NUFT 442 Community Exam 3 Practice Questions

What antibiotics should be given after an Anthrax exposure? a. Ciprofloxacin and Doxycycline b. Ciprofloxacin and Metronidazole c. Doxycycline and Metronidazole d. Doxycycline and Fluconazole

ANS: A Ciprofloxacin and Doxycycline are recommended by the CDC for prevention of anthrax following exposure. *review the bioterrorism agents listed in ATI, the manifestations of each, and the potential preventions/ treatments* (see ATI ch 8, pp 75-76)

A nurse is working with a client who has systemic lupus erythematosus and recently lost their health insurance. Which of the following actions should the nurse take in the implementation phase of the case management process? A. Coordinating services to meet the client's needs B. Comparing outcomes with original goals C. Determining the client's financial constraints D. Clarifying roles of interprofessional team members

ANS: A Coordinating services to meet the client's needs is an action to take in the implementation phase of the case management process. Comparing outcomes with original goals is an action to take in the evaluation phase of the case management process. Determining the client's financial constraints is an action to take in the assessment phase of the case management process. Clarifying roles of interprofessional team members is an action to take in the planning phase of the case management process. (ATI ch 9 application exercise)

A nurse developing a community health program is determining barriers to community resource referrals. Which of the following factors should the nurse include as an example of a resource barrier? A. Costs associated with services B. Decreased motivation C. Inadequate knowledge of resources D. Lack of transportation

ANS: A Costs associated with services are an example of a resource barrier to community referrals. The other options are examples of client barriers to community referrals. (ATI ch 9 application exercise) *review barriers to the referral process on page 82*

During the disaster recovery stage, what is the most crucial factor in minimizing damage from chemical agents of mass destruction? A. Detecting of an increase in people with similar signs and symptoms B. Restoring economic and civil life C. Providing counseling for caregivers and victims D. Accessibility to stockpiled antibiotics

ANS: A Detecting of an increase in people with similar signs and symptoms is early detection which aids in minimizing damage. The other options may mitigate damage but are not as crucial or priority. (see ATI ch 8)

A nurse at an urban community health agency is developing an education program for city leaders about homelessness. Which of the following groups should the nurse include as the fastest-growing segment of the homeless population? a. Families with children b. Adolescent runaways c. Individuals who have experienced spouse or partner violence d. Older adults

ANS: A Families with children are the fasting-growing segment of the homeless population. The other options are segments of the homeless population but not the fastest growing. (ATI ch 7 application exercise) *review characteristics of segments of the homeless population on page 64*

A nurse is planning interventions for migrant farm workers in a rural area. Which of the following should the nurse include as part of primary prevention? a. Establish food banks at locations throughout the community. b. Provide employers handouts on recognizing pesticide toxicity. c. Partner with clinics to provide on- site care for acute injuries. d. Create handouts on identifying skin cancer in multiple languages.

ANS: A Food insecurity is a problem for many migrant workers. Providing healthy, accessible foods promotes overall health, which is characteristic of primary prevention. Recognizing pesticide toxicity is a form of screening, which is secondary prevention. Treating acute injuries is not preventive. Providing on-site care is an appropriate strategy to promote care access for migrant workers. Identifying cancerous lesions is a form of screening, which is secondary prevention. Providing instructions in multiple languages addresses languagebarriers faced by many migrant workers. (ATI ch 7 application exercise) *review levels of prevention and strategies for rural and migrant health care on page 66*

A migrant farmworker presents to the clinic at the end of the day reporting an acute onset of severe abdominal pain, nausea, vomiting, diarrhea, and headache with difficulty concentrating. Which condition should the nurse consider first? A. Pesticide poisoning B. Viral illness C. Drug overdose D. Bacterial gastroenteritis

ANS: A Migrant farmworkers are at increased risk for pesticide exposure. Manifestations of pesticide poisoning includes headache, dizziness, dyspnea, nausea, abd cramps, poor concentration, eye irritation, confusion, irritability, muscle weakness and twitching, nasopharyngeal irritation, vomiting, and rash. (see ATI ch 7, p 65)

The community health nurse is notified of a bioterrorism incident. Which secondary level of prevention should the nurse implement? a. monitor mortality and morbidity b. monitor medication regimes c. monitor referrals d. monitor chain of command

ANS: A Monitoring mortality and morbidity is secondary (early recognition). Monitoring medication regimes and referrals is tertiary (rehabilitation of survivors). Monitoring chain of command is primary (bioterrorism planning). *review the levels of prevention in the event of a bioterrorism emergency* (see ATI ch 8, p 76)

What is the delivery mechanism for subcutaneous anthrax? a. direct contact b. blood contact c. simple dispersal device d. water contamination

ANS: A Review delivery mechanisms for biological agents. (see ATI ch 8, pp 76)

The community health nurse visits a patient with exposure to an agent of bioterrorism. The patient has red eyes, fever, bloody nose, vomiting, and joint pain. What agent of bioterrorism will the nurse suspect when planning the patient's care? a. Ebola b. Tularemia c. Malaria d. Zika virus

ANS: A Right off the bat we can eliminate Malaria and Zika, they are not included under the bioterrorism agents we learned about. Tularemia may manifest with fever and joint pain but lists nothing about the others. The key here is red eyes and bloody nose - Ebola is a viral *hemorrhagic* fever. *review the bioterrorism agents listed in ATI, the manifestations of each, and the potential preventions/ treatments* (see ATI ch 8, pp 75-76)

