Population Health exam 3 (ch. 12 & 13 davis questions)

A PHN advises the owners of a local supermarket chain about an employee wellness program. Which strategies would be the most effective?SELECT ALL THAT APPLY. 1) Conduct free biometric screenings once a month. 2) Offer discounted memberships to local health clubs. 3) Provide paid time off for employees without benefits. 4) Organize walking groups that meet twice a week. 5) Give employees a store gift card after an annual physical.

1, 2, 3, 4, 5. Biometric screenings provide opportunities to prevent chronic diseases by identifying risk factors for health issues such as obesity, diabetes, and hypertension. Offering discounted memberships to health clubs provides an incentive to increase physical activity, which prevents obesity and related health issues. Employees without benefits often come to work when they are ill. Providing paid time off allows the employees time to recover and see a health-care provider, decreases stress, and protects other employees from becoming ill. Walking groups encourage physical activity and provide an opportunity to socialize; both contribute to good health. Giving employees a store gift card when they complete an annual physical is an incentive to monitor their health status and make changes early.

A nurse performs home inspections to look for risk factors related to unintentional poisoning. Which findings indicate a need for further teaching?SELECT ALL THAT APPLY. 1) Cleaning products stored in an unlocked cabinet 2) Open medicine bottles on the bathroom sink 3) A nonworking carbon monoxide detector 4) A working smoke detector 5) An older home that has been newly painted Show Feedback

1, 2, 3, Further teaching is needed. Cleaning products should be stored out of the reach of children. Keeping them in an unlocked cabinet provides easy access to poisonous substances. Further teaching is needed. Open medicine bottles on the bathroom sink are a significant risk factor for unintentional pediatric poisonings. Further teaching is needed. A nonworking carbon monoxide detector puts everyone in the home at risk for unintentional poisoning. Carbon monoxide is an odorless, colorless gas that is lethal in higher concentrations. 4. The answer refers to burn injuries, not unintentional poisonings. 5. Lead was banned from paint in 1973, but many homes built before then still have walls and ceilings with lead-based paint. A newly painted older home would not have lead-based paint.

A nurse knows that the Zero Suicide (ZS) model is a multi-level approach to help implement evidence-based practices for suicide prevention in the behavioral health system. What are the four aspects of clinical care?SELECT ALL THAT APPLY. 1) Engage 2) Transition 3) Improve 4) Treat 5) Identify

1, 2, 4, 5. Identify, Engage, Treat, and Transition are the four aspects of clinical care in the Zero Suicide model. 3. 'Improve' is one of three components at the administration level, not the clinical care level, of the Zero Suicide model. The three administration components are Lead, Train, and Improve.

Which of the following are benefits of public health accreditation?SELECT ALL THAT APPLY. 1) Increased transparency 2) Stronger management processes 3) Identification of organizational strengths 4) Increased use of quality improvement information in decisionmaking

1, 2, 4, Increased transparency is a benefit of accreditation. Stronger management processes are a benefit of accreditation. Increased use of quality improvement information in decision making is a benefit and leads to a more robust quality improvement culture. 3. Identifying organizational weaknesses is the benefit. Finding the weaknesses allows for process improvement.

Following a widely publicized case of a toddler who died after being left in a hot car, the state public health department (PHD) decided to begin a campaign to educate the public. Which programs would be the most effective?SELECT ALL THAT APPLY. 1) Require hospitals to educate new mothers about the dangers of leaving children in hot cars. 2) Place ads on television and social media warning about the dangers of leaving children in hot cars. 3) Offer child and infant seat safety checks at police and fire departments. 4) Provide "Look Before You Lock" seminars conducted by PHNs at schools and libraries. 5) Create legislation mandating jail time for individuals who leave children locked in hot cars.

1, 2, 4, Requiring hospitals to educate new mothers on the dangers of leaving children in hot cars targets one of the most appropriate populations. Ads on television and social media educate the entire population, reach a large audience, and provide safety information. A "Look Before You Lock" campaign educates the community by providing information on how to avoid leaving children in hot cars. Due to their knowledge of human health, disease, nursing care, and injury prevention, PHNs are the most appropriate health-care professionals to conduct the seminars. 3. Child passenger and infant seat safety checks would not be the most effective as they are not directly related to educating the public about the dangers of leaving children in hot cars. 5. Mandatory jail time is punitive and does not educate the community about the dangers of leaving children in hot cars.

