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The community you are involved in is concerned regarding public safety and the care of their elders living at home. When you assess the community you find that there is potential to solve their problems within the community setting without outside resources. The plans to meet the community needs are accepted by the members of the community. One method to create a successful environment for assessment is to A) make the assessment process empowering to the community. B) assess the community through interview and share findings in a timely manner. C) involve the community when there is difficulty with the assessment. D) create an environment of change within the community.

A

You are a member of a disaster team responding to a chemical disaster. You assess the clients in a systematic fashion concentrating on their ability to breathe. When entering the evacuation site, prior to your physical assessment, you should A) don PPEs. B) interview the client. C) report to the "hotzone." D) request HAZMAT to witness client assessment.

A

You are a public health nurse and a first responder in a community disaster, secondary to a flood. One section of the town has experienced a loss of water and electricity for 4 days. What actions would you take to meet the needs of the community at this time? A) Refer the members of the community to a spiritual outreach program. B) Provide access to safe food and water. C) Inform the fire department of potential risks within the community setting. D) Provide an immunization program.

B

The nurse researches whether the community would benefit from monthly blood pressure clinics. Which system level would such an intervention address? A) Upstream B) Mainstream C) Sidestream D) Downstream

B Mainstream interventions effect change at the population or community level, as in this scenario. Upstream interventions effect change at the societal, environmental, or policy level. Downstream interventions effect change at the individual level. There is no "sidestream" system level.

A tornado touched down in the city where you are employed as a public health nurse. As a member of the disaster management team, your role includes which of the following? (select all that apply) A) Search and rescue B) Clinical assessment and triage C) Providing health education D) Hazardous materials management

B C

Posthurricane, your disaster team chooses to use a collaborative model to assess the needs of the community. Each of you is given a community analysis and the task to create a tentative plan of action. Why would the use of a collaborative model hamper the progress of the assessment and plan in a disaster? (select all that apply) A) Individual decision making creates bias. B) Assessment is time consuming. C) Approach to problem solving is linear. D) Approaches must be pre-established . E) Collaboration is limited.

B C

In the United States, detention centers, jails, and prisons are places that provide safety to the public by incarcerating people who have committed crimes and who are deemed a threat to society. Which demographics are true of the majority of inmates? (Select all that apply.) A) Incarcerated for violent crimes B) Latino or African-American C) Average age of 37 years D) Serving sentences of more than 10 years E) Male gender

B C E

Which is the first step in developing a plan for evaluating a community-level intervention? A) Determine indicators or measures to answer evaluation questions B) Decide what method you will use to collect data C) Develop evaluation questions D) Decide how you will communicate your results

C

Which most accurately describes the purpose of force field analysis? A) Unfreezing the status quo B) Changing or moving to a new state C) Identifying the forces driving the change and those resisting it D) Refreezing to sustain the change or changes made

C

Which correctly ranks the top four rural health priorities according to the Healthy People goals? A) (1) Access to quality healthcare, (2) mental health and mental disorders, (3) diabetes, (4) heart disease B) (1) Mental health and mental disorders, (2) access to quality healthcare, (3) heart disease, (4) diabetes C) (1) Diabetes, (2) heart disease, (3) mental health and mental disorders, (4) access to quality healthcare D) (1) Access to quality healthcare, (2) heart disease, (3) diabetes, (4) mental health and mental disorders

D

developmental model

retrospective, historical analysis of system parameters such as physical environment, education, safety, and transportation, politics and government, health, and social services

bioavailabilty

the amount of a substance that is absorbed or becomes available at the site of physiological activity

environmental justice

the belief that no group of people should bear a disproportionate share of negative environmental health consequences

epidemiological model

uses data collected from descriptions and statistical relationships to evaluate the level of health and well-being within a community

Children may be more vulnerable to environmental exposures than adults. There are several factors that increase children's vulnerability. Which are the factors to consider with children? 1. Body systems are still rapidly developing. 2. Eat less, drink less, and breathe more in proportion to their body size than adults. 3. Body may be less able to break down and excrete contaminants. 4. Behaviors can expose them to more contaminants.

