Promotion Exam 4

signs of drug abuse

-Not taking medication as prescribed (too much at a time)or not in the form as prescribed (crushed if meant to be swallowed whole) -Taking medications that do not belong to you -Feeling of withdrawal such as nausea, sweats, diarrhea, vomiting, headache, constipation, irritability, anxiety, confusion, seizures and in some cases fever -Sleeping too much or too little and not able to function well in everyday life Failing to tell a doctor about medications you are taking or how you are feeling -Spending more money; stealing money or things to get what you need -Crave or can't stop thinking about using -Loss of interest in things you love, friends, family -Making more risky decisions (e.g. driving while intoxicated)

Which statement indicates that further teaching is needed for a patient involved in family planning? 1. "I can't get human papilloma virus (HPV) from my boyfriend because he doesn't have genital warts." 2. "I need to use condoms to prevent transmission of sexually transmitted diseases." 3. "Even though I have no signs or symptoms, I still may have Chlamydia." 4. "I can give my unborn baby warts during childbirth."

1. "I can't get human papilloma virus (HPV) from my boyfriend because he doesn't have genital warts."

The community health nurse is working in an emergency shelter with displaced families. Which of the following clients have risk factors for posttraumatic stress disorder (PTSD)? Select all that apply. 1. An 18-year-old client with a previous gunshot wound 2. A 50-year-old client who saw people die in the disaster 3. A 23-year-old client experiencing extreme fear 4. A 60-year-old client who had little social support before the event 5. A 35-year-old client with a history of schizophrenia

1. An 18-year-old client with a previous gunshot wound 2. A 50-year-old client who saw people die in the disaster 3. A 23-year-old client experiencing extreme fear 5. A 35-year-old client with a history of schizophrenia

Which of the following factors causes primary vaccine failure? (select all that apply) 1. Inefficient storage 2. An intramuscular vaccine injection given subcutaneously 3. Waning immunity in immunocompromised patients 4. Light-sensitive vaccines exposed to light 5. Seroconversion

1. Inefficient storage 2. An intramuscular vaccine injection given subcutaneously 4. Light-sensitive vaccines exposed to light 5. Seroconversion

Which of the following statements about homicide in the United States is false? 1. Most homicides are caused by stabbings. 2. Homicide is the third leading cause of death for 1- to 4-year-old children. 3. Blacks are more likely to be the victims of homicide than whites. 4. Over 50% of homicide victims are killed by someone they knew.

1. Most homicides are caused by stabbings.

You teach a community disaster preparedness class on how to find shelter during and after a disaster situation. This is an example of what kind of prevention? 1. Primary 2. Secondary 3. Tertiary 4. Disaster

1. Primary

Which of the following statements about adolescent substance abuse is FALSE? 1. Teen use of cigarettes and smokeless tobacco is increasing. 2. Alcohol use among youth declined between 2010 and 2011. 3. Most of the movement in teen substance abuse has been in the downward direction. 4. Marijuana use among teens is increasing.

1. Teen use of cigarettes and smokeless tobacco is increasing.

Which of the following assessment findings by the community health nurse would suggest that an elderly client may be the survivor of physical abuse by a caregiver? Select all that apply. 1. The client has a laceration on her forehead that was sutured. 2. The client has a flat affect. 3. The client has bruises on her forearms in various stages of healing. 4. The client withdraws from soft touch. 5. The client is not sexually active but has a diagnosis of Chlamydia.

1. The client has a laceration on her forehead that was sutured. 3. The client has bruises on her forearms in various stages of healing. 5. The client is not sexually active but has a diagnosis of Chlamydia.

Seven cases of hepatitis A are diagnosed in a community over a period of 2 weeks. An investigation results in a determination that all of the infected individuals ate at a local restaurant. Which of the following statements explains the possible connection between hepatitis A and a restaurant? 1. The route of transmission for hepatitis A is fecal-oral. 2. A food worker likely coughed on the customers. 3. A food worker may have a bleeding wound. 4. Hepatitis A is transmitted where people congregate.

1. The route of transmission for hepatitis A is fecal-oral

Chemical warfare agents such as pulmonary agents and cyanides are classified as which of the following? 1. Weapons of mass destruction 2.Computer-based attack weapons 3. Recovery agents 4. Prevention medications

1. Weapons of mass destruction

On discharge after treatment for alcoholism, a client plans to take disulfiram (Antabuse) as prescribed. When teaching the client about this drug, the nurse emphasizes the need to: 1. avoid all products containing alcohol. 2. adhere to concomitant vitamin B therapy. 3. return for monthly blood drug level monitoring. 4. limit alcohol consumption to a moderate level.

