Community Nursing Final

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

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

Personal care provided by physicians is delivered by various basic models. The following is an example of an integrated health maintenance model: Dr. Jones is a family practitioner. He has his own practice in his own office. He covers all of his own expenses. Dr. Cohen and Dr. Bernard are cardiologists who share a practice. They divide the expenses, income, and offices. Dr. Davis is a general surgeon, Dr. Brown is an orthopedic surgeon, and Dr. Burnett is a vascular surgeon. They share the practice, along with all of their expenses, income, and offices. Dr. Smith is an internist, Dr. Gregory is a pediatrician, and Dr. Stanley is a family practitioner. They are paid a monthly salary by an organization to see all of its patients.

Dr. Smith is an internist, Dr. Gregory is a pediatrician, and Dr. Stanley is a family practitioner. They are paid a monthly salary by an organization to see all of its patients. The integrated health maintenance model has prepaid multispecialty physicians, such as in option D. Option A is an example of a solo practice. Option B is an example of a single specialty group model. Option C is an example of a multispecialty group practice.

Which description does not reflect a current definition of family? A social unit interacting with the larger society Individuals living together related by kinship, marriage, or choice Mother, father, and children interacting with extended family Two or more persons living together who share common interests

Two or more persons living together who share common interests

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

United Nations International Children Emergency Fund (UNICEF).

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

use of violence to handle disputes.

The case manager reviews the chart of a patient to determine appropriateness and timeliness of medical care while the patient is in the hospital. This function of case management is referred to as care coordination. utilization review. continuum of care. care management.

utilization review. Utilization review (UR) defined by CMSA consists of the evaluation of medical appropriateness or medical necessity of care. This review ensures that patients receive the "right care at the right time" to improve clinical outcomes and lower costs. Care coordination is defined as the deliberate organization of patient care activities between two or more participants (including the patient) involved in a patient's care to facilitate the appropriate delivery of health care services. Continuum of care is defined as the long-term services required for discharged patients with chronic illness. Care management consists of programs that apply systems, science, incentives, and information to improve medical practice and to allow clients and their support systems to participate in a collaborative process with a goal of improving medical, social, and mental health conditions more effectively.

A public health nurse is surveying a population of coal miners. Which question would elicit information about related risk to a miner's children? "Do you wear a respirator?" "How close do you live to your workplace?" "How many accidents has the mine had this year?" "Do you have a good rapport with your boss?"

"How close do you live to your workplace?"

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

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

Which statement would indicate that the hospice patient's caregiver understood the nurse's instructions related to pain management? "I didn't wake him (the patient) up last night for the 2:00 AM dose because he was sleeping." "I gave him (the patient) the ordered medicine whenever he complained of pain." "I gave the pain medicine every 3 hours as we planned even when he (the patient) didn't complain of pain." "I'm worried he (the patient) will become hooked on the medicine, so I only gave one-half of the dose."

"I gave the pain medicine every 3 hours as we planned even when he (the patient) didn't complain of pain."

While caring for a client from a different culture, the community health nurse must assess the client's health-related beliefs. All of the following questions would be appropriate and would elicit the desired information except "Are there certain foods you eat when you are sick?" "When do you know you are sick enough to visit a health care provider?" "Is it OK if I speak in English?" "What does health mean to you?"

"Is it OK if I speak in English?" Determining the meaning of health, health practices, and habits and usual health practices of the client will help the nurse provide culturally sensitive care that will be accepted by the client. "Is it OK if I speak in English?" does not address health.

The nurse is assisting Sargeant Earl in applying for VA benefits. Which statement made by Sargeant Earl indicates he understands VA benefits? "This is a wonderful health insurance program that will cover all of my health care needs." "I can see any provider I wish under the VA health insurance plan." "I still need to carry private insurance to assist with the most expensive treatments." "My primary care copay is $15 a visit and outpatient specialist copays are $50 per visit."

"My primary care copay is $15 a visit and outpatient specialist copays are $50 per visit." VA primary care copays are $15 per visit, and outpatient specialist copays are $50 per visit. VA benefits are not a health insurance plan where the veteran has to "pay into" the system. VA benefits are rewarded in exchange for the veteran's service to the country. The "coverage" received in the form of VA benefits is not transferable to other non-VA providers, except through formal contracts deemed appropriate by the VA and its providers. The VA always bills an individual's private insurance for medical care, supplies, and prescriptions provided for nonservice-connected conditions. Any monies collected from a veteran's private insurance offsets his or her copayments, and furthermore, the veteran is not responsible for any balance the private insurance does not cover.

A client who regularly participates in activities at the local senior center is celebrating his 65th birthday today. Without regard to gender, according to the U.S. average, how many additional birthdays can he anticipate celebrating? 10 14 19 22

19 According to federal statistics, individuals who survive to age 65 years can expect to live an average of 19.3 more years.

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

Al-Anon Al-Anon and Alateen are support groups for family members of substance abusers. A psychiatrist's referral is not necessary. Alcoholics Anonymous is focused more on the substance abuser than their families.

Rural residents in the United States compose more than _____% of the nation's poor. 50 35 20 18

50

It has been estimated that individual behaviors and environmental factors are responsible for what percentage of all premature deaths in the United States? 20% 40% 50% 70%

50%

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

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

A 16-year-old young woman arrives at the local emergency department (ED) early Sunday morning and states, "I was on a date last night, and the last thing I remember was eating dinner with my boyfriend." She comments that she woke up in her bed with her clothes "messed up" and states, "I just don't feel right down there" as she points to her genital area. She appears medically stable. Which health care provider would be most appropriate to conduct the physical examination? An experienced obstetrical nurse because the patient could be pregnant A SANE (sexual assault nurse examiner) The physician on call in the ED department An emergency nurse

A SANE (sexual assault nurse examiner)

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

A flyer advertising an ice cream and pizza party for the student awards program

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

A tornado resulting in flood and destruction of electrical systems for a community

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

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

A community health nurse often provides health education for individual clients. Her office has a play center because some clients bring small children with them. She routinely offers her clients bottled water, juice, or soda. She works with her clients at a small table rather than at her desk. Which statement below best sums up her approach? Clients enjoy hospitality, but her approach has no support in learning theory. Adults learn better in a facilitative and nonrestrictive environment. The nurse's approach simply takes the clients' minds away from their troubles. This approach is too informal and contrary to most learning theories.

Adults learn better in a facilitative and nonrestrictive environment.

There are many ways the community health nurse can be engaged in health education in the community. Which are frequent roles or activities that the nurse can be expected to fulfill? (Select all that apply.) Advocate Consultant Diagnostician Collaborator Mediator

Advocate Consultant Collaborator Mediator In general, the physician is considered to be the diagnostician. All of the other roles are appropriate for community health nurses, and all require knowledge and skills related to health education.

Which minority group hit an all-time low high school drop-out rate in 2013? African Americans Chinese Americans Polish Americans Italian Americans

African Americans

The nurse working in the community is aware that there are different models for studying the epidemiology of a health condition in a population. One model of investigation of the interrelationships and characteristics of disease is the epidemiological triangle. This model analyzes what three elements? Incidence, prevalence, and etiology Agent, host, and environment Person, place, and time Virus, bacteria, and fungus

Agent, host, and environment

Which environmental stressor directly assaults human health? Global warming Air pollution Noise Litter

Air pollution

Certification for registered nurses in the field of case management is provided through which professional organization? (Select all that apply.) American Nurses Association American Nurses Credentialing Center American Hospital Association Case Management Society of America National Association for Healthcare Quality

American Nurses Credentialing Center Case Management Society of America

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

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

Which is an example of "community health nursing" rather than "community-based nursing"? An RN assisting a doctor in a pediatrician's office An RN visiting a home-bound patient to monitor for congestive heart failure An RN reviewing school clinic records to determine which children are not up to date on their immunizations An RN dispensing medications in a nursing home

An RN reviewing school clinic records to determine which children are not up to date on their immunizations "Community health nursing" focuses on groups of people, with the primary responsibility being the population as a whole (as with a school). Care typically focuses on health promotion and illness prevention, such as the nurse who reviews school clinic records to determine which children are not up to date on their immunizations. "Community-based nursing" is setting specific and emphasizes care to individuals, often in homes and ambulatory clinics, and typically addresses acute and chronic health conditions. The other options are examples of nurses providing care to individuals.

Based on the Department of Housing and Urban Development (HUD) definitions of homelessness, which individual would be considered homeless? An individual whose residence lacks access to public water and electricity An individual who has a permanent nighttime residence in the housing for mentally ill people An individual imprisoned or detained under an act of Congress or state law An individual who spends most nights at public or private places not designed for regular sleeping accommodations

An individual who spends most nights at public or private places not designed for regular sleeping accommodations

An epidemic is occurring in a public health nurse's community, and the nurse is working with the epidemiologist and other health professionals seeking to identify the causative agent. What phrase best describes such efforts? Cohort study Descriptive epidemiology Point prevalence study Analytic epidemiology

Analytic epidemiology Analytic epidemiology investigates the causes of disease by determining why a disease rate is lower in one population group than in another. This method tests hypotheses generated from descriptive data and either accepts or rejects them on the basis of analytic research. Cohort studies obtain information about the cause of disease by establishing a relationship between the presumed causal factors and the effect. The study of the amount and distribution of disease constitutes descriptive epidemiology. When prevalence rates describe the number of people with the disease at a specific point in time, they are sometimes called point prevalences.

Which "determinants of health" would include predisposition to prostate cancer and a history of depression? Biology Behaviors Social environment Physical environment

Biology

One of the first health insurance companies established in the 1930s to provide health care to subscribers was Aetna Insurance. Woodmen of the World. Humana Health Maintenance Organization. Blue Cross and Blue Shield.

