week 2 edapts
A school nurse in a rural area noticed an increased number of students complaining of nausea, vomiting, fever, and abdominal pain after lunch. Seven students were sent home to seek medical treatment from a healthcare provider and five more students complained of milder symptoms. One cafeteria worker was found vomiting in the restroom. A caregiver of one child who was sent home called the nurse to report that the child was hospitalized with suspected poisoning of an unknown origin. Which findings should concern the nurse? Select all that apply. A) Students with clinical manifestations B) Employee found vomiting in the restroom C) Students with reports of milder symptoms D) Geographical location of the school E) Hospitalization of a student
A) Students with clinical manifestations B) Employee found vomiting in the restroom C) Students with reports of milder symptoms E) Hospitalization of a student
The client was transferred to the medical-surgical unit after an extended stay in the intensive care unit (ICU) from complications resulting from COVID-19. The client will be discharged to home tomorrow under home health care and will require supplemental oxygen. Which indicates an effective outcome and resolution of the client's condition? A) The client is being discharged. B) The client experienced complications. C) The client's post-discharge medical needs. D) The client was transferred to a step-down unit. E) The client will be cared for by a home health nurse.
A) The client is being discharged.
A nurse's Mantoux test is positive for exposure to tuberculosis (TB). Which conclusion should be drawn by the employer regarding the nurse's test result? A) The nurse has been exposed to tuberculosis. B) The test is inaccurate and needs to be repeated. C) The positive test result is probably due to a problem in the testing process. D) The nurse has tuberculosis.
A) The nurse has been exposed to tuberculosis.
An older adult client with a history of hypertension and type II diabetes is being triaged in the emergency department (ED). He reports he has had a headache, runny nose, lethargy, muscle aches, sweating, and fever for the past 2 days. Today, the client developed a persistent cough that has continued to worsen, which prompted the ED visit. The client states, "I have difficulty catching my breath," when attempting to get up from the couch to go to the bathroom. The client is visibly nervous and asks the nurse, "Do I have that COVID they keep talking about on the television?" The client lives with his spouse of 40 years in a retirement community in a large urban city where the number of COVID-19 cases continues to rise and is uncontrolled. For which issues is the client at risk? Select all that apply. A) Upper respiratory infection B) Pneumothorax C) Influenza D) Pneumonia E) COVID-19
A) Upper respiratory infection C) Influenza D) Pneumonia E) COVID-19
A newspaper published an article stating that an athletic banquet at a local high school had approximately 1,000 members in attendance. Exactly 650 persons became ill within 24 hours, complaining of severe diarrhea, vomiting, and cramping. Which best describes the attack rate? A) 650 per 1000 B) 1000 persons C) 6.5% D) 650 persons
A) 650 per 1000
A community health nurse in a small, rural town recognizes that 95% of the population identifies as Hispanic or Latino. Most families live at or below the poverty level. In this town, the adolescent pregnancy rates are the highest in the state. The community health nurse is planning to conduct health education classes to educate students about teenage pregnancy and sexually transmitted infections (STIs). Which facts are considered assessment findings in the given scenario? Select all that apply. A) 95% identify as Hispanic or Latino B) Adolescent pregnancy rates are the highest in the state C) Small, rural town D) Most live at or below poverty level E) Teenage pregnancy and STI classes
A) 95% identify as Hispanic or Latino B) Adolescent pregnancy rates are the highest in the state C) Small, rural town D) Most live at or below poverty level
The school nurse is evaluating the effectiveness of the intervention. Which outcomes indicate the intervention was successful? Select all that apply. A) A new school policy for outbreak prevention B) A food safety education program started C) Heightened awareness of food safety issues D) No further hospitalizations E) Reduced student attendance the next day
A) A new school policy for outbreak prevention B) A food safety education program started C) Heightened awareness of food safety issues D) No further hospitalizations
A nurse is preparing to administer a vaccine to a client. What is the priority nursing assessment to monitor for when administering vaccinations? A) Anaphylaxis B) Myalgias C) Symptoms of infection D) Pain at the injection site
A) Anaphylaxis
An infant receives a diphtheria, tetanus, and acellular pertussis (DTaP) immunization at a well-baby clinic. The caregiver returns home and calls the clinic to report that the infant has developed swelling and redness at the site of injection. Which intervention should the nurse suggest to the caregiver? A) Apply a cold pack to the injection site B) Monitor the infant for a fever C) Apply a hot pack to the injection site D) Bring the infant back to the clinic
A) Apply a cold pack to the injection site
