Co 27,30,24,22,11

A nurse believed strongly that intervention for technology-dependent children was needed. What is the most useful intervention that could be implemented by the nurse? a. Advocating for quality child care, especially respite care b. Emphasizing with all the nurse's friends and neighbors the necessity of supporting parents with technology-dependent children c. Lobbying insurance companies to pay as much for home care as for hospital care d. Teaching young parents how to care for their technology-dependent children at home with minimal stress

A All parents need quality child care, especially respite care for chronically ill children. Although all of the options might be useful, the need for child care is of highest priority.

A clinical specialist in gerontology accepted a position with the local health department as a community/public health nurse. For whom can the nurse expect to provide care? a. To geriatric clients and the local senior citizen centers b. To the neighborhood at highest risk in the city c. To the neighborhood where the nurse lives d. To wherever the nurse selects

A A nurse can be assigned a specific neighborhood or a specific aggregate. As a clinical specialist in gerontology, the nurse would probably be assigned to work where there is a need for such expertise. The nurse could also be assigned a specific neighborhood, but not on the basis of risk, the nurse's own residence, or the nurse's choice.

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

B School health programs vary markedly across the United States. The local schools primarily define their program but are influenced by federal, state, and local regulations.

Which of the following interventions is an example of primary prevention? a. Assessing the neighborhood children for lead paint poisoning b. Encouraging use of car seats and bicycle helmets c. Facilitating a support group for divorced parents with children d. Screening all the children for scoliosis at the local school

B The only one of the options that represents primary prevention is encouragement to engage in safe habits, such as wearing seat belts and helmets. The other options are examples of secondary or tertiary prevention

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.

C Although abortion is common in all five industrialized nations, the rate is highest in the United States.

What would be the school nurse's 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

D Although all of the options may be the nurse's goals, the primary purpose of health education is to promote health maintenance and wellness, not just to prevent disease and injury.

Which natural disaster is the most common worldwide? a. Earthquakes b. Floods c. Hurricane (water)/tornado (over land) d. Volcanic eruption

B Flooding is the most common natural disaster worldwide and also the third leading cause of weather-related deaths in the United States.

What is the major cause of death in children aged 1 to 18? a. Accidents b. Birth defects c. Homicide d. Infectious diseases

A Accidents are the major cause of death in children aged 1 to 18. Most accidents occur in or near the home and can be prevented.

A father repeatedly heard that it was important for his son to get his immunizations before he entered school. What are the most probable reasons that his son has not yet received them? (Select all that apply.) a. No public transportation was available to take them to the clinic. b. The father was familiar with many of the staff members who worked at the clinic. c. The clinic was open only during the day. d. The clinic had a lengthy application in order to receive low cost or free care. e. The father did not have health insurance coverage for his son. f. There was no clinic located in their neighborhood.

, C, D, E, F It is often very difficult for poor families to obtain care, since the single parent may be employed. Clinic hours are limited, transportation can be unavailable, the fees may be high and unaffordable if they do not have health insurance, and the eligibility processes can be extremely challenging. Working with staff members from other cultures can also be a barrier; however, if the father knows many of the staff at the clinic, this would not be a barrier. After all the teaching received, the father probably understands the importance, but barriers prevent him from taking action.

A community/public health nurse decided to provide a free program to the newly employed staff at a local daycare facility. What would the nurse want to emphasize during this presentation? a. Consistent hand-washing for both children and staff b. Environmental safety throughout the center c. First aid measures to use in case of an accident d. Normal growth and development of preschool-age children

A A primary concern in daycare is the easy spread of pathogens, which is attributable, in part, to the young age of the children, the increased amount of bodily contact, and the decreased ability of children to control their bodily functions.

An adolescent was at a clinic with her mother for a sports physical examination. After filling out the sports form and completing the examination, the nurse practitioner asked the mother to step out of the room. Why would the health care provider have asked the mother to leave momentarily? a. The adolescent should be allowed privacy with the health care provider to share information or ask questions perhaps related to sexuality. b. Having a private conversation with the health care provider demonstrates the adolescent's maturity and independence. c. The health care provider wanted the adolescent, not the mother, to answer the questions asked. d. The gynecologic examination is usually performed in private.

A Adolescents may share information with health care providers that they do not want to share with their parents. Adolescents may seek information about birth control, human immunodeficiency virus (HIV) infection, sexually transmitted diseases (STDs), or peer relationships. Privacy should be given for this opportunity. Having a conversation in private with a health care provider does not necessarily demonstrate the adolescent's maturity.

A new mother asked the community/public health nurse what a nurse visiting her at home would do differently from what the nurses in the hospital had already done. Which of the following would be the best response from the nurse? a. "All nurses try to help people stay well, but I can also help you assess your home for any dangers to the baby." b. "Hospital nurses and I all try to be helpful, but I can also tell you how to obtain excellent child care." c. "In the hospital, you had a nurse focus on your baby and another nurse focus on your care. I'll be focusing on both you and your baby." d. "The other nurses in the hospital focus on helping you and the baby get off to a great start. I'm going to repeat everything to be sure you really know it."

A Although all nurses try to keep clients safe and healthy, the community/public health nurse is most qualified to assess the home environment and wider community for dangers as well as resources.

Which of the following would be an appropriate tertiary intervention for a young mother who had previously physically hurt her baby? a. A hotline or crisis phone number for when the mother believes she is losing control b. A support group with professionals for new mothers to answer questions c. Education regarding age-appropriate behaviors in a young child d. Reporting the suspected child abuse to children's protective services or the police

A Although all of the options would be helpful, only a crisis number for when the mother believes she may be getting too frustrated and angry represents tertiary intervention. Families in abusive situations need parenting role models and a support system during periods of stress. Hotline or crisis telephone numbers can be one way to provide help in stressful situations. A support group and education are primary prevention. The child abuse would have been reported to children's protective services the first time the child was hurt because such reporting is mandatory. It is hoped that a social welfare representative has been to the home and has concluded that the mother should keep the baby. Therefore, to maximize the health of the newborn, a hotline allows the mother to reach out for additional support.

The nurse is to visit newly referred clients for the first time after their discharge from the nursing home back to their apartment. Which of the following is the most likely feeling the clients will have regarding the nurse's visit to them? a. Ambivalence because the nurse could be helpful but also judgmental of their situation b. Glad because the nurse can be of immediate help c. Fearful because the nurse is someone who has the authority to intervene in their lives d. Angry because the nurse is essentially an intruder into their lives

A Although all the options are possibly true, if the clients are home for the nursing visit they are at worst feeling ambivalent about the meeting. They are willing to consider what the nurse may have to offer.

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

A Although any of the options might cause a school nurse to consider teaching a specific program of study, teaching is most effective when the learner (an individual or a group) has a teachable moment or has expressed a desire or need to know.

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 "couldn't help myself" basis.

A Although there is little difference in sexual experience or age at initial sexual intercourse among teenagers in the industrialized countries, there are differences in contraceptive behaviors. Teenagers in the United States are less likely to know contraceptive methods, to know how to obtain contraceptives, or to use contraceptives. Peer pressure and the need for belonging to a peer group do influence the choice to engage in sexual activity, but the major problem related to lack of contraceptive use in the United States is the lack of education

Which of the following would be appropriate to help ensure a nurse's safety? a. Before leaving his or her car, he or she should check the immediate surroundings for anyone or any situation that makes the nurse uncomfortable. b. The nurse should intervene immediately with a family whose fighting is starting to become physical, before it escalates further. c. The nurse should visit a family over the weekend, when no one is expecting an outsider to drop by. d. When approached on the street by an unknown person, the nurse should stop and tell them how to reach the agency to be formally accepted as a client.

A Any of these behaviors could cause the nurse to be physically injured except checking one's surroundings before exiting the car, which is an effective precaution the nurse should always take.

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 newborn's 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.

A As the mother, she can give consent for care to be given to her newborn; as a minor, however, she needed parental consent for her own care.

A woman explained to a nurse that she knew her children needed to receive health care. However, she had no money to pay for their care and there was no way for her to obtain care for them. Should the nurse be surprised by the mother's statement? a. No; many parents of eligible children do not know how to access Medicaid. b. No; most parents are too proud to ask for assistance from Medicaid. c. Yes; it is common knowledge that poor persons are eligible to apply for Medicaid. d. Yes; many public health clinics see children without charge.

