Community Final
A community health nurse is teaching a community group about the Medicaid program. Which statement from the group would indicate to the nurse that additional teaching is necessary? A) Medicaid has a monthly fee that recipients must pay. B) Medicaid is administered individually by each state. C) Medicaid will provide nursing home services to those over 21 years. D) It is possible to be on both Medicare and Medicaid
A) Medicaid has a monthly fee that recipients must pay.
A community health nurse implements the use of promotoras to promote health in migrant communities. Which person would the nurse be using A) Nonprofessional community outreach worker B) Trained childbirth assistant C) Retired nurses knowledgeable of the area D) Language translators
A) Nonprofessional community outreach worker
When attempting to describe the characteristics of a typical rural population to a group of community health nurses, which characteristic would the nurse include? A) Older, with a lower income and less formal education B) Young minorities with a higher income and less formal education C) Wealthier, more highly educated, older White Americans D) A reflection of the population as a whole
A) Older, with a lower income and less formal education
The community health nurse is concerned for the local community with the raising health care costs. The nurse recognizes that managed competition is a potential solution, based on which factor? A) Promotes cost containment and universal access to health care B) Eliminates burdensome government regulations C) Reduces state and federal control over health care delivery D) Discourages consumers from making responsible choices
A) Promotes cost containment and universal access to health care
A public health nurse is discussing the core public health functions with a group of student nurses. Which fact should the nurse include in the discussion? A) Public health nurses practice as partners with other public health professionals within these core functions. B) Assessment involves the actual provision of services. C) Policy development relates to assessment. D) Assurance means that the public health agency must directly provide the needed services.
A) Public health nurses practice as partners with other public health professionals within these core functions.
When providing home health care, which individual is responsible for coordinating the care? A) Registered nurse B) Social worker C) Physician D) Dietician
A) Registered nurse
When assessing a family, which would lead the nurse to question the health of the family? A) Role relationships are inflexible. B) Coping is actively attempted. C) Family members communicate regularly. D) The family lacks regular links with the broader community
A) Role relationships are inflexible.
A community health nurse is reviewing information related to rural hospitals and closures. Which reason would the nurse most likely note as an issue that would force the closure of a rural hospital? A) Rural hospitals have a high risk for financial problems. B) Rural hospitals do not have access to high-tech equipment and services. C) Rural hospitals are able to attract many specialty physicians. D) Many rural residents depend heavily on public health department services
A) Rural hospitals have a high risk for financial problems.
The home health nurse is completing a genogram depicting three generations of family history. Which object would the nurse use to demonstrate a marriage relationship between two individuals? A) Solid line B) Broken line C) Triangle D) Square
A) Solid line
A public health nurse has been meeting with a group of clients who have recently been diagnosed with HIV. The nurse has noted improved appointment compliance among the group with the use of which technique? A) Text messaging B) Mailed post cards C) Monthly newsletters D) Voice messages
A) Text messaging
A public health nurse is organizing a group consisting of health care providers from other clinics and facilities in the community to address various challenges in providing adequate care to the community. The nurse recognizes that inadequate sharing of health records among the facilities can be addressed best by which solution? A) Use of compatible software programs among facilities B) Educating public on advantages of sharing information C) Management of electronic health records by a local information technology (IT) company D) Encourage each citizen to store their medical information in a portable electronic device to carry with them to share
A) Use of compatible software programs among facilities
An instructor is describing the various types of home health care agencies and uses the visiting nurse association as an example of which type? A) Voluntary nonprofit B) Hospital based C) For-profit proprietary D) Noncertified
A) Voluntary nonprofit
. A community health nurse visits an 81-year-old newly diagnosed insulin-dependent diabetic who lives alone. The nurse has visited the family three previous times and is visiting early in the morning to observe his client's insulin administration technique. The nurse finds the client depressed over his or her situation one morning. The nurse suggests that together they list positive points about his or her situation and discuss his or her feelings. The nurse is demonstrating: A) strengthening. B) data collection. C) goal-directed questioning. D) measuring family functioning.
A) strengthening.
19. A community health nurse determines that it is time for teaching a family about health promotion activities one member states: A) "Is there a place we can go for the medicine?" B) "It's time we do something about eating right." C) "When are you coming back to visit?" D) "Our grandchildren visit every summer."