1. avoid all products containing alcohol.

Personality traits associated with an increased risk of alcohol abuse include: Select all that apply. 1. impulsive. 2. shy. 3. withdrawn. 4. disinhibited. 5. aggressive.

1. impulsive. 4. disinhibited.

As a school nurse, you know the leading reason cited as the cause of school violence is: 1. use of violence to handle disputes. 2. an unhappy home life. 3. overly protective parental situations. 4. poor communication with authority figures.

1. use of violence to handle disputes.

Nurses, including public health nurses, are at increased risk for workplace violence. Risk factors for violence in the workplace include all of the following except: 1. working in pairs. 2. access to medications. 3. increased number of mentally ill patients. 4. inadequate security.

1. working in pairs.

Which of the following individuals should be evaluated for intimate partner violence (IPV)? Select all that apply. 1.The 24-year-old white woman with low self-esteem 2. The 33 year-old black divorced single mother 3. The 18-year-old Hispanic gay man with multiple sexual partners 4. The 50-year-old Asian man who is addicted to methamphetamine 5. The 48-year-old black woman who was recently hospitalized for depression

1.The 24-year-old white woman with low self-esteem 3. The 18-year-old Hispanic gay man with multiple sexual partners 4. The 50-year-old Asian man who is addicted to methamphetamine 5. The 48-year-old black woman who was recently hospitalized for depression

Which of the following clients is at highest risk for elder abuse? 1. A 75-year-old nursing home client who is alert and has osteoporosis 2. A 70-year-old client being with dementia cared for at home 3. A 65-year-old client who has just had a hip replacement 4. A 72-year-old client on a rehabilitation unit with bilateral above-the-knee amputations

2. A 70-year-old client being with dementia cared for at home

A family of five people presented to a hospital after the flooding of their urban home. These family members are classified as which of the following? 1. Poverty victims 2. Displaced persons 3. Indirect victims 4. Mass casualties

2. Displaced persons

Which phase of the community response to disaster includes medical personnel contributing long hours of volunteer work helping unfamiliar people after a disaster? 1. Honeymoon phase 2. Heroic phase 3. Reconstruction phase 4. Disillusionment phase

2. Heroic phase

Investigating all contacts of a person infected with a sexually transmitted disease is an example of what? 1. Primary prevention 2. Secondary prevention 3. Tertiary prevention 4. Initial prevention

2. Secondary prevention

A high school student is referred to the school nurse for suspected substance abuse. After the nurse's assessment and interventions, what would be the most desirable outcome? 1. The student discusses conflicts over drug use. 2. The student accepts a referral to a substance abuse counselor. 3. The student agrees to inform his parents of the problem. 4. The student reports increased comfort with making choices.

2. The student accepts a referral to a substance abuse counselor.

A survey done by The National Institute on Drug Abuse (NIDA) found that the most commonly abused prescription drug among high-school seniors is: 1. OxyContin. 2. Vicodin. 3. Xanax. 4. codeine.

2. Vicodin.

A pathogen lives and multiplies in a __ and transfers from one host to another by a __. 1. host, susceptible portal of entry 2. reservoir, mode of transmission 3. infectious agent, portal of exit 4. mode of transmission, reservoir

2. reservoir, mode of transmission

The school nurse is interviewing a student who has been assaulted by another student. Both students proclaim to be gang members. The nurse understands the reasons most youth give for joining a gang include the following: Select all that apply. 1. financial gain. 2. sense of belonging. 3. peer pressure. 4. relative is in a gang. 5. need for respect.

2. sense of belonging. 3. peer pressure. 5. need for respect.

The community health nurse is trying to encourage a client to attend Alcoholics Anonymous meetings. When the client asks the nurse what he must do to become a member, the nurse should respond: 1. "You must first stop drinking." 2. "Your physician must refer you to this program." 3. "Admit you are powerless over alcohol and that you need help." 4. "You must bring along a friend who will support you."

3. "Admit you are powerless over alcohol and that you need help."