A Because of the inability to document meeting eligibility requirements or overcome administrative barriers, or because of the sheer lack of knowledge about how to obtain health care, many children do not have access to Medicaid or Children's Health Insurance Program (CHIP) funds. Although public health clinics are often the caregivers of last resort, they typically use a sliding scale for payment rather than providing care totally free of charge.

The Mississippi River floods a small riverside town. A few citizens decide to stay even after the flood hits the town. Assuming flooding overwhelms city services, which of the following is the most dangerous problem? a. Inability to drink safe water from the flooded city water pipes b. Inability to eat because of food spoilage from lack of electrical service to refrigerators c. Inability to relax, which would result in anxiety and tension d. Inability to sleep because furniture will be wet

A Canned food would be edible. Although anxiety, tension, and sleeplessness may well occur, safe drinking water is the most important immediate physiologic need. Priority would have to be first to obtain safe drinking water for stranded people.

When making a home visit to a new teenage mother and her infant, the community/public health nurse watched the new mother change her baby's wet diaper and then carefully wrap a long length of cloth around the baby's abdomen covering the umbilical cord stump. What should the nurse do about the mother's 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.

A Cultures vary in child care custom and practices. There is no reason to discourage or eliminate a tradition if it does no harm. The use of cultural traditions does not mean that the grandmother is taking over care.

A registered nurse flown in to help with a disaster was feeling very tired, irritable, and anxious. In addition, the nurse seemed to be having difficulty concentrating and making decisions. Which of the following is the most likely cause of such feelings? a. The close involvement in the disaster, which has traumatized the nurse as well b. The knowledge that the nurse cannot meet all of the needs of the flood victims c. The realization that the nurse cannot undo the damage of the flood d. The recognition that the nurse is not adequately compensated for working this hard

A Disaster workers also experience distress and need debriefing and support. Many disaster workers report being overwhelmed by the devastation and extent of personal injuries. Some may feel unqualified to cope, particularly after working for 24 to 36 hours without adequate support staff. Care providers also need care and an opportunity to address their own stress issues.

A senior student nurse asked the instructor, "Why do we have to make home visits? The client learned self-care in the hospital." Which of the following statements would be the best response from the instructor? a. "Home visits allow you to focus on the entire family and see threats to health and safety." b. "Making home visits will increase your marketability after you graduate." c. "Our State Board of Nursing requires home visits as part of community/public health education." d. "The national accreditation policies require that students make home visits before they graduate."

A Home visits allow the nurse to see threats to the family health and safety in the home or immediate environment. Home visits also encourage a family focus, although they do not guarantee it. It is common for new nurses who have little experience in home visiting to feel uncertain and ambivalent about the experience.

After being invited into the apartment of some elderly clients, the nurse was shocked to realize the elderly husband was smoking marijuana. Which of the following actions should the nurse take? a. Indicating that he or she will return at another time and then leaving the home b. Asking the man to stop and stress that the nurse cannot return if they are going to engage in illegal behavior while the nurse is there c. Calling the police, reporting the illegal behavior, and agreeing to serve as a witness if the case goes to trial d. Leaving and refusing to come back until all illegal drugs are out of the apartment

A In some households, members may be intoxicated from consuming alcohol or may be using illicit drugs during the visit. Such individuals are likely to be cognitively impaired and will not benefit from your visit. You should indicate that you will return at another time, and then leave the home.

A woman was told that everyone would be getting low-interest loans to rebuild their houses and businesses, and several of her neighbors were starting to rebuild. No one from the government had even come to look at damage to her house yet, which caused her to feel angry and resentful. What is the most likely reason for these feelings? a. She is focusing on her own problems. b. She is grieving over loss of her own property. c. She is suffering from acute posttraumatic stress disorder. d. She does not care about anyone else's damage.

A In the disillusionment phase, there are negative feelings of disappointment because of delays or failures when promises of aid are not fulfilled. People seek help to solve their own personal problems rather than community problems.

Which statistic is most often used by governments, whether state or national, to compare health outcomes? a. Infant mortality rates b. Length of life of citizens c. Newborn mortality rates d. Premature birth rates

A Infant mortality rates provide an excellent indicator of the health status of a community, state, or nation.

A community/public health nurse is working with an extremely poor child who does not have health insurance. What should the nurse recommend the family do in order for the child to receive preventive care? a. Apply for Medicaid, including the Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) program. b. Contact the Children's Health Insurance Program (CHIP). c. Determine the child's eligibility for Title V. d. Request that preventive care be provided at a local free clinic.

A Many poverty-level children are eligible for care through the Medicaid program (Title XIX), including the EPSDT program. The CHIP program (Title V) allows states to provide health insurance to children whose families are above the financial eligibility for Medicaid. Because this child is extremely poor, use of Medicaid is the most appropriate choice. Although free clinics provide care for people without insurance, regular preventive care is best provided through a stable funding source such as Medicaid.

Which of the following is an appropriate definition of mitigation? a. The actions used to avoid or prevent disaster damage b. The cleaning-up process after a disaster c. The process used to react to a disaster in order to minimize the death rate d. The psychological intervention used to help people cope with a disaster

A Mitigation is a term used in disaster planning that describes actions or processes, or both, that can be used to prevent or reduce the damage caused by a specific disaster event.

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 nurse's 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 student's family and friends.

A Nurses are responsible for case finding, or identifying children at risk and developing appropriate interventions. Common risk factors for drug use include academic failure, low degree of commitment to education, and low level of attachment to teachers and schools.

What should all nurses know about their community? a. All the medical and social agency resources that may be available b. All of the nursing roles that may need to be fulfilled in a disaster c. The emergency personnel departments in the local area that may need to be recruited d. The nursing actions that may be performed during a disaster as defined by the state's nurse practice act

A Nurses should know in advance all community medical and social agency resources that will be available during a disaster, as well as where equipment and supplies have been stored and their own role and rendezvous site. As a volunteer during a disaster, the nurse in most situations is covered by the Good Samaritan Act of the state.

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 Only the HIV prevention education program represents primary prevention. All the other options represent secondary or tertiary intervention. Distribution of free condoms would also eliminate the barrier of being unable to afford contraceptives.

During the aftermath of a disaster, the nurse is assigned to triage incoming injured people. A man shows all the symptoms of a myocardial infarction. What should the nurse do first? a. Give him a red tag so that he is the next person for the physician to treat. b. Give him a green tag because without a cardiac care unit, the man will not survive. c. Allow him to die with dignity by giving him a black tag. d. Provide care for the man until a physician becomes available.

A Red tags are used to identify the most urgent, first-priority injuries. Although his condition is life threatening, survival probability is high, so the man would be a first-priority client. Green tags are used to show third priority and black tags are used for persons who are dying or dead.

It was suggested a public health department's funding for home visits be cut because so much time and money were spent in travel and such expenses seemed inappropriate in a time of fiscal restraint. Which of the following would be the nurse's best response to this suggestion? a. "Research has shown home visits save far more than their cost in decreasing child abuse, drug-resistant infections, and even emergency department visits." b. "The public health department staff members are the most knowledgeable concerning funding needed and how best to spend the funds." c. "The voters agreed on the tax levy funding the department. It would not be politically wise to act against voters' obvious desires." d. "With all the fear about bioterrorism, it is an inappropriate time to cut funds to the public health department."

A Research has demonstrated that home visits result in fewer instances of child abuse and neglect and fewer emergency department visits, accidents, and poisonings during the child's first 2 years of life. These effects were still apparent 15 years later.

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.

A States define emancipated adolescents as those who are married, those who are members of the armed forces, and those who are living apart from their parents. Living independently is often accepted as demonstrating that the adolescent is emancipated and can make her own medical decisions.

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

A Students who are academically motivated, are progressing well in school, are future oriented, and have established goals generally delay sexual activity. Parental expectations also influence teenagers of both genders to postpone sexual activity.

A pregnant teenager tells the community/public health nurse that the baby's 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 child's upbringing as much as they are able. d. Fathers remain involved with the mother and her infant for several years.

A Studies have demonstrated that the baby's father is generally available to the pregnant teenager before delivery, but their relationship weakens over time. Most such fathers are still involved at delivery. By the time the child is 5 years old, only a handful of these fathers have regular contact with the mother or child.

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.

A Such life skills are components of successful programs that help students avoid smoking, drug use, and other high-risk behaviors.