A community health nursing student who recently completed a mental health clinical experience is volunteering at a behavioral health clinic. The student recognizes which people are at increased risk for suicide?SELECT ALL THAT APPLY. 1) A woman with major depressive disorder (MDD) who recently lost her job 2) A veteran in rural Montana who is experiencing some health issues 3) A man who has been cancer-free for 10 years 4) A man receiving psychiatric treatment for schizophrenia 5) A woman whose partner is abusing her

1, 2, 5. The woman has MDD, a diagnosable mental health disorder, and recently lost her job. Those with mental health disorders who are at risk for suicide often have other risk factors such as job or relationship problems or physical health issues. Veterans are a vulnerable group at higher risk of suicide. In Montana between 2013 and 2016, veterans accounted for 20% of all suicides. People living in rural areas are at a higher risk for suicide than those in urban areas. Intimate partner violence is a significant risk factor for suicide. The woman is at increased risk because she is being abused by her partner. 3. People with physical health problems are at increased risk of suicide. The man has no indication of current health problems and has been cancer-free for 10 years. 4. The man is receiving treatment for schizophrenia, reducing his risk of suicide.

The county public health department (PHD) is managing a tuberculosis (TB) outbreak. Which interdisciplinary team members are the most appropriate to manage the outbreak?SELECT ALL THAT APPLY. 1) Physicians 2) IT specialists 3) Epidemiologists 4) Nutritionists 5) Environmental health specialists

1, 3, 4, 5. Physicians, particularly infectious disease specialists, should be involved in managing a TB outbreak. Epidemiologists deal with human diseases and understand the disease process of TB. They should be involved in managing a TB outbreak. Malnutrition is considered a risk factor for TB. The nutritionist should be among the interdisciplinary team members managing a TB outbreak. Environmental health specialists have extensive knowledge of environmental risk factors for exposure to and transmission of disease, including TB. Environmental health specialists should be among the interdisciplinary team members managing a TB outbreak. 2. Information technology (IT) specialists deal more with informatics and computer systems and would not be among the most appropriate interdisciplinary team members managing a TB outbreak.

WHO adopted a global plan for road safety for the decade 2011-2020. It included five pillars or categories of prevention. Which of the following are among the five pillars?SELECT ALL THAT APPLY. 1) Further developing the safety of vehicles 2) Making the driver's license test more difficult 3) Improving the behavior of road users 4) Improving the safety of road infrastructure

1, 3, 4, The five pillars, or categories, of prevention efforts are: 1) Building road safety management capacity; 2) Improving the safety of road infrastructure and broader transport networks; 3) Further developing the safety of vehicles; 4) Improving the behavior of road users; and 5) Improving post-crash care. 2. This is not one of the five pillars.

The local YMCA is providing free swim lessons for local residents. During the first lesson, the instructor teaches safety measures to prevent drowning. Which statements indicate a need for further teaching?SELECT ALL THAT APPLY. 1) "I don't need to keep a close eye on my child at the pool because he is swimming with a foam pool noodle." 2) "I make sure my child always swims with a buddy." 3) "I keep a constant watch on my 5-year-old at the community pool." 4) "I don't need to learn CPR; the lifeguards know how to do it." 5) "I just won't let my child go in the water if there isn't a lifeguard."

1, 4. Further teaching is needed. Air-filled and foam toys are not safety devices. Children always should be closely watched while swimming. Further teaching is needed. Learning CPR can help improve outcomes in drowning victims. 2. Children always should swim with a buddy. 3. Parents should provide continuous supervision of small children at pools and anywhere near water, including bathtubs. Most young children who drown in pools were out of sight of their parents less than 5 minutes and were in the care of one or both at the time. 5. Children always should swim under the supervision of a lifeguard.

The county public health department (PHD) wants to reduce the incidence of influenza in the community by 20% this year. Which is a community level of care? 1) Conduct workshops and distribute influenza fact sheets at schools and libraries. 2) Mandate that all county pharmacies and clinics provide free flu shots. 3) Enact legislation requiring county residents to receive the flu vaccine. 4) Schedule individual home visits to give flu shots to residents aged 65 years and older.

1. Health education is a community-level intervention. PHDs can enlist PHNs to educate the community through workshops and influenza fact sheets distributed at public locations. 2. The PHD does not have authority to mandate that pharmacies and clinics provide free flu shots. 3. Vaccinations cannot be required legally. 4. This is an individual-level intervention.