Blue Cross and Blue Shield. During the 1930s, in an effort to provide care and avoid bankruptcy, health care providers began to establish health insurance plans. One of the most recognizable of these is Blue Cross and Blue Shield. The other options were all created later.

The home health care industry has changed significantly in the past 20 years. Which is a factor that is responsible for the change in the home health care industry? Failure of traditional home health services to change to meet the needs of clients with new needs such as AIDS patients, terminally ill patients, and increasing numbers of elderly Advanced technology that resulted in new procedures and equipment not possible for use in the home Changes in reimbursement that resulted from the implementation of the prospective payment system (PPS) for home health care, particularly for Medicare patients Nurses lack of knowledge regarding cost-containment strategies

Changes in reimbursement that resulted from the implementation of the prospective payment system (PPS) for home health care, particularly for Medicare patients

Which is an example of a modifiable risk factor? (Select all that apply.) Air pollution Cigarette smoking Gender Sexual practices Diet

Cigarette smoking Sexual practices Diet

Based on the common illnesses and risky health behaviors among farmers, the community health nurse should implement which health promotion activity? Partner with the local health department to offer smoking cessation classes for farmers and their spouses. Collaborate with health care providers and provide support and education for farmers with respiratory conditions and their families. Collaborate with health care providers to conduct skin assessments at a meeting of local farmers. Work with mental health consultations to outline a community-based program to address the high rate of suicide and depression among farmers. Plan, implement, and evaluate an outreach program designed to improve the cardiovascular status of farmers and their families.

Collaborate with health care providers to conduct skin assessments at a meeting of local farmers. Several types of farming activities are associated with higher than expected occurrences of acute and chronic respiratory conditions. The role of the nurse is to refer patients to appropriate health care providers and provide support and education for affected people and their families. Farmers have a lower rate of cardiovascular disease, use of mental health services, and tobacco use than their urban cohorts.

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

Communication

Which characteristics are demonstrated by healthy or energized families? (Select all that apply.) Communication is appropriate and clear. Support and respect are evident and appreciated. Roles are static and change only in times of crisis. Common beliefs and values are shared. Members play and share leisure time appropriately.

Communication is appropriate and clear. Support and respect are evident and appreciated. Common beliefs and values are shared. Members play and share leisure time appropriately.

Which nursing intervention is the most appropriate as an initial intervention for a prison inmate? Manage a chronic illness through needed education. Administer the routine medication ordered. Complete the medical history and physical assessment. Test for HIV and tuberculosis.

Complete the medical history and physical assessment.

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

Contact the parents and educate them about the immunization requirements.

What is the process used when conceptual differences, which impact the provision of health care, exist between the client and the nurse? Cultural diversity Cultural negotiation Cultural competence Cultural imposition

Cultural negotiation Cultural negotiation refers to the process in which messages, instructions, and belief systems are manipulated, linked, or processed between the professional and lay models of health problems and preferred treatment. In each act, the nurse gives attention to eliciting the client's views regarding a health-related experience (e.g., pregnancy, complications of pregnancy, or illness of an infant). Cultural diversity is a multifaceted and complex concept that refers to the differences among people, especially those related to values, attitudes, beliefs, norms, behaviors, customs, and ways of living. Cultural competence is respecting and understanding the values and beliefs of a certain cultural group so that one can function effectively in caring for members of that cultural group. Cultural imposition is a person's tendency to impose his or her own beliefs, values, and patterns of behavior on individuals from another culture.

A smoking cessation class stresses increased lung function, money saved that is not spent on cigarettes, and smelling clean and fresh as benefits to quitting smoking. These support which concept? Perceived barriers Decisional balance Precontemplation Contemplation

Decisional balance In the transtheoretical model, "decisional balance" describes weighing the benefits of a behavior change against the cost of behavior change. Perceived barriers to action are one's beliefs regarding the tangible and psychological costs of an advised action and include perceived unavailability, inconvenience, expense, difficulty, or time regarding health behaviors. In the precontemplation stage of change, the individual has no intention to take an action toward changing a behavior in the next 6 months. In the contemplation stage, the individual has some intention to take action toward behavior change in the next 6 months.

What official national organization provides financial housing assistance to low-income families? World Health Organization (WHO) Federation of National Organizations Working with the Homeless (FEANTSA) Robert Wood Johnson Foundation Department of Housing and Urban Development (HUD)

Department of Housing and Urban Development (HUD)

The public health nurse is working with a specific population and is preparing to participate in a descriptive epidemiology study. Which of the statements apply to descriptive epidemiology? (Select all that apply.) Descriptive epidemiology seeks to answer questions about the amount of disease in a given population. Descriptive epidemiology seeks to answer questions about the cause of disease in a given population. Descriptive epidemiology seeks to answer questions about the cure for disease in a given population. Descriptive epidemiology seeks to answer questions about the distribution of disease in a given population.

Descriptive epidemiology seeks to answer questions about the amount of disease in a given population. Descriptive epidemiology seeks to answer questions about the distribution of disease in a given population. The study of the amount and distribution of disease constitutes descriptive epidemiology. Patterns identified through descriptive epidemiology may indicate possible causes. When these possible causes are investigated with different and more advanced epidemiologic methods, this is analytic epidemiology.

Which statement best describes the demographics of rural America? Despite the shrinking number of family farms and full-time farmers, agriculture continues to be an important part of the rural and U.S. economy. There has been a shift in the economic base of rural America as more communities are dependent on income generated from mining and construction. There has been a decline in diversity in rural America, with more Hispanics and youth moving to urban areas rather than rural communities and small towns. There are more positive health behaviors (e.g., less smoking, obesity, and drug use) among residents of rural America when compared with urban America.

Despite the shrinking number of family farms and full-time farmers, agriculture continues to be an important part of the rural and U.S. economy. Despite the shrinking number of family farms and full-time farmers, agriculture continues to be an important part of the rural and U.S. economy, with agriculture-related employment representing 5% of the gross domestic product (GDP) and farms representing 1% of the GDP. Changes in rural demographics include a shift in the economic base from agriculture to industry, as well as more diversity as the number of rural Hispanics increases. Additionally, there has been a rise in negative health outcomes for rural residents; obesity, smoking, and drug use are more prevalent in rural America than in urban America.

For an RN to apply for certification for case management through the Case Management Society of America (CMSA), the nurse must perform essential activities of case management. Which is not one of the required activities? Diagnosis Coordination Evaluation Outcomes Assessment

Diagnosis To apply for nursing case management certification through the CMSA, the nurse must perform essential activities of case management, including assessment, planning, facilitation, coordination, monitoring, evaluation, and advocacy, achieved through collaboration with the client and others involved in the client's care (CMSA, 2016). Diagnosing is not an essential function of case management.

Which prospective payment method determined the amount of reimbursement that health care providers would receive for specific illnesses from Medicare? Current procedural terminology codes Actuarial classifications Diagnosis-related groups Medigap insurance

Diagnosis-related groups

An elderly client expresses the following concerns to the community health nurse. Which of these concerns is a physiological change associated with the aging process? Increased saliva Decreased pain threshold Increased nightly sleep time Difficulty remembering new names

Difficulty remembering new names With aging, the human body experiences physiological changes in all systems. Included are changes in taste, including diminished taste sensation, decreased saliva production, and decreased sensitivity to sweetness and salt. Pain threshold is increased, perhaps associated with physical changes in brain weight, reductions in functioning neurons, and increases in neurofibrillary tangles. Sleep changes include decrease in stage 3 and 4 sleep, as well as a reduction in total sleep time. Multiple cognitive changes occur as part of normal aging, including better long-term versus short-term memory retrieval. Remembering new names is an aspect of short-term memory.

Studies indicate that which lifestyle behaviors can prevent many chronic illnesses? (Select all that apply.) Consuming a sugar-free diet Exercising regularly Maintaining an optimal body weight Reducing stress Decreasing smoking

Exercising regularly Maintaining an optimal body weight Reducing stress Studies indicate that the following lifestyle behaviors can prevent many chronic diseases: consuming a low-fat diet, exercising regularly, maintaining an optimal body weight, reducing stress, and ceasing smoking.

A major limitation of the Health Belief Model is that the burden of action related to health behaviors is exclusively on the aggregate. True False

False A major limitation of the Health Belief Model is that the burden of responsibility for health behaviors is on the individual client.

A client provides information regarding medical and health history. This is an example of which assessment tool? Genogram Family health tree Ecomap Ancestry mapping tool

Family health tree A family health tree provides a mechanism for recording the family's medical and health histories. The genogram is a tool that helps the nurse outlines the family's structure. The ecomap is used to depict a family's linkages to their suprasystems. Option D is not an assessment tool used by the community health nurse.

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

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

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

Federally funded breakfast and lunch program.

Which nurse leader formulated the first theory-based conceptual model for nursing care? Nancy Milio Lillian Wald Florence Nightingale Dorthea Orem

Florence Nightingale

The first nurse to establish international links and networks was Clara Barton. Mary Breckenridge. Dorothea Dix. Florence Nightingale.

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

Which method of gathering data is most effective for remote and vulnerable segments of a community and for those communities with underdeveloped opinions? Interviewing community informants Community forum Focus groups Telephone surveys

Focus groups Focus groups are effective for remote and vulnerable segments of a community and for those with underdeveloped opinions. These sessions can produce greater interaction and expression of ideas than surveys and may provide more insight into an aggregate's opinions. The community health nurse may gather some data by interviewing key informants in the community. Informants may be knowledgeable residents, elected officials, or health care providers. A community forum may be held to discuss selected questions. A telephone survey may be useful for selected questions.

The first visiting nurse in the United States was Lillian Wald. Mary Brewster. Florence Nightingale. Francis Root.