What group or organization defined the term disaster as "a threatening or occurring event," either natural or man-made, "that causes human suffering and creates human needs that victims cannot alleviate without assistance"? a. American Red Cross b. Department of Health and Human Services c. National Office of Disaster Control d. Department of Homeland Security

A The American Red Cross—the voluntary agency historically most involved in disaster relief—so defined the term in 1975.

Knowing that a disaster can occur at any time, staff at a community hospital create a disaster plan that is based on a risk assessment. Which of the following activities should be included in the plan? a. Scheduling periodic mock disasters to practice preparedness b. Developing an ongoing media campaign that stresses the excellence of the employer c. Reviewing all of the hospital policies for consistency and appropriateness d. Sharing stories of problems that have occurred when communities have not been prepared for a disaster

A The Joint Commission (TJC) requires all hospitals to have a disaster plan, hold disaster drills, and regularly evaluate those plans and activities to meet accreditation requirements.

A community/public health nurse implemented a home visiting program with a teenage mother and child from the prenatal period through the child's 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.

A The Nurse Home Visiting Program provided care from the prenatal period through the infant's second birthday; however, the results appeared to continue long term (Olds et al., 1999). The women who participated in this program deferred subsequent pregnancies and improved their workforce participation. Their children had fewer arrests and convictions, smoked and drank less, and had fewer sexual partners than did their peers.

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.

A The United States is ambivalent about sex education; abstinence is strongly encouraged, and several federal efforts have been made to restrict access to reproductive services. Parental permission requirements are one example of such restrictions.

Although originally school nursing's 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

A The health issues seen by the school nurses expanded the nursing practice to include prevention, examination, treatment, and advocacy.

Why has there been an increasing emphasis on caring for chronically ill children in their homes rather than in the hospital? a. Hospitalized children are at risk for contracting a nosocomial infection and do not cope well with all the noise, light, and people. b. Insurance will not pay for children to stay in the hospital, but they will pay for home care. c. It is too dangerous to use unlicensed assistive personnel to staff pediatric units and too expensive to hire professional nurses. d. There are not enough expert pediatric nurses to staff additional pediatric units.

A The hospital setting interferes with normal growth and development and is a high-risk environment. A hospitalized child is at increased risk for contracting nosocomial infections because of invasive procedures, multiple caretakers, and increased contact with organisms from other children and staff. Altered environments with noise, light, and large numbers of people result in sensory overload, sleep deprivation, and decreased learning opportunities.

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.

A The motives for intercourse are different by gender: For teenage girls, intimacy is the most important reason, whereas teenage boys list physical pleasure and social status as more important

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

A The nurse should, in addition to the usual newborn assessment, look for signs of adequate maternal and infant bonding and evidence of attachment. Infants of young unwed mothers are at high risk for child abuse and neglect. It is important that the mother receive support from other people, but it is not appropriate for the grandmother to take over care, nor does the father need to be involved if other supports are in place. Also, it is not always necessary for the mother to apply for assistance programs.

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 master's degree in nursing d. An associate degree plus a certificate in school nursing

A To be a school nurse, the nurse should have academic credentials comparable with those of other faculty members in the school. The minimum qualification that the National Association of School Nurses (NASN) advocates is a baccalaureate degree.

A nurse at a school-based neighborhood health clinic noticed there were many different nationalities of children at the school, including some who did not speak English. What is important for the nurse to do? a. Recognize that certain ethnic groups may have different expectations of appropriate behaviors by their child. b. Share with the families research findings regarding appropriate childhood and effective parenting behavior. c. Teach the mother how to make the major health care decisions for the family. d. Help the families adapt to the United States by using teaching materials that demonstrate American beliefs and values.

A To engage in culturally sensitive nursing care, the nurse should clarify what each parent considers appropriate childhood behavior and use teaching materials that are culturally sensitive.

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

A Wald's project with Lina Rogers Struthers, the first school nurse, demonstrated that school nursing decreased school absences significantly, down 90% within 1 year.

A nurse visited a middle-aged client at home after his hospital discharge. The client was cleaning a gun. When the nurse asked the client to put the gun away, the client became agitated. What is the nurse's best action at this time? a. Apologizing and saying that the visit will be rescheduled when the client is feeling better b. Focusing on client assessment and staying calm because filling out the necessary forms will not take long c. Hurrying through the visit and finishing the documentation inside the safety of the nurse's car d. Using a low voice and slow, calm movements, and asking whether there is a problem

A When a client has a gun and has become agitated and the nurse is feeling uncomfortable, the number one priority is the safety of the nurse. Therefore, the nurse should leave the immediate environment.

Which of the following actions should the nurse take before performing a painful procedure on a 6-year-old child? (Select all that apply.) a. Providing the child an opportunity to express an opinion b. Obtaining consent from the parent c. Notifying the child's primary physician d. Consulting the ethics committee e. Obtaining consent from the parent and the child f. Offering suggestions for alternative treatments

A, B Parents decide on health care, with some exceptions such as refusal of lifesaving measures. In that case, the child has the right to petition the court. However, whenever possible, the nurse should give children opportunities to express opinions about decisions that affect them. Children should participate in the decision-making process as soon as they are able. Because children are minors, their parents or guardians make the legal decisions, such as consenting or not consenting to treatment. Although nurses can tell parents various options, the treatment is typically chosen by the parents in collaboration with the primary health care provider. It is not typically necessary to involve the ethics committee when procedures are performed. The committee is typically involved when the nurse is addressing an ethical dilemma. A physician has ordered the procedure, and so it should not be necessary to contact the primary physician before the procedure is performed.

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.

A, B, C, D The 2009 Youth Risk Behavior Survey (YRBS) revealed that 46% of all high school students had engaged in sexual intercourse. Asthma is a major public health problem; it accounts for millions of missed school days each year. Dental caries is the most common chronic childhood disease in the country, five times more common than asthma. Dermatologic disorders affect many children psychologically, especially if they affect their physical appearance or will cause their exclusion from school. Scabies and pediculosis are not reasons to have students stay home, because they are not dangerous. Tinea capitis and impetigo do not usually necessitate exclusion from school.

Why would parents resist having their chronically ill child cared for in their home? (Select all that apply.) a. All the necessary high-technology equipment limits living space. b. Career demands and household functioning leave little time for child care. c. Finding supportive funding can involve incredible time and effort. d. Home care results in less time for bonding between child and parents. e. Normal growth and development of the child may be delayed. f. Other children in the family may resent being caregivers and receiving less parental attention.

A, B, C, F There are drawbacks to home care. Home environments become disrupted with high-technology equipment, which limits living space. Siblings feel displaced or frightened by all the equipment, procedures, and disrupted routines. Other siblings often have to serve as caregivers. Demands of caregiving, careers, household duties, and other children in the household limit leisure and cause stress. The most significant barrier is funding. Obtaining funding involves long waiting periods, negotiations, and evidence of discharge planning. Although insurance programs pay for inpatient care, they typically do not pay for home care.

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.

A, D, F A comparison of data gathered in 2000 with that collected in 2006 reveals progress made in regard to the core components of comprehensive school health and stressed in Healthy People 2020. The findings show that the percentage of states that have adopted a policy mandating schools and districts to follow national or state health education standards or guidelines has increased from 60.8% to 74.5%. However, only 25% of teachers delivering required health curricula received training in any of the 14 identified health topics.

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 Sexually active teenagers are three times more likely to feel depressed and are at greater risk for suicide than are teenagers who are not sexually active.

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.

B Today, most pregnant teenagers decide to keep their babies. Approximately 66% choose childbirth, and 25% choose abortion. Most unwed mothers keep their infants. Few teenagers opt for marriage if they become pregnant.

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.

B Although there is evidence that teenagers are delaying the start of sexual activity, by age 18 or 19 the majority of both genders have had sexual experience.

Which of the following actions is the most important to perform first in caring for victims of a mass casualty incident? a. Call in all part-time and on-call staff to help care for newly admitted clients. b. Contact surrounding communities for assistance. c. Call the hospital supply store and order extra dressings, intravenous fluids, and other materials. d. Discharge as many hospital patients as possible to make room for disaster victim admissions.

B A mass casualty incident involves 100 or more people, which overwhelms a single institution, help must be summoned immediately, before the patients even arrive.

