Community Health Chapter 16-25

An older client is seeking a fourth refill on a prescription for benzodiazepines. The nurse is concerned that the client may be developing a tolerance for the drug. Which comment by the client would most confirm this concern? A)"Lately I've had to double up on my dose just for it to be effective." B)"I ran out of pills a week ago and have felt sweaty and agitated ever since." C)"I feel like I just can't function without the medicine." D)"The medicine has been wonderful. I think one more refill should do it for me."

A) "Lately I've had to double up on my dose just for it to be effective."

Changes to water supplies and increased flooding, which are believed to result from climate change, may make some areas more vulnerable to diseases. Which diseases are expected to become more prevalent as a result of climate change? (Select all that apply.) A) Asthma B) Lung cancer C) Diarrhea D) Malaria E) Dengue fever

A) Asthma C) Diarrhea D) Malaria E) Dengue fever

Bioavailability is the amount of the contaminant that: A) Is absorbed into the body and becomes available at the site of physiological activity B) Initially escapes a container and becomes available for contact with living organisms C) Is airborne and available for inhalation D) Is waterborne and available for skin contact

A) Is absorbed into the body and becomes available at the site of physiological activity

The nurse visits the home of client in a low-income community and notices that paint is flaking off the walls and forming a dust in the corners of some rooms. The nurse asks the client when the house was built, and she responds that it was built in 1959. Which contaminant should the nurse expect to find in this home? A) Lead B) Radon C) Asbestos D) Pesticide

A) Lead

The nurse asks a client, "Do you wear the clothes you wear at work to home?" This is an example of which subject on the exposure history? A) Present work B) Past work C) Home/residence D) Concerns

A) Present work

The information gained from environmental epidemiologic studies can be very helpful in trying to identify whether an exposure or what particular exposures have made people ill. Major challenges to most environmental epidemiology studies include: (Select all that apply). A) Resource intensive in terms of personnel and money B) Period between exposure and illness can be very short C) Weak ability to identify outbreaks of infectious disease D) Limited availability of data on many contaminants and their effect on people's health E) Time consuming to perform

A) Resource intensive in terms of personnel and money D) Limited availability of data on many contaminants and their effect on people's health E) Time consuming to perform

Children may be more vulnerable to environmental exposures than adults. There are several factors that increase children's vulnerability. Which factors should be considered with children? (Select all that apply.) A) Their body systems are still rapidly developing. B) They eat less, drink less, and breathe more in proportion to their body size than do adults. C) Their bodies may be less able to break down and excrete contaminants. D) Their behaviors can expose them to more contaminants. E) Their breathing zone is further from the ground.

A) Their body systems are still rapidly developing. C) Their bodies may be less able to break down and excrete contaminants. D) Their behaviors can expose them to more contaminants.

During an assessment, a teenager reveals a 2-year history of inhalant use. Using knowledge that fumes may be inhaled through the mouth, this will achieve a state of intoxication similar to: A)Alcohol B)Cannabis C)Cocaine D)Morphine

A)Alcohol

5. Response to a disaster is in its final phase. Although still in the recovery phase of the response, an evaluation meeting is arranged. The purpose of the evaluation meeting is to: A)Analyze the strengths and weaknesses of the response and submit a plan to improve response in the future B)Create a report that emphasizes the cohesiveness of the departmental response to the disaster C)Analyze the effectiveness of the disaster relief teams from respondent states D)Create a postdisaster report for FEMA

A)Analyze the strengths and weaknesses of the response and submit a plan to improve response in the future

4. Five weeks after a category 4 hurricane, a town in southern Louisiana continues to battle for survival. The flood waters have now receded. The nurse is part of the disaster recovery team. Epidemiologic analysis of this town includes factors that influence the health status of this community. Which data may be included in the epidemiologic analysis report? (Select all that apply.) A)Continuing death B)Population shift C)Contamination of water supplies D)Limited access to places of worship E)Collapse of access to healthcare

A)Continuing death B)Population shift C)Contamination of water supplies E)Collapse of access to healthcare

A nurse receives blood test results that indicate that a 14-year-old client has been using cannabis. Based on knowledge of factors that affect rate of cannabis use among youth, which would be the most effective strategy to discourage this behavior? A)Explain the risks associated with cannabis use B)Remind the client that it is still illegal in your state C)Refer the client for counseling D)Share about your own experience with drug use

A)Explain the risks associated with cannabis use

3. The management team is in the process of identification of hazards associated with the ice storm that is expected to disable electrical service to the city. To identify areas most vulnerable to damage and plan for an effective response, which data or methods of data collection may be used? (Select all that apply.) A)Geographic information B)Satellite imagery C)Census data D)Historical data on previous events E)Planning board declarations

A)Geographic information B)Satellite imagery D)Historical data on previous events

In assessing a 13-year-old Native American boy who lives on a reservation, the nurse finds that he regularly drinks alcohol and smokes cannabis. He says that most of his friends do so, as well. The nurse is aware that this rate of prevalence is far higher than that for 13-year-olds of all ethnicities nationwide. Which social conditions have researchers associated with this health disparity? (Select all that apply.) A)Greater availability of cannabis from local farms B)Higher socioeconomic status C)Lower academic attainment D)Proximity to Mexico and drug gangs E)College enrollment

A)Greater availability of cannabis from local farms C)Lower academic attainment D)Proximity to Mexico and drug gangs

The nurse assesses a 33-year-old who abuses alcohol. To gauge how the client's substance use is impairing his ability to fulfill normal role functions, the nurse should use: (Select all that apply.) A)History of arrests for drunken driving B)Age at the time of first alcoholic drink C)Jobs lost due to intoxication at work and chronic absenteeism D)Failing grades in night classes at the local community college E)Blood alcohol level at time of last arrest for driving while intoxicated

A)History of arrests for drunken driving C)Jobs lost due to intoxication at work and chronic absenteeism D)Failing grades in night classes at the local community college

10.Which are advantages of disaster management JITT for nurses? (Select all that apply.) A)Is cost-effective because it requires the least amount of resources to produce the final result B)Provides the nurse with comprehensive knowledge of how to respond to many different types of disaster C)Shortens the period of time between learning and application D)Includes classroom sessions and on-site presentations E)Is offered online for easy access

