Community Exam 3 Practice Questions
Which of the following statements by a women's group indicates that they have understood the teaching about heart disease and women?
"Heart disease is the number-one killer of women."
After teaching a group of pregnant women about the need for proper oral health during pregnancy, which of the following statements by the group indicates the need for additional teaching?
"If we need dental work, we can postpone it until after the birth."
A community health nurse is teaching a group of older adults at a senior center about strategies for successful aging. Which of the following would the nurse include?
"Keep in touch with friends and family."
Which of the following statements would alert a community health nurse to the need for education about older adults?
"Older adults rarely have mental health problems."
A community health nurse implements a teaching program for new parents about ways to reduce infant mortality. Which suggestion would the nurse include as most important?
"Put the infant to sleep on his or her back."
After reviewing the history of nurse-managed health centers, the instructor determines that the teaching was successful when the students identify which of the following as when today's model began?
1960s
An older adult comes to the community health center for a check-up. During the visit he mentions that he is somewhat constipated. Which of the following suggestions would be most appropriate?
Increase intake of fresh fruits and vegetables.
Community health nurses have found that as an aggregate, rural elders are at special risk because of which of the following?
Increased chronic diseases in conjunction with access barriers to specialists
A community health nurse is integrating the Healthy People 2010 goals into programs for a local community. Which of the following goals would the nurse identify as having been met?
Increased infants put to sleep in their back
A community health nurse is part of a group working with local and state legislators to expand health insurance coverage for those with inadequate or no insurance. Which outcome would the nurse hope to achieve if the group is successful?
Increased use of early screenings
A corrections nurse is working to develop programs for inmates and reviews the demographics of this population to determine issues. Which of the following would the nurse expect to find?
Increasing number of women in prison
A community health nurse is making a family home visit. The family consists of the mother, father, a 1-year-old, and a 4-year-old. The mother tells you that the 4-year-old, who is in preschool, had a cold last week, and now the 1-year-old has it. She asks the nurse if she can use the over-the-counter cold medication that she gave to the 4-year-old for the 1-year-old. Which response would be most appropriate?
"That type of medicine should not be used in children under age 2."
During a home postpartum visit, a community health nurse suspects that the woman is experiencing depression. Which of the following responses would be most appropriate?
"Try napping when the baby is napping."
After presenting a seminar on disabilities to a local community group, the community health nurse determines that the seminar was successful when the group states which of the following?
"We need a clear definition of disability and people with disabilities."
A community health nurse is teaching a group of parents about attention-deficit/hyperactivity disorder. Which statement by the parents would indicate the need for additional teaching?
"We need to keep him away from foods that have additives in them."
After teaching a group of older adult women about preventing osteoporosis, which of the following if stated by the group indicates the need for additional teaching?
"We should avoid activities that involve weight-bearing."
A community health nurse is making a home visit to a family. The family has a son with a disability who requires a motorized wheelchair. The family asks for the nurse's assistance. Which response by the nurse would be most appropriate?
"We'll need to check with the insurance company about coverage."
When visiting a local senior center, a community health nurse engages several of the older adults in a discussion about immunizations. Which statement best reflects the importance of older adult immunization?
"We're at greater risk of dying from the flu or pneumonia."
A community health nurse is working with a group of parents who have infants and toddlers. Which of the following would the nurse include in a teaching plan for this group about reducing dental caries?
...
When determining a target population for education about alcohol use, which age group would the community health nurse most likely plan to address?
18- to 25-year-olds
While working with another group of community health nurses, a nurse overhears one of the nurses saying, "That older man should just retire. He's 70 years old. How productive can he be?" The nurse interprets this statement as reflecting which of the following?
...
The following is a list of the top-five causes of unintentional injuries accounting for the majority of adult deaths due to injury. Order these in their proper sequence from first to fifth.
1. MCV 2. Firearms 3. poisoning 4. falls 5. suffocation
The community health nurse is reviewing the Healthy People 2010 priorities for rural residents. Rank the selected issues below, starting with the highest-priority issue.
1. access to health care 2. heart disease and stroke 3. diabetes 4. oral health 5. tobacco use 6. substance abuse
When creating a faith community nurse position, the nurse performs several steps. Place the steps below in their proper sequence.
1. conduct a needs assessment 2. identify possible activities 3. seek support of key faith community leaders 4. obtain formal approval from the governing body 5. negotiate aspects of position and services 6. obtain authorization for the practice
Order the following conditions managed at home, starting with the most common.
1. essential hypertension 2. heart failure 3. diabetes 4. chronic skin ulcers 5. osteoarthritis
A community health nurse is involved in a screening program for lead exposure. The nurse would target this program primarily to which age group?
1.5- to 3-year-olds
A community health nurse is providing immunizations to schoolchildren at a local health department. At which age would the nurse expect to administer the first dose of human papillomavirus (HPV) vaccine?
11
A community health nurse is part of community discussion group on alcohol. The nurse recommends that adult men should have less than:
14 standard drinks weekly
An older adult interested in nutrition asks the community health nurse about the number of calories that he should eat every day. Which of the following would be most appropriate?
2,000 to 2,400 calories
A community health nurse is discussing alcohol use disorders and is explaining what is meant by a standard drink. Which of the following would the nurse include as an example?
3 ounces of an 80-proof spirit
A community health nurse who is working with a program to foster early detection of prostate cancer recommends prostate-specific antigen testing and a digital rectal exam for men with average risk starting at which age?
50 years
When working with the community to develop plans to meet the needs of people with disabilities, the community health nurse reviews the statistics involving individuals with disabilities. Which of the following would the nurse identify as accurately reflecting the number of persons with ongoing disability
54 million people, about 20% of the U.S. population
A home health care nurse makes an initial visit to a client and determines that the client meets the criteria for services with Medicare reimbursement. The nurse understands that this service will be reimbursed for which period?
60 days
A community health nurse is working with the local health department on screening teens for sexually transmitted infections. Which of the following would the nurse identify as the most common?
Chlamydia
When explaining the concept of disability to a local community group, which of the following descriptions would be most appropriate for the nurse to include?
A disability is a condition someone has, not something one is.
A community health nurse is working to develop programs to address the health status of migrant families. Which of the following would the nurse need to keep in mind when planning these programs? Select all that apply.
A greater mortality from injuries, TB, respiratory and cerebrovascular diseases An infant mortality rate that is 25% to 30% higher than for other infants in the U.S. Health needs compromised by limited access to health care and high mobility A much lower life expectancy than that of the general population
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 high prevalence of poverty exists among rural families. About 25% of all US residents live in rural settings. About 25% of all US residents live in rural settings. Rural residents are less likely to engage in preventive behavior and they tend to be poorer than their urban counterparts (more than 25% of rural Americans live in or near poverty, and nearly 40% of all rural children are impoverished). Nearly one half of all rural adults suffer from at least one chronic condition. Stress, stress-related conditions, and mental illness are prevalent among populations that have economic difficulties, including rural populations.
A community health nurse is preparing for a presentation on disabilities and is planning to include information about Healthy People 2010 goals. When addressing these goals, the nurse identifies differences from the goals addressed by Healthy People 2000. Which of the following would the nurse identify as different?
A majority of the focus areas for 2010 are related to chronic illness and disability.
Which of the following best describes a health professional shortage area (HPSA)?
A region with insufficient numbers of health care providers An HPSA is a geographical area that has insufficient numbers of health professionals according to criteria established by the federal government. Often rural areas have a physician, nurse practitioner, or nurse in community health who provides services to residents who live in several counties. The incorrect responses do not fit the definition of a HPSA.
After describing the various models for nurse-managed health centers, the instructor determines that the students understand the information when they identify which organization structure as being partnered legally with a human services organization?
Affiliated center
When assessing a population for health disparities, which of the following would the nurse be least likely to evaluate?
Age
When developing programs for substance use prevention, the community health nurse engages in the following activities. Place the activities in the order in which they would occur, from first to last.
A. Determine the trends related to substance use across different populations. B. Recognize the difference between legal and illegal substance abuse. C. Understand the consequences of substance use affecting the community as a whole. D. View the substance use from an environmental perspective.