A nurse is making a home visit to see a new teenage mother who is currently living with her own mother. With whom should the nurse discuss how to care for the new baby? a. All the family members who happen to be home when the nurse visits b. Both the infant's mother and the infant's grandmother c. The infant's grandmother, who will probably be providing most of his care d. The new young mother, who is the one responsible for the infant

B All caregivers should be included in well-baby care counseling. Teenage mothers frequently live with their mothers, who may help care for the baby.

Which of the following reasons explains why new community/public health nurses are very uncomfortable with home visiting, even in nice neighborhoods? a. Home visits are a new skill to be mastered, and learning is uncomfortable. b. Home visits reflect a situation under the client's control and in the client's environment. c. Home visits require lots of supervision, backup, and extra resources. d. Home visits take much more time and effort than does giving care in the hospital.

B All of these factors can lead a nurse, especially an inexperienced one, to feel uncomfortable. However, the major difference is that the setting and the control are clearly the client's, not the nurse's.

Of the five clients listed below, whom should a nurse visit first? a. A married couple who have been having problems with independent living since the husband developed a staphylococcal infection b. A client with acquired immune deficiency syndrome (AIDS) who is waiting for a hospice opening c. A new admission who was discharged from the hospital with a diagnosis of pneumonia d. A man with a draining chest abscess who is receiving intravenous antibiotics

B Because an AIDS client is immunosuppressed, the nurse should visit that client before visiting clients who have, or may have, an infection.

A terrorist releases a poison gas in a crowded subway. This is an example of which of the following? a. Appropriate political action b. Man-made disaster c. Media event d. Natural disaster

B By definition, release of poison gas is a man-made disaster. Man-made disasters include war, chemical and biologic terrorism, transportation accidents, food or water contamination, and building collapse.

Of the following disasters, which would probably cause the most suffering? a. A fire during finals' week in a private residential college b. A fire in an Alzheimer disease unit of an extended-care facility c. A fire in an outpatient dermatology clinic at a major urban hospital d. A thunderstorm that downs electrical lines to the local rural hospital

B Certain characteristics of humans influence the severity of the disaster's effect on individuals and communities. For example, the age of a person, preexisting health problems, degree of mobility, and emotional stability all play a part in how someone responds in a disaster situation. Because patients with Alzheimer disease are less cognitively capable and physically less fit, many of them would probably be unable to escape and therefore would be injured or killed.

Which of the following actions is considered most important by the Centers for Disease Control and Prevention? a. Assisting in recognizing and detaining known terrorists b. Educating health professionals to recognize and treat biochemical hazards c. Establishing and maintaining a database about known biochemical hazards d. Printing and distributing informational materials about known biohazards

B Educating health professionals to recognize and treat biochemical hazards is a priority because there is concern that biologic hazards can be used as terrorist weapons.

A nurse visited a new family to help them adapt to the needs of their newborn. The family asked the nurse to help them obtain diapers, formula, and transportation to the clinic. How should the nurse respond? a. "I can't believe you even asked me that. I don't have any money!" b. "I can't help with those items, but I can share with you some other resources that may help you adapt to having this new little person in your lives." c. "I'll ask at the home office and see if someone knows a resource for you." d. "My sister has some cloth diapers she isn't using anymore; I can bring those over, but I don't have any formula. Have you tried asking the hospital for free samples?"

B Families may test what the nurse is willing to do, or they may be so overwhelmed that they make inappropriate or unrealistic demands. The nurse must state limits immediately to maintain trust. However, referrals are appropriate for emergency food, clothing, and shelter, including formula for newborns.

A nurse is assisting at a disaster shelter. Which of the following interventions would be most appropriate for the nurse to implement? a. Encouraging everyone in the shelter to guard their own things from possible theft b. Keeping healthy victims busy by assigning them specific duties to perform c. Putting hysterical or panic-stricken victims with adults who can listen to them d. Separating the children from the adults so that the adults can rest while the children play

B Families should be kept together. Panic-stricken or hysterical people should be isolated. Although watching one's things may seem important, stressing that need feeds fear and loss. Survivors may be given tasks to keep them busy and reduce trauma to their self-esteem.

Which of the following actions should every nurse take to prepare for a possible local disaster? a. Completing an American Red Cross training program b. Having a personal preparedness kit stored in the home c. Providing volunteer assistance during a disaster in a neighboring community d. Educating the community about the recovery phases after a disaster

B Having personal supplies will allow the nurse to provide self-help, as well as aid others. The American Red Cross has many training programs, such as cardiopulmonary resuscitation (CPR). It is assumed that most nurses have completed programs such as CPR training before graduating from their nursing program. Community education is necessary for preparedness for a disaster; the priority would not be for education about the recovery phases.

Which of the following programs provides educational, nutrition, health services, and parent involvement opportunities to low-income children? a. Daycare centers b. The Head Start program c. Nursery school d. Private child care providers

B Head Start provides educational services, nutrition, health services, and parent involvement opportunities to low-income children. It was based on the model of nursery schools, which originally were designed to enhance children's ability to learn, promote social skills, and provide remedial learning time, if it was needed.

Which tendency common to adolescents is the primary reason why it is so difficult to keep them healthy and safe? a. Binge drinking at parties b. Engaging in high-risk behaviors c. Engaging in unprotected sex d. Using tobacco and other drugs

B High-risk behaviors include smoking, drinking, and unprotected sex. Adolescents have a tendency to dismiss the dangers associated with high-risk behaviors. Alcohol and drug use contributes to this tendency.

Everyone in the emergency shelter told their neighbors what they were doing and how they got away. Which of the following is the most likely reason why these people are sharing their escape stories? a. They are euphoric because they are safe in the shelter. b. They are in the "honeymoon phase," when everyone draws together. c. They are in the reconstruction phase, reviewing just how everything happened. d. They are totally unrealistic, as they clearly had no idea of the extent of the disaster.

B In the "honeymoon phase," there is a drawing together of people who simultaneously experienced the catastrophic event

A local community has experienced a disaster. What should the community do first? a. Call the federal government for immediate funding assistance. b. Implement its emergency operations plan. c. Recruit volunteers who will see what needs to be done and start doing it. d. Try to escape the disaster area.

B Local communities are responsible for safety and welfare of their residents and are required to have an emergency operations plan.

Which fact would suggest to a family that they may want to check building codes and availability of insurance and reconsider the location of their next home? a. The area where they are looking had a huge neighborhood fire after a lightning strike last year, and people are just starting to rebuild. b. The building lot is beautiful but in an area that has had forest fires and all the houses have burned three times in the past 20 years. c. The empty building lot was in a neighborhood of very nice homes, but the home that used to be there was burned when the smoker fell asleep in his bed. d. The home is very historic with features that cannot be replicated at any price today, but the damage from the fireplace fire is still very visible in the main living area.

B Most disasters are infrequent (such as being struck by lightning) and controllable (a person does not have to smoke, particularly in bed), but if such an event is predictable and frequent, action should be taken to avoid a disaster. In this case, it is probably foolish to build in an area where forest fires recur at frequent intervals.

What should a nurse bring to the home visit when first going to the apartment of a newly admitted patient whose referral sheet was essentially blank? a. Everything that might possibly be needed b. Liquid soap, paper towels, educational materials, and assessment equipment c. Nothing; the nurse should assess the situation and then get supplies d. Agency forms and a pen

B Not knowing what he or she will see or need, the nurse should bring safety supplies (soap, paper towels) and basic assessment tools. The nurse can return to the car for additional supplies or equipment if it is needed.

A nurse briefly summarized a home visit with the agency supervisor. How can discussing clients with a colleague help the nurse? a. By ensuring that the agency's policies and procedures are correct b. By confirming the nursing inferences that have been developed c. By ensuring that appropriate referrals are made for the client d. By confirming that the client understands the obligations of the agency

B Nurses are in the position to share assessment information, determine what it means to the family, and discuss nursing inferences that have been made. Consultation and collaboration with other professionals within the agency are important to make sure that the nurse is seeing the complete situation of the patient and that an appropriate plan of care has been developed for the client.

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 Of the 10 most prevalent infectious diseases, 5 are STDs: Chlamydia infection, gonorrhea, acquired immune deficiency syndrome (AIDS), syphilis, and hepatitis B. Men are usually asymptomatic and do not generally seek reproductive health care services, and their infections are more likely to go undetected. Infections can be spread multiple ways, such as through direct contact. The rates of chlamydia and gonorrhea are higher among women than among men.

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 nurse's 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.