A)Is cost-effective because it requires the least amount of resources to produce the final result C)Shortens the period of time between learning and application D)Includes classroom sessions and on-site presentations E)Is offered online for easy access

The nurse performs motivational interviewing with a college student in the university health center regarding the student's history of binge drinking. The nurse hopes to ascertain the student's readiness to change her behavior and encourage her to make better choices related to alcohol use. The interview should begin with: A)Listening empathetically to establish trust B)Eliciting feelings about how the drinking behavior is affecting the student's life C)Noting discrepancies between attitudes toward alcohol and alcohol-associated harms D)Being supportive of the student's life goals

A)Listening empathetically to establish trust

7. The nurse is a member of the emergency and disaster preparedness committee for an organization. The nurse's role is to head the data collection subcommittee. What are the key areas that would be included in your plan? A)Morbidity, mortality, mental health, and infectious disease B)Morbidity, mortality, displacement, and community infrastructure C)Morbidity, mortality, mental health, and chronic illness D)Morbidity, mortality, displacement, and healthcare workers

A)Morbidity, mortality, mental health, and infectious disease

13.The nurse is in charge of implementing a personal protective equipment (PPE) program at the hospital, in response to a chemical terrorist attack. Which components should be included in this program? (Select all that apply.) A)Selection, maintenance, and use of PPE B)Training of employees in PPE use C)Identification of hazards present D)Identification of commodities to be distributed via POD emergency supply centers E)Clinical assessment and triage drills

A)Selection, maintenance, and use of PPE B)Training of employees in PPE use C)Identification of hazards present

5. The nurse visits a community health clinic in a remote rural area, at which emergency care is not provided because the facility lacks the medical staff necessary to offer such services. Based on this information, which is the most accurate description of this situation? A) Health professional shortage area B) Medically underserved area C) Medically underserved population D) Undeserved population

Ans: A Feedback: A health professional shortage area (HPSA) is a geographic area, population group, or medical facility with shortages of healthcare professionals to a degree that a full complement of healthcare services is not possible. A medically underserved area (MUA) is an area with a lack of medical care services as determined by the number of primary medical care physicians per 1,000 population, infant mortality rate, percentage of the population with incomes below the poverty level, and percentage of the population 65 years or older. A medically underserved population (MUP) is a U.S. federal designation for those populations that face economic, cultural, or linguistic barriers to accessing primary medical care services. An underserved population is a subgroup of the population that has a higher risk of developing health problems because of marginalization in sociocultural status, access to economic resources, age, or gender.

16. Which accurately defines femicide? A) A homicide of a female that occurs in the context of intimate partner violence B) Violence that targets people or groups of people on the basis of their gender C) A pattern of assaultive and coercive behaviors D) A suicide by a female that occurs in the context of intimate partner violence

Ans: A Feedback: Femicide is a homicide (not a suicide) of a female that occurs in the context of intimate partner violence (IPV). Gender-based violence is violence that targets people or groups of people on the basis of their gender. IPV is a pattern of assaultive and coercive behaviors that is perpetrated against an individual by one who is, was, or wishes to be in an intimate relationship with that individual and that may include inflicted physical injury, psychological abuse, sexual assault, progressive social isolation, deprivation, intimidation, and threats.

21. The nurse cares for a woman who is in her 39th week of gestation and who recently revealed that she is being physically abused by her partner. Which conditions associated with intimate partner violence (IPV) should the nurse look for in this client and in her child now and in the coming weeks? (Select all that apply.) A) Depression in the mother B) Low-birth weight infant C) Down syndrome in the infant D) Gestational diabetes in the mother E) Cleft palate in the infant

Ans: A, B Feedback: Depression before, during, and after birth has been strongly correlated with IPV. Researchers have also found that pregnant women who are assaulted by an intimate partner are at increased risk of giving birth to infants of reduced weight. Down syndrome is a genetic disorder and is not associated with IPV. Gestational diabetes is an endocrine disorder and would not be caused by IPV. A cleft palate is a congenital birth defect not associated with IPV.

12. The nurse suspect a 16-year-old client is being physically abused by her boyfriend. Compared with adolescent girls with no abuse history, this client is at significantly increased risk for: (Select all that apply.) A) Smoking cigarettes B) Anorexia C) Becoming pregnant D) Assaulting her siblings E) Theft

Ans: A, B, C Feedback: Adolescent girls who reported experiencing sexual or physical assault were significantly more likely to report smoking, attempt suicide, use cocaine, become pregnant, and engage in unhealthy eating habits, compared with adolescents with no abuse history. There is no evidence of an association of assaulting one's siblings or theft with exposure to violence.

1. An underserved population is a subgroup of the population that has a higher risk of developing health problems due to marginalization in which areas? (Select all that apply.) A) Age B) Gender C) Sociocultural status D) Political affiliation E) Religion

Ans: A, B, C Feedback: An underserved population is a subgroup of the population that has a higher risk of developing health problems due to marginalization in sociocultural status, access to economic resources, age, or gender. Marginalization in religion and political affiliation are not typically associated with underserved populations.

15. Which instance would be considered child abuse and neglect according to the federal Child Abuse and Prevention and Treatment Act? A) A father leaving a child in the back seat of a car on a hot August day B) A mother not feeding a 5-year-old child all day C) A mother allowing her boyfriend to punch her daughter D) A caregiver smacking away a toddler's hand when she reaches for a hot stove E) A neighbor touching the private parts of a 12-year-old boy

Ans: A, B, C, E Feedback: The federal Child Abuse Prevention and Treatment Act (CAPTA) (42 U.S.C.A. §5106g), as amended by the Keeping Children and Families Safe Act of 2003 (U.S. Department of Health and Human Services, 2003), defines child abuse and neglect as the following: any recent act, or failure to act, on the part of a parent or caretaker that results in death, serious physical or emotional harm, sexual abuse or exploitation, or an act or failure to act that presents an imminent risk of serious harm. A caregiver smacking away a toddler's hand would not result in serious physical or emotional harm. All of the other answers would.