Which of the following programs would be least effective to institute for a community of school-age children who are experiencing dental caries?
Advising parents to encourage the children to brush once daily
A community health nurse is working with a political group to lobby for increased funding for a mental health promotion program. The nurse is functioning in which role?
Advocate
Which of the following roles would be critical for a faith community nurse to assume to achieve the goals of this practice? Select all that apply.
Advocate Health educator Volunteer coordinator Health counselor
A school nurse is addressing dental health issues. Which activity would be most appropriate at the community level?
Advocating for the fluoridation of drinking water
When reviewing the concept of universal design with a group of community developers, the community health nurse recognizes that emphasis on which of the following is the underlying theme?
Access
When assessing vulnerable populations, a community health nurse uses a model that involves environmental resources. Which of the following would the nurse include?
Access to health care
After teaching a group of students about the factors associated with vulnerable populations, the instructor determines the need for additional teaching when the students identify which as a factor?
Acute illness
While providing preconception counseling to a group of women, the community health nurse emphasizes the need for adequate weight gain during pregnancy based on the understanding of which of the following?
Adequate weight gain is positively correlated with normal birthweight.
After teaching a group of students about public health nursing and the U.S. Public Health Service Commissioned Corps, the instructor determines that the students need additional instruction when they state which of the following is necessary to qualify for a position in the Corps?
Age over 45 years
When preparing a program about substance abuse prevention for adolescents, the community health nurse would focus on which substance as the most commonly used?
Alcohol
A community health nurse is involved in a screening program for alcohol use with an ethnically diverse population. Which of the following would be the best instrument to use?
Alcohol Use Disorders Identification Test (AUDIT)
Which of the following adolescent(s) would receive care from the advanced practice nurse without parental consent? (Select all that apply.)
An adolescent in an emergency situation; A pregnant adolescent; A 16-year-old who is living on his own (not with his parents) Most states have enacted laws allowing health care providers to treat adolescents in certain situations without parental consent. These situations include emergency care, substance abuse, pregnancy, and birth control. All 50 states recognize the "mature minors doctrine." This allows youths 15 years of age and older to give informed medical consent if it is apparent that they are capable of understanding the risks and benefits and if the procedure is medically indicated. If an adolescent has a diagnosis that has a serious prognosis, parental consent will be neededed as this is not a situation that involves emergency care, substance abuse, pregnancy, and birth control.
When developing appropriate programs for adult mental health promotion, the nurse incorporates knowledge about the most prevalent mental disorders. Which of the following would the nurse identify as the most prevalent?
Anxiety disorders
A community health nurse is reviewing the effects of the Americans with Disabilities Act of 1990. Which of the following would the nurse identify as a major result of this legislation?
Architectural barriers must be removed from pathways so that they are accessible by wheelchair.
When providing palliative care to a client receiving hospice care, which of the following would be important? Select all that apply.
Assume nothing about what is wrong. Believe what the client is reporting. Be persistent in trying different strategies.
A school nurse is reviewing the population of school-age children for chronic conditions. Which of the following would the school nurse expect to find most often? Select all that apply.
Asthma Diabetes Seizures
Which of the following would the community health nurse most commonly need to address when planning programs for children with chronic illness?
Asthma control
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?
At the city's homeless shelter, which is, by policy, vacant during the day The most convenient place for the clients would be the homeless shelter, where transportation and lack of comfort in an unfamiliar place would not be issues. It is helpful to provide comprehensive services in locations where people live and work, including schools, churches, neighborhoods, and workplaces. Thus, for the homeless population the homeless shelter would be an appropriate location. Homeless persons would probably avoid the police station, and many may not wish to go to the medical center—also, there would be transportation issues. Depending on the location of the community college, there may also be transportation issues.
A nurse is caring for a child who has been diagnosed with a chronic health condition. Which of the following conditions would the child most likely have?
Autism Spectrum Disorder (ASD) Common chronic conditions seen in children are autism spectrum disorder (ASD), spina bifida, cerebral palsy, asthma, ADHD, diabetes, cystic fibrosis, neuromuscular disorders, seizure disorders, congenital heart disease, cancer, hemophilia, brochopulmonary dysplagia, juvenile rheumatoid arthritis, and AIDS. Heart disease, emphysema, hypertension, chronic bronchitis, and adult rheumatoid arthritis are common chronic health conditions of adults, not children.
A community health nurse is preparing a presentation for a group of local community nurses about measures to decrease health disparities. Which of the following would be the least effective suggestion?
Avoiding political involvement in issues
A nurse is instructing the adult male members of a family on how to perform testicular self-examination. Which of the following would the nurse include?
Do the exam right after a hot shower.
A community health nurse is advocating for the development of school-based health centers in community high schools as a means to accomplish which of the following?
Increase access to health care services
A nurse is considering accepting the faith community nursing position within his congregation. Which of the following educational preparation is crucial for the nurse to have received?
Baccalaureate education including community health nursing experience Current educational preparation for the parish nurse includes the successful completion of extensive continuing education contact hours or designated coursework in parish nurse preparation at the baccalaureate or graduate level, as well as a thorough grasp of the scope and standards of the practice. These basic programs provide an orientation to the role and functions of the parish nurse, as well as worship experiences for the process of ministry. Graduate education is not necessary to be employed as a parish nurse. A national certification exam for parish health nurses does not exist at this time. The parish nurse must be a member of the faith community and be comfortable with worship practices and traditions to function; however, the main function of the parish nurse is not ministry.
A nurse is considering public health nursing as a career. The nurse would need to obtain which of the following for entry-level practice?
Bachelor's degree in nursing
A group of nursing students are scheduled to present a program on healthy hearts to various community groups, with a daycare center being the first location. What of the following advice should be given to them by their instructor?
Base the program on the audience's development and maturity. For younger learners, it is important to keep the lesson to no more than 20 minutes in length; to use plenty of examples, pictures, and stuffed animals in the talk; and to remember the developmental stage of the children when teaching them. It will be important for the nurse to assess the developmental level of the audience in order to determine if models or handouts are appropriate to be used. Keeping the presentation short should assist in keeping the learner's attention.
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?
Because injuries are the leading cause of death in children and most injuries are preventable The school nurse, as the trusted person at school, is able to quickly give information to help prevent injuries from occurring, since most injuries are preventable. Injuries are the leading cause of death in children and teenagers. The nurse is a trustworthy person, but the children may likely have heard this information from someone else. The role of health educator is an appropriate and important role of the school nurse which is the same as the role of the direct caregiver in caring for injured children and documenting care.
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?
Begin tests to determine the cause of the bleeding while asking about other family concerns from nutrition to shelter for the night. It is important to provide comprehensive, family-centered, "one-stop" services. Providing multiple services during a single clinic visit is an example of one-stop services. If social and economic assistance are provided and included in interdisciplinary treatment plans, services can be more responsive to the combined effects of social and economic stressors on the health of special population groups. If the family is referred to a different provider or agency, it is likely that this follow up will never occur. Only addressing the urinary infection, and not the homeless status of this family, does not provide the comprehensive services that are expected from a public health clinic.
A community health nurse is working with local schools to prevent teen pregnancy. To best improve outcomes, the nurse would focus interventions on which of the following?
Better use of contraceptives
...
Body functions Activities Environmental factors Personal factors
Which of the following is the best way to ensure good nutrition in infants?
Breastfeeding only Breastfeeding is the preferred method of infant feeding. Breast milk provides appropriate nutrients and antibodies for the infant. Breastfed infants have fewer illnesses and allergies. Breastfeeding is associated with a lower risk in developing childhood obesity. Feeding brand-name foods, homemade cereals, and supplementing with formula are not the best ways to ensure good nutrition in infants. Breastfeeding is the best option to ensure good nutrition.
When developing a plan of care for a group of men experiencing erectile dysfunction, which of the following would the nurse expect to institute first?
Lifestyle changes
A faith community nurse networks with a local transportation service to provide service to several clients who need rides to health care appointments. The nurse is functioning in which role?
