Community Exam 3

In 2016, 1,817 cases of TB were diagnosed in a population of 23,910,873. In 2017, 1,432 cases of TB were diagnosed in a population of 24,232,212. In 2018, 1,273 cases of TB were diagnosed in a population of 25,118,982. What is the prevalence per 100,000?

18.79

By 2019, 807 women in Grove Island were living with diabetes. The total population of women in 2019 was 3000. Calculate the prevalence of diabetes per 100 women in this group.

26.9

In an outbreak of gastroenteritis among attendees of a corporate picnic, 120 persons ate potato salad, 42 of whom developed gastroenteritis.

35%

In 2014 there were 17,582 new cases of cancer in Kingston. The population of Kingston in 2014 is 29,287,454. Calculate the annual incidence rate of cancer in Kingston in 2014 per 10,000.

6.003

In 2010, 2,832 new cases of TB were reported in Hunt City. The estimated population of Hunt City in 2010 was approximately 29,809,000. Calculate the incidence rate of AIDS in 2010 per 100,000

9.5

Which statements by a nurse demonstration understanding of the unique needs of vulnerable groups? Select all that apply. A. "I always address the problem that the client believes is the most important." B. "I try to observe the client's cultural traditions as I complete my assessment." C. "I avoid asking clients for income and financial information because that is an invasion of privacy." D. "I make sure to do a comprehensive assessment, since we often don't know when the person will return to the clinic

A. "I always address the problem that the client believes is the most important." B. "I try to observe the client's cultural traditions as I complete my assessment."

A nurse is helping a client's family prepare to have an intervention that hopefully will encourage the alcoholic father to realize the need for change. Which of the following instructions by the nurse to the client's family members would be most effective? Select all that apply. A. "Point out that his behavior is his choice and his responsibility." B. "Let him know that you understand how much he loves being with his drinking pals and that you agree that their friendship is important." C. "Express your love and your belief that he can change." D. "Remind him that entering treatment is better than going to prison."

A. "Point out that his behavior is his choice and his responsibility." C. "Express your love and your belief that he can change."

A nurse suspects that a family care giver is neglecting an older adult. Which of the following statements by the caregiver should the nurse identify as a priority to address? A. "We buy the prescriptions that are cheaper." B. "We sit outside every afternoon." C. "We only have enough money for two meals a day." D. "We can't always find the right batteries for his hearing aid."

A. "We buy the prescriptions that are cheaper?

A school nurse is asked by a parent group to explain risk factors of alcoholism. Which of the following information should the nurse include? A. Alcoholism is determined partly by genetics B. Persons born with fetal alcohol syndrome are alcoholics at birth C. Persons who are alcoholic are usually women D. Alcoholism is determined completely by the family environment

A. Alcoholism is determined partly by genetics

A nurse is caring for a client experiencing withdrawal. Which of the following findings should the nurse expect? A. Anxiety and diaphoresis B. Fatigue and depression C. Arrhythmia and respiratory depression D. Muscle aches and chills

A. Anxiety and diaphoresis

The wife in an abusive relationship reports to the nurse that her partner has been increasingly more abusive over the last year. Which of the following should be the first action that is take by the nurse? A. Develop the plan for the client to escape if the violence starts again. B. Work with the client on developing self-esteem C. Arrange for the couple to attend marital counseling. D. Teach the client how to avoid initiating the partner's anger

A. Develop the plan for the client to escape if the violence starts again.

A community health nurse would like to implement an intervention to increase lasting resilience among new immigrants. Which of the following actions should be taken by the nurse? A. Direct clients to English-as-a-second-language courses B. Give immigrant families money to help them get settles C. Identify area of the city where housing is less expensive D. Solicit donations for food, clothing, and other needs

A. Direct clients to English-as-a-second-language courses

The Community Health Nurse is conducting a community assessment collecting primary data. Which method has the potential to provide the greatest amount of data with the least amount of effort? A. Focus groups of 8-10 people B. Key informant interviews of 10-12 people C. Email surveys to 25 people D. Participants observation of 8-10 people

A. Focus groups of 8-10 people?

Which of the following approaches has research suggesting is the most effective way to approach drug addiction? A. Harm reduction B. substance abuse education C. Criminal justice system D. Punishment approach

A. Harm reduction

A community health nurse encourages members of the community to partner and assists in creating health programs. Which of the following best describes the rationale for this action? A. Participation in planning results in agencies having a vested interest in the outcome B. Partnering results in increased access to established databases C. Involving community members result in contributions of time and money D. Having many partners result in increased publicity