B One of the recommendations for school substance use prevention programs is to develop and enforce a school policy on substance abuse; creating a no-smoking policy meets this recommendation. The other interventions, although important, do not address the recommendations addressed in the text

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.

B One third of men aged 25 to 29 years have female partners that are either 3 to 6 years younger or 7 or more years younger. One study of California teenage mothers revealed that the fathers of their babies were an average of 3 years older than the mothers. Boys aged 19 and younger rarely father a child; they are not responsible for most pregnancies among adolescent girls.

Several people were involved in a local community shooting, and one victim died shortly thereafter. Which person will need the most help immediately after the shooting? a. The police officer who will have to notify the victim's family and follow up with the crime investigation b. The woman who has been living with victim and has never experienced death of a close friend or family member c. The woman who broke up with victim about a month ago and has not forgiven him for moving out of her apartment d. The victim's best friend, who is accustomed to gang shootings and random violence

B Personal variables influence an individual's reaction. Psychological proximity and previous experience influence response. Risk for developing severe consequences is greater if that person is emotionally close to the individual affected or has never before experienced a disaster.

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

B Research suggests that the main factors leading to sexual activity among teenagers are peer pressure, an adolescent's need to belong to a group of peers, and the sexual content of media messages.

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 nurse's 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 child's educational record." c. "Yes; as parents you have the right to your child's 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."

B School-based health clinical and center records, records connected to drug or alcohol abuse, and records connected with child abuse or neglect are not considered part of the educational record available to the parents.

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 Studies reveal that students who are academically motivated and progressing well in school generally delay sexual activity. Adolescents from single-parent families with fewer support sources and adolescents who engage in risky behaviors have sex earlier than do teenagers from families in which both parents are present and teenagers who do not engage in smoking, drinking, or drug use

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 Teenage motherhood is a risk factor for the infant. Stillbirths are twice as common among infants born to teenage mothers as among infants born to mothers in their twenties, and the mortality rate is higher. Babies born to very young mothers are at greater risk for health problems and hospitalization than are babies born to older mothers.

The President of the United States has declared an area a major disaster area. Which of the following actions will be taken by the American Red Cross? a. Ensuring that privacy and confidentiality of affected families are maintained b. Engaging in mass care, including provision of food, shelter, supplies, health services, and family services c. Establishing a financing loan program for people to rebuild their homes and businesses d. Keeping details of the extent of the disaster confidential

B The American Red Cross was granted a charter in 1905 to act as the primary voluntary national disaster relief agency for the American people if a disaster has been declared by the President. Among the responsibilities of the American Red Cross are damage assessment; mass care, including provision of food,

As the flood receded from the town, the Disaster Action Team (DAT) met for debriefing. Why is this debriefing important for the whole community, as well as for the disaster team members? a. The DAT is too tired to keep working and needs to sit and rest a while. b. The DAT has insights that can help modify disaster plans to be used in the future. c. The DAT has to give details of their names and addresses, so formal appreciation for their efforts can be sent. d. The DAT needs some time to just socialize.

B The experience of implementing the disaster plan is extremely useful in knowing which changes need to be made.

What is a problem with the federal government's Education for All Handicapped Children Act (PL 94-142) and its amendment (PL 99-457)? a. Each state decides how to educate its children who have handicaps. b. The federal government did not allocate any funds to implement the law. c. The law established rigid definitions for "at risk" or "handicapped" children. d. Most parents choose not to be involved in the program because of its restrictions.

B The federal government enacted the law but provided no funding. Funding is the responsibility of the individual states. Locating such funding is difficult for states in a time of fiscal restraint.

What right do all handicapped children with disabilities aged 6 through 21 have because of the Education for All Handicapped Children Act? a. At-home tutors to maximize their learning b. Education in the least restrictive environment c. Learning without excessive cost to the local school system d. Attending public schools at regular intervals for socialization

B The law guaranteed free and appropriate education for all children in the least restrictive environment. For most children, this means they have the privilege of attending public school at the schools' expense.

Which of the following citizens trapped in a flood is in most need of supportive intervention by the nurse? a. A handyman who was planning to remodel soon anyway b. The man who had never been in a flood before and did not realize how much damage could be done c. The store owner whose storefront was under water yet again d. The woman whose house and small business were badly damaged but who had flood insurance

B The man who had no previous experience with a flood is psychologically unprepared for the disaster, whereas the other three citizens seem more prepared or do not seem to perceive the disaster as overwhelming.

A new resident was touring the local elementary school where she planned to enroll her 5-year-old child. She was surprised by the number of children who had special needs that she saw in the classrooms. She asked, "Why are all of these children in the regular classroom setting? Don't you have a special place for them to go?" How might the nurse respond? a. "Most of these children will be transferring soon to a new school that will better meet their needs." b. "All children may receive education in the traditional classroom setting." c. "Our school receives additional federal funding to provide care for these children." d. "The rising cost of special education has forced us to combine classrooms."

B The number of children surviving the perinatal period with significant impairment has grown rapidly as a result of advances in medical technology. The 1975 Public Law 94-142, the Education for All Handicapped Children Act, guaranteed free and appropriate education for all children in the least restrictive environment. Thus, children with disabilities are in public schools and may receive education in the traditional classroom setting

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 The problems of teenage pregnancy not only are caused by age but also result from lower socioeconomic status, poor prenatal care, inadequate nutrition, and unhealthy lifestyle practices.

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

B The traditional school health approach included the three domains of health services, health education, and environment.

Five years after a major flood, a 52-year-old woman visits the family nurse practitioner (FNP) complaining primarily of inability to sleep but also of trouble concentrating on her job and household tasks and lack of interest in her former hobbies. Which of the following actions should the nurse take next? a. Ask whether she has any other menopausal symptoms such as hot flashes. b. Ask whether she has frequent nightmares or intrusive memories about the flood. c. Suggest ferrous sulfate for anemia, which may be the underlying cause of the symptoms. d. Suggest hot cocoa and relaxation exercises to help the woman sleep and regain her vigor.

B The woman's symptoms suggest posttraumatic stress disorder, but further assessment is needed to confirm the initial diagnosis.

What would be the school nurse's 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.

B, C, D, F Both anorexia nervosa and bulimia nervosa are characterized by disturbed eating patterns. Major depression commonly accompanies both anorexia and bulimia, and obsessive-compulsive disorder is associated with anorexia. These eating disorders have the highest mortality rate of any psychiatric disorder.

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.

B, C, E The most common reasons teenagers give for choosing abortion are as follows: being too young to be a mother, being unable to afford a child now, believing that a baby would change her life, believing that parents would want her to have an abortion, and unreliability of the partner.

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

B, C, E, F Stillbirths are twice as common among the infants of teenagers, and the mortality rate is two to four times higher during the first year of life for infants born to adolescents. Also, babies born to young mothers are at increased risk for child abuse and neglect, for poorer cognitive development, and for poorer educational achievement.

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 infant's grandparents assist with child care

B, C, F Among the consequences of pregnancy among adolescents are increased risk of medical complications and poorer outcomes for the mother. Education may be jeopardized, which endangers future employment expectations and hence results in a greater risk for poverty with all its negative outcomes.

Why do health care providers support providing care for children with chronic conditions at home? (Select all that apply.) a. At home, there are more caregivers. b. At home, there is decreased chance of infection. c. Home care is less expensive for the family than hospital care. d. There is less sensory overload and sleep deprivation at home. e. Living at home with a family is the normal lifestyle. f. At home, there will be more room for all the special equipment needed for the child.

B, D, E Home care promotes the professional care goals of normalization and maximizing the family's self-care. However, care at home may also be disruptive for the family, may be expensive, and may require both family and home structure readjustments

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 infant's grandparents may have to become infant caregivers again. c. Older siblings may fight for the chance to be the infant's baby-sitter during evenings. d. The teenage mother's 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.

B, E, F The newborn infant affects members of the family with changes in family pattern and routine. The teenage mother's siblings can become resentful because they may have to compete for attention. Family members may have less privacy and may have to share resources. The grandparents may have to assume economic costs, as well as infant care responsibilities. The family may not be equipped to deal with the economic and emotional pressure, and such pressure is often a burden.

Which of the following would most likely be a problem for the nurse making home visits? (Select all that apply.) a. Assessing the client may be more complex when family and environmental factors are considered in the assessment. b. The nurse may be unable to care for as many clients because of the time lost in transportation. c. Clients will be unable to receive individualized care. d. Teaching may be more time-consuming when both the client and the family are involved. e. The nurse may sometimes be concerned for personal safety. f. It may be difficult to control distractions, such as noisy children.