Francis Root. Francis Root was an 1877 graduate nurse sent by the Women's Board of the New York City Mission to provide care to sick individuals in their homes. This was considered an innovation in nursing care in the United States and the precursor to modern visiting nurses' associations. Lillian Wald and Mary Brewster established a district nursing service in New York City in 1893. Florence Nightingale began her work in the mid-19th century and is credited with establishing "modern nursing."

Which educator is credited with developing the concept of empowerment and included activism on the part of the educator as a teaching methodology? Bandura Pender Freire Burris

Freire

Edwin Chadwick's Report on an Inquiry into the Sanitary Conditions of the Laboring Population of Great Britain greatly contributed to the development of the National Organization for Public Health Nursing. American Medical Association. General Board of Health for England. National Institute.

General Board of Health for England.

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

Green

Which communicable diseases found in prison inmates is of ongoing concern? (Select all that apply.) HIV Hepatitis Tuberculosis Bronchitis Chlamydia

HIV Hepatitis Tuberculosis

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

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

Approaching health at the aggregate level is the initiative of which agency or document? Occupational Safety and Health Administration (OSHA) Clean Air for All Healthy People 2020 Centers for Disease Control and Prevention (CDC)

Healthy People 2020 An attempt to approach health at the aggregate level is the Healthy People 2020 initiative. It deals with issues ranging from decreasing ozone levels to decreasing Escherichia coli outbreaks. All of these issues deal with the broader environmental origins of disease, not just deleterious personal habits. OSHA, Clean Air for All, and the CDC have a more narrow focus.

When assisting specific aggregates, which should be included in the community health nurse's outcomes? Helping people learn from their own experiences and analyzing the world with the intention to change it Honesty, fairness, and mutuality in the interactions Intervening in mutual exchanges with community members and citing the current literature Asking critical questions of the aggregates involved

Helping people learn from their own experiences and analyzing the world with the intention to change it Nursing's role in the community is to create a context from which people can learn and identify health-damaging problems from within their environment. It is essential that the affected people participate in the process of identifying and working to solve environmental problems. The other options do not allow the people to participate in the process that affects their ability to learn and thus make change.

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

Heroic phase

The community health nurse is caring for a client who abstains from eating any form of meat. This dietary preference is commonly practiced by members of which faith? Hinduism Mormonism Judaism Islam

Hinduism People of the Hindu faith abstain from eating meat of any type. Mormons do not necessarily restrict meat from their diets. Muslims abstain from eating pork but do eat other types of meat. Members of the Jewish faith do not eat pork, predatory fowl, shellfish, or some other water creatures.

Which does not accurately describe home health nursing as "officially" defined by the U.S. Department of Health and Human Services (USDHHS)? Home health care is a system of comprehensive health care for people in their homes. Home health care is provided to homebound or disabled people in any residence or medical facility. Home health care has as its purpose to promote, maintain, or restore a client's health. Home health care requires a coordinated plan of care provided by professional health care providers.

Home health care is provided to homebound or disabled people in any residence or medical facility.

Which statement is true concerning home health nursing? Home health nursing is a new nursing specialty originating with the inception of Medicare in the 1960s. Florence Nightingale is credited with creating the idea of home health nursing. Home health nursing has as a purpose to provide nursing care to individuals and clients in their homes. Home health nursing has as a purpose to provide nursing care only for the referred individual patient.

Home health nursing has as a purpose to provide nursing care to individuals and clients in their homes.

Lillian Wald and Mary Brewster's Henry Street Settlement was a model of modern health care. Which services were provided to people living in the Lower East Side of New York City by the Henry Street Settlement nurses? (Select all that apply.) Emergency care and first aid Home visits to ill mothers and children School health services Industrial health services to local workers Support programs for immigrants

Home visits to ill mothers and children School health services Industrial health services to local workers Support programs for immigrants The Henry Street Settlement was a model comprehensive health care center that provided many services, including home visits to mothers and children, support services for immigrants, the first school health and industrial health programs, and many other services. Emergency care and first aid were not provided services.

Which was not a public health service provided by the Romans? A supervisor of the public baths Street cleaners Supervision of the sale of food Housing for the indigent population

Housing for the indigent population Public health services provided by the Romans included a water board to maintain the aqueducts, a supervisor of the public baths, street cleaners, and supervision of the sale of food. Housing for the indigent population was not a public service provided by the Romans; in fact, inhabitants of the Roman slums did not share in public health amenities, and their health suffered accordingly.

An emergency department nurse assesses a 25-year-old patient with tachycardia, headache, and nausea. The patient denies drug use, heart problems, and smoking. She works from her house and states that everyone in her house has had the "flu" but that she is the only one who has not been feeling better. The nurse notices that the patient lives in the historic section of the town. What environmental hazard should the nurse be primarily concerned about? Food quality Housing quality Water quality Occupational risks

Housing quality

A community nurse is reviewing health statistics to gain a better understanding of a population's health needs. Crude rates are available for several health occurrences. What statement accurately describes crude rates? In calculating a crude rate, the numerator is the size of the population at risk. In calculating a crude rate, the average population size may be used as denominator. The denominator in a crude rate represents the population at risk for the event. Crude rates are used frequently because they avoid bias in interpretation.

In calculating a crude rate, the numerator is the size of the population at risk. Crude rates are calculated by using the number of events as the numerator. The denominator used may be the average population size or the population size at midyear and not the population at risk. Crude rates are subject to certain biases in interpretation.

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

Inefficient storage An intramuscular vaccine injection given subcutaneously Light-sensitive vaccines exposed to light Seroconversion

The home care nurse is caring for a client recently diagnosed with inoperable cancer. Which best expresses the nurse's role related to end-of-life issues? Monitoring for the client to express interest in talking about these issues Asking the client whether an advance directive has been completed Exploring end-of-life issues with the client's family Initiating discussion and education

Initiating discussion and education Clients frequently are hesitant to discuss end-of-life issues. This hesitancy arises from a wide variety of psychosocial issues. The nurse-client therapeutic relationship includes proactive communication and education about end-of-life issues, including living will, durable power of attorney or medical surrogate, or do-not-resuscitate order. Discussion regarding end-of-life issues with family members should not be to the exclusion of the client.

Identify the etiologic or causal statement component of the following community diagnosis: "There is an increased risk for undetected testicular cancer among young men related to insufficient knowledge about the disease and the methods for preventing and detecting it at an early stage as demonstrated by high rates of late initiation of treatment." Risk for undetected testicular cancer Young men Insufficient knowledge about the disease and methods of prevention High rates of late initiation of treatment

Insufficient knowledge about the disease and methods of prevention

Which action is inappropriate for a correctional nurse when testifying in court? Looking the jurors in the eye when answering questions Asking the attorney to repeat a question when not understood Practicing saying difficult medical terms before the court date Interrupting when necessary to verbalize correct medical information

Interrupting when necessary to verbalize correct medical information

Lemuel Shattuck, a Boston bookseller with an interest in public health, published the 1850 book Report of the Massachusetts Sanitary Commission. Which was not a recommendation of the report? Keeping a record of vital statistics Developing well-infant and well-child care programs Introducing modern family planning methods in the United States Beginning a system of vaccination and health education

Introducing modern family planning methods in the United States Shattuck recommended major health reform that included keeping vital statistics; providing environmental control; food, drug, and communicable disease control; well-infant, well-child, and school-age child health programs; mental health care; vaccination; and health promotion. His recommendations were not implemented until nearly 19 years later, when a state board of health was formed in Massachusetts. Modern family planning methods were not introduced until the 20th century.

Which intervention would be the most appropriate to implement for a community that has a high risk for environmental health hazards? Facilitate the evaluation of ongoing community health interventions. Document participation levels of families in environmental issues. Involve citizens in decision-making processes about proposed activities that could pose an environmental threat. Screen at-risk populations for asthma and test blood levels for air pollutants.

Involve citizens in decision-making processes about proposed activities that could pose an environmental threat. Community health nurses have a mandate to assist vulnerable aggregates who have fewer options in protecting themselves from pollution, inadequate housing, toxic poisoning, unsafe products, and other hazards. An appropriate nursing intervention would be to involve citizens in decision-making processes about proposed activities that could pose an environmental threat. Evaluating ongoing health interventions, documenting participation levels of families, and screening at-risk populations are important evaluation methods for determining the needs of the community but are not the most appropriate intervention.

Which statement is not true about the "thinking upstream" model of community health nursing practice? It is a conceptual model to assist the nurse in community health planning. It helps to focus the time, energy, and programmatic resources available to community health nursing clients. It focuses the nurse on short-term, individual-based nursing interventions. It focuses the nurse on long-term, "bigger picture" issues related to community health practice, such as social justice or power.

It focuses the nurse on short-term, individual-based nursing interventions.

In the 1850s, a researcher studied a cholera epidemic among people living in different sections of London. The researcher who used epidemiologic methods to study the epidemic and used rates as an epidemiologic tool was Joseph Lister. William Farr. John Snow. Edward Jenner.

John Snow.

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

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

A client meeting with a community health nurse inquires about diabetes education classes. The client's health records reveal the diagnosis of diabetes was made a little over 1 year ago. The client reports partial compliance with diet, gradual improvement in her exercise program, and a 15-pound weight loss. The client reports that she takes her medication as prescribed but rarely monitors her blood glucose level. Which statement best reflects the impact of initial diabetes education on this client? Learning occurred, but additional support and education are needed. It is apparent that the diabetic education was totally inadequate. It is not possible to draw any conclusions about the education. The education did not work because this client is noncompliant.

Learning occurred, but additional support and education are needed.

Over 13% of residents in the United States were born in other countries. More than half (52%) of these individuals were born in Asia. Europe. Africa. Mexico and Latin America.

Mexico and Latin America.