A nurse in the ED assesses a patient who presents with lesions on the arms and hands. The nurse originally suspected that the patient has chicken pox, but later found out the patient was diagnosed with smallpox. Which of the following correctly describes lesions associated with smallpox? a. Deep vesicles b. Appear in various stages of development c. Vesicles collapse when punctured d. Primarily on the trunk

ANS: A Smallpox lesions are all in the same stage of development, deep vesicles, and do not collapse when punctured. Rash appears 2 to 4 days after fever, more on the face and limbs than trunk. Chickenpox lesions appear in various stages of development and are superficial, vesicles collapse when punctured, and the rash is primarily on the trunk. *Review the differences between smallpox and chickenpox on pg. 75*

A nurse is implementing strategies aimed to reduce social violence. Which of the following strategies would be considered a primary level of prevention? a. Teach individuals that no one has a right to touch or hurt another person b. Refer sexual assault or rape survivors to a local ED for assessment by a sexual assault abuse team c. Alert all involved about available resources within the community d. Refer to mental health professionals for long-term assistance

ANS: A B and C are secondary levels of prevention. D is a tertiary level of prevention. *review strategies to reduce societal violence and levels of prevention in ATI on p 61*

Which of the following are health care issues that a nurse needs to be aware of when caring for pregnant adolescents? (Select all that apply) a. Limited education and job opportunities b. Increased risk of malnutrition c. Increased risk for school problems d. Increased risk of chronic disease e. High incidence of substance use disorders

ANS: A, B, C Other health care issues regarding pregnant adolescents include increased risk for poverty and homelessness, increased incidence of violence, and increased risk for low birth weight or premature infants. (D) and (E) are not listed as major health care issues for pregnant adolescents. (see ATI ch 7 pg. 67)

The nurse is presenting an educational program about delivery mechanisms for biological agents. Which examples can the nurse cite as delivery mechanisms? Select all that apply. A. Droplet contact B. Dispersal device C. Blood contact D. Direct contact E. Food contamination

ANS: A, B, C, D, E All of the options are examples of delivery mechanisms for biological agents. (see ATI ch 8, pp 76)

Which of the following are considered cardinal/primary indications of alcohol dependence? (Select all that apply) a. The individual requires more alcohol to achieve the desired effect b. Tachycardia c. Low self-esteem d. Agreeing there is a problem, vowing to change, but the change doesn't occur e. Sleep disturbances

ANS: A, B, D, E The cardinal indicators of dependence are manifestations of tolerance (defined in A), withdrawal (i.e. tachycardia and sleep disturbances) and denial (option D is an example of denial). Low-self esteem does not fall under tolerance, withdrawal or denial. Self-esteem is may be a common characteristic used to describe someone with alcohol dependence but it is not an indicator of dependence. *review the Substance use disorders section in ATI ch 7. p 61-62*

Which of the following describes the health status of rural residents? (Select all that apply) a. Higher infant and maternal morbidity rates b. Increased risk of skin cancer from sun exposure c. Lower rates of obesity d. More likely to seek preventive care e. Increased occupational-associated risks

ANS: A, B, E Rural communities often have higher infant and maternal morbidity rates. Farming involves being exposed to the sun for long periods of time, increasing one's risk for skin cancer. There are higher, rather than lower, rates of obesity in rural residents. Rural residents are less, not more, likely to seek preventive care because of distance to services; usually due to a lack of personal/public transportation and inability to pay for care (barriers to healthcare listed on pg. 65) *review the Rural residency section on pg 65*

The community health nurse is working with the community to develop strategies to address disasters. What are the phases of disaster management that need to be addressed? (select all that apply) a. prevention b. evaluation c. preparedness d. response e. debriefing

ANS: A, C, D The phases of disaster management are mitigation (prevention), preparedness, response, and recovery. Evaluation is part of the nursing process and the response to disaster is evaluated but it is not a phase of the disaster management cycle. Debriefing does occur throughout the cycle but is not a phase. *review the disaster management cycle on pages 73-74*

Unauthorized immigrants often have a waiting period to receive financial assistance for medical care and are only eligible for which of the following? (Select all that apply) a. Immunizations b. Hospice care c. School lunch d. Treatment for communicable diseases e. Speciality outpatient programs

ANS: A, C, D Unauthorized immigrants are also eligible for emergency care. (B) and (E) are incorrect, unauthorized immigrants are not eligible for these services. (see ATI ch 7 pg. 67)

A nurse is researching disasters that occurred within the past year in the U.S. The nurse will classify the disasters according to: (Select all that apply) a. Type b. Activity c. Level d. Scope e. Groups

ANS: A, C, D Disasters are classified according to type, level, and scope. Activity and groups are not classifications of disasters. (see ATI pg. 74)

A community health nurse is planning a meeting that aims to discuss issues that affect vulnerable populations. Which of the following would the community nurse address at his/her meeting? (Select all that apply) a. Violence b. Urban Residency c. Disability d. Government employment e. Depression

ANS: A, C, E Other possible answers include substance use disorders, mental health issues/illness (i.e. depression), poverty/homelessness, rural (not urban) residency, migrant employment, and veteran status. Government employment is not included in the list (see ATI ch 7, p 59)

A community health nurse is educating the public about manifestations of botulism. Which of the following signs and symptoms would the nurse include in the teaching? a. Blurred vision b. Shock c. Fever d. Difficulty swallowing e. Progressive muscle weakness

