Population 2
The community health nurse assesses the neighborhood in which the clients live. When observing the physical environment, the nurse notes that most of the homes in the neighborhood are well kept and the children playing in the yards are wearing clean clothing. The children appear well nourished. The nurse determines that the neighborhood has little need for a well-child clinic. This assessment is based on: A)Subjective data B)Objective data C)Cognitive analysis D)Valid data
A)Subjective data
The school nurse notifies the community nurse that there have been five confirmed cases of pertussis in the sixth-grade classes. In addition to responding to the cluster of cases, the community nurse should immediately: A)Recommend that the school be closed B)Research the vaccine compliance in the school C)Recommend that notes be sent home to the parents regarding a pertussis epidemic D)Consult with the infection control physician at the local hospital
B)Research the vaccine compliance in the school
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)Mentally ill people
Environmental justice is most accurately described as the belief that: A)Those who violate the environment should be required to pay significant fines or face extensive prison sentences. B)All the harms humans have committed against the environment will one day result in divine judgment. C)All people should have equal access to the environment. D)No group should suffer more from environmental health consequences than others.
D)No group should suffer more from environmental health consequences than others.
When the community collaborates in a plan to create services and education to enhance their health and well-being, the plan is most likely to: A)Create an environment that fosters change B)Have an increased rate of success C)Empower the community but diminish the rate of success D)Shift the focus from dependency to empowerment
D)Shift the focus from dependency to empowerment
The physician approaches the client with a treatment plan for his cancer. The client states that his life is in God's hands and refuses conventional treatment. This is an example of: A)Fatalistic behavior B)Denial C)Anger D)Bargaining
A)Fatalistic behavior
Which exemplifies a nuclear family? A)First-degree relatives who live together B)First- and second-degree relatives who live together C)First- and second-degree relatives who live in the same neighborhood D)Individuals who are not blood relatives but share a common locale of origin or culture
A)First-degree relatives who live together
The community health nurse explores pedestrian access to all healthcare facilities in the community. Which tool would be most helpful in performing this task? A)Geographic information systems B)Functional health pattern C)Epidemiologic model D)Developmental model
A)Geographic information systems
The nurse visits the home of client in a low-income community and notices that paint is flaking off the walls and forming a dust in the corners of some rooms. The nurse asks the client when the house was built, and she responds that it was built in 1959. Which contaminant should the nurse expect to find in this home? A)Lead B)Radon C)Asbestos D)Pesticide
A)Lead
What percentage of rural children live in poverty? A) 14% B) 24% C) 34% D) 44%
B) 24%
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)Create daily homework routines and limit television viewing.
The community health nurse is responsible for the general health of the community on multiple levels. The nurse discovers an increase in the number of sick days used by children aged 7 to 11 years at the local elementary school in recent weeks. Research indicates that the families of asthmatic children tend to be less educated and less likely to comply with current treatment plans. Using the epidemiologic approach, the next step in the care plan should be to: A)Conduct a broad-based survey of all families with asthmatic children within several communities B)Determine trends that interfere with family problem-solving techniques C)Develop school-based education programs for both the children and their caregivers D)Submit a proposal to the town for neighborhood asthma clinics
C)Develop school-based education programs for both the children and their caregivers
Definitions of rural areas are based on which concepts? (Select all that apply.) A)Administrative B)Religious C)Land-use D)Political E)Economic
A)Administrative C)Land-use E)Economic
The nurse assesses a community undergoing change. Five years ago, a series of setbacks caused the local foundry to close. Through interviews, the nurse discovers that generations of families worked at the foundry. Research indicates that no other businesses have been able to provide work for those who no longer work at the foundry. Developmental data gathered through this research into the community's history will help the nurse: (Select all that apply.) A)Determine what resources were available before the foundry closed B)Determine what variables may have enhanced or detracted from community development C)Develop an understanding of the community's strengths and resources today D)Understand cultural changes within the community over time E)Identify where in the community health clinics are most needed
A)Determine what resources were available before the foundry closed B)Determine what variables may have enhanced or detracted from community development D)Understand cultural changes within the community over time
Which are included in the five types of health risk factors that affect families? (Select all that apply.) A)Genetics B)Age C)Intelligence D)Personal health habits and lifestyle E)Environment
A)Genetics B)Age )Personal health habits and lifestyle E)Environment
A client is fearful of being infected with the Ebola virus. To which reliable source of family risk reduction information should this client turn? A)A report from the client's neighbor whose daughter was recently infected with the Ebola virus B)Information the client's wife reported from a newspaper article about the Ebola virus that she read C)Data from an Internet site that the client's daughter conveyed D)A conversation the client has with his healthcare provider