B) "It's time we do something about eating right."
A home health care nurse performs 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? A) 30 days B) 60 days C) 90 days D) 120 days
B) 60 days
A new graduate is exploring various options in public health nursing employment. The nurse recognizes a major difference between a rural and metropolitan setting is determined by which factor. A) Federal legislation B) Complexity C) State legislation D) Leadership
B) Complexity
The home health nurse is working with a client and their family during care transition. The home health nurse is operating within which standard of practice? A) Consultation B) Coordination of care C) Collaboration D) Communication
B) Coordination of care
A public health nurse is seeking grants to assist with providing low- to no-cost influenza shots for a small rural community, which routinely experiences high rates of influenza each winter. Which action by the nurse will help improve the changes of a grant being awarded to this community? A) Verified low income for the community B) Documented collaboration with other local health facilities C) Pledges from community members to accept flu shot if free D) Agreement to be involved with a research project if chosen
B) Documented collaboration with other local health facilities
The community health nurse is completing an initial home visit for a family and will need to include a visual that depicts the dynamic family-environment interactions. Which diagram would the nurse use to depict this information? A) Genogram B) Eco-map C) Gedcom file D) Satellite map
B) Eco-map
A community health nurse is remaining calm and firmly reassuring when dealing with a family in acute crisis. The nurse recognizes this is the best defense against which barrier to communication? A) Filtering information B) Emotional influence C) Language barrier D) Selective perception
B) Emotional influence
During a lively class discussion on health care rationing, several students indicate that they find this upsetting. What is the best response from the instructor? A) Rationing is the end result of today's market. B) Fair rationing focuses on the needs of the population. C) The main focus for rationing is to expand medical care to all. D) Advances in knowledge and technological capabilities will eliminate the need for rationing in the future.
B) Fair rationing focuses on the needs of the population.
Which would a community health nurse use when conducting an outcome evaluation? A) Organization B) Family progress C) Timing D) Performance
B) Family progress
A public health nurse is reviewing information sent from various facilities in a large community and notes an unexpected increase in the cases of Lyme disease. Which resource is available to assist this nurse in planning an appropriate response? A) Electronic health records (EHR) from each facility B) Geographic Information System (GIS) C) Emailing a survey to each patient diagnosed with Lyme disease D) Door-to-door survey of the affected neighborhoods
B) Geographic Information System (GIS)
The nurse educator knows that the nursing student has grasped the concept of self-evaluation when the nursing student makes which statement? A) It is important for the family to evaluate itself. B) It is important for the nurse's growth and effectiveness as a community health nurse. C) Evaluations by others are not helpful. D) Individuals can always see their own strengths or flaws.
B) It is important for the nurse's growth and effectiveness as a community health nurse.
A home health care nurse is assigned to visit a client's home. The nurse identifies the area as a problem neighborhood. Which action would be most appropriate for the nurse to take? A) Perform the visit via telephone B) Make joint visits C) Reschedule the visit for another time D) Leave the cell phone at home
B) Make joint visits
A group of students are preparing to debate about public health care agencies and private health care agencies. Which factor should the group representing the private sector include in the debate? A) Are ready for disasters B) More likely to promote health legislation C) Administers grants to provide care D) Usually focus on needs that are met
B) More likely to promote health legislation
A community health nurse arrives at a family's home, which behaviors by the nurse would be non therapeutic? A) Maintaining eye contact with the family members B) Paging through paperwork for information C) Sitting on the furniture near the family members D) Placing car keys in the nurse's carryall bag
B) Paging through paperwork for information
A student nurse is having difficulty understanding the differences between public health care agencies and private health care agencies. What is the best response from the instructor? A) Private sector health services are complementary and supplementary to government health agencies. B) Public sector health care agencies usually meet the needs of people with special needs. C) Private sector health agencies usually are constrained in developing innovations in health care. D) Public health sector agencies generally satisfy the health care needs of a community.
B) Public sector health care agencies usually meet the needs of people with special needs.