ANS: A, D, E Other manifestations of botulism include slurred speech and difficulty breathing. If asked about priorities in treatment of botulism, remember that airway management is priority. Fever and shock are not manifestations of botulism. *Review the bioterrorism agents listed in ATI, the manifestations of each, and the potential preventions/ treatments on pages 75-76*

A nurse at a community clinic is conducting a well-child visit with a preschool-age child. The nurse should identify which of the following manifestations as a possible indication of child neglect? (Select all that apply.) A. Underweight B. Healing spiral fracture of the arm C. Genital irritation D. Burns on the palms of the hands E. Poorhygiene

ANS: A, E Being underweight and having poor hygiene are possible manifestations of child neglect. A healing spiral fracture is a possible manifestation of physical abuse. Genital irritation is a possible manifestation of sexual abuse. Burns on the palms of the hands are a possible manifestation of physical abuse. (ATI ch 7 application exercise) *review different types of violence and manifestations associated with each on page 60*

A newly hired public health nurse is reviewing the disaster management cycle. Which of the following is a component of disaster prevention? (Select all that apply) a. Identification and assessment of populations at risk b. Setting up a communication protocol c. Initial assessment of the span of the disaster d. Implementing the National Incident Management System e. Strengthening levees/barriers to prevent flooding

ANS: A, E Setting up a communication protocol is part of disaster preparedness. Initial assessment of the span of the disaster is part of disaster response. Implementing the National Incident Management System (NIMS) is part of disaster response. *review the disaster management cycle on pages 73-74*

When does disaster recovery begin? a. when the disaster warning system is activated b. when danger no longer exists c. when the assessment of disaster is completed d. when stress counseling has been completed

ANS: B *Recovery begins when danger no longer exists. Recovery lasts until the economic and civil life of the community are restored.* review the disaster management cycle on pages 73-74

Which of the following provides funding for migrant health centers across the U.S.? a. Fair Labor Standards Act b. Migrant Health Act c. Occupational Safety and Health Administration Protections d. Department of Labor

ANS: B A and C are incorrect, agricultural workers are not covered under these labor laws. The Department of Labor has regulations regarding standards for migrant and seasonal agricultural workers but does not provide funding for migrant health centers across the US. (see ATI ch 7 pg. 65)

A nurse is reviewing the various roles of a community health nurse. Which of the following actions is an example of a nurse functioning as a consultant? a. Advocating for federal funding of local health screening programs b. Updating state officials about health needs of the local community c. Facilitating discussion of a client's ongoing needs with an interprofessional team d. Performing health screenings for high blood pressure at a local health fair

ANS: B Advocacy is a function of a change agent. Updating officials about community health needs is an example of a nurse functioning as a consultant. Community health nurses serve as a consultant regarding the health care needs of individuals, families, and groups within the community served. Working with an interprofessional team is a function of a case manager. Performing health screening is a function of a caregiver. (ATI ch 9 application exercise) *review the roles of a community health nurse*

A nurse is preparing a presentation on bioterrorism. Which of the following findings should the nurse include as an indication of potential bioterrorism? a. Nationwide incidence of pneumonia is higher than the prior year. b. A large number of otherwise healthy adults are dying from sepsis. c. A health department reports cases of influenza in October. d. Most of the clients' diagnoses with pneumonia have an elevated white blood cell count.

ANS: B An increase in disease that is higher in one geographic area than others (rather than nationwide) is an indication of possible bioterrorism. A large number of people dying with similar manifestations is an indication of possible bioterrorism. It is not unusual for influenza to be diagnosed in the fall; an occurrence of disease at an unusual time can indicate bioterrorism. Unexpected manifestations of a condition could indicate possible bioterrorism. An elevated white blood cell count is an expected manifestation of pneumonia. (ATI ch 8 application exercise)

A nurse is teaching a seminar about homelessness. Which of the following statements requires further teaching? a. Homeless individuals do not have a regular nighttime residence b. Healthcare for the homeless population primarily focuses on chronic illnesses c. Incidence and prevalence counts can be used to number homeless individuals d. Hypothermia and health-related illnesses from environmental exposure is a health issue of the homeless population

ANS: B Health care for the homeless population does not focus on chronic illnesses. Health care for individuals who are impoverished or homeless is often only in times of acute exacerbation or crisis. The other statements are accurate. *review facts and statistics about homelessness, pg. 64* Remember that questions that ask "which statements requires further teaching" mean "which is *incorrect.*"

A community health nurse is determining available and needed supplies in the event of a bioterrorism attack. The nurse should be aware that community members exposed to anthrax will need access to which of the following medications? A. Metronidazole B. Ciprofloxacin C. Zanamivir D. Fluconazole

ANS: B Metronidazole is used to treat trichomoniasis, skin infections, and septicemia. Community members exposed to anthrax will need access to ciprofloxacin. This medication is used for the prophylactic treatment of anthrax. Zanamivir is used to treat influenza. Fluconazole is used to treat candidiasis. (ATI ch 8 application exercise) *review the bioterrorism agents listed in ATI, potential preventions/ treatments* (pp 75-76)

What should the nurse case manager advise the paraplegic woman to ask when making an appointment for a mammogram? A. Does the facility make accommodations for persons with cognitive impairment? B. Does the facility have adaptive equipment for patients who are wheelchair bound? C. Does the facility have staff who understands that persons with disabilities have a higher incidence of cancer? D. Does the facility provide free services for persons with disabilities?