D)A conversation the client has with his healthcare provider
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)Awareness
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)Drug possession and trafficking
In comparison with other generations, members of generation X: A)Respect authority, but want recognition for their individual contributions B)Are likely to multitask and have more than one career in their lifetimes C)Prefer authoritarian leadership and direct personal interaction with superiors and others D)Are goal oriented and focused people who desire guidance
B)Are likely to multitask and have more than one career in their lifetimes
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)Cultural belief
The nurse visits a community along a creek where residents have begun to report upper respiratory illnesses and asthma. After investigating, the nurse learns that several miles upstream is a hazardous material disposal site. In addition, chemicals have leached through the soil into the creek water and have been carried downstream to this community. Although children are not allowed into the creek, they do often play along the bank. Which represents the route of exposure in this situation? A)Creek water B)Chemicals C)Bank of the creek D)Inhalation
D)Inhalation
The nurse is approached by the health department to investigate and assess the rise in developmental disabilities in an isolated section in the community. To begin the assessment, the nurse should gather objective data from which source? A)Client interview—aggregate data B)Internet—aggregate data C)Internet—Wikipedia D)Direct observation of the area
B)Internet—aggregate data
The nurse travels to Nigeria with a humanitarian aid organization to assess and treat members of a remote community. The children all have high levels of lead in their blood, as a result of exposure to lead dust created by gold mining. Many children are dying. The nurse has never witnessed such a phenomenon in the United States. Which are the most likely reasons for this discrepancy? (Select all that apply.) A)Larger mining operations than in the United States B)Lack of environmental regulations or of their enforcement C)Lack of knowledge concerning environmental dangers D)Weaker immune systems than in the United States E)Need of the miners to earn a living and fewer work options
B)Lack of environmental regulations or of their enforcement C)Lack of knowledge concerning environmental dangers E)Need of the miners to earn a living and fewer work options
The nurse is present when a mother begins cupping her child. She states that it will help to heal the child's respiratory tract infection. The nurse understands that the cultural belief that cupping will aid in the healing process is a: A)Shared instinct B)Learned behavior C)Private idiosyncrasy D)Genetically programmed idea
B)Learned behavior
There are several approaches to family assessment that use particular concepts that nurses typically encounter in practice. These models provide an organized framework with which to conduct a family assessment. Which is the aim of the family assessment in the Life Span Development approach? A)To identify family routines and rituals that could influence family health B)To identify family health practices within a social and historical context C)To assess health patterns in 11 areas of family health D)To engage the family as a way to identify its strengths, with attention to family dynamics and concerns related to health and illness
B)To identify family health practices within a social and historical context
The nurse conducts a community assessment. The community is large and the members range from affluent executives to poor migrant workers. To most accurately assess the community, the nurse should: A)Use a questionnaire written on a fifth-grade reading level B)Use multiple methods or perspectives C)Interview a subpopulation of each group represented D)Analyze census data
B)Use multiple methods or perspectives
In a 15-minute family interview, after asking a question, the nurse pauses and remains silent while the grandmother, whose English is limited, replies to the question. The nurse makes eye contact with her and nods while she talks. When she is finished, the nurse asks a few follow-up questions. Which principle to maximize information during an interview is demonstrated in this behavior? A)Manners B)Use of therapeutic conversation C)Use of therapeutic questions D)Acknowledgment of family strengths
B)Use of therapeutic conversation
Reasons blended families are becoming more widespread include an increase in the number of: (Select all that apply.) A)People who remarry following a divorce B)People who remain single after being widowed C)Recognized gay and lesbian relationships D)Married couples having children E)Couples cohabiting with children from prior relationships
A)People who remarry following a divorce C)Recognized gay and lesbian relationships E)Couples cohabiting with children from prior relationships
Which are among the key categories of indicators of health presented in Healthy People 2020? (Select all that apply.) A)Physical activity B)Exposure to allergens C)Responsible sexual behavior D)Tobacco use E)Occupation
A)Physical activity C)Responsible sexual behavior D)Tobacco use
The nurse asks a client, "Do you wear the clothes you wear at work to home?" This is an example of which subject on the exposure history? A)Present work B)Past work C)Home/residence D)Concerns
A)Present work
Following a hurricane, the disaster team chooses to use a collaborative model to assess the needs of the community. Each team member is given a community analysis and assigned 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 preestablished. E)Collaboration is limited.
