Chapters 14-32

a,b,d

Many nurses enjoy the independence and creativity of being among the few professional caregivers in a rural community. What might be a problem in this situation? (Select all that apply.) a. Feelings of being alone and isolated b. Feelings of being overwhelmed with responsibility c. Absence of physicians to delegate the nurses responsibilities d. Absence of professional colleagues to offer support and consultation e. Difficulty in accessing resources when questions arise f. Standards of practice that are different in rural settings

b

An 18-year-old adolescent learns that she is pregnant. She knows her choices are abortion, adoption, or keeping her newborn. Statistically, she is more likely to a. Abort the products of conception. b. Keep her newborn. c. Marry the father and make a mutual decision. d. Put her infant up for adoption.

a,b,c,f

A community/public health nurse is providing care for the mentally ill. Of the following needs that the nurse can help the client meet, which are most important? (Select all that apply.) a. Access to medications b. Basic life necessities c. Integration of provided services d. Funding for care e. Options for day treatment f. Support for family members

d,e,f

A 15-year-old girl came to the free clinic for care as she had become sexually active some time ago and decided she needed to obtain appropriate health care. What care can the clinic probably give to her without involving her parents? (Select all that apply.) a. An abortion if that is her decision b. Antibiotics for a skin infection from scratching her acne c. Birth control pills or Depo-Provera d. Pap smear and routine gynecologic care e. Pregnancy tests and prenatal care if she is pregnant f. Diagnosis of and treatment for any sexually transmitted disease (STD)

a.

A 15-year-old mother was living with her parents, who supported her and her newborn child. She held the baby while the first series of immunizations was given to the infant. However, when it was time for her own tetanus shot booster, there was a problem. What might have been the problem? a. Although she can consent to her newborns care, she needs parental consent for her own. b. The young mother could not have an immunization while breast-feeding a baby. c. The young mother should not have an immunization until she has had her postpartum checkup. d. The period after childbirth is an inappropriate time for a new mother to receive an immunization.

c

A community/public health nurse caring for mental health patients in the late 1990s noticed changes in the services that were available for this population. What led to these changes? a. Communities began banding together to demand increased funding from the federal budget. b. Psychiatrists were given some power to speak for their patients about services necessary to facilitate their recovery. c. Psychiatric patients and their families organized and became involved in policy development. d. States convinced the federal government that they could not cope with the demands of this population.

d

A community/public health nurse has been having difficulty interacting with a family with multiple problems and has asked the agency supervisor for advice. Which of the following actions will most likely be suggested? a. Exchange caseloads with another nurse at periodic intervals to obtain fresh insight. b. Reassure the family that things will eventually be alright. c. Help the family recognize how they are responsible for their own problems. d. Recognize that the family has potential for improvement.

d

A community/public health nurse has contacted her legislator to discuss a bill that would enact the provisions of Timothys Law in the state where she lives. Which of the following statements would the nurse most likely make during this conversation? a. Timothys Law suggests that foster care is often the only workable approach to children in trouble. b. Timothys Law encourages an increase in the amount of support and counseling available in schools. c. Timothys Law demonstrates how helpful it is for families to have insurance coverage. d. Timothys Law shows off the success of local collaboration to address the inequities in mental health coverage.

a

A community/public health nurse implemented a home visiting program with a teenage mother and child from the prenatal period through the childs second birthday. Which of the following long-term effects would be most likely? a. The program assisted this child in becoming a well-adjusted young adult. b. The cost of this program was too high for it to be continued for other children. c. The program was too short to have any lasting effects that could be measured. d. The support from a nurse was insufficient to create long-term improvements.

b,d

A community/public health nurse is assessing a family who is experiencing multiple problems. Which of the following observations is the nurse most likely to make if the family is experiencing a disturbance in internal dynamics? (Select all that apply.) a. The family adapts to changing situations and problems. b. Communication is indirect and sometimes inconsistent. c. Family myths and secrets are shared among family members. d. Achievement of tasks for the developmental stage is difficult. e. Parental roles and functions are shared among the various family members. f. Values are established and modifiable.

a

A community/public health nurse is caring for a family in poverty, who has stated that the nurses visits cause them increased stress. Which of the following assumptions has the family made about health care providers? a. That health care providers blame the family for their problems b. That health care providers expect the family to know about available resources c. That health care providers plan for the short term and do not recognize long-term needs d. That health care providers wait for the family to decide what should be done

a

A community/public health nurse is completing a home visit with a new teenage mother and her infant. Which of the following observations should the nurse make? a. Evidence of adequate maternal and infant bonding b. Evidence that the grandmother is taking over care of the infant c. Evidence that the mother has applied for assistance programs d. Evidence of adequate involvement by the father

d,e

A community/public health nurse is developing programming for the community to reduce adolescent sexual activity and teenage pregnancy. Which of the following options would be the most appropriate? (Select all that apply.) a. A signed commitment to delay sexual intercourse until marriage (virgin pledges) b. Off-site abstinence program c. On-site (at the school) abstinence program d. The Care for Your Egg family-life program e. School-based clinics with comprehensive services f. Teenage mothersgrandmothers program

c

A community/public health nurse is visiting a new teenaged mother in her home. As the teenage mother walked into the room, the babys grandmother stated, This whole thing is your fault. Why are you still in this house? The teenager walked out the front door with her baby. Which of the following reasons explains why the grandmother would say such a thing to her teenage daughter? a. The teenager created the problem; therefore, she should be the one to cope with it. b. The grandmother is jealous that the teenager is young and lacks responsibility. c. The use of scapegoating is an attempt to decrease overwhelming anxiety. d. The fight had begun earlier, and the nurse just witnessed a part of the conversation.

d

A community/public health nurse links a mental health client with the necessary services in the community. This is an example of which category of individual client-focused interventions? a. Consulting b. Teaching c. Providing therapy d. Case management

d

A community/public health nurse providing care for the mentally ill in the 1980s had difficulty finding funds to provide care for her clients. What was the end result of this lack of funding? a. Many of the mentally ill died from lack of care and basic life necessities. b. Most of the mentally ill returned to the large state institutions. c. New, more progressive, modern state institutions were designed, built, and included community-based services. d. Severely disabled clients remained in state institutions, and the less disabled clients used the services of community mental health centers.