Town officials are concerned that recent flooding and mudslides have contaminated the local water supply. Which of the following is the priority action? 1) Issue a boil water alert. 2) Monitor the incidence of waterborne illnesses. 3) Administer hepatitis B vaccine to all residents. 4) Supply bottled water to all residents.

1. Issuing a boil water alert is the priority action to prevent waterborne illness. 2. Waterborne illness will be monitored if the water supply is found to be contaminated. 3. Vaccination against hepatitis B is unnecessary, as it is not a waterborne illness. 4. Providing residents with bottled water is the next action to ensure they have an uncontaminated source of water until the boil alert is lifted.

Local health-care providers contacted the local public health department (PHD) when they became concerned that the incidence of sexually transmitted infections (STIs) was rapidly increasing. The PHD initiated actions to manage a potential outbreak of STIs. Which of the following would be the first action? 1) Provide treatment options for people diagnosed with an STI. 2) Ask those who test positive for an STI to provide names and phone numbers of their sexual partners. 3) Gather data from local physicians and hospitals on the number of cases of STIs they have received. 4) Screen people suspected of having an STI.

1. Provide treatment options for those diagnosed with an STI. Patients with an STI need to be treated by a private physician or at a health clinic, but this would not be the first action. 2. Ask those who test positive for an STI to provide names and phone numbers of sexual partners so they can be treated. This would be the second action. 3. Ask those who test positive for an STI to provide names and phone numbers of sexual partners so they can be treated. This would be the second action. 4. Ask those who test positive for an STI to provide names and phone numbers of sexual partners so they can be treated. This would be the second action

Public health departments provide direct care individually and at the community level. Which of the following is an example of direct individual care? 1) Well baby clinics 2) Tobacco cessation classes for teens 3) Legislative changes for the Healthy Start initiative 4) Counseling school administrators on mandatory vaccinations

1. Providing well baby clinics is an example of individual care. Establishing working relationships with families has been a strength of PHN and has resulted in improved outcomes. 2. Tobacco cessation classes for teens is an example of community-level care. The focus is on improving the ability of individuals and populations to practice healthy living. 3. Legislative changes are an example of system-level care. The Healthy Start initiative was signed into law in 1991. 4. Counseling school administrators on vaccinations is community-level care. Not only does this protect individuals, it also reduces both the spread of communicable disease and its overall prevalence.

A mother of a newborn tells the nurse, "I don't think I can afford the baby's formula." Which is the best response from the nurse? 1) "The WIC program provides free formula." 2) "If you breastfeed, you won't need formula." 3) "I can only give you six bottles of formula." 4) "Can someone lend you money to buy formula?"

1. The Women, Infants, and Children (WIC) program is a federally funded program offered through PHDs. WIC provides vouchers to purchase formula and food to meet infant and maternal nutritional needs. 2. Although this is true, the mother stated she cannot afford formula. The nurse should respond to the client's stated need and refer her to the WIC program. 3. The nurse can provide the mother with additional bottles of formula, but it is a temporary solution. She also should refer the mother to the WIC program. 4. Borrowing money for formula is a temporary solution, and advice giving is a nontherapeutic communication technique. The nurse should refer the mother to the WIC program.

A woman is brought to the emergency department with a fractured nose and facial contusions. She tells the nurse, "My husband did this to me." What is the nurse's best response? 1) "Do you have a safe place to stay tonight?" 2) "Do you want me to call the police?" 3) "What did you do to make your husband hurt you?" 4) "Don't worry, he'll apologize and buy you flowers."

1. The patient's safety is the highest priority. The nurse must assess whether the woman has a safe place to go. 2.Calling the police is not the highest priority. Victims of intimate partner violence are often reluctant to call police for fear of retaliation by the partner. 3. The nurse's statement communicates blame and may cause the woman to feel diminished. 4. The nurse's nontherapeutic statement is false reassurance. The nurse is referring to the honeymoon phase of the domestic violence cycle, during which the abuser may apologize and attempt to convince the victim that the abuse will not happen again.

There has been a significant increase in drive-by shootings and assaults in the community due to gang actions. The nurse recognizes this as what type of violence? 1) Collective 2) Self-inflicted 3) Family 4) Acquaintance

1. Violence that occurs when a large group of people engage in dangerous, threatening behavior is known as collective violence. Gang violence is an example of this. 2. Self-inflicted violence is that in which the perpetrator and victim are one and the same. 3. Family violence occurs between family members or partners and includes intimate partner violence, elder abuse, and child abuse. 4. Acquaintance violence occurs between individuals who know each other.