Referral agent
Which of the following would a community health nurse include when describing the differential vulnerability hypothesis?
Certain groups are affected by stressful events more than others.
When providing home health care, which individual is responsible for coordinating the care?
Registered nurse
Which of the following addictive drugs is both legal and culturally acceptable throughout almost all of the United States?
Caffeine Caffeine is in commonly served beverages such as coffee, tea, and soft drinks, as well as in some commonly used pain medications. Beer, cigarettes, and mixed alcoholic beverages are not as culturally acceptable as caffeine, as there are regulations that limit the age that these products can be used.
When describing the major functions of an occupational and environmental health nurse, which of the following would the nurse identify as being the most time-consuming?
Care of injured employees
A community health nurse is making a home visit to a family who has been providing care to an older adult member with Alzheimer disease for the past 6 months. During the visit, which of the following would be most important for the nurse to assess?
Caregiver's status
A public health nurse is working with several communities to develop appropriate programs for health surveillance. Which agency would the nurse contact to obtain information on this topic?
Centers for Disease Control and Prevention
As part of a community health program to address the needs of pregnant adolescents, the community health nurse provides a class on nutrition using a variety of teaching methods and then evaluates the results of each method. Which method would the community health nurse most likely identify as being the least effective?
Classroom lecture
When evaluating a client's eligibility for Medicare-reimbursed home care, which of the following is crucial?
Client is homebound
A community health nurse is working to empower clients of a vulnerable population. Which of the following client behaviors indicates that the nurse is achieving this goal?
Collaborate with their health care providers
Which of the following activities are addressed by most public health departments on the federal, state, and local levels? (Select all that apply.)
Collecting and analyzing various health statistics; Identifying and planning for high-risk populations; Planning for and responding to emergencies The majority of local, state, and federal public health agencies engage in collecting and analyzing vital statistics, providing health education and information, receiving reports about and investigating and controlling communicable diseases, protecting the environment to reduce the risk to health, providing some health services to particular populations at risk, planning for and responding to natural and human-made disasters and emergencies, identifying public health problems for at-risk and high-risk populations, conducting community assessments to identify community assets and gaps, and partnering with other organizations to develop and implement responses to identified public health concerns. Public health departments do not regulate the practices of businesses; thus, they would not be responsible for fining or terminating businesses.
A community health nurse is presenting a program to a local elementary parent-teacher association on the topic of pediculosis. The nurse determines that the group needs additional teaching when they identify which of the following as a likely mode of transmission?
Coming into contact with an animal
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?
Community outreach When participating in community outreach, nurses reach out to residents in the community. One common way this occurs is when nurses are involved in activities such as community health fairs or festivals in the schools. As a consultant, the school nurse can provide professional information about proposed changes in the school environment and their effect on the health of the children. As a counselor, the school nurse is considered a trustworthy person to whom the children can go if they are in trouble or when they need to talk. As a researcher, the nurse can study outcomes related to school nursing services which may advance the practice of school nursing.
After teaching a class on urban health to a group of community health nursing students, the instructor determines that the teaching was successful when the students describe it as which of the following?
Considering effects of environment on the health of people living in large cities
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?
Consulant Local public health agencies provide and disseminate health information, provide leadership in health planning, provide essential public health and environmental services, analyze statistics on births to monitor community health status, and file a certificate for every birth or death in the community. Enforcement of laws and regulations related to public health nationwide, providing experts in various specialties, and surveying the state's public health needs would all occur at the state level.
Which of the following criteria must a nurse-managed health center meet to ensure designation as a federally qualified health center?
Consumers on the board of directors
After discussing nurse-managed care centers with a group of community health nursing students, the instructor determines that the teaching was effective when the students identify which of the following as one of the main challenges?
Continuing services after funding has stopped
After teaching a class about the International Classification of Functioning, Disability, and Health, the instructor determines that the teaching was successful when the students identify which of the following as a personal factor?
Coping styles
Which of the following would the community health nurse identify as a major limitation for using biological markers for screening for substance use?
Cost of the test
Which of the following would a community health nurse address as a means for enhancing the life of the public?
Creative outlets
As part of a group exercise, students are to compare and contrast home care and hospice care. The instructor determines that the activity was successful when the students identify which of the following as reflective of home health care?
Emphasis on rehabilitation
A community health nurse is part of a group planning a research study to address vulnerable populations. Until recently, vulnerable populations were not included in research studies. The underlying reason for this was which of the following?
Desire to protect these clients
Quality measures are being determined for a home health care agency. For which of the following would the agency want to achieve higher percentage rates?
Decreased pain with movement
A nurse is employed by a state public health department. Which of the following functions would most likely be completed by this agency? (Select all that apply.)
Delegating power to engage in certain activities such as quarantine; Monitoring health status of citizens within its geographic boundaries; Enforcing laws and regulations that protect public health State public health agencies are responsible for monitoring health status and enforcing laws and regulations that protect and improve the public's health. These agencies receive funding from federal agencies for the implementation of public health interventions such as the maternal and child health programs. State agencies distribute federal and state funds to the local public health agencies to implement programs and provide oversight and consultation for local public health agencies. State health agencies also delegate some public health powers, such as the power to quarantine, to local health officers. Local departments file birth and death certificates and often ask for volunteers to assist.
After teaching a group of students about the federal agencies involved in public health, the instructor determines that the teaching was successful when the students identify which agency as the main organization?
Department of Health and Human Services
When working with the older adult population in the community, which of the following would be most important for the community health nurse to do?
Develop case management programs to channel clients to appropriate services
Which of the following interventions would the nurse most likely implement when addressing the problem of asthma among school-aged children? (Select all that apply.)
Develop home and environmental assessment guides; Assess schools and day care centers for environmental "friendliness." Population-focused strategies for asthma management include education programs for families of children and adolescents who have asthma, development of home and environmental assessment guides to identify triggers, education and outreach efforts in high-risk populations to aid in case finding (e.g., in areas with low income, high unemployment, and substandard housing, where there is exposure to secondhand smoke), development of community clean air policies (e.g., no burning of leaves, use of smoke-free zones), improved access to care for asthmatic patients (e.g., developing clinic services with consistent health care providers to decrease emergency department use), and assessment of schools and day-care centers for lack of asthma triggers. Sharing nutritional information is not related to the care of asthma patients. It is not necessary that all school personnel know how to use rescue inhalers, rather those who are in direct contact with the child with asthma.
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? (Select all that apply.)
Developing mentoring programs for at-risk youth; Creat a zero tolerance policy for weapons on school property; Engaging parents in school activities Interventions that are aimed at preventing violence from occurring are: engaging parents in school activities that promote connections with their children, and foster communication, problem solving, limit setting, and monitoring of children; supporting/assisting with creating policies of zero tolerance for weapons on school property, including school grounds; and developing mentoring programs for at-risk youth and families. Encouraging students to attend the after school program at a local community center may assist with the students having additional supervision, but it does not contribute to the students having an increased loyalty or connection to the school. It is important to facilitate student connectedness to the school community.
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?
Direct clients to English-as-second-language courses Vulnerability can be reversed by obtaining resources to increase resilience. Learning the basic language of the country of residence will give immigrants the ability to communicate and navigate through systems and thus remove barriers that promote disenfranchisement and disadvantaged status. Although money, food, and clothing meet needs for the short term, they do not help the immigrant develop the power and control to improve health risks over the long term or contribute to lasting resilience.
A community health nurse is implementing a tertiary prevention activity related to tuberculosis. Which of the following interventions is the nurse most likely completing?
Directly observing clients with active tuberculosis as they take their antitubercular medications Tertiary prevention is exemplified when nurses provide directly observed medication therapy for people with active TB. Administration of skin tests, assessing for signs and symptoms, and interpreting tuberculosis skin test findings are all examples of secondary prevention as these interventions are all focused on screening or the follow up on a screening test.
Which of the following would a community health nurse expect to find in adolescents with an eating disorder?