The nurse is planning to make a home visit on a client who has Medicare as a primary payer. The client has been receiving home care for 60 days. The nurse would select which assessment to complete during the home visit? A) OASIS-1 B) Recertification C) Discharge assessment D) Transfer assessment
B) Recertification
An instructor is describing the various differences between government health agencies and private organizations. Which comment by the students would indicate understanding of the function of a public health agency? A) Most often have a very specific focus B) Responsible for promoting and protecting the health of everyone C) Limits employment to nurses and environmental health practitioners D) Works independently with complete autonomy
B) Responsible for promoting and protecting the health of everyone
When describing the role of hospice nurses to a group of students, a hospice nurse identifies which action as most important? A) Speaking the truth B) Sustaining oneself C) Encouraging choice D) Strengthening the family
B) Sustaining oneself
When evaluating a client's eligibility for Medicare-reimbursed home care, which is crucial? A) The client needs visits by a homemaker. B) The client is homebound. C) The client is a veteran. D) The client is terminally ill.
B) The client is homebound.
A group of student nurses are discussing the various international health organizations. Which statement at the end of the discussion indicates that the students understand the information? A) PAHO is a separate agency from WHO. B) UNICEF promotes child and maternal health and welfare globally. C) WHO focuses primarily on developing countries. D) UNICEF is a temporary emergency program
B) UNICEF promotes child and maternal health and welfare globally.
The family of a hospice client is 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: A) palliative care. B) guided letting go. C) connecting. D) responsive use of self.
B) guided letting go.
During a home visit and assessment of an infant and new mother, the nurse determines that the infant looks healthy. The mother asks several questions and listens attentively. One question she asks is whether the nurse is going to visit her again. Which response would be most appropriate? A) "Your baby looks healthy. You should not have any further questions." B) "The agency limits the number of visits I can make; I will let you know." C) "I plan to visit again. What would you like to accomplish at the next visit." D) "I can come weekly for the next 16 weeks, and then a staff nurse will visit."
C) "I plan to visit again. What would you like to accomplish at the next visit."
During a home visit, a client asks the community health nurse to take his or her shopping to purchase some of the food items he or she needs for his or her diet, which response by the nurse would be most appropriate? A) "I can't, I'm going in a totally different direction." B) "You need to find some other way to get to the store." C) "I'll help you find a way to get to the store." D) "Use the foods you have in the house and shop next week."
C) "I'll help you find a way to get to the store."
An instructor is discussing the impact of the Shattuck Report on community health care. The instructor recognizes the students understand the information by which response? A) "It influenced the speed with which health-focused bills pass the legislature." B) "The report set up the organizational structure of the U.S. Public Health Service." C) "It emphasized sanitary progress forming the basis for current public health practice." D) "It de-emphasized the issues addressed in the Hebrew hygienic code."
C) "It emphasized sanitary progress forming the basis for current public health practice."
The instructor is leading a class discussion on macroeconomics and its effect on today's health care. Which effect should the class identify as a result of macroeconomics on health care after the discussion? A) Quantity of services available B) Consumer's willingness to buy services C) Comparison of health care spending between two entities D) Allocation of the available resources
C) Comparison of health care spending between two entities
A community health nurse is attempting to empower a family to become independent. Which action would be most appropriate? A) Focus attention on the problem areas B) Do for the family what they cannot C) Emphasize the family's strengths D) Reinforce positive traits
C) Emphasize the family's strengths
When providing care for migrant workers, which of the following would be most appropriate for the community health nurse to do? A) Maintain existing services B) Use standard methods of health care delivery C) Employ information tracking systems D) Use professionals for community outreach
C) 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 event as the most significant influence on the growth of home care agencies? A) Creation of the visiting nurse associations B) Era of the Medicare Home Health Benefit C) Enactment of the Balanced Budget Act D) Discharge of nonacute clients
C) Enactment of the Balanced Budget Act
A new graduate nurse is expressing frustration with the supervisor concerning the apparent lack of patients taking conversations serious and not following care plans. Which skill will be most important for the supervisor to evaluate? A) Active listening B) Paraphrasing C) Nonverbal messages D) Rapport
C) Nonverbal messages
A public health nurse is responsible for teaching school-aged children how to live with type 1 diabetes mellitus. The nurse has utilized various approaches and techniques to help these young clients learn and cope with their challenges. The nurse recognizes which video game can be very effective to achieve this goal? A) Snow World B) Bronkie the Bronchiasaurus C) Packy and Marlon D) SpiroGame
C) Packy and Marlon
. A home health care nurse is invited as a guest speaker to talk to a group of students about challenges of working in the home. As part of the discussion, the nurse describes medication safety. Which would the nurse include as a measure to address this issue? A) Asking the client what he or she takes the drug for B) Throwing out any medications over 1-month-old C) Reconciling drugs in the home with those on the discharge sheet D) Setting up medication boxes to organize the medications
C) Reconciling drugs in the home with those on the discharge sheet
After teaching a group of community health nurses about urban sprawl and its effects, the nurse determines that additional teaching is needed when the group identifies which situation as an effect? A) Water pollution B) Heat islands C) Reduced exposure to pesticides D) Decreased air quality
C) Reduced exposure to pesticides
1. When visiting a client in the home for the first time, which information is absolutely critical to remember? A) There may be dangers lurking around every corner. B) Clients are glad to have the nurse in their home. C) The nurse is a guest in the client's home. D) The nurse knows what is best for the client.