The belief that health deficits result from an imbalance between the population's health needs and its health-sustaining resources is the premise of which theory? Orem's self-care deficit theory The Health Belief Model Milio's framework Critical social theory

Milio's framework

hich statement regarding military sexual trauma (MST) is true? MST is more common among male veterans. MST is always perpetrated by a stranger. MST is associated with diabetes. MST is associated with mild PTSD.

MST is associated with diabetes. A number of health conditions are more prevalent among women with a history of sexual trauma, including sexually transmitted infections, diabetes, obesity, arthritis, irritable bowel syndrome, hypertension, and eating disorders. MST is reported by 32.4% of female vetrans and only 4.6% of male veterans. It is estimated that in one of seven women who report MST, the trauma was perpetrated by an intimate partner. Among veterans seeking treatment for PTSD, sexual trauma has been associated with more severe PTSD than any other type of trauma, including combat trauma.

Enacted in 1965 as part of the Social Security Act, __________ was intended to provide health care to the population of U.S. citizens 65 years of age and older. Medicare Medicaid Social Security Blue Cross/Blue Shield

Medicare The intent for Medicare, when enacted in 1965, was to provide health care to the growing population of those 65 years of age or older. Medicaid is a public welfare assistance program that finances health care coverage for the indigent and children. Social Security was created in 1935 to provide retirement benefits to workers. Blue Cross and Blue Shield were health insurance plans that paid all of the costs of covered services provided to the enrollee.

Which is classified as a vector of disease? Humans Door handles Water and food Mosquitoes

Mosquitoes

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

Most homicides are caused by stabbings.

A community health nurse participating in planning programs for the coming year considers incidence rates to better understand the needs of the community. Which statement below is the most accurate explanation of incidence rates? New cases of a disease or condition in a community over a period of time are included in incidence rates. The number of all cases of a specific disease or condition in a population at a given point in time relative to the population at the same point in time is included in incidence rates. Incidence rate refers to the number of new cases of a disease in those exposed to the disease. The term incidence rate refers to the percentage of deaths in a specific period of time from a specific cause.

New cases of a disease or condition in a community over a period of time are included in incidence rates. Incidence rates describe the occurrence of new cases of a disease or condition in a community during a period of time relative to the size of the population at risk for that disease or condition during that same time period. In calculating this rate, the numerator is the number of new cases during the specific period of time, and the denominator consists only of those who are at risk for developing the disease or condition during the specific period of time. A prevalence rate is the number of all cases of a specific disease or condition in a population at a given point in time relative to the population at the same point in time. Attack rates document the number of new cases of a disease in those exposed to the disease. The percentage of deaths in a specific period of time from a specific cause refers to the mortality rate.

What is the most common chemical dependence in the United States? Alcohol Cocaine Marijuana Nicotine

Nicotine

What is the purpose of the Homeless Information Management System (HIMS)? Provides means to feed homeless people Obtains national data on homeless individuals Serves as a screening tool to obtain any history of criminal activity Provides homeless individuals with educational materials

Obtains national data on homeless individuals The intent of the HIMS is to obtain national data, including the number of and demographic information on the homeless population. Providing means to feed homeless people, serving as a screening tool to obtain any history of criminal activity, and providing homeless individuals with educational materials are not functions of the HIMS.

In which case management setting is the nurse responsible for providing primary prevention to employees to keep the work force healthy? High-risk clinic setting Occupational health setting Home health and hospice setting Public health clinic setting

Occupational health setting More employers are providing health screening and education to their employees to keep their workforce healthy. Community health nurses who work in occupational health settings are in a position to provide primary prevention designed for the needs of the employees. The case manager in the high-risk clinic setting provides services to high-risk clients in settings such as HIV clinics, dialysis settings, and infusion centers. In the home health and hospice setting, the case manager would provide services to clients in their homes. In the public health setting, the case manager would provide services to clients in the community at large.

Which theory is based on the assumption that individual needs and related activities are the focus of nursing care? Orem's self-care deficit theory The Health Belief Model Milio's framework Critical social theory

Orem's self-care deficit theory

eterans with a substance use disorder (SUD) are most likely to suffer from TBI MST VHA PTSD

PTSD Although problems with alcohol or other drugs affect veterans at about the same rates as the general population, there is a strong relationship between SUD and PTSD: more than 2 of 10 veterans with PTSD also have SUD.

A veteran was awarded VA disability compensation for a medical condition he contracted in 1965 while serving in Vietnam. Which condition did this veteran most likely have? Cardiac dysrhythmia Parkinson disease Diabetes type 1 Irritable bowel syndrome

Parkinson disease The VA awards disability compensation for the following conditions to anyone who served in the Republic of Vietnam from 1962 to 1975: AL amyloidosis, chronic B-cell leukemia, chloracne, diabetes mellitus type 2, hodgkin disease, ischemic heart disease, multiple myeloma, non-Hodgkin lymphoma, Parkinson disease, peripheral neuropathy, porphyria cutanea tarda, prostate cancer, respiratory cancers, soft tissue sarcomas, and Lou Gehrig disease (or AML).

Agricultural workers are at high risk for occupational injuries and illnesses. To reduce the most common cause of fatalities among youth on farms, which is the most important strategy for the community nurse to implement? Planning a community media campaign advocating the use of helmets Partnering with the county extension agent to offer tractor safety classes Working with local health care providers to encourage use of personal protective equipment, such as hearing and respiratory protection Offering a class for local health care providers addressing the signs and symptoms of pesticide toxicity

Partnering with the county extension agent to offer tractor safety classes Tractor-related accidents, especially overturns, are the most frequent cause of farm accidents. Encouraging the use of helmets is important, but the most important measure would be to offer tractor safety education. Working with local health care providers to encourage use of personal protective equipment, such as hearing and respiratory protection and offering a class for local health care providers addressing the signs and symptoms of pesticide toxicity are less important measures.

Assisting the family of a special needs child through the complex health care system is an example of what type of case management? Disease-specific case management System-centered case management Patient-centered case management Public health case management

Patient-centered case management Case management is patient centered and system centered. Patient-centered case management assists the client through a complex, often fragmented and confusing health care delivery system and achieves specific client-centered goals. System-centered processes recognize that health care resources are finite. Some case management programs are disease based; for example, case management is focused on clients with heart failure. Case management has its origins in public health.

Which model of care was developed to provide collaborative, quality-driven, safe, primary care? Community case management model Disease-specific case management model Patient-centered medical home Geriatric care management

Patient-centered medical home The patient-centered medical home (PCMH) is a recent model of care developed to provide collaborative, quality-driven, safe primary care. The PCMH uses care coordination and case management processes to provide comprehensive, patient-centered, cost-effective, high-quality care. In the community-case management model, case managers provide services exclusively in the community after discharge. Disease-specific case management and geriatric care management are specific types of case management services provided to specific populations.

Access to health care is determined by the circumstances of the individual that obstruct the means to obtain desired health care. Which is not a barrier to health care access? Preexisting conditions Nonparticipating physician Inability to communicate Personal avoidance of a health problem

Personal avoidance of a health problem Any condition that prevents an individual from seeking desired health care presents a barrier. Chosen avoidance is not a barrier.

Which "determinants of health" refers to factors that are experienced with the senses-things that can be seen, touched, heard, and smelled? Biology Behaviors Social environment Physical environment

Physical environment

Which are principles of a patient-centered medical home? (Select all that apply.) Physician-led, team based care Value-based purchasing Integration and coordination of care Improved access to care Quality and safety

Physician-led, team based care Integration and coordination of care Improved access to care Quality and safety The seven principles of a patient-centered medical home include the patient's relationship with the primary care physician; the physician-led, team-based care; the patient as a "whole person" who requires comprehensive care at various stages of life; integration and coordination of care; quality and safety; improved access to care; and a payment system that accurately reflects the efforts and care provided by the team. A value-based purchasing program was established by Centers for Medicare and Medicaid as a part of the Patient Protection and Affordable Care Act of 2010.

A man has been smoking for 20 of his 40 years. He smokes a pack of cigarettes daily and states, "My dad smoked two packs a day and lived to be almost 90. Besides, I'm going to die from something anyway, so why quit"? He is in which "stage of change" in the transtheoretical model? Contemplation Maintenance Precontemplation Preparation

Precontemplation In the precontemplation stage of change, the individual has no intention to take an action toward changing a behavior in the next 6 months. In the contemplation stage, the individual has some intention to take action toward behavior change in the next 6 months. In the maintenance stage, the individual has changed overt behavior for more than 6 months. In the preparation stage, the individual intends to take action within the next month and has taken steps toward behavior change.

Through epidemiologic investigations, effective prevention measures are often identified. When the nurse is engaged in providing prevention for the community before disease has developed, the prevention activities meet the definition for what level of prevention? Primary Secondary Tertiary Pathogenic

Primary

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

Primary

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

Professional intervention is needed to change the abusers' behavior.

The percentage of deaths resulting from a specific cause provides the nurse with information about areas in which public health programs might make significant contributions in reducing deaths. Select the statistic often used for this purpose. Proportionate mortality rate Crude death rate Age-adjusted death rate Standardized mortality rate

Proportionate mortality rate Proportionate mortality rate is calculated using the number of deaths resulting from a specific cause in a specific time period as the numerator and the total number of deaths in the same time period as the denominator. In crude death rates, the numerator is the number of deaths and the denominator is the average population size or the population size at midyear multiplied by a constant. Age adjustment or standardization reduces bias when there is a difference between the age distributions of two populations.

Which is a goal of case management? (Select all that apply.) Providing high-quality care Decreasing fragmentation of health services Containing cost of health care Integrating specialty care Enhancing quality of life for clients

Providing high-quality care Decreasing fragmentation of health services Containing cost of health care Enhancing quality of life for clients According to the American Nurses Credentialing Center (ANCC), nursing case management is a health care delivery process whose goals are to provide quality health care, decrease fragmentation, enhance the client's quality of life, and contain costs.