Distorted body image
A community health nursing instructor is developing a class plan about faith community nursing. Which of the following would the instructor expect to include?
Diversity of activities and interventions
After teaching a group of students about the concept of social justice, which of the following, if stated by the group as a component, indicates effective teaching?
Diversity viewed as a strength
A nurse has just met the parents of a 10-year-old child who has been diagnosed with a congenital heart defect. When interviewing the parents, which of the following would be a priority question for the nurse to ask?
Does your child have a medical home? The use of a medical home, in which one provider or clinic has all of the child's records, is important for this population. Communication among all providers who are working with this child is essential in order for the child to achieve optimal health and functioning. Learning needs, nutritional needs, and peer relationships are important for a 10 year old child. However, without having the coordination and consistency of a medical home to coordinate medical care these other things may be insignficant.
Which of the following best describes where health care dollars in the United States be focused to improve breast cancer cure rates?
Early detection programs with referral to ongoing access to a care provider Early detection can promote a cure, whereas late detection typically ensures a poor prognosis. The differences in the outcomes between women of color and white women point to issues associated with early detection, access to health care, and follow-up by a regular care provider. Education for women about breast cancer is not as effective as early detection programs. Screening must be completed which is accomplished through secondary, not primary prevention. Tertiary care does not occur until after diagnosis has occurred and this is too late.
A nurse is implementing Wagner's Chronic Care Model (CCM). Which of the following actions would the nurse most likely take?
Educate a community group about hypertension control. Use of electronic health records, provider reminders for key evidence-based care components, interprofessional teams communicating regularly, and community health classes to educate people with chronic diseases are various ways the CCM is being implemented. Creating a budget is not a way to use CCM. Administration of immunizations and conducting depression screenings do not address the management of the most common and costly chronic diseases: heart disease, diabetes, stroke, cancer, and arthritis.
A community health nurse is evaluating a population for socioeconomic resources. Which of the following would the nurse address?
Educational opportunities
A community health nurse has prepared handouts that describe the need for annual gynecologic exams and is sending them to local health clinics that provide care for individuals with disabilities. The nurse is fulfilling which role?
Educator
When describing elder abuse to the families of older adults who are attending a local community presentation, which of the following would the community health nurse identify most commonly as the perpetrator?
Elder's partner
After teaching a class to a group of students about the most common health problems affecting older adults in the community, which of the following if identified by the students would alert the instructor to the need for additional teaching?
Emphysema
When providing care for migrant workers, which of the following would be most appropriate for the community health nurse to do?
Employ information tracking systems
After reviewing the various events associated with the history of home health care, the students demonstrate understanding of the events when they state which of the following as the most significant influence on the growth of home care agencies?
Enactment of the Balanced Budget Act
A nurse is providing contraceptive counseling to a female client. Which of the following is the most appropriate outcome of this counseling?
Ensure the individual is educated to make an informed choice about reproduction. The goal of contraceptive counseling is to ensure that women have appropriate instruction to make informed choices about reproduction. The nurse should provide a nonjudgmental approach during counseling and allow the woman to choose the appropriate contraceptive method. Nurses do advocate for reproductive services for women, but that is not a goal of contraceptive counseling. Reduction in the health risks of the individual is a goal of pre-conceptual counseling.
A pregnant woman with hypertensive disease comes to the community health center for follow-up. Which of the following would be appropriate to include when teaching the woman about controlling her blood pressure at this time?
Ensuring rest periods with legs elevated
A school nurse functions to promote a healthy school environment. Which of the following would be most appropriate for the nurse to do?
Ensuring school breakfasts and lunches are provided
A school nurse is providing care to a group of children with severe food allergies. Which of the following would be most important for the nurse to include in the child's plan of care?
Ensuring that the child has ready available access to an EpiPen®
A community implements a plan to enforce the underage drinking law. The community health nurse interprets this action as reflecting which public health model?
Environmental prevention
Which of the following is the underlying science or area of study on which public health is based?
Epidemiology It works across many disciplines and is based on the scientific core of epidemiology. Public health uses biostatistics in its practice. It is not a branch of medicine; it is an organized community approach designed to prevent disease, promote health, and protect populations. Public health is not based on the social sciences, which is the study of society and relationships.
A community health nurse has completed a community assessment. Which of the following would be next?
Establish a community diagnosis
A nurse wants to promote improved health for obese children in the community. Which of the following best describes a tertiary prevention measure that the nurse would implement?
Establish lifestyle improvement programs through local youth organizations. Tertiary prevention includes activities aimed to reduce the complications of the disease process. Only lifestyle improvement programs are directed toward preventing problems in children who are already obese. Evaluating food intake and evaluating BMI are types of screening programs (secondary prevention). Providing education programs to overweight expectant parents does not involve children.
A community health nurse meets with a group of adults at the local senior center. They range in age from 65 to 70 years. The nurse would recommend vision screening at which frequency?
Every 2 years
When assessing a vulnerable population's relative risk, which of the following would the community health nurse identify as most likely to contribute to this risk?
Exposure to abuse
A corrections nurse is visiting a local nursing school to describe this career. Which of the following would the nurse include in the discussion?
Extensive employee benefits
A local community health center is providing classes to childbearing families about the effects of alcohol use during pregnancy. During one of the classes, a community health nurse describes fetal alcohol spectrum disorder (FASD). Which of the following would the nurse include as a common finding in the newborn?
Facial abnormalities
A nurse is conducting a screening for type 2 diabetes for children attending a local school. In addition to an elevated BMI, which of the following risk factors should the nurse consider?
Family history of type 2 diabetes Screening for type 2 diabetes mellitus is recommended for children with a BMI from the 85th to 95th percentile with two or more for the following risk factors: family history of type 2 diabetes in a first or second degree relative; Native American, African American, latino, Asian American or Pacific Islander descent; signs of insulin resistance or conditions associated with insulin resistance; or maternal history of diabetes or GDM during the child's gestation. Native American, African American, latino, Asian American or Pasific Islander descent is a risk factor, not Caucasian descent. Elevated birthweight and poverty have not been identified by the American Diabetes Association as significant risk factors that indicate the need for additional screening.
When describing the population of migrant workers to a local community group, a community health nurse would identify the population as which of the following?
Farm workers living in any state in the union, often remaining "invisible"
As one aspect of ensuring adequate brain development in a child, a community health nurse would encourage the intake of which during the first 2 years of life?
Fats
A public health nurse is employed by the Indian Health Service. This nurse is working at which level?
Federal
When defining the term "frontier area," which of the following would the nurse include as the most common description?
Fewer than six people per square mile
A home health care nurse is working with informal caregivers. Which of the following is most important?
Focus on caretaker abilities, not limitations.
In the Surgeon General's "Call to Action to Improve the Health and Wellness of Persons with Disabilities," which of the following made this document unique?
Focus on personal responsibility for healthy lifestyle by persons with disabilities
When describing the differences between public health nursing and nursing in general, which of the following would an instructor include as a characteristic of public health nursing? Select all that apply.
Focus on the greater good Seeking out clients in need Community commitment
A nurse is providing preconceptual counseling to a young woman. Which of the following supplements would the nurse most likely recommend?
Folic acid Research has shown that intake of folic acid can significantly reduce the occurrence of serious and often fatal neural tube defects. A recommendation was made that women capable of or planning a pregnancy take 400 mcg of folic acid daily (USDHHS, 2010). Iron, calcium, and vitamin C are not used as routine prenatal supplements.
A local community has a significant population of migrant workers. In response, a community health nurse plans to present a program to the local community about this population. As part of the program the nurse plans to include information about Cesar Chavez, describing him as which of the following?
Founder of the United Farm Workers, who spent his life fighting for social justice
After teaching a class about the various approaches to older adult care, the instructor determines that the students have understood the teaching when they identify which of the following as the study of all aspects of the aging process?
Gerontology
Which of the following would be most important for a community health nurse to do first when working with vulnerable populations?
Get them to interact with the nurse
A community health nurse is engaged in a community-wide program for promoting nutrition in adolescents. Which of the following would lead the nurse to target the program to adolescent girls?