C) The nurse is a guest in the client's home.
A community health nurse is concerned that certain members of the local community do not comprehend the educational material due to low literacy. The nurse recognizes which approach to this problem is the most appropriate? A) Make the message as basic and simple as possible because the client likely has low intelligence. B) Best to use simple, written materials for clients who have low literacy. C) Very important for clients with low literacy to have ample opportunity to provide feedback. D) Health literacy is not a very important factor in mortality and morbidity.
C) Very important for clients with low literacy to have ample opportunity to provide feedback.
A community health nurse working at the local level is attending an in-service program about health care economics. The nurse asks the presenter, "Why do I need to know this information? My focus is my clients." Which response by the presenter would be most appropriate? A) "You are required to know this information because your agency receives government funding." B) "You might be in management one day and have to deal with cost control and reimbursement." C) "Although it seems foreign to you, it's an important topic that you might have to deal with someday." D) "This knowledge is important to the success of your practice and for the agency's survival."
D) "This knowledge is important to the success of your practice and for the agency's survival."
A community health nurse is engaged in provision of care to clients in a clinic setting at the local health department. This nurse is engaging in which core public health function? A) Clinical B) Assessment C) Policy development D) Assurance
D) Assurance
3. Which statement best describes the family caregiver burdens of providing home care? A) Family members are expected to contribute financially to cover all of the costs of home care. B) Individuals recovering from severe illness or living with debilitating chronic illness rely on family members for unpaid assistance. C) Informal caregivers assume a considerable physical, psychological, and economic burden in the care of their loved one at home. D) Caregivers often describe themselves as emotionally and physically drained
D) Caregivers often describe themselves as emotionally and physically drained
A group of students are discussing the various parts of effective communication with the instructor. The instructor recognizes they understand the discussion when they correctly identified an e-mail request to the local health department is which part of communication? A) Sender B) Message C) Decoding D) Channel
D) Channel
Quality measures are being determined for a home health care agency. Which measure would the agency want to achieve higher percentage rates? A) Hospital admissions B) Urgent unplanned medical care C) Deteriorating wound status D) Decreased pain with movement
D) Decreased pain with movement
A community health nurse is conducting a program for a group of community health nurses working in distant locations. When describing the term "frontier and remote area," which information would the nurse most likely include? A) A population of fewer than 1,000 people per square mile B) Population of less than 50,000 but more than 2,500 C) Fewer than 10,000 residents in the community D) Fewer than six people per square mile
D) Fewer than six people per square mile
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, using which description? A) A Mexican president who worked to keep people from crossing the border illegally B) A well-known actor who advocates for increasing the number of Latinos in Hollywood C) The senator who wrote the Children's Health Insurance Program (CHIP) bill D) Founder of the United Farm Workers who spent his life fighting for social justice
D) Founder of the United Farm Workers who spent his life fighting for social justice
A public health nurse has noticed a trend in the number of patients with low compliance in routine health maintenance from a certain area in the state. Which resource can the nurse use to best justify the creation of a new public health clinic? A) School district immunization records B) Use of telemedicine by patients C) Patient load and wait times at the surrounding emergency department D) Geographic Information System data
D) Geographic Information System data
A community health nurse is conducting a program for a group of nurses working with migrant families. After describing this population and their health issues, the nurse determines that additional teaching is necessary when the group identifies which situation as problematic? A) Higher rates of tuberculosis. B) Higher rates of childhood nutritional deficiencies. C) Increased access to health care. D) Higher life expectancy than the general population.