1 3 4

As a member of a disaster team, you respond to a confirmed outbreak of the plague. You understand that the pneumonic plague has a high mortality rate. The decision to meet the needs of the public on a wide scale includes which of the following? A) Administration of antibiotics via PODs B) Administration of antivirals via PODs C) Door-to-door visits to administer preventative medication D) Isolating designated hospitals to prevent spread of the plague A) Administration of antibiotics via PODs

A

The disaster is over and your team prepares to return to normal operations. Prior to disbandment of the team it is essential to create a safe environment for the staff. The staff will participate in a A) critical incident stress debriefing. B) support group to foster recovery. C) information debriefing for prevention purposes. D) interrogation process to identify unsafe behaviors.

A

The environment and its effect on human health are often considered in two ways. What is an example of how to focus on contaminants in the environment? A) Radon influence on human health B) Neighborhood safety C) Access to grocery stores D) Climate effects on health

A

The nurse cares for a client in a community health clinic. The nurse is uncomfortable because the client remains very close when communicating. This discomfort makes it difficult to concentrate on the interview. When the nurse backs away, the client stops speaking and leaves. This is an example of: A) Differing views of personal space B) Treatment limitation C) Aggressive behavior D) Cultural bias

A

What is a major challenge to most environmental epidemiology studies? A) Resource intensive in terms of personnel and money B) Period between exposure and illness can be very short C) Limited understanding of how exposure to one contaminant can make people ill D) Limited availability of data on individual contaminant effect on people's health

A

What is bioavailability? A) The amount of a contaminant that actually ends up in the systemic circulation B) Process of using medical tests to determine whether a person has been exposed to a contaminant C) Focus on the incidence and prevalence of disease or illness in a population from exposures in their environments D) Number of adverse effects of chemical, physical, or biological agents on people, animals, and the environment A) The amount of a contaminant that actually ends up in the systemic circulation

A

he client is admitted to the hospital for new-onset hypertension and chest pain. During the admission interview you ask the client if she takes over-the-counter medications, and she states no. She adds that she routinely visits a folk healer. The nurse's response should include: A) Obtaining a list of the herbs and folk medications that are taken and notifying the physician B) Requesting the client to stop the ingestion of the folk herbs C) Calling poison control with the list of herbs and folk medications D) Encouraging the client to continue to take the herbs and folk medications

A

The nurse is reviewing the sources of funding for the local community health intervention program on smoking cessation. In the federal grant proposal, the nurse elaborates on all the various local organizations and private foundations that have pledged to support the program after initial funding from the grant ends. The nurse also explains the plan for ongoing fundraising efforts for the program for years to come. With these comments, the nurse is attempting to establish which essential component of funding? A) Sustainability B) Program replication C) Clinical expertise D) Accountability

A Feedback: Sustainability is an important consideration in program planning and a key factor in grant making. Most funding agencies expect programs to give a clear and convincing plan outlining how efforts started with grant funding will be continued after the grant ends. Accountability includes regular communication about how funds were used, details of program activities, and progress toward achieving program goals. The ability to replicate or reproduce a successful program within a different community or with a new population aggregate is a test of the strength of the design of an intervention. The explanation provided in the grant request does not mention the nurse's clinical expertise.

. How can genomics help improve care of underserved populations? (Select all that apply.) A) Identify increased risk in certain populations for specific diseases. B) Boost the immune system of individuals in the community. C) Predict how a community might metabolize medications. D) Reduce the cost of medications. E) Predict a community's unique vulnerability to environmental changes that can control gene expression in some diseases.