a,e,f

A community/public health nurse was caring for mentally ill clients in the community during the 1960s. Which of the following changes in the community was the nurse likely to notice? (Select all that apply.) a. Communities resented becoming dumping grounds for such severely ill people. b. Community health centers were rapidly built, staffed, and prepared to provide appropriate care. c. Families were relieved that they did not have to travel so far to visit their ill family member. d. Housing units were quickly built for the patients capable of independent living. e. Psychiatric patients were feared, mocked, and stigmatized and found life outside frightening. f. Without adequate financial support, patients were admitted for crisis care but were quickly discharged.

a

A community/public health nurse working in the late 1960s saw an increase in the number of psychiatric patients who were being cared for in the community. What was the reason for this increase? a. Phenothiazine drugs such as chlorpromazine had been discovered. b. Lobbyists had demanded closure of state psychiatric hospitals. c. State funding encouraged the establishment of community mental health centers. d. Community-based therapy was found to be effective at controlling psychiatric symptoms.

a

A community/public health nurse would like to implement a secondary prevention strategy within the community to meet the needs of the families caring for members with mental illness. Which of the following interventions would the nurse be most likely to complete? a. Providing counseling services for the family members b. Offering mental health consultation services to businesses in which family members are employed c. Developing discharge planning instructions for the family members d. Advocating within the political arena for the rights of the family members

c.

A family nurse practitioner is employed in a rural health clinic. What generalization would the practitioner most likely be able to make about the local clients? a. They carefully budget their money in order to afford health insurance. b. They define health as self-actualization of potential. c. They are fatalistic and oriented to the land, nature, and the seasons. d. They are open to sharing their problems and accepting my advice.

d

A home care client suffering from cancer asked the home care nurse if he could be referred to hospice, considering his diagnosis. How should the nurse respond? a. Certainly, since you are going to die regardless of what we do. b. If you and your physician agree to keep you comfortable while battling the cancer, your doctor can refer you. c. If you are sure you will die within the next 6 months and no longer want a physicians care, I will be happy to make the referral to hospice. d. For your physician to refer you to hospice, you need to decide to concentrate on enjoying life and staying comfortable rather than treating your cancer.

a

A home care client was no longer eligible for insurance reimbursement of needed home care. What is the appropriate action for the nurse to take next? a. Providing care until the client can be transferred to a different agency b. Explaining that care is not free and that the nurse will not be returning c. Consulting with the public health department so that the client will receive free services d. Referring the client to social services for assistance

a,f

A home care nurse is caring for an adult client who has an infectious disease. What measures should the nurse tell the clients family members to take to protect themselves from the disease? (Select all that apply.) a. Use protective barriers to prevent exposure to blood and other body fluids. b. Body substances should be put in the toilet along with 1 cup of bleach each time the toilet is flushed. c. Keep young children out of direct contact with the client. d. Soiled dressings should be thrown in a trash can labeled Hazardous Waste. e. Use disposable dishes when serving the client his food. f. Wash hands frequently.

b

A home care nurse is going to a clients home to admit the client for home care services. What should the nurses priority action be during the admission visit? a. Complete the Outcomes Assessment and Information Set (OASIS) form for the Centers for Medicare and Medicaid Services (CMS). b. Discuss the availability of financial resources or eligibility for a third-party payer. c. Inform the client of his or her responsibility to follow the plan of care to continue receiving services. d. Set up the equipment for the computer to relay data between the nurse and the client.

d

A home care nurse was discussing her day with a nursing colleague who worked in acute care at the nearby metropolitan hospital. You have it easy, said the home care nurse. You never have to . . . . Complete the home care nurses sentence accurately. a. Remember to take exactly what you need with you on the visit. b. Spend hours every day documenting everything you did. c. Worry about whether your client will recover. d. Worry about who is going to pay for services or the rules of that payer.

b

A home care nurse was scheduled to attend a Medicare case conference for a client who was receiving care from the nurse and a physical therapist. What was the probable reason why the case conference was scheduled? a. It offers an opportunity for the financial officer to evaluate the nurse and the physical therapist, as well as the appropriateness of care being given. b. Medicare mandates a case conference every 60 days to coordinate care. c. The home care staff was providing inadequate care and needed additional staff in-services. d. Data could be collected and reported to the primary physician to ensure continued reimbursement for the physician.

a

A home health nurse did not know what to do when a family was home but did not invite the nurse in. Which of the following actions should the nurse take? a. Leave a note saying the nurse would come back, and return as stated in the note. b. Give care to someone who wants nursing care services. c. Report the incident to the agency supervisor and ask to be reassigned elsewhere. d. Stay for awhile; the family might change their mind and let the nurse in.

a

A home health nurse felt overwhelmed and asked to be assigned to a better neighborhood. Why would the agency supervisor decline to change the nurses assignment? a. Although the nurse is just beginning to assess the families, the nurses continued efforts to visit and support the families will be therapeutic. b. Lots of nurses are willing to work in nice neighborhoods; most agencies need nurses who are willing to work in poor, needy neighborhoods. c. The nurse had signed a contract and must work where assigned, regardless of personal feelings. d. The nurse is capable of learning about how to improve interactions with these families and will do better with experience.

d

A home health nurse was competent and efficient, and yet a client simply was not ready to be discharged from care, although the clients date of discharge had now expired. What will happen to the client now that the original assessment and plan of care suggested that the client be discharged? a. A different nurse can begin again with assessment and planning in preparation for an appeal of discontinuation of financial reimbursement. b. The nurses original assessment and plan were inaccurate, so a correction has to be filed to justify continued financial reimbursement. c. The client will be discharged as planned and will have to depend on family or friends for assistance. d. The client will continue to receive care as needed, and the agency will suffer a financial loss.

b

A home health nurse was visiting an assigned multiproblem family. The grandmother welcomed her in. Two toddlers were playing on the floor, but none of the other adults was present. Which of the following actions should the nurse take? a. Complete a developmental assessment on the two toddlers playing on the floor. b. Focus on interacting with the grandmother, who is caring for the toddlers. c. Refuse to stay because none of the other adults were present. d. Spend the majority of time discussing the need for interaction with the toddlers.