Which of the following describes a NA-TECH (natural technological) type of disaster? 1. A flood covering crops and recreational areas of a geographic area 2. A terrorism attack causing major interruption of communication technologies 3. A tornado resulting in flood and destruction of electrical systems for a community 4. A nuclear accident at a power plant causing evacuation of people in an urban community

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

The wife of an alcoholic client is considering joining a support group to help her respond to her husband's condition in a healthy way. Where should the nurse refer this client? 1. A psychiatrist for a referral to a suitable group 2. Spouses Anonymous 3. Al-Anon 4. Alcoholics Anonymous

3. Al-Anon

Which agency has a mission to support citizens and first responders to ensure that as a nation everyone works together to build, sustain, and improve the capacity to prepare for, protect against, respond to, recover from, and mitigate all? 1. American Red Cross (ARC) 2. National Institute for Health (NIH) 3. Federal Emergency Management Agency (FEMA) 4. Centers for Disease Control and Prevention (CDC)

3. Federal Emergency Management Agency (FEMA)

Katie, a 2-year-old child, is brought to the doctor's office after 2 days of vomiting and diarrhea. Upon completion of the medical history, the mother tells the nurse that several of the other children at the daycare who played with the same toys as Katie have the same symptoms. The mode of transmission for the pathogen more likely was which of the following? 1. Vector 2. Direct 3. Indirect 4. Airborne

3. Indirect

The community health nurse is visiting the home of a known substance abuser. The client is talking excessively and is excited and aggressive. The nurse notes that the patient's heart rate is 158 beats/min. The nurse recognizes the client is most likely high on which substance? 1. PCP 2. Alcohol 3. Methamphetamine 4. Inhalants

3. Methamphetamine

Transmission of an infectious disease can be efficiently controlled by: 1. breaking all links in the transmission chain. 2. destroying all reservoirs of infectious agents. 3. breaking only one link in the transmission chain. 4. maintaining high levels of herd immunity.

3. breaking only one link in the transmission chain.

Women have a higher risk of contracting a sexually transmitted disease (STD) than men because: 1. women usually have more sexual partners 2. women are less likely to use protection methods against STDs 3. the anatomical structure of women promotes transmission of STDs 4. treatment for STDs in women is usually ineffective.

3. the anatomical structure of women promotes transmission of STDs

What element of a community disaster plan investigates the citizen's reliance on telephone systems or cell phones during disasters? 1. Authority 2. Logistical 3. Rescue 4. Communication

4. Communication

Four-month-old Lucy is in for immunizations at the local health department. The Vaccine Information Sheet is given to Lucy's mother, and informed consent is obtained. However, the mother then states, "Lucy did have a temperature around 99.1 degrees the night of her last immunizations." After this statement, the nurse should do which of the following? 1. Consult the child's pediatrician. 2. Delay the immunizations. 3. Do not give the immunizations because of the contraindication. 4. Give the immunizations.

4. Give the immunizations.

The nurse at the disaster site is using the SMART triage system. What color triage tag would be provided to an ambulatory individual with a superficial cut on the left elbow and bruise to the right hand? 1. Red 2. Yellow 3. Black 4. Green

4. Green

Which of the following is classified as a vector of disease? 1. Humans 2. Door handles 3. Water and food 4. Mosquitoes

4. Mosquitoes

Chronic stress characterizes the lives of people living with domestic violence. As the community health nurse, you recognize which of the following as a long-term effect of violence? 1. Spontaneous disclosure of abuse to health care provider 2. Not complaining of physical symptoms 3. Having disturbed eating patterns, but sleeping well 4. Suffering chronic fatigue and tension

4. Suffering chronic fatigue and tension

When a client regularly takes a drug that is a central nervous system (CNS) stimulant, such as cocaine, what symptoms would the nurse expect to see when the client abstains from this substance? 1. The client will have symptoms of CNS stimulation. 2. The client will experience anxiety, insomnia, and tremors. 3. Common symptoms include hallucinations and seizures. 4. The client will feel depressed, somnolent, and lethargic.

4. The client will feel depressed, somnolent, and lethargic.

Which of the following is the purpose of the staging area in a disaster plan? 1. A triage area outside the hospital, supplying first aid and transport to medical facilities 2. A stage for entertainment to cheer up disaster victims 3. To provide sheltered area for displaced victims to sleep, eat, and bathe 4. To act as command station for disaster responders to report to and get assignments

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

Child maltreatment cases are most frequently attributed to: 1. sexual abuse. 2. physical abuse. 3. psychological abuse. 4. neglect.