ANS: B Nursing Action: Ensure public buildings are accessible to individuals who have a physical disability (see ATI ch 7, p 66)

A newly hired public health nurse is reviewing the disaster management cycle. Which of the following actions is a component of disaster prevention? A. Outlining specific roles of community agencies B. Identifying community vulnerabilities C. Prioritizing care of individuals D. Providing stress counseling

ANS: B Outlining specific roles of community agencies is a component of disaster preparedness. Identifying community vulnerabilities is a component of disaster prevention. Prioritizing care of individuals is a component of disaster response. Providing stress counseling is a component of disaster recovery. (ATI ch 8 application exercise) *review the disaster management cycle on pages 73-74*

Communication plans provide access to emergency agencies, such as the American Red Cross and state and federal government agencies. Which QSEN competency does this align with? a. Quality improvement b. Teamwork and collaboration c. Assurance d. Informatics

ANS: B Quality improvement and informatics are QSENs but are not applicable here. Assurance is a core function, not a QSEN. If a question asks about a QSEN competency, you can automatically eliminate options if they are not one of the six QSENs. *Review the definitions of the six QSEN competencies on ATI p IV. Recognize how the competencies apply to different nursing actions and health goals.* This specific example is on page 73.

The community health nurse receives a call about a community exposure to tularemia and is told to expect to treat between 200-300 patients, which exceeds their resources. Which antibiotic should the nurse be prepared to administer? a. Penicillin b. Ciprofloxacin c. Gentamycin d. Fluoroquinolones

ANS: B The antibiotic of choice to treat tularemia is streptomycin or gentamicin. The key in this question is that the patient load exceeds the community's resources. In the case of mass casualty, tularemia is treated with doxycycline or ciprofloxacin. *review the bioterrorism agents listed in ATI, the manifestations of each, and the potential preventions/ treatments* (see ATI ch 8, pp 75-76)

The Individuals with Disabilities Education Act (IDEA) ensures free public education and accommodation to prepare children with disabilities for independent living, assists with funding of education and evaluates the effectiveness of the education. Which QSEN competency does this address? a. Policy Development b. Patient-Centered Care c. Quality Improvement d. Assurance

ANS: B This intervention addresses the clients' specific physiological, psychological, and sociological needs -> patient-centered care. Quality improvement is a QSEN but is not applicable here. (A) and (D) are incorrect because they are core functions, not QSENs (see ATI p 4 for core functions). If a question asks about a QSEN competency, you can automatically eliminate options if they are not one of the six QSENs. *Review the definitions of the six QSEN competencies on ATI p IV. Recognize how the competencies apply to different nursing actions and health goals.* This specific example is on page 67.

A nurse is implementing strategies aimed at improving mental health. Which of the following strategies would be considered a tertiary level of prevention? a. Teach stress-reduction techniques b. Identify behavioral, environmental and biological triggers that can lead to relapse c. Screen to detect mental health disorders d. Implement parenting classes

ANS: B (A) and (D) are both examples of primary level of prevention; they aim to prevent the initial occurrence of disease or injury. (B) is considered tertiary; the goal is reduce the limitations of the disability and promote long-term rehabilitation. (C) is an example of secondary level of prevention; the goal is early detection. *review strategies to reduce substance use disorders and levels of prevention in ATI on pp 63-64*

A newly hired nurse is learning about her role in disaster planning, response and recovery. Which of the following are included within disaster planning? a. Perform triage b. Evaluate the efficiency, response time, and safety of disaster drills c. Provide and coordinate care in shelters d. Make home visits and reassess the health care needs of the population

ANS: B Performing triage is part of disaster response. Provide and coordinate care in shelters and making home visits to reassess needs are part of disaster recovery. *Review the roles of community health nurses throughout the disaster management cycle on pg. 74*

A nurse is assessing a child that developed a sudden fever with severe body aches about 3 days ago. The nurse observes a rash on the child's face and tongue. What might these signs indicate? a. Ebola b. Smallpox c. Tularemia d. Bubonic plague

ANS: B Signs and symptoms of smallpox include high fever, fatigue, and head and body aches. A rash appears 2 to 4 days after the fever, starting on the face and tongue and then quickly spreads to the trunk, arms, and legs, then hands and feet. The rash eventually turns to pus-filled lesions. *Review the bioterrorism agents listed in ATI and the manifestations of each on pages 75-76*

The community health nurse is preparing to treat patients who have been exposed to botulism. Which treatments and supportive care should the nurse be prepared to administer? Select all that apply. A. Vaccine B. Antitoxin C. Fluids D. Surgical excision E. Nutrition

ANS: B, C, D, E There is no vaccine for botulism. *review the bioterrorism agents listed in ATI, potential preventions/ treatments* (see ATI ch 8, pp 75)

The community nurse is treating a client going through alcohol withdrawal. What manifestations can the community nurse expect? (Select all that apply) a. Bradycardia b. Tremors c. Sleep disturbances d. Lower blood pressure e. Headaches

ANS: B, C, E Manifestations of alcohol withdrawal include irritability, tremors, nausea, vomiting, headaches, diaphoresis, anxiety, sleep disturbances, tachycardia (not bradycardia), and elevated blood pressure (not lowered blood pressure). *review the Substance use disorders section in ATI ch 7. p 61-62*