a,c

A local community hospital that is highly valued by its community has just announced that it will be closing within the next year. What would be the most anticipated reason for its closure? (Select all that apply.) a. The departure of a health care provider resulted in an inadequate number of providers to staff the hospital. b. Clinics and home care are being used more so that there is no need for a hospital in the community. c. Large care networks have purchased the hospital but have found it unprofitable. d. Most residents prefer to access the specialized services available in the large city nearby. e. It is too expensive for the hospital to meet the new magnet hospital standards. f. Nurses have demanded a salary increase, which they feel is necessary because of their multiple responsibilities.

c

A nurse is working with nonprofessional staff in the school setting. Which of the following actions is important for the nurse to take? a. Writing grants for funds to support the use of nonprofessional staff in the school b. Engaging in political action to educate legislators about the need for funding for school health c. Keeping records that document training and ongoing evaluation of the nonprofessional staff d. Providing direct care services as needed for the children and staff in the school system

b

A nurse knew that the home health agency had been accredited by the Community Health Accreditation Program (CHAP). What will be the agencys status in relation to required Medicare visits and self-study? a. The agency will have difficulties because Medicare reimburses only agencies accredited by the Joint Commission. b. The agency will have deemed status as accreditation standards are more rigorous than Medicare criteria. c. The agency will need to demonstrate evidence of achieving positive outcomes in order to receive Medicare reimbursement. d. The agency will need to engage in another self-evaluation and submit to Medicare peer review site visits.

b.

A new family nurse practitioner at the rural health clinic soon saw much strength in the community. What might be some resources used and accepted by ill people in a rural area? a. Charity efforts that are publicized and coordinated by members of the nearby city b. Family and friends who volunteer to help with food, cleaning, child care, and other tasks c. Use of the extended-care facility in the community until the ill person feels better d. Care that is coordinated by social services and the public health agency

d.

A new female family nurse practitioner employed at the rural health clinic became very frustrated. What might be cause for complaint? a. I cant survive on this salary with the high cost of living here! b. I make this incredible salary, but there is nowhere here to spend it. c. The men seem to make all the health decisions. d. The clients keep asking me when Im going to get married.

a

A nurse believed that it would be unprofessional to continue in a role that had become intolerable and left the community/public health area to work in acute care. Which of the following actions should the nurse continue to perform? a. Advocate for health legislation and funding supportive of families and professional nursing. b. Encourage new graduates to enter the community/public health nursing area of practice. c. Send cards and small gifts to the staff at the nurses former agency. d. Write letters to the newspaper editorial page describing the heroism of the agencys nurses in their ongoing endeavors against great odds.

b

A nurse encourages a pregnant teenager to attend a prenatal clinic. This an important nursing intervention because pregnant teenagers are more likely to a. Need adoption counseling. b. Have poor nutrition and lifestyle habits. c. Ignore their pregnancy. d. Have gestational diabetes.

b

A nurse is admitting a client to home care services, using Medicare as the funding source for the care that will be provided. Which of the following substantiated findings would make a client ineligible for these services? a. Care is needed from both a nurse and a physical therapist. b. Care is needed 24 hours a day on an ongoing basis. c. The client is incapable of leaving the home. d. None of these; the requested care seems reasonable and medically necessary.

d.

A nurse is employed in a rural area. What might be a dismaying reality about this setting of nursing practice? a. Cultural values require clients to refuse pain relief medications. b. Farmers have to visit care providers when not busy in the fields. c. Rural residents have a tendency to use folk healers instead of scientific care providers. d. There is no off duty because everyone feels free to request information or service any time.

b

A nurse is planning care for multiproblem families. Which of the following is the most important action for the nurse to take? a. Bring another nurse along to assist. b. Keep goals concrete, realistic, and mutually desired. c. List all needs to be addressed in a systematic, organized manner. d. Plan for longer-than-normal visits.

b.

A nurse is working in a rural health clinic. Which of the following situations may cause difficulties in maintaining confidentiality at the clinic? a. Neighbors care about each other and will ask the nurse questions. b. Neighbors recognize each others cars in the clinic parking lot. c. The nurse will want to share information in a quest to seek assistance for the client. d. The nurse will have to use names in referring clients to other agencies for assistance.

c

A nurse was creating health education units to be taught in the community high school. Which unit would be most helpful to adolescents, their teachers, and the community as a whole? a. First aid and preparedness in case of natural disasters b. Healthy lifestyles with an emphasis on the need for physical activity c. Signs of depression and suicide and ways of helping someone at risk for suicide d. Sex education about subjects ranging from abstinence to avoiding pregnancy and sexually transmitted diseases (STDs) among teenagers who are sexually active

d

A nurse was told that the home health nursing agency had just been accredited by the Community Health Accreditation Program (CHAP). Among other requirements, what has the agency probably just completed? a. A review of policies and procedures from other similar agencies b. A walk-through assessment of the agency c. Certification of the staff of the agency d. A thorough self-evaluation

d

A patient asks the community/public health nurse why there has been an increase in the number of self-help programs in the community. What was one factor that led to the popularity of these programs? a. Community mental health centers wanted to avoid paying professionals to work as counselors. b. Families were unhappy with professional care and helped their family members to do it yourself. c. There was a lack of professionals available to fulfill these needed responsibilities. d. Patients chose to do this to give their lives meaning by making a difference to someone else through giving as well as receiving.

b,c,e

A pregnant teenage girl is considering abortion. Which of the following are reasons why she may choose abortion? (Select all that apply.) a. She believes that being pregnant will ruin her figure and no one will want to date her. b. She cannot afford a child now. c. She cannot trust the father to support her and the baby. d. She does not want anyone to know that she is pregnant. e. She believes that she is too young to be a mother. f. She believes that her parents will not support her if they find out that she is pregnant.

a

A pregnant teenager tells the community/public health nurse that the babys father is very involved in her pregnancy, but she wonders if this will continue in the future. Which of the following best describes the most likely involvement by teenage fathers? a. Fathers are involved through delivery, but then the relationship dissipates. b. Fathers are not involved with the mother once the pregnancy is known. c. Fathers contribute financially to the childs upbringing as much as they are able. d. Fathers remain involved with the mother and her infant for several years.

a.