Which concerns were local boards of health focused on during the late 18th century? 1) Sanitation 2) Communicable diseases 3) Maternal and child health 4) Rural health

2. Local health boards focused on communicable diseases in densely populated cities during the late 18th century. 1. The focus on the connection between sanitation and disease increased during the late 1880s and early 1900s. 3. Maternal-child health services grew following passage of the Social Security Act in 1935. 4. Rural health programs expanded with the development of county health departments in the early 1920s.

A nursing faculty is discussing how to best address the need for additional public health workers. The best option is to: 1) Require all nursing students to take a course in public health nursing 2) Aggressively recruit and offer incentives to public health nurse educators 3) Offer students a paid externship at the local public health department 4) Invite the local PHD to speak to students about career opportunities in public health

2. Since there is a shortage of nursing faculty, the best option is to aggressively recruit nurse educators specializing in public health nursing. This can be done by offering incentives such as competitive salaries. 1. Many nursing schools offer public health nursing courses, but this does not address the shortage of public health workers. 3. An externship at the PHD provides a practical opportunity for students who have had a course in public health nursing, but it does not increase the number of PHNs. 4. A speaker from the local PHD will educate students about public health careers but will not increase the number of PHNs.

Approximately 20% of the population of North Orange, New York, lives at or below the U.S. Federal Poverty Guidelines. Many residents have health-care coverage through Medicaid or Medicare, but there are very few providers in the community who accept this coverage, and residents use the emergency department for nonurgent health issues. The hospital and public health department (PHD) decide to address the problem. Which is the best solution? 1) Petition the state to build a county hospital. 2) Establish federally qualified health centers (FQHCs). 3) Contract with the hospital to provide primary care. 4) Provide family nurse practitioners in every school.

2. The best solution is for the PHD is to establish an FQHC. PHDs can obtain funding to provide health care through FQHCs to serve an underserved area or population, provide comprehensive services, and offer a sliding fee scale. Medicaid and Medicare reimbursement rates are higher; FQHCs have a governing board of directors and an ongoing quality assurance program. 1. A county hospital will not address the issue. The best solution is for the PHD to establish an FQHC. PHDs can obtain funding to provide health care through FQHCs to serve an underserved area or population, provide comprehensive services, and offer a sliding fee scale. Medicaid and Medicare reimbursement rates are higher; FQHCs have a governing board of directors and an ongoing quality assurance program. 3. Contracting with the hospital to provide primary care will address the issue, but it is not the best solution. The best solution is for the PHD to establish an FQHC. PHDs can obtain funding to provide health care through FQHCs to serve an underserved area or population, provide comprehensive services, and offer a sliding fee scale. Medicaid and Medicare reimbursement rates are higher; FQHCs have a governing board of directors and an ongoing quality assurance program. 4. Providing family nurse practitioners in schools increases children's access to health care but does not address the needs of the entire community. The best solution is for the PHD to establish an FQHC. PHDs can obtain funding to provide health care through FQHCs to serve an underserved area or population, provide comprehensive services, and offer a sliding fee scale. Medicaid and Medicare reimbursement rates are higher; FQHCs have a governing board of directors and an ongoing quality assurance program.

Following the fire chief's lesson on fire safety, the nurse recognizes the lesson was successful when students: 1) State it is OK to cook on the stove when no one is home. 2) Demonstrate how to stop, drop, and roll. 3) Say it's OK to light firecrackers in the basement. 4) Demonstrate walking above the smoke to get out of a burning building.

2. The lesson is successful when students demonstrate how to stop, drop, and roll if their clothes are on fire. This is an example of a secondary prevention method used to teach children what to do in the event of a fire. 1. Children should be kept away from the stove and pot handles should be turned inward. 3. Children should not have matches, and fireworks at home should be avoided 4. During a fire, students should drop below the smoke and crawl to safety.

The nurse tells the family of a patient who died that the death certificate will be sent to the public health department (PHD). Which individual certifies information regarding the cause of death? 1) The funeral director 2) The medical examiner 3) The nurse 4) The hospitalist

2. The medical examiner or coroner completes the second part of the death record, which includes information related to cause of death. 1. The funeral director completes the first part of the death record, which includes the deceased person's basic demographic information. 3. The nurse does not have a role in completion of the death record. 4. The hospitalist confirms the time of death.