A nurse is creating partnerships to address health needs within the community. The nurse should be aware that which of the following characteristics must exist for partnerships to be successful? (Select all that apply.) a. Being a leading partner with decision-making authority b. Flexibility among partners when considering new ideas c. Adherence of partners to ethical principles d. Varying goals for the different partners e. Willingness of partners to negotiate roles

ANS: B, C, E Shared power must exist for a partnership to be successful. Shared goals must exist for a partnership to be successful. (ATI ch 9 application exercise) *review the section on page 84 Partnerships with legislative bodies*

The community health nurse is teaching a community information session about substance use. Which of the following substances should the nurse include in the teaching about opiates? (Select all that apply) a. Caffeine b. Morphine c. Cocaine d. Codeine e. Fentanyl

ANS: B, D, E Caffeine and cocaine are both stimulants. Morphine, codeine, and fentanyl are opiates; heroin is another listed opiate. *review substance categories in ATI on p 62*

The community health nurse is teaching a community information session about substance use. Which of the following substances should the nurse include in the teaching about depressants? (Select all that apply) a. MDMA (ecstasy) b. Barbiturates c. Methamphetamine d. Chloral hydrate e. Gamma Hydroxybutyrate (GHB)

ANS: B, D, E MDMA (ecstasy) is a hallucinogen. Methamphetamine is a stimulant. Benzodiazepines are other listed depressants. *review substance categories in ATI on p 62*

A community health nurse can assist community members in making a disaster kit. Which of the following should be included within the disaster kit? (Select all that apply) a. At least 1 day supply of food b. Medication c. Batteries d. Copies of personal documents e. First aid supplies

ANS: B, D, E The disaster kit should have at least 3 days' supply of food (not 1 day), water, clothing, and hygiene items per person. Batteries may be helpful in a disaster are not essential items to include in the disaster kit. *review disaster kits and other aspects of disaster planning on pg. 74*

A nurse is implementing strategies aimed at improving mental health. Which of the following strategies would be considered a primary level of prevention? a. Work directly with at-risk individuals, families, and groups through formation of a therapeutic relationship b. Conduct crisis intervention c. Promote protective factors (coping abilities) and risk factor reduction d. Educate a client with depression regarding medication adverse effects and potential interactions

ANS: C (A) is secondary prevention because the individuals have already been assessed and deemed at-risk; working with them is considered early intervention. (B) is secondary because "conducting crisis intervention" implies that the crisis is happening and the intervention is acute care. (C) is primary because the intervention is attempting to prevent the initial occurrence of mental health issues. (D) is considered a tertiary level of prevention because the client has already been diagnoses and the intervention is regarding chronic care. *review strategies to reduce substance use disorders and levels of prevention in ATI on pp 63-64*

A community health nurse wants to develop a program to remove barriers to health care for vulnerable populations. Which grant proposal does the nurse write? A. Improving access to healthy food in all areas of the city. B. Increasing the number of shelters for homeless families. C. Developing a mobile clinic rotation schedule for residents in rural areas. D. Cultural competency classes for high school students.

ANS: C (see ATI ch 7)

While visiting a family in their home, a community health nurse hears a parent screaming who says, "Everything you do is wrong. Can't you do anything right ever?" The nurse is concerned about which of the following? A. Neglect B. Sexual abuse C. Emotional abuse D. Sexual exploitation

ANS: C *Review the different forms of abuse, risk factors, and things to recognize* (see ATI ch 7, p 60 and the violence ppt)

A nurse wants to increase accessibility to health care services for mentally ill homeless patients. Which tertiary prevention strategy is most likely to achieve that goal? A. Distributing flyers to the homeless that detail the location of various types of health care services. B. Referring homeless patients to areas that provide temporary housing. C. Applying for a grant to fund a mobile clinic to take health care to the patients. D. Soliciting donations for food and clothing to be distributed to the homeless.

ANS: C *Rush did say she wouldn't use a distractor like (b) because the term "referral" creates confusion about the level.* Distributing flyers is considered education so it's primary. Writing grants is tertiary. (see ATI ch 7, p 63-64)

The community health nurse is developing a program to help clients with mental health issues during the pandemic. Which tertiary level of prevention should the nurse implement? a. Organize a support programs for new parents b. Screening for clients whose partner recently died c. Teaching clients who have schizophrenia about medication interactions d. Discussing stress reduction techniques with employees at an industrial site

ANS: C *Rush said she won't include anything like (a) in the test because it is confusing but ATI does say that it is primary* This question is directly from ATI ch 7 application exercises. Screening for clients whose partner recently died is secondary prevention. Teaching clients who have schizophrenia about medication interactions is tertiary; they already have a diagnosis and this intervention is for long term care. Discussing stress reduction techniques is primary prevention. *review other examples of the three levels of prevention in strategies for improving mental health.* (see ATI ch 7, p 63-64)

Which risk factors do perpetrators and victims of Intimate Partner Violence have in common? A. Depression and high-risk sexual behavior. B. Being female and having a history of Intimate Partner Violence. C. Unemployment and low academic achievement. D. Being American Indian and having few friends

ANS: C *review common characteristics of perpetrators (slide 10) and of victims (ATI p 60)* (see the violence ATI ch 7 ppt)

A nurse is implementing strategies aimed to reduce social violence. Which of the following strategies would be considered a tertiary level of prevention? a. Teach alternative methods of conflict resolution, anger management, and coping strategies in community settings. b. Support and educate the offender, even though a report must be made c. Provide grief counseling to families following the death of a family member to suicide or homicide. d. Screen all pregnant women for potential abuse

ANS: C A is a primary level of prevention. B and D are considered a secondary level of prevention. *review strategies to reduce societal violence and levels of prevention in ATI on p 61*

Considering the cycle of violence, which of the following can the nurse expect to observe when the cycle continues? A. Frequency of the cycle slows. B. Periods of loving reconciliation last longer. C. Acute battering episodes occur more often. D. Violence frequency slows but severity increases.