A program to recruit advanced-practice nurses to practice in a rural community is being developed. The program developers have applied to receive federal training monies to help fund the costs of the program. Which of the following questions must be addressed when they apply for these funds? a. Does the health of the clients improve as a result of interventions? b. Have professional schools increased enrollment? c. Are advanced-practice nurses taught to embrace rural cultural values? d. Should improvements be made to the buildings and equipment at the agency?

b

A registered nurse was attending new employee orientation at a home nursing agency. The agency supervisor reviewed the Conditions of Participation. To what was the supervisor referring? a. County statutes regarding who could be employed as a caregiver b. Federal rules, standards, and criteria for Medicare certification c. Professional standards concerning appropriate care documentation d. State legislation regarding who was eligible for care

a,b,f

A rural family is trying to obtain health care. Which of the following barriers would they be most likely to encounter? (Select all that apply.) a. Fewer health care providers in the community b. Greater travel distances for health care, especially for pregnant women and young children c. Less willingness to accept help from local health care providers d. Little attention being paid to the problems of the rural population by federal legislators e. Many competing insurance companies with different rules and policies f. Providers of health care inadequately prepared to cope with differences between rural and urban lifestyle and values

c

A school nurse attended school-wide parents meetings and gave a report on the health education courses currently being taught and some of the feedback from students in those courses. What would be the primary reason for the nurse to share such information on a regular basis? a. To ensure job security in the future with all the school budget cuts b. To convince the principal of the importance of having a school nurse on staff c. To increase awareness and, it is hoped, support from the local community d. To show progress in meeting state school standards

b

A school nurse completed a needs assessment and concluded that illegal use of drugs, including alcohol and tobacco, was a major problem. What would be the nurses first intervention? a. Ask police officers to educate the students about the penalties for illegal drug use. b. Create, with administrative support, a policy of no smoking while on school grounds. c. Inform teachers that smoking on school grounds will not be tolerated. d. Tell the local newspapers of the findings so that the media can inform parents.

d.

A teenager has just learned she is pregnant. Which of the following is the most expected response by the family? a. The family will draw closer together as they confront this new family crisis. b. The family will likely distance themselves from their daughter. c. The family will be excited to play with the new baby. d. The family will have unexpected economic and emotional pressure.

b,c,f

A teenager has recently discovered that she is pregnant. Which of the following consequences is she likely to experience? (Select all that apply.) a. Admiration, but also jealousy, among friends who do not have an infant b. Greater risk of poverty for her and her infant c. Increased risk of lower education and fewer employment choices d. Loss of friends and peers who get tired of baby-sitting e. Marriage to a man whom she does not love f. Upset family dynamics as the infants grandparents assist with child care

b

A young teenager has recently had a baby. Which of the following is most probable for this infant? a. Increased attention b. Increased risk of health problems c. Increased incidence of high birth weights d. Increased success in school

b

According to E. Fuller Torrey, where would a person most likely encounter a mentally ill person? a. State mental hospital b. State prison or jail c. Grocery store d. Living with a family member

d

After obtaining several resources for a family with multiple problems, a nurse was unprepared when, during the next visit, although two children peeked out the window, no one answered the door. Which of the following best explains why the family did not answer the door? a. They did not want those particular resources. b. They had really expected more from the nurse than they had received. c. They had not had time to clean their house. d. They were testing the nurse to see whether she was really reliable and consistent.

c

After the stress of having a child at such an early age, being in (or needing to be in) school, and having difficulties with employment, most young mothers a. Are careful to use birth control to avoid further pregnancies. b. Are so angry at men that they do not engage in sexual relationships. c. Become pregnant again while still a teenager. d. Postpone further childbearing until they are through school and have a good job.

a

Although originally school nursings purpose was preventing the spread of contagious diseases, what additional responsibility was quickly added? a. Incorporating health education into the curriculum b. Replacing physicians for those children whose parents could not afford a physician c. Substituting for classroom teachers when the teacher was ill d. Teaching safety, first aid, and universal precautions to teachers

d.

Although there were many problems, a family was struggling to survive and reached out to others with similar problems. What was this family doing that made the difference between them and families who were not able to cope? a. Expressing their hopelessness and frustration through acting out b. Rearranging roles and tasks of family members while communicating information c. Refusing to change lifestyles or functions until the crisis is over d. Retaining a sense of hope and mutual support

c

An adolescent in a rural community has recently committed suicide. What is the significance of this event in the community? a. Rural residents are less religious than urban residents and less capable of coping with the loss. b. Because of the size of the community, it is likely that no one will discuss what has happened. c. There could be a cluster of such deaths in small towns where everyone knows everyone so well. d. Without the adolescent to work, the family may have increased economic difficulties.

b

An adolescent is faced with a choice of engaging in sexual activity. Which of the following is the most important factor in this decision? a. Parents beliefs and values b. Peer pressure and the need to belong to a group of peers c. Educational programs presented in the school d. Religious beliefs

a

An adolescent living in the United States has chosen not to use contraception. Which of the following is the most likely reason for this decision? a. The adolescent does not know how to use or obtain birth control. b. The adolescent feels the need to belong to a group of peers, and those peers have suggested not using contraception. c. The adolescent fears that condom use will interfere with the sensations enjoyed during intercourse. d. The adolescent prefers to have sex on a spontaneous couldnt help myself basis.

d

An elderly woman receiving care reimbursed by Medicaid was moving to a different state to stay with her daughter-in-law. The disabled woman asked about Medicaid reimbursement in her daughters state. How should the nurse respond? a. Because you paid into Social Security (FICA), you are eligible for assistance no matter where you go. b. Just be sure to call a home care agency as soon as you arrive so that they can assess your daughter-in-laws house and make sure it is acceptable. c. Medicaid is a federal program, so the rules will be the same wherever you go. d. Medicaid is sponsored in part by the state, so the rules may be very different there.

a

An infant has been born with several congenital anomalies and is ventilator dependent. The nurse discusses options for home care services with the infants parents. Why is home care considered in this situation? a. Children at home have fewer infections and more consistent development. b. Parents vastly prefer home care so that they can care for their child continuously. c. It is easier for family members to visit the child at home rather than in the hospital. d. There is better reimbursement for services provided in the home setting.

