach stress reduction techniques -Good coping skills, suicide hotline, posting flyers everywhere, social media postings Promote protective factors and risk reduction factors Share suicide hotline information Secondary Prevention: Screen to detect mental health disorders -Screen for depression because most debilitating; should ask everyone at primary care doctors; public health: health fairs Conduct crisis intervention -Be available to respond to those issues -A house fire, car wreck (child has died and apart of a large school system) -Mass shooting -Hurricane/tornado -People that were apart of incidence and that had to care for them Tertiary Prevention: -Make referrals to mental health professionals and support groups -Educate client and family on medication adverse effects and possible interactions -Prevent relapse and frequent hospitalization

Strategies to Improve Mental Health: Primary, Secondary, and Tertiary Prevention?

Men die by suicide 3.5 times more than woman and white males account for 7/10 suicides (AFSP, 2017) Second leading cause of death among 10-14 and 25-34 year olds, third leading cause for 15-24 and fourth leading for 35-44. (NIMH, nd) -Schools are a great place to start suicide prevention; especially for young kids Previous suicide attempt leading risk factor, substance use and mental illness increase risk Suicide warning signs mnemonic- IS PATH WARM (Table 25.2, page 506) Protective factors- clinical care, access and support to clinical interventions, social support system, problem solving skills, cultural beliefs that discourage suicide

Suicide Statistics?

Ideation: Does the person state that he or she is having thoughts of suicide? Substance abuse: Is the person demonstrating increased use of alcohol or drugs? Purposelessness: Does the person state that he or she feels as if there is no purpose in his or her life? Anxiety: Is the person demonstrating anxiety-related behaviors such as talking about being overly worried about things, ruminating, difficulty concentrating, or exhibiting increased psychomotor agitation? Trapped: Does the person state that he or she feels trapped, that there is no way out of the current situation except to die? Hopelessness: Does the person state that he or she feels hopeless? Is the person able to describe something to look forward to? Withdrawal: Is the person withdrawing from others such as family and friends? Is the person isolating? Anger: Is the person demonstrating uncontrolled anger? Is the person acting with rage or seeking revenge? Recklessness: Is the person engaged in risk-taking behaviors? Is the person acting as if he or she "doesn't care" or isn't thinking about the consequences of the risk-taking behavior? Mood changes: Is the person experiencing dramatic mood changes?

Suicide Warning Signs: "Is Path Warm"?

• Persistent sad, anxious, or "empty" feelings • Feelings of hopelessness or pessimism • Feelings of guilt, worthlessness, or helplessness • Irritability, restlessness • Loss of interest in activities or hobbies once pleasurable, including sex • Fatigue and decreased energy • Difficulty concentrating, remembering details, and making decisions • Insomnia, early-morning wakefulness, or excessive sleeping • Overeating or appetite loss • Thoughts of suicide, suicide attempts • Aches or pains, headaches, cramps, or digestive problems that do not ease even with treatment

Symptoms of Depression (Box 25.2)?

c.) "Admit you are powerless over alcohol and that you need help." As a nonprofessional ongoing source of assistance, Alcoholics Anonymous is viewed as an invaluable resource to the community. The first step of the 12-step program is the admission of defeat and surrender to a higher power. The other options are false.

The community health nurse is trying to encourage a client to attend Alcoholics Anonymous meetings. When the client asks the nurse what he must do to become a member, the nurse should respond a.) "You must first stop drinking." b.) "Your physician must refer you to this program." c.) "Admit you are powerless over alcohol and that you need help." d.) "You must bring along a friend who will support you."

c.) Methamphetamine Short-term effects of methamphetamine are increased heart rate, insomnia, excessive talking, excitation, and aggressive behavior. PCP is known for its violent dissociative and anesthetic effect. Alcohol intoxication causes euphoria, disinhibition, and sedation. Inhalants cause euphoria.

