Test 3 - Community

A nurse is communicating the definition of a genogram to a client. Which of the following statements should the nurse make to define a genogram? -"A genogram is a tool for assessing the resources a family possesses to deal with challenges or a crisis." -"A genogram is a visual illustration of the family in relation to other systems within the community, such as school, health care entities, work, and other social communities." -"A genogram is a tool that is useful for assessing the ability of the family to respond to challenges and crises they may face." -"A genogram contains all the information in a typical family tree, and also has details about family structure, timelines of major family events, conflicts, and documentation of family patterns."

"A genogram contains all the information in a typical family tree, and also has details about family structure, timelines of major family events, conflicts, and documentation of family patterns." This is the definition of a genogram.

A nurse is caring for a 2-year-old child who has been diagnosed with autism spectrum disorder (ASD). The parents ask the nurse what treatments are available to cure the disorder. Which of the following responses should the nurse make? -"Autism spectrum disorder is a chronic condition with no known cure at this time. However, early intervention offers the best chance to help your child achieve optimal functioning." -"Autism cannot be cured; however, a combination of diet and medication can help eliminate many symptoms of the disorder." -"When your child is older, you can put them in schools that teach them to control their behavior." -"Sometimes hiring a professional to give your child speech and physical therapy can reduce or eliminate the symptoms of the disorder."

"Autism spectrum disorder is a chronic condition with no known cure at this time. However, early intervention offers the best chance to help your child achieve optimal functioning." The cause of autism spectrum disorder is unknown, and there is no known cure. However, early identification and intervention offer the greatest chance for children to achieve the best possible functioning and development throughout their life.

A clinic nurse is assessing a 6-year-old child during a well-child examination. The child's guardian asks the nurse how much longer the child will need to ride in a booster seat. Which of the following responses should the nurse make? -"Children should ride in the back seat with a belt-positioning booster until they are at least 12 years old." -"Children should ride in the back seat with a belt-positioning booster until they reach the maximum height and weight listed by the seat manufacturer." -"Children should ride in the back seat with a belt-positioning booster until they are at least 4 feet tall." -"Children should ride in the back seat with a belt-positioning booster until they are at least 4 feet 9 inches tall and are 8 to 12 years of age."

"Children should ride in the back seat with a belt-positioning booster until they are at least 4 feet 9 inches tall and are 8 to 12 years of age." Children need the booster until they have reached 4 feet 9 inches in height and are 8 to 12 years of age.

A nurse is educating a group of parents and guardians about promoting healthy body weight during childhood. Which of the following statements by a parent indicates that the teaching has been effective? -"Family activities such as trail walking and bike riding can help encourage my child to be active." -"I should encourage my child to look for food they like to eat when eating lunch at school." -"My child should visit their primary care pediatric health provider when ill." -"If my child looks like they are not gaining weight, I should limit what they eat and only let them drink water."

"Family activities such as trail walking and bike riding can help encourage my child to be active." Interventions that create opportunities for people to engage in physical activity are effective in increasing activity levels.

A nurse is assessing a 5-year-old child who reports tooth pain and has an elevated temperature. The nurse asks the child's guardian about the child's diet. Which of the following statements by the guardian indicates the child has an increased risk of dental caries? -"I only allow him to drink water between meals." -"He snacks on gummy fruit snacks every day between meals when he gets hungry." -"I help him brush his teeth at night since he doesn't do a good job on his own." -"I don't like him to eat dessert, but he gets it as a treat when we eat with my parents on Sundays."

"He snacks on gummy fruit snacks every day between meals when he gets hungry." Frequent exposure to sweets is associated with dental caries.

A nurse is reinforcing dietary teaching with a 45-year-old client whose sibling died from colon cancer. Which of the following statements by the client indicates an understanding of the teaching? -"I can eat grilled steak and a baked potato for dinner." -"I can eat broiled chicken breast and a cup of blueberries for dinner." -"I can eat beef stew and a cup of boiled rice for dinner." -"I can eat a salami sandwich and a cup of yogurt for dinner."

"I can eat broiled chicken breast and a cup of blueberries for dinner." The client is a risk for colon cancer because of their family history. The nurse should inform the client to consume a diet with minimal red meat, but high in fruits and vegetables, which are beneficial to colon health.

A nurse is assisting with a community group presentation about the needs of vulnerable groups. Which of the following statements by the nurse indicates an understanding of the unique needs of vulnerable groups? -"I always address the problem that the client believes is the most significant." -"I avoid asking clients for income or financial information, because this is an invasion of privacy." -"I include the client's cultural traditions as I complete my assessment." -"I make sure to do a complete assessment, since we often don't know when the person will return to the clinic."

"I include the client's cultural traditions as I complete my assessment." It is important to keep the client's cultural traditions in mind when completing an assessment so that the nurse is able to provide culturally competent care.

A home health nurse is conducting a home visit for a client and their caregiver. Which of the following statements by the caregiver indicates stress? (Select all that apply.) -"I've been depressed lately." -"I'm tired most of the day." -"I'm very detailed oriented." -"I often blame myself for things." -"I am hopeful about the future." -"I've been keeping to myself lately."

"I've been depressed lately" is correct. Signs of caregiver stress include depression, exhaustion, feelings of isolation or guilt. Blaming yourself for things is a finding associated with care stress. "I'm tired most of the day" is correct. Signs of caregiver stress include depression, exhaustion, feelings of isolation or guilt. Blaming yourself for things is a finding associated with care stress. "I'm very detailed oriented" is incorrect. Signs of caregiver stress include depression, exhaustion, feelings of isolation or guilt. Blaming yourself for things is a finding associated with care stress. "I often blame myself for things" is correct. Signs of caregiver stress include depression, exhaustion, feelings of isolation or guilt. Blaming yourself for things is a finding associated with care stress. "I am hopeful about the future" is incorrect. Signs of caregiver stress include depression, exhaustion, feelings of isolation or guilt. Blaming yourself for things is a finding associated with care stress. "I've been keeping to myself lately" is correct. Signs of caregiver stress include depression, exhaustion, feelings of isolation or guilt. Blaming yourself for things is a finding associated with care stress.

A school nurse is educating parents and students regarding effective strategies for reducing adolescent motor-vehicle crashes. Which of the following statements by a student indicates that the teaching has been effective? -"Newly licensed drivers are at a decreased risk of being involved in a motor-vehicle crash." -"Driving late at night or when I am tired can decrease my risk of being in a motor-vehicle crash." -"Many states have a zero-tolerance law for anyone under the age of 21 driving under the influence of drugs or alcohol." -"Driving with friends in the car can help me identify dangers and reduce my risk of being in a motor-vehicle crash."

"Many states have a zero-tolerance law for anyone under the age of 21 driving under the influence of drugs or alcohol." Enforcing zero-tolerance laws for anyone under age 21 found to be driving under the influence, enforcement of seat belt laws, and educating adolescents and parents about safe driving practices lowers the risk of adolescent motor-vehicle crashes.

A nurse is teaching about palliative care with a client who has recently developed Parkinson's disease. Which of the following statements by the client indicates understanding? -"Palliative care services should begin at the beginning of my treatment." -"I should start palliative care services if I have side effects of therapy." -"I should start palliative care services if my treatment is not effective." -"Palliative care services should begin 6 months following my treatment."

"Palliative care services should begin at the beginning of my treatment." Palliative care should begin at the beginning of treatment for a chronic condition, as the goals of the program can best be met if the treatment is initiated early.

A nurse at an urgent care clinic is discharging a child who was diagnosed with pediculosis. The child's guardian asks how their child could have developed this condition. Which of the following responses should the nurse make? -"Pediculosis is transmitted through direct contact with saliva or feces from an infected person or indirect contact with contaminated surfaces." -"Pediculosis is transmitted through direct contact with feces from an infected person or through ingesting contaminated food or water." -"Pediculosis is transmitted through direct contact with blood from an infected person or animal or indirect contact with contaminated surfaces." -"Pediculosis is transmitted through direct hair-to-hair contact or indirect contact with the personal belongings of an infected person."