d

Besides professional home health care, what other kind of home care may be needed? a. Community health home care, based on care needed in a community b. Public health home care, based on principles of caring for aggregates c. Technologic home health care, based on reimbursement guidelines d. Technical home health care, based on a need for a piece of medical equipment

d

Having completed an initial assessment, a nurse was overwhelmed with the current problems the family was facing. Which of the following actions should the nurse take first? a. Arranging for tangible sources of external support b. Helping the family explore current and alternative coping mechanisms c. Providing information on crisis management and the health issues that the family is facing d. Recognizing sources of family resiliency and strength

c,e,f

Healthy People 2020 objectives include which of the following? (Select all that apply.) a. Distribution of free condoms in public high schools b. Assisting adolescents in learning gender anatomy, physiology, and functioning c. Delaying the age at first intercourse d. Establishing sex/family education in all public schools e. Increasing the use of protective measures during sexual activities f. Reducing the number of adolescents engaging in sexual activity

b

How are home health agencies reimbursed for care from Medicare? a. Diagnostic-related groups (DRGs) b. Home Health Resource Group (HHRGs) c. Outcomes Assessment and Information Set (OASIS) d. Preferred Provider Organizations (PPOs)

d

How would a typical home care nurse spend the majority of his or her time? a. Providing direct care in clients homes b. Calling physicians and getting certification for treatment c. Supervising the home health aides who are giving the clients personal care d. Teaching other family members and home care aides how to care for the client

d

In 1995, which type of agency provided most of the home care services? a. Hospital-based home care agencies b. Local and county health departments c. Privately owned, but nonprofit, entrepreneurial home care agencies d. Proprietary for-profit incorporated home health agencies

a

In addition to being licensed as a registered nurse to practice in that state, what academic preparation is recommended for a school nurse? a. A baccalaureate degree in any academic subject b. A baccalaureate degree in nursing c. A masters degree in nursing d. An associate degree plus a certificate in school nursing

c

In addition to having low income and few resources, how are poverty-stricken families often notably different from mainstream families? a. Children have been removed from the household by Childrens Protective Services. b. Many predictable life events occur for which they do not prepare. c. The time for each developmental period is shorter, with ambiguous transitions. d. They have relationships with controlling family members.

c

In comparisons of costs and outcomes of health care among countries, what is true about the United States outcomes in relation to adolescent pregnancies? a. The rate of adolescent pregnancies is lower in the United States than in most other industrialized nations. b. The rate of adolescent pregnancies is about the same in the United States as in other industrialized nations. c. The rate of adolescent pregnancies is higher in the United States than in most other industrialized nations. d. The rate of adolescent pregnancies is lower in the United States than in most other industrialized nations but is rising rapidly.

c

In relation to ethnic groups, which of the following statements concerning teenage pregnancies is true? a. African American teenagers have the highest number of pregnancies and births. b. Asian or Pacific Islander teenagers have the highest number of pregnancies and births. c. White teenagers have the highest number of pregnancies and births. d. Hispanic teenagers have the highest number of pregnancies and births.

b

In the 1960s, what was recommended by the Mental Health Survey Acts Joint Commission on Mental Illness and Health? a. That an increased number of professionals who were prepared to treat the mentally ill be educated and employed b. That mental health patients be deinstitutionalized and treatment be given to them in the community c. That families reintegrate the ill family member into the home d. That large state institutions be demolished and smaller, more homelike cottages be built

a

On the federal level, American policy on adolescent sexuality is a. Ambivalent about sex education, with restricted access to contraception. b. Focused on abstinence-only programs with or without parental approval. c. Restricted to federal funding for clinics for financially disadvantaged adolescents. d. Supportive of comprehensive sex education, including contraceptive services.

c

One of the ways adolescents are effectively avoiding sexual intercourse is by a. Avoiding situations in which temptation and opportunity may be available. b. Continuing to believe in a strong moral code that forbids sexual intercourse. c. Engaging in oral sex instead. d. Taking a pledge to remain a virgin until marriage.

b

Research findings have suggested that adolescents who engage in sexual activity at earlier ages may also be at risk for a. Alcoholism and heavy drug use. b. Depression and suicide. c. Ridicule and harassment by peers who are not sexually active. d. Unemployment and financial hardships.

b

The Nursing Home without Walls (NHWW) staff compared the cost of care in the home with care in the hospital and drew what conclusion? a. Home care services are slightly less expensive than what hospital care would cost. b. Home care services are about half of what hospital care would cost. c. Home care services are roughly equivalent to what hospital care would cost. d. Home care services do not clearly demonstrate a difference in cost.

a

Statistically, what are poverty-stricken families more likely to have demographically? a. A female head of the family, with few social and financial resources b. Employment outside the immediate neighborhood c. More children than the male head of household can support d. Ongoing predictable life events

b

Statistics on teenage sexual activity, including having unprotected intercourse, demonstrate that a. Both the abortion rate and the birth rate among adolescents are continuing to increase. b. By age 18 to 19, the majority of adolescents have had sexual experience. c. Teenage pregnancy in the United States was at its highest in decade between 2000 and 2010. d. Teenage pregnancy in the United States is lower than that in at least four other industrialized nations.

a

The nurse was teaching refusal skills, coping with peer pressure, and avoiding certain situations. A group of parents visiting the school asked why the nurse was using their tax dollars to teach social skills. What might the nurse need to explain? a. These skills help students avoid smoking, use of drugs, and early sexual intercourse. b. The nurse was providing information that the teacher had requested. c. The nurse was fulfilling state-mandated standards under the No Child Left Behind Act. d. These students had been identified as being at high risk and needed this education.

d

Which of the following is an example of a customer of home care? a. An agency that employs and pays the nurse b. A group of colleagues who evaluate the nurses care c. A client for whom the nurse is caring d. A physician who refers a client to the home care agency

c.

The registered nurse came to see many strengths and resources in the rural area. Among these were that rural residents are a. Diverse, both in ethnic groups and in age groups. b. Politically open to new ideas and approaches. c. Very resourceful and self-reliant. d. Willing to spend money to improve safety.

b

The school nurse reported suspected child abuse to the appropriate local authorities. The parents became very upset and stormed into the school, demanding a copy of all the records related to their child, including the health record that led the nurse to make such an accusation. What would be the nurses best response? a. No; I will need to get permission from the principal before I release those records to you. b. No; you are unable to view these because school health records are not part of your childs educational record. c. Yes; as parents you have the right to your childs records, but you must allow me time to pull the records together. d. Yes; you have every right to a copy of the records, although not the originals, which must remain at the school.

a

The young woman was requesting prenatal services, although she admitted that her family did not know about her pregnancy. Under what condition could she receive services without her parents consent? a. She and her 17-year-old boyfriend have been living in their own apartment for 6 months. b. She has worked part-time for years while attending high school. c. She is employed as an aide in a legal office on Saturdays and might sue the health care agency if she does not receive the care she is requesting. d. She is living with her grandmother, not her parents.