B, E, F Travel time is costly, and it is less efficient for the nurse than working with groups or seeing many clients in an ambulatory site. Distractions, such as television and noisy children, may be more difficult to control. In addition, nurse safety can be an issue.

Which of the following would be the first priority when a nurse is completing a home visit? a. Consistency with agency rules and procedures b. Legally, whatever the medical referral requires c. Unless a medical emergency, whatever the client believes is most important d. What the nurse's professional judgment determines to be the major threat to health

C Because the client is the ultimate decision maker, the client's priorities must be addressed first.

A new mother seemed hesitant to let the community/public health nurse into her apartment. However, the visit seemed to go well, with the nurse sharing information, resources, and positive support to the new mother. At the end of the visit, the mother thanked the nurse profusely but said she thought she was all right now so there was no need for the nurse to return. Which of the following actions would be most appropriate for the nurse to take? a. Chart that the mother was noncompliant and would not let the nurse return. b. Plan on returning in 1 week to answer any new questions the mother might have about her baby, how to care for him, or how infants grow and develop. c. Stress how to get in touch with the public health agency if the mother ever has questions or needs assistance and then wish her the very best. d. Try to find free formula, baby cereal, infant clothes, and other goodies to give the new mother so she will let the nurse back into the apartment.

C After discussing the options and choices that the family has if it declines further visits, the nurse has provided information so the family can engage in informed decision making. The nurse has no further obligation.

After a completing a home visit, which of the following would be the priority action for the nurse? a. Submit the insurance and other third-party payer forms correctly. b. Call the family and determine their satisfaction with the visit. c. Complete the documentation and discuss questions beyond the nurse's expertise with a consultant. d. Order the necessary supplies and equipment for the return visit.

C After the visit, the nurse should make sure that documentation is complete, make any necessary referrals, and consult with colleagues or an expert in a particular clinical area about unresolved issues. Legal documentation is always required after a home visit.

Which of the following would be the nurse's primary goal during the first visit to home-bound clients? a. To assess the health of all family members and the immediate environment b. To discuss the time and financial limits to the care the nurse can give c. To establish rapport with the clients and work with them to define mutually agreeable goals d. To implement the nursing care plan established before hospital discharge

C Although all the steps are important, establishing rapport, defining problems, and agreeing on goals must be done before it is possible to begin the other steps. These events occur during the initiation phase, which starts during the first visit and may take several visits

Two young people were smiling as a nurse brought in their new baby in preparation for leaving the hospital and going home. What do the new parents need? a. A diaper bag filled with formula, baby product brochures, and coupons b. A list of community agencies who work with young families c. Anticipatory guidance on parenting and time management d. Educational material related to continuing marital satisfaction while raising a child

C Although any of the options might be helpful, the primary need is for anticipatory guidance and education regarding infant and child care, normal growth and development, new communication patterns, and the task of managing time and energy.

A mother who provides care for her ventilator-dependent child told the nurse, "My child is ill and has to go to the hospital. I think she is getting a serious infection." What other factor should the nurse assess in addition to possible infection? a. Potential child abuse by the mother b. Hydration and nutritional status of the child c. The mother's level of exhaustion and stress d. The cleanliness of the ventilator equipment

C Although any of these could be true, the most probable response, because a ventilator-dependent child requires more services than almost any other child, is that the overwhelmed mother feels inadequate and desperately needs a respite. The nurse must always be alert for signs of parent stress and burnout. Acknowledging the mother's heavy responsibility will help.

A 7-year-old boy happily introduced a nurse to a man he called "Dad" and a woman he called "Mom." What may the nurse safely assume? a. The mother and father are the child's biologic parents. b. The mother and the father are married to each other. c. The child lives with a man and a woman whom he considers his parents. d. The mother, father, and child live together as a nuclear family.

C Although most children younger than 18 typically live with both parents, it is not safe to assume that either parent is the biologic parent or that they are married or that they live together. Thus, they may or may not be a nuclear family. On the basis of the introduction, the child considers the woman his mother and the man his father. Either one may be a stepparent or an adoptive parent. The values of affection and responsibility, not biology, are what bond contemporary families.

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

C Curriculum must accommodate the unique local needs and preferences of each community to increase support from and awareness of community members.

Which federal government entity is responsible for coordinating all federal disaster assistance? a. American Red Cross b. Department of Homeland Security c. Federal Emergency Management Agency (FEMA) d. National Disaster Risk Reduction and Management Council

C FEMA was established in 1979 as the coordinating agency for all available federal disaster assistance. The American Red Cross is a voluntary nongovernmental organization. The Department of Homeland Security is responsible for managing domestic incidents. The National Disaster Risk Reduction and Management Council is part of the Philippine government and is not a federal government agency in the United States.

What are today's 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

C Formerly, children and adolescents had to confront contagious diseases, but today adolescents face risks related to high-risk behaviors. Adolescents die from motor vehicle crashes, other unintentional injuries, homicides, and suicide.

After a disaster, one citizen was most impressed with how much his neighbors went out of their way to help rescue him and take him to the emergency shelter. What is the most likely reason why his neighbors helped him? a. They feared that he would sue them if they did not help him. b. They hoped that, because he was very wealthy, he might give a reward for their help. c. Such help is part of the pattern of behavior during the heroic phase of reaction to a disaster. d. Such behavior is what any American would expect of a neighbor today.

C Helping other people survive is often the first phase of a community's reaction to a disaster.

A school nurse decided to offer a parenting class to all parents of children in kindergarten and first grade. Which of the following content would the nurse want to discuss? a. Correctly interpreting the child's communication cues b. Importance of immunization and screening schedules on the child's health c. Recognizing the influence of school peers on the child's behavior and health d. Understanding their own feelings about having a second child

C Immunizations are required before a child enters school, and most parents decide whether to have a second child when the first child is at the preschool age. Parents and children learn to recognize communication cues when the child is still an infant. Thus, the crucial information is recognizing the influence of the school on the child's behavior, as well as how children are exposed to contagious diseases in the school setting.

When is the term mass casualty incident used in a disaster or crisis? a. Fewer than 100 victims, which strains resources b. Man-made disaster events c. More than 100 victims, which overwhelms resources d. Natural disaster events

C In a multiple casualty incident, 2 to 99 people are injured. In a mass casualty incident, a large number people, usually 100 or more, are injured, which significantly overwhelms available emergency medical services, facilities, and resources.

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

C Key elements of a comprehensive school health education program include a documented, planned, and sequential program of health instruction for students in grades kindergarten through 12; a curriculum that addresses and integrates education about a range of categorical health problems; activities that help young people develop skills to avoid health problems; instruction for a prescribed amount of time at each grade level; management and coordination by an educational professional; instruction from teachers who are trained to teach the subject; involvement of parents, health professionals, and community members; and periodic evaluation. Involving parents and community members in health education programs meets the identified key elements. The other options, although important, are not part of a comprehensive school health education program.

In a city where tornadoes have been known to strike, an emergency siren sounds, suggesting to its citizens that an emergency is imminent. What should a community/public health nurse do first? a. Call every family member and tell them to come home immediately. b. Call the local civil defense office for specific instructions for the nurse's agency. c. Follow the disaster plan of the local emergency management agency. d. Start driving to the hospital and prepare to care for the injured.

C On the basis of their employment position, nurses should know their role and specific responsibilities for disaster response. Therefore, the nurse should be prepared to follow the emergency preparedness plan.

A nurse, serving as a volunteer, was helping community residents who had been taken to an emergency shelter for food, clothes, and life necessities. Of the following families, which is in most need of receiving assistance from the nurse? a. A woman who is visiting her father and sees the flood as helpful to finally convince her father to move in with her and her husband b. The couple who believe the flood is God's will and are attempting to determine its meaning for their life c. The man who cannot believe that everything important to him is now lost d. The man who believes the flood is a test of his faith but knows he will be alright

C Professionally, the nurse should concentrate on the victim to whom the disaster is the most overwhelming psychologically.

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.

C The practice of oral sex is now as common as intercourse. About 25% of all teenagers use oral sex as a substitute for intercourse. Research suggests that teenagers do not consider oral sex to be a sexual activity.

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.