A C E

As an advocate for leukemia research, the nurse along with many others succeeded in urging the U.S. Congress to debate and vote on a bill that significantly increases federal funding for this research. Which system level would such an intervention address? A) Upstream B) Mainstream C) Sidestream D) Downstream

A Feedback: Upstream interventions effect change at the societal, environmental, or policy level; such is the case in this scenario. Mainstream interventions effect change at the population or community level. Downstream interventions effect change at the individual level. There is no "sidestream" system level.

Response to a disaster is in its final phase. Although still in the recovery phase of the response, an evaluation meeting is arranged. The purpose of the evaluation meeting is to A) analyze the strengths and weaknesses of the response and submit a plan to improve response in the future. B) create a report that exemplifies the cohesiveness of the departmental response to the disaster. C) analyze the effectiveness of the disaster relief teams from respondent states. D) create a postdisaster report for FEMA.

A) analyze the strengths and weaknesses of the response and submit a plan to improve response in the future.

The nurse asks the client "Do you wear the clothes you wear at work to home?" This is an example of what subject on the exposure history? A) Present work B) Past work C) Home/residence D) Concerns

A) present work

The nurse is called to make an unscheduled visit to a new client in her home. The purpose of the visit is to admit the client and treat an abdominal wound. The nurse discovers that the client is from a culture unfamiliar to her. In this situation, the nurse should demonstrate cultural competence and awareness by: (Select all that apply.) A) Being open to the client's ideas and way of life B) Obtaining objective data when caring for the client C) Exhibiting respect and patience D) Being aware of your own culture E) Assuming that you have enough knowledge to get by

A,C,D

15. After successfully implementing and managing a smoking cessation program in an inner-city neighborhood for 5 years, the group expands the efforts to include a nearby rural community. After a challenging first year, the nurse finds that with a few modifications the program is proving successful in the rural setting, as well. Which essential component of program design has been established by success in the rural community? A) Sustainability B) Program replication C) Clinical expertise D) Accountability

B

An ice storm cripples the city and electrical outages affect the power grid. Trees and frozen wires are down throughout the city and the timeline for restoration of power is 7 to 10 days. You expect the management team to classify this occurrence as a(n) _________ according to established guidelines. A) emergency B) natural disaster C) terrorism D) accidental disaster

B

Community assessment is a critical process for the future because the process may A) identify the need for a community commission. B) identify a method to improve the health of at-risk clients. C) provide a means of grant funding for clinics. D) provide a client base for at-risk neighborhoods.

B

Environmental justice is an important consideration when working with tribal communities. Many tribal communities still continue to try and practice traditional tribal life ways. In what aspect are traditional practices often directly affected by contaminated land and water? A) Spiritual practices B) Dietary practices C) Work opportunities D) Exercise opportunities

B

The Children's Defense Fund supports initiatives at the individual, family, community, organizational, and government levels. Encouraging families to spend quality time together by hosting a movie or game night at a local church is an example of a strategy at which level? A) Family B) Community C) Organizational D) Government

B

The nurse is caring for a client who refuses the food as served. He states that the food is foreign to him and will make him ill. All food must be blessed. The personal care attendant is upset by this behavior and states that the client should eat the food anyway. The client's behavior is most likely a result of: A) Psychosocial deficit B) Cultural belief C) Allergies D) Hygiene

B

A nurse is assessing a client who was recently released from prison. Based on knowledge of the incidence rates of various types of crimes that lead to incarceration, the nurse suspects that the client may have committed which crime? A) Murder B) Rape C) Assault D) Drug possession and trafficking

D

Which most accurately defines a medically underserved area? A) A geographic area, population group, or medical facility with shortages of healthcare professionals to the degree that a full complement of healthcare services is not possible B) An area with a lack of medical care services as determined by the number of primary medical care physicians per 1,000 population, infant mortality rate, percentage of the population with incomes below the poverty level, and percentage of the population 65 years or older C) A U.S. federal designation for those populations that face economic, cultural, or linguistic barriers to accessing primary medical care services D) A subgroup of the population that has a higher risk of developing health problems because of marginalization