B)Assessment is time-consuming. D)Approaches must be preestablished.
Community assessment is a critical process for the future because it can: 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)Identify a method to improve the health of at-risk clients
There are 12 students with confirmed cases of the H1N1 flu in grades 6 to 8 at the local middle school in the community. The community nurse advises the caregivers of the ill children to keep the children home for a minimum of 5 to 7 days. Which should be the nurse's next step? A)Recommend closing the school for 6 weeks B)Implement education in the school setting regarding respiratory and hand hygiene C)Require each child in the school to undergo a physical evaluation by the school nurse D)Initiate a system of discipline in the school setting for improper hand washing
B)Implement education in the school setting regarding respiratory and hand hygiene
The new community health nurse introduces herself to the local minister and attends various neighborhood meetings. The nurse learns about the ethics, values, and culture of the neighborhood. The community is vocal about the need for public safety and the care of the homeless, especially in the winter. Which is the best rationale for considering all of the influences in the neighborhood affecting their health and well-being? A)The information can be used to obtain funds to create shelters for the homeless B)A neighborhood watch may be created with police support C)The information will help to effectively assess the community D)It will help the nurse create a controlled clinical environment
C)The information will help to effectively assess the community
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) (1) Access to quality healthcare, (2) heart disease, (3) diabetes, (4) mental health and mental disorders
The community health nurse works in a community recently devastated by a tornado. Many of the survivors are cared for in their homes. Care is needed for those who are ill, recovering, or in hospice. To provide the most holistic and effective care to the community, the nurse should: A)Refer the clients to an outreach center B)Consult with the hospice nurse and the social worker C)Provide care according to the physician's orders D)Collaborate with other health care workers and the clients
D)Collaborate with other health care workers and the clients
Which is the most accurate definition of a risk assessment? A)Assessment of the adverse effects of chemical, physical, or biological agents on people, animals, and the environment B)Process to help determine whether an individual has been exposed to environmental contaminants C)Assessment of factors that determine a person's level of exposure to an environmental contaminant D)Determination of the likelihood of adverse effects in a group exposed to an environmental contaminant
D)Determination of the likelihood of adverse effects in a group exposed to an environmental contaminant
The nurse applies the nursing process to a case in which a client has been exposed to an environmental contaminant. The nurse considers the question, "Has the exposure pathway been interrupted?" This question would be considered during which phase of the nursing process to examine the impact of the environment on human health? A)Assessment B)Planning C)Intervention D)Evaluation
D)Evaluation
Which type of assessment considers a configuration of behaviors that occur sequentially over time? A)Asset-based assessment B)Epidemiologic model C)Collaborative model D)Functional health pattern
D)Functional health pattern
Which is an example of a radiological contaminant? A)Lead B)Mercury C)Ricin D)Radon
D)Radon
The community health nurse is using a genogram to aid in the family assessment. What aspect of family connections and relationships is included in the genogram? A)Influence of other systems on families B)Influence of groups on families C)Family relationships and their vital connections D)Relationships across two or more generations
D)Relationships across two or more generations
There are different methods for conducting risk assessment for environmental contaminants. Which formula determines 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
Which best describes the function of the grand nursing theory in nursing practice? A)Presents a systematic view of related statements to describe, explain, predict, or prescribe a phenomenon of interest B)Relates human experience to nursing practice and nursing care C)Assesses health patterns in 11 areas of family health D)Engages the family as a way to identify its strengths with attention to family dynamics and concerns related to health and illness
B)Relates human experience to nursing practice and nursing care