19. Which risk factors are associated with committing gun-related homicide? (Select all that apply.) A) Low income B) Lack of education C) Female gender D) Being a victim of discrimination E) Lack of employment opportunities

Ans: A, B, D, E Feedback: Factors that associated with committing gun-related homicides are as follows: low income, being a victim of discrimination, lack of education, and lack of employment opportunities. Most often, males are the victims as well as the perpetrators of homicides.

8. Which statements by a caregiver would indicate the presence of risk factors for violence and should cause the nurse to have significant concern for the safety of children? (Select all that apply.) A) "My boyfriend says that one day he'll put a bullet through my head if I don't stop nagging him." B) "My 3-year-old daughter cries when my partner and I argue." C) "My husband sometimes makes our son come into our bedroom and watch as he hits me." D) "The last time we fought, he threatened to go pull out his shotgun." E) "My husband got upset with how much our daughter was texting and took her phone away from her for a month."

Ans: A, C, D Feedback: Risk factors that indicate significant concern for the safety of the children are as follows: (1) threats to kill the caretaker, children, and/or self or fears on the part of the caretaker for the children's safety; (2) a child was physically injured in an incident in which the caretaker was the target; (3) a child was coerced to participate in or witness the abuse of the caretaker; (4) a weapon was used or threats to use a weapon were made, and the caretaker believed that there was intention and ability to cause harm. A toddler crying because of an argument and a father taking away a daughter's phone for a month are not causes for significant concern regarding the safety of the children.

11. After examining a young woman, the nurse asks her questions about some bruises on her back. The client confides that her husband has started hitting her when they argue. The nurse makes recommendations about getting help; the client dismisses them and states, "It's just a few bruises. I think I can handle it." Which long-term consequences of exposure to violence, according to Healthy People 2020, should the nurse discuss with this client? (Select all that apply.) A) Premature death B) Breast cancer C) Disability D) Lost productivity E) Obesity

Ans: A, C, D Feedback: Healthy People 2020 emphasizes a need to prevent violence and the sequelae known to result from exposure to violence recognizing that violence leads to the following: premature death, disability, poor mental health, high medical costs, and lost productivity. Breast cancer and obesity are not known as long-term consequences of exposure to violence.

6. The nurse is completing a lethality assessment with a female client. Which are appropriate lethality risk questions? (Select all that apply.) A) Is there a gun in your house? B) Are you using drugs or drinking excessively? C) Has your partner ever been arrested? D) What is the worst thing your partner has ever done to you? E) Do you feel that the partner is capable of hurting you?

Ans: A, C, D, E Feedback: Appropriate questions to ask a client to assess for lethality risks associated with intimate partner violence include the following: (1) Is there a gun in the house? (2) Is the woman's partner unemployed? (3) What is the worst thing the partner has ever done to the victim? (4) Does the victim feel that the partner is capable of hurting her, of carrying out his threats? (5) Has the woman's partner ever been arrested? (6) Is the woman's partner (not the woman herself) using drugs or drinking excessively?

21. How can genomics help improve care of underserved populations? (Select all that apply.) A) Identify increased risk in certain populations for specific diseases. B) Boost the immune system of individuals in the community. C) Predict how a community might metabolize medications. D) Reduce the cost of medications. E) Predict a community's unique vulnerability to environmental changes that can control gene expression in some diseases.

Ans: A, C, E Feedback: Understanding the genetic predictors of disease through genomics is a determinant of how certain individuals, families, and communities may be disproportionately affected by illness, and why public health must be part of a strategy that addresses discoveries in a practical way in this developing science. We also know that different groups of people by gender or other key demographic characteristics respond to preventive treatment differently because of their genetic make-up. For example, some genotypes may metabolize medications differently. Some populations may have specific vulnerability and key environmental influences related to their health. Gomes and Pelosi (2013) discuss how the potential vulnerability to environmental changes can control gene expression in diseases of great interest in public health such as cancer, autoimmune diseases, and perhaps even the aging process.

3. Definitions of rural areas are based on which concepts? (Select all that apply.) A) Administrative B) Religious C) Land-use D) Political E) Economic

Ans: A, C, E Feedback: Definitions of rural areas can be based on administrative, land use, or economic concepts, including variations of these three themes. Religious and political concepts are not among the themes on which the definitions of rural areas are based.

4. Which most accurately defines a medically underserved area? A) A geographic area, population group, or medical facility with shortages of healthcare professionals to the degree that a full complement of healthcare services is not possible B) An area with a lack of medical care services as determined by the number of primary medical care physicians per 1,000 population, infant mortality rate, percentage of the population with incomes below the poverty level, and percentage of the population 65 years or older C) A U.S. federal designation for those populations that face economic, cultural, or linguistic barriers to accessing primary medical care services D) A subgroup of the population that has a higher risk of developing health problems because of marginalization

Ans: B Feedback: A medically underserved area (MUA) is an area with a lack of medical care services as determined by the number of primary medical care physicians per 1,000 population, infant mortality rate, percentage of the population with incomes below the poverty level, and percentage of the population aged 65 or older. A health professional shortage area (HPSA) is a geographic area, population group, or medical facility with shortages of healthcare professionals to a degree that a full complement of healthcare services is not possible. A medically underserved population (MUP) is a U.S. federal designation for those populations that face economic, cultural, or linguistic barriers to accessing primary medical care services. An underserved population is a subgroup of the population that has a higher risk of developing health problems because of marginalization in sociocultural status, access to economic resources, age, or gender.

9. While visiting the home of an 89-year-old woman out in the country, the nurse learns that her primary care provider's office is one hour's drive away. The client states, "I've just stopped going in for appointments in the past few years. It's just too far for me to drive by myself." This situation exemplifies which of the seven A's of challenges to elders in rural areas? A) Availability B) Accessibility C) Affordability D) Awareness

Ans: B Feedback: Accessibility refers to amount of adequate, appropriate, and affordable transportation as well as the degree of cultural and geographic isolation. Availability refers to the number and diversity of formal services and providers, number of acceptable services, and amount of human service infrastructure. Affordability refers to the ability to pay for services. Awareness refers to the level of information dissemination and degree of literacy.