B

While visiting the home of an 89-year-old woman out in the country, the nurse learns that her primary care provider's office is one hour's drive away. The client states, "I've just stopped going in for appointments in the past few years. It's just too far for me to drive by myself." This situation exemplifies which of the seven A's of challenges to elders in rural areas? A) Availability B) Accessibility C) Affordability D) Awareness

B

During a conference after rounds, a nurse states, "They are in the United States now; you would think that they would act like us." This nurse is exhibiting: A) Cultural humility B) Ethnocentrism C) Cultural competence D) Cross-cultural nursing

B Ethnocentrism refers to the tendency of people to view their way of doing things and their culture as superior to the cultures and ways of others.

Which best illustrates systems theory? A) School systems in two different counties each setting up their own independent afterschool exercise programs B) Father being challenged to stop smoking because his daughter learned of the hazards of smoking from a smoke cessation program at her middle school C) Hospital requiring all of its nurses to wear an identification badge while on duty D) Physician in one state deciding to stop accepting Medicaid clients, while another physician in another state begins accepting Medicaid clients

B The theory focuses on the response of the patient system to actual or potential environmental stressors and the use of primary, secondary, and tertiary nursing prevention intervention for retention, attainment, and maintenance of patient system wellness.

After a hurricane, you are placed on a planning committee to meet the direct needs of the committee. Most of the clean-up and rescue work has been completed and several members of the community are living in shelters and are homeless. One of the foremost priorities of your committees is to establish which of the following? A) Ecumenical centers for long-term worship B) Home repair resources C) POD emergency supply centers D) Financial aid centers

C

An older woman in a rural health clinic tells the nurse that this is the first time she's been in a medical facility for more than 10 years. She shows signs of advanced diabetes, including significant necrosis in her feet. When asked why she didn't come in sooner, she says, "I don't drive, myself, and I hate asking my son to bring me—I feel like such a burden." This situation exemplifies which of the seven A's of challenges to elders in rural areas? A) Awareness B) Adequacy C) Acceptability D) Assessment

C

What is the point of the exposure? A) Describe what the contaminants are and where they originate B) Medium that the contaminant is in to determine who is exposed C) Place where people come in contact with the contaminated medium D) How the contaminant enters the body

C

The Children's Defense Fund supports initiatives at the individual, family, community, organizational, and government levels. Which exemplifies a strategy at the family level? A) Mentor a child in a READ program. B) Volunteer with children who are homeless or in foster care. C) Create daily homework routines and limit television viewing. D) Vote in every election and advocate for children.

C

The Children's Defense Fund supports initiatives at the individual, family, community, organizational, and government levels. Which level is represented by hosting a health fair to ensure all children who are eligible for Medicaid or state children's health insurance program are enrolled? A) Family B) Community C) Organization D) Government

C

The national weather service warns of an impending ice storm that may have crippling effects on the community. Widespread electrical outages are predicted as well as freezing temperatures. The community health nurses are mobilized to establish emergency living quarters and clinics for those without heat. The impending crisis will affect the health and well-being of the community and the community responses are considered the ______ phase of disaster management. A) impact B) postimpact C) preimpact D) preparation

C

The nurse is scheduling a follow-up appointment for a client who recently immigrated from Nicaragua. The client agrees to a 9:00-AM appointment on the following Wednesday. The nurse should anticipate that on the following Wednesday, this client will: A) Show up half an hour before the scheduled time B) Not return at all for the follow-up appointment C) Arrive late for the appointment, after completing whatever tasks the client feels need to be accomplished first D) Arrive exactly on time

C

The nurse prepares community program objectives that are specific, measurable, achievable, relevant, and time bound (SMART) to help in planning interventions and establishing measurement systems to evaluate programs and outcomes. Which is a measurable objective? A) Program will reduce teenage obesity. B) Fewer teens will start smoking. C) Blood pressure for children aged 12 to 18 years in Marks School will be reduced by 5% after petting the dog for 1 day in March 2019. D) Number of older minority residents in Legacy Independent facility receiving a flu shot will triple.