Which entity strives to improve the health of all the public by promoting healthy lifestyles, preventing disease and injury, and protecting the health of communities? Managed care organizations (MCOs) Medicare Public health system Affordable Care Act

Public health system

Which model supports upstream thinking with the purpose to improve homelessness through reduction of structural conditions contributing to homelessness? Social justice Market justice Physical justice Mental justice

Social justice

The health literature accessed by the community health nurse often addresses the probability of an adverse event. What term refers to the likelihood that healthy people exposed to a specific factor will experience a specific health condition? Prevalence Rates Risk Incidence

Risk

Which activites are performed by psychiatric forensic nurses? (Select all that apply.) Sanity and competency evaluations Parole and probation considerations Sexual predator screening Assessment of prison health clinics Evaluation of prison nurses

Sanity and competency evaluations Parole and probation considerations Sexual predator screening

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

Secondary prevention

Knowledge of various learning theories is important for community health nurses involved in health education. Enhancing self-confidence and self-efficacy are important aspects of which learning theory? Cognitive learning theory Humanistic learning theory Behavioral learning theory Social learning theory

Social learning theory

The nurse is meeting with a client who has been referred for assistance with smoking cessation. During their first meeting, the client states he is very doubtful about his ability to stop smoking. In the Health Belief Model, the client's belief that actions can be performed to achieve the desired outcome is referred to by which term? Self-efficacy Perceived susceptibility Perceived benefits Cues to action

Self-efficacy

In which historical age would people have had an increased risk for contracting salmonella, anthrax, Q fever, or tuberculosis from the proximity of domesticated animals and herds? Hunting and gathering stage Settled village stage Preindustrial cities stage Industrial cities stage

Settled village stage

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

Suffering chronic fatigue and tension

A 71-year-old man is brought to the emergency department by his daughter and states that he has fallen and appears to have a broken arm. He is alert and oriented and walks alone without difficulty. Which nursing intervention is most appropriate after he is seen and treated by the physician? Talk with the daughter about nursing home placement for the patient. Discuss the dietary needs and regimen with patient and family. Review the patient's current medications. Talk with the patient alone and question the possibility of elder abuse.

Talk with the patient alone and question the possibility of elder abuse.

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

Teen use of cigarettes and smokeless tobacco is increasing.

A community health nurse is concerned about reducing the fatal injuries to America's rural children. To address this problem, the nurse organizes a community of solution (see Chapter 1). For this group, it would be important to have representatives from all groups or organizations: (Select all that apply.) The Department of Public Highway and Safety Emergency department staff (both doctors and nurses) from local hospitals Teachers and coaches from area schools Area employers City or county governme

The Department of Public Highway and Safety Emergency department staff (both doctors and nurses) from local hospitals Teachers and coaches from area schools City or county government Limited resources are available in rural areas, and more can be accomplished when resources are pooled. Also, to ensure a more successful outcome, all players with a vested interest in the problem should have a voice in the problem-solving approach. This would include public personnel (city and county government, police, teachers) and private groups (RNs and MDs). Less important for looking at children's issues, however, would be private employers.

A community health nurse explores a group of teenagers' beliefs about the seriousness of eating disorders and their related susceptibility. The nurse is applying principles from which theory? Orem's self-care deficit theory The Health Belief Model Milio's framework Critical social theory

The Health Belief Model

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

The client has a laceration on her forehead that was sutured. The client has bruises on her forearms in various stages of healing. The client is not sexually active but has a diagnosis of Chlamydia.

A community health nurse is caring for a Native American client who often stares at the floor while the nurse is talking. The nurse knows this indicates which culturally appropriate behavior? The client is showing respect to the nurse. The client is listening carefully. The client's religion forbids him from making eye contact with women. The client is depressed.

The client is listening carefully. Eye contact is among the most culturally variable nonverbal behaviors. Although most nurses have been taught to maintain eye contact while talking with clients, individuals from culturally diverse backgrounds may misconstrue this behavior. Asian, Native American, Indochinese, Arab, and Appalachian clients may consider direct eye contact impolite or aggressive, and they may avert their own eyes during the conversation. Native American clients often stare at the floor when the nurse is talking. This culturally appropriate behavior indicates that the listener is paying close attention to the speaker.

While caring for a client from an Asian culture, the community health nurse might expect which behaviors? (Select all that apply.) The client is quiet and compliant, asking few questions. The client asks many questions related to the health problem and the nurse's instructions. The client may avert his or her eyes during the conversation. Folk healers and complementary health care providers may also be present. The client may provide the nurse with the answers he or she thinks the nurse wants to hear.

The client is quiet and compliant, asking few questions. The client may avert his or her eyes during the conversation. The client may provide the nurse with the answers he or she thinks the nurse wants to hear.

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

The client will feel depressed, apathetic, and lethargic.

Learner assessment is an important aspect of health education. The assessment performed by the community health nurse includes questions about the client's age, family roles, social roles, and various responsibilities. Which is the most important reason for obtaining this information? The nurse will need this information to plan the meetings with the client. The information will help the nurse to understand the client's desired outcomes. The client's developmental stage and roles have an impact on readiness to learn. The information is necessary to understand how much time the client will have.

The client's developmental stage and roles have an impact on readiness to learn.

What discovery by Edward Jenner resulted in one of the greatest medical advances of the 18th century? The benefits of isolation in the control of communicable disease such as bubonic plague The discovery that cholera was transmissible through contaminated water The identification of modern epidemiologic principles, such as agent-host-environment The development of the smallpox vaccination that resulted in immunity after inoculation with the cowpox virus

The development of the smallpox vaccination that resulted in immunity after inoculation with the cowpox virus

The community health nurse is working with a client who has recently been diagnosed with diabetes. The physician has prescribed a diet and recommended adding an exercise regimen. Assessment reveals the client has been smoking two packs of cigarettes per day for approximately 30 years. Which statement most accurately reflects the appropriate approach for establishing health education priorities for this client? The nurse must assist the client to recognize that smoking cessation should be the highest priority. The nurse and client must partner in establishing health education priorities for the client. The client does not have his priorities in order and must be informed by the nurse as to the most important priority. The nurse should not discuss smoking cessation because this is not the client's most important health issue.

The nurse and client must partner in establishing health education priorities for the client.

A community health nurse is asked to review a draft of a brochure developed for distribution to clients. The nurse finds the brochure generally well designed but suggests replacing several words with simpler words that have fewer syllables and are more commonly used. What is the best explanation for the nurse's recommendation? The nurse assumes the clients are uneducated because they have low income. The nurse knows that English may not be the primary language of many clients. The nurse is assuming that most of the client's will read at a third-grade level. The nurse knows that more difficult words will pose a barrier to some clients.

The nurse knows that more difficult words will pose a barrier to some clients.

Which statement is true regarding the state level subsystem? States share central authority of the public health care system with the federal government. The organization and activities of public health services vary widely among the states. It is the role of the governor to direct most state health agencies. Compared with other state programs, state health programs usually have a small, specialized staff.

The organization and activities of public health services vary widely among the states. States are responsible for the health of their citizens and are the central authorities in the public health care system. The organization and activities of public health services vary widely among the states. A health commissioner or secretary of health who is typically appointed by the governor directs most state health agencies. The health officer is usually a physician with a degree and experience in public health. In some states, the health officer directs the health department. Many states have boards of health, which determine policies and priorities for allocation of funds. Staffing of the state agency varies among states; however, compared with other state programs, state health programs usually have a large staff.

In the United States today, where are most personal health care services provided? The private sector The public sector The nonprofit sector The community health sector

The private sector

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

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

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

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

Which statement differentiating hospice and traditional home health is not true? Hospice patients need not be homebound but must be certified as within the last months of life by a physician. Hospice services may be provided in the home, hospital, nursing home, or other health care site as appropriate. The type of hospice services are limited as in home health care to skilled nursing, social services, physical therapy, occupational therapy, and speech therapy. The hospice plan of care includes caring for the caregiver during and after the death of the patient.

The type of hospice services are limited as in home health care to skilled nursing, social services, physical therapy, occupational therapy, and speech therapy.

Which is true of adolescents who have been convicted and incarcerated in adult facilities rather than in a juvenile facility? They are less likely to be sexually assaulted. They are usually not attacked by other inmates. They are more likely to commit suicide. They are less likely to be diagnosed with a mental illness.

They are more likely to commit suicide.

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

To act as command station for disaster responders to report to and get assignments

Which was a result of the Patient Protection and Affordable Care Act of 2010? Social Security benefits were denied to selected aggregates. Third-party payers (e.g., preferred provider organizations and health maintenance organizations) use prospective payments systems to negotiate reimbursement. Value-based purchasing programs for hospitals were established. Health care providers received a fixed amount of money based on the relative cost of resources they use to treat Medicare patients within each diagnosis-related group.

Value-based purchasing programs for hospitals were established.

A veteran is a person who has served in the military. Which statement about veterans is correct? There are 5 million veterans in the United States today. Employees of the National Aeronautics and Space Administration (NASA) are considered veterans. People who were honorably discharged from the military are still considered veterans. Veterans include those that have served in the active military, naval, or air service.

Veterans include those that have served in the active military, naval, or air service.

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

Vicodin.

Which source of information about a community's health would give the community health nurse information about births, deaths, and marriages and aid in providing indicators of population growth or reduction? Census tracts Vital statistics National Health Survey data Needs assessment

Vital statistics

When chronic disease became a more important cause of death in developed countries, different epidemiologic models were developed to study the many factors involved in the development of these health conditions. Which is an example of such a model? Person-place-time model Epidemiologic triangle Web of causation Wheel model

Web of causation

When building a collective strategy by framing an environmental problem, the community health nurse should ask which question? Who is affected by the problem? What individual should I talk to? What nursing diagnosis is involved? What is my role?