6. Which is an accurate health factor or effect of living in rural geopolitical areas? A) Only about 5% of physicians practice in rural America despite that nearly one fourth of the population lives in these areas. B) Although only one third of all motor vehicle accidents occur in rural areas, two thirds of the deaths attributed to these accidents occur on rural roads. C) Rural residents are nearly three times as likely to die from unintentional injuries other than motor vehicle accidents than are urban residents. D) Abuse of alcohol and use of smokeless tobacco is a significant problem among rural older adults.

Ans: B Feedback: Although only one third of all motor vehicle accidents occur in rural areas, two thirds of the deaths attributed to these accidents occur on rural roads. Only about 10% (not 5%) of physicians practice in rural America despite that nearly one fourth of the population lives in these areas. Rural residents are nearly twice (not three times) as likely to die from unintentional injuries other than motor vehicle accidents than are urban residents. Abuse of alcohol and use of smokeless tobacco are a significant problem among rural youth (not older adults).

11. The Children's Defense Fund supports initiatives at the individual, family, community, organizational, and government levels. Encouraging families to spend quality time together by hosting a movie or game night at a local church is an example of a strategy at which level? A) Family B) Community C) Organizational D) Government

Ans: B Feedback: Encouraging families to spend quality time together by hosting a movie or game night at a local church is an example of a strategy at the community level and not at the family, organizational, or government levels.

1. Which most accurately defines gender-based violence? A) A homicide of a female that occurs in the context of intimate partner violence B) Violence that targets people or groups of people on the basis of their gender C) A pattern of assaultive and coercive behaviors perpetrated against an individual by one who is, was, or wishes to be in an intimate relationship with the victim D) A type of violence typically committed by one gender but not the other

Ans: B Feedback: Gender-based violence is violence that targets people or groups of people on the basis of their gender. Femicide is the homicide of a female that occurs in the context of intimate partner violence (IPV). IPV is a pattern of assaultive and coercive behaviors perpetrated against an individual by one who is, was, or wishes to be in an intimate relationship with that individual and that may include inflicted physical injury, psychological abuse, sexual assault, progressive social isolation, deprivation, intimidation, and threats. Gender-based violence is based on the gender of the victim, not that of the perpetrator.

18. What percentage of rural children live in poverty? A) 14% B) 24% C) 34% D) 44%

Ans: B Feedback: Nearly 24% of rural children live in poverty.

20. The nurse assesses a new client and performs a standard screening for intimate partner violence. Which is the most appropriate question to ask first? A) "Are you in danger now?" B) "It's normal for couples to disagree about things. What happens when you and your partner disagree?" C) "Do you ever think about hurting yourself, cutting, stopping eating, or purging food?" D) "Have you ever thought about or been granted a restraining order?"

Ans: B Feedback: The most appropriate question to ask first is, "It's normal for couples to disagree about things. What happens when you and your partner disagree?" This question is open-ended and allows the client to share information about behavior that she may not even recognize as abuse. The other questions listed are more appropriate to ask as follow-up questions, once the woman has stated that she is being abused.

13. In the United States, detention centers, jails, and prisons are places that provide safety to the public by incarcerating people who have committed crimes and who are deemed a threat to society. Which demographics are true of the majority of inmates? (Select all that apply.) A) Incarcerated for violent crimes B) Latino or African-American C) Average age of 37 years D) Serving sentences of more than 10 years E) Male gender

Ans: B, C, E Feedback: Most inmates are males who are African-American or Latino. The average age of inmates is 37. Seventy-five percent of all prisoners are nonviolent and have been incarcerated for drug possession and trafficking, bribery, and extortion, and 40% are serving sentences of more than 10 years.

19. Which most accurately characterize Medicare clients with acute myocardial infarctions (AMIs) who are treated in rural hospitals? (Select all that apply.) A) Less likely to experience an opportunistic infection than those in urban hospitals B) Less likely to receive recommended treatments than those in urban hospitals C) More likely to have a second AMI within a month of the first than those in urban hospitals D) Have significantly higher adjusted 30-day post-AMI death rates from all causes than those in urban hospitals E) Experience faster recovery times than those in urban hospitals

Ans: B, D Feedback: Medicare clients with AMI who were treated in rural hospitals were less likely than those treated in urban hospitals to receive recommended treatments and had significantly higher adjusted 30-day post-AMI death rates from all causes than those in urban hospitals. The other answers are not true.

17. Intimate partner violence is a pattern of assaultive and coercive behaviors. This definition includes: (Select all that apply.) A) Emotional injury B) Sexual assault C) Progressive social interaction D) Physical injury E) Deprivation

Ans: B, D, E Feedback: Intimate partner violence (IPV) is a pattern of assaultive and coercive behaviors that is perpetrated against an individual by one who is, was, or wishes to be in an intimate relationship with that individual and that may include inflicted physical injury, psychological abuse, sexual assault, progressive social isolation (not interaction), deprivation, intimidation, and threats. Emotional injury is not included in IPV.

9. A nurse is preparing to make a mandatory report of intimate partner violence (IPV) with regard to the caregiver of a pediatric client. Which actions are appropriate? (Select all that apply.) A) Tell the child about the possibility of filing a mandatory report B) Determine whether it will be safe to inform the child about the report C) Ask about the child's incidence of using drugs D) Ask the victim whether she has a plan to keep herself and the child safe E) Ask the victim if she would like to file a report at the same time as you file yours

Ans: B, D, E Feedback: The nurse should take the following actions when making a mandatory report of IPV: (1) Talk with the adult victim (not the child) about the possibility of filing a mandatory report. (2) Consider the safety concerns of filing. (3) Determine whether it will be safe to inform the children about the report. (4) Share concerns of safety with the Child Protective Agency. (5) Ask about the perpetrator's behaviors with questions such as the following: What is the worst thing he or she has done? Does he or she own a gun? Has he or she been arrested? Does he or she use drugs (not does the child use drugs)? Do you think he or she is capable of hurting you or your children? (6) Address safety planning with the nonoffending victim. (7) Consider filing in concert with the adult victim.