A. Participation in planning results in agencies having a vested interest in the outcome

Which of the following is the primary cause of vulnerability to health problems? A. Poverty B. Social isolation C. Prejudice D. Break down of family structure

A. Poverty

A nurse offers homeless clients yearly tuberculosis (TB) screening. Which of the following levels of prevention is being used? A. Secondary B. Tertiary C. Secondary and tertiary D. Primary

A. Secondary

A large financial grant was being offered to whichever health facility wanted to accept the responsibility for giving care to local vulnerable populations. Which of the following actions would most likely be taken by the local medical centers? A. Strongly consider not applying, because this population would be expensive to treat B. Agree to collaboratively apply for the funds in a cooperative proposal C. Individually compete eagerly for the additional funds now available D. Reach out enthusiastically to this previously underserved population

A. Strongly consider not applying, because this population would be expensive to treat

Which of the following factors may lead to increased violence? Select all that apply. A. Violence normalized by the media B. Adequate social support C. Living in a crowded environment D. Feelings of powerlessness

A. Violence normalized by the media C. Living in a crowded environment D. Feelings of powerlessness

A staff member is orienting a new nurse to a health clinic that serves primarily vulnerable populations. Which of the following statements indicates a need for additional staff education? A. "We try to take care of as many problems as possible in one visit, so when you interview the client ask about additional concerns." B. "You will like working with Hispanic immigrants because they have close knit family structures." C. "If a client does not speak English presents to the clinic, you must obtain an interpreter right away." "D. You will need to assist clients by scheduling any referral or follow up appointments around their work schedules."

B. "You will like working with Hispanic immigrants because they have close knit family structures."

Which of the following bills would a nurse lobbyist, who believes strongly in social justice, encourage legislators to support? A. A bill that establishes policies requiring all persons to pay the same cost for services regardless of income B. A bill that promotes universal health insurance coverage C. A bill that requires all health care providers to give care to uninsured persons without charge D. A bill that requires health care workers to report undocumented immigrants who present for treatment.

B. A bill that promotes universal health insurance coverage

A homeless family brought their father to the public health center after he reported bleeding when he went to the bathroom. Which of the following nursing actions would be most appropriate? A. Suggest the family take him to an urgent care center immediately B. Begin tests to determine the cause of the bleeding while asking the family about other family concerns such as food and shelter for the night C. Treat for a urinary tract infection and give the man medication to take to prevent any return infections D. Refer the man to a urologist to address the bleeding

B. Begin tests to determine the cause of the bleeding while asking the family about other family concerns such as food and shelter for the night

A nurse in an urban community is developing an education program for city leaders about homelessness. Which of the following groups should the nurse include as the fastest growing segment of the homeless population? A. Individuals who have experienced intimate partner violence B. Families with children C. Older adults D. Adolescent runaways

B. Families with children

The nurse is concerned about the possibility of suicide in a teenage boy. Which of the following characteristics are high risk factors for suicide in this client? A. He is between the ages of 15 and 19. B. He is depressed and has a history of being sexually abused. C. He has threatened harm to his school peers. D. He has been accused of abusing animals.

B. He is depressed and has a history of being sexually abused

A nurse noted a provider frequently arrives on the unit with bloodshot eyes and smells like alcohol after lunch. Which of the following actions should the nurse take? A. Inform the state medical board for an immediate investigation B. Notify the nursing supervisor of your concern C. Counsel the providers to determine the cause of the substance abuse D. Encourage clients to change to a different provider

B. Notify the nursing supervisor of your concern

A mother confides to the nurse that her live-in boyfriend knocked down her 2-year-old child because he was crying too much. She begs the nurse not to tell anyone because her boyfriend has agreed to take anger management classes. Which of the following actions should be take by the nurse? A. Abide by the mother's wished because this information was provided in confidence B. Report the incident to child protective services C. Arrange for counseling for the boyfriend at the earliest possible availability D. Encourage the mother to take the child and find alternate housing right away

B. Report the incident to child protective services

A nurse is developing a community-based activity aimed at preventing substance abuse in the community. Which of the following interventions would the nurse most likely implement? A. Educate preschoolers about the long-term side effects of drugs and alcohol B. Support an increase in the availability of recreational facilities C. Provide general health screenings for low income families D. Lobby state legislators to approve a higher cigarette tax