C Public funds (ultimately all taxpayers) pay for much of the care and consequences associated with teenage pregnancies, including the cost of treating sexually transmitted diseases (STDs), prenatal care, and support costs such as Temporary Assistance to Needy Families (TANF), Women, Infants, and Children (WIC), and Medicaid.

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

C School personnel in general have no training in health-related fields and generally do not anticipate having to perform health care functions when they accept employment as teachers or school employees. Because lack of funding impedes the presence of full-time nurses at many school buildings, school nurses must train and delegate some tasks to unlicensed school staff. Thus, keeping documentation of the training and evaluation of their performance of the skills that have been delegated is essential.

During the second visit, a nurse noticed that although an elderly gentleman had not been able to clean up the apartment, he had been able to clean up the kitchen. Why would the nurse praise him for his cleaning efforts when only one room had changed? a. It demonstrated that the home-bound man was trying to be compliant with the nurse's suggestion. b. It made the apartment so much nicer for both the client and the nurse. c. It was a successful short-term achievement toward the long-term goal of environmental safety. d. The elderly gentleman obviously expected considerable praise for doing such a female task.

C Short-term objectives are often helpful toward slowly achievable long-term goals. It is also wise to be aware of and verbalize small, subtle changes or achievements.

What must a child achieve to legally become an adult? a. Demonstrate adequate maturity and judgment. b. Join the military. c. Meet state law requirements based on chronologic age. d. Obtain a driver's license or otherwise demonstrate responsibility.

C State laws determine legal age, typically by chronologic age rather than maturational or mental age

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.

C Statistics show that teenagers who are parents are at significant risk for having another child while they are still teenagers.

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.

C Suicide is the third leading cause of death among young people; 6.3% of high school students report making at least one suicide attempt.

As the nurse entered the house of an elderly couple and was invited to sit, three cats rubbed against the nurse's legs. Which of the following would be the most appropriate comment for the nurse to make? a. "Are these cats hungry? Or do they want something else?" b. "Cats can really cause health problems. Would you like me to call the animal shelter for you?" c. "Would you like to introduce me to your cats?" d. "Would you please lock up your cats until we're done?"

C The appropriate response to animals in the house is to first assess for safety. If safety is not an issue, then ask for an introduction. Pets are often considered members of the family.

On the first home visit, a nurse explained to an elderly couple how the nurse could help them. Who would be the most knowledgeable concerning the couple's health needs? a. The nurse who had analyzed all of the background data b. The hospital case manager who had coordinated the couple's care c. The elderly couple themselves d. The nurse who had been the primary care provider in the hospital before discharge

C The clients are the experts in their own health, their health history, their experience in various stages of health and illness, and their health and illness concerns.

What is the first and most important aspect of managing disasters? a. Evacuating injured persons to medical facilities b. Giving immediate first aid and medical care to the victims c. Planning to prevent such disasters whenever possible d. Rescuing the victims

C The eight principles of disaster management, in order of priority, begin with prevention of the disaster whenever possible.

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.

C The majority of teenage pregnancies are among white adolescents. However, African Americans are at greater risk for adolescent pregnancy. Hispanic and black teenagers have a higher proportional rate of adolescent pregnancy, but because they are fewer in number, the largest number of teenage births is to white mothers.

A family is supporting each other in the emergency shelter after a flood. The nurse overhears the conversation. Which family member most needs the other family members to listen and understand? a. An 11-year-old girl, who lost her teddy bear collection and is crying b. A 45-year-old adult, who keeps telling everyone that at least he still has his job and that they can cope with this c. A 43-year-old woman, who keeps saying, "Without our family pictures, we've lost our history" d. A 16-year-old boy, who has lost his favorite hunting rifle and seems angry

C The nurse should concentrate on the victim whose perception of the disaster is the most overwhelming. Losing one's personal history would be the most overwhelming loss both psychologically and objectively.

What should a nurse know about American children? a. Any child younger than 21 years must have parental consent to receive health care. b. Children with significant disabilities are cared for primarily in institutions. c. Almost one per five children lives in poverty, especially if living with a single parent. d. Since the early 1900s, infection has been the primary cause of death among children.

C The proportion of U.S. children younger than 18 years who live in poverty increased from 18% in 2007 to 20% in 2009. Women earn less than men do, and single-parent families have only one adult wage earner. Although, in the past, infection was the primary threat to well-being and children with significant disabilities were institutionalized, more children now die from accidents than from infections.

After leaving the home of a new mother and her newborn, the student nurse asked the instructor, "What will the new mother do when we aren't there to help?" Which of the following statements would be the best reply from the nursing instructor? a. "I am going to ask you to come back tomorrow to help the new mother further." b. "Why would the new mother experience any problems?" c. "We have to assume that the new mother will be able to manage without us." d. "We'll have another nurse stop by tomorrow to help the new mother."

C The purpose of care in the community is to enable the family to remain at home and manage without the constant presence of health care providers.

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 The rate of adolescent pregnancies in the United States is one of the highest pregnancy rates among industrialized nations.

Of the following families, which is most likely to need the most support to recover from the loss of electricity? a. The family who moved into their motor home with its generator b. The family who was away on vacation at the time c. The family who was without electricity for 2 weeks d. The family who was without electricity for 3 days

C The scope and severity of the disaster have a major effect on a person's ability to cope. In general, people without electricity for longer periods of time have a more difficult time. Consequently, 2 weeks is more difficult than a few days to be without a major utility.

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.

C There is little evidence that abstinence-only programs are successful in curtailing sexual activity until marriage or in reducing STDs or pregnancy among adolescents. Research showed no difference in outcomes related to sexual activity and unprotected sex between teenagers who attended such a program and those who did not.

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 Violence and abusive behaviors are major causes of death and injury. Violence prevention programs have been established in many schools. One of the most important recommendations made by the Centers for Disease Control and Prevention (CDC) is to implement violence prevention programs to promote substantial reductions in antisocial and delinquent behaviors.

A disaster is occurring in a community. Which of the following actions should the nurse take first? a. Calling all members of the nurse's family together at their home b. Immediately driving to the hospital in preparation for giving care to victims c. Remaining in place until the situation has stabilized d. Contacting the emergency operations center to receive instructions

C While a disaster is occurring, professionals are usually advised to remain in place until the situation has stabilized before attempting to provide care. Phone lines may be nonoperable, and roads may not be open for traffic. The priority is to remain in place, and the next step will be to contact the emergency operations center if necessary.

A school health nurse made a home visit each month to a ventilator-dependent child. The mother verbalized wanting to stop taking care of her child at home. What benefits of receiving home care should the nurse reinforce to the mother? (Select all that apply.) a. Home care provides a quieter and less intrusive environment. b. The child will enjoy better sibling interaction at home. c. The child will have better motor and socialization skills. d. The child will have fewer infections and better nutrition. e. Home care improves marital relationships with her spouse. f. Home care is a much safer environment with less chance of mortality.

C, D The home environment provides better socialization opportunities and usually better motor skills. It also means fewer infections and better nutrition. However, because siblings may be asked to help care for the ventilator-dependent child, relationships between siblings may worsen. In addition, there is risk of accidental death related to the complex care provided in the home.

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

C, E, F The identified priorities associated with teenage sexual activity in Healthy People 2020 are increasing the age at first intercourse, reducing the number of adolescents engaging in sexual activity, and increasing the number of adolescents who use protective measures when engaging in sexual activity.

The supervisor suggested that a nurse use a contract to confirm goals and plans with an elderly man who had recently moved into a self-care halfway house. Which of the following is an advantage of such a contract? a. It documents the cost of each nursing service. b. It protects the nurse if the nurse is ever sued for malpractice. c. It is legally binding for both parties. d. It clarifies who will do what, when, where, and why.

D A contract clarifies and documents mutual understandings. The agreement usually entails one or more family members continuing to meet with the nurse for a specific number of visits or weeks. Initially, specific goals and the nurse's role regarding health promotion and illness prevention may be unclear.

What is the most crucial aspect of the first visit to a new client? a. Confirming that all needed assessment data are obtained b. Creating an accurate and appropriate list of nursing diagnoses c. Establishing a systematic evaluation plan d. Establishing trust for a productive relationship

D Although all the options listed are important, the relationship is the most important because without it, the other tasks cannot be completed. Without at least earning trust, the nurse will not be able to visit the family again. Also, building and preserving relationships is a central focus of home visiting.