Who is affected by the problem? Dialogue from critical thinking should facilitate community involvement and is not focused on a single individual. Asking about role or diagnosis does not facilitate community involvement.

One dimension of a community, which looks at personal characteristics and risks of a group, is called aggregate of people. location in space and time. social system. census tract.

aggregate of people.

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

reservoir, mode of transmission

A community health nurse would include which in her assessment of environmental health? (Select all that apply.) Work-related exposures Atmospheric quality Families Job availability Radiation risks

Work-related exposures Atmospheric quality Radiation risks Environmental health is a vast field of subcategories, including living patterns, work risks, atmospheric quality, water quality, housing, food quality, waste control, and radiation risks. Families and job availability are not environmentally related.

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

World Health Organization (WHO)

What group of homeless individuals is known for their involvement in survival sex? Young adult gay men Middle-aged women Young women Elderly men

Young women Young homeless women may become involved in survival sex because they need money to meet subsistence needs, hence the term survival sex.

According to the vulnerability index, the individual at highest risk for death is a 46-year-old person who has been homeless for 2 months and has HIV. a 22-year-old person who lives in a homeless shelter and is addicted to heroin. a 65-year-old person who is being evicted from his home after living there for 25 years. a 60-year-old person who has been homeless for 9 months.

a 60-year-old person who has been homeless for 9 months. Those at high risk for death are individuals who have been homeless for 6 months or more with one or more conditions: More than three hospitalizations or emergency department (ED) visits in 1 year? More than 3 ED visits in the previous 3 months? 60 years or older? Cirrhosis of the liver? End-stage renal disease? History of frostbite, immersion foot, or hypothermia? HIV/AIDS? Co-occurring psychiatric, substance abuse, and chronic medical conditions

According to the American Nurses Association's (ANA) Scope and Standards of Home Health Nursing Practice, basic preparation for the generalist home health nurse is an associate degree in nursing. a baccalaureate degree in nursing (BSN). a diploma in nursing. a master of science degree in nursing.

a baccalaureate degree in nursing (BSN).

The U.S. Department of Education defines a homeless child as a child abandoned in a hospital. a child in foster care. a child in a group home. a child living with a grandparent.

a child abandoned in a hospital. The definition of a homeless child according to the U.S. Department of Education includes children and youth who are: Sharing the housing of other persons because of loss of or inadequate housing? Abandoned in hospitals? Awaiting foster care placement

A major cause for the rise in health care costs is an increase in the specialization of physicians. a decrease in nonprofit hospitals. a shortage in the number of primary care physicians. a demand for complex and advanced services.

a demand for complex and advanced services. The spiraling health care costs, starting from the mid-1960s and persisting into the twenty-first century, were fueled by the presence of very rapid technological advances, society's sense of entitlement to these therapies, a guaranteed payer, and the prevailing medical orientation toward curative measures. The number of physicians or hospitals is not a primary contributor to rising health care costs.

Forensic nursing is best defined as a field of legal nursing in which the nurse works with or for lawyers. a field of correctional nursing in which the nurse works with inmates. investigational nursing in which the nurse works with law enforcement. a link among the health care system, the investigative process, and courts of law.

a link among the health care system, the investigative process, and courts of law.

Public health efforts focus on prevention and promotion of population health. The local level of the health care system provides direct services to community members through community and personal health services. An example of a health service that targets the larger community, rather than individuals, is (Select all that apply.) providing well-infant care. a mobile immunization clinic. condemning or repairing unsafe housing. encouraging family planning. airing a weekly public service announcement to remind women to do breast self-examination.

a mobile immunization clinic. condemning or repairing unsafe housing. airing a weekly public service announcement to remind women to do breast self-examination.

The use of theory in population-focused community health nursing encourages (Select all that apply.) a reactive approach to care. a proactive approach to care. development of population-focused programs. development of individual-focused health protocols for community use.

a proactive approach to care. development of population-focused programs.

Disease prevention activities protect people from disease and the effects of disease. An example of primary disease prevention is teaching people with diabetes how to prevent complications. administering vaccines to children before kindergarten. checking the skin of farm workers for signs of skin cancer. identifying and testing individuals exposed to someone with tuberculosis.

administering vaccines to children before kindergarten.

Public health policy in the United States is influenced by two types of justice, market justice and social justice. Examples of market justice include (Select all that apply.) all people are entitled to the status they create for themselves. all people are entitled to a livable minimum wage. all people are entitled to happiness if they put forth enough effort. all people are entitled to the income they work for. all people are entitled to access to health care.

all people are entitled to the status they create for themselves. all people are entitled to happiness if they put forth enough effort. all people are entitled to the income they work for.

Using critical theory when exploring issues of environmental health ultimately allows the nurse to develop a community diagnosis. raise additional questions related to environmental health and safety. design community health interventions. alter the precursors of poor health.

alter the precursors of poor health. Critical theory is used to help community health nurses think about social, cultural, economic, and political factors of health, thereby assisting them to attack the problem at its source and alter community-wide precursors of poor health. The community health nurse can develop a community nursing diagnosis and design interventions by using the nursing process.

The nurse is aware that a risk factor for elder abuse is a caregiver with low income. an elder with urinary incontinence. an elder who is irritable and demanding. a caregiver with a strong need for control.

an elder with urinary incontinence. Individuals who are most at risk for elder abuse include female widows age 75 years and older, elders dependent on a caregiver for food and shelter, those with incontinence, and individuals who are frail or have illness or mental disability. Studies have described the typical abuser as a family member (typically a son or daughter) who is middle age or older with low self-esteem and low impulse control. The caregiver's perception of his or her own stress is strongly related to the risk for abuse. Elder abuse occurs at all cultural and socioeconomic levels.

A microscopic approach to the community health problem of childhood obesity would focus on asking an obese child and his or her parent(s) to complete a 24-hour food diary. analyzing aggregate body mass indexes (BMIs) of school-age children in a school. advocating for a change in health policy related to school lunches. exploring changing cultural changes and societal values related to activity.

asking an obese child and his or her parent(s) to complete a 24-hour food diary.

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

avoid all products containing alcohol.

A 22-year-old college student explains to the nurse at the health clinic that she drinks four to five beers when she goes out with friends on Saturday nights. Otherwise, she rarely drinks during the week because of her classes, studying, and part-time job. This would be considered age- and circumstance-appropriate behavior. alcoholism. binge drinking. excessive drinking.

binge drinking. Binge drinking is defined as drinking five or more drinks on a single occasion for men and four or more for women. Excessive drinking is drinking more than two drinks per day on average for men or more than one drink per day for women. Binge drinking is the most common form of excess alcohol use in America. Most people who binge drink are not alcohol dependent. Binge drinking is not age- and circumstance-appropriate behavior. Binge drinking is not the same as alcoholism or excessive drinking.

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

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

Cost containment incentives include (Select all that apply.) capitated reimbursement. limited access to care. fee-for-service billing. health care rationing. carve-out services.

capitated reimbursement. limited access to care. health care rationing.

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

cardiovascular accidents, stroke, and diabetes.

When nonindustrial cultures adopt Western customs and transition into urban environments, Western diseases begin to appear. Epidemiologic studies suggest that common risk factors that contribute these health conditions include: (Select all that apply.) changes in diet. environmental alterations. economic changes. increased population density. occupational hazards.

changes in diet. environmental alterations. increased population density. occupational hazards. Epidemiologic studies suggest that common risk factors that contribute to chronic health conditions are changes in diet (e.g., increases in refined sugar and fats and lack of fiber), environmental alterations (e.g., use of motorized transportation and climate-controlled living and work sites), and occupational hazards. An increase in population and population density also increase mental and behavioral disorders. Economic improvements in nonindustrialized communities would decrease the risk of disease. Economic changes in nonindustrialized communities are not listed as a common risk factor that contributes to chronic health conditions.

Two unrelated heterosexual adults that share a housing unit with their three children is an example of nuclear family. cohabitation. internal structure. external structure.

cohabitation Cohabitation is defined as a living arrangement in which an unmarried couple live together in a long-term relationship that resembles a marriage. A nuclear family is composed of a husband, wife, and their immediate children. Internal and external structure of a family refer to the family and their relationships within the immediate family and the extended family.

Which group is an example of a community of solution? A group that lives within a specific geographic location. concerned with reducing teenage suicides. with the same ethnic background. in which all members enjoy hiking.

concerned with reducing teenage suicides.

The community health nurse is teaching a prenatal class and includes the societal cost of fetal alcohol syndrome in one of the educational sessions. The nurse is demonstrating an understanding of Orem's self-care deficit theory. the Health Belief Model. Milio's framework. critical theoretical perspective.

critical theoretical perspective.

The phrase "All Chinese people like rice" is an example of cultural stereotyping. culture-bound syndrome. cultural imposition. ethnocentrism.

cultural stereotyping.

A community health nurse needs to understand that most families in today's society can be described as blended. nuclear. extended. defined by its members.

defined by its members. The families of today are defined by the members because of the numerous definitions of family. Many different types exist, such as single-parent families, second families or grandparents raising children, gay or lesbian families, or traditional families.

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

displaced persons.

A primary role of the community health nurse in facilitating community participation and partnership is solving environmental health problems. educating about environmental health hazards. altering individual behaviors. implementing solutions to environmental racism.

educating about environmental health hazards.

A community health nurse in the assessment phase of the nursing process conducted research to identify the distribution pattern of breast cancer within a population and the associated risk factors. This is called statistical analysis. needs assessment. census collection. epidemiology.

epidemiology Epidemiology involves the analysis of health data to discover the patterns of health and illness distribution in a population. It also involves conducting research to explain the nature of health problems and identify aggregates at increased risk. Statistical analysis is a general term for the analysis of data. A needs assessment is completed by the community health nurse to gain understanding of the community's perspective on health status, the services used or required, and concerns. Census information is collected every 10 years by the U.S. Census Bureau to describe the population characteristics of the nation.