10. The Children's Defense Fund supports initiatives at the individual, family, community, organizational, and government levels. Which exemplifies a strategy at the family level? A) Mentor a child in a READ program. B) Volunteer with children who are homeless or in foster care. C) Create daily homework routines and limit television viewing. D) Vote in every election and advocate for children.

Ans: C Feedback: Individual strategies include mentoring a child in a READ program, volunteering with children who are homeless or in foster care, and voting in every election and advocating for children. A family strategy is to create daily homework routines and limit television viewing.

20. The Children's Defense Fund supports initiatives at the individual, family, community, organizational, and government levels. Which level is represented by hosting a health fair to ensure all children who are eligible for Medicaid or state children's health insurance program are enrolled? A) Family B) Community C) Organization D) Government

Ans: C Feedback: Organizations, not families, communities, or government, are likely host a health fair to ensure all children who are eligible for Medicaid or your state children's health insurance program are enrolled.

4. Preventing intimate partner violence (IPV) and recurrence of violence requires targeting efforts at all three levels of prevention: primary, secondary, and tertiary. Which is a secondary prevention strategy? A) Creating and broadcasting a public service announcement that raises awareness about IPV B) Putting up posters around the health provider's office that give tips on what to do if one is in an abusive relationship C) Screening a woman for evidence of abuse who has several risk factors for IPV D) Providing a woman who is being abused by her husband the number to an abuse hotline so that she can get help leaving him

Ans: C Feedback: Primary prevention includes screening and prevention efforts that target the general population. Secondary prevention occurs through generalized screening and inquiry with high-risk populations. Tertiary prevention involves caring for victims affected by or currently experiencing violence. Creating and broadcasting a public service announcement and putting up posters are examples of primary prevention, as they are aimed at the general public. Screening a woman for evidence of abuse who has several risk factors for IPV is an example of secondary prevention. Providing help to a woman who is being abused is an example of tertiary prevention.

10. Who is in the best position to recognize both children being victimized and children perpetrating violence? A) Pediatric primary care provider B) Parent C) School nurse D) Next door neighboR

Ans: C Feedback: School nurses play a pivotal role in recognizing both children who are being victimized and those who are perpetrating violence, as they are in daily contact with the children. The parents of the children might know whether their own child is a victim or a perpetrator, but they likely would know the other children involved. The child's primary care provider and next door neighbor are not as likely to know of violence experienced or perpetrated by children as the school nurse is, due to the nurse's more frequent contact with the children and location in the school setting.

18. An injury prevention objective of Healthy People 2020 is: A) Prevention of drug-related deaths B) Identification of improper chemical storage in homes C) Decreased incidents of homicide, child maltreatment, and physical assaults D) Elimination of alcohol possession by adolescents on school property

Ans: C Feedback: The injury prevention objectives of Healthy People 2020 include the following: (a) prevention and reduction of firearm-related (not drug-related) deaths; (b) identification of improper firearm (not chemical) storage in homes; (c) surveillance of external causes of injury in emergency departments; (d) decreased incidents of homicide, child maltreatment, and physical assaults; (e) prevention and reduction of sexual assaults; and (f) elimination of weapon (not alcohol) possession by adolescents on school property.

15. The nurse works at a clinic in Arizona that provides bilingual (English and Spanish) care to low-income immigrant workers from Mexico. Which designation most accurately describes the area or the population this nurse serves? A) Health professional shortage area B) Medically underserved area C) Medically underserved population D) Inmates

Ans: C Feedback: A medically underserved population (MUP) is a U.S. federal designation for those populations that face economic, cultural, or linguistic barriers to accessing primary medical care services. A medically underserved area (MUA) is an area with a lack of medical care services as determined by the number of primary medical care physicians per 1,000 population, infant mortality rate, percentage of the population with incomes below the poverty level, and percentage of the population 65 years or older. A health professional shortage area (HPSA) is a geographic area, population group, or medical facility with shortages of healthcare professionals to a degree that a full complement of healthcare services is not possible. An inmate is a person who is held in a jail or prison to protect the public.

17. An older woman in a rural health clinic tells the nurse that this is the first time she's been in a medical facility for more than 10 years. She shows signs of advanced diabetes, including significant necrosis in her feet. When asked why she didn't come in sooner, she says, "I don't drive, myself, and I hate asking my son to bring me—I feel like such a burden." This situation exemplifies which of the seven A's of challenges to elders in rural areas? A) Awareness B) Adequacy C) Acceptability D) Assessment

Ans: C Feedback: Acceptability refers to the degree of reluctance to ask for help. Awareness refers to the level of information dissemination and degree of literacy. Adequacy refers to the level of service standards and evaluation and degree of evidence-based practice. Assessment refers to the amount of basic information available on what is needed using research rigor and analyses.

5. Pediatric providers face special issues in screening for intimate partner violence (IPV) in a caregiver who is accompanying a child. Which are appropriate strategies for addressing this screening issue? (Select all that apply.) A) Asking the mother directly, with the child present B) Asking the child directly, while the mother is out of the room C) Asking the mother indirectly, with a written questionnaire or computer survey D) Screening for the safety and dangerousness of the situation before deciding whether to ask the mother E) Informing parents about mandatory reporting law after asking questions

Ans: C, D Feedback: Appropriate strategies include the following: asking mothers indirectly (written questionnaire, computer survey), asking mothers directly, without (not with) the child present; informing parents about mandatory reporting laws before (not after) asking questions; screening for safety and dangerousness of the situation; and being aware of resources and referrals. It would not be appropriate to ask the child about IPV that the mother may have experienced.

12. The Children's Defense Fund supports initiatives at the individual, family, community, organizational, and government levels. Which strategies are at the government level? (Select all that apply.) A) Provide free tax filing assistance to low-income working families. B) Educate families about how they can apply for food stamps, Head Start, federal nutrition programs, and other similar benefits. C) Ensure children in foster care and detention receive quality treatment to address their mental, behavioral, and emotional needs. D) Promote high-quality children's television programming and access to other quality electronic media. E) Start a halfway house and counseling program for youth who have run away.