ANS: C As the cycle of violence continues, violence becomes more frequent and more severe. Periods of loving reconciliation (honeymoon phase) become shorter and less intense. *review the cycle of violence and the phases* (see the violence ATI ch 7 ppt)

A nurse is preparing to enter a patient's room that is on droplet and contact isolation precautions. Before entering, the nurse asks a colleague if he/she would supervise when doffing PPE. Which of the following diseases does this patient have? a. Smallpox b. Plague c. Ebola d. Botulism

ANS: C For Ebola, it is recommended that a second caregiver supervise doffing and both droplet and contact isolation precautions are maintained. (see ATI ch 8 p 75)

What is the treatment of choice for Tularemia in the United States? a. Doxycycline b. Tularemia vaccine c. Gentamicin d. There is no cure, only supportive care

ANS: C Gentamicin and streptomycin are the antibiotics of choice to treat tularemia. Doxycycline or ciprofloxacin can be given to treat tularemia in the case of mass casualty but are not the treatment of choice. There is a vaccine for tularemia under review by the FDA however, it is not currently available in the US. Smallpox, not tularemia, has no cure and is treated only with supportive care. *review the bioterrorism agents listed in ATI, the manifestations of each, and the potential preventions/ treatments on pages 75-76*

The community health nurse is visiting a client who returned home from a camping trip with chills, fever, and muscle aches. The client now, 2 days later, has a dry cough, vomiting, headache, and shortness of breath. What agent of bioterrorism exposure will the nurse suspect? A. Smallpox B. Anthrax C. Hantavirus D. Botulism toxin

ANS: C Hantavirus is a category C agent of bioterrorism. The virus is found in rodent feces; when infected feces becomes airborne, humans could inhale it. Early symptoms of hantavirus include chills, fever, and muscle aches. Later symptoms (1-2 days after onset) include dry cough, headache, nausea, vomiting, and shortness of breath. Hantavirus is most prevalent in rural areas. Campers are likely to catch the virus because tents rest on the ground. The virus cannot be spread between humans. (see ATI ch 8 ppt, slide 4)

A nurse is implementing strategies aimed to reduce substance use disorders. Which of the following strategies would be considered a primary level of prevention? a. Screen individuals for substance use disorders b. Monitor pharmacological management c. Encourage development of life skills d. Provide emotional support to recovering substance users and their families

ANS: C Screening individuals for substance use disorders is secondary level of prevention. Monitoring pharmacological management and providing emotional support to recovering substance users and their families are tertiary prevention. *review strategies to reduce substance use disorders and levels of prevention in ATI on pp 63-64*

A nurse is implementing strategies aimed to reduce social violence. Which of the following strategies would be considered a secondary level of prevention? a. Assist in reducing factors that contribute to stress by referring caregivers to respite services b. Provide telephone numbers of crisis lines and shelters to survivors of violence c. Advocate for legislation designed to assist older adult independence and caregivers d. Organize parenting classes to provide anticipatory guidance of expected age-appropriate behaviors

ANS: C A and D are primary levels of prevention. B is a tertiary level of prevention. *review strategies to reduce societal violence and levels of prevention in ATI on p 61*

A nurse is implementing strategies aimed at improving mental health by making referrals to various groups of professionals, including support groups. Which QSEN competency is the nurse demonstrating? a. Safety b. Assurance c. Teamwork and Collaboration d. Quality Improvement

ANS: C By making referrals, the nurse is collaborating with other health care professionals to achieve continuity of care, which leads to positive health outcomes. Safety and quality improvement are QSEN competencies but they are not applicable here. Assurance is a core function of public health, not a QSEN competency (see ATI p 4 for core functions). If a question asks about a QSEN competency, you can automatically eliminate options if they are not one of the six QSENs. *Review the definitions of the six QSEN competencies on ATI p IV. Recognize how the competencies apply to different nursing actions and health goals.* This specific example is on the top of page 64.

A newly hired nurse is learning about prevention and treatment of inhalational anthrax. Which of the following statements made by the nurse requires further teaching? a. "The anthrax vaccine can be used for those at high-risk for exposure to anthrax." b. "Antitoxin and IV antibiotics are administered with two or more antimicrobial agents." c. "Maintain droplet precautions until 72 hours after antibiotics are given." d. "Ciprofloxacin and doxycycline are recommended by the CDC for prevention of anthrax following exposure."