D) Higher life expectancy than the general population.
A public health nurse is conducting a program on social justice and public health for a group of community health nurses. After teaching the group about this topic, the nurse determines that the program was successful when the group identifies which concept as a component? A) Decreased burden borne by all B) Increased benefits obtained for all C) Narrow isolated view of health D) Impartiality as the goal
D) Impartiality as the goal
Which has a negative influence on family health and individual health? A) The level at which a family functions significantly affects the individual's level of health. B) A healthy family fosters individual growth and sustains members during times of crisis. C) Family patterns dictate whether members participate in their own health care. D) Individuals can obstruct the family's health and families can obstruct individual family members' health.
D) Individuals can obstruct the family's health and families can obstruct individual family members' health.
17. When a community health nurse is conducting a family assessment on an assigned family, which action would be most appropriate? A) Use quantitative data only to maintain and preserve objectivity B) Interview one family member to avoid confusion and repeated information C) Use a checklist format, completing the tool in the family's presence D) Make several visits and accumulate data from all family members
D) Make several visits and accumulate data from all family members
When assessing a group of migrant farmworkers, the community health nurse notes that the group leaves their home base for part of the year to travel to the same place along a route during the agricultural season, usually returning on yearly basis. The community health nurse identifies this as which of the following? A) Restricted circuit migration B) Point-to-point migration C) Nomadic migration D) Migrant stream migration
D) Migrant stream migration
A group of students are discussing the results of the various legislative acts affecting health care. Which legislation will the students recognize as resulting in decreasing federal government involvement? A) Social Security Act B) Medicare/Medicaid C) State Children's Health Insurance Program D) Omnibus Budget Reconciliation Act
D) Omnibus Budget Reconciliation Act
A rural community health nurse is acting in the role of a mentor. Which activity would the nurse most likely be doing? A) Providing childbirth classes B) Contacting a specialist for a client C) Collecting immunization data for program development D) Orienting a new rural health nurse to the community
D) Orienting a new rural health nurse to the community
Which action would the community health nurse to take first when planning an initial home visit to a family? A) Obtain the basic supplies that will be needed B) Gather appropriate educational materials C) Contact the family via telephone D) Review the referral information
D) Review the referral information
When planning for a home visit, which action would be most helpful to ensure a successful home visit? A) Documentation in a timely manner B) Summarizing the main visit points C) Providing incidental teaching D) Scheduling an appropriate visit time
D) Scheduling an appropriate visit time
. The home health nurse is completing a genogram depicting three generations of family history. Which object would the nurse use to demonstrate a union without marriage? history. Which object would the nurse use to demonstrate a union without marriage? A) Broken line B) Circle C) Triangle D) Square
D) Square
. The home health nurse is completing a genogram depicting three generations of family history. Which object would the nurse use to demonstrate two male siblings? A) Solid line B) Circle C) Triangle D) Square
D) Square
A community health nurse is meeting with a group of clients and notes some clients are misinterpreting the information. What does the nurse recognize as the most likely barrier to communication for this group? A) The nurse's sharing of complete and accurate information with the clients B) The clients' use of medical terminology in the discussion C) The clients' offering of feedback to allow the nurse to learn what the client understands D) The clients' interpretation of the message through their own perceptions
D) The clients' interpretation of the message through their own perceptions
A client will receive hospice care under the Medicare Hospice Benefit. The nurse understands which is true? A) The client denies terminal prognosis. B) The client has a prognosis of at least 6 months of life. C) The client chooses life-extending care. D) The hospice acts as clinical and financial case manager.
D) The hospice acts as clinical and financial case manager.