The community health nurse is visiting the home of a known substance abuser. The client is talking excessively and is excited and aggressive. The nurse notes that the patient's heart rate is 158 beats/min. The nurse recognizes the client is most likely high on which substance? a.) PCP b.) Alcohol c.) Methamphetamine d.) Inhalants

a.) An 18-year-old client with a previous gunshot wound b.) A 50-year-old client who saw people die in the disaster c.) A 23-year-old client experiencing extreme fear e.) A 35-year-old client with a history of schizophrenia Risks for PTSD include living through dangerous events or traumas; having a history of mental illness; getting hurt; seeing people hurt or killed; feeling horror, helplessness, or extreme fear; having little or no social support after the event; and dealing with extra stress after the event, such as loss of a loved one, pain and injury, or loss of a job or home.

The community health nurse is working in an emergency shelter with displaced families. Which clients have risk factors for posttraumatic stress disorder (PTSD)? (Select all that apply.) a.) An 18-year-old client with a previous gunshot wound b.) A 50-year-old client who saw people die in the disaster c.) A 23-year-old client experiencing extreme fear d.) A 60-year-old client who had little social support before the event e.) A 35-year-old client with a history of schizophrenia

a.) World Health Organization (WHO) The WHO introduced the goal of "health for all." The CDC strives to prevent and control infectious and chronic diseases, injuries, workplace hazards, disabilities, and environmental health threats. UNICEF focuses on child and women's health.

The concept of "health for all by the year 2000" was initially introduced by which international organization? a.) World Health Organization (WHO) b.) Centers for Disease Control (CDC) c.) United Nations International Children Emergency Fund (UNICEF) d.) National Institutes of Health (NIH) Healthy People 2000

d.) Florence Nightingale. Florence Nightingale's legacy serves as the foundation for community health nursing in the global health care arena. She channeled her energy into all aspects of health from the care of wounded soldiers at Scutari to the broad public policies that affected health in her time. The other three women were instrumental primarily for their contributions in the United States.

The first nurse to establish international links and networks was a.) Clara Barton. b.) Mary Breckenridge. c.) Dorothea Dix. d.) Florence Nightingale.

c.) United Nations International Children Emergency Fund (UNICEF). UNICEF works for children's survival, development, and protection by developing and implementing community-based programs. UNICEF achievements are well documented in child health, nutrition, education, water, sanitation, and progress for women. PAHO is an international public health agency that works to improve the health and living standards of the Americas. The WHO introduced the goal of "health for all." The CDC strives to prevent and control infectious and chronic diseases, injuries, workplace hazards, disabilities, and environmental health threats.

The global health organization that works for children's survival, development, and protection is the a.) World Health Organization (WHO). b.) Centers for Disease Control (CDC). c.) United Nations International Children Emergency Fund (UNICEF). d.) Pan American Health Organization (PAHO).

b.) malaria. Malaria is a life-threatening parasitic disease transmitted by mosquitoes. Malaria causes more than 212 million acute illnesses and 429,000 deaths annually. AIDS is a disease caused by the HIV virus. Tuberculosis is an infectious disease caused by the tubercle bacillus. Hepatitis is inflammation of the liver.

The life-threatening parasitic disease that causes nearly 500,000 deaths annually is a.) AIDS. b.) malaria. c.) tuberculosis. d.) hepatitis.

d.) Green Green is for the wounded or individuals with minor injuries who are able to walk and to wait several hours before receiving medical treatment. Red is for those with life-threatening injuries but have a high probability of survival, yellow is for those with systemic but non-life-threatening complications, and black is for the deceased or those with nonsurvivable injuries.

The nurse at the disaster site is using the SMART triage system. What color triage tag would be provided to an ambulatory individual with a superficial cut on the left elbow and bruise to the right hand? a.) Red b.) Yellow c.) Black d.) Green

b.) sense of belonging. c.) peer pressure. e.) need for respect. Reasons that young people give for joining gangs include the belief that gangs will protect them, peer pressure, the need for respect, and a sense of belonging.

The school nurse is interviewing a student who has been assaulted by another student. Both students proclaim to be gang members. The nurse understands the reasons most youth give for joining a gang include the following: (Select all that apply.) a.) financial gain. b.) sense of belonging. c.) peer pressure. d.) relative is in a gang. e.) need for respect.

c.) Al-Anon Substance abuse has been called a family disease because it affects the entire family system and holds potential adverse psychological and physical consequences for the family members in addition to the abuser. Al-Anon and Alateen are support groups for family members of substance abusers. A psychiatrist's referral is not necessary. Alcoholics Anonymous is focused more on the substance abuser than their families.