In the United States, most citizens have access to clean water and sanitation services and often take these services for granted. Worldwide, however, clean water and sanitation are not standard. How many people worldwide in 2010 lacked access to improved water sources? A)7 million B)78 million C)783 million D)7.8 billion
C)783 million
The community health nurse is assessing stressful life events in a family. Which exemplifies a life event related to illness and family care strains? A)A history of police reports of a 23-year-old man's hitting his girlfriend B)A couple in their 40s divorcing C)A 63-year-old woman's sense of responsibility as the oldest among her siblings for taking care of her chronically ill parents D)A 35-year-old woman not speaking to her sister for 5 years after not being invited to her wedding
C)A 63-year-old woman's sense of responsibility as the oldest among her siblings for taking care of her chronically ill parents
A client, diagnosed with hypertension, is prescribed a no-added-salt, low-fat diet. He agrees and repeats the teaching principles. At the next visit, the nurse notices salted meat on the counter and the client shows the nurse his food diary. The diet in the past week does not reflect the physician's orders. What cultural component may have contributed to the noncompliance with the diet order? A)Diet may be too lean B)Wife cooks according to the husband's preferences C)Diet may not meet the cultural criteria for food choices D)Food tastes bland and unappetizing
C)Diet may not meet the cultural criteria for food choices
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)Acceptability
An underserved population is a subgroup of the population that has a higher risk of developing health problems due to marginalization in which areas? (Select all that apply.) A)Age B)Gender C)Sociocultural status D)Political affiliation E)Religion
A)Age B)Gender C)Sociocultural status
Changes to water supplies and increased flooding, which are believed to result from climate change, may make some areas more vulnerable to diseases. Which diseases are expected to become more prevalent as a result of climate change? (Select all that apply.) A)Asthma B)Lung cancer C)Diarrhea D)Malaria E)Dengue fever
A)Asthma C)Diarrhea D)Malaria E)Dengue fever
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)Being open to the client's ideas and way of life C)Exhibiting respect and patience D)Being aware of your own culture
During an ice storm, people in one neighborhood banded together and shared the home of a neighbor who still had power and heat. Other neighbors provided food, water, and bedding. In another neighborhood the neighbors did not know one another and weathered the storm alone. Both neighborhoods are part of the same community. What characteristic did the people in the first neighborhood share that made them a subculture that those in the second neighborhood lacked? A)Belief in the value of cooperation B)Religion C)Socioeconomic status D)Geography
A)Belief in the value of cooperation
A Mexican-American client arrives at the emergency department. He reports abdominal pain and has been vomiting for 5 days. The nurse notes that he is exhibiting symptoms of dehydration, and his vital signs and labs confirm this. The nurse asks the client why he waited so long to seek medical care. He states that he is being treated by the Curandero and wishes to continue while in the hospital. The nurse recognizes the different cultural assumptions regarding care. This situation is an example of: A)Cross-cultural nursing B)Ethnocentrism C)Cultural safety D)Transcultural bias
A)Cross-cultural nursing
A group of teens develop their own method of texting in a language that they feel is all their own. The change is subtle, but the meanings and the feelings associated with the text are known only to a select few. This behavior is an example of: A)Culture B)Cultural competence C)Cultural safety D)Ethnocentrism
A)Culture
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)Differing views of personal space
The nurse visits a community health clinic in a remote rural area, at which emergency care is not provided because the facility lacks the medical staff necessary to offer such services. Based on this information, which is the most accurate description of this situation? A)Health professional shortage area B)Medically underserved area C)Medically underserved population D)Undeserved population
A)Health professional shortage area
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)Identify increased risk in certain populations for specific diseases. C)Predict how a community might metabolize medications. E)Predict a community's unique vulnerability to environmental changes that can control gene expression in some diseases.