4. neglect.

All of the following outcomes may contribute to the diagnosis of substance abuse except: 1. the substance use has placed someone in danger. 2. the individual uses the substance despite negative consequences. 3. the substance use interferes with the ability to function at work or at home. 4. the client is without a job.

4. the client is without a job.

As a visiting community health nurse, you must take precautions to avoid unsafe situations. To avoid putting yourself in danger, you would do which of the following? 1. If you enter a house where a violent act is occurring, call 911 and wait inside for the police to arrive. 2. Expect the client to control angry family members. 3. Repeat the reason for your visit and stay and continue your task. 4.Do not enter a home if you hear sounds of fighting.

4.Do not enter a home if you hear sounds of fighting.

Examples of primary prevention efforts for violence include (select all that apply): A. advocacy for reduction of TV and other media violence B. establishment of a safety plan for victims of intimate partner violence C. teen parenting class at high school D. lobbying for handgun control E. increased availability of foster care for child abuse victims

A. advocacy for reduction of TV and other media violence C. teen parenting class at high school D. lobbying for handgun control

It is important that these volunteers recognize underlying causes of community violence. Examples of risk factors that most commonly have been related to violence include (select all that apply): A. being a young adult B. being an older person C. use of multiple drug and/or alcohol D. access to a handgun E. having a developmental disability

A. being a young adult B. being an older person C. use of multiple drug and/or alcohol D. access to a handgun

Eight weeks have passed since John followed up with case contacts of the infected child. A total of 12 cases of pertussis have been identified, with no new cases identified in the last 3½ weeks. Assuming that these cases have been contained in the local community, this situation would be called a(n): A. outbreak B. endemic C. epidemic D. pandemic

A. outbreak

What level of prevention was being addressed as the county planned how to spend its grant funds? A. primary B. secondary C. Tertiary D. disaster prevention

A. primary

addition definition

Addiction is defined as a chronic, relapsing brain disease that is characterized by compulsive drug seeking and use, despite harmful consequences." -2016 Addiction is a chronic disorder with biological, psychological, social and environmental factors influencing its development and maintenance. About half the risk for addiction is genetic." -American Psychological Association 2017

Acellular pertussis vaccine is widely available and is a required vaccine for school entry. Which of the following correctly describe the pertussis vaccine? Select all that apply. A. live, attenuated vaccine B. killed (inactive vaccine) C. primary prevention activity D. secondary prevention activity E. Tertiary prevention activity

B. Killed inactive vaccine C. Primary prevention activity

Dr. Miller reported the pertussis case to John, and John has now reported it to the state department of health. Which of the following levels of government has the ultimate responsibility for monitoring and controlling communicable diseases in the state? A. Local B. State C. Federal D. International

B. State

Gloria would also like to make health care providers aware of those aggregates considered particularly vulnerable to substance abuse problems. Those aggregates include all of the following groups except: A. preadolescence and adolescents B. business professionals C. older adults D. women E. mentally ill F. health care professionals

B. business professionals

All of the following aggregates are at an increased risk for homicide, except: A. young people B. older adults C. women D. African american males E. Hispanic males

B. older adults

Which phase of disaster management was under way when the committee distributed information about how to assemble a disaster emergency kit? A. prevention stage B. preparedness/plan stage C. response stage D. search and rescue

B. preparedness/plan stage

Which group of people uses alcohol and/or illicit drugs as a result of isolation fear, uncontrolled chronic pain, anxiety, and sleep disturbances? A. Teenagers B. children C. elderly persons D. middle aged men

C. elderly persons

As Gloria teaches local health care providers about assessing for substance use, she finds it helpful to discuss the typical course of addictive illness. She notes that the stage where substance use becomes abuse is a critical stage. During this period, both the user and his or her social network are aware of adverse effects. Use increases during this stage, and use occurs in more varied settings. This stage is referred to as: A. initiation B. continuation C. transition D. abuse E. dependency and addiction

C. transition

What agency would be the first to respond to this disaster? A. CDC B. FEMA C. DHS D. Office of Emergency managements

D. Office of Emergency managements

It takes approximately 6 to 20 days from the time Bordetella pertussis enters the body until symptoms of the disease occur. This time period is referred to as the: A. Period of latency B. Communicable period C. Period of Manifestation D. Incubation period