ANS: C Inhalation anthrax is not contagious, therefore droplet precautions are not necessary. Maintaining droplet precautions until 72 hours after antibiotics are given is for a patient who has been exposed to pneumonic plague. All other options are correct. *Review the bioterrorism agents listed in ATI, the manifestations of each, and the potential preventions/ treatments*

Community members join together a week after a tornado swept through their city to discuss their feelings and experiences of the event. Which of the following describes this phase of emotional reaction? a. Heroic b. Disillusionment c. Honeymoon d. Reconstruction

ANS: C The honeymoon phase is when affected individuals begin to bond and relive their experience. Heroic phase encompasses intense excitement and concern for survival. Disillusionment is when responders experience depression and exhaustion. Reconstruction involved adjusting to a new reality and continued rebuilding of the area. *Review: what do each of the phases entail? what are examples of individuals in each emotional phase?* (see ch 8 p 74)

A nurse is interviewing a group of people several weeks after a community tornado. Which of the following statements by a group member should the nurse identify as the emotional reaction of reconstruction? (Select all that apply.) a. "I am tired and don't think I'll ever be able to fix everything." b. "I can't believe we survived. I keep telling everyone what happened." c. "Things will never be the same, but we will find a way to go on." d. "Our neighborhood is working together to make good changes." e. "My old hobbies don't seem interesting anymore since the tornado."

ANS: C, D (a) shows that the group member feels fatigued, which indicates emotional disillusionment. (b) shows that the group member is still reliving the experiences, and is still in the honeymoon phase of emotional reaction. (c) indicates an adjustment to the new reality, which is characteristic of the reconstruction phase. (d) indicates rebuilding and looking ahead to the future, which are characteristic of the reconstruction phase. (e) shows the group member might be experiencing depression, which indicates emotional disillusionment. (ATI ch 8 application exercise) *review the phases of emotional reaction during a disaster on page 74*

A community health nurse is educating the public on the agents of bioterrorism. Which of the following agents should the nurse include as Category A biological agents? (Select all that apply.) A. Hantavirus B. Typhus C. Plague D. Tularemia E. Botulism

ANS: C, D, E Hantavirus and typhus are Category C biological agents. (ATI ch 8 application exercise) *review categories of biological agents and examples, page 75*

The community health nurse is part of an initiative to prevent a community disaster. What suggestion should the nurse make? a. activation of the National Response Framework b. development of a community action plan c. check emergency equipment for proper operation d. improve inspections and airport security

ANS: D (A) is during the response phase. Review what the NRF is and when it is activated. (B) is during the preparedness phase. (C) occurs during disaster planning. (D) is during the prevention phase. Other suggestions during the prevention phase include increasing surveillance and strengthening public health processes such as immunizations, isolation, and quarantine. *review the disaster management cycle on pages 73-74*

Among the many victims found at the site of a plane crash the nurse finds an adult male. He has no respirations, no pulse and remains unresponsive after opening the airway. What should the nurse do? A. Start chest compressions B. Call 911 C. Classify the patient as Immediate / Red triage category D. Classify the patient as Expectant / Black triage category

ANS: D Based on the SMART triage method, this patient is expectant. *Review the four categories of the SMART method and examples of each* (see the Disaster ppt)

Why are Category A Biological Agents the highest priority? a. they are easily mass produced b. they have high morbidity rates c. they include influenza virus d. they have high mortality rates

ANS: D Category A biological agents are easily transmitted and have high mortality rates. Category B biological agents are moderately easy to disseminate, and have high morbidity rates and low mortality rates. Category C biological agents can be engineered for mass dissemination because they are easy to produce and have the potential for high mortality and morbidity rates. The influenza virus is a Category C agent. *review categories of biological agents and examples, page 75.* Also, review definitions of morbidity versus mortality.

Which phase of emotional reaction during a disaster includes depression and exhaustion? a. Heroic b. Honeymoon c. Reconstruction d. Dissillusionment

ANS: D During disillusionment, responders can experience depression and exhaustion. *Review: what do each of the phases entail? what are examples of individuals in each emotional phase?* (see ch 8 p 74)

A nurse is implementing strategies aimed to reduce substance use disorders. Which of the following strategies would be considered a secondary level of prevention? a. Assist in the formation of parental action and awareness groups b. Refer the client to community groups, such as AA or NA c. Assist the client recovering from substance use to avoid high-risk situations and to enhance coping and lifestyle changes. d. Identify at-risk individuals and assist them to reduce sources of stress

ANS: D Key word here is identifying - similar to screening or assessing - secondary prevention. Forming action and awareness groups is primary. Making references for recovery and assisting with recovery are both tertiary. *review strategies to reduce substance use disorders and levels of prevention in ATI on pp 63-64*

A case management nurse is preparing to initiate referrals for a client as part of discharge planning. Which of the following actions should the nurse take first? A. Monitor the client's satisfaction with the referral. B. Provide the client information to referral agencies. C. Review available resources with the client. D. Identify referrals that the client needs.

ANS: D Monitor the client's satisfaction with the referral as part of patient-centered care. However, another action must occur first in the referral process. Provide the client with information to referral agencies to enable the client to access needed services. However, another action must occur first in the referral process. Review available resources with the client to promote self-determination. However, another action must occur first in the referral process. Using the nursing process, the first action to take at this point in the referral process is to assess client needs. After gathering client data, identify referrals that the client needs and prioritize plans. This allows the nurse and client to focus on specific needs while moving forward in the referral process. (ATI ch 9 application exercise) *review the referral process on page 82*

Which of the following statements about violence is true? a. Most homicides are committed by someone unknown to the victim b. Most rapes are reported c. Females are more likely to be assaulted than males d. Females are more likely to attempt suicide

ANS: D Most homicides are committed by someone known to the victim, not unknown. Rape is often unreported. Males are more likely than females to be assaulted Females are more likely to attempt suicide; males are more likely to complete suicide. (see ATI ch 7, p 60) *review facts and statistics about violence*

Part of disaster preparedness involves creating an action plan and coordinating community efforts. Which QSEN competency is addressed at this stage of the cycle? a. Quality Improvement b. Act of foresight c. Assessment d. Safety

ANS: D Quality improvement is a QSEN but not applicable here. Act of foresight is not a QSEN. Assessment is a core function, not a QSEN. If a question asks about a QSEN competency, you can automatically eliminate options if they are not one of the six QSENs. *Review the definitions of the six QSEN competencies on ATI p IV. Recognize how the competencies apply to different nursing actions and health goals.* This specific example is on page 73.