Ans: C, D Feedback: Government strategies include ensuring that children in foster care and detention receive quality treatment to address their mental, behavioral, and emotional needs and promoting high-quality children's television programming and access to other quality electronic media. Organization strategies include providing free tax filing assistance to low-income working families and educating families about how they can apply for food stamps, Head Start, federal nutrition programs, and other similar benefits. Community strategies include starting a halfway house and counseling program for youth who have run away.

16. Which qualifies as an urbanized area according to the U.S. Census Bureau? (Select all that apply.) A) A central city with population of 30,000 and surrounding densely settled territory with a population of 25,000 with a combined population density of 500 people per square mile B) A central city with population of 50,000 and surrounding densely settled territory with a population of 10,000 with a combined population density of 750 people per square mile C) A central city with population of 25,000 and surrounding densely settled territory with a population of 25,000 with a combined population density of 1,100 people per square mile D) A central city with population of 20,000 and surrounding densely settled territory with a population of 30,000 with a combined population density of 1,250 people per square mile E) A central city with population of 100,000 and surrounding densely settled territory with a population of 50,000 with a combined population density of 1,500 people per square mile

Ans: C, D, E Feedback: The U.S. Census Bureau defines an urbanized area (UA) by population density. According to this definition, each UA includes a central city and the surrounding densely settled territory that together have a population of 50,000 or more and a population density generally exceeding 1,000 people per square mile.

13. A 50-year-old woman recently underwent a divorce and has two teenaged children. She has an associate's degree from her local community college and earns an annual salary of $22,000. Which risk factors place this woman at risk for intimate partner violence (IPV)? (Select all that apply.) A) Age of 50 years B) Education at associate's degree level C) Recent divorce D) Having two teenaged children E) Annual salary of $22,000

Ans: C, E Feedback: Risk factors include age less than 45 years, low income, lack of employment, recent separation or divorce, education at the high school (not associate's degree) level or less, and having young (not teenaged) children.

14. The nurse helps a client who is a victim of intimate partner violence (IPV) with safety planning. The client worries about what to do if her partner becomes violent again. A safety suggestion for the when the client is at home is for her to go to the: A) Kitchen because it is well-lit B) Bathroom because it is a small space C) Basement because there are places to hide D) Living room because there are windows

Ans: D Feedback: Components for safety planning include a crisis/"disaster" plan, a place to go, how to get there, and other considerations. Safety planning involves discussing measures that the client may not have considered. For example, if an argument occurs at home, the woman should stay away from (1) the kitchen because sharp instruments are there and (2) the bathroom because the space is small and contains many hard surfaces. She should go to a room with a window or door, carry her cell phone, with 911 set to speed dial, and tell family members and neighbors. The basement is not appropriate because it is less likely to have windows or doors.

2. In the Healthy People 2020 federal initiatives in the United States, which group is identified as needing special attention and creative solutions to live a healthy life in the face of sobering health disparities and social injustices? A) Older adults B) People with acute infectious diseases C) People recovering from traumatic accidents D) Mentally ill people

Ans: D Feedback: In the Healthy People 2020 federal initiatives in the United States, the following groups are identified as needing special attention and creative solutions to live a healthy life in the face of sobering health disparities and social injustices: (1) high-risk mothers, (2) chronically ill and disabled people, (3) people living with HIV/AIDS, (4) mentally ill people, (5) substance abusers, (6) homeless people, and (7) immigrants and refugees.

2. Which is a relationship risk factor for intimate partner violence? A) Emotional dependence and insecurity B) Belief in strict gender roles C) Desire for power and control D) Unhealthy family interactions

Ans: D Feedback: Individual risk factors for intimate partner violence include emotional dependence and insecurity, belief in strict gender roles, and desire for power and control. Relationship risk factors include unhealthy family relationships and interactions.

7. Preventing intimate partner violence (IPV) and recurrence of violence requires targeting efforts at all three levels of prevention: primary, secondary, and tertiary. Which is a tertiary prevention strategy? A) Adding a question to the standard health history form that asks whether the client is currently experiencing abuse B) Putting up posters around the health provider's office that give tips on what to do if one is in an abusive relationship C) Screening a woman for evidence of abuse who has several risk factors for IPV D) Providing a woman who is being abused by her husband the number to an abuse hotline so that she can get help leaving him

Ans: D Feedback: Primary prevention includes screening and prevention efforts that target the general population. Secondary prevention occurs through generalized screening and inquiry with high-risk populations. Tertiary prevention involves caring for victims affected by or currently experiencing violence. Adding a question to the standard health history form and putting up posters are examples of primary prevention, as they are aimed at the general public. Screening a woman for evidence of abuse who has several risk factors for IPV is an example of secondary prevention. Providing help to a woman who is being abused is an example of tertiary prevention.

7. Which correctly ranks the top four rural health priorities according to the Healthy People goals? A) (1) Access to quality healthcare, (2) mental health and mental disorders, (3) diabetes, (4) heart disease B) (1) Mental health and mental disorders, (2) access to quality healthcare, (3) heart disease, (4) diabetes C) (1) Diabetes, (2) heart disease, (3) mental health and mental disorders, (4) access to quality healthcare D) (1) Access to quality healthcare, (2) heart disease, (3) diabetes, (4) mental health and mental disorders

Ans: D Feedback: The correct ranking of rural health priorities is (1) access to quality healthcare, (2) heart disease, (3) diabetes, and (4) mental health and mental disorders.

3. Which is a societal risk factor for intimate partner violence? A) Experiencing poor parenting B) Marital instability C) Unwillingness of neighbors to intervene when violence is witnessed D) Traditional gender roles

Ans: D Feedback: Traditional gender roles is a societal risk factor, as it is primarily determined by the society one lives in, rather than by individual characteristics, relationship dynamics, or even local community factors. Experiencing poor parenting is an individual risk factor. Marital instability is a relationship factor. Unwillingness of neighbors to intervene when violence is witnessed is a community factor.