"Pediculosis is transmitted through direct hair-to-hair contact or indirect contact with the personal belongings of an infected person." Pediculosis, or head lice, is transmitted through direct hair-to-hair contact or indirect contact with the personal belongings of an infected person.

A public health nurse is educating nursing students about pediatric obesity in rural areas. Which of the following statements made by a nursing student indicates that the teaching has been effective? -"Rural areas have lower rates of pediatric obesity due to decreased physical activity and manual labor." -"Rural areas have higher rates of pediatric obesity due to lack of healthy and nutritional food choices." -"Rural areas have lower rates of pediatric obesity due to a lack of recreational areas and parks." -"Rural areas have lower rates of pediatric obesity due to lack of local adequate grocery stores."

"Rural areas have higher rates of pediatric obesity due to lack of healthy and nutritional food choices." The lack of availability of healthy foods is considered to be a contributing factor to pediatric obesity.

A nurse is caring for a 17-year-old adolescent who is being treated for depression. Which of the following statements by the adolescent should the nurse report to the provider immediately? -"I am tired of feeling sad all the time." -"I don't think anyone would miss me." -"Sometimes I think I should just drive my car off a cliff." -"Sometimes I think everyone would be better off without me."

"Sometimes I think I should just drive my car off a cliff." The client is not only expressing thoughts of self-harm but has a plan on how they would hurt or kill themselves.

A nurse is educating a group of new parents and guardians about safe sleep practices for infants. Which of the following statements by a guardian indicates an understanding? -"My baby should sleep on a soft mattress." -"My baby should sleep in my bed with me until they are at least 6 months old." -"My baby can sleep on their stomach for naps." -"There should not be any pillows or toys in the bed with my baby."

"There should not be any pillows or toys in the bed with my baby." Blankets and other loose items can block the infant's airway, increasing the risk of suffocation, entrapment, or sudden infant death syndrome (SIDS).

A nurse is reviewing Medicare Part B with a client. Which of the following statements by the client indicates understanding? -"This covers admission to a long-term care facility." -"This covers diagnostic testing and preventative treatment." -"This will reduce my out- of-pocket costs." -"This covers my prescription medications."

"This covers diagnostic testing and preventative treatment." Medicare Part B will cover medically necessary services and preventative services, including durable medical equipment, to provide health maintenance and prevention of disease.

A public health nurse is conducting a home visit with new clients and completing a primary family assessment. Which of the following statements by a parent indicates the parent is experiencing caregiver role strain? -"I frequently ask a family member to come over and help me take care of the children so I can get some rest." -"My partner and I argue about money, and they don't think we need to be paying someone to help when I am capable of taking care of the children." -"We don't have a lot of friends or family in the area, and money is tight, so we mostly go to the park to get out of the house." -"We don't really have a routine; I feel sick and drained most of the time, so we can't keep up with a schedule."

"We don't really have a routine; I feel sick and drained most of the time, so we can't keep up with a schedule." The parent is indicating emotional and physical symptoms and indicating that they are having difficulties providing care.

A nurse is providing discharge instructions to a family of a client who is postoperative from knee surgery. A family member informs the nurse that they are concerned that they will not be able to care for client because of employment. Which of the following responses should the nurse make? -"Maybe we can ask the doctor to let the client stay in the hospital longer." -"You can use FMLA that is available through your job." -"You can hire someone to help care for them while you work." -"I'm sorry you are concerned about that. Here is a referral to a support group."

"You can use FMLA that is available through your job." FMLA allows an employee who is taking care of a seriously ill loved one to take a leave from their job and their position will be protected.

A nurse is educating a group of students about calculating body mass index (BMI) related to age when determining obesity in children. The nurse should include that obesity in children is defined as having a BMI for age that is greater than which of the following percentiles? -95th percentile -85th percentile -90th percentile -97th percentile

95th percentile Obesity in children is defined as having a BMI for age that is greater than the 95th percentile.

A nurse is assisting with the care of multiple clients at a community health center. For which of the following clients should the nurse anticipate a referral for a social worker? -A client who has asthma and reports increased need for inhaler use -A client who has diabetes mellitus and reports inadequate medical supplies at home -A client who has depression and reports inability to sleep at night -A client who has hypertension and reports recent weight gain

A client who has diabetes mellitus and reports inadequate medical supplies at home Individuals who are part of a vulnerable population may have low socioeconomic status or are without housing. A social work referral can help the client with identification of resources to obtain medical supplies.

A nurse is reviewing discharge planning for several older adult clients. Which of the following clients should the nurse identify as most likely to require additional health care services? -A client who has severe arthritis and lives alone. -A client who has diabetes mellitus and lives alone. -A client who has a cognitive disorder and lives with their family. -A client who is scheduled for discharge to an acute rehab facility.

A client who has severe arthritis and lives alone. A client who has severe arthritis and lives alone would be at risk for injury, such as from falls. Therefore, the nurse should recommend additional community care services to assist the client with functioning independently in their home.

A nurse is caring for a group of clients. The nurse should identify that which of the following clients is a member of a vulnerable population? (Select all that apply.) -A client who has substance use disorder and tests positive for HIV -A client who smokes and uses chewing tobacco daily -A client who recently had a baby and requests information about child care -A client who has limited access to health care because they live in a rural area -A veteran who just returned from an overseas tour of duty after being injured

A client who has substance use disorder and tests positive for HIV is correct. Vulnerable populations include clients who have low socioeconomic status, are without housing, have special needs, have mental illness, have substance use disorder, and have been incarcerated. Vulnerable populations can include adolescents who are pregnant, migrant workers and immigrants, and individuals who are at risk for or have communicable diseases. A client who smokes and uses chewing tobacco daily is in correct. Vulnerable populations include clients who have low socioeconomic status, are without housing, have special needs, have mental illness, have substance use disorder, and have been incarcerated. Vulnerable populations can include adolescents who are pregnant, migrant workers and immigrants, and individuals who are at risk for or have communicable diseases. A client who recently had a baby and requests information about child care is incorrect. This is an expected response by a new parent. A client who has limited access to health care because they live in a rural area is correct. Vulnerable populations include clients who have low socioeconomic status, are without housing, have special needs, have mental illness, have substance use disorder, and have been incarcerated. Vulnerable populations can include adolescents who are pregnant, migrant workers and immigrants, and individuals who are at risk for or have communicable diseases. A veteran who just returned from an overseas tour of duty after being injured is correct. A veteran who returned home from a duty assignment following an injury is at risk for mental health disorders as a result of the trauma experienced and is vulnerable.

A nurse is caring for several clients in a community health clinic. Which of the following clients should the nurse identify as at risk for transmitting HIV? -A client who uses contraceptives -A client who has unprotected intercourse -A client who lives with an adult who has HIV -A client who participates in oral intercourse

A client who has unprotected intercourse Unprotected intercourse is a risk factor for the development of sexually transmitted infections and HIV.

A nurse understands a family operates as a unit and that what impacts one family member can impact all members. Which of the following findings should the nurse identify as significant in relation to the family systems theory? -A family member in the household was recently diagnosed with cancer. -The client has an elevated blood pressure reading today. -The client has recently quit smoking. -The family has recently obtained a pet.

A family member in the household was recently diagnosed with cancer. This is a component of family systems theory. Family systems theory is based on the premise that families are a unit and that any change in one family member affects all members.

A nurse is caring for a non-Hispanic Black client who is experiencing preterm labor. When assessing the client for pregnancy complications, the nurse recognizes that pregnant clients who are non-Hispanic Black have an increased risk for which of the following? -Cesarean delivery -Hysterectomy -Admission to the ICU -Having a child with a congenital birth defect

Admission to the ICU Pregnant clients who are non-Hispanic Black, Indigenous Peoples, and Alaskan Natives have higher rates of gestational hypertension, eclampsia, and admission to the ICU than pregnant clients who are non-Hispanic White.

A nurse is discussing care options with the family of an older adult client who is currently living with them. The family is concerned that the client will fall at home while they are at work. Which resource should the nurse recommend for the family? -Long term care facility placement -Home health care -Adult day care -Senior health center

Adult day care Adult daycare provides assistance and support, and promotes an active lifestyle for older adults during the day. The client would benefit from a safer, supervised environment during the day which would decrease the risk for injury.