The wife of an alcoholic client is considering joining a support group to help her respond to her husband's condition in a healthy way. Where should the nurse refer this client? a.) A psychiatrist for a referral to a suitable group b.) Spouses Anonymous c.) Al-Anon d.) Alcoholics Anonymous

a.) the U.S. Department of Health and Human Services mandated occupational health nurses be hired for industrial settings that employed more than 350 people. The focus of health care for employees changed as a result of the two world wars, which changed the demographics of the workforce and increased the need for health services for employees, and the birth of the first national association for this specialty. The federal government never required companies to employ occupational health nurses.

There was an increase in the number and voice of occupational health nurses during the years of 1938 to 1943. All occurrences explain the rationale for this change except a.) the U.S. Department of Health and Human Services mandated occupational health nurses be hired for industrial settings that employed more than 350 people. b.) a national association for the specialty of occupational health nursing was created. c.) more women entered the workforce, changing the demographics of the workplace. d.) the government demanded health services for defense contract workers.

a.) refer him immediately for evaluation. It should be noted that suicide is the third leading cause of death among persons 15 to 24 years of age. Thus, it is important that all community health nurses become familiar with assessing for suicide warning signs and accessing appropriate resources. Whenever individuals exhibit suicide warning signs, nurses should refer the person to a mental health clinic or provider as soon as possible.

Tony, age 16 years, comes to see you, the school nurse, with complaints of abdominal pain. You note that Tony exhibits signs and symptoms of depression, states he wishes he did not wake up today, and exhibits signs of anxiety. You would a.) refer him immediately for evaluation. b.) see him back in your office next week. c.) refer him next month for evaluation. d.) do nothing; this is normal in a 16-year-old boy.

c.) breaking only one link in the transmission chain. Breaking just one link of the chain can control transmission of an infectious agent. Destroying all reservoirs of infectious agents and maintaining high levels of herd immunity are two of several ways to break a link in the chain of transmission.

Transmission of an infectious disease can be efficiently controlled by a.) breaking all links in the transmission chain. b.) destroying all reservoirs of infectious agents. c.) breaking only one link in the transmission chain. d.) maintaining high levels of herd immunity.

Preadolescents/Adolecents- often used as coping mechanism, peer pressure, abuse/neglect, ADHD, depression, selling drugs for money Elderly- social isolation, increase prescriptions, decreased physiological tolerance -With more drugs = more chance for misuse -Polypharmacy -Confusion so moire likelihood for mistakes -Decreased tolerance for medications = can end up with overdose Women- absorb and metabolize alcohol differently, increase risk due to economic, social and cultural factors, history of abuse risk factor -Could use alcohol for history of abuse Ethnocultural considerations- numb "social pain" with substances, race, ethnicity, socioeconomic status -Due to disparities Dual diagnosis- comorbid SA and MI, high risk for STIs, may have difficulty maintain MI medication regimen -Substance use disorder and mental illness at the same time -Much higher risk for STIs, homelessness, maintaining medication regimen

Vulnerable Aggregates for Substance Abuse?

d.) Communication Communication is one of the biggest problems during a disaster. The reliance on telephone systems or cell phones should not be the only plan for communication during a disaster. Authority focuses on the people in charge, logistical includes focuses on storage of equipment and location of key responders, and search and rescue focuses on the search and rescue of victims.

What element of a community disaster plan investigates the citizen's reliance on telephone systems or cell phones during disasters? a.) Authority b.) Logistical c.) Rescue d.) Communication

d.) The client will feel depressed, apathetic, and lethargic. Symptoms of withdrawal from CNS stimulants are depression, apathy, lethargy, and sleepiness. The client may experience signs of CNS stimulation while high on the CNS stimulant. The client withdrawing from opioids may experience anxiety and tremors. The client withdrawing from alcohol may experience hallucinations and seizures.

When a client regularly takes a drug that is a central nervous system (CNS) stimulant, such as cocaine, what symptoms would the nurse expect to see when the client abstains from this substance? a.) The client will have symptoms of CNS stimulation. b.) The client will experience anxiety, insomnia, and tremors. c.) Common symptoms include hallucinations and seizures. d.) The client will feel depressed, apathetic, and lethargic.

b.) Reporting accusations of sexual harassment to local police Maintaining confidentiality of medical records, reporting occupational injuries and illnesses, and providing personal protective equipment training are all mandated by law. Sexual harassment allegations are routinely reported to administrative officials.