A community health nurse wants to develop activities and programs for a local community that are aimed at primary level prevention. Which of the following activities or programs should the nurse consider? Select all that apply. A) Cigarette smoking cessation education B) Influenza vaccinations C) Papanicolaou (Pap) tests D) Blood pressure screenings E) Manitoux (PPD) testing F) Prenatal classes
A) Cigarette smoking cessation education B) Influenza vaccinations
An older adult client with a history of hypertension and type II diabetes is being triaged in the emergency department (ED). He reports he has had a headache, runny nose, lethargy, muscle aches, sweating, and fever for the past 2 days. Today, the client developed a persistent cough that has continued to worsen, which prompted the ED visit. The client states, "I have difficulty catching my breath," when attempting to get up from the couch to go to the bathroom. The client is visibly nervous and asks the nurse, "Do I have that COVID they keep talking about on the television?" The client lives with his spouse of 40 years in a retirement community in a large urban city where the number of COVID-19 cases continues to rise and is uncontrolled. Select the findings that require immediate follow-up. Select all that apply. A) Client's medical history B) Client's current social history C) Client's mental status D) Client's difficulty performing activities of daily living (ADLs) E) Client's reports of physical symptoms
A) Client's medical history D) Client's difficulty performing activities of daily living (ADLs) E) Client's reports of physical symptoms
The nurse is preparing to administer a vaccine to a client. For which allergy should the nurse check before injecting the vaccine? A) Egg B) Corn C) Soy D) Wheat
A) Egg
Before establishing an evaluation plan, what information must be created to determine the success of the project? A) Establish observable and measurable objectives B) Determine who will collect the evaluation data C) A clear set of both short-term and long-term goals D) Set up a computer program to analyze the evaluation data
A) Establish observable and measurable objectives
A client develops a vaginal yeast infection after being treated with antibiotics for strep throat. Which component(s) of the epidemiological triangle is primarily responsible? A) Interaction of agent and host B) Agent C) Host D) Environment
A) Interaction of agent and host
Which vaccines are contraindicated during pregnancy? Select all that apply. A) Measles, Mumps, Rubella (MMR) B) Tetanus, Diphtheria, and Pertussis (Tdap) C) Zoster D) Varicella E) Influenza vaccine
A) Measles, Mumps, Rubella (MMR) C) Zoster D) Varicella
Which clients are the focus of care for public health nursing? Select all that apply. A) Populations B) Aggregates C) Families D) Individuals E) Communities
A) Populations B) Aggregates E) Communities
A nurse is preparing to administer a live vaccine to a client. The nurse knows that live vaccines are contraindicated if a client has which conditions? Select all that apply. A) Pregnancy B) Moderate or severe acute illness C) Allergy to a vaccine component D) Use of aerosolized steroids E) Immunosuppression
A) Pregnancy B) Moderate or severe acute illness C) Allergy to a vaccine component E) Immunosuppression
Which actions are core public health functions? Select all that apply. A) Promoting the development of health policy B) Providing personal health services for all community residents C) Investigating health hazards within a community D) Assuring community residents that health services are equally accessible E) Assessing the health status of a community
A) Promoting the development of health policy C) Investigating health hazards within a community D) Assuring community residents that health services are equally accessible E) Assessing the health status of a community
What is the primary goal of public health nursing? A) Promotion of quality of life B) Illness-oriented care C) Care of families D) Care of high-risk populations
A) Promotion of quality of life
Which activities reflect the public health essentials for which a public health nurse is responsible to implement? Select all that apply. A) Serves on a community coalition to address the needs of persons with diabetes in the community B) Educates individual clients on asthma prevention at a local health clinic C) Identifies population-focused needs among the clients within their jurisdiction D) Collaborates with a local health system to offer health services in an underserved population E) Mobilizes community faith-based institutions to establish a volunteer transportation program
A) Serves on a community coalition to address the needs of persons with diabetes in the community C) Identifies population-focused needs among the clients within their jurisdiction D) Collaborates with a local health system to offer health services in an underserved population E) Mobilizes community faith-based institutions to establish a volunteer transportation program
HOST
Age Genetics Occupation
A client is using a primary prevention strategy to avoid getting an infectious disease. Which of the following actions is the client most likely to take? A) A client receives a tetanus booster after stepping on a nail. B) A client receives tetanus immunoglobulin after stepping on a nail. C) A client receives a tetanus booster every 10 years. D) A client with tetanus is given antibiotics and placed on seizure precautions.