A patient was admitted to the emergency department for an overdose. Which medication is the nurse most likely to find in the patient's pocket? 1) Aleve 2) Percocet 3) Tylenol 4) Prozac

2. The nurse is most likely to find Percocet, a prescription painkiller. Prescription painkillers are the drugs most commonly involved in overdoses. 1. The nurse is not likely to find Aleve, an over-the-counter painkiller. Prescription painkillers are the drugs most commonly involved in overdoses. 3. The nurse is not likely to find Tylenol, an over-the-counter painkiller. Prescription painkillers are the drugs most commonly involved in overdoses. 4. The nurse is not likely to find Prozac, an antidepressant. Prescription painkillers are the drugs most commonly involved in overdoses.

A nurse is performing a home safety inspection for young parents. Which finding provides an opportunity to educate them about risk factors for child burn injuries? 1) There are covers on the electric wall outlets. 2) The water heater temperature is set to 130°F. 3) There is a small fire extinguisher under the sink. 4) Pot handles on the stove are turned inward.

2. This finding indicates a need for further education. The water heater should be set at 120°F or lower. 1. Covers on the wall outlets prevent burn injuries that occur when children insert their fingers or toys into them. 3. Having a fire extinguisher is a secondary prevention against burn injuries. 4. Turning pot handles inward prevents burn injuries by reducing the chances of children pulling hot pans off the stove.

During a community health fair, the public health nurse is educating a woman about unintentional poisonings in children. Which statement indicates the need for further teaching? 1) "I vacuum my floors every day." 2) "I keep toilet bowl cleaner under the bathroom sink." 3) "Our medications are in a locked cabinet." 4) "I keep bleach on the top shelf in the upper cabinet."

2. This statement indicates the need for further teaching. Keeping household cleaners under the bathroom sink places a child at high risk for unintentional poisoning as it allows the child easy access to poisonous substances. 1. Daily vacuuming is a good idea but is not related to unintentional poisonings. 3. Keeping medications in a locked cabinet reduces the risk of unintentional poisoning. Self-ingestion of prescription products is a cause of high morbidity. 4. Keeping a poisonous substance on a high shelf reduces risk for unintentional poisoning.

Pediatric nurses at Community North Hospital are evaluating health education materials about infant drowning. Which brochure is the most appropriate? 1) "Stay Safe at the Pool" 2) "Teach Your Children to Swim" 3) "Make Bath Time Safe Time" 4) "Tips for a Safe Trip to the Lake"

3. "Make Bath Time Safe Time" is the most appropriate brochure. The most common sites for infant drowning are bathtubs and 5-gallon buckets. 1. The "Stay Safe" brochure is most appropriate for parents of children ages 1 to 4 years who are at greatest risk of drowning in swimming pools. 2. The "Teach Your Children to Swim" brochure is not specific to infant drowning. 4. "Tips for a Safe Trip to the Lake" is appropriate for parents of older children. The most common sites for drowning in older children are pools, lakes, and rivers.

Community leaders in Camden, New Jersey, are implementing a violence prevention program focused on developing positive relationships between youth and adults. The nurse knows the best intervention is to: 1) Provide workshops on conflict resolution 2) Offer tutoring for high school students 3) Establish a mentoring program 4) Create a summer job placement program

3. A mentoring program meets the objective of decreasing violence. It provides youth with adult role models and focuses on positive relationships between the two groups. This is one of the six recommendations published by the CDC as a guide to evidence-based programs aimed at reducing youth violence. 1. Learning conflict resolution skills does not achieve the objective of building positive relationships between youth and adults. Developing conflict resolution skills helps children learn nonviolent means to solve problems by strengthening personal capacity. 2. Strategies to help students graduate high school do not achieve the objective of building positive relationships between youths and adults. 4. Job placement programs do not achieve the objective of building positive relationships between youth and adults. Employment enhances productivity, self-esteem, and social skills.

The public health nurse is speaking at a college campus on the topic of acquaintance violence. Which is an example of this? 1) A man hits his wife across the face. 2) A student is robbed and beaten by someone he did not know. 3) A college student is sexually assaulted by a classmate from high school. 4) An adolescent intentionally cuts herself with a razor blade.

3. Acquaintance violence is a type of community violence that occurs between individuals who know each other. The college student was a victim of acquaintance violence because she knew the person who sexually assaulted her. 1. Family violence occurs between family members or partners. A man hitting his wife is an example of family violence. 2. A student being robbed and beaten by someone he did not know is an example of stranger violence, a type of community violence that occurs between individuals who do not know each other. 4. An adolescent intentionally cutting herself represents self-inflicted violence, which occurs when the perpetrator and the victim are one and the same.

