Community
A nurse is conducting a postpartum home follow-up visit with a Spanish-speaking woman. The woman delivered a healthy male infant by cesarean section 6 days ago. The client tells the nurse breastfeeding is going well. When the client shows the nurse her incision, the nurse notes there is erythema and a small amount of yellow drainage at one end of the incision. The client tells the nurse she noticed it but did not know what to do. What nursing intervention might have prevented this situation? 1) Arranging for a home health nurse to do daily dressing changes 2) Instructing the client's husband to call the discharge nurse every day 3) Providing the client with written discharge instructions translated into Spanish 4) Having the client demonstrate how to change the dressing before discharge
Providing the client with written discharge instructions translated into Spanish The client may have known what action to take if she had written discharge instructions in Spanish. Such instructions should be provided for all clients, translated into the appropriate language. The discharge nurse also should assess whether the client's literacy level is adequate to understand the instructions.
The nurse caring for aging adults understands that a greater number of healthy years before decline and a reduction in the variability of age at death is referred to as: 1) Life expectancy 2) Lifespan 3) Population aging 4) Rectangularization of aging
Rectangularization of aging The rectangularization of aging refers to a trend toward a greater number of healthy years before decline, or a reduction in variability of the age of death.
The nurse caring for aging adults understands that a greater number of healthy years before decline and a reduction in the variability of age at death is referred to as: 1) Life expectancy 2) Lifespan 3) Population aging 4) Rectangularization of aging
Rectangularization of aging The rectangularization of aging refers to a trend toward a greater number of healthy years before decline, or a reduction in variability of the age of death.
Which of the following recommendations identified by Healthy People 2020 and shared by WHO Commission on Social Determinants of Health policies could the community health nurse implement at individual, family, and community levels? 1) Disseminate evidence-based interventions to address health inequalities. 2) Improve daily living conditions for all, especially the very young. 3)Reduce barriers to ensure access to effective health-care and prevention services. 4) Support community development at the local level to establish partnerships.
Reduce barriers to ensure access to effective health-care and prevention services. The community health nurse can work at individual, family, and community levels to reduce barriers to ensure access to health care. This can be accomplished through health promotion, screening, referrals, community partnerships, advocacy, and additional public health nursing core competencies.
The constructivism theory of learning believes people learn best from
Reflecting on own experiences
The nurse is reviewing data on persons over 65 in the community and discovers more than 50% have more than one noncommunicable disease (NCD). Which is a priority to address NCDs among older adults? 1) Health education 2) Screening for early disease detection 3) Self-management of NCDs 4) Vaccinations
Screening for early disease detection
A nurse notices erythema around a bedridden client's sacral area and implements a turning schedule every two hours. This is an example of: 1) Secondary prevention 2) Primary prevention 3) Tertiary prevention 4) Immediate action
Secondary The nurse's actions represent secondary prevention. The goal of secondary prevention is early identification of disease and initiation of treatment. The nurse identified the first stage of a pressure ulcer and intervened immediately.
According to the World Health Organization, which of the following accounts for unfair and avoidable differences in health status within and between countries? 1) Social capital 2) Social justice 3) Social gradient 4) Social determinants
Social determinants Social determinants account for the unfair and avoidable differences in health status seen within and between countries. {Social gradient reflects the relationship between health and income at the population level. Social justice is a state of egalitarianism rather than avoidable differences. Social capital is defined in terms of resources available to individuals and communities based on membership in social networks}
The nursing instructor is lecturing about older adults and the concept of aging in place. Which indicates a need for further teaching? 1) "Aging in place involves programs that promote health and improve functioning." 2) "Aging in place is difficult since many older adults live in nursing homes." 3) "Barriers to aging in place include home modifications and consumer awareness." 4) "Aging in place provides older adults resources so they can remain in their homes."
"Aging in place is difficult since many older adults live in nursing homes."Further teaching is needed. Only 3.1% of older adults were living in skilled nursing facilities in 2010. The aging-in-place approach includes implementation of community-based programs such as health promotion, prevention of disease, improvement of functioning, and enhancement of quality of life in older adults while maintaining them in their homes.