D. incubation period

The trait that is most characteristic of a perpetrator of intimate partner violence is: A. anger B. unemployment C. poor impulse control D. need for control

D. need for control

death rates from opioids

Death Rate from opioids has increased 600% in 10 years Most common death rate are white males aged 31-39 2016: 96 deaths from oversdose; heroin 75 heroin and cocaine 23

homicide

One of the leading causes of death in the United States. For black males aged 15 to 34, homicide is the leading cause of death. Young people, women, and African American and Hispanic males at higher risk than the general population. African Americans were more likely to commit homicide than whites and were more likely to be victims of homicide than whites (2010 data)

illinois trends

The annual Illinois statewide economic costs associated with alcohol, other drug, and tobacco-related mortality is in excess of $3.5 billion Among adolescents, alcohol is still the most widely used substance. *2014 IYS DATA substances used in the past year: 62.8% Alcohol; 39.1% Marijuana, 12.6 Medications not prescribed to them.

Natech (p. 560)

a natural disaster that creates or results in a widespread technological problem

herd immunity p. 495

a state in which those not immune to an infectious agent will be safe if at least 80% of the population has been vaccinated or is otherwise immune

cold chain p. 498

a system used to ensure that vaccines are kept at a designated temperature from the time they are manufactured until they are used for vaccination

FEMA

agency whose mission is to lead the efforts to prepare the nation for all hazards and to manage the federal response and recovery efforts following a national incident. FEMA also initiates proactive mitigation activities, trains first responders, and manages the National Flood Insurance Program and the U.S. Fire Administration.

mass casualty

an event that causes injuries to more than 100 people who require emergency health care in the same period of time

multiple causality

an event that causes injuries to more than 2 people but fewer than 100 people who require emergency health care in the same period of time

disaster

any event that causes a level of destruction, death, or injury that affects the abilities of the community to respond to the incident using available resources

communicable period

communicability follows latency and begins with shedding of the agent. Frequently, the communicable period begins before symptoms are present.

elimination

controlling a disease within a specified geographical area, such as a single country, an island, or a continent, and reducing the prevalence and incidence to eventual eradication

notifiable diseases p. 496

infectious diseases that are designated by the Centers for Disease Control and Prevention as "nationally notifiable." Health care providers who encounter these diseases must report them to the local or regional health department.

Many of the center's clients are dealing with an addiction to the most widely produced controlled substance in the United States. Dealing with abuse of this substance is particularly difficult because there is evidence of a profound neurological effect after first use. This substance is: A. cocaine B. oxycodone C. methamphetamine D. marijuana

methamphetamine

child maltreatment p. 546

neglect, physical abuse, emotional abuse, and/or sexual abuse of a child

eradication p. 496

reducing the incidence of a disease worldwide to zero as a function of deliberate efforts, with no need for further control measures

mitigation

refers to actions taken to reduce loss of life and property by lessening the impact of disasters. It means taking action now—before the next disaster—to reduce human and financial consequences (FEMA, 2013f).

frequency

refers to how often a disaster occurs

terrorism p. 551

the calculated use of unlawful violence or threat of unlawful violence to instill fear; intended to coerce or intimidate governments or societies in the pursuit of goals that are generally political, religious, or ideological

direct transmission

the immediate transfer of an infectious agent from an infected host or reservoir to an appropriate portal of entry in the human host through physical contact

Intimate Partner Violence (IPV) p. 544

the intentional emotional or physical abuse by a spouse or ex-spouse, boyfriend or girlfriend, ex-boyfriend or ex-girlfriend, or date

violence p. 543

the intentional use of physical force against another person or against oneself, which either results, or has a high likelihood of resulting, in injury or death

Latency

the period of replication before shedding

control

the reduction of incidence or prevalence of a given disease to a locally acceptable level as a result of deliberate efforts

indirect transmission p. 493

the spread of infection through vehicle fomites, animals, and vectors that carry a parasite or pathogen to a suitable portal of entry in the human host

incubation period p. 492

the time from invasion to the time when disease symptoms first appear

date rape drugs p. 545

used to reduce inhibitions and promote anesthesia or amnesia in the victim. Examples are gamma y-hydroxybutyrate (GHB) and Rohypnol

workplace violence p. 549

violence in the workplace that includes physical assaults such as rape and homicide, muggings, and verbal and written threats