c

What are todays children and adolescents more likely to confront as health problems in comparison with previous generations? a. Problems resulting from alcohol and tobacco use b. Problems resulting from sexually transmitted diseases c. Problems resulting from high-risk behaviors d. Problems resulting from communicable diseases

a,d,f

What conclusions were drawn from the 2006 School Health Policies and Programs Study? (Select all that apply.) a. Progress toward meeting goals had improved since the 2000 data was collected. b. Progress toward meeting goals had declined since the 2000 data was collected. c. Teachers delivering health education were appropriately prepared. d. Teachers delivering health education were inadequately prepared. e. The percentage of states mandating the adoption of health education standards decreased. f. The percentage of states mandating the adoption of health education standards increased.

b,c,e,f

What documented consequences are seen among infants of adolescent mothers? (Select all that apply.) a. Having to accept charity and gifts from other family members b. Higher incidence of child abuse and neglect c. Increased risk of lower education and hence fewer employment choices d. Lower probability of a successful marriage in adulthood e. Mortality rate two to four times higher than that among other infants and twice the risk of stillbirths f. Risk of infant daughter also becoming an unwed teenage mom at an early age

a,b,c,d

What findings would be expected if a school nurse collected data related to the health issues experienced by students? (Select all that apply.) a. Almost half of all high school students have had sexual relations. b. Asthma is a common cause of absenteeism. c. Dental caries is the most common chronic health problem of children. d. Children may be psychologically affected by skin disorders that affect their physical appearance. e. Scabies and pediculosis necessitate that the student stay home. f. Tinea capitis and impetigo are major contributors to absenteeism.

b

What has been a traditional focus of school health programs since the 1980s? a. Drug abuse b. Environment c. First aid and safety d. Sexual behaviors

a, d

What is a problem when urban dwellers move into rural areas, seeking a more satisfying lifestyle? (Select all that apply.) a. Aging water, sewage, housing, and schools in the rural area b. Expectations for the amenities in art, recreation, and sports c. Complaints arising from farming by neighbors, such as odors and insects d. Disruption of local informal helping networks e. Farmers reluctance to sell their land, especially for development f. Sudden increase in money being difficult for the community to absorb

a

What is a reason why home health nurses do not engage in case finding and preventive health teaching to all members of the family? a. These services do not result in reimbursement for the agency. b. Caseloads are so high that there is no time to provide these services. c. Home health nurses do not feel comfortable providing these services. d. Federal regulations limit the amount of these services that agencies can provide.

d

What is the leading cause of disability in the United States among individuals aged 15 to 44? a. Arthritis b. Cardiac conditions c. Cerebrovascular disorders d. Mental illness

b.

What is the most common definition of health among those living in rural areas? a. Balance or homeostasis b. Capable of fulfilling work requirements c. Feeling of well-being, not merely the absence of disease d. Purposive adaptive response to stimuli

c

What is the most important requirement in order for a community/public health nurse to continue to be effective when serving multiproblem families? a. Ongoing graduate study b. Supervision when requested c. Support from other agency staff d. Time for continuing education travel opportunities

d.

What is the poverty rate in rural areas? a. 10% b. 20% c. 30% d. 40%

a

What is the primary reason why home care agencies share information, such as how data are collected and terms defined? a. Agencies are required to report these data to the Centers for Medicare and Medicaid Services (CMS). b. Each is looking for weaknesses in the others that they can use as the basis of marketing campaigns for themselves. c. Each wants to determine the cost for an episode of care for both themselves and the others in order to remain competitive. d. Group data will help them negotiate managed care contracts with maximum gain on both sides.

b

What is the rationale behind public health departments not offering home nursing? a. Most of the agencies energy and resources are spent on controlling communicable diseases instead. b. Priorities have changed to focus on addressing the increasing public health problems. c. Profit-making agencies are now providing more care for homebound clients. d. Public health has not traditionally been involved in home care of individuals.

a

What major event related to the mental health care system occurred in the late 1980s? a. The Reagan administrations Omnibus Budget Reconciliation Act terminated funding specifically for community mental health services. b. States refused to continue to be told how to spend their money by the federal level and refused to provide matching funds to community mental health centers. c. The budget crisis resulted in less funding for mental health services on the federal level and more funding on the local level. d. The Presidents Commission on Mental Health confirmed that community mental health centers were ineffective in meeting the needs of the patients.

d

What might be a school health nurses concern regarding the No Child Left Behind Act? a. The law does not meet local needs as the school boards perceive them. b. The law is based on erroneous assumptions. c. The law meets the needs of urban states but not rural ones. d. The law will divert funds from health services and physical education.

d

What trends have occurred in the teenage pregnancy rate in the United States? a. It remained consistent from 2004 to 2009. b. It has continued to rise. c. It has been fluctuating rather wildly. d. It has remained high, but rates are decreasing.

c

What typically happens to the adults who grew up in maladaptive families? a. They create very different lifestyles, as they promised themselves when very young. b. They look back and laugh at how naive they were. c. They repeat the multigenerational life patterns of their parent or parents. d. They attempt to change, but some behaviors consistent with their parents behaviors remain.

b

What was one of the suggestions given to President Carter in the 1970s when the mental health needs of the nation were reassessed? a. Decrease support for mental health research. b. Establish national health insurance that includes coverage for mental health services. c. Require private insurance carriers to include mental health coverage. d. Return responsibility for mental health from the states to the federal level.

b.