What might be a school health nurse's 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 Because the law focuses exclusively on academic progress to determine the funding that schools receive, it encourages schools and districts to funnel resources in ways that limit support for necessary but indirect influences on academic outcomes. This has resulted in diminished support for health services, which are shown to improve learning readiness, promote student retention rates, and improve academic performance.

Which of the following would be essential characteristics of a professional helping relationship? a. Acceptance and sympathy b. Enthusiasm and energy c. Positive intent, supportiveness, and trust d. Positive regard, empathy, and genuineness

D Carl Rogers wrote that the three characteristics of a helping relationship are positive regard, empathy, and genuineness, which are relevant in all nurse-client relationships.

Children make up approximately what percentage of the total population in the United States? a. 10% b. 15% c. 20% d. 25%

D Children made up about 25% of the population in 2010.

A man continued to state that the flood was not that bad, the town can rebuild, and no real damage was done. From his statements, what can be concluded? a. He has totally recovered and thinks everyone else has as well. b. He is having a strong emotional response but is overcompensating. c. He is psychotic and needs medication. d. He is still in denial, and the disaster has not really registered yet.

D Denial is the first stage of emotional response to a disaster. Victims will deny the magnitude of the problem or understand the problem but seem unaffected emotionally.

A home health nurse was making an initial visit to an elderly man. As the nurse began the assessment, the wife gave all the information requested. Which of the following actions would the nurse take next? a. Agreeing upon appropriate interventions with the family b. Creating appropriate nursing diagnoses c. Assessing the environment of the wider community d. Confirming the information obtained with the client

D Having heard from only the wife, the nurse must attempt to validate the information with the husband or recognize that all information was from only one perspective.

Of the following communities, which had a poor reaction to a disaster? a. Chicago, which, after a large fire, now requires all buildings to be made of fireproof brick b. Hilo, Hawaii, which, after the downtown was again destroyed by a tsunami, created an oceanfront park and moved small businesses farther up the mountain c. Los Angeles, which is in the process of strengthening highway resistance to earthquake damage d. Settersville, which, after a tornado flattened downtown, decided to appeal for state funds to rebuild, and which, if no funds are forthcoming, will simply cease to exist as a town

D Healthy cities that are susceptible to particular disasters on a frequent basis try to establish prewarning, or control, measures that can reduce the impact of disasters. Thus, a healthy community is one that plans to minimize damage and strengthens structural resources. An unhealthy community might just give up.

Floods have hit a small town on the Mississippi many times. The last time, a levee broke, and there was extensive property damage, as well as several deaths. What should be the first preparation that the nurse should make before another flood hits? a. Create child care centers. b. Establish morgue facilities. c. Plan for a parking area for rescue workers. d. Practice the nurse's personal family response plan.

D Nurses should establish their own family disaster response plans to protect their family and homes and still be able to respond to their community's need.

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

D One of the biggest epidemics in the United States today is that of obesity. Benefits of regular physical activity are clearly documented. The 2006 School Health Policies and Programs Study (SHPPS) recommended an increase in quantity and quality of physical exercise.

In a state where a disaster occurred, which of the following actions should the governor take first? a. Touring the disaster area with the media b. Encouraging community members to volunteer c. Publicizing the disaster and asking the national government for funding d. Opening the state's Emergency Operations Center

D One state agency is usually designated as the emergency management agency for all state-coordinated efforts. The state governor will open the state's Emergency Operations Center to coordinate state agencies' disaster relief efforts. The Emergency Management Agency advises the governor when the state has exhausted its resources or if the disaster is such that the state does not have adequate resources to respond.

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.

D Preliminary data through 2009 indicate a sharp decline in teenage pregnancy rates and a moderate decline in birth and abortion rates among adolescents.

What information would be helpful for a mother of a toddler who was just beginning to explore the mother's small apartment? a. Persuade the child to take his vitamins by saying, "Isn't this good candy?" b. Give the child lots of finger foods such as peanuts, popcorn, or banana slices. c. Provide a warm, caring environment for the child. d. Suggest environmental changes such as safety plugs in all electrical outlets.

D Safety measures include keeping pot handles away from the edge of the stove; using safety plugs in the outlets; not providing peanuts, popcorn, or other hard-to-chew foods; and reinforcing that pills are not candy. Providing a warm, caring environment does not assist with keeping the home safe.

In an earthquake, the roads and underground pipes were all destroyed. Fires and explosions began to occur from the broken leaking gas lines. Which of the following would be used to describe the fire? a. A man-made disaster b. The cause of the earthquake c. The primary agent d. The secondary agent

D The earthquake was the primary agent that caused the damage; the fires were secondary agents that resulted from damage by the primary agent. In this incident, primary agents include falling buildings, heat, wind, rising water, chemical and biologic agents, and smoke; secondary agents include bacteria and viruses that produce contamination or infection after the primary agent has caused injury or destruction. Primary and secondary agents vary according to the type of disaster

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.

D The family now has added economic and emotional pressure, which is often a burden with which the family is not equipped to deal. Grandparents may become the infant's primary caregivers, and siblings and other family members become resentful of the added burden.

A nurse is often frustrated when clients do not comply with the nurse's suggestions that would improve their health. What might be helpful to remember in such situations? a. It takes a long time and much effort to change people's behavior. b. The clients may not change today, but they may change tomorrow. c. The nurse may have to change the client's values in order for the client to want to change behaviors. d. The only person the nurse can change is the nurse.

D The only person the nurse can change is the nurse. Trying to change another person may make that person feel dominated and thus feel more strongly that change must be resisted.

Why do not all public health agencies provide nursing home visits for new mothers and babies? a. It is too difficult to get the names and addresses of new mothers from the hospitals. b. New mothers are too overwhelmed to have another visitor in their homes. c. Physicians prefer to do the education with new mothers in their offices. d. Private third-party payers will not reimburse such a primary health promotion effort.

D Third-party payers do not reimburse home visits for early intervention, even though such interventions decrease mortality and morbidity.

What conclusion can be drawn in a comparison of hospital costs with home care costs for ventilator-dependent children? a. Hospital costs are about the same as home care costs. b. Hospital care is less expensive than home care. c. Hospital care is more expensive than home care. d. Hospital care is less expensive if one of the parents is not in the labor market.

D Whether there are significant cost savings in home care of the ventilator-dependent child remains in question. When caregiver time value or forfeited wages are factored in, home care remains less costly in 70% of the situations. If the caregiver is not in the labor market or holds only a low-paying job, then it may be less expensive. The primary reason for home care is not to save money but the increased family interaction for the child.

Why might citizens be concerned about disasters, especially terrorism, even before they occur? a. Charities will be trying to collect money for the victims by using personal stories. b. Financial costs of a disaster or terrorist attack increase citizens' taxes. c. Laws have been passed requiring preparation for disaster education for laypeople. d. There have been an increased number of terrorist activities throughout the world.

D Worldwide, there have been an increased number of terrorist activities that have been widely publicized using various forms of media.

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 mothers-grandmothers program

D, E School-based clinics have successfully reduced the rates of sexual intercourse and pregnancy among teenagers in a growing number of communities. Comprehensive family life programs have also been shown to be successful. A teenage mothers-grandmothers program would undoubtedly be helpful after delivery but not in preventing such pregnancies.

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)

D, E, F In any state, the conservative answers would be pregnancy tests, prenatal care, and care for any STD. All 50 states allow treatment for care of STDs, although two states (Texas and Utah) do not allow use of state funds for that purpose. Contraception availability depends on the state. Abortions are severely restricted.

After a severe tornado hit the center of town, the American Red Cross set up an emergency shelter. The Emergency Operations Center was established. What would a nurse member of the Disaster Action Team most likely be asked to do? (Select all that apply.) a. Debrief all the professionals assisting at the shelter. b. Establish a personal family disaster response plan. c. Appear on the local radio and TV stations to encourage citizens to stay calm. d. Ride in a helicopter and assess the amount of damage done to the community. e. Assign people who come to the shelter a space and give them emotional support. f. Triage injured people, set up morgue facilities, and help with immediate first aid.

E, F Nurses who are members of the disaster action team will be assigned a shelter and asked to assess needs and provide support. During the disaster, injured people are triaged, morgue facilities are established, and rescue activities are organized. Although a personal family disaster response plan is an excellent idea, the plan should be prepared before a disaster hits. Debriefing occurs during the recovery phase, not immediately after the disaster hits.