C) A client receives a tetanus booster every 10 years.
Which scenario represents a major ethical and legal issue for all community/public health care professionals? A) Ensuring total compliance by clients to their treatment regimens. B) Allowing human immunodeficiency virus (HIV) carriers, even if licensed professionals, to be employed within health care agencies. C) Balancing individual autonomy against community protection D) Providing home care versus insisting that the client come to the clinic.
C) Balancing individual autonomy against community protection
Which best describes the primary focus of healthcare efforts in the United States? A) Diarrhea and starvation B) Acute illnesses and trauma C) Chronic diseases D) Infectious diseases
C) Chronic diseases
What is the first action that should be taken by the nurse before planning intervention for a specific disease in the community? A) Determine the available resources for intervention. B) Analyze whether the disease is a priority to the nurse's agency. C) Compare the current rate with the previous rate of the disease. D) Share the findings with leadership within the public health department.
C) Compare the current rate with the previous rate of the disease.
Which example best represents effective primary prevention? A) Engaging in breast self-examination (women) or testicular self-examination (men) B) Following up on any positive screening test C) Immunization according to the recommended schedule D) Attending a free community screening
C) Immunization according to the recommended schedule
After considering potential solutions to the outbreak at the school, the nurse decided to send all affected persons with clinical manifestations home. The nurse's decision making met which one of the following public health actions and interventions? A) Early identification of the problem B) Education C) Prevention and control D) Prophylaxis
C) Prevention and control
A case of severe acute respiratory syndrome (SARS) was diagnosed based on signs of illness at a tourist site in China. Which priority action should be taken to prevent the spread of this illness and protect the tourism revenue that supports the Chinese economy? A) Close the airports and refuse to let tourists in the area leave. B) Begin to immunize everyone in the immediate area with protective vaccine as soon as possible. C) Quarantine the ill person and use isolation techniques when providing care. D) Screen everyone in the area by requiring a blood and urine sample.
C) Quarantine the ill person and use isolation techniques when providing care.
A local health department nurse noticed an increase in the number of clients being treated for a sexually transmitted infection (STI). Which is the first step in preventing the further spread of an STI? A) Having a citywide free screening program in all high schools and colleges B) Providing public education about safe sex, from abstinence to monogamous relationships C) Treating each infected person with the appropriate pharmaceutical agent D) Requiring public facilities to sanitize all restrooms with a stronger, more effective agent
C) Treating each infected person with the appropriate pharmaceutical agent
Mortality
Death
Understanding VS Not Understanding A) "The vaccine could have prevented this." B) "I can take the Norco pill and the Tylenol pill at the same time." C) "Anyone over 50 should get the vaccine, which includes my spouse" D) "I can take colloidal oatmeal baths to help with the itching."
UNDERSTAND C, D NOT UNDERSTAND A, B
Direct Contact
infectious mononucleosis sexually transmitted infections
Essential or Nonessential: A) Abstinence B) Birth Control C) Child Support D) Physical Health E) Mental Health F) Women, Infants and children Programs
ESSENTIAL A, B, D, E NONESSENTIAL C, F
Manifestations of Pneumococcal Disease
Fever Chest pain
Manifestations of Herpes Zoster
Fever Headache Painful rash
Manifestations of Hepatitis A
Fever Jaundice Dark colored urine
Manifestations of Meningococcal Disease
Fever Photophobia Headache
Vector Borne
Lyme disease Malaria
Places where pathogens live and multiply. It may be a human, another animal, or part of the environment, such as water or food supply.