What was one purpose of Rural Health Clinic (RHC) Public Law 95-210? a. To define rural areas as underserved and therefore eligible for many tax reductions b. To encourage utilization of advanced practice nurses by providing reimbursement for their services under Medicare and Medicaid c. To fund structures (building, equipment, supplies) for rural health care providers d. To pay for physicians to serve in rural underserved areas

b

What was the primary reason home care agencies expanded so drastically in the late 1960s and 1970s? a. Hospitals chose to focus on providing care for more acutely ill clients. b. Increased numbers of elderly and poor persons were eligible for care because of federal legislation. c. Early discharges influenced the need for clients to receive home care services after hospitalization. d. There was lack of interest by the American society to contribute to charitable causes.

a

What was the primary reason why Lillian Wald was able to develop the practice of school nursing in this country in the early twentieth century? a. Concern over the increasing number of school absences b. Expansion of public health care from adults to children c. Government mandate to have nurses in the schools d. Additional funds available to finance health care in school systems

d

What would a nurse who is aware of national statistics regarding mortality, morbidity, and epidemics in the United States emphasize at school meetings for parents and staff? a. Dangers of bioterrorism and how staff must be prepared for disasters b. How to react in the safest manner if violence breaks out in the school c. Importance of not sharing personal items to avoid spread of infections and parasites d. Need for physical exercise for each student on a daily basis

b,c,d,f

What would be the school nurses motivation for educating adolescent girls about self-esteem and body image? (Select all that apply.) a. Body image is strongly related to a tendency to engage in bullying and verbal violence. b. Bulimia is associated with major depression. c. Disturbed eating patterns are associated with distorted body image and low self-esteem. d. Eating disorders have the highest mortality rate of any psychiatric disorder. e. Obesity is strongly related to distorted body image. f. Obsessive-compulsive disorder commonly accompanies anorexia.

d

What would be the school nurses primary goal when choosing to teach a class about the importance of daily physical activity? a. Fulfilling federal legislation requirements b. Fulfilling state legislation requirements c. Helping the children avoid disease and injury d. Motivating the children to promote their own health and well-being

a

When making a home visit to a new teenage mother and her infant, the community/public health nurse watched the new mother change her babys wet diaper and then carefully wrap a long length of cloth around the babys abdomen covering the umbilical cord stump. What should the nurse do about the mothers behavior? a. Ignore this cultural tradition if the baby is not harmed. b. Recognize that this is evidence that the grandmother is taking over care. c. Inform the mother that the use of such a cloth serves no purpose and should be stopped. d. Investigate the purpose of this cloth.

d

When working with a multiproblem family, which of the following goals should the nurse approach first? a. The goal that best matches the agencys policies and procedures b. The goal that can be achieved behind the scenes without any effort from the family c. The goal easiest for the nurse to complete because of her or his expertise d. The goal that the family believes is the most important

b

Which of the following actions demonstrates a home care nurse integrating the Healthy People 2020 objectives into home care practice? a. Referring a client to physical therapy b. Instructing a client to visit the dentist on an annual basis c. Administering an insulin injection to a diabetic client d. Counseling a client about how to prevent the spread of infectious disease

b

Which of the following aggregates is most likely to delay sexual activity? a. Teenagers from single-parent homes b. Teenagers who are doing well in school and planning to attend college c. Teenagers who are or have been sexually abused d. Teenagers who engage in smoking, drinking, and using drugs

b

Which of the following concerning sexually transmitted diseases (STDs) in the United States is true? a. Infected men are usually aware that they have an STD. b. Of the 10 most prevalent infectious diseases, 5 are STDs. c. Most STD infections are spread by direct contact. d. More men than women are infected with STDs.

b.

Which of the following descriptions is the most accurate example of a rural community? a. The residents of the community are subject to environmental hazards. b. It takes longer than 30 minutes to get from the community to health care services. c. The community has less than 20,000 residents. d. The residents of the community say, This is smaller than where I grew up.

a

Which of the following features of hospice differentiates it from traditional home care? a. Use of direct service volunteers as part of the interdisciplinary team b. Need for accurate documentation in order to receive reimbursement c. Use of Medicare reimbursement for services provided d. Provision of direct nursing services for the client

b

Which of the following internal coping strategies is often used by resilient and adaptive families? a. Expressing their hopelessness with other family members b. Supporting other family members while communicating information c. Refusing to change lifestyles or functions until the crisis is over d. Seeking financial assistance and information from community resources

c

Which of the following is a reason why teenage pregnancy is viewed as a community problem? a. Teenage pregnancy is inconsistent with community values and norms. b. Pregnant teenagers are poor role models for younger children. c. The community pays financially for the consequences of teenage pregnancy. d. There are cultural and social sanctions against adolescent sexuality.

d

Which of the following is an example of a catchment area? a. A community mental health center that provides comprehensive services b. A community where the homeless meet each evening and are taken to a shelter for safety c. A jail or prison where the severely mentally ill are kept isolated from prisoners who do not suffer from such illnesses d. A city or several rural communities small enough to allow collaboration among themselves

d.

Which of the following is part of the first level of social support for people living in rural communities? a. Big city charities that rely on agricultural donations to help feed urban poor persons b. Church or civic group assistance, to which a person is expected to contribute when able c. Professional agencies or people who are paid financially for their contribution d. Volunteer assistance by family and friends, which one is expected to reciprocate as needed

a

Which of the following is probably most influential in delaying when an adolescent begins engaging in sexual intercourse? a. Academic motivation and orientation toward the future b. Availability and cost of contraceptives c. Gender and socioeconomic status d. Racial/ethnic group

d

Which of the following is the most crucial factor in how a family responds to a natural disaster that almost destroyed their house? a. How many of the familys relatives will allow them to move in temporarily b. How much of house is repairable c. How much governmental aid will be given to them to rebuild their house d. How the family perceives the disaster and their ability to cope

c

Which of the following is true with regard to federally funded abstinence-only programs? a. They persuade young persons to postpone sexual activity. b. They help young persons avoid pregnancy and transmission of sexually transmitted diseases (STDs). c. They are ineffective in reducing sexual activity, STDs, and pregnancies. d. They reinforce the reasons to avoid sexual activity until after marriage.

b,d,f

Which of the following nursing interventions would be appropriate when a nurse is working with a multiproblem family? (Select all that apply.) a. Assuring the family that the nurse will be there to help them with their problems b. Describing how one persons thoughts and behaviors affect another family member c. Expressing the nurses own feelings about the family and its situation d. Giving feedback on emotions and behavior and distinguishing between them e. Role-modeling circular communication with adequate ambiguity and vagueness f. Working toward small but achievable success in small areas

b

Which of the following primarily determines the school nurses role in a community? a. The communitys priorities for its schools b. The local school systems goals as influenced by federal and state legislation c. The nurse practice act of the state in which the nurse practices d. The employed nurses education, credentials, and skill level

a.