Girls tend to diet inappropriately.
The family of a hospice client are holding a vigil at the client's bedside. During a visit, a hospice nurse participates in this vigil and encourages each of the family members to say their good-byes. The nurse is demonstrating which of the following?
Guided letting go
As part of a health screening program, a community health nurse determines that a client is infected with the human papillomavirus (HPV). The nurse encourages the client to do which of the following?
Have a pelvic examination and Pap smear.
A home health care nurse is assigned to visit a client's home. The nurse identifies the area as a problem neighborhood. Which of the following would be most appropriate for the nurse to do?
Have another nurse come along.
Which of the following agencies was instrumental in developing the first scope and standards of parish nursing practice?
Health Ministry Association
When dealing with urban populations, which of the following issues would a community health nurse most likely face? Select all that apply.
Health disparities in the population Increased cases of asthma High levels of poverty
When developing teaching programs for a community of adult men and women, which of the following would the community health nurse identify as a key aspect for this community's ability to follow through with the teaching?
Health literacy
A community health nurse who is participating in a nutritional screening program with school-age children measures their body mass index (BMI). The majority of children fall within the 45th to 65th percentile for their age. The nurse would classify these children as which of the following?
Healthy weight
Which of the following would a community health nurse recommend that adult men and women over age 50 receive yearly?
Hemoccult stool testing
When describing the philosophy of hospice care to a group of students, which of the following would the instructor include?
Holistic and family-centered care to terminally ill clients
When developing programs to assist individuals with disability and chronic illness, which of the following would be most important?
Holistic practice
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?
Home health nursing Home health nursing is provided in the client's environment, regardless of where that may be. "Home" may be a house, apartment, trailer, boarding house, shelter, car, makeshift shelter under a bridge, or cardboard box. Community-oriented nursing refers to any care that is provided in a community setting. Hospice nursing is care that is provided to a client and his/her family who has a terminal illness. Private duty nursing is care that is primary care that is paid for by an individual who is requesting the care.
When preparing a program to address violence among school-age children and adolescents, the community health nurse integrates knowledge of which of the following?
Homicide is the second highest cause of death for all adolescents.
The community health nurse is using effect theory to design a prevention program for behavioral health. Which of the following would be the most likely place for the nurse to start?
Identifying the specific health problem
A community health nurse working with urban populations integrates the concept of social justice into practice by demonstrating which of the following?
Impartiality
A nursing instructor is preparing a group of students for a clinical rotation in a nurse-managed health center. Which of the following would the instructor include when describing the students' role?
Implementation of best practices
When describing the importance of the WHO report to a group of students, the instructor would emphasize which of the following?
Improvement in health outlook worldwide
A community health nurse is developing a program that would encourage mothers to breastfeed exclusively for the first 6 months. The nurse bases this program on the understanding about which of the following?
Infant mortality would significantly decrease.
As a guest speaker for a group of community health nurses who are considering corrections nursing as a career, a corrections nurse provides an overview of the history of corrections nursing. Which of the following would the nurse describe as the typical view?
Inmates were viewed as not deserving care paid for by public dollars.
An occupational and environmental health nurse recently treated approximately 20 employees for hand injuries. The employees all work on the factory assembly line. The nurse decides to implement a program for primary prevention. Which of the following activities would be appropriate?
Institute an orientation for employees about the equipment.
An instructor is reviewing the vision, mission, and goal of the National Nursing Centers Consortium with a group of community health nursing students. The instructor determines that additional teaching is needed when the students identify which of the following as a goal?
Instituting measures and methods to address population needs that reduce health disparities
A community health nurse is assessing an older adult's ability to perform activities such as shopping, doing the laundry, using the telephone, and handling finances. Which assessment tool would be most appropriate for the nurse to use?
Instrumental Activities of Daily Living Scale
A community health nurse is applying the behavioral model for vulnerable populations when evaluating a local community. Which of the following would the nurse include as an enabling factor?
Insurance
A community health nurse is providing a class for pregnant women about the dangers of alcohol consumption during pregnancy. Which of the following would the nurse include as an effect on the newborn? Select all that apply.
Intellectual impairment Low birthweight Altered growth and development
Which of the following activities best exemplifies a community health nurse forging a relationship?
Introducing oneself as a community health nurse
After teaching a group of students about the socioeconomic gradient in health, the instructor determines that the students understand the concept when they state that the relationship between social class and health is which of the following?
Inverse
After teaching a group of students about participatory action research, the instructor determines that the students need additional teaching when they state which of the following as a main component?
Issue identification
A community health nurse working at a local women's health clinic is planning a teaching session for a group of women about menopause. Which of the following would the nurse include in the session?
It can occur as early as age 30 but more commonly occurs at ages 45 to 55 years.
A nurse is providing nutrition counseling to the parents of a 4-year-old. Which of the following recommendations is the nurse most likely to provide?
It is recommended that the child consume approximately four cups of fruits and vegetables daily. It is recommended that children of 4 to 8 years old consume 1.5-2.5 cups of vegetables and 1-2 cups of fruits on a daily basis. It is recommended that children 4 to 8 years old consume 4-6 ounces of grains on a daily basis. It is recommended that children 4 to 8 years old consume 2 cups of dairy on a daily basis. It is recommended that children 4 to 8 years old consume 3-5.5 ounces of proteins on a daily basis.
After reviewing the impact of the Supreme Court decision Estelle v. Gamble, the instructor determines that the students understand the material when they identify which of the following about this decision?
It led to major reforms, including establishment of inmates' rights.
What has the COVID-19 pandemic shown us about public health? (Select all that apply.)
Lack of adequate vaccines to meet community's needs; Public health's need for additional funding and resources; The unrecognized importance of nurses in addressing critical response activities at all levels The COVID-19 pandemic has alerted policymakers to the weakening public health infrastructure required to respond to emerging infectious diseases, natural disasters, and bioterrorism events. Unprecedented influenza, tetanus, and childhood vaccine shortages and emerging infections competed with bioterrorism activities for resources. The general public has not understood how nursing functions (immunizations, contact tracing, testing, staffing all the over-crowded facilities) are essential in responding to all these events. For public health services to receive adequate funding, it is necessary for the public and the government to be aware of the benefits provided to a community by nurses. These events showed that the public health system needed to be strengthened in order to operate effectively to keep the public safe.
After teaching a group of community health nursing students about urban sprawl and its effects, the instructor determines that additional teaching is needed when the students identify which of the following as an effect?
Less exposure to pesticides
When developing community health programs targeting adult men, which of the following would the nurse need to integrate into the plan?
Limited male-specific research
When assessing a population's vulnerability, which of the following would the community health nurse identify as a predisposing factor?
Living conditions
Which of the following agencies are responsible for implementing and enforcing local, state, and federal public health codes and ordinances and providing essential public health programs to a community?
Local health agencies Local public health agencies are the agencies responsible for implementing and enforcing local, state, and federal public health codes and ordinances and providing essential public health programs to a community. State public heatlh ageencies are reponsible for monitoring health status and enforcing laws and regulations that protect and improve the public's health; they do not provide essential public health programs to the community. Federal health agencies develop regulations that implement policies formuated by Congress. Community health clinics may provide essential public health programs to the community, but are not responsible for implementing and enforcing local, state, and federal public health codes and ordinances.
A community health nurse visits a local women's health center to provide teaching about the effects of smoking during pregnancy. After teaching the class, the nurse determines that the women have understood the teaching when they identify which of the following as a possible maternal or infant effect?
Low-birthweight newborns
After teaching a group of students about the major types of cancer affecting men and women, the instructor determines that the teaching was successful when the students identify which of the following as the number-one cause of cancer deaths among adults?
Lung
After teaching a class about commonly used illicit substances, the instructor determines that the teaching was successful when the class identifies which of the following as the most commonly used illicit drug?
Marijuana
When describing the causes of vulnerability to a group of students, which of the following would the instructor include?
Many of the factors and conditions suggesting vulnerability overlap.
Which of the following would be the most likely source of funding for services provided in a comprehensive primary care center?