Which action of the occupational health nurse is not mandated by state or federal regulations? a.) Maintaining confidentiality of medical records b.) Reporting accusations of sexual harassment to local police c.) Recording and reporting occupational injuries and illnesses d.) Providing personal protective equipment training

b.) Negotiation with an employer for an onsite fitness program for all employees Promoting physical activity is an example of health promotion activities at the primary prevention level. Blood pressure, diabetes, and cholesterol screenings and mammograms are all secondary prevention strategies aimed at early diagnosis and early treatment. Weight loss programs for the severely obese would be considered tertiary prevention.

Which activity implemented by an occupational health nurse would be considered primary prevention? a.) Annual blood pressure, cholesterol, and diabetes screenings b.) Negotiation with an employer for an onsite fitness program for all employees c.) Scheduling a mobile mammography van to see employees older than age 40 and their wives d.) Overseeing a weight loss competition among workers who are considered to be morbidly obese

c.) Federal Emergency Management Agency (FEMA) FEMA's mission is to support citizens and first responders to ensure that as a nation everyone works together to build, sustain, and improve the capacity to prepare for, protect against, respond to, recover from, and mitigate all. The other agencies may be peripherally involved in national disasters, but it is not their primary focus.

Which agency has a mission to support citizens and first responders to ensure that as a nation everyone works together to build, sustain, and improve the capacity to prepare for, protect against, respond to, recover from, and mitigate all? a.) American Red Cross (ARC) b.) National Institute for Health (NIH) c.) Federal Emergency Management Agency (FEMA) d.) Centers for Disease Control and Prevention (CDC)

a.) The client has a laceration on her forehead that was sutured. c.) The client has bruises on her forearms in various stages of healing. e.) The client is not sexually active but has a diagnosis of Chlamydia. Signs of physical abuse include bruises, lacerations, fractures, dislocations, untreated injuries in various stages of healing, and STDs in sexually inactive clients. The other options are not indications of physical abuse.

Which assessment findings by the community health nurse would suggest that an elderly client may be the survivor of physical abuse by a caregiver? (Select all that apply.) a.) The client has a laceration on her forehead that was sutured. b.) The client has a flat affect. c.) The client has bruises on her forearms in various stages of healing. d.) The client withdraws from soft touch. e.) The client is not sexually active but has a diagnosis of Chlamydia.

b.) A 70-year-old client with dementia who is cared for at home The most likely victims of elder abuse are individuals who are in poor physical or mental health and dependent on others for physical or financial support; these clients are often confused and depressed.

Which client is at highest risk for elder abuse? a.) A 75-year-old nursing home client who is alert and has osteoporosis b.) A 70-year-old client with dementia who is cared for at home c.) A 65-year-old client who has just had a hip replacement d.) A 72-year-old client on a rehabilitation unit with bilateral above-the-knee amputations

c.) A tornado resulting in flood and destruction of electrical systems for a community A natech disaster is a natural disaster that creates or results in a widespread technological problem. A flood covering crops and recreational areas of a geographic area does not mention a technological problem, and a terrorism attack and a nuclear accident are not natural disasters.

Which describes a NA-TECH (natural technological) type of disaster? a.) A flood covering crops and recreational areas of a geographic area b.) A terrorism attack causing major interruption of communication technologies c.) A tornado resulting in flood and destruction of electrical systems for a community d.) A nuclear accident at a power plant causing evacuation of people in an urban community

a.) AIDS d.) Parasitic infection e.) Dengue fever Among the infectious diseases that contribute to higher mortality rates in developing countries are AIDS, tuberculosis (TB), malaria, hepatitis B, rheumatic heart disease, parasitic infection, and dengue fever. Although these diseases claim the lives of millions, it is estimated they could be reduced by up to 50% through effective public health interventions.

Which diseases contribute to higher mortality rates in developing countries? (Select all that apply.) a.) AIDS b.) Hepatitis C c.) Cancer d.) Parasitic infection e.) Dengue fever

b.) Air pollution Air pollution and lead poisoning directly assault human health. Noise and litter affect quality of life. Global warming affects the ecologic balance.