The nurse notes that a client with hepatitis C has elevated liver enzymes. Results of the physical assessment are: Temperature is 97.9 (F), blood pressure is 118/72, heart rate is 86, and respirations are 18. Skin tone is pink and feels warm to the touch. Sclera are white. The nurse concludes that the client is in which phase of hepatitis C? 1) Subclinical2) Resolution3) Susceptibility4) Clinical disease with development of symptoms
Subclinical
The nurse is going over a 64-year-old female's medication list. Which would be the most important question to ask the patient? 1) "Where do you get your medications from?" 2) "Do you feel safe at home?" 3) "How many alcoholic drinks do you consume per week?' 4) "How often do you exercise?"
"How many alcoholic drinks do you consume per week?' The issue of adverse interactions between alcohol and prescribed medication is a special concern in older adults because about 62.5% are using medications with potential alcohol interactions. Two types of interactions occur: pharmacokinetic interaction, wherein alcohol interferes with the body's ability to metabolize the medication; and pharmacodynamic interaction, wherein alcohol enhances the effects of the medication. This would be the most important question to ask.
___ refers to having a shared geographic origin, language, dialect, religion faith food preferences, and culture while ___ categorize groups of people based on superficial criteria such as physical characteristics. a) Gender b) Ethnicity c) Culture D) Race
-Ethnicity -Race
The nurse has identified a high incidence of asthma-related complications in the community. As the nurse plans community interventions, which of the following social determinants of health should be considered? SELECT ALL THAT APPLY. 1) Safety along routes to health providers 2) Ability to pay for medications 3) Incidence of asthma-related complications 4) Age and condition of housing 5) Access to public transportatio
1) 2) 4) 5)
Americans are living longer today than at any other time in history. Which factors account for increased lifespan?SELECT ALL THAT APPLY. 1) Penicillin 2) Greater distribution of wealth 3) Improved prenatal and obstetrical care 4) Flushing toilets 5) Cancer screenings
1) Penicillin 3) Improved prenatal and obstetrical care 4) Flushing toilets 5) Cancer screenings Feedback 1: Answer 1 is correct. In the first half of the 20th century, diseases that once led to early death became less threatening due to the development of antibiotics and other medications.Feedback 2: Answer 2 is incorrect. A greater distribution of wealth is not among the main reasons Americans are living longer. Income inequality in America is increasing.Feedback 3: Answer 3 is correct. Improved prenatal and obstetrical care is contributing to Americans' longer lifespans. Fewer women die in childbirth and more children are born healthy.Feedback 4: Answer 4 is correct. Flushing toilets reduced bacteria in water supplies and improved sanitation to contribute to Americans' longer lifespans.Feedback 5: Answer 5 is correct. Cancer screenings are an example of diagnostic advances and technological applications that are helping Americans live longer.
According to Healthy People 2020, which of the following are examples of the impact of social and physical determinants of health? SELECT ALL THAT APPLY. 1) Access to parks and safe sidewalks is associated with physical activity in adults. 2) Family and community rejection of LGBTQ+ youth is not associated with serious or long-term health impacts. 3) Education is associated with longer life expectancy and improving health and quality of life. 4) Discrimination can increase blood pressure, heart rate and stress.
1-Access to parks and safe sidewalks is associated with physical activity in adults. 3-Education is associated with longer life expectancy and improving health and quality of life. 4-Discrimination can increase blood pressure, heart rate and stress.
Americans are living longer today than at any other time in history. Which factors account for increased lifespan? SELECT ALL THAT APPLY. 1) Penicillin 2) Greater distribution of wealth 3) Improved prenatal and obstetrical care 4) Flushing toilets 5) Cancer screenings
1-Penicillin 3- Improved prenatal & obstetrical care 4- flushing toilets 5- CA screenings
Which is not apart of healthy aging? a) stopping smoking b) controlling HTN c) regulating blood glucose d) taking prescribed medications e) preventing bone loss and muscle weakness
Taking prescribed medications others that are apart of healthy aging: combating depression maintaining social contact being physical active lower cholesterol screening for CA keeping current on vaccinations
The adult children of an 83-year-old woman with osteoarthritis and age-related vision changes want their mother to continue living independently in the community where she has been for more than 40 years. The mother and adult children discuss her fixed income, active social life, health status, and daily needs. All agree she would benefit from assistance with household tasks and errands a few times a week. Which is the best option? 1) A skilled nursing facility 2) An assisted living facility 3) A Naturally Occurring Retirement Community (NORC) 4) A Continuing Care Retirement Community (CCRC)
A Naturally Occurring Retirement Community (NORC) A NORC is a community that provides residential housing with supports, transportation to shopping and appointments, individual risk assessment, and coordination of nonprofessional services. NORCs exist in different forms in various neighborhoods, but all make use of the density and proximity of older adults, resources, and economies of scale to deliver services that promote healthy aging in place. A NORC is the best option.