The nurse conducts a community assessment in a town once supported by multiple paper factories. The factories closed 2 years ago and most of the population is now out of work. The school nurse notes that 68% of the students are behind schedule in their physicals and immunizations. On the basis of this community assessment, the nurse should recommend: A)Initiation of neighborhood clinics at low or no cost to the community B)Creation of a task force to assess the impact of low income on immunization compliance C)A formal petition to the local government to mandate immunizations by imposing monetary fines on parents whose children are not immunized D)A tax relief program for new companies wishing to settle in the community
A)Initiation of neighborhood clinics at low or no cost to the community
Bioavailability is the amount of the contaminant that: A)Is absorbed into the body and becomes available at the site of physiological activity B)Initially escapes a container and becomes available for contact with living organisms C)Is airborne and available for inhalation D)Is waterborne and available for skin contact
A)Is absorbed into the body and becomes available at the site of physiological activity
The community is concerned about public safety and the care of their elders living at home. When the nurse assesses the community, the nurse finds 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. Which action has been most successfully demonstrated in your assessment of this community? 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)Make the assessment process empowering to the community
A client is admitted to the hospital. On admission, it is noted that the client does not speak English. It will take 20 minutes for the hospital interpreter to arrive. The nurse decides to wait for the interpreter rather than relying on the client's husband. Appropriate rationales for this decision include that the interpreter is: (Select all that apply.) A)More likely to be fluent in both languages B)More likely to be familiar with the client's symptoms C)Trained in ethics and will be better at explaining cultural differences D)More likely to understand the client's needs E)More likely familiar with technical healthcare terms
A)More likely to be fluent in both languages C)Trained in ethics and will be better at explaining cultural differences E)More likely familiar with technical healthcare terms
The 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)Obtaining a list of the herbs and folk medications that are taken and notifying the physician
Which exemplifies cultural diversity? A)People from South Korea, Brazil, and Nigeria all living in the same apartment complex B)A town in which everyone speaks Spanish, is originally from the same region in Mexico, and prepares similar types of food C)A university where all of the professors share the same political views D)A workplace in which accountants, lawyers, marketing executives, information technologists, and maintenance workers are all employed
A)People from South Korea, Brazil, and Nigeria all living in the same apartment complex
The information gained from environmental epidemiologic studies can be very helpful in trying to identify whether an exposure or what particular exposures have made people ill. Major challenges to most environmental epidemiology studies include: (Select all that apply). A)Resource intensive in terms of personnel and money B)Period between exposure and illness can be very short C)Weak ability to identify outbreaks of infectious disease D)Limited availability of data on many contaminants and their effect on people's health E)Time consuming to perform
A)Resource intensive in terms of personnel and money D)Limited availability of data on many contaminants and their effect on people's health E)Time consuming to perform
The nurse investigates a family's health routines and rituals as part of the overall family assessment. Which exemplify family health routines? (Select all that apply.) A)Siblings all brushing their teeth together before bed every night B)Parents taking their 9-month-old child to the health clinic when he has a fever C)Entering a 5K run/walk charity event each year as a family D)Taking a walk together around the neighborhood after dinner each evening E)The mother having a mammogram performed every year
A)Siblings all brushing their teeth together before bed every night D)Taking a walk together around the neighborhood after dinner each evening
The nurse is selecting a health appraisal related to alcoholism to assess health risk in a client. Which are examples of information that should be included in the appraisal? (Select all that apply.) A)Signs and symptoms of alcoholism B)Recommended daily limit of alcoholic drinks consumed per day C)Examples, such as frequently drinking an alcoholic beverage in the morning D)Incidence rates of alcoholism in the United States E)Information on local substance abuse programs
A)Signs and symptoms of alcoholism B)Recommended daily limit of alcoholic drinks consumed per day C)Examples, such as frequently drinking an alcoholic beverage in the morning E)Information on local substance abuse programs
Children may be more vulnerable to environmental exposures than adults. There are several factors that increase children's vulnerability. Which factors should be considered with children? (Select all that apply.) A)Their body systems are still rapidly developing. B)They eat less, drink less, and breathe more in proportion to their body size than do adults. C)Their bodies may be less able to break down and excrete contaminants. D)Their behaviors can expose them to more contaminants. E)Their breathing zone is further from the ground.
A)Their body systems are still rapidly developing. C)Their bodies may be less able to break down and excrete contaminants. D)Their behaviors can expose them to more contaminants.
Which rationales are appropriate for performing community assessments in the school setting? (Select all that apply.) A)To learn about an outbreak of lice B)To assess effectiveness of children with type I diabetes managing insulin shots at school C)To stage a student's brain tumor D)To assess students for food allergies E)To provide education on preventing the spread of influenza
A)To learn about an outbreak of lice B)To assess effectiveness of children with type I diabetes managing insulin shots at school E)To provide education on preventing the spread of influenza
A nurse, new to the community health agency, works in a culturally diverse area of the community. The nurse is responsible for providing holistic care to clients and to be culturally competent. The health agency requires the nurse to demonstrate which competency to exhibit cultural competence? (Select all that apply.) A)Value diversity B)Adopt the client's cultural values C)Acquire cultural knowledge D)Adapt to diversity E)Speak the language of the client
A)Value diversity C)Acquire cultural knowledge D)Adapt to diversity
At an international nurses' conference, nurses from all around the world make contact. The various communities represented at this conference most likely: (Select all that apply.) A)Vary significantly in composition B)Have no shared interests and goals related to health and safety C)Are challenged in their attempts to identify its members D)Thought of as members of a global community E)Do not need to assess their communities' needs because they are obvious
A)Vary significantly in composition C)Are challenged in their attempts to identify its members D)Thought of as members of a global community
The community health nurse is reviewing guidelines for the 15-minute assessment to keep the interview focused and family centered. Which questions and considerations for the family assessment can be asked for the question "Who is part of the family?" (Select all that apply.) A)What is the nature of individuals' connections to one another? B)Does the individual live alone or have no living family members? C)What influences from the family of origin are present in daily life? D)Do members speak independently or is an interpreter present? E)What observations can be made about the interpersonal dynamics between members?