A nurse in an acute setting has witnessed a peer make uncivil remarks to a new staff member in the unit. The nurse should take which of the following actions to promote a safe work culture in the unit? (Select all that apply.) -Advocate for a zero-tolerance policy regarding incivility in the workplace. -Create peer-to-peer conflict resolution programs. -Reprimand the nurse who made the uncivil remarks. -Speak with the new staff member about any concerns they have regarding adjusting to the unit. -Advocate to terminate the employee that made the inappropriate remark.

Advocate for a zero-tolerance policy regarding incivility in the workplace is correct. This is an example of establishing social norms that do not support incivility in the workplace. Create peer-to-peer conflict resolution programs is correct. This is an example of building relationships in the workplace, which can promote a safe work culture. Reprimand the nurse who made the uncivil remarks is incorrect. The nurse should not respond to incivility with further incivility. Speak with the new staff member about any concerns they have regarding adjusting to the unit is correct. This is an example of facilitating a safe work culture among peers. Advocate to terminate the employee that made the inappropriate remark is incorrect. Advocating to terminate the employee masks the greater issue at hand which is to address the inappropriate remark.

A nurse is caring for a client who is a member of a vulnerable population. Which of the following actions should the nurse take? -Set a time limit for the client to become self-sufficient. -Take control of the client's care decisions. -Advocate for the client needs. -Refer the client to another community center.

Advocate for the client needs. It is important for the nurse to advocate for all vulnerable groups to obtain equal treatment regardless of their socioeconomic status, immigration status, sexual orientation, gender identity, or any other factor that can lead to vulnerability.

A community health nurse is working with adolescents living in a shelter for people without housing. The nurse should recognize that frequent moving leaves these adolescents at an increased risk for which of the following? -Developmental delays -Asthma -Diabetes -Alcohol and drug use disorder

Alcohol and drug use disorder In adolescents, frequent moving affects mental health and is associated with alcohol and drug use disorder.

A nurse is caring for several clients who all have caregivers. Which of the following clients should the nurse identify as most likely to have their caregiver experience caregiver stress? -A middle-aged client whose caregiver is their parent parent who utilizes adult day care during the week -An older adult client whose grandchild is the paid caregiver several days per week -An older adult client whose caregiver is their middle-aged adult child who works full time and has a school aged child -An older adult client with a chronic condition whose caregiver is their spouse who is retired and has family that lives nearby

An older adult client whose caregiver is their middle-aged adult child who works full time and has a school aged child This caregiver assists with providing care for their parent and child and works full time. Therefore, this caregiver would be a great risk for caregiver stress because of the inability to balance work, caregiving, and other aspects of life.

A nurse is caring for a client in an infectious disease clinic at the health department. The client is being treated for an STI and reports they have left an abusive partner. Which of the following is an example of patient-centered care? -Have the client undress, as this is necessary for the examination. -Ask the client if they are comfortable with having an examination today. -Tell the client they are proud of them for leaving their abusive relationship and they should have done this many months ago. -Avoid mentioning the abuse with the client, as it was in the past.

Ask the client if they are comfortable with having an examination today. The nurse who understands the history of trauma will ask if the client is comfortable with an examination today.

A nurse is caring for a 36-year-old client in a health clinic and notices that the client's genogram shows their mother had a history of breast cancer. Which of the following actions should the nurse take? (Select all that apply.) -Ask the client if they smoke. -Explain to the client that their 12-year-old daughter will not be at an increased risk of breast cancer. -Discuss with the client that they are at an increased risk for developing breast cancer. -Show the client a video of how to perform a breast self-examination. -Report this data to the state health department.

Ask the client if they smoke is correct. Smoking increases the risk for breast cancer. The nurse needs to assess for all risk factors and implement risk reduction interventions. Explain to the client that their 12-year-old daughter will not be at an increased risk of breast cancer is incorrect. This information is incorrect. The client's genogram places their daughter at an increased risk as well. Discuss with the client that they are at an increased risk for developing breast cancer is correct. Based on the client's genogram, the nurse should explain their risk for developing breast cancer. The client's family history of their mother having breast cancer places them at risk. Show the client a video of how to perform a breast self-examination is correct. The nurse should educate the client about breast self-examinations to help the client to detect breast cancer at an early stage. Report this data to the state health department is incorrect. The nurse should not report this information to the state health department. A client's risk factors for a disease are not a reportable incident.

A nurse is conducting an assessment on a 7-year-old child. The guardian reports the child frequently displays trouble with organization, is easily distracted, has difficulty paying attention, and is overly active. The nurse should recognize that these symptoms are commonly associated with which of the following pediatric health problems? -Autism spectrum disorder (ASD) -Attention deficit hyperactivity disorder (ADHD) -Depression -Anxiety

Attention deficit hyperactivity disorder (ADHD) Children who have ADHD frequently have difficulty paying attention, are distracted easily, have trouble with organization, have difficulty controlling impulsive behaviors, or may talk excessively and be overly active.

A nurse is caring for a child who was resuscitated following a near drowning in a home swimming pool. The child's parents ask what they can do to prevent another incident. Which of the following recommendations should the nurse make? (Select all that apply.) -Avoid drinking alcohol while supervising children who are swimming, unless multiple adults are present. -Avoid distracting activities like listening to music, using a cell phone, or reading books when supervising children who are near swimming pools or other bodies of water. -Gated isolation fences should separate any play area from the pool to keep children away from the water when not swimming. -All parents and caregivers should have certification in cardiopulmonary resuscitation (CPR). -Children should be supervised around pools and lakes only when they are in the water. -Formal swim lessons are recommended once children reach preschool age.

Avoid drinking alcohol while supervising children who are swimming, unless multiple adults are present is incorrect. Adults responsible for the children need to avoid distracting activities like listening to music, using a cell phone, reading books, and drinking alcohol. Avoid distracting activities like listening to music, using a cell phone, or reading books when supervising children who are near swimming pools or other bodies of water is correct. Adults responsible for the children need to avoid distracting activities like listening to music, using a cell phone, reading books, and drinking alcohol. Gated isolation fences should separate any play area from the pool to keep children away from the water when not swimming is correct. Restricting access to areas with water is recommended for preventing drowning in children. All parents and caregivers should have certification in cardiopulmonary resuscitation (CPR) is correct. CPR training is recommended for all parents and caregivers. Children should be supervised around pools and lakes only when they are in the water is incorrect. Children should be supervised at all times when playing in or near water. Formal swim lessons are recommended once children reach preschool age is incorrect. Formal swim lessons are recommended for toddlers and preschoolers.

A nurse notices on a client's intake form that there is a history of heart disease in their family. Which of the following risk factors should the nurse identify this information as? -Behavioral -Environmental -Biological -Cultural

Biological Heart disease is a biological risk factor.

A public health nurse is educating community leaders about the causes of adverse childhood experiences (ACEs). Which of the following should the nurse include as potential types of adverse childhood experiences? (Select all that apply.) -Child maltreatment -Intimate partner violence -Chronic health problems -A parent who is incarcerated -Divorce -Developmental delay

Child maltreatment is correct. The CDC defines ACEs as potentially traumatic events that occur in childhood (0 to 17 years), including psychological, physical, and sexual forms of maltreatment. Intimate partner violence is correct. The CDC defines ACEs as potentially traumatic events that occur in childhood (0 to 17 years), including intimate partner violence. Chronic health problems is incorrect. While chronic health problems can have a significant effect on a child's mental health, it is not included as an adverse childhood experience. A parent who is incarcerated is correct. The CDC defines ACEs as potentially traumatic events that occur in childhood (0 to 17 years), including parental incarceration. Divorce is correct. The CDC defines ACEs as potentially traumatic events that occur in childhood (0 to 17 years), including parental separation. Developmental delay is incorrect. While developmental delays significantly affect pediatric health, they are not considered an adverse childhood experience.