8. When speaking with an older man in a rural community about his lifelong smoking habit, the nurse is alarmed to learn that he has never heard that cigarette smoking is the major cause of lung cancer. This situation exemplifies which of the seven A's of challenges to elders in rural areas? A) Availability B) Accessibility C) Affordability D) Awareness

Ans: D Feedback: Awareness refers to the level of information dissemination and degree of literacy. Availability refers to the number and diversity of formal services and providers, number of acceptable services, and amount of human service infrastructure. Accessibility refers to the amount of adequate, appropriate, and affordable transportation as well as the degree of cultural and geographic isolation. Affordability refers to the ability to pay for services.

14. A nurse is assessing a client who was recently released from prison. Based on knowledge of the incidence rates of various types of crimes that lead to incarceration, the nurse suspects that the client may have committed which crime? A) Murder B) Rape C) Assault D) Drug possession and trafficking

Ans: D Feedback: Seventy-five percent of all prisoners are nonviolent and have become incarcerated for drug possession and trafficking, bribery, and extortion.

Which most accurately defines gender-based violence? A) A homicide of a female that occurs in the context of intimate partner violence B) Violence that targets people or groups of people on the basis of their gender C) A pattern of assaultive and coercive behaviors perpetrated against an individual by one who is, was, or wishes to be in an intimate relationship with the victim D) A type of violence typically committed by one gender but not the other

B Feedback:Gender-based violence is violence that targets people or groups of people on the basis oftheir gender. Femicide is the homicide of a female that occurs in the context of intimate partner violence (IPV). IPV is a pattern of assaultive and coercive behaviors perpetrated against an individual by one who is, was, or wishes to be in an intimate relationship withthat individual and that may include inflicted physical injury, psychological abuse, sexual assault, progressive social isolation, deprivation, intimidation, and threats. Gender-based violence is based on the gender of the victim, not that of the perpetrator.

A client arrives at the clinic shaky and requesting a refill on a prescription for alprazolam (Xanax). The nurse suspects that the client might be experiencing substance withdrawal. Which comment by the client would most tend to confirm your suspicion? A)"Lately I've had to double up on my dose just for it to be effective." B)"I ran out of pills a week ago and have felt sweaty and agitated ever since." C)"I feel like I just can't function without the medicine." D)"The medicine has been wonderful. I think one more refill should do it for me."

B) "I ran out of pills a week ago and have felt sweaty and agitated ever since."

The nurse conducts biomonitoring of residents of a community exposed to mercury vapor from a manufacturing facility nearby. Which form of biomonitoring is the method for the purpose of determining exposure to this contaminant? A) Measuring heart rate B) Collecting blood or urine C) Assessing respiratory rate D) Obtaining body weight and composition measures

B) Collecting blood or urine

Environmental justice is an important consideration when working with tribal communities. In which way is traditional tribal practices most often directly affected by contaminated land and water? A) Spiritual practices B) Dietary practices C) Work opportunities D) Exercise opportunities

B) Dietary practices

Which exemplify environmental media and transport mechanisms within an exposure pathway? (Select all that apply.) A) Mercury B) Groundwater C) Pond D) Air E) Subsurface soil

B) Groundwater C) Pond D) Air E) Subsurface soil

The nurse travels to Nigeria with a humanitarian aid organization to assess and treat members of a remote community. The children all have high levels of lead in their blood, as a result of exposure to lead dust created by gold mining. Many children are dying. The nurse has never witnessed such a phenomenon in the United States. Which are the most likely reasons for this discrepancy? (Select all that apply.) A) Larger mining operations than in the United States B) Lack of environmental regulations or of their enforcement C) Lack of knowledge concerning environmental dangers D) Weaker immune systems than in the United States E) Need of the miners to earn a living and fewer work options

B) Lack of environmental regulations or of their enforcement C) Lack of knowledge concerning environmental dangers E) Need of the miners to earn a living and fewer work options

1. The public health nurse works in New England during the winter months. An ice storm cripples the city, and electrical outages affect the power grid. Trees and frozen power lines are down throughout the city, and the timeline for restoration of power is 7 to 10 days. The management team should classify this occurrence as: A)An emergency B)A natural disaster C)Terrorism D)An accidental disaster

B)A natural disaster

15.The nurse is notified that a possible anthrax exposure occurred at the local military base. Civilian workers are routed to the local hospital's emergency department. The nurse's responsibility is to set up PODs in the community. The function of the PODs in response to the anthrax exposure is to: A)Distribute decontaminated food B)Administer prophylactic medications C)Distribute decontaminated water D)Provide triage

B)Administer prophylactic medications

The nurse assesses a 15-year-old client who shows some signs of possible drug addiction. The nurse reviews the client's health and family history, looking for key indicators for risk of substance dependence, such as: (Select all that apply.) A)Obesity B)Age at first use of illicit substance C)Family history of alcoholism D)Presence of a learning disability E)Early onset of diabetes

B)Age at first use of illicit substance C)Family history of alcoholism

A politically active community health nurse assists in drafting state legislation for alcohol use laws. Which principles of the World Health Organization should be integrated into the draft legislation? (Select all that apply.) A) Legislation should be guided and formulated by the interests of local business owners. B) Alcohol policies should be equitable for all in the state. C) Alcohol policies should be sensitive to cultural contexts. D) Legislation should protect those with substance use disorders from serving extended prison sentences. E )Legislation should protect those exposed to the harmful effects of drinking by others.

B)Alcohol policies should be equitable for all in the state. C)Alcohol policies should be sensitive to cultural contexts. E)Legislation should protect those exposed to the harmful effects of drinking by others.