A)What is the nature of individuals' connections to one another? B)Does the individual live alone or have no living family members? C)What influences from the family of origin are present in daily life?
The nurse assesses a family in which the wife and mother has recently been diagnosed with breast cancer. Which factors will likely affect the family's response to the health risk that this diagnosis presents? (Select all that apply.) A)What the husband and wife learned about dealing with serious illness in their families of origin B)Whether the family is covered by health insurance C)How the children tend to cope with stressful situations D)The response of fellow members of the family's mosque E)The incidence rate of breast cancer in the family's community
A)What the husband and wife learned about dealing with serious illness in their families of origin B)Whether the family is covered by health insurance C)How the children tend to cope with stressful situations D)The response of fellow members of the family's mosque
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) Latino or African-American C) Average age of 37 years E) Male gender
The nurse is caring for a client who is from a culture for which the nurse has a limited knowledge base. The nurse conducts the admission interview using cultural humility. Which should the nurse ask in the interview? (Select all that apply.) A)Yes or no questions B)About traditions C)Open-ended questions D)How the client has addressed the illness E)If the cause of the illness is spiritual
B)About traditions C)Open-ended questions D)How the client has addressed the illness
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)Accessibility
Which is an accurate health factor or effect of living in rural geopolitical areas? A)Only about 5% of physicians practice in rural America despite that nearly one fourth of the population lives in these areas. B)Although only one third of all motor vehicle accidents occur in rural areas, two thirds of the deaths attributed to these accidents occur on rural roads. C)Rural residents are nearly three times as likely to die from unintentional injuries other than motor vehicle accidents than are urban residents. D)Abuse of alcohol and use of smokeless tobacco is a significant problem among rural older adults.
B)Although only one third of all motor vehicle accidents occur in rural areas, two thirds of the deaths attributed to these accidents occur on rural roads.
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)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
The nurse conducts biomonitoring of residents of a community exposed to mercury vapor from a manufacturing facility nearby. Which form of biomonitoring is the method for the purpose of determining exposure to this contaminant? A)Measuring heart rate B)Collecting blood or urine C)Assessing respiratory rate D)Obtaining body weight and composition measures
B)Collecting blood or urine
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)Community
A new client, who is Latin American, is getting settled in the hospital. She is expecting her family to arrive soon. A physician enters and informs the client that she requires surgery and asks that she sign the necessary documents. The client refuses and becomes agitated. Which is the most likely cultural reason for the client's reluctance to sign the documents? A)Client is reluctant to have the surgery. B)Decision of importance is typically made by the family as a group. C)Client does not feel comfortable with the surgeon. D)Client is medicated and is having difficulty making a decision.
B)Decision of importance is typically made by the family as a group.