A public health nurse is educating community members about the incidence of child maltreatment in the area at a local health fair. Which of the following should the nurse include as the most commonly reported type of child maltreatment? -Sexual maltreatment -Physical maltreatment -Child neglect -Emotional maltreatment

Child neglect The most commonly reported type of child maltreatment is neglect, which is the failure of the caregiver to meet a child's basic needs.

A group of community health nursing students is preparing a presentation about lead toxicity in children. Which of the following characteristics of children should the students include as factors that increase a child's susceptibility to environmental lead exposure? (Select all that apply.) -Children eat less food and drink more water per pound of bodyweight than adults. -Children's organ systems grow at a slower rate than adults. -Children breathe at a faster rate and inhale less air than adults. -Young children frequently place objects in their mouths. -Children spend a greater amount of time close to the ground and soil. -Children have more years of life ahead of them than adults.

Children eat less food and drink more water per pound of bodyweight than adults is incorrect. Children eat more food and drink more water per pound of bodyweight than adults, resulting in increased exposure to water and food pollutants. Children's organ systems grow at a slower rate than adults is incorrect. Children's organ systems and cells grow and mature at a rapid rate. This rapid process leaves them vulnerable to injury or disruption that could result in potentially permanent damage. Children breathe at a faster rate and inhale less air than adults is incorrect. Children inhale more air than adults, resulting in increased exposure to air pollutants. Young children frequently place objects in their mouths is correct. Young children frequently place objects in their mouths, increasing their exposure to pollutants in the soil. Children spend a greater amount of time close to the ground and soil is correct. Children, especially infants, toddlers, and preschoolers, spend more time close to the ground and soil. Children have more years of life ahead of them than adults is correct. Children have more years of life ahead of them than adults, giving them a longer period of time for the development of chronic health problems following exposure.

A public health nurse is conducting a windshield survey in a new community they will be serving. Which of the following data should the nurse expect to collect? -Condition of roads and other infrastructure -Number of homes containing lead paint -How many children live in the neighborhood -Where the informal community leaders live

Condition of roads and other infrastructure A windshield survey is conducted by driving through a community and gathering information about the environment and specific populations, especially vulnerable populations of people who live there.

A nurse in the emergency department is assisting with the care for an older adult client who lives with a family member. The client's family member reports the client has blood in their urine. Which action should the nurse suggest taking first? -Determine the cause of the bleeding while asking about other social family concerns. -Plan to refer the client to an outpatient urologist to address blood in the client's urine. -Send the client home with their family member and inform the client to return to the ED if fever develops. -Provide the client prescribed medication to manage their condition.

Determine the cause of the bleeding while asking about other social family concerns. A client who is an older adult is considered vulnerable. Therefore, it is important for the nurse to provide comprehensive assessment and determine the cause of the client's symptoms and inquire about their social concerns. This would allow for the nurse to determine the need for social and economic assistance as well.

A nurse is educating a nursing student about the leading causes of death from unintentional injuries in toddlers. The nurse knows teaching has been effective when the student correctly identifies which of the following as the leading cause of death from unintentional injuries in toddlers? -Poisoning -Suffocation -Drowning -Motor-vehicle crashes

Drowning Drowning is the leading cause of death from unintentional injuries in toddlers.

A public health nurse is collaborating with a community team and considering which assessment tool looks at health as a broad, multifaceted concept and considers health as impacted by individual, community, social, political, and physical elements. Which of the following tools should the nurse recommend? -CHANGE model -Built environment assessment tool -CHNA -Ecological model

Ecological model The nurse should recommend the ecological model because it fulfills the community's needs. The ecological model looks at health as a broad, multifaceted concept and considers health as impacted by individual, community, social, political, and physical elements.

A public health nurse wants to implement a local prevention program to help with mental health disorders among adolescents. Which of the following primary prevention strategies is effective in addressing mental health disorders in adolescents? (Select all that apply.) -Educating parents of children who have depression about recognizing concerning behaviors -Adolescent programs for safe dating and healthy relationship skills -Programs for treatment and support of alcohol and drug use disorder -Establishing partnerships between primary pediatric health care organizations and mental health providers -Programs to strengthen household financial security -Programs for early childhood home visitation

Educating parents of children who have depression about recognizing concerning behaviors is incorrect. Educating parents of children who have depression is a secondary or tertiary prevention strategy for reducing mental health disorders in children. Adolescent programs for safe dating and healthy relationship skills is correct. Educating adolescents about safe dating and relationship skills can decrease the incidence of adverse childhood events (ACEs) associated with the development of childhood mental health disorders. Programs for treatment and support of alcohol and drug use disorder is incorrect. Increasing the availability of treatment services for alcohol and drug use disorder is a secondary prevention strategy for reducing mental health disorders in children. Establishing partnerships between primary pediatric health care organizations and mental health providers is incorrect. Increasing the availability of mental health services are a secondary prevention strategy for reducing mental health disorders in children. Programs to strengthen household financial security is correct. Ensuring families have adequate financial resources can decrease the incidence of adverse childhood events (ACEs), which are associated with the development of childhood mental health disorders. Programs for early childhood home visitation is correct. Early childhood home visitation can ensure a healthy start for children and decrease the incidence of adverse childhood events (ACEs), which are associated with the development of childhood mental health disorders.

A nurse is caring for a client who has a terminal illness. Which of the following actions would be priority for the nurse? -Ensure the client gets adequate rest. -Encourage the client to make their own decisions about their care. -Involve the client's family in all aspects of decision-making. -Arrange for a chaplain visit if desired.

Encourage the client to make their own decisions about their care. According to evidence-based practice the nurse should first ensure that the client has pertinent information and resources available to make their own end-of-life decisions and overall decisions about their care. This action promotes autonomy.

A nurse at a clinic is assessing a client who is part of a vulnerable population. Which of the following actions should the nurse take? (Select all that apply.) -Ensure the environment is comfortable and nonthreatening. -Provide the client with financial advice. -Discuss client care with other members of the interprofessional team. -Provide culturally appropriate health care. -Offer the client personal medical advice.

Ensure the environment is comfortable and nonthreatening is correct. Nurses working with clients in vulnerable populations should aim to create a comfortable, nonthreatening environment, provide culturally and linguistically competent care, and collaborate with others as appropriate. A nurse should not provide financial or legal advice. Provide the client with financial advice is incorrect. A nurse should not provide financial advice because this is outside the nursing scope of practice. Discuss client care with other members of the interprofessional team is correct. A nurse should collaborate with interprofessional team members to identify and manage client needs. Provide culturally appropriate health care is correct. Nurses working with clients in vulnerable populations should aim to create a comfortable, nonthreatening environment, provide culturally and linguistically competent care, and collaborate with others as appropriate. Offer the client personal medical advice is incorrect. A nurse should not provide personal medical advice because this is not within the nursing scope of practice.

\A nurse is preparing an in-service about methods to remove barriers to health care. Which of the following information should the nurse include? -Attend an antidiscrimination rally held in the local community. -Provide free food at a food bank. -Support an initiative to add more homeless shelters to the community. -Establish a mobile clinic to provide services for clients in rural communities.

Establish a mobile clinic to provide services for clients in rural communities. Barriers to access health care include policies and financial, geographic, or cultural features of health care that make services difficult to obtain or so unappealing that clients do not want to seek care. Removing barriers to health care can improve access to health care services. Examples of removing barriers to health care include providing extended clinic hours, low-cost or free health services for people who are uninsured or underinsured, providing transportation to and from clinics, mobile vans, and professional interpreters.

A nurse is caring for an older adult client and is reviewing the health record. Which of the following findings should the nurse identify as a risk factor for chronic heart disease? (Select all that apply.) -Ethnicity: Black American -Smoker - 1 pack per day -Occupation: Retired -BMI 30 -Residence: Rural -Lifestyle: Denies participating in aerobic activity

Ethnicity: Black American is correct. Black Americans are at increased risk for chronic diseases, such as high blood pressure and diabetes, that increase risk of chronic heart disease. Smoker - 1 pack per day is correct. Smoking greatly increases the risk of chronic heart disease, especially in older adults. Occupation: Retired is incorrect. Retirement from former occupation is not a risk factor for development of heart disease. BMI 30 is correct. A BMI greater than 25 could indicate obesity which is a risk factor for heart disease. Residence: Rural is incorrect. Living in a rural community may contribute to the client not receiving diagnostic or therapeutic care if it is not available, but overall does not contribute to the development of heart disease. Lifestyle: Denies participating in aerobic activity is correct. A client who does not participate in exercise is at risk for developing heart disease.