6.A tornado touched down in the city. The public health nurse is a member of the disaster management team. The nurse's role includes: (Select all that apply.) A)Search and rescue B)Clinical assessment and triage C)Provision of health education D)Hazardous materials management E)Protection of property

B)Clinical assessment and triage C)Provision of health education

8.The public health nurse is a first responder in a community disaster, secondary to a flood. One section of the town has experienced a loss of water and electricity for 4 days. The nurse's first action to meet the needs of the community at this time should be to: A)Refer the members of the community to a spiritual outreach program B)Provide access to safe food and water C)Inform the fire department of potential risks within the community setting D)Provide an immunization program

B)Provide access to safe food and water

A nurse working in the rural Southeast United States sees many young white adolescent girls in the clinic. The nurse should be aware that which type of substance use is highest among this demographic? A)Smoking cannabis B)Sniffing glue C)Injecting heroin D)Drinking alcohol

B)Sniffing glue

9. The nurse cares for a client who has symptoms of high fever and unexplained bleeding. After receiving blood test results, the client's primary care provider diagnoses the client with Ebola hemorrhagic fever. What interventions should the nurse anticipate implementing for this client? (Select all that apply.) A)Administration of an antiviral B)Strict infection control C)Isolation of the client D)Rinsing of the client's eyes E)Administration of an antitoxin

B)Strict infection control C)Isolation of the client

14.The nursing team cares for victims of a possible anthrax white powder investigation. Which information must be documented by the nurse scribe? (Select all that apply.) A)Victims' names B)Time and place C)Name of the Incident Commander D)General assessment of the field E)Victims' health histories

B)Time and place C)Name of the Incident Commander D)General assessment of the field

In the United States, most citizens have access to clean water and sanitation services and often take these services for granted. Worldwide, however, clean water and sanitation are not standard. How many people worldwide in 2010 lacked access to improved water sources? A) 7 million B) 78 million C) 783 million D) 7.8 billion

C) 783 million

Several important pieces of legislation have helped highlight the importance of environmental health and environmental protection. Which best describes Superfund? A) National program to control the damaging effects of air pollution B) Program that protects and enhances the quality of the nation's air by regulating stationary and mobile sources of air emissions C) Environmental program established to address abandoned hazardous waste sites D) Comprehensive framework of standards, technical tools, and financial assistance to address the many causes of pollution and poor water quality

C) Environmental program established to address abandoned hazardous waste sites

Which most accurately describes environmental epidemiology? A) Focuses on the amount of a contaminant that is absorbed into the body B) Involves monitoring the results of medical tests to determine whether a person has been exposed to a contaminant C) Focuses on the incidence and prevalence of disease or illness in a population from exposures in their environments D) Involves monitoring the number of adverse effects of chemical, physical, or biological agents on people, animals, and the environment

C) Focuses on the incidence and prevalence of disease or illness in a population from exposures in their environments

Which is the most accurate definition of an exposure pathway? A) The total amount of a contaminant that comes in direct contact with the body B) Factor that determines a person's level of exposure to a contaminant C) Method by which people are exposed to an environmental contaminant D) Process to determine whether exposure to an environmental contaminant has occurred

C) Method by which people are exposed to an environmental contaminant

The nurse works with a recovering heroin addict who is currently receiving opioid substitution treatment. Besides reducing his use of heroin, what additional benefits are offered by this treatment? (Select all that apply.) A)Reduction in alcohol use B)Weight loss C)Decrease in transmission of HIV D)Improving the client's overall health E)Decrease in depression

C)Decrease in transmission of HIV D)Improving the client's overall health

The nurse teaches a client about pharmacologic treatments for alcohol-dependent disorders. The client correctly understands the teaching when she tells the nurse that a medication that induces aversive effects if alcohol is consumed is: A)Naltrexone B)Acamprosate C)Disulfiram D)Buprenorphine

C)Disulfiram

A woman who is at high risk for alcohol abuse has just found out that she is pregnant. The nurse counsels her about the long-term effects of alcohol on the child. The nurse should include mention of: (Select all that apply.) A)Down syndrome B)Type 1 diabetes C)Low IQ D)Facial anomalies E)Short attention span

C)Low IQ D)Facial anomalies E)Short attention span

The nurse works with a 16-year-old client who has an alcohol use disorder. Which mental disorder, highly correlated to substance use disorder, should the nurse also assess for in this client? A)Obsessive compulsive disorder B)Anxiety disorder C)Major depression D)Bipolar disorder

C)Major depression

The community health nurse is concerned with the prevalence of new HIV infections in the community and understands the strong correlation between substance use disorders and HIV. Which interventions should the nurse promote in the community health clinic to best address this problem? (Select all that apply.) A)12-step self-help groups B)Family and couples therapy C)Opioid substitution treatment D)Syringe exchange programs E)Motivational interviewing

C)Opioid substitution treatment D)Syringe exchange programs

12.After a hurricane, the nurse is placed on a planning committee to meet the direct needs of the community. Most of the clean-up and rescue work has been completed, and several members of the community are living in shelters and are homeless. One of the foremost priorities of the committees is to establish: A)Ecumenical centers for long-term worship B)Home repair resources C)POD emergency supply centers D)Financial aid centers

C)POD emergency supply centers

2.The national weather service warns of an impending ice storm that may have crippling effects on the community. Widespread electrical outages are predicted as well as freezing temperatures. The community health nurses are mobilized to establish emergency living quarters and clinics for those without heat. The nurses' actions are occurring during which phase of the disaster? A)Impact B)Postimpact C)Preimpact D)Preparedness

C)Preimpact

Which is a relationship risk factor for intimate partner violence? A) Emotional dependence and insecurity B) Belief in strict gender roles C) Desire for power and control D) Unhealthy family interactions

D

1. The client states a history of substance abuse but reports current abstinence. If valid, this report means that the client has not used alcohol or illicit substances in at least how many months? A)3 B)6 C)9 D)12

D) 12

Which is the most accurate definition of a risk assessment? A) Assessment of the adverse effects of chemical, physical, or biological agents on people, animals, and the environment B) Process to help determine whether an individual has been exposed to environmental contaminants C) Assessment of factors that determine a person's level of exposure to an environmental contaminant D) Determination of the likelihood of adverse effects in a group exposed to an environmental contaminant

D) Determination of the likelihood of adverse effects in a group exposed to an environmental contaminant

The nurse assesses a 19-year-old client for alcohol abuse. Which would be the most significant risk factor for alcohol abuse in this client? A)African-American race B)Female gender C)History of type 1 diabetes D)Enrollment in college

D) Enrollment in college

The nurse applies the nursing process to a case in which a client has been exposed to an environmental contaminant. The nurse considers the question,"