Chapter 30
21. A corrections nurse is visiting a local nursing school to describe this career. Which of the following would the nurse include in the discussion? A) Lower salaries than other fields B) Primarily assessment oriented C) Extensive employee benefits D) Low safety risk
C Feedback: Salaries depend upon the state, although they tend to be higher salaries than in other nursing fields. Moreover, corrections nurses usually receive extensive employee benefits and insurance packages as government employees. Corrections nurses must have good mental health and assessment skills. They must be able to communicate well and be strong nursing advocates and strong advocates for their clients. They work in an intense environment where their safety could be threatened, and they must deal with clients who may be noncompliant, combative, and manipulative. Corrections nurses must also be very flexible and knowledgeable about a variety of nursing specialties.
3. When describing the differences between public health nursing and nursing in general, which of the following would an instructor include as characteristic of public health nursing? Select all that apply. A) Acute care services B) Focus on the greater good C) Seek out of clients in need D) Community commitment E) Health restoration
B, C, D Feedback: Public health nurses focus on the greater good, seek out clients in need, and are committed to the community. Public health nursing is grounded in social justice and focuses on health promotion and disease prevention. Public health nursing does not usually include acute care services or health restoration.
15. A school nurse who is not a nurse practitioner works in an elementary school (K-4) with 1,200 students. Which of the following would the nurse engage in with this group? Select all that apply. A) Screening for scoliosis B) Vision and hearing screening C) Teaching basic health practices D) Monitoring chronic illnesses E) Ordering medications F) Providing primary care
B, C, D Feedback: Vision and hearing screening, teaching basic health practices, and monitoring chronic illnesses are appropriate school nurse activities for children in this age group. Scoliosis screening would be more appropriate for children in their early adolescent growth spurt years, not at this age. A school nurse would not order medications. A school nurse practitioner would provide primary care and if allowed by the state, prescribe medications.
13. Which of the following health conditions would the corrections nurse expect to address as most prevalent? Select all that apply. A) Heart disease B) Tuberculosis C) Hepatitis C D) Asthma E) Substance abuse
B, C, E Feedback: Communicable diseases such as tuberculosis and Hepatitis C are of great concern in the correctional community. In addition, drug abuse by inmates is very high. Heart disease and asthma rates vary.
17. A school nurse is reviewing the population of school age children for chronic conditions. Which of the following would the school nurse expect to find most often? Select all that apply A) Rheumatoid arthritis B) Asthma C) Diabetes D) HIV/AIDS E) Tuberculosis F) Seizures
B, C, F Feedback: The four chronic conditions most often seen in school-age children are asthma, diabetes, seizures, and severe food allergies. Rheumatoid arthritis is not as common. HIV/AIDS and tuberculosis are more commonly seen in correctional settings.
7. A public health nurse is employed by the Indian Health Services. This nurse is working at which of the following levels? A) Local B) Community C) State D) Federal
D Feedback: The Indian Health Service is an agency headed by the Department of Health and Human Services, a federal agency. Thus the nurse would be working at the federal level.
10. A community health nurse is advocating for the development of school-based health centers in the community high schools as a means to accomplish which of the following? A) Maintain the current absentee rate B) Provide contraceptive services C) Increase ready access to health care services D) Promote increased use of emergency services
C Feedback: School-based health centers (SBHC) provide ready access to health care for large numbers of children and adolescents during school hours, reducing absences from school due to health care appointments. SBHCs provide a variety of services in a user-friendly manner at a convenient location. Many SBHCs do not provide contraceptive services on the school site due to school district policy or state law. These centers also are a cost-effective way to decrease visits to the emergency department.
6. After teaching a group of students about the federal agencies involved in public health, the instructor determines that the teaching was successful when the students identify which agency as the main organization that is involved in public health? A) Environmental Protection Agency B) Department of Homeland Security C) Department of Agriculture D) Department of Health and Human Services
D Feedback: The main organization involved with public health is the Department of Health and Human Services (DHHS). Other federal agencies that also impact public health include the Environmental Protection Agency (EPA), the Department of Homeland Security, the Department of Agriculture, the Department of Education, and the Department of Veterans Affairs.
22. A school nurse is addressing the dental health issues of the local community of school children. Which activity would be most appropriate at the community level? A) Educating parents about the importance of oral health B) Teaching children how to brush and floss properly C) Assisting with finding resources for those without dental insurance D) Advocating for the fluoridation of drinking water
D Feedback: At a community level, school nurses can educate the public about the benefits of dental fluoride treatments. They can advocate for fluoridation of drinking water, school-based fluoride rinses or gels, and dental sealant programs. At the classroom level, school nurses can provide dental education and provide toothbrushes, toothpaste, and floss to ensure that students are able to practice good dental hygiene habits. At an individual level, school nurses can assist in finding resources for those with no dental health insurance. Finally, school nurses can successfully educate parents regarding the importance of oral and dental health.