A nurse is reviewing the data for the number of new colorectal cancer screenings. This data is for the 6 months following a community campaign stressing the importance of screening for colorectal cancer. The nurse should identify that this is an example of which of the following phases of the nursing process? -Assessment -Evaluation -Planning -Implementation

Evaluation During the evaluation phase, the nurse would examine the recent data to determine the plan was successful or in need of revision.

A nurse is working with a family in which a few members have a chronic disease. Which of the following tools should the nurse use to gain insight into the strengths and vulnerabilities of a family who has chronic disease? -Family APGAR -Family genogram -Family ecomap -Family SCREEM

Family SCREEM This tool is especially effective for families that have members who have chronic or terminal illnesses.

A nurse is working with a client who was recently diagnosed with type 1 diabetes mellitus. The nurse recommends that the client and their family attend diabetes education classes. Which of the following theories will assist the nurse in determining whether the client and their family will be receptive to this recommendation? -Family life cycle theory -Family systems theory -Biological ecosystems theory -Modeling and role modeling theory

Family life cycle theory This theory proposes that families establish boundaries during times of crisis and will either facilitate openness or closedness to handling of crisis.

A nurse should understand that which of the following is an example of the socialization family function and structure? -Family members learning how to budget and spend wisely -Family members learning about relationship boundaries -Family members learning how to interact with other members of society -Family members learning how to take care of their health

Family members learning how to interact with other members of society This is a socialization function. The family's children will learn from the adults how to operate effectively and fit into the social environment. The values and beliefs systems of the members are learned through family interactions with each other and society.

A nurse notices that the age and gender of each family member has been recorded in a client's chart. This information is a characteristic of which of the following? -Family function -Family dysfunction -Family structure -Family characteristics

Family structure Age and gender of each member is included as part of family structure.

A nurse is completing a genogram on a client. Which of the following should the nurse expect to learn about the client from the genogram? -Family structures, major family events, conflicts, and family patterns -The strength of family relationships in the community -The primary language of the client -The ability of the family to respond to challenges and crisis

Family structures, major family events, conflicts, and family patterns The genogram can depict family structures, major family events, conflicts, and family patterns.

A nurse is reviewing a client's chart. Which of the following tools would assist the nurse in identifying family relationships and patterns? -Ecomap -Genogram -Family APGAR -Family SCREEM

Genogram A genogram can show different family types over several generations.

A nurse is working in a primary care clinic. Which of the following is a way the nurse can identify clients who have experienced abuse or violence? -Have all clients complete a partner violence screening. -Expect adult clients to let the nurse know if there is a history of abuse. -Recognize that there is no abuse if an older adult client is accompanied by a caregiver. -Assume that an adolescent client's dislike of school is normal.

Have all clients complete a partner violence screening. Screening all clients for partner violence is recommended in identifying past or present abuse.

A nurse and a community team are assessing their community using the CHANGE model. The team recognizes they should consider which of the following as a sector of their model? -Community population -Health care -Political leaders -Individual

Health care The nurse should identify that CHANGE sectors include community at large, community institution/organization, health care, school, and work sites.

A nurse is collecting data on a 19-year-old client and notices that the client is up-to-date on immunizations. Which of the following family functions does this meet? -Physical function -Health promotion and self-care function -Affective nurturance function -Socialization function

Health promotion and self-care function One of the functions of the family is to teach members how to promote health and care for themselves.

A public health nurse is discussing wellness initiatives to assist with wellness promotion by the Department of Health and Human Services with a newly hired nurse. Which of the information should the nurse discuss? -Medicare -Healthy People 2030 -Medicaid -National Institute on Aging

Healthy People 2030 Healthy people is an initiative that has a goal of health promotion and disease prevention for all people, including those who have health care disparities or risk factors.

A public health nurse is working with a team to plan a community initiative. The nurse looks to national initiatives to drive community action. Which of the following outlines national objectives for health improvement and can be used to help drive community-specific objectives? -The CHANGE model -Community health assessment -The Centers for Disease Control and Prevention -Healthy People 2030

Healthy People 2030 The nurse should identify that Healthy People 2030 outlines national objectives for health improvement and can be used to help drive community-specific objectives.

A community health nurse is obtaining a health history from a client who has heart disease. Which of the following findings should the nurse identify as a modifiable risk factor? -Family history of diabetes -75 years of age -High-fat diet -Hearing loss

High-fat diet Eating a diet that is high in fat is a modifiable risk factor. The client can choose to change this lifestyle behavior and consume a diet that is lower in fat.

A nurse is reinforcing teaching with the family of a client who has a terminal illness. Which health care management options should the nurse include for discussion? (Select all that apply.) -Hospice care in an acute care facility -Hospice care in a rehabilitation center -Hospice care in the home -Hospice care in an inpatient hospice center -Hospice care arranged through the physician's office -Hospice care at an outpatient center

Hospice care in an acute care facility is correct. A client who has a terminal illness and for whom death is imminent can require hospice care during inpatient admission to provide comfort at the end of life. Hospice care in a rehabilitation center is incorrect. A rehabilitation center operates with the goal of returning a client to their optimal level of functioning. This is not the goal of hospice, which provides comfort measures and care at the end of life, so a rehab center would not be an appropriate setting for a client who has a terminal illness. Hospice care in the home is correct. A client may benefit from home hospice, since this service will allow them to remain in their familiar home with their family, which may provide a great deal of comfort at the end of life. Hospice care in an inpatient hospice center is correct. Inpatient hospice centers may be a good option for clients who have been discharged from the hospital, but their families are not able to fully care for them at home. These centers provide a comfortable, home-like environment for end-of-life care. Hospice care arranged through the physician's office is correct. A physician's office would be able to provide an order and arrange for hospice care for a client and assist with connecting the client and family to the appropriate resources. Hospice care at an outpatient center is incorrect. An outpatient center would require the client and family to visit the center, which does not provide the optimal comfort that is a component of hospice care. The client should be allowed to remain in a comfortable environment.

A nurse who works in a low socioeconomic status neighborhood where most families live below the poverty line finds that many of the children suffer from malnutrition. The nurse should identify that which of the following aspects of poverty increases a child's risk for malnutrition? -Access to health care -Inability to pay for medications -Environmental exposures -Housing insecurity

Housing insecurity Housing insecurity is linked with food insecurity, and both are associated with malnutrition in children.

A nurse and a community team are trying to increase interest within the community for the community program they are working to implement. Which of the following is a key strategy used to give community members a reason they should care about a community program or goal? -Craft a clear message. -Identify outreach methods. -Identify incentives. -Define goals.

Identify incentives. Community involvement should be incentivized. By providing incentives, community members are given a reason they should care about or be involved in the issue.

nurse is working with a family to develop a family care plan that has four steps. Identify the correct order of steps when creating a family care plan. (Move the steps into the box on the right, placing them in the selected order of performance. Use all the steps.) -Develop family-centered interventions. -Evaluate the progress toward outcome measures. -Plan interventions with goals and objectives. -Identify the problem.

Identify the problem is the first step. This step is accomplished by obtaining objective data from the medical record and the nurse's observations. These steps follow the nursing process to assess, analyze, plan, implement, and evaluate. Plan interventions with goals and objectives is the second step. Goals should be structured using the SMART goal framework. These steps follow the nursing process to assess, analyze, plan, implement, and evaluate. Develop family-centered interventions is the third step. Involving family members in the formulation of the interventions can help achieve success for the family. These steps follow the nursing process to assess, analyze, plan, implement, and evaluate. Evaluate the progress toward outcome measures is the final step. Evaluation of the care plan will include reviewing the set goals and interventions and determining if they have been met, are still ongoing, or require modification. These steps follow the nursing process to assess, analyze, plan, implement, and evaluate.