A number of injuries and fatalities are anticipated following the derailment of a commuter train during rush hour in New York City. Which is the public health nurse's best response? 1) Determine whether there are adequate medical response teams. 2) Set up a command post at the site of the derailment. 3) Initiate the community's emergency response plan. 4) Debrief hospital staff and first responders.

3. Initiating the emergency plan is part of the response phase of disaster and emergency planning. The PHN will alert the hospital so it can provide and prepare staff for a large number of injuries and casualties. 1. Determining whether there are adequate response teams is part of the preparedness phase of disaster and emergency planning. 2. Setting up the command post occurs during the response phase of disaster and emergency planning, but it is usually the responsibility of law enforcement or fire officials. 4. Crisis debriefing occurs during the recovery phase.

Nurses at Community North Hospital are alarmed when there is a sudden and dramatic increase in the incidence of heat stroke among toddlers left in hot cars. The nurses' best action to prevent further occurrences is to: 1) Have parents arrested and prosecuted for child endangerment 2) Offer monthly CPR classes for parents at the hospital 3) Mandate a "Look Before You Lock" class before discharge 4) Provide parents with educational materials about symptoms of heat stroke

3. Mandating a "Look Before You Lock" class before discharge is the best action because it is a prevention strategy. Health education is provided for parents of newborns about the risks of leaving children in hot cars. 1. Arresting and prosecuting parents for child endangerment does not provide education to prevent further occurrences. 2. Offering CPR classes does not prevent the initial act of leaving a child in a hot car. 4. Providing educational materials about the signs of heat stroke does not address the problem of heat stroke among children.

Public health departments (PHDs) are facing increasing population-level health concerns; at the same time, there is an increasing shortage of public health nurses (PHNs). Which is a priority? 1) Increase the number of PHDs serving rural areas. 2) Create certification programs for public health assistants. 3) Fund advanced education for nurses specializing in public health. 4) Increase PHN salaries to compete with private nursing salaries. Show Feedback

3. Nurses with advanced degrees in public health would address the shortage of nursing faculty and enable colleges to graduate more nurses. 1. Increasing the number of PHDs would create an increased need for PHNs and worsen the shortage. 2. Creating certification programs does not address the need for more PHNs and is not a priority. It would standardize the requirements for public health workers. 4. Making PHN salaries competitive with private nursing salaries would improve recruitment, but it is not a priority in addressing the overall shortage of PHNs.

The nurse visiting a family suspected of child maltreatment notices the child is very thin but there are no bruises or injuries. The mother states, "After I pay rent, I often don't have enough money to buy food." What is the nurse's best action? 1) Call the police and Child Protective Services (CPS) to report child abuse. 2) Give the mother $100 to buy some food. 3) Refer the mother to the women's resource center for job counseling. 4) Arrange for the child to live with a relative who can afford food.

3. Prevention of childhood maltreatment includes creating access to community resources. Referring the mother to a job counseling program gives her tools to obtain employment and provide housing and food for herself and her child. 1. Calling the police and CPS are punitive actions and do not provide a long-term solution. 2. Giving the woman $100 may elicit feelings of guilt or shame as she cannot afford food. It is also a temporary solution. 4. Arranging for the child to live with relatives is a temporary solution.

The nurse knows public health departments (PHDs) with the weakest infrastructure often are challenged to provide public health services for which population? 1) City dwellers 2) Mothers and children 3) Farmers in rural areas 4) Single-parent households

3. Public health departments with the weakest infrastructure often are challenged to address rural health problems that are worse than those in urban areas. Farmers represent a population with higher morbidity and mortality rates and environmental health challenges. 1, 2, 4. Public health departments with the weakest infrastructure often are challenged to address rural health problems that are worse than those in urban areas.

A nurse from the public health department (PHD) visits a family who cannot afford their son's asthma medications. Which member of the PHD's interdisciplinary team is the best resource for this patient? 1) Physician 2) Pharmacist 3) Social worker 4) Nutritionist

3. Social workers are knowledgeable about community resources. This person is the best member of the interdisciplinary team for the nurse to contact. 1, 2,4. The family needs a referral for resources to obtain medications. The physician provides medical care. The social worker is the best team member to contact.