C

To demonstrate true cultural sensitivity and awareness, the nurse must: A) Travel to other countries on occasion B) Become bilingual C) Be competent in his or her own cultural heritage D) Know the practices of all major cultures in one's region of the country

C

What is an exposure pathway? A) The total amount of a contaminant that comes in direct contact with the body. B) Factors that determine a person's level of exposure to a contaminant. C) Method by which people are exposed to an environmental contaminant that originates from a specific source. D) Process to help determine whether an individual has been exposed to environmental contaminants.

C

What is environmental epidemiology? A) Focus on the amount of a contaminant that actually ends up in the community B) Monitoring the results of medical tests to determine whether a person has been exposed to a contaminant C) Focus on the incidence and prevalence of disease or illness in a population from exposures in their environments D) Monitoring of the number of adverse effects of chemical, physical, or biological agents on people, animals, and the environment

C

The Children's Defense Fund supports initiatives at the individual, family, community, organizational, and government levels. Which strategies are at the government level? (Select all that apply.) A) Provide free tax filing assistance to low-income working families. B) Educate families about how they can apply for food stamps, Head Start, federal nutrition programs, and other similar benefits. C) Ensure children in foster care and detention receive quality treatment to address their mental, behavioral, and emotional needs. D) Promote high-quality children's television programming and access to other quality electronic media. E) Start a halfway house and counseling program for youth who have run away.

C D

The nurse is in the process of forming a coalition to support a community flu shot program. Which step should the nurse take as part of this process? (Select all that apply.) A) Assign members of the coalition to tasks in a random manner. B) Seek out people with similar opinions and roles in the community. C) Consider how each member of the coalition and the organization or group represented will benefit from the work of the coalition. D) Understand group dynamics and members' motives for serving. E) Form a group that is heterogeneous but able to show mutual respect.

C,D,E

In the Healthy People 2020 federal initiatives in the United States, which group is identified as needing special attention and creative solutions to live a healthy life in the face of sobering health disparities and social injustices? A) Older adults B) People with acute infectious diseases C) People recovering from traumatic accidents D) Mentally ill people

D

What is the correct formula for determining the amount of risk? A) Hazard = exposure + risk B) Exposure = risk + hazard C) Risk = contaminant presence + exposure D) Risk = hazard + exposure D) Risk = hazard + exposure

D

What is the most complete description of environmental justice? A) Belief that the majority of people should not bear a disproportionate share of negative environmental health consequences regardless of income B) Belief that the majority of people should not bear a disproportionate share of negative environmental health consequences regardless of race and culture C) Belief that the majority of people should not bear a disproportionate share of negative environmental health consequences regardless of race or culture D) Belief that no group of people should bear a disproportionate share of negative environmental health consequences regardless of race, culture, or income

D

What is the process to help determine whether an individual has been exposed to environmental contaminants called? A) Exposure B) Exposure estimate C) Exposure pathway D) Exposure history

D

When speaking with an older man in a rural community about his lifelong smoking habit, the nurse is alarmed to learn that he has never heard that cigarette smoking is the major cause of lung cancer. This situation exemplifies which of the seven A's of challenges to elders in rural areas? A) Availability B) Accessibility C) Affordability D) Awareness

D

Contaminants that stay in the environment longer may influence health over a greater period of time. What is an example of a radiological contaminant? A) Lead B) Mercury C) Ricin D) Uranium

D)Uranium

collaborative model assessment

begins with planning that includes representative parties of a population, including service organizations, corporations, and governmental officials

environmental epidemiology

field of public health science that focuses on the incidence and prevalence of disease or illness in a population from exposures in their environments

exposure pathway

method by which people are exposed to an environmental contaminant that originates from a specific course

exposure history

process to help determine whether individual has been exposed to contaminants


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