A nurse is reinforcing the importance of adhering to their medication regimen with a vulnerable group of clients who has been diagnosed with a mental illness. The nurse should identify that this is an example of which of the following phases of the nursing process? -Assessment -Analysis/Diagnosis -Implementation -Planning

Implementation During the implementation phase, the nurse would provide instruction and reinforce with the clients about the importance of adhering to their medication regimen.

A nurse is caring for a client following a suicide attempt. The client has a history of depression, substance use disorder, and anorexia nervosa. Which of the following actions should the nurse take first? -Administer a depression assessment tool. -Review the client's laboratory report. -Make a contract with the client regarding their eating behavior. -Initiate suicide precautions.

Initiate suicide precautions. The client's safety is the nurse's priority. Therefore, the first action the nurse should take is to initiate suicide precautions.

A nurse is admitting a 60-year-old client who has a history of chronic hypertension and hypercholesterolemia. The client reports that they live alone in a rural area, have been unemployed for six months, and have not been taking their medications as prescribed. Which factors should the nurse identify as placing the client at high risk for health care disparities? (Select all that apply.) -Male gender identity -Employment status -Having free time -Medical history -Residence -Socioeconomic status

Male gender identity is correct. According to the CDC, suicide is one of the most common causes of death among clients who identify as male. A person who lives alone may be more prone to depression and poor health outcomes related to lack of health support. Employment status is correct. Unemployment and socioeconomic concerns increase risk of depression and suicide in clients. Having free time is incorrect. Having free time is not associated with health care disparities. Medical history is correct. Chronic health conditions affect all clients, but clients who identify as male have a shorter life expectancy. Residence is correct. A person who lives alone may be more prone to depression and poor health outcomes related to lack of health support. Those who reside in rural communities have worse health outcomes than those who reside in urban areas, since access to health care may be limited. Socioeconomic status is correct. Unemployment and socioeconomic concerns increase risk of depression and suicide in clients.

A nurse is preparing to discuss palliative care with nurses caring for a minority population group. Which of the following information should the nurse include? -Minority groups are more likely to utilize palliative care services. -Minority groups are less likely to access palliative care services. -Minority groups are less likely to experience death in a hospital setting. -Minority groups do not have disparities in palliative care services.

Minority groups are less likely to access palliative care services. Minority populations are considered vulnerable and less likely to access to palliative care services.

A public health nurse is working in a low-income neighborhood composed primarily of non-Hispanic Black families. The nurse is developing a teaching plan for parents about common pediatric health concerns. When compared to non-Hispanic Whites, for which of the following health concerns are low-income, non-Hispanic Black children at a greater risk? (Select all that apply.) -Obesity -Autism -Asthma -Diabetes -Preterm birth -Child mortality

Obesity is correct. Among racial and ethnic minorities, obesity rates are as high as 25.6% among Hispanic children and 24.2% among non-Hispanic Black children, compared to 16.1% among non-Hispanic White children. Autism is incorrect. Non-Hispanic Black children are at a greater risk of a delay in diagnosis; however, they are not shown to be at a greater risk of developing autism. Asthma is correct. Non-Hispanic Black children had the highest rates of asthma, followed by Indigenous Peoples and Alaskan Natives and Hispanics. Diabetes is correct. The rates of diabetes have increased dramatically among non-Hispanic Blacks since 2002. Preterm birth is correct. Infants born to non-Hispanic Black parents were more likely to be born preterm, have low birth weight, and be admitted to the neonatal nursery. Child mortality is correct. The rate of child mortality among non-Hispanic Black children is higher than the national average.

A nurse is caring for a client who is receiving inpatient hospice services and requests additional pain medication. Which of the following actions should the nurse take? -Provide distraction measures. -Obtain a prescription to administer more analgesics. -Inform the client that more medication is not indicated. -Administer a prescribed sedative for the client.

Obtain a prescription to administer more analgesics. Obtaining a prescription for additional pain medication would assist with minimizing the client's discomfort, which is a goal of hospice therapy.

A nurse is working with the state health department to ensure children in the community have health insurance. The nurse should recognize that the caregivers of children who do not have health insurance are more likely to do which of the following? -Attend regular well-child visits -Over-use emergency care services -Obtain treatment for chronic health conditions -Experience lower rates of hospitalization for treatable conditions

Over-use emergency care services The caregivers of children who do not have health insurance are more likely to over-use emergency services for the child's health care.

A nurse is caring for a child who has experienced neglect from a caregiver. Which of the following most accurately describes the caregiver? -Perpetrator of violence -Attentive caregiver -Victim of abuse -At risk for abuse

Perpetrator of violence Perpetrators of violence are individuals who are at risk for causing harm to others.

A nurse is admitting a client whose adult child provides full-time care for them. Which of the following tasks should the nurse anticipate the adult child provides for the client? (Select all that apply.) -Preparing meals -Maintaining safety -Performing procedures -Providing companionship -Bathing and dressing -Making health care decisions

Preparing meals is correct. A caregiver provides basic daily care for a client, including meal preparation and assistance. Maintaining safety is correct. A caregiver assumes the responsibility of creating and promoting safety in the client's environment. Performing procedures is incorrect. A caregiver manages daily care and assists the client, but does not perform procedures, as this is in scope of care for a provider, not a caregiver. Providing companionship is correct. A caregiver provides companionship for a client, since their presence is often the only human contact the client has regularly. Bathing and dressing is correct. Part of the role of a caregiver is assisting the client with daily activities, such as bathing and dressing. Making health care decisions is incorrect.A caregiver may know the client well, and is often in a position, legally or informally, to make medical decisions on behalf of the client.

A nurse is working in the NICU. The nurse should take which of the following actions to advocate for protective factors to prevent abuse for infants and parents in the community? (Select all that apply.) -Present to all the staff the use of IPV screening on the unit. -Provide breastfeeding support for nursing parents. -Teach infant development classes at the local library. -Start a parenting class for expectant partners at the hospital. -Confirm the parent has a well-child visit scheduled for their infant.

Present to all the staff the use of IPV screening on the unit is correct. This is an example of advocacy on community level prevention. Provide breastfeeding support for nursing parents is incorrect. This is a protective factor for individual parents and infants. Teach infant development classes at the local library is correct. This is an example of advocacy on community level prevention. Start a parenting class for expectant partners at the hospital is correct. This is an example of advocacy on community level prevention. Confirm the parent has a well child visit scheduled for their infant is incorrect. This is a protective factor for individual parents and infants.

A nurse and a team of community members are beginning to prioritize the data they have collected. Which of the following is true about prioritization of community-level data? -Prioritization at the community level must focus on needs impacting the community or subpopulations. -Prioritization of community data should be left to formal community leaders, such as a mayor or councilperson. -Prioritization is not important; all community data should be treated equally, and focus should be put on all initiatives in an equal fashion. -Prioritization should focus solely on community needs.

Prioritization at the community level must focus on needs impacting the community or subpopulations. Prioritization at the community level must focus on needs impacting the community or subpopulations. Realistic analysis will look at available resources and the ability to harness existing and further resources to meet initiatives.

A nurse is caring for a client in an emergency department who is being seen for treatment of injuries sustained from their partner. The nurse should take which of the following actions to provide care to this client? (Select all that apply.) -Provide a partner violence crisis number to the client. -Ask the client how they make their partner angry. -Advise the client to leave their partner immediately. -Provide the client with information on healthy relationships. -Provide information on how people may experience abuse in relationships.

Provide a partner violence crisis number to the client is correct. Provide a partner violence crisis number to the client is correct. Provide the client with a crisis number that they can call. Ask the client how they make their partner angry is incorrect. Ask the client how they make their partner angry is incorrect. The client is not responsible for their abusive relationship. Advise the client to leave their partner immediately is incorrect. Advise the client to leave their partner immediately is incorrect. The client should make the decision to report or leave their partner. Provide the client with information on healthy relationships is correct. Provide the client with information on healthy relationships is correct. The nurse provides information on healthy relationships and provides support for the client to make decisions. Provide information on how people may experience abuse in relationships is correct. Provide information on how people may experience abuse in relationships. The nurse supports the client and their decisions on creating their safety plan.