Which environmental stressor directly assaults human health? a.) Global warming b.) Air pollution c.) Noise d.) Litter

a.) Inefficient storage b.) An intramuscular vaccine injection given subcutaneously d.) Light-sensitive vaccines exposed to light e.) Seroconversion Primary vaccine failure is the failure of a vaccine to stimulate any immune response. It can be caused by improper storage that renders the vaccines ineffective, an improper administration route, or light-sensitive vaccines exposed to light. Additionally, some immunized persons never seroconvert, either because of failure of their own immune system or for some other unknown reason. Secondary vaccine failure is the waning of immunity after an initial immune response.

Which factors cause primary vaccine failure? (Select all that apply.) a.) Inefficient storage b.) An intramuscular vaccine injection given subcutaneously c.) Waning immunity in immunocompromised patients d.) Light-sensitive vaccines exposed to light e.) Seroconversion

d.) Mosquitoes Vectors can be animals or arthropods and can transmit disease through biological and mechanical routes. The other options are not vectors.

Which is classified as a vector of disease? a.) Humans b.) Door handles c.) Water and food d.) Mosquitoes

d.) To act as command station for disaster responders to report to and get assignments The staging area is the onsite command station. Dispatch responders should report to this area and check-in. This allows everyone to be accounted for and to gather assignments. The other options are not appropriate uses for the staging area in a disaster.

Which is the purpose of the staging area in a disaster plan? a.) A triage area outside the hospital, supplying first aid and transport to medical facilities b.) A stage for entertainment to cheer up disaster victims c.) To provide sheltered area for displaced victims to sleep, eat, and bathe d.) To act as command station for disaster responders to report to and get assignments

a.) Negotiation of workplace accommodation for a worker with a disability On a tertiary level, the occupational health nurse plays a key role in the rehabilitation of a worker to the optimal level of functioning and includes such strategies as negotiation of workplace accommodation and counseling and support for workers who will continue to be affected by chronic disease. The other options are primary level strategies.

Which occupational health nursing intervention is an appropriate tertiary level strategy? a.) Negotiation of workplace accommodation for a worker with a disability b.) Work with an employer to build an onsite fitness center c.) Providing health-screening programs to detect conditions that could aggravate the disability of worker d.) Get automated external defibrillators AEDs for the workplace and train workers on how to use them

d.) All of the above Secondary prevention strategies are aimed at early diagnosis, early treatment interventions, and attempts to prevent disability. All three choices focus on identification of health needs, health problems, and employees at risk.

Which occupational health nursing intervention would be appropriate secondary prevention strategies? a.) Arrange for the collection of baseline liver function tests if the employee will be working with a chemical known to cause liver toxicity b.) Provide vision, blood pressure, hearing, and cancer screenings on an annual basis c.) Coordinate periodic evaluations to ensure workers are placed in the safest worksite setting d.) All of the above

b.) Heroic phase The heroic phase of a community's reaction to a disaster involves people feeling the need to rush to help people survive the disaster. Medical personnel may volunteer to work long hours without sleep and in dangerous conditions to care for patients. During the honeymoon phase, people who have survived the disaster get together to talk about their experiences. People begin to look to the future during the reconstruction phase and during the disillusionment phase people recognize that many things are different, and much needs to be done to adjust to the current situation.

Which phase of the community response to disaster includes medical personnel contributing long hours of volunteer work helping unfamiliar people after a disaster? a.) Honeymoon phase b.) Heroic phase c.) Reconstruction phase d.) Disillusionment phase

a.) Teen use of cigarettes and smokeless tobacco is increasing. Teen use of cigarettes and smokeless tobacco has declined. Youth (ages 12 to 20) binge and heavy drinking rates in 2015 (13.4% and 3.3%, respectively) were higher than rates in 2010 (7.8% and 1.7%, respectively). The percentage aged 12 to 17 years who perceived great risk in smoking marijuana once or twice a week decreased from 47.5% in 2010 to 40.6% in 2015. Teen substance abuse, overall, is increasing.