Medical insurance plans
After teaching a group of students about hospice and its view of end-of-life care, which statement by the students indicates a need for additional teaching?
Medical technology should be used widely.
Assessment of a client in the home reveals that his services will be paid by a government source. Which of the following would be a possible source of payment?
Medicare
A community health nurse is speaking to a group of parents of incoming college freshmen who will be living in the dormitories. The focus of the program is on the college health program, health issues, and immunizations. Which immunization would the nurse most strongly encourage the students to receive if they have not received it previously?
Meningococcal vaccine
A nurse is implementing a tertiary prevention program to promote health among middle-aged women with diabetes. Which of the following best describes the intervention being implemented by the nurse?
Monitoring blood glucose levels closely and modifying diet accordingly Tertiary prevention includes activities that are aimed to reduce the complications of the disease process. Only monitoring blood glucose levels is directed toward preventing problems in women who already are diagnosed with diabetes. Developing lifestyle improvement programs for women at risk for diabetes is an example of secondary prevention as this group is at risk for developing the problem. Presenting lifestyle management at women's conferences is an example of primary prevention, preventing the disease before it occurs. Screening glucose levels is an example of secondary prevention, as all screening tests are secondary prevention.
A community health nurse is describing social capital and its impact on populations to a group of local community leaders. Which of the following would the nurse suggest as a way to improve the social capital of the community?
More community organizations
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?
Most school districts are unable to afford a nurse in every school. In Healthy People 2020, objective ECBP-5 states that there should be one nurse for every 750 children in each school (U.S. Department of Health and Human Services, 2010). Most schools have not achieved this objective. In 2006, approximately 40% of the nation's schools met that standard. The new objective is that 44.7% of the country's elementary, middle, junior high, and senior high schools have this many nurses by 2020 (U.S. Department of Health and Human Services, 2010). Having fewer nurses in the schools means that the nurses are expected to perform many different functions. It is therefore possible that they are unable to provide the amount of comprehensive care that the students need. There is not a national requirement that school nurses must have baccalaureate preparation or school nurse certification. Preference of employers by nurses does not impact why school nurses are unable to ensure that adequate care if provided. School districts may see that the need for nurses is important, but may have insufficent funds to be able to afford to pay for their services.
Which statement about eating disorders is correct?
Most women with bulimia are concerned with the shape and weight of their body. Those with bulimia are usually concerned with the shape and weight of their body. Those with anorexia view themselves as normal or overweight, purging is associated with bulimia, and anorexia is considered to have more complications than bulimia.
When providing safety education for parents of school-age children, the community health nurse would focus interventions on which of the following as the priority?
Motor vehicle safety
Which of the following is a primary requirement for a client to be eligible for home health nursing and Medicare reimbursement of services?
Must be homebound To receive home health services, clients must be homebound. Although home health care is less expensive than hospitalization, it remains much more costly than a traditional visit to a clinic; therefore, those who are not homebound would be expected to receive care at a clinic. It is not necessary to be living in a medically underserved area or be indigent in order to receive home care services. In order to receive Medicare reimbursement, the client must have Medicare.
A community health nurse is compiling a list of organizations that serve persons with disabilities. Which of the following would the nurse categorize as a federal agency?
National Council on Disability
A community health nurse is working with a group of visually impaired individuals and is developing a program to promote self-confidence and self-respect. Which of the following organizations would be a valuable resource for the nurse?
National Federation of the Blind
A community health nurse is planning to apply the International Classification of Functioning, Disability, and Health to clinical care in the community. The nurse could use this document as a basis for which of the following?
Needs assessment
A patient comes to the community health clinic with complaints of changes in urination. Which of the following would lead the community health nurse to suspect that the patient has benign prostatic hypertrophy (BPH)?
Nighttime frequency
A community health nurse implements the use of "promotoras" to promote health in migrant communities. Which of the following best describes a promotora?
Nonprofessional community outreach worker
A rural community health nurse is a guest speaker at a nearby nursing school. The nurse is describing how rural community health nursing compares with community health nursing in urban and suburban areas. Which of the following would the nurse include about rural community health nurses?
Nurses viewed as active, highly respected community members
When describing public health research to a group of students, which of the following would the nurse emphasize as the ultimate goal?
Obtain information to benefit the community
A community health nurse is working with an older adult population ranging in age from 75 to 85 years of age. The nurse correctly classifies this group as which of the following?
Old-old
When describing the characteristics of a typical rural population to a group of community health nurses, which of the following would the nurse include?
Older, white, with a lower income and less formal education
A rural community health nurse is acting in the role of a mentor. Which of the following activities would the nurse most likely be doing?
Orienting a new rural health nurse to the community
A community health nurse is developing a plan to address the nutritional needs of infants, toddlers, and preschoolers. Which of the following would the nurse need to incorporate as a major issue associated with nutritional problems?
Overfeeding of infants
A community health nurse is working to improve the health of children of migrant families. Which of the following issues would be of least importance for the nurse to address?
Participation in chores
A nurse is implementing a primary prevention activity to decrease the incidence of communicable disease. Which of the following actions is the nurse most likely taking?
Partnering with schoolteachers to teach and observe hand washing techniques in elementary school children An example of primary prevention is to educate daycare centers, schools, and the general community about the importance of hand hygiene to prevent transmission of communicable diseases. The goal of primary prevention is to prevent the disease from occurring. Identifying and treating clients is part of secondary prevention, as screening is being completed to determine at the earliest stage possible who has the disease. Providing case maangement services for those with communicable disease and performing DOT therapy with clients are both examples of tertiary prevention as the populations that the nurse is working with both already have the disease. Through tertiary prevention, the nurse is working to restore their health to the highest level possible.
When assessing a group of migrant farmworkers, the community health nurse notes that the group leaves their homebase for part of the year to travel to the same place along a route during the agricultural season, usually returning on a yearly basis. The community health nurse identifies this as which of the following?
Point-to-point migration
A community health nurse is preparing a teaching program that addresses chronic diseases common among older adults. Which of the following would be most appropriate to include?
Postural hypotension can be related to falls in elders.
Which of the following factors has the largest impact on health disparities among all populations?
Poverty Poverty is a strong and underlying current factor that affects all special groups. Ethnicity, education level, and lifestyle choices do not have as large of an impact on health disparities than income level related to poverty.
A community health nurse is applying Gordon's classification of disease prevention model to address prevention of alcohol use during pregnancy and prevention of fetal alcohol syndrome. Which of the following populations would the nurse target using indicated prevention strategies?
Pregnant women who have a child with fetal alcohol syndrome
A community health nurse is preparing a presentation about drug use and abuse for a group of adults. Which of the following would the nurse include as the one of the fastest-growing forms of drug abuse?
Prescription drugs
A school nurse is describing the responsibilities associated with this specialty to a group of students. Which of the following would the school nurse identify as a primary responsibility?
Preventing illness among the school community
A community health nurse is implementing a family planning program near inner-city schools. The nurse is engaging in which type of health service?
Preventive program
A home health care nurse is invited as a guest speaker to talk to a group of students about the challenges of working in the home. As part of the discussion, the nurse describes medication safety. Which of the following would the nurse include as a measure to address this issue?
Reconciling drugs in the home with those on the discharge sheet
Which of the following activities best reflects a public health nurse's role in the public health function of assessment?
Prioritizing the issues of a community to determine appropriate interventions
A community health nurse is providing an in-service program to the agency staff about effect theory, which will be used to develop behavioral intervention programs. The nurse determines that the staff needs additional teaching when they identify which of the following as a component of the theory?
Process theory
Which of the following would an occupational and environmental health nurse need to keep in mind when selecting this field of nursing?
Production or service is a primary goal.
A community health nurse is planning activities to promote mental health. Which of the following outcomes would be the priority?
Productive activities
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?
Promote healthy lifestyles with physical activity. The nurse is engaging in primary prevention efforts against substance abuse by helping to promote healthy lifestyles and resiliency factors. The purpose of the nurse requesting this funding is to address the problem of substance abuse, not obesity. This program may offer an alternative to children and keep them safe and off of the streets; however, the primary objective is to address the overall healthy lifestyle of these youth.