Family interviewing requires the community health nurse to understand or develop specific skills. All demonstrate appropriate family interviewing skills or techniques except introducing oneself by name and addressing the client appropriately, such as "Mr. Jones." planning the focus for the family visit in advance and engaging all family members present during the home visit. establishing the nursing goals based exclusively on the physician's orders. including time to identify family strengths and commend the family on these during the family assessment.

establishing the nursing goals based exclusively on the physician's orders.

A risk factor refers to a(n) probability that a specific event will occur in a given time frame. exposure that is associated with a disease. systematic way of distinguishing the risks posed by potentially harmful exposures. proactive process in which individuals participate in behaviors that enable them to react to actual or potential threats to their health.

exposure that is associated with a disease.

A community health nurse is caring for a family that includes the husband, wife, children, and other blood relatives. This type of family is called a(n) nuclear family. communal family. extended family. nuclear dyad.

extended family.

In preparing a presentation for seniors and supportive family members, the nurse includes safety information. This is in response to the knowledge that the leading cause of death because of injuries for seniors is fire. falls. heat or cold stress. motor vehicle accidents.

falls

Mary is a nursing student doing her senior project in community health. Part of her assignment is to conduct an activity that illustrates "social health" within a group in her community. The most appropriate activity for Mary to organize would be a neighborhood block party. food bank in a local church. community yard sale. school fundraiser for the school band.

food bank in a local church.

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

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

In a managed care organization, physicians are responsible for the approval or referral of some services. In this position, they are referred to as enforcers. gatekeepers. carriers. distributors.

gatekeepers. Some services may only be accessed on approval or referral from physicians who are called gatekeepers (the primary care providers). The other options do not pertain to the referral or approval of services by a physician.

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

give the immunizations.

Using theory to guide community health nursing practice serves to (Select all that apply.) guide data collection and interpretation in a clear and organized manner. provide uniformity in community health nursing practice. improve community health nursing practice. validate traditional community health nursing beliefs. focus the student on factors that are critical to understanding the situation.

guide data collection and interpretation in a clear and organized manner. improve community health nursing practice. focus the student on factors that are critical to understanding the situation. Theory-based practice guides data collection and interpretation in a clear and organized manner. Although using theory makes it easier to plan standardized care for aggregates, the goal of theory is to improve nursing practice, thereby ensuring quality care. Through the process of integrating theory and practice, the student can focus on factors that are critical to understanding the situation. The lack of uniformity in theory definitions reflects the evolution of thought and the individual differences in the understanding of relationships among theory, practice, and research.

Receiving immunizations, regular health screenings, and physical examinations is an example of health promotion. health protection. secondary prevention. health maintenance.

health protection. Health protection refers to behaviors in which the individual engages with the intent to prevent disease, detect disease in early stages, or maximize health. Immunizations and physical examinations are examples. Green and Kreuter (1991) define health promotion as "any combination of health education and related organizational, economic, and environmental supports for behavior of individuals, groups, or communities conducive to health." Secondary prevention refers to early detection and prompt intervention during the period of early disease pathogenesis, such as checking the skin for signs of skin cancer or identifying and treating individuals who have been exposed to contagious diseases. Health maintenance occurs when the individual has changed overt behavior for more than 6 months and strives to prevent relapse.

Services provided in the private subsystem include all except health promotion. disease prevention. heath care regulation. treatment of disease.

heath care regulation. Services in the private subsystem include health promotion, prevention and early detection of disease, diagnosis and treatment of disease with a focus on cure, rehabilitative-restorative care, and custodial care. The public health subsystem is required by law to address the health of populations. Legal provisions at the local, state, and federal levels of government direct the establishment, implementation, and evaluation of these activities

Epidemiologic data can be useful in the planning phase of the community assessment process because they help discover the patterns of health and illness distribution in a population. help construct benchmarks to gauge achievement of program objectives. identify the aggregate at risk. explain the nature of the health problem.

help construct benchmarks to gauge achievement of program objectives. Inherent in the planning phase of the nursing process is a plan for the intervention and its evaluation. Epidemiologic data can be useful as a basis for determining success. By comparing baseline data, national and local data, and other relevant indicators, the nurse can construct benchmarks to gauge achievement of program objectives. The other options are useful in the assessment phase of the nursing process.

Every 10 years, the U.S. Department of Health and Human Services publishes a national prevention initiative titled Healthy People. One of the new objectives for Healthy People 2020 is to achieve access to preventive services of all Americans. improve the nation's ability to prevent, prepare for, respond to, and recover from a major health incident. reduce health disparities among Americans. increase independence of older Americans.

improve the nation's ability to prevent, prepare for, respond to, and recover from a major health incident. One of the new objectives for Healthy People 2020 focuses on preparedness for major health incidents. Achieving access to preventive services of all Americans and reducing health disparities among Americans were goals of Healthy People 2000, and increasing the independence of older Americans was a goal of the original 1979 Healthy People version.

The primary purpose of hospice care is to provide anticipatory grief support to the patient and family. improve the quality of life for the terminally ill patients. decrease the cost of traditional home health services. coordinate the services reimbursed by Medicare for terminally ill patients.

improve the quality of life for the terminally ill patients.

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

impulsive. disinhibited.

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

in an emergency.

During the Renaissance period, much was learned about health and disease. The Elizabethan Poor Law was enacted during this time to govern personal and community hygiene such as contagion, disinfection, and sanitation. make local parishes responsible for caring for the poor in the community. enforce hygienic codes from Leviticus and establish leper houses. legislate social reform, addressing issues such as child welfare and factory management.

make local parishes responsible for caring for the poor in the community.

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

malaria.

The community health nurse is reviewing the Healthy People 2020 objectives. She understands a primary goal for the elderly population is decrease the proportion of older adults who have diabetes. increase the proportion of older adults with reduced physical or cognitive function who engage in light, moderate, or vigorous leisure-time physical activities. increase the proportion of older adults who qualify for Medicare benefits. increase the proportion of older adults who seek medical care for chronic conditions.

increase the proportion of older adults with reduced physical or cognitive function who engage in light, moderate, or vigorous leisure-time physical activities. Healthy People 2020 establishes national objectives for health promotion and disease prevention. Healthy People 2020 has incorporated specific objectives related to older adults that are designed to promote healthy outcomes for this population, including increasing the proportion of older adults with reduced physical or cognitive function who engage in light, moderate, or vigorous leisure-time physical activities; increasing the proportion of older adults who receive Diabetes Self-Management Benefits; increasing the proportion of older adults who use the Welcome to Medicare benefit; and increasing the proportion of older adults with one or more chronic health conditions who report confidence in managing their conditions.

Population overcrowding can result in increased productivity. improved education. increased incidence of disease. decreased mortality.

increased incidence of disease.

The early Blue Cross and Blue Shield plan was an example of a/an health maintenance organization. prospective payment plan. indemnity plan. cafeteria plan.

indemnity plan. The early Blue Cross and Blue Shield plan was an example of an indemnity plan. This plan paid all of the costs of covered services provided to the enrollee. The enrollee enjoyed free choice of provider and services. Indemnity plans preserved the enrollee's right of choice and allowed the person to manage his or her own health care. A health maintenance organization is a managed care plan that acts as an insurer and sometimes a provider for a fixed prepaid premium. Prospective payment is payment for health care providers based on the disease or injury that is treated. Cafeteria plans are customizable health care plans.

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

indirect.

The scope of health services at the federal level subsystem targets all major health areas mentioned except the general population. individual families. special populations. international health.

individual families.

The nurse is facilitating a support group for caregivers of parents with dementias. She discusses strategies to ensure safety of the client who wanders. These strategies include (Select all that apply.) inform the local police of the potential problem. keep current pictures of the client available. consider restraining the client when left alone. place bells on doors. use childproof doorknobs.

inform the local police of the potential problem. keep current pictures of the client available. place bells on doors. use childproof doorknobs.

The composition of the family is an example of internal structure. external structure. subsystem. large system.

internal structure. Family composition, gender, and rank order are all examples of internal structure. External structure refers to the extended family and larger systems.

The number one health concern identified by the majority of rural health care leaders is lack of health insurance. limited access to health care. increase in communicable diseases. social isolation of rural dwellers.

lack of health insurance. Rural health leaders identified ten priorities for health care in rural America, with access and affordability to care topping the list. Surveys have found rural uninsured people are more likely to have a usual source of care compared with their urban counterparts. An increase in communicable diseases and social isolation of rural dwellers were not listed as a priority health concern identified by rural health leaders.

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

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

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

lack of physical activity. poor nutrition. alcohol and drug use. injury and violence.

When making health-related decisions, clients from different cultural backgrounds depend on relationships. One type of relationship involves the client seeking assistance from other members of the family and allowing a relative to make decisions about important health-related issues. This relationship is a(n) lineal relationship. collateral relationship. cultural relationship. individual relationship.

lineal relationship. Lineal relationships involve a client seeking assistance from another family member and allowing a relative to make important decisions related to health matters. A collateral relationship's focus is primarily on group goals, and family orientation is important. A cultural relationship is characterized by tolerance and respect. Individual relationships refer to personal autonomy and independence. Individual goals dominate, and group goals become secondary.

Provisions of the Patient Protection and Affordable Care act included (Select all that apply.) mandating that all citizens obtain health insurance. reducing Medicaid eligibility. subsidizing insurance premiums for all citizens. prohibiting denial of coverage for preexisting conditions. establishing health insurance exchanges.

mandating that all citizens obtain health insurance. prohibiting denial of coverage for preexisting conditions. establishing health insurance exchanges. The Patient Protection and Affordable Care Act provisions included mandating that all citizens obtain health insurance, expanding Medicaid eligibility, subsidizing insurance premiums for low income purchasers, prohibiting denial of coverage for preexisting conditions, and establishing health insurance exchanges.