A community health nurse is speaking with an older adult client about methods to reduce the risk of depression. Which of the following is a primary intervention the nurse should include in the teaching? -Provide stress reduction techniques for the client. -Encourage the client to move to a nursing facility. -Request their provider to prescribe an antidepressant. -Offer a mental health support group for the client to attend.

Provide stress reduction techniques for the client. When working with older adult clients who are at an increased risk for depression, primary prevention interventions should be aimed at stopping the disorder before it begins. An example would be to provide stress reduction techniques, so the client is better able to adapt to life's stressors.

A nurse in a newborn nursery is caring for a parent with their first child. The parent shares with the nurse that they were abused as a child. Which of the following are steps the nurse can take to break the possible intergenerational cycle of violence? (Select all that apply.) -Provide the parent with information on parenting classes at their local library. -Refer the parent to a case manager. -Provide information on the location of nutritional services in their local health department. -Follows the usual discharge plan for all parents to assure they have a car seat. -Refer the parent for a visiting nurse program that visits parents and newborns in their community.

Provide the parent with information on parenting classes at their local library is correct. This is an action the nurse can take to promote a positive relationship between the parent and infant. Refer the parent to a case manager is incorrect. This is not appropriate since there are other interventions that promote positive relationships within families. Provide information on the location of nutritional services in their local health department is correct. This is a way to support the parent and child as poverty may contribute to risks of abuse and neglect in communities. Follows the usual discharge plan for all parents to assure they have a car seat is incorrect. This is important for all infants; however, it does not directly address the concern for abuse. Refer the parent for a visiting nurse program that visits parents and newborns in their community is correct. Supportive services in communities are vital for breaking cycles of violence in communities.

A public health nurse is working with a health coalition to address the high rates of preterm birth in their area. The coalition is discussing possible primary prevention techniques that could be implemented. Which of the following interventions is considered a primary prevention strategy to address preterm birth? -Pregnancy nutrition programs aimed at pregnant clients who have gestational diabetes -Public health campaigns that clearly show the public the risks to pregnant clients and the fetus from smoking during pregnancy -Free screenings at prenatal care clinics to help providers identify pregnant clients who are at an increased risk of preterm delivery -Home visitation program for clients placed on bed rest during pregnancy for the prevention of preterm labor

Public health campaigns that clearly show the public the risks to pregnant clients and the fetus from smoking during pregnancy Primary prevention strategies include intervening before any negative health effects and consequences occur.

A family has set goals and action steps for meeting an identified problem. Which of the following steps should the nurse take? (Select all that apply.) -Refer the family to community resources and agencies. -Develop a family-nurse contract. -Review the goals and action steps and change those that do not seem realistic. -Add additional goals and objectives based on what the provider thinks the family needs. -Schedule the family's next visit.

Refer the family to community resources and agencies is correct. This will be an important step in helping the family meet the goals and identified action steps. Develop a family-nurse contract is correct. Developing a family-nurse contract can help the family take an active role in meeting their health outcomes. Review the goals and action steps and change those that do not seem realistic is incorrect. This is not a step the nurse should take without family input. Add additional goals and objectives based on what the provider thinks the family needs is incorrect. Goals and objectives should be driven by the family, not the nurse or provider. Schedule the family's next visit is correct. The nurse should schedule the next visit. Once the goals and action steps have been determined, the next step in the nursing process is for the nurse to evaluate if the goals have been met, and if not, to revise the plan of care with the family.

A public health nurse is educating nursing students about pediatric lead exposure. The teaching has been effective when the nursing students identify which of the following interventions as the most effective method of preventing children from environmental lead exposure? -Home visits to identify sources of lead exposure when a child has elevated lead levels -Administration of lead exposure questionnaires at well-child health care exams -Lead blood screening for children at high risk for lead exposure -Removal of lead from the environment before the child can be exposed

Removal of lead from the environment before the child can be exposed Removal of lead from the environment before a child can be exposed is the most effective way to protect children from harmful long-term effects of lead exposure.

A nurse in a long-term care facility is concerned that residents are showing signs of poor nutrition. What are examples of ways to address environmental factors to prevent neglect of residents? (Select all that apply.) -Review policies on number of staff assigned to clients during mealtime. -Review policies allowing family visits during mealtime. -Review each client's individual meal plan. -Review policies on reporting signs of neglect. -Assess the client's ability to feed themselves.

Review policies on number of staff assigned to clients during mealtime is correct. Policies on client-to-staff ratios are an example of environmental factors that may increase risk of abuse and neglect. Review policies allowing family visits during mealtime is correct. Policies on family visitation hours are an example of environmental factors that may increase risk of abuse and neglect. Review each client's individual meal plan is incorrect. Individual meal plans are at the individual level not at the population level. Review policies on reporting signs of neglect is correct. Policies that allow staff to report potential neglect are an example of environmental factors that may increase risk of abuse and neglect. Assess the client's ability to feed themselves is incorrect. Individuals' abilities are an example of individual risk factors, not environmental factors.

A nurse understands that social determinants contribute to poor health, health disparities, and inequities. Which of the following is an example of a social determinant of health? -Gender -Socio-economic status -Age -Genetic disorder

Socio-economic status Social determinants of health are complex circumstances in which individuals are born and live that affect their health status. They include intangible factors such as education, stress, economic status, environmental factors, nutrition, prejudice, as well as tangible factors such as accessible health care, education systems, safe environmental conditions, well-designed neighborhoods, and availability of nutritious foods.

A nurse is creating a plan of care for a client who has experienced abuse. Which of the following steps should the nurse take when creating the plan? (Select all that apply.) -Takes the lead in deciding what is best for the client -Works with the client to create a plan of care -Respects the client's decision not to call a domestic abuse hotline immediately -Supports the client's decision to incorporate holistic measures in the plan of care -Makes a referral to an agency without the client's consent

Takes the lead in deciding what is best for the client is incorrect. Patient-centered care involves the client in all decisions. Works with the client to create a plan of care is correct. Patient-centered care involves the client in all decisions. Respects the client's decision not to call a domestic abuse hotline immediately is correct. Patient-centered care involves the client in all decisions. Supports the client's decision to incorporate holistic measures in the plan of care is correct. Patient-centered care involves the client in all decisions. Makes a referral to an agency without the client's consent is incorrect. Patient-centered care involves the client in all decisions.

A nurse is assessing a young adult client in the emergency department for abdominal pain. The client is accompanied by an unrelated person. The nurse should identify which of the following signs as a risk for human trafficking? (Select all that apply.) -The accompanying person refuses to leave the room during the assessment and examination. -The client appears fatigued and anxious. -The client states they are traveling and are not sure of the name of the city they are in. -The accompanying person leaves the room for the client to be examined and provides transportation. -The adolescent requests that the unrelated person remain in the room during interviewing and examination.

The accompanying person refuses to leave the room during the assessment and examination is correct. When a client is accompanied by controlling individuals, it is a potential indicator of abuse. The adolescent appears fatigued and anxious is correct. Poor hygiene, untreated medical conditions, sleep deprivation, and fatigue are signs of human trafficking. The adolescent states they are traveling and are not sure of the name of the city they are in is correct. The client being unaware of their current location is a sign of human trafficking. The accompanying person leaves the room for the client to be examined and provides transportation is incorrect. When a client is accompanied by controlling individuals, this is a red flag for abuse. An accompanying person that is not controlling may be further assessed as being a support person. The adolescent requests that the unrelated person remain in the room during interviewing and examination is incorrect. The client request of having the unrelated person remain in the room during interviewing and examination could reveal that the client is comfortable. Therefore, this is not an indication of human trafficking.

A school nurse is caring for an adolescent who has been the victim of cyberbullying. What concerns may the nurse have for the school community? -The child may also be a perpetrator of violence with peers. -This is an isolated event between 2 students that should be handled by the caregivers. -The school may need student education on social media and bullying to encourage students to share when they are victims. -The school nurse does not have control over cyberbullying.