A community health nursing student is preparing a presentation about injuries related to motor vehicle crashes (MVCs). What is the best source for data regarding MVCs? 1) Department of public health 2) Child Protective Services (CPS) 3) Department of Transportation (DOT) 4) World Health Organization (WHO)

3. The Department of Transportation (DOT) monitors MVCs and is the best place for the student to obtain data on them. 1. A department of public health does not monitor MVCs. It is responsible for surveillance of injuries and illnesses. 2. Child Protective Services (CPS) does not monitor MVCs. It monitors child welfare and abuse. 4. WHO does not monitor MVCs.

There has been a measles outbreak in New York state. Which of the following information technology programs can be used to visualize data in a designated area and show various characteristics of cases? 1) The CDC website 2) Electronic health records 3) Geographic Information System 4) Public Health Nursing Scope and Standards of Practice

3. The Geographic Information System can visualize data geographically in a designated area. During a disease outbreak, the case data can be entered into a GIS program and maps can be created to show various characteristics of the cases. 1. The CDC website contains a wealth of knowledge about outbreaks but does not provide specific data on designated areas. 2. Electronic health records are patient records that integrate clinical data from all providers. 4. Public Health Nursing: Scope and Standards of Practice is a core competency publication.

A new mother asks the labor and delivery nurse why her infant's weight, length, and head measurements are reported to the public health department (PHD). Which is the nurse's best response? 1) "The PHD stores the information as a backup to the hospital's database." 2) "The PHD sends the information to the pediatrician's office." 3) "The PHD monitors and evaluates health trends in the population." 4) "The PHD sends the information to the PHN before your home visit."

3. The PHD collects birth data to understand population-level trends related to birth and evaluates how well Healthy People 2020 objectives are being met.

A student nurse is caring for an 8-year-old child who fell from a window. Based on this fact, the student nurse would not be surprised to learn that the child: 1) Lives in a single-family home 2) Plays basketball at the park 3) Lives in an affordable housing development 4) Is on the varsity football team

3. The child lives in an affordable housing development, which is a multi-dwelling setting. Window falls occur most often in urban, low-income, multi-dwelling settings. 1. Window falls usually do not occur in single-family homes. They most often occur in multi-dwelling settings. 2. The child fell from a window, not on the playground. Playgrounds are a common place for preschool and school-age children to fall. 4. An 8-year-old boy is too young to be on a varsity football team.

A public health nurse (PHN) wants to create a health program to address obesity in the community. Which of the following would be the nurse's first action? 1) Request that schools remove all vending machines. 2) Petition the city council to tax soda at a higher rate. 3) Collect data regarding obesity rates and diabetes. 4) Distribute educational materials at fast food restaurants.

3. The first step in developing a health program is to perform a community assessment. The PHN should collect data regarding obesity rates and diabetes first. 1. The PHN's first action should be to collect data regarding obesity rates and diabetes, since assessment is always the first step of the nursing process. Proposing the removal of vending machines is an intervention. 2. The PHN's first action should be to collect data regarding obesity rates and diabetes, since assessment is always the first step of the nursing process. Proposing a soda tax is an intervention. 4. The PHN's first action should be to collect data regarding obesity rates and diabetes since assessment is always the first step of the nursing process. Distributing educational materials is an intervention.

The mission of public health in the mid-19th century focused on: 1) Housing conditions and slavery 2) Maternal death and communicable diseases 3) Housing conditions and communicable diseases 4) Women's suffrage and communicable diseases

3. The mission of public health in the mid-19th century focused on housing conditions and communicable diseases.

Regulations and requirements to move health records from paper-based systems to electronic ones have caused public health departments to face unique challenges. Which of the following is necessary to allow implementation of systems with a broader focus than clinical care? 1) Electronic systems for individual patient care 2) Maintenance of population-based core functions 3) Increase in use of quality improvement information 4) Expansion of capacity for psychosocial, behavioral, and environmental client data Show Feedback

4. By including expanded capacity for psychological, behavioral, and environmental client data, electronic health records allow PHDs to have a much broader view of a patient's health than just that of clinical care. 1. Electronic systems for individual patient care are necessary, but they do not allow for a broader focus than clinical care. 2. Maintenance of population-based core functions is an overall example of how electronic health records affect public health systems. 3. Increased use of quality improvement information in decisionmaking and a more robust quality improvement culture are the most significant benefits of accreditation.