Environmental justice is an important consideration when working with tribal communities. In which way is traditional tribal practices most often directly affected by contaminated land and water? A)Spiritual practices B)Dietary practices C)Work opportunities D)Exercise opportunities
B)Dietary practices
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
Which exemplify environmental media and transport mechanisms within an exposure pathway? (Select all that apply.) A)Mercury B)Groundwater C)Pond D)Air E)Subsurface soil
B)Groundwater C)Pond D)Air E)Subsurface soil
During a home visit of a client with high blood pressure with whom the nurse has developed a strong therapeutic relationship, the nurse learn that the client keeps a large salt shaker near the stove and heavily salts whatever he is cooking. He also keeps a salt shaker on the dinner table and adds more salt when eating. The nurse suggests removing the salt shaker near the stove and only lightly salting food when eating as a way to help reduce the client's sodium intake. This intervention would most likely achieve the goals for assessment associated with which nursing theory? A)Science of Unitary Beings B)Health as Expanding Consciousness C)Roy Adaptation Model D)Self-care Agency
B)Health as Expanding Consciousness
. Which most accurately characterize Medicare clients with acute myocardial infarctions (AMIs) who are treated in rural hospitals? (Select all that apply.) A)Less likely to experience an opportunistic infection than those in urban hospitals B)Less likely to receive recommended treatments than those in urban hospitals C)More likely to have a second AMI within a month of the first than those in urban hospitals D)Have significantly higher adjusted 30-day post-AMI death rates from all causes than those in urban hospitals E)Experience faster recovery times than those in urban hospitals
B)Less likely to receive recommended treatments than those in urban hospitals D)Have significantly higher adjusted 30-day post-AMI death rates from all causes than those in urban hospitals
The nurse is conducting a 15-minute interview with a family. On the basis of the five leading principles for interviewing, appropriate actions for the nurse to take include: (Select all that apply.) A)Having family members share their family history with you, going back several generations B)Listening actively as the family members speak C)Constructing an ecomap of the family D)Asking family members to prioritize their needs and to express their expectations regarding nursing care E)Pointing out the strong relationships they enjoy in their family and explaining how they will help them cope with the health issue of concern
B)Listening actively as the family members speak C)Constructing an ecomap of the family D)Asking family members to prioritize their needs and to express their expectations regarding nursing care E)Pointing out the strong relationships they enjoy in their family and explaining how they will help them cope with the health issue of concern
Which qualifies as an urbanized area according to the U.S. Census Bureau? (Select all that apply.) A)A central city with population of 30,000 and surrounding densely settled territory with a population of 25,000 with a combined population density of 500 people per square mile B)A central city with population of 50,000 and surrounding densely settled territory with a population of 10,000 with a combined population density of 750 people per square mile C)A central city with population of 25,000 and surrounding densely settled territory with a population of 25,000 with a combined population density of 1,100 people per square mile D)A central city with population of 20,000 and surrounding densely settled territory with a population of 30,000 with a combined population density of 1,250 people per square mile E)A central city with population of 100,000 and surrounding densely settled territory with a population of 50,000 with a combined population density of 1,500 people per square mile
C)A central city with population of 25,000 and surrounding densely settled territory with a population of 25,000 with a combined population density of 1,100 people per square mile D)A central city with population of 20,000 and surrounding densely settled territory with a population of 30,000 with a combined population density of 1,250 people per square mile E)A central city with population of 100,000 and surrounding densely settled territory with a population of 50,000 with a combined population density of 1,500 people per square mile
The nurse enters a client's home to provide care to a wound and teach the client's wife how to care for the wound. The nurse is comfortable with the client's culture and the fact that it is matriarchal in nature. As teaching begins, the husband interrupts and states that the woman does not change bandages according to his culture. He asks if the nurse is familiar with his culture and then says that all members of his neighborhood follow its principles. The nurse should suspect that the client is a member of: A)A cult B)An orthodox religious group C)A subculture D)An occupation
C)A subculture
While completing a community assessment, the nurse notes that the computer companies in the community hire a disproportionate number of their employees from local suburban communities rather than the community in which the company is housed. To create an accurate assessment, the nurse should collect data on: A)All of the company's employees but count those living outside the community separately, as outliers B)Only the employees that live in the community, disregarding the others as statistically irrelevant C)All of the company's employees and include those living outside the community as part of the aggregate D)Only the employees that live in the community in your initial assessment; then collect data on the others as part of a separate assessment for the community in which they live.
C)All of the company's employees and include those living outside the community as part of the aggregate
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)Arrive late for the appointment, after completing whatever tasks the client feels need to be accomplished first
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)Be competent in his or her own cultural heritage
Many in the community have developed cancer. The EPA has discovered a leak of biohazardous waste from a local factory that has leached into the water table. The area is decontaminated and cleaned. The community identifies the need for a local hospice for those with cancer who are dying. Area communities participate in the fund drive. This type of community effort may best be described as: A)Geopolitical community B)Epidemiologic model C)Community of solution D)Developmental model
C)Community of solution
The nurse conducts a well-child clinic in your community. The client population is culturally diverse, and, although the clinic is busy, it runs smoothly because it has an interpreter. In addition to the interpreter, it is important that the nurses treat each client that reflects his or her individual cultural needs. This is cultural: A)Bias B)Artwork C)Competence D)Beliefs
C)Competence
The nurse is caring for a client who is a refugee from Haiti. The client's family has been displaced because of an earthquake in their country. The client has healing fractures on his right arm as well as fractured ribs. He tells the nurse that, before care begins, the nurse must consult with his Voodoo healer. Which is the nurse's best response? A)Teaching the client that he is in the United States and should abide by Western medical practices B)Informing the physician that the client is noncompliant C)Consulting with the healer and updating the physician regarding treatment and any herbal medications that may be used D)Encouraging the client to use a complementary approach to his care
C)Consulting with the healer and updating the physician regarding treatment and any herbal medications that may be used
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)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.