The child may also be a perpetrator of violence with peers. Children who are victims of bullying may bully their peers in turn. Identifying perpetrators is an important step in preventing violence.

A nurse is caring for a client in an acute pediatric unit. The nurse should identify that which of the following most likely puts the child at risk for exposure to violence? -The child's caregiver reports an abusive partner. -The child attends a school that is known for high success. -The neighborhood has stress reduction technique classes for parents at the community center. -The child's sibling has reported bullying at school.

The child's caregiver reports an abusive partner. Children are at risk for exposure to violence when their caregivers are victims of violence.

A home-health nurse is caring for a client in their home. The nurse is concerned that the client may be at risk of neglect. The nurse should identify which of the following as relationship factors that can put the client at an increased risk for neglect? -The client does not receive visits from friends or family. -The client is 80 years of age. -The client lives in a neighborhood with many empty homes. -The client has limited services for food delivery in the city.

The client does not receive visits from friends or family. Positive relationships can help protect clients from abuse and neglect.

A visiting nurse is assessing an older adult client who is living alone in an apartment. The nurse should identify which of the following as a risk for abuse? -The client has back pain from a previous work-related injury. -The client keeps medications on the kitchen table. -The client has unwashed hair and clothing. -The client has prepared meals delivered to their home daily.

The client has unwashed hair and clothing. The nurse should investigate further for possible neglect when finding clients who have poor hygiene.

A nurse is caring for an older adult client and notices bruising on the client's wrists. Which of the following is a concern for the nurse? -The client is a perpetrator of abuse. -The nurse is not concerned since older adults bruise easily. -The client may be experiencing abuse. -The client is not taking care of personal hygiene.

The client may be experiencing abuse. The client may be at risk of abuse. The nurse should further assess the client.

A nurse is collecting data from an adolescent who is pregnant. Which of the following findings represents the greatest risk factor for the client? -The client had their first prenatal visit in the third trimester. -The client has an elevated blood pressure. -The client reports being without housing. -The client has a sexually transmitted infection.

The client reports being without housing. Using the nursing process, the nurse should determine that the client's lack of housing is the greatest risk. Clients without housing are at a greater risk for disease, often cannot meet basic needs, and have shortened life expectancies.

A nurse is discussing care options with the family of an older adult client who has dementia. The family states they will provide care for the client by using available family members. Which of the following family members should the nurse identify as most likely to be the client's full-time caregiver? -The client's grandchild who is a young adult part-time college student -The client's son who who is of middle-age and is currently employed -The client's daughter who who is of middle age and is currently employed -The client's sibling who is of middle age and is currently employed

The client's daughter who who is of middle age and is currently employed Statistical data reveals that women are more likely to become full-time caregivers than males. Other evidence suggest that children of the client are most likely to be caregivers as well.

A nurse in a pediatric clinic is assessing an infant during a well-child visit. The nurse should identify which of the following as a possible sign of child abuse? -The infant's weight and length follow the expected growth curve. -The infant is up to date on immunizations. -The infant has faded bruise marks on their upper arms. -The infant cries when they are held by the nurse.

The infant has faded bruise marks on their upper arms. Unexpected bruises are a possible sign of child abuse.

A nurse is in a newborn nursery in a rural community. The nurse notices new parents are often isolated at home with their newborns. Which is an example of how the nurse can promote prevention of child abuse in the community? -The nurse provides referrals to visiting nurses from the health department. -The nurse asks to review visitation policies for new parents in the hospital. -The nurse establishes a peer-to-peer new parenting class at the local church. -The nurse screens the new parent for partner violence.

The nurse establishes a peer-to-peer new parenting class at the local church. This is a way to build strong relationships in the community. For example, a peer-to-peer program provides the opportunity for new parents to meet other parents for support.

A nurse working in a college health center is caring for a student who experienced sexual assault 1 year ago and is having trouble sleeping. Which of the following would be an appropriate plan of care for the client? -The incident was 1 year ago, so the nurse advises the client to give it time to fade away from memory. -The perpetrator was apprehended, so the nurse advises the client that they have nothing to fear. -The nurse refers the client to a campus support group for those who have experienced violence in their lives. -The nurse refers the client to a counselor for advice on making wise decisions when choosing partners.

The nurse refers the client to a campus support group for those who have experienced violence in their lives. Referring the client to a support group is appropriate if the client is also in agreement with the plan.

A community health nurse is planning to create a partnership within a community for the advancement of community initiatives. The nurse should identify which of the following as an important aspect of this partnership? -A partnership should involve a system in which community leaders dictate policy and community activities to enhance the wealth of a community. -The concept of community as partner recognizes the importance of relying on community health care providers to lead all aspects of community initiatives. -A partnership should be limited to community financial leaders to ensure feasibility of initiatives. -The promotion of health within a community should involve collaborative community efforts from a diverse group of community partners.

The promotion of health within a community should involve collaborative community efforts from a diverse group of community partners. Community efforts should involve a diverse group of community partners.

A school nurse is concerned with safety in the school. The nurse wants to address community risk factors that increase the risk of students experiencing violence. The nurse should identify which of the following as community risk factors for the students? -Students have low academic performance. -The school has known gang groups and graffiti marking territories near the school. -Bullying is common among students in the school. -The school has a peer-to-peer counseling program.

The school has known gang groups and graffiti marking territories near the school. This is an example of a characteristic in the community that puts individuals at risk for exposure to violence.

A nurse working in a labor and delivery unit has been feeling distressed about the work environment due to comments made by their supervisor. Which of the following would be a form of microaggression by the supervisor? (Select all that apply.) -The supervisor remarks that the unit should not hire nurse immigrants. -The supervisor does not allow male nurses to rotate into the unit to provide additional coverage. -The supervisor hires nurses of all races and ethnicities. -The supervisor does not allow the use of interpreters in the labor room for clients who do not speak English. -The supervisor encourages clients who are in labor to have support that reflects their cultural practices of childbirth.

The supervisor remarks that the unit should not hire nurse immigrants is correct. Derogatory comments about ethnic groups is an example of bias. The supervisor does not allow male nurses to rotate into the unit to provide additional coverage is correct. Intentionally keeping men from providing care is an example of gender bias. The supervisor hires nurses of all races and ethnicities is incorrect. An inclusive work environment creates a respectful workplace culture. The supervisor does not allow the use of interpreters in the labor room for clients who do not speak English is correct. Restricting access to interpreters is an example of ethnic bias. The supervisor encourages clients who are in labor to have support that reflects their cultural practices of childbirth is incorrect. Microaggressive behaviors are communications that intentionally or unintentionally direct bias against people of color, ethnic and gender groups.

A nurse is reviewing a client's health record. Which of the following findings should the nurse identify as a risk factor for breast cancer? -Family history of heart disease -Receiving yearly mammograms -Use of hormonal therapy -Participation in aerobic activities three times weekly

Use of hormonal therapy Risk factors for breast cancer include sedentary lifestyle, drinking alcohol, female gender, using birth control or hormone therapy after menopause, not having children or having children after 30, tall stature, family history, exposure to DES.

A nurse manager is preparing an in-service about vulnerable populations for nursing staff. Which of the following information should the nurse include? -Population-based community health nursing interventions are focused only on those individuals who seek health care services. -Childhood poverty does not increase the risk for poorer health across the lifespan. -Pre-existing illness and age are social factors that can lead to vulnerability. -Vulnerable populations experience more adverse health outcomes than the general population.

Vulnerable populations experience more adverse health outcomes than the general population. Vulnerable populations are at a higher risk for poor health outcomes due to several factors including the lack of access to health care, low socioeconomic status, and fewer education and employment opportunities.

A nurse is reviewing community partnerships to help identify resources for families in the community. Which of the following is an example of a community partnership the nurse should expect? -Working with the local news media -Working with elected officials -Creating a blog for community members -Creating a health newsletter for community members

Working with elected officials This is an example of a community partnership. Partnerships can be with elected officials, community leaders, citizens within the community, and various agencies that provide services.