When developing the plan of care for a client receiving home health care services, which of the following would be the most important goal?
Promoting client independence
A group of community health nurses who work in continuing care retirement centers are asked to talk to a group of seniors about what they do. Which of the following would the nurses identify as unique to this setting?
Provide a variety of housing and care options that elders need as they age
Which of the following would the community health nurse use to describe resiliency?
Recovery ability
After teaching a group of students about community nutrition programs, the instructor determines that the teaching has been successful when the students identify which of the following as a result of the WIC program?
Reduced rates of infant iron deficiency anemia
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.)
Provide realistic feedback to the daughter about her performance at school. Encourage her daughter to become involved in extracurricular activities. Provide opportunities for her daughter to develop her talents. Prevention guidelines to teach parents and teachers how to increase resiliency in youths include the following strategies: help them develop an increased sense of responsibility for their own success; help them identify their talents; motivate them to dedicate their lives to helping society rather than believing that their only purpose in life is to be consumers; provide realistic appraisals and feedback, stress multicultural competence, and encourage and value education and skills training; and increase cooperative solutions to problems rather than competitive or aggressive solutions. Based on the inforamtion provided, there is no reason to suggest the the child needs to develop new friendships. Keeping consistent friendships may provide the support the child needs to avoid engaging in these behaviors.
A community health nurse works to offer increased health care services to meet the needs of a local migrant population. Which of the following ideas will work well for this population? Select all that apply.
Providing a mobile van clinic that comes to the farms during the day. Offering a clinic at the migrant camp from 7 to 10 p.m.. Offering school-based health services for the children. Providing a breakfast program for the children at school.
Which of the following is the primary focus of hospice care?
Providing palliative care to maintain comfort until death The primary goal of hospice care is to help maintain the client's dignity and comfort. Alleviating pain; encouraging the client, family, and friends to communicate with each other about essential sensitive issues; and coordinating care to ensure a comfortable, peaceful death all contribute to palliative care. Curing the disease is not part of hospice care; patients who have begun hospice care are no longer seeking a cure for their disease or illness. Hospice care focuses on providing safe and effective care so that the client is able to maintain dignity and comfort during the dying process; it does not relate to decreasing the use of hospital resources. The purpose of hospice care is not to teach self-care.
A community health nurse is working with a group of school nurses to develop interventions for a 10-year-old girl exhibiting signs and symptoms of school refusal. Which of the following would be most appropriate?
Providing relaxation training
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?
Psychosocial norms of the setting The employee will only be safe if the employee uses the PPE. If the employee doesn't use the PPE or uses only part of the equipment, then the employee will be at risk. The primary determination of whether the PPE is used correctly and used all the time is the psychosocial norms of the setting. If others are careless in PPE use, then such carelessness is the norm. If everyone is extremely careful to use their PPE, then that is the norm in that setting. Through education, employees have the knowledge and skills available to correctly use PPE. The educational session should also make the employees comfortable with its use. The use of PPE does not depend on the effectiveness of the teaching, rather the employees choice to correctly put into practice the knowledge and skills that that they have received.
Which of the following behaviors results in men being less healthy than women?
Reluctance to visit physicians A major obstacle to improving men's health is their apparent reluctance to consult their primary care provider. Men are not well connected to the health care system. Men do not participate in health care at the same level as women, apparently because of the traditional masculine gender role learned through socialization (Bonhomme, 2007). Only 57% of US men see a doctor, nurse practitioner, or physician assistant compared with 74% of women (AHRQ, 2010). Hobbies, employment, and preference on how to spend money may influence a man's decision to seek medical care. However, these have not been identified as major obstacles in comparance to overall reluctance to seek care.
An instructor is reviewing the principles of the U.N. Convention on the Rights of Persons with Disabilities with a class. Which of the following would the nurse include?
Respect for individual autonomy
A community health nurse is developing a plan of care for a family who is providing round-the-clock care in their home for a daughter who is chronically ill. Which of the following would be most important for the nurse to integrate into the plan?
Respite care
Which of the following would be appropriate as secondary-level prevention activities focusing on child abuse and neglect?
Respite care for families with special needs children
A home health nurse is preparing to terminate the first home visit with teenage parents and their new baby. Which of the following actions will the nurse take before leaving?
Review the family's learning and other accomplishments of the visit During the termination phase, the nurse reviews the visit with the family, summarizes what has occurred and what has been accomplished, and may make plans for future visits. The incorrectoptions listed occur during the pre-visit phase.
A community health nurse is working with other professionals to develop preventive programs to address the leading cause of death in men and women. Which of the following would be appropriate?
Risk reduction for heart disease
When working with community groups to develop appropriate programs for adolescent health promotion, the nurse integrates knowledge of the Healthy People 2010 objectives, keeping in mind that many of the objectives address which of the following?
Risk-taking behaviors
A corrections nurse is proactively working with the institution to develop programs to address future trends. Which type of program would be most appropriate for the nurse to recommend?
Routine cervical cancer screening for female inmates
A public health nurse traces sexual contacts of clients with sexually transmitted diseases for screening and treatment. Which of the following levels of prevention is being implemented?
Secondary prevention Tracing individuals exposed to a client with a sexually transmitted disease is secondary prevention because the nurse is attempting to find those exposed and screen them. Once the exposed persons have been located, screening is another secondary prevention activity. Through tertiary prevention, the nurse is working to restore their health to the highest level possible. If the nurse were to provide direct care to the clients with sexually transmitted diseases this would be an example of tertiary prevention. The goal of primary prevention is to prevent the disease from occurring. Thus, when providing primary prevention the nurse could provide free condoms for sexually active persons or provide education about ways to prevent the tranmsission of these diseases.
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?
Secondary prevention Screening homeless adults and providing medications to those who test positive for TB are examples of secondary prevention. The TB screening identifies infection in early stages. Medications work to prevent infection from developing into disease. Primary prevention refers to actions taken to prevent the disease from occurring. Tertiary prevention refers to actions taken after the disease has already occurred. A screening test can not be both secondary and tertiary prevention.
Which of the following would be least helpful to a novice community health nurse working with vulnerable populations who is feeling overwhelmed and somewhat guilty about her personal situation as compared to her clients?
Sending a personal donation to an agency in the area
Which of the following factors predisposes many migrant farmworkers to disenfranchisement?
Short length of time in the community Disenfranchisement refers to a feeling of separation from mainstream society. The person does not seem to have an emotional connection with any group in particular or the larger society. For migrant workers who are frequently moving, the short length of time they stay in the community does not allow for the development of social ties. Being a minority group member would not by itself cause disenfranchisement if the minority group member lived in a community with persons from similar ethnic and cultural backgrounds. An inability to attend religious services or previous physical abuse are not specifically related to disenfranchisement of the population of migrant farmworkers.
While working in a community health clinic, a community health nurse interviews a 24-year-old client. Which of the following would lead the nurse to suspect that the client is binge eating?
Significant weight loss from dieting last year
Which of the following care options would be most appropriate for an older adult who experiences confusion, requires daily insulin injections and blood glucose monitoring, and needs assistance with bathing, dressing, and feeding?
Skilled nursing facility
When assessing a group of individuals for factors related to an increased risk for alcohol use disorders, which of the following would the nurse expect to find?
Social anxiety difficulties
A community health nurse is working with a grant-funded project to address stroke prevention nationwide. After reviewing statistics related to stroke, which area of the United States would the nurse identify as having the greatest need for this type of program?
Southeast
A community health nurse is working with local community agencies to provide services for children and adolescents with disabilities. Based on the nurse's knowledge of the most common disabilities affecting this group, the nurse would advocate for which of the following to address the largest group?
Special education services
Which of the following principles is central to the role of the faith community nurse?
Spiritual dimension of care The spiritual dimension of health care is central to the practice of faith community nursing. Advanced nursing practice education and skills, although helpful, is not necessary for a nurse to become a parish nurse. Having a faith that is consistent with those who the nurse is working with is helpful, but not essential to the role of the parish nurse. Willingness to serve others is not specific to the role of the parish nurse, but rather a role that all nurses should embrace.