The nursing instructor is lecturing about older adults and the concept of aging in place. Which indicates a need for further teaching? 1) "Aging in place involves programs that promote health and improve functioning." 2) "Aging in place is difficult since many older adults live in nursing homes. 3) "Barriers to aging in place include home modifications and consumer awareness. 4) "Aging in place provides older adults resources so they can remain in their homes."
Aging in place is difficult since many older adults live in nursing homes." Further teaching is needed. Only 3.1% of older adults were living in skilled nursing facilities in 2010.
A public health nurse (PHN) is speaking with hospital staff about elder mistreatment and the role of Adult Protective Services (APS). Which best describes APS' role? 1) Confront the suspected perpetrator and call the police. 2) Contact APS before talking to the client when there is any suspicion of maltreatment. 3) Arrange for the client to live elsewhere until the investigation is complete. 4) Allow the client to live at risk of harm if the person is capable of making that decision.
Allow the client to live at risk of harm if the person is capable of making that decision. Freedom over safety is a principle of APS. The client has a right to live at risk of harm provided he or she is capable of making that choice, harms no one else, and does not commit a crime.
A public health nurse (PHN) is speaking with hospital staff about elder mistreatment and the role of Adult Protective Services (APS). Which best describes APS' role? 1) Confront the suspected perpetrator and call the police. 2) Contact APS before talking to the client when there is any suspicion of maltreatment. 3) Arrange for the client to live elsewhere until the investigation is complete. 4) Allow the client to live at risk of harm if the person is capable of making that decision.
Allow the client to live at risk of harm if the person is capable of making that decision. Freedom over safety is a principle of APS. The client has a right to live at risk of harm provided he or she is capable of making that choice, harms no one else, and does not commit a crime.
The community health nurse reviews vital statistics and finds that the infant mortality rate (IMR) for Town North (TN) for the past year was 150 per 1,000 live births. The IMR for Town South (TS) for the past year was 300 per 1,000 live births. What conclusion can the nurse make regarding these statistics? 1) There is a health disparity between TN and TS. 2) The IMR for TN decreased over the past year. 3) The IMR for TS increased over the past year. 4) TN had fewer case of communicable illness.
There is a health disparity between TN and TS. The term health disparity reflects differences in incidence, prevalence, and severity of health conditions among subpopulations. The IMR refers to the number of deaths of children under one year per 1,000 live births. The children younger than one year in TN and TS are the subpopulations for which a health disparity exists.
What does Prevalence pot indicate?
Total amount of current cases.
Taking environmental and societal factors into consideration when examining an individual's health choices is known as a(n): 1) Downstream approach 2) Midstream approach 3) Upstream approach 4) Community approach
Upstream An upstream approach takes environmental and societal factors into consideration when examining an individual's health choices.
Nurses at the cardiac rehabilitation center are concerned about clients with type 2 diabetes. The nurses decide to develop a population-level intervention. They collaborate with the diabetes educator to create a health promotion strategy. What is the nurses' first action? 1) Gather data on type 2 diabetes and noncommunicable diseases (NCDs). 2) Create a PowerPoint presentation about complications of type 2 diabetes. 3) Determine measurable and objective program goals. 4) Conduct a literature review regarding NCDs and type 2 diabetes.
Assessment is the first step of the nursing process and always should be done prior to implementing an intervention at the individual, family, or community level. Assessment data are used to identify needs the program will address and determine program goals and objectives. It is important to gather data on type 2 diabetes and other NCDs among the target population, because more than 77% of older adults have more than one NCD.
A client tells the nurse she wants to lose weight. The nurse discusses strategies the client can use to modify her dietary habits and physical activity. What strategy is the nurse using? 1) Clinical prevention 2) Behavioral prevention 3) Nutrition assessment 4) Environmental prevention
Behavioral prevention
You are a PNH teaching a group of elementary school-age children about healthy eating habits. You show them pictures of veggies and every time a child correctly names a veggie you reward them with a sticker. Which learning strategy is being used? 1) Behaviorism 2) Humanism 3) Cognitivism 4) Constructivism
Behaviorism Behaviorism focuses on classical conditioning, in which learning is based on changing behavior through reward and punishment. The client's statement is not an example of behaviorism.