The nurse is creating a Haddon matrix for motor vehicle crashes (MVCs). Which factor is placed in the "post-event" row? 1) Seatbelt use 2) Alcohol use 3) Drowsy driving 4) EMS response time

4. EMS response time is placed in the "post-event" row since emergency personnel arrive after the crash. 1. Seatbelt use is placed in the host/event box since it is a factor in how the MVC will affect the host during the crash. 2. Alcohol use is placed in the host/pre-event box since it is a risk factor in causing the crash. 3. Drowsy driving is placed in the host/pre-event box since it is a risk factor in causing the crash.

Results of a 2-year study on motor vehicle crashes (MVCs) in Smithville indicate injuries can be reduced by addressing environmental risk factors. What is the best recommendation the public health nurse can make? 1) Coordinate a campaign with state police to ticket drivers not wearing seatbelts. 2) Request government funding for programs to assist drivers impaired by drugs or alcohol. 3) Establish a 24-hour hotline to report aggressive or impaired drivers. 4) Reduce the speed limit during hazardous driving conditions.

4. Hazardous driving conditions such as icy roads represent an environmental risk factor that plays a role in MVCs. 1. Ticketing drivers not wearing seatbelts does not address environmental risk factors; it addresses behavioral risk factors. 2. Funding programs to assist impaired drivers does not address environmental risk factors; it addresses behavioral risk factors. 3. A 24-hour hotline to report aggressive driving addresses behavioral risks; it does not address environmental risk factors.

Smithville, West Virginia, is a small rural community. It falls under which type of public health department (PHD) jurisdiction? 1) County-based 2) City-based 3) Federal 4) Regional

4. Multicounty or regional jurisdictions make up 8% of PHDs and are the proposed vehicle for strengthening public health services in rural areas. Smithville is a small, rural community and falls under the jurisdiction of a multicounty, or regional, PHD. 1. Most PHDs are county-based, but rural areas are more likely to be served by a multicounty or regional PHD. 2. Many PHDs are city- or town-based, but rural areas are more likely to be served by a multicounty or regional PHD. 3. A federal agency such as the Department of Health and Human Services would be under the jurisdiction of the United States government.

The occupational health nurse is assessing an employee who reports feeling stressed by his job and financial responsibilities. Which statement indicates he may be at risk for suicide? 1) "I guess I need to find a job that pays more money." 2) "Some days I don't want to live, but then I realize I have a great wife and kids." 3) "I make sure I take my antidepression medications every day." 4) "It's hopeless. I just want to take my bottle of Percocet."

4. This statement indicates the man is at high risk for suicide. He reports feelings of hopelessness and a desire to harm himself, and he has the means to do so. 1. This statement indicates problem solving and planning for the future. 2. This statement is concerning, but the man did not report thoughts of wanting to injure himself or others. 3. Because he is taking antidepressant medications, the man's mood disorder is treated and his risk of suicide is reduced significantly.

A nurse is doing a follow-up phone interview with a patient after his recovery from knee surgery. Which statement indicates a need for further teaching? 1) "I was finished with my pain medication, so I took the remaining pills to a drug take-back site." 2) "I forgot how often I could take my pain medication, so I called the pharmacist to ask." 3) "I kept my medication up high in a medicine cabinet in the bathroom." 4) "My knee stopped hurting after surgery, so I gave the rest of my pain medication to my wife because she hurt her back at work."

4. This statement indicates the need for further teaching. Prescription medication never should be shared. 1. This statement shows that he safely disposed of his medicines by taking the remainder of his pain medication to a drug take-back site. 2. Calling the pharmacy or doctor's office are both good options for medication dosage teaching. 3. Keeping medication on a high shelf reduces the risk of unintentional poisoning in a child.

The public health nurse (PHN) is visiting a client newly diagnosed with tuberculosis. The medical team is concerned that the client may be unable to adhere to the medication regimen. Which would be the best method to initially promote adherence? 1) Call the client every day to ask if medications were taken. 2) Send daily text messages and email reminders. 3) Monitor adherence with a microchip in the medication bottle cap. 4) Observe the client taking the medication at home or the public health department

4. With medications taken for 6 months or longer, directly observed therapy is the best method to promote adherence. 1. With medications taken for 6 months or longer, directly observed therapy is the best method to promote adherence. 2. With medications taken for 6 months or longer, directly observed therapy is the best method to promote adherence. 3. With medications taken for 6 months or longer, directly observed therapy is the best method to promote adherence.