B. Support an increase in the availability of recreational facilities C. Provide general health screenings for low income families

A male IV drug abuser admits to the nurse that he has no desire to stop using drugs, so rather than lecture him on the dangers of drug addiction, the nurse counsels him on needle-exchange programs. Which of the following prevention efforts is the nurse attempting to achieve? A. Primary prevention by education about safe injections B. Tertiary prevention to reduce transmission of blood-borne diseases C. Secondary prevention to reduce the risk for infection or other complications D. Primary prevention by avoidance of future legal complications

B. Tertiary prevention to reduce transmission of blood-borne diseases

Which of the following statements is the best explanation as to why some countries are more violent that others? A. Geographic differences are the primary factor. B. Violence is a learned behavior controlled or allowed by social norms. C. Population differences are the main determinant- for example having more males than females. D. Civilized society are less violent that primitive societies.

B. Violence is a learned behavior controlled or allowed by social norms.

Which of the following statements, made by the care giver of an older client, should alert the nurse to assess for evidence of elder abuse? A. "She has not been having incontinence problems since we have been taking her to the toilet every 2 to 3 hours which she is awake." B. "Mom wanted to stay in her own home, but we were scared for her safety, so we moved some of her personal things into our home and brought her to live with us." C. "Mom is always into something and can't seem to stay still, so I've been giving her half a Valium to get her to relax so I can get some rest." D. "We have to feed Mom baby food now because she had trouble chewing and swallowing regular food."

C. "Mom is always into something and can't seem to stay still, so I've been giving her half a Valium to get her to relax so I can get some rest."

Which of the following best describes a principle of care that the nurse should abide by when working with abusive families? A. Notify the abuser's clergyman, boss, and others who can exert pressure for change. B. Exclude the abuser from family meetings because the abuser is the one creating the problems C. Demonstrate respect for all family members, including the abuser. D. Confront the abuser and shame them into penitence and desire to change.

C. Demonstrate respect for all family members, including the abuser.

A community health nurse is implementing a tertiary prevention activity related to tuberculosis. Which of the following interventions is the nurse most likely completing? A. Interpretation of TB skin test findings B. Assessing signs and symptoms of active tuberculosis C. Directly observing clients with active TB as they take their anti-tubercular medications D. Administration of skin test to identify persons who have been infected with tubercle bacilli

C. Directly observing clients with active TB as they take their anti-tubercular medications

The nurse is assessing an older adult who lives with a family member. The nurse identifies several bruises in various stages of healing. The client and family member explain that the bruises are a result of clumsiness. However, based on the distribution of the bruises, the nurse suspects abuse. Which of the following actions should the nurse take first? A. Discuss respite care with the client's family and ask them to make an appointment with the case manager. B. Report the findings to the supervisor. C. Document the bruises in the client's chart and report the suspected abuse to Adult Protective Services. D. Provide the client with a crisis hotline number and location of the local homeless shelter.

C. Document the bruises in the client's chart and report the suspected abuse to Adult Protective Services.

A nurse is counseling a woman following a sexual assault. Which of the following feelings is the woman most likely to state she felt during the assault? A. Aggression B. Confusion C. Helplessness D. Satisfaction

C. Helplessness

Which of the following is a common factor found among those who abuse others? A. Fear and belief that others are "out to get them" B. Low education attainment and unawareness of alternatives C. Previous observations of violent behaviors to manage conflict D. Difficulty in keeping commitments

C. Previous observations of violent behaviors to manage conflict

During which of the following activities is the nurse in community health acting as a partner in change? A. Analyzing community problems to determine the best interventions B. Administering immunizations to preschoolers C. Teaching anger management skills to a group of teens in a halfway house D. Establishing an elder care center for older adults living with family members who work

C. Teaching anger management skills to a group of teens in a halfway house

Nurses at a homeless clinic are concerned that homeless clients rarely return to have the nurses assess the findings of their tuberculosis (TB) skin tests. Which of the following is the most appropriate policy for the clinic to have regarding the screening test findings? A. Routinely refer all homeless clients for chest x-rays B. Re-administer the TB skin test if the client returns later than schedule for test interpretation C. Use QuantiFeron Gold testing as the results are available without the client having to return D. Call all the homeless clients 48 hours after TB skin testing to remind them to return to the clinic for interpretation

C. Use QuantiFeron Gold testing as the results are available without the client having to return

Which of the following statements by a parent indicates the need for increased learning regarding appropriate discipline of a child? A. "When my child misbehaves, I distract him and focus his attention on other things. If he throws a tantrum, I have been known to just pick him up and leave wherever we are." B. "I have stopped using a switch on my child, and I am learning to count to 10 before reacting." C. "I use time-outs when my child acts out or is naughty. Sometimes my child doesn't cope well with all this, but I am persistent. D. "I never spank or hit; I yell at them to stop being stupid, and if they don't, I tell them no one is every going to love them if they act like that."