Reservoir
Identification of risk factors and diseases in their earliest stages
Screening
Describes and monitors health events through a systematic process
Surveillance
Choose underlined assessment findings that require follow up by the nurse. An elderly client wishes to be seen for a painful rash on the abdomen. Client reports a loss of appetite for the last 4 days, abdominal discomfort, and increased frequency of diarrhea. Client is accompanied by their spouse. Vital signs: T 100.9ºF P96 RR 16 BP 114/78.
painful rash loss of appetite abdominal discomfort, increased frequency of diarrhea T 100.9ºF
A nurse is educating a client on vaccines. The nurse knows that the client understands the education when the client makes which statement? A) "I will not get the flu if I get the flu shot." B) "The influenza vaccination gives me acquired immunity to the flu." C) "The flu can be treated with antibiotics." D) "If I am pregnant, I should not get the flu vaccine."
B) "The influenza vaccination gives me acquired immunity to the flu."
What best defines an aggregate? A) A collection of individuals and families B) A group of persons who share one or more characteristics C) A large group of persons D) Another name for demographic group
B) A group of persons who share one or more characteristics
A nurse has determined that there is always a consistent level of people in the population who experience pneumonia. Which term best describes the occurrence of this disease? A) Epidemic B) Endemic C) Pandemic D) Prevalent
B) Endemic
Which infectious disease intervention best represents the use of secondary prevention? A) Healthcare workers are encouraged to receive annual vaccinations for influenza. B) Healthcare workers are required to have a tuberculosis (TB) skin test or chest x-ray. C) Clients with human immunodeficiency virus (HIV) infection are encouraged to use condoms to protect sexual partners. D) Clients with human immunodeficiency virus (HIV) infection are given medications to improve immunological response.
B) Healthcare workers are required to have a tuberculosis (TB) skin test or chest x-ray.
Which items are core functions unique to community health/public health nursing? Select all that apply. A) Collaborating and cooperating with other health care team members B) Incorporating epidemiological approaches throughout the nursing process C) Gathering appropriate comprehensive assessment data on the community D) Being willing to travel to give care in an appropriate setting E) Keeping accurate and detailed medical records on care given F) Being willing to contribute to state public health policy development
B) Incorporating epidemiological approaches throughout the nursing process C) Gathering appropriate comprehensive assessment data on the community F) Being willing to contribute to state public health policy development
A caregiver wanted to get her child vaccinated against measles. When the caregiver read the Vaccine Information Sheet (VIS) noting the risks and benefits, the caregiver decided against vaccination. The child is the only one in the class who did not get immunized. What is the likelihood of the child getting measles in school? A) Fairly low, as measles usually hits in late adolescence now. B) Low, as most of the child's playmates have been immunized. C) Very high without the protection of immunization. D) Fairly high, as there is no way to prevent being exposed to measles during childhood.
B) Low, as most of the child's playmates have been immunized.
Which actions are consistent with the key principles of public health nursing? Select all that apply. A) Focusing on the individual and family in the delivery of sick care B) Mobilizing community resources for health action C) Assisting high-risk pregnant clients with access to prenatal care D) Facilitating a safety fair in the community for fire safety and fire detectors E) Assuring a community safety net exists for poor populations
B) Mobilizing community resources for health action C) Assisting high-risk pregnant clients with access to prenatal care D) Facilitating a safety fair in the community for fire safety and fire detectors E) Assuring a community safety net exists for poor populations
Which best describes why clinical areas are so careful to ensure sanitization of surfaces and equipment between each client visit? A) To provide a clean environment for clients and staff B) To decrease transmission by fomites C) To decrease transmission by vectors D) To avoid direct client-to-client transmission of infection
B) To decrease transmission by fomites
Which issues are included under the One Health approach? Select all that apply. A) Acute illnesses B) Vector-borne diseases C) Zoonotic diseases D) Environmental contamination E) Antibiotic resistance F) Occupational health
B) Vector-borne diseases C) Zoonotic diseases D) Environmental contamination E) Antibiotic resistance F) Occupational health
Statistics collected in the first quarter of the year demonstrate that there are repeatedly more cases of a disease in one neighborhood. What is a likely explanation for a single neighborhood having such a different pattern of illness? A) The time of year the statistics were collected throughout the city B) The geographical location of the neighborhood within the city C) A statistical coincidence without meaning D) A cultural or ethnic concentration in the neighborhood
D) A cultural or ethnic concentration in the neighborhood
Which activity demonstrates public health nursing and population-based nursing care? A) Providing first aid in a school setting B) Giving an insulin injection to a newly diagnosed diabetic client C) Educating the caregivers of a child with developmental disabilities D) Conducting health screening for hypertension at a health fair
D) Conducting health screening for hypertension at a health fair
The rate of new cases of diabetes and the rate of new cases of flu during the month of February are the same. Which disease has the higher prevalence rate? A) Diabetes has a higher prevalence rate because recovery from the flu can take longer in this population. B) Flu has a higher prevalence rate because it is very contagious. C) Flu has a higher prevalence rate because people can get the flu more than once in one season. D) Diabetes has a higher prevalence rate because it is a chronic condition.
D) Diabetes has a higher prevalence rate because it is a chronic condition.
A caregiver brings their 4-month-old infant to a well-baby clinic for immunizations. The infant is up-to-date with the immunization schedule. The nurse should prepare to administer which immunizations to this infant? A) Measles Mumps, Rubella (MMR); Haemophilus influenzae Type B (Hib); Diphtheria, Tetanus, acellular Pertussis (DTaP) B) Diphtheria, Tetanus, acellular Pertussis (DTaP); Measles, Mumps, rubella (MMR); Inactivated Poliovirus vaccine (IPV) C) Varicella, hepatitis B vaccine (HepB) D) Diphtheria, Tetanus, acellular Pertussis (DTaP); Haemophilus influenzae Type B (Hib); Inactivated Poliovirus vaccine (IPV); pneumococcal vaccine (PCV); rotavirus vaccine (RV)
D) Diphtheria, Tetanus, acellular Pertussis (DTaP); Haemophilus influenzae Type B (Hib); Inactivated Poliovirus vaccine (IPV); pneumococcal vaccine (PCV); rotavirus vaccine (RV)
Environment
Geography Water supply Access to healthcare Poverty
Qualities such as general health status, personal behaviors, and immunization status will determine if the host will develop an infection.
Host Susceptibility
Indicated or contraindicate? A) Remove the ill food handler B) Close the school C) Communicate with the families of the students D) Decontaminate the school cafeteria E) Provide an alternative meal for affected students
INDICATED A, C, D CONTRAINDICATED B, E
Indicated vs Contraindicated? A) Request an order for airborne contact isolation B) Monitor temperature C) Monitor urine output D) Request a prescription for Shingrix
INDICATED B, C CONTRAINDICATED A, D
Agent
Illegal Drugs Toxins Viruses Bacteria
Morbidity
Illness
Occurrence of new cases of a disease
Incidence
Examples are prions, viruses, bacteria, fungi, or protozoa. They act differently from one another, depending on their characteristics and how they interact with their human hosts.
Infectious Agent
A community health nurse in a small, rural town recognizes that 95% of the population identifies as Hispanic or Latino. Most families live at or below the poverty level. In this town, the adolescent pregnancy rates are the highest in the state. The community health nurse is planning to conduct health education classes to educate students about teenage pregnancy and sexually transmitted infections (STIs). Complete the following sentence: The community health nurse should address the ______ followed by the ______
Language preferences location for classes.
Airborne
Measles
It can be either direct or indirect contact.
Mode of transmission
Course of a disease over time from onset to resolution
Natural life history
Places where pathogens can enter their hosts: respiratory passages, gastrointestinal tract, mucous membranes, genitourinary tract, eyes, blood vessels, or skin.
Portal of entry
Places where the pathogens exit their hosts: respiratory secretions (coughing or sneeze droplets), feces, blood, semen, vaginal secretions, saliva and emesis, and skin lesion exudates (draining wounds).
Portal of exit
Number of all cases of a specific disease in a population at a given point in time
Prevalence
A school nurse in a rural area noticed an increased number of students complaining of nausea, vomiting, fever, and abdominal pain after lunch. Seven students were sent home to seek medical treatment from a healthcare provider and five more students complained of milder symptoms. One cafeteria worker was found vomiting in the restroom. A caregiver of one child who was sent home called the nurse to report that the child was hospitalized with suspected poisoning of an unknown origin. Indicate whether the school nurse should consider each factor relevant or irrelevant to investigating an outbreak in a school. A) Increased number of cases B) Illnesses outside of the school C) Possible exposure routes of pathogens D) Potential zoonotic or human component E) Weather and climate changes F) More severe disease progression
RELEVANT A, C, D, F IRRELEVANT B, E