Several important pieces of legislation have helped highlight the importance of environmental health and environmental protection. Which best describes Superfund? A)National program to control the damaging effects of air pollution B)Program that protects and enhances the quality of the nation's air by regulating stationary and mobile sources of air emissions C)Environmental program established to address abandoned hazardous waste sites D)Comprehensive framework of standards, technical tools, and financial assistance to address the many causes of pollution and poor water quality
C)Environmental program established to address abandoned hazardous waste sites
Which most accurately describes environmental epidemiology? A)Focuses on the amount of a contaminant that is absorbed into the body B)Involves monitoring the results of medical tests to determine whether a person has been exposed to a contaminant C)Focuses on the incidence and prevalence of disease or illness in a population from exposures in their environments D)Involves monitoring the number of adverse effects of chemical, physical, or biological agents on people, animals, and the environment
C)Focuses on the incidence and prevalence of disease or illness in a population from exposures in their environments
The nurse works at a clinic in Arizona that provides bilingual (English and Spanish) care to low-income immigrant workers from Mexico. Which designation most accurately describes the area or the population this nurse serves? A)Health professional shortage area B)Medically underserved area C)Medically underserved population D)Inmates
C)Medically underserved population
Which is the most accurate definition of an exposure pathway? A)The total amount of a contaminant that comes in direct contact with the body B)Factor that determines a person's level of exposure to a contaminant C)Method by which people are exposed to an environmental contaminant D)Process to determine whether exposure to an environmental contaminant has occurred
C)Method by which people are exposed to an environmental contaminant
The nurse educator is responsible for conducting educational seminars for the staff. After the education component of the program, the group engages in discussion. It is important that nurses routinely attend educational programs related to cultural competence because: A)The information is lost when caring for clients in real life. B)One can't be competent at all times. C)Nurses can facilitate social change. D)Classes are necessary for regulatory compliance.
C)Nurses can facilitate social change.
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)Organization
The community health nurse has limited time for family assessments because of demanding caseloads or staffing shortages. Using your knowledge that focused family interviews of 15 minutes or less can yield a wealth of information, which is an example of an activity that will acknowledge the family's strengths? A)Ask family members if they see an area that could be changed B)Allow everyone present to voice observations, insights, or concerns before offering how they could change the situation C)Share any genograms and ecomaps that illustrate relationships with family members D)Collaborate with the family to set priorities, plan care, and evaluate goals
C)Share any genograms and ecomaps that illustrate relationships with family members
The community health nurse learns that there are statistically high levels of obesity and elevated cholesterol in the community. In addition, the community has a disproportionately high number of fast food restaurants, compared with surrounding communities. Which would be the most appropriate next step, based on these data? A)Gather support in the community to ban fast foods B)Gather further information regarding trans fats C)Target education and support programs D)Create local exercise programs
C)Target education and support programs
The nurse assesses a 77-year-old woman who has been caring for her husband who has Alzheimer disease in their home for the past 8 years. The client complains of exhaustion and depression. Which stressors should the nurse most suspect as the cause of this client's symptoms? A)Marital strain B)Caregiver burden C)Spillover D)Interfamily strain
D)Interfamily strain
The case manager for two families with children who have type 2 diabetes is struck by the differences between the families. In one family, the parents are intentional about providing fruits and vegetables for their child to eat, regularly remind him to check his blood glucose level, and make sure that he engages in some sort of outdoor activity every afternoon. In the other family, the kitchen is stocked primarily with potato chips and processed snack foods, the child does not monitor her glucose level consistently, and she spends her afternoons texting or watching videos on the sofa. By this comparison, the case manager realizes how critical the family is in forming the attitude the child has toward caring for his or her own health. Which grand nursing theory does this experience best illustrate? A)Science of Unitary Beings B)Health as Expanding Consciousness C)Roy Adaptation Model D)Self-care Agency
D)Self-care Agency