According to the Centers for Disease Control and Prevention (CDC), which of the following are among the five leading causes of death in the United States? SELECT ALL THAT APPLY. 1) Chronic lower respiratory disease 2) Heart disease 3) Accidents 4) Alzheimer disease 5) Diabetes
COPD Heart Disease Accidents
Healthy People 2020 added the topic area Older Adults for which reason? 1) The incidence of dementia and other age-related cognitive disorders is growing. 2) The economic burden of providing health care for the aging population is increasing. 3) Chronic conditions are the leading cause of death and disability for older adults. 4) There is a higher risk of injury among older adults staying in the workforce.
Chronic conditions are the leading cause of death and disability for older adults. Healthy People 2020 added a new topic area, Older Adults, because chronic conditions are the leading cause of death and disability among older adults. More than 60% of older adults will manage more than one chronic health condition by 2030, and many have numerous hospitalizations and nursing home admissions, receive low-quality care, and may lose the ability to live independently.
Healthy People 2020 added the topic area Older Adults for which reason? 1) The incidence of dementia and other age-related cognitive disorders is growing. 2) The economic burden of providing health care for the aging population is increasing. 3) Chronic conditions are the leading cause of death and disability for older adults. 4) There is a higher risk of injury among older adults staying in the workforce.
Chronic conditions are the leading cause of death and disability for older adults. Healthy People 2020 added a new topic area, Older Adults, because chronic conditions are the leading cause of death and disability among older adults. More than 60% of older adults will manage more than one chronic health condition by 2030, and many have numerous hospitalizations and nursing home admissions, receive low-quality care, and may lose the ability to live independently.
Which of the following are included in the Public Health Nursing Core Competencies? SELECT ALL THAT APPLY. 1) Communication 2) Cultural competency 3) Exercise and nutrition 4) Analytic assessment 5) Pursuit of a master of science in nursing (MSN)
Communication Cultural competency Analytic assessment
A public health nurse (PHN) is assessing a 65-year-old man at a community health fair. Which does the nurse suggest? SELECT ALL THAT APPLY. 1) Depression screening 2) Adult tetanus, diphtheria, pertussis (Tdap) vaccine 3) Blood pressure screening 4) Cervical cancer screening 5) Proper insulin use
Depression screening & BP screening
A primary care nurse is assessing a 65-year-old woman whose skin is thin and dry. Which question is best? 1) Have you had a flu shot? 2) Have you had a shingles vaccine? 3) Do you use body lotion? 4) Do you bruise easily?
Have you had a shingles vaccine? Decreased immunity is a main reason for increased vulnerability to communicable diseases among older adults. Drying and thinning of the skin decreases immunity. Shingles is a skin disease that occurs from the reactivation of the varicella zoster virus years after initial exposure to chicken pox. Adults over the age of 60 are 10 times more likely to get shingles than children under 10. Asking about a shingles vaccine is the best question.
You are taking care of a patient w/ type II Diabetes. He has been struggling financially and tells you he hasn't been able to afford his insulin. which concept does this represent? a) Health equality b) Health inequity c) Social equality d) Transverse equality
Health inequity
A community member calls the smoking cessation hotline. This is an example of: 1) Health protection 2) Tertiary prevention 3) Ecological health promotion 4) Cultural shift
Health protection This is an example of health protection, which emphasizes a person's own ability to protect against disease.
The hospitalist has ordered stat blood work for a newly admitted 60-year-old patient. Which blood test does the nurse expect?
Hep C The patient meets criteria to be screened for hepatitis C. Three-fourths of all people diagnosed with chronic hepatitis C are over age 50. In 2012, the Centers for Disease Control and Prevention (CDC) released recommendations for screening for chronic hepatitis C in those born between 1945 and 1965.
A client newly diagnosed with type II diabetes states, I usually eat out, but I want to figure out how to cook at home so my blood sugar stays under control. the client statement represents which learning theory? 1) Behaviorism 2) Humanism 3) Cognitivism 4) Constructivism
Humanism refers to self-directed learning and encourages the development of personal actions to fulfill one's potential. The client's statement indicates that he knows what he wants to learn.
A client newly diagnosed with type 2 diabetes states, "I usually eat out, but I want to figure out how to cook at home so my blood sugar stays under control." The client's statement represents which learning theory? 1) Behaviorism 2) Humanism 3) Cognitivism 4) Constructivism
Humanism Humanism refers to self-directed learning and encourages the development of personal actions to fulfill one's potential. The client's statement indicates that he knows what he wants to learn.