A community health nurse and a client are negotiating a contract for home health services. After agreeing on the shared goals, which statement/question by the nurse would be most appropriate? A) "Great, now that we know our goals, let's decide on when we want to accomplish them." B) "Okay, so at the next appointment we will see how well the plan is working." C) "So what else would you like to accomplish at these meetings?" D) "Is there anything you would like to change?"
A) "Great, now that we know our goals, let's decide on when we want to accomplish them."
A community health nurse is about to make the first home visit to a family based on a referral from the hospital where the high-risk infant was born to an adolescent mother about 6 days ago. The nurse plans to assess the family and home environment and provide anticipatory guidance. On arrival, the mother sleepily answers the door after the nurse rings the bell and knocks several times. The mother lets the nurse in but is not happy to see the nurse. She gets the infant and places him in the nurse's arms, then sits across the room and turns on the TV. Which response by the nurse would be most appropriate? A) "You must be very tired caring for a newborn baby." B) "I wasn't planning to hold the baby. You should hold him, you are the mother." C) "I need to talk to you, so please turn off the TV." D) "How do you feel being a mother at 17?"
A) "You must be very tired caring for a newborn baby."
The home health nurse is synthesizing evidence and clinical data and theory during an initial home visit. The home health nurse is operating within which standard of practice? A) Consultation B) Health promotion C) Assessment D) Planning
A) Consultation
Which group of actions fulfills the three core public health functions in their proper order? A) Counting the number of kindergarten students who are fully immunized, encouraging the school officials to exclude children who are not fully immunized, and offering immunization clinics at the school B) Identifying a source of pollution in the community, educating local residents about precautions that should be taken when the pollution exceeds minimum standards, and asking legislators to apply sanctions to the responsible party for the source of pollution C) Providing prenatal care for pregnant adolescents, determining how many pregnant adolescents currently attend the school, and encouraging school officials to provide an alternative school setting for the pregnant adolescents D) Lobbying for a citywide ban on smoking in public, providing smoking cessation services in the community, and reviewing mortality data to determine the number of people in the community who die each year from lung cancer
A) Counting the number of kindergarten students who are fully immunized, encouraging the school officials to exclude children who are not fully immunized, and offering immunization clinics at the school
A public health nurse is preparing a report for the town council concerning a specific health concern and is researching specific information to share. Which option will provide the nurse with the best information? A) Drill down the big data information B) Sample surveys in the community C) Drill up the big data information D) Review EHRs from local clinics and offices
A) Drill down the big data information
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 as reflective of home health care? A) Emphasis on rehabilitation B) Focus on health of the whole family C) Expert use of opioids for suffering D) Management of symptoms
A) Emphasis on rehabilitation
A community health nurse working with a local community has found entering into a contract with clients to be very beneficial, and positive results are being achieved. Which concept does the nurse recognize to best explain this successful outcome? A) Encourages client participation in the decision-making process B) Contributes to a trusting nurse-client relationship C) Decreases client stress during home visits D) Reduces client visit time by over 50%
A) Encourages client participation in the decision-making process
A public health nurse in the state's health department notes various facilities in a large community are reporting increased numbers of whooping cough. What should be the nurse's first response? A) Gather more information such as immunization records B) Organize an immunization event for the community C) Send the information to the CDC D) Contact the local health facilities to encourage immunizations
A) Gather more information such as immunization records
A community health nurse is working with community leaders to address health issues in the community related to urban sprawl. The nurse identifies several new areas where parking lots have been built, replacing large open fields. Which term would the nurse use to identify this change? A) Heat islands B) Built environment C) Urbanized area D) Frontier area
A) Heat islands
The nurse recognizes the financial means of individuals often determines the amount of health care received. As health care has improved, the costs have increased. Which factor has contributed the most to rationing over the recent years? A) Increased life expectancy B) Decrease in medical staff C) Increase in health care insurance coverage D) Decrease in preventive health measures
A) Increased life expectancy
A public health nurse is preparing to work with a group of college students to help decrease the incidence of STIs. What is the best response from the nurse when asked why a contract is needed? A) It provides motivation for each of us to achieve the intended outcomes. B) The contract identifies what can happen if you don't follow the plan. C) It provides documentation for requesting grants to cover the expenses for the group. D) The contract is just a document outlining what we plan to do.
A) It provides motivation for each of us to achieve the intended outcomes.