A variety of health indicators are used by health providers, policy makers, and community health nurses to measure the health of the community. Indicators that illustrate the health status of a community and may be useful in analyzing health patterns over time include (Select all that apply.) morbidity. mortality. birth rates. life expectancy. cancer incidence rates.

morbidity. mortality. life expectancy. cancer incidence rates.

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

neglect.

An example of care provided under the local health department category of environmental health services is disease surveillance. immunizations. occupational health. nutrition services.

occupational health. Environmental health services include food hygiene, such as inspection of food-producing and food-processing plants and restaurants; protection from hazardous substances; control of waste, air, noise, and water pollution; and occupational health. The other options are examples of community health services.

n long-range planning for community needs, the community health nurse considers that the fastest-growing segment of the senior population is the young-old (ages 65 to 74 years). middle-old (ages 75 to 84 years). old-old (ages 85 years and older). elite-old (more than 100 years old).

old-old (ages 85 years and older). The greatest growth will occur in the population aged 85 years and older, whose numbers are projected to grow from 6 million in 2014 to nearly 20 million by 2060.

Joanne, a 37-year-old incarcerated woman, is reluctant to seek medical attention for a routine Pap smear. The correctional nurse knows this is usual; women do not seek health services as much as men in this setting. other factors may be influencing Joanne's hesitancy in seeking medical attention. Joanne is delaying the visit because she probably has a sexually transmitted disease or HIV. because she is not sexually active, Joanne is not in need of a Pap smear at this time.

other factors may be influencing Joanne's hesitancy in seeking medical attention.

According to the Health Belief Model, the inconvenience of driving to a gym to exercise is an example of a perceived susceptibility. perceived barrier. perceived benefit. cue to action.

perceived barrier.

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

physical examinations and comprehensive health history.

A veteran has a traumatic brain injury (TBI), hearing impairment, and an amputated arm. The nurse knows that this patient is suffering from polytrauma. posttraumatic stress disorder. military sexual trauma. substance use disorder.

polytrauma.

Modern community health nursing requires the nurse to __________, which empowers people to understand and address their health issues and disease. practice from a population focus adopt a medical model of care return to earlier models of prevention focus on the individual and family

practice from a population focus A population focus for nursing addresses the health of all in the population through the careful gathering of information and statistics. A population focus better enables community health nurses to contribute to the ethic of social justice by emphasizing society's responsibility for health (Beauchamp, 1986). Helping aggregates help themselves empowers people and create avenues for addressing their concerns. Adopting a medical model of care and returning to earlier models of prevention will not empower people to understand and address their health issues. Modern community health nurses focus on the population, not the individual and family.

In providing care for a client who recently had a liver transplant, a nurse case manager would focus attention on all except medication monitoring and management. provision of direct clinical skilled care (e.g., dressing changes, medication administration). identification of potential problems and notification of the physician. evaluation of progress to meeting projected outcomes or goals.

provision of direct clinical skilled care (e.g., dressing changes, medication administration). Case management services focus primarily on care coordination, assessment, monitoring, planning, and evaluation. The case manager will coordinate and monitor care; however, in most cases, the interventions are provided by other health professionals, including other nurses.

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

reach almost 10 billion.

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

refer the child to an eye specialist.

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

remain outside if you hear sounds of fighting in a home.

Local health department service categories fall into all except community health services. school health services. personal health services. mental health services.

school health services. Local health department service categories include community health services, environmental health services, personal health services, and mental health services. School health services may be provided at the federal, state, or local level, but it is not a service category of the local health department.

A priority health education topic for school-age children is schoolyard safety. motor vehicle safety. sports safety. immunization schedules.

schoolyard safety.

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

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

Migrant and seasonal farm workers constitute a high-risk population because of their low income and migratory status. These workers lack adequate access to preventive services. The most important role of the rural community health nurse in meeting the health care needs of this vulnerable population is to address the multiple communicable diseases of these farm workers. serve as an advocate working to gain health care access for these farm workers. participate in political activities with an emphasis on changing immigration laws. learn to speak Spanish to improve communication with this specific population.

serve as an advocate working to gain health care access for these farm workers.

Jennifer is a community health nurse in a large metropolitan area. According to the American Nurses Association's Code of Ethics (2015), community health nurses must align themselves with public health programs that promote and preserve the health of populations by influencing socioeconomic issues. psychosocial issues. sociocultural issues. developmental issues.

sociocultural issues. The Code of Ethics of the American Nurses Association (2015) promotes social reform by focusing on health policy and legislation to positively affect accessibility, quality, and cost of health care. Community health nurses must align themselves with public health programs that promote and preserve the health of populations by influencing sociocultural issues, such as human rights, homelessness, violence, and stigma of illness. Directing care toward socioeconomic issues, psychosocial issues, or developmental issues focuses on individuals, families, or groups, which in turn contributes to the health of the total population.

When writing a community diagnosis, the community health nurse notes that the "among" phrase presents a synthesis of all assessment data. provides the supporting data. specifies the aggregate that will benefit from the nurse's plan. describes the cause of the health problem and directs focus of interventions.

specifies the aggregate that will benefit from the nurse's plan.

A single white male veteran served two tours in Afghanistan. The veteran has returned home from Afghanistan where he lives alone, begins drinking alcohol daily around 11 am, and watches television from rising until bedtime. This veteran is at high risk for suicide. cognitive impairment chronic pain unresolved conflict

suicide.

Early public health nurse Lillian Wald and her associates were successful in addressing health and disease in the immigrant community by supporting political activities to improve social and environmental conditions of immigrant families. administering bedside nursing care to immigrants and their families. teaching the immigrant family members to provide health care in the home. obtaining and administering medications to the immigrants and their family members.

supporting political activities to improve social and environmental conditions of immigrant families. These early public health nurses saw that neither administering bedside clinical nursing, including obtaining and administering medication, nor teaching family members to deliver care in the home adequately addressed the true determinants of health and disease. They resolved that collective political activity should focus on advancing the health of aggregates and improving social and environmental conditions by addressing the social and environmental determinants of health. Wald and colleagues (1971) impacted the health of the community by organizing the community, establishing school nursing, and taking impoverished mothers to testify in Washington, DC.

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

the client is without a job.

the greatest promise for improving health outcomes for rural residents is the increase in health care providers migrating to rural areas. the expansion in Medicare services to rural hospitals and clinics. the increase in distribution of technology, providing more education and health services. the expansion of public transportation, allowing rural residents to travel to tertiary care hospitals for specialty services.

the increase in distribution of technology, providing more education and health services.

It is vital that the forensic psychiatric nurse be knowledgeable about mental illnesses and personality disorders because the nurse will be diagnosing many of the illnesses. the nurse will work in psychiatric facilities. the nurse may be an expert witness in court. the nurse will be identifying new cases.

the nurse may be an expert witness in court. The nurse will not be diagnosing or identifying illnesses, that is a physician's role. Although the nurse may be working in a psychiatric facility, the best reason for being knowledgeable about these illnesses is because the forensic psychiatric nurse may be called to be an expert witness in court.

The home health nurse receives a referral for an evaluation visit for a patient. The nurse notes that the patient's primary diagnosis is end-stage lung cancer and that the patient is currently receiving daily palliative radiation treatments for pain management. This is not an appropriate home health referral because the patient is receiving palliative care. the patient's needs are too complex. the patient is not homebound. the patient does not have a skilled need.

the patient is not homebound.

Posttraumatic stress disorder (PTSD) can develop due to (Select all that apply.) having recurring nightmares. viewing a dead body. having a history of mental illness. surviving a natural disaster. experiencing chronic pain.

viewing a dead body. having a history of mental illness. surviving a natural disaster. PTSD can develop among those involved in car accidents, natural disaster survivors, and victims of rape or incest. Factors that contribute to an individual developing PTSD include getting injured or seeing another person injured, viewing a dead body, feeling helpless, having little or no social support after a traumatic event, dealing with extra stress after the event (e.g., loss of a loved one, pain, and injury), or having a history of mental illness or substance abuse. Haivng recurring nightmares and experiencing chronic pain are symptoms of, not causes of, PTSD.

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

weapons of mass destruction.

In the role of advocate, the community health nurse recognizes that compared with men in the same age range, women age 65 years and older are most at risk for divorce. widowhood. social isolation. criminal victimization (e.g., robbery, burglary, assault).

widowhood. Elderly women are two to three times more likely to be widowed compared with men of the same age. Relatively small proportions of older men and women are divorced each year. Social isolation and criminal victimization are equal risks for older men and women.

One of the first steps in community assessment may involve the community health nurse driving or walking through an area and making observations about such things as environmental layout and location of agencies, hospitals, industries, and so forth. This is called a(n) census survey. needs survey. informant survey. windshield survey.

windshield survey.

In contrast to people who live in urban areas, rural residents frequently describe their health by their ability to avoid hospitalizations. maintain social connections. perform activities of daily living. work and be productive.

work and be productive. Rural residents generally describe themselves as healthy if they can do their usual work and remain productive. Performing activities of daily living may be one part of being productive. Avoiding hospitalizations and maintaining social connections are the most frequent descriptions of health by rural residents.

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

working in pairs.

The steps in the community assessment process for community health nurses are (Select all that apply.) writing a community diagnosis. evaluating the outcomes. collecting assessment data. identifying the cause of the problem. planning community interventions.

writing a community diagnosis. evaluating the outcomes. collecting assessment data. planning community interventions. The steps of the community assessment process for community health nurses are collecting the assessment data, synthesizing assessment data into diagnostic statements about the community's health, planning interventions, and evaluating the outcomes. Identifying the cause of the problem helps with planning the interventions.

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

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