When assessing a group of men in their fifties and early sixties, the community health nurse determines that the men would need assistance with this stage of life when they exhibit which of the following?
Sporadic exercise
A community health nurse is working with a group of pregnant women in the community to reduce risk factors associated with low-birthweight newborns and infant mortality. Which of the following would the nurse address?
Strenuous employment
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?
Strongly consider not applying, because this population will be expensive to treat. Many agencies do not wish to provide services to vulnerable populations. Vulnerable populations are more expensive to treat because they have multiple, cumulative risks and require special service delivery considerations (e.g., to help overcome transportation problems or provide culturally competent care). Because of the major costs associated with providing care to this population and risks related to reimbursement, it would not be in the best interest of the agency to want to eagerly apply to provide care to this group.
Which activity would an occupational and environmental health nurse expect to perform in the future based on current trends?
Suggest cost-effective in-house health services
After teaching a group of women in the community about common mental health disorders affecting them, the community health nurse determines the need for additional teaching when the group identifies which of the following as common in women?
Suicide completion
When working with school districts, which of the following would the community health nurse encourage as the most effective school-based approach to prevent teenage suicide?
Suicide prevention programs with direct interventions
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.)
Support an increase in the availability of recreational facilities. Provide general screenings for substance abuse. Supporting an increase in additional recreational facilities would engage the community members in healthy activities rather than having them potentially turn to substances for relaxation. Providing screenings for substance abuse in the community may assist community members in recognizing the problem sooner. It would not be appropriate to educate preschoolers about the long-term side effects of drugs and alcohol. Preschoolers have difficulty understanding long term effects. This education may be more appropriate for older students. Lobbying state legislators for increase in a higher cigarette tax may be beneficial, but this intervention is focused on a larger area than only the community where the nurse is working.
When describing the changes occurring in the older adult population globally, which of the following would be most accurate?
The over-80-years age group is the fasting-growing segment of the group.
When describing the role of hospice nurses to a group of students, a hospice nurse identifies which of the following as most important?
Sustaining oneself
A nurse wants to empower the family of a mother who has been newly diagnosed with breast cancer. Which of the following actions would the nurse most likely take?
Teach the family how to navigate the health care system. Definitions of empowerment reflect three characteristics of the empowered family seeking help: access and control over needed resources, decision-making and problem-solving abilities, and the ability to communicate and to obtain needed resources. Approaches for helping individuals and families assume an active role in their health care should focus on empowering, rather than giving direct help.
Which of the following would the community health nurse implement as primary prevention efforts to reduce substance abuse?
Teaching teens about the genetic predisposition to alcohol addiction
A nurse advises a client who has HIV not to donate blood, plasma, or organs. Which of the following levels of prevention is being used?
Tertiary prevention Tertiary prevention includes those interventions aimed at disability limitations and rehabilitation from disease, injury, or disability. Primary prevention and health promotion both address the use of interventions before the disease occurs and to reduce the risk of developing the disease. Secondary prevention is aimed at detecting the disease early through screening programs and early intervention for at risk individuals.
A community health nurse is reviewing research related to women's health. Which of the following would the nurse use to obtain information about postmenopausal women's health?
The Women's Health Initiative
A community health nurse is meeting with a group of individuals who have been diagnosed with a serious mental illness. The nurse interprets this to mean which of the following?
The clients have impaired functioning and quality of life,
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?
The fact that tobacco smoking causes more deaths than any other behavior in the United States. The most relevant action in this case is making it clear to students that tobacco is a drug—and that smoking cigarettes accounts for one in five deaths in the United States. Smoking is the foremost preventable cause of death in the United States. Because the students are engaging in tobacco use, this is the most important topic to address with them at this time. If the students were not engaging in this behavior the other topics of commonly used drugs on campus, just "saying no", and overcoming peer pressure may have been just as appropriate.
A client will receive hospice care under the Medicare hospice benefit. The nurse understands that which of the following is true?
The hospice acts as clinical and financial case manager.
A nurse is employed at the state department of public health. Which of the following is a fundamental principle guiding his practice?
The interaction of the local-state-federal partnership is critical to success. In the United States, the local-state-federal partnership includes federal agencies, the state and territorial public health agencies, and the local public health agencies. Their effective interaction is critical to the effective use of both financial and personnel resources to address the health of populations. Nurses working in all of these agencies work together to identify, develop, and implement interventions that will improve and maintain the nation's health. Decisions can be made and implemented at the federal, state, and local levels. The health of individuals and populations is influenced by the health policies that are in place. The state agency may provide some oversight of local health departments, but that is not its primary purpose.
When visiting a client in the home for the first time, which of the following is critical to remember?
The nurse is a guest in the client's home.
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?
The sidestream smoke that the baby is exposed to is more dangerous than the mainstream smoke that the parents are inhaling themselves. Sidestream smoke contains higher concentrations of toxic and carcinogenic compounds than mainstream smoke. Sidestream smoke contains higher concentrations of toxic and carcinogenic compounds than does mainstream smoke.
Which of the following health conditions would the corrections nurse expect to address as most prevalent? Select all that apply.
Tuberculosis Hepatitis C Substance Abuse
Which of the following would a community health nurse use to define vulnerable populations?
Those at increased risk for adverse health outcomes
When developing plans for older adults in the community, the community health nurse would focus activities on which of the following?
Thriving
A home health nurse who is visiting a family for the first time asks, "Could we review your extended family and other persons or groups with whom you interact each week?" Which of the following provides the best rationale for the nurse asking this question?
To assess the family's environment and social resources and risks The question by the nurse indicates that she is trying to obtain an ecomap. Ecomaps can provide information about relationships that the family has with others (such as relatives and neighbors), the family's connections with other social units (such as church, school, work, clubs, and organizations), and the flow of energy, positive or negative, in the family. An ecomap represents the family's interactions with other groups and organizations. Environmental or social risk and resources can be assessed from an ecomap. An ecomap does not assess extended family relationships or financial assets. An ecomap is not used as a communication method.
After teaching a group of students about leading health risks, the instructor determines that the teaching was successful when the students identify which of the following as the leading health risk?
Underweight
A group of students are studying for a test on child health statistics. The students demonstrate that they are prepared for the test when they identify which of the following as a major cause of death in the 1- to 4-year-old population?
Unintentional injuries
After teaching a group of community health nursing students about the trends affecting occupational and environmental health nursing, the instructor determines that more teaching is needed when the students identify which of the following as a trend?
Upturn in the global economy
Which of the following measures would be most appropriate for a community health nurse to include when developing programs to address childhood obesity?
Urging participation in physical activity for 30 minutes per day
A community health nursing student is interviewing several occupational and environmental health nurses about their experiences. Each of the nurses works in a small organization and is the only nurse for the company. Which of the following would the student most likely note as being similar among the nurses?
Use of critical thinking skills
Which of the following would a faith community health nurse identify as being the same as all other professional nurses?
Use of the nursing process
When describing nurse-managed health centers to a group of students, which of the following would the instructor emphasize?
Used as a vital "safety-net" health care provider
A community health nurse working with a group of vulnerable clients is focusing on empowering them. Which of the following would be most effective?
Viewing the clients as active partners in the process
A school nurse who is not a nurse practitioner works in an elementary school (K-4) with 1,200 students. Which of the following would the nurse engage in with this group? Select all that apply.
Vision and hearing screening Teaching basic health practices Monitoring chronic illnesses
An instructor is describing the various types of home health care agencies and uses the visiting nurse association as an example of which type?
Voluntary nonprofit
A group of students are preparing for an examination focusing on the legislation associated with disabilities. The students demonstrate understanding of the material when they identify which of the following as the first piece of legislation?
Voting Accessibility for the Elderly and Handicapped Act
During a home visit to a family, a community health nurse encourages the mother, age 42, and grandmother, age 67, to have a clinical breast exam at which frequency?
Yearly