The nurse is applying mock injuries for a mass-casualty training exercise. What will make the injuries more realistic? A. Diverse dressings B. Intravenous access C. Striped triage tags D. Moulage

ANS: D Rush mentioned this as kind of a "fun fact," it's not in the notes or ATI. Moulage is defined as the art of applying mock injuries for the purpose of training emergency response teams and other medical and military personnel.

A community health nurse is developing an education program on substance use disorders for a group of adolescents. Which of the following information should the nurse include when discussing nicotine and smoking? a. Smoking is the fifth-most preventable cause of death in the United States. b. Nicotine is a central nervous system depressant. c. Withdrawal effects from smoking are minimal. d. Tolerance to nicotine develops quickly.

ANS: D Smoking is the leading preventable cause of death in the U.S. Nicotine is a central nervous system stimulant. Withdrawal effects from smoking are substantial and increase physical dependence. Tolerance to nicotine does develop quickly (ATI ch 7 application exercise) *review information about substance use on pages 61-63*

The community health nurse is responding to a call after a bioterrorism attack. Where will the nurse obtain mass quantities of medications for people? a. Department of Defense b. The Center for Disease Control c. The United States Food and Drug Administration d. The National Stockpile

ANS: D The Strategic National Stockpile enables large amounts of these medications to be made available on short notice. CDC's Strategic National Stockpile is the nation's largest supply of potentially lifesaving pharmaceuticals and medical supplies for use in a public health emergency severe enough to cause local supplies to run out. (see Demarco ch 20)

Which is an example of a Category C Biological agent? a. Tularemia b. Anthrax c. West Nile Virus d. Rabies virus

ANS: D Tularemia and anthrax are category A. West Nile virus is category B. Rabies virus is category C. Other category C agents include hantavirus, influenza virus, and tuberculosis. *review categories of biological agents and examples, page 75.*

A community health nurse is evaluating the area, effect, and level of a disaster. This action addresses which QSEN competency? a. Safety b. Teamwork and Collaboration c. Assurance d. Quality Improvement

ANS: D Evaluating the area, effect and level of a disaster allows nurses to develop and implement plans that better meet the communities' needs. Safety and Teamwork/Collaboration are QSENs but not applicable here. Assurance is a core function, not a QSEN. If a question asks about a QSEN competency, you can automatically eliminate options if they are not one of the six QSENs. *Review the definitions of the six QSEN competencies on ATI p IV. Recognize how the competencies apply to different nursing actions and health goals.* This specific example is on the top of page 74.

Which of the following is a national health goal addressing vulnerable populations? a. Increasing the number of visits to urgent care facilities b. Restrictions are placed on addictive substances such as opioids c. Reducing the number of people who rely on Medicaid and Medicare d. Increasing the number of people who have a routine primary care provider

ANS: D National health goals also include increasing the number of people who have health insurance, reducing the number of people who are unable to access, or have a delay in accessing health care services and prescribed medications, and reducing the number of people who have disabilities who report physical barriers to accessing health and wellness programs in the community (aka American Disability Act). (see ATI ch 7, p 59) *remember, in general, national health goals increase the good and decrease the bad*

A nurse practices cultural competence to design care for individuals and groups of seasonal and migrant farmworkers. Which QSEN does this address? a. Teamwork and collaboration b. Informatics c. Assessment d. Patient-centered care

ANS: D The nurse is providing culturally-sensitive care to address client needs - patient-centered care. (A) is incorrect because the nurse is not collaborating with other members of the health-care team to improve health care services. (B) is incorrect because the nurse is not using information technology as a tool to support clinical decision making. (C) is incorrect because it is a core function, not a QSEN (see ATI p 4 for core functions). If a question asks about a QSEN competency, you can automatically eliminate options if they are not one of the six QSENs. *Review the definitions of the six QSEN competencies on ATI p IV. Recognize how the competencies apply to different nursing actions and health goals.* This specific example is on page 65.

Which of the following diseases do not have an approved or available vaccine in the U.S.? (Select all that apply) a. Ebola b. Smallpox c. Botulism d. Inhalation anthrax e. Plague f. Tularemia

Answer: A, C, E, F Smallpox and inhalation anthrax have vaccines. There is no approved vaccine for ebola or botulism. For plague, the vaccine is no longer available in the U.S. Tularemia has a vaccine under review by the FDA, but is not currently available. *Review the bioterrorism agents listed in ATI, the manifestations of each, and the potential preventions/ treatments on pages 75-76*

A newly hired public health nurse is reviewing the disaster management cycle. Which of the following is a component of disaster recovery? a. Increasing surveillance b. Creating a disaster kit c. Communicable disease and sanitation controls d. Disaster Drills

Answer: C *Per Rush, these two components are priority in disaster recovery.* Increasing surveillance is part of disaster mitigation/prevention. Creating a disaster kit and disaster drills is part of disaster preparedness. *review the disaster management cycle on pages 73-74*