The nurse is concerned about coronary disease among African Americans and knows this is a national trend related to health inequities. Which of the following is the most important reason for eliminating health inequities in this patient population? 1) Improvement of health outcomes 2) Increased number of racial and ethnic minority health-care providers 3) Eliminating the use of emergency departments for minor illness 4) Reducing the cost of insurance copayments and medications
Improvement of health outcomes Heart disease is 40% higher among African Americans than non-Hispanic whites. Eliminating inequities would reduce premature deaths through improved access to care.
A nurse is working in a very diverse town where there are people of many different ethnicities. what is the best way for the nurser to improve her cultural competency?
Increase her knowledge through online research
The Affordable Care Act helped reduce health disparities by improving access to care. Which of the following actions should be the next priority to eliminate health disparities? 1) Increase availability of personal and public transportation 2) Increase numbers of primary care providers and specialists 3) Increase racial and ethnic diversity among health-care workers 4) Increase medication assistance programs and expand Medicare
Increase numbers of primary care providers and specialists There is a lack of primary care providers and specialists, especially in rural areas and inner cities.
The Affordable Care Act helped reduce health disparities by improving access to care. Which of the following actions should be the next priority to eliminate health disparities? 1) Increase availability of personal and public transportation 2) Increase numbers of primary care providers and specialists 3) Increase racial and ethnic diversity among health-care workers 4) Increase medication assistance programs and expand Medicare
Increase numbers of primary care providers and specialists There is a lack of primary care providers and specialists, especially in rural areas and inner cities.
According to the American Journal of Public Health, what were the leading causes of death in the U.S. in 1875? SELECT ALL THAT APPLY. 1) Infant diarrhea 2) Pulmonary tuberculosis (TB) 3) Influenza 4) Heart disease 5) AIDS
Infant diarrhea Pulmonary TB Influenza
Which of the following is an example of a health inequity? 1) Greater infant mortality rates in African American populations 2) Insufficient access to essential health-care services for diabetic patients 3) Freely chosen behaviors that negatively impact health 4) Higher obesity rates in low-income populations
Insufficient access to essential health-care services for diabetic patients
Which of the following are included in the Standards of Public Health Nursing Practice? SELECT ALL THAT APPLY. 1) Integration of research into practice 2) Treatment of communicable illness 3) Collaboration 4) Environmental inspection 5) Application of public health policies
Integration of research into practice Collaboration Application of public health policies
According to the Intervention Wheel, what are the areas of focus for individual level practice? SELECT ALL THAT APPLY. 1) Policy changes and laws 2) Knowledge 3) Attitudes 4) Beliefs 5) Changing community norms
Knowledge Attitudes Beliefs
Which population is at risk for modern slavery?
Migrant workers
A nurse is interested in developing a program to reduce the number of falls among older adults at the senior living complex. Which strategy is best? 1) Request that the city repair broken sidewalks. 2) Organize an adult exercise program to improve balance. 3) Obtain funding to install grab bars in every apartment. 4) Conduct a community-based workshop about fall prevention.
Organize an adult exercise program to improve balance. Unsteady gait is a risk factor for falls in the older adult. Organizing an exercise group is the best strategy, as exercise appears to have statistically significant beneficial effects on balance.
A person without adequate shelter—for example, someone who is living in a vehicle or squatting in abandoned buildings—is experiencing which of the following? 1) Primary homelessness 2) Secondary homelessness 3) Tertiary homelessness 4) Quaternary homelessness
Primary homelessness Primary homelessness means living without adequate shelter. This includes living in vehicles, surviving on the streets, staying in parks, or squatting in abandoned buildings.
Which of the following is a priority in public health nursing? 1) Communicable disease 2) Primary prevention 3) Secondary prevention 4) Community partnerships
Primary prevention The priority of public health nursing is to prevent disease and promote health, which is best achieved through primary prevention. Interventions of this kind are designed to prevent illness or injury from occurring.
Which of the following is not an example of health promotion? 1) Teaching adolescents about distracted driving 2) Conducting a class on child safety 3) Planning an injury prevention program 4) Providing immunizations at a health department clinic
Providing immunizations at a health department Providing immunizations (vaccinations) is an example of health protection, not health promotion