Which statement about adolescent substance abuse is false? a.) Teen use of cigarettes and smokeless tobacco is increasing. b.) Alcohol use among youth declined increased between 2010 and 2015. c.) Most of the movement in teen substance abuse has been in the downward direction. d.) Marijuana use among teens is decreasing.

a.) Most homicides are caused by stabbings. Most homicides are caused by firearms. The other statements are true.

Which statement about homicide in the United States is false? a.) Most homicides are caused by stabbings. b.) Homicide is the third leading cause of death for 1- to 4-year-old children. c.) Blacks are more likely to be the victims of homicide than whites. d.) Over 50% of homicide victims are killed by someone they knew.

d.) Professional intervention is needed to change the abusers' behavior. Abusers will stop the abuse only after receiving treatment. Abusers do not change behaviors on their own. The other statements are true.

Which statement about intimate partner violence (IPV) is true? a.) It occurs only in poor, uneducated, minority households. b.) It only occurs in heterosexual relationships. d.) Victims can change the abusers' behavior. d.) Professional intervention is needed to change the abusers' behavior.

a.) "I can't get human papilloma virus (HPV) from my boyfriend because we're not having intercourse." Option A indicates the patient needs more teaching. HPV can be transmitted via sexual intercourse, as well as any other means of direct contact. The other statements are true.

Which statement indicates that further teaching is needed for a patient involved in family planning? a.) "I can't get human papilloma virus (HPV) from my boyfriend because we're not having intercourse." b.) "I need to use condoms to prevent transmission of sexually transmitted diseases." c.) "Even though I have no signs or symptoms, I still may have Chlamydia." d.) "I can give my unborn baby warts during childbirth."

c.) Half of the STD rate in the United States falls within the 15 to 24 age range. An estimated 20 million cases of STDs occur each year in the United States, almost half of them in persons aged 15 to 24 years. The other statements are not true.

Which statement regarding sexually transmitted diseases (STDs) is correct? a.) The rate of STDs is decreasing because of effective medication therapies. b.) Women are less likely to use protection methods against STDs. c.) Half of the STD rate in the United States falls within the 15 to 24 age range. d.) Treatment for STDs in women is usually ineffective.

c.) Contact the parents and educate them about the immunization requirements. All states require proof of current immunization status or evidence of immunity unless there is an exception (religious, moral belief, or medical contraindication). It is the nurse's responsibility to assess the situation and educate the family. The nurse's responsibility is not to expel the students or immunize them herself.

While verifying compliance with immunization requirements, a school nurse notices that three students from the same family have not completed their immunizations. How should the nurse address this problem? a.) Discuss with the principal the lack of immunizations. b.) Expel the children from school. c.) Contact the parents and educate them about the immunization requirements. d.) Pull the students from class and immunize them.

d.) many factors cause the problem. Information from studies to date is insufficient to establish a definitive biological cause for mental illness. Scholars have concluded that mental disorders are multifactorial, complex physiological phenomena.

You are working in a mental health facility as a nurse. You are involved with patients who have varied diagnoses. One of your patient's family members asks what biological problem causes all of these people to have mental illness. You respond that most experts believe a.) brain structure is the problem. b.) neurotransmitters are the problem. c.) genetics are the problem. d.) many factors cause the problem.

a.) Primary Primary prevention occurs in the nondisaster and predisaster stages. Actions during these stages includes developing local, state, and federal disaster plans; conducting drill tests; training volunteers and health care providers; and providing educational programs. Secondary measures are those taken after the disaster has occurred and tertiary measures are aimed at rehabilitation. Disaster prevention is a broad term covering all types.

You teach a community disaster preparedness class on how to find shelter during and after a disaster situation. This is an example of what kind of prevention? a.) Primary b.) Secondary c.) Tertiary d.) Disaster

c.) family history of depression. A family history of depression is a major risk factor for childhood depression. Other associated factors that may increase the risk of depression in children and adolescents include a history of verbal, physical, or sexual abuse; frequent separation from or loss of a loved one; poverty; mental retardation; attention-deficit/hyperactivity disorder; hyperactivity; and chronic illness.

You work in a community clinic that specializes in pediatric mental health. Joy, age 12 years, has been diagnosed with depression. You know a major risk factor for depression in childhood is a.) family history of diabetes. b.) family history of abuse. c.) family history of depression. d.) family history of poverty.