14. A school nurse functions to promote a healthy school environment. Which of the following would be most appropriate for the nurse to do? A) Advocating for proper nutrition and exercise to prevent and reduce the incidence of obesity in school-age children B) Providing care for children with asthma C) Developing individualized health plans D) Engaging in incidental teaching about scoliosis
A Feedback: Promotion of healthful school living emphasizes planning a daily schedule for monitoring healthful classroom experiences, extracurricular activities, school breakfasts and lunches, emotional climate, discipline programs, and teaching methods. It also includes screening, observing, and assessing to identify needs early and report illegal drug use, suspected child abuse, and violations of environmental health standards. Health promotion involves the nurse in supporting the physical, mental, and emotional health of school personnel by being an accessible resource to teachers and staff regarding their own health and safety. Providing asthma care and developing individualized health plans are examples of providing health services. Engaging in incidental teaching reflects the function of health education.
18. A school nurse is providing care to a group of children with severe food allergies. Which of the following would be most important for the nurse to include in the child's plan of care? A) Ensuring that the child has ready available access to EpiPen B) Advising teachers to call the child's parents in case of a reaction C) Teaching other students how to administer the EpiPen D) Administering daily medication to control the allergies
A Feedback: Severe food allergies can lead to anaphylactic shock. School nurses coordinate and work with students and their families, along with school personnel to raise awareness and enlist caution. They also work with families and health care providers to ensure that epinephrine via an autoinjector EpiPen is available for the child in case of emergencies. School nurses also work with teachers and lunch room personnel to alert them of the allergy, explain what can happen in a case of anaphylaxis, and provide training on how to use the EpiPen or other needed medication. Calling the child's parents in case of a reaction would be important but prompt treatment with epinephrine is the priority. Responsible adults, not other children should know how to administer the epinephrine. Daily medication usually is not required for children with food allergies, however, avoidance of the allergen is.
9. A public health nurse working with several communities to develop appropriate programs for health surveillance. Which agency would the nurse contact to obtain information on this topic? A) Centers for Disease Control and Prevention B) National Institutes of Health C) Agency for Health Care Research and Quality D) Food and Drug Administration
A Feedback: The nurse would contact the Centers for Disease Control and Prevention that is responsible for health surveillance and the prevention of disease and bioterrorism. The National Institutes of Health provide medical research. The Agency for Health Care Research and Quality is responsible for research on health care quality and effectiveness. The Food and Drug Administration works to ensure the safety of food, medication, medical procedures, and equipment.
4. Which of the following activities best reflects a public health nurse's role in the public health function of assessment? A) Prioritizing the issues of a community to determine appropriate interventions B) Evaluating for potential safety hazards in a childcare center C) Ensuring that children in a day care center are properly immunized D) Working with officials to develop a program for solving a problem
A Feedback: The public health function of assessment is reflected when a public health nurse identifies the problems in a community and then prioritizes which issue to address first by deciding which issue impacts the most people and what interventions will help the population thrive. Evaluating for potential safety hazards and ensuring proper immunizations reflect the assurance function of public health. Working with officials to develop programs reflects the function of policy development.
8. After teaching a group of students about public health nursing and the U.S. Public Health Service Commissioned Corps, the instructor determines that the students need additional instruction when they state which of the following is necessary to qualify for a position in the Corps? A) Age over 45 years B) Bachelor's degree in nursing C) Valid nursing license D) U.S. citizenship
A Feedback: To qualify as a nurse in the Commissioned Corps, one must be a U.S. citizen, <44 years old, able to pass a physical examination, possess a bachelor's or higher degree from an accredited nursing program, pass the National Council Licensure Examination (NCLEX), and hold a valid nursing license from one of the 50 states, the District of Columbia, Puerto Rico, Guam or the U.S. Virgin Islands.
23. Which of the following would the school nurse who is dealing with a primarily adolescent school population focus on? Select all that apply. A) Substance abuse B) Eating disorders C) Suicide prevention D) Sexual activity E) Dental sealants
A, B, C, D Feedback: Many of the health issues that modern adolescents face are a result of their own choices and high-risk activity; for example, sexual activity, substance abuse, injury, and violence. Eating disorders are most prevalent in adolescent females. Dental sealants are more appropriate for elementary school children.
1. As a guest speaker for a group of community health nurses who are considering corrections nursing as a career, a corrections nurse provides an overview of the history of corrections nursing. Which of the following would the nurse describe as the historic view of corrections nursing? A) Health care to inmates occurred primarily as emergency treatment. B) Inmates were viewed as not deserving care paid by public dollars. C) The emphasis was on corrections, not punishment. D) Prisons provided safe havens from communicable diseases.
B Feedback: Although the correctional system of prisons and jails has been around for a very long time, it historically provided minimal, if any, health care to inmates. Prison was a punishment, and the inmates were viewed as not deserving of care that was being paid for from public dollars. Communicable diseases were and continue to be a major health issue.
20. A corrections nurse is proactively working with the institution to develop programs for the facility to address problems to address the trends for the future. Which type of program would be most appropriate for the nurse to recommend? A) Treatment of typical disorders found in younger inmates B) Dealing with older, sicker, and longer periods of incarceration for many inmates C) Clinics to address acute disease conditions D) Education for release after shorter incarcerations
B Feedback: Typically, inmates are older, sicker, and remain in prison longer than in previous years. Therefore, the nurse would need to develop programs to address older inmates with more chronic illnesses and longer incarcerations.