Which of the following programs demonstrates the use of primary prevention? a. Intense human immunodeficiency virus (HIV) prevention education program with distribution of free condoms b. Group meetings and counseling of new mothers to help with family coping c. Peer counselors visiting pregnant teenagers and offering suggestions d. Volunteers educating the families of pregnant teenagers to ensure early prenatal care

a

Which of the following situations would be the best time for the school nurse to engage in informal teaching? a. When a student asks a question, thereby creating a teachable moment b. When a written request is submitted by a classroom teacher c. When parents have requested information on a particular topic d. When the principal has concluded that specific content should be added to the curriculum

c

Which of the following statements about the United States outcomes in relation to abortion is true? a. The abortion rate is lower in the United States than in other industrialized nations. b. The abortion rate is about the same in the United States as in other industrialized nations. c. The abortion rate is higher in the United States than in other industrialized nations. d. The abortion rate is higher among white teenagers in the United States than among white teenagers from other industrialized nations.

d

Which of the following statements is a reality regarding disturbances in family dynamics and high-risk problems in families? a. Chronic ongoing problems have no relationship to disturbed family dynamics. b. Chronic family problems lead to difficulties in family dynamics. c. Disturbances in these areas lead to the majority of problems in families. d. It is impossible to state which issue leads to the other.

b,e,f

Which of the following statements reflect the effect that teenage pregnancy has on the family? (Select all that apply.) a. When the teenager attends school, her parents must become the primary caregivers. b. The infants grandparents may have to become infant caregivers again. c. Older siblings may fight for the chance to be the infants baby-sitter during evenings. d. The teenage mothers siblings get to enjoy playing with the infant. e. The teenage mother requires more of her parents financial resources to manage. f. The family may not be equipped to deal with the economic and emotional pressures.

a

Which of the following statements regarding adolescent male and female motivation for sexual intercourse is accurate? a. Female adolescents desire intimacy, whereas male adolescents enjoy the physical pleasure and social status. b. Female adolescents love the acceptance and attention, whereas male adolescents enjoy the control and power. c. Female adolescents want to be like everyone else, whereas male adolescents consider sex a game. d. Female adolescents try to keep male adolescents interested in them, whereas male adolescents want to report a conquest.

b,c,d,e

Which of the following strategies should a nurse use when working with multiproblem families? (Select all that apply.) a. Encouraging rapid progress toward change in behaviors b. Focusing on empowering the family and developing its self-esteem c. Helping the family identify its strengths d. Organizing possible sources of tangible support e. Pointing out opportunities for doing things differently f. Trying to resolve one major problem before beginning work on another

c

Which of the following would be considered a key element of a comprehensive school health education program? a. Offering daily physical education classes b. Ensuring safety on the school playground c. Involving parents and the community members in health education programs d. Facilitating a well-balanced diet through the school lunch program

a

Which of the following would make a family with a newborn who is severely handicapped be considered a vulnerable family? a. When all of the choices related to the situation have negative consequences b. When there are no backup caregivers to care for the severely handicapped infant c. When the family welcomes someone else taking responsibility for them d. When the family has to choose a lifestyle that is dependent on others

a.

Why are children at risk on their own familys farm? a. Children often help with the work without much regard for training or safety. b. It is expected that children fulfill the roles that are assigned to them. c. Machinery can injure someone faster than a parent can turn the machine off. d. Parents are too busy completing their own tasks to supervise the children.

b,c,d,e,f

Why are rural residents considered a group at high risk for health problems? (Select all that apply.) a. They are very self-sufficient and self-reliant. b. Few health care providers are locally available. c. The residents are exposed to high-powered machinery, extensive sun, and chemicals. d. They have difficulty accessing affordable insurance if they are self-employed. e. They must travel long distances to obtain specialized services. f. They work in dangerous occupations (farming and ranching).

b

Why did home care agencies expand in the 1980s? a. Clients discovered they much preferred home care to hospital care. b. The diagnostic-related group (DRG) system of reimbursement was phased into hospitals. c. An increased number of elderly and poor persons became eligible for care because of federal legislation. d. There was a lack of interest by American society in contributing to charitable causes.

d

Why did many psychiatric patients have impaired social interaction, decision-making skills, and life skills when they were discharged from the large state mental hospitals? a. They had families who had not socialized them appropriately. b. They heard nurses tell them too often that they were incompetent and incapable. c. They lacked the ability to learn how to behave in front of others. d. They were accustomed to having needs met and decisions made by the institution.

b

Why do clients typically prefer home care over hospital care? a. Clients feel better wearing personal clothing and preparing their own favorite foods. b. Clients are comforted by the feeling of control and the familiarity of their own home. c. Clients know that more visitors can stop by without concern for having limited space. d. Clients resent the constant interruptions by nurses and other caregivers in a hospital.

a

Why might the school nurse want to examine students academic achievement? a. Academic failure is a risk factor for adolescent drug use. b. Some teachers may need the nurses help to be effective in health education. c. Students are easier to teach if divided into groups by academic ability. d. The nurse may want to discuss the failure with the students family and friends.

a,b,d,f

Why will home health care continue to expand? (Select all that apply.) a. Complex care can be more efficiently provided in the home setting. b. Cost-containment measures are being implemented at all levels of government. c. Insurance companies are requiring increased use of generic medications. d. The public is demanding quality health care services in the home. e. The public is exerting pressure to receive care in the most comfortable setting. f. Technologic advances are occurring.

c

Why would a school nurse encourage the school district to create a violence prevention program? a. A government-endorsed teaching unit that focused on this topic is available. b. Additional funds are being offered in the state to provide this educational program. c. The prevalence of violence, including homicide, among adolescents is recognized. d. High-risk behaviors are common among adolescents.

c

Why would a school nurse seek funds to implement a program to teach adolescents how to recognize depression and low self-esteem in their peers? a. Funds are available for such mental health programs. b. Such programs are a priority in Healthy People 2020. c. The incidence of adolescents considering or attempting suicide is high. d. The nurse has expertise in this area and wants to share this knowledge with others.

b

With regard to the ages of the fathers, the majority of the fathers involved in teenage pregnancies are a. About the same age as the teenage mother. b. Several years older than the teenage mother. c. Undetermined; studies have not yet determined this information. d. Younger than the teenage mother.

a

hich of the following is the most probable reason that some families have multiple problems? a. Presence of multiple, ongoing, intense stressors beyond their resources b. Lack of cultural integration into mainstream society c. Being supported by government resources for several generations d. Being unwilling to change or consider new approaches to problems