D. "I never spank or hit; I yell at them to stop being stupid, and if they don't, I tell them no one is every going to love them if they act like that."

Three clients were brought to the emergency department by ambulance after a two-car accident at a busy intersection. Which of the following tests should automatically be done under such circumstances? A. Cardiac work up B. Pregnancy test C. STI testing D. Alcohol blood level

D. Alcohol blood level

A nurse is working as a case manager with a vulnerable population. Which of the following actions should the nurse do when providing care? A. Rotate assignments periodically to prevent attachment and co-dependency B. Direct and control the client's care because the nurse knows what is most needed C. Encourage families to become self-sufficient and less dependent on nursing personnel for advice and referrals D. Be willing to enter into a long-term relationship with families

D. Be willing to enter into a long-term relationship with families

Which of the following addictive drugs is both legal and culturally acceptable throughout most of the United States? A. Mixed alcoholic beverages B. Nicotine C. Beer D. Caffeine

D. Caffeine

A nurse is planning a community health program. Which of the following actions should the nurse include as a part of the evaluation plan? A. Gain approval for the program from local leaders B. Determine the availability of resources to initiate the plan C. Establish a timeline for implementation of the interventions D. Compare the program impact to similar programs

D. Compare the program impact to similar programs

A nurse is caring for a client who is experiencing acute alcohol withdrawal. Which of the following findings should the nurse expect? A. Hypotension B. Lowered level of consciousness C. Bradycardia D. Hand tremors

D. Hand tremors

A teacher asks the school nurse to assess a child for neglect. Which of the following assessment findings could indicate neglect? A. Failure of the parent to attend parent-teacher conferences or return teacher phone calls B. Lice in the hair C. Bruises in various stages of healing D. Lack of weight gain and wearing dirty clothes

D. Lack of weight gain and wearing dirty clothes

A nurse is implementing a primary prevention strategy to address abuse in the community. Which of the following action is the nurse most likely taking? A. Referring care givers to community respite centers if abuse is beginning to occur. B. Screening each pregnant woman in private for intimate partner abuse. C. Encouraging others to interfere when they see child hit or hurt in a public place. D. Lobbying for passage of legislation to outlaw physical punishment in schools.

D. Lobbying for passage of legislation to outlaw physical punishment in schools.

A nurse is interviewing a client during admission to an alcohol treatment center. Which of the following approaches should the nurse take? A. Verbalize disapproval of the client's substance abuse B. Avoid displaying an emotional response C. Offer sympathetic support D. Maintain a non-judgmental attitude

D. Maintain a non-judgmental attitude

An older client lives alone and tells the clinic nurse that he is unable to drive himself to the story and is afraid to cook on the stove. Which of the following community resources should the nurse recommend for the client? A. Temporary Assistance for Needy Families (TANF) B. Hospice care C. A transitional living facility D. Meals on Wheels

D. Meals on Wheels

An occupational health nurse is conducting drug screening to detect drug use by employees before problems develop. Which of the following levels of prevention does this action represent? A. Tertiary B. Primary and secondary C. Primary D. Secondary

D. Secondary

Which of the following is the top risk factor for intimate partner homicide? A. The woman's young daughter also lives with them. B. There is a gun in the house. C. The husband has make threats against the wife before. D. The wife has previously called 9-1-1 because of the husband's physical abuse.

D. The wife has previously called 9-1-1 because of the husband's physical abuse.

Which of the following terms is used to describe aggregates who are at high risk of having poor health outcomes because of limited resources? A. Disadvantaged families B. Resilient families C. multi-problem families D. Vulnerable populations

D. Vulnerable populations

A nurse is working toward the objective to "increase to at least 90% the proportion of all pregnant women who receive first trimester prenatal care." During which of the following phase of the nursing process would the objective be determined? A. Diagnosis B. Implementation C. Assessment D. Evaluation E. Planning

E. Planning