5. Which one of the following statements best illustrates the similarities and differences between public health nursing and other types of nursing? A) The priorities are the same for both public health nursing and other types of nursing. B) In hospital nursing, nurses must address the issues that come to them. Whereas in public health nursing, it is necessary for the nurse to actively seek out and identify potential problems and situations. C) Nurses whose main practice is in the hospital are required to collaborate more effectively than public health nurses. D) Nurses who work in public health do not use the nursing process as a foundation for their work.
B Feedback: In hospital nursing, nurses must address the issues that come to them. Whereas in public health nursing, it is necessary for the nurse to actively seek out and identify potential problems and situations. The priorities vary for both public health nursing and other types of nursing and certainly within different communities that a public health nurse practices. Nurses who work in public health must collaborate as must nurses who work in the hospital. However, the types of people and agencies that a public health nurse must collaborate with vary from the types of people and agencies that a hospital nurse must collaborate with. Nurses who work in public health use the nursing process as a foundation for their work, just as nurses who work in hospitals do. In public health nursing, the community is the client but the nursing process may also be applied to individuals and families.
19. A corrections nurse is working to develop programs for inmates and reviews the demographics of this population to determine potential issues. Which of the following would the nurse expect to find? A) Greater portion of inmates who are white B) Increasing numbers of women in prisons C) Equal distribution of socioeconomic backgrounds D) Incarceration primarily for commission of minor crimes
B Feedback: Looking at the demographics of inmates, there are many differences from the general population. First, inmates have all committed some type of crime, with nearly half (52%) being violent crimes. National statistics indicate a larger portion of Black (3,042 per 100,000) and Hispanic (1, 261 per 100,000) male inmates than White male inmates (487 per 100,000). Although males are still the majority population (88.6%), trends show an increase in the number of women in state or federal prisons. In addition, the inmate population is drawn disproportionately from lower socioeconomic backgrounds when compared with the general public.
11. Which one of the types of services that may be available in a school-based health center may be controversial and not be supported by all parents and community members? A) On-site sexually transmitted infections testing and treatment B) On-site provision of contraceptives C) Well-child care D) Sick-child care
B Feedback: Many school-based health centers do not provide contraceptive services on the school site because of school district policy or state law.
24. Which one of the following statements about the common roles and functions of public health nurses, school nurses, and corrections nurses is most accurate? A) Emphasis is placed on the treatment of disease and disability. B) Nurses in all of these areas serve the population as client as opposed to individuals as clients. C) All of these specialty nursing fields are paid very well because their setting is supported through public funds. D) Public health nurses can influence the health of vulnerable populations more than any of the other specialties.
B Feedback: Nurses in all of these areas serve the population as client as opposed to individuals as clients. Emphasis is placed on prevention of disease or disability. These community nurses all work in settings that are supported by public funds but the amount of pay varies. All of these specialties of nursing can influence the health of vulnerable populations.
2. A nurse is considering a career in public health nursing. The nurse determines the need to obtain which of the following for entry-level practice? A) Associate's degree in nursing B) Bachelor's degree in nursing C) Master's degree in nursing D) Post-master's degree certification
B Feedback: The American Nurses Association recommends that an entry-level PHN should have a bachelor's degree in nursing. Some states, such as California, require nurses to take additional classes and obtain certification beyond a bachelor's degree if the BSN program does not offer specific content (e.g., child abuse, public health didactic and practicum). PHNs working with specific populations, or in administration, should hold a master's degree. A PHN with a master's degree in community/public health nursing may take a national certification examination offered by the American Nurses Credentialing Center.
12. During a class, an instructor reviews the impact of the Supreme Court decision regarding Estelle v. Gamble. The instructor determines that the students understand the material when they identify which of the following about this decision? A) It created the need for cleaner, less crowded facilities. B) It led to major reforms including establishment of inmates' rights. C) It required the use of managed care organizations for service. D) It mandated care to be provided in a timely fashion.
B Feedback: The Supreme Court ruled that not providing medical services inflicted pain and denied inmates of their Eighth Amendment rights. This decision led to major reforms in the corrections health system. Medical providers were hired and inmates' rights were established. The decision did not address facilities or use of managed care organizations. Treatment in a timely fashion was not part of this decision. However, later lawsuits involve this issue.
16. A school nurse is describing the responsibilities associated with this specialty to a group of students. Which of the following would the school nurse identify as a primary responsibility? A) Providing care to children with special health needs B) Preventing illness among the school community C) Performing health screenings D) Assessing acute health problems
B Feedback: The primary responsibilities of the school nurse are to prevent illness and to promote and maintain the health of the school community. The school nurse serves not only individuals, families, and groups within the context of school health but also the school as an organization and its membership (students and staff) as aggregates. Caring for children with special health needs, performing health screenings, and assessing acute health problems are aspects associated with the primary responsibilities of preventing illness and promoting and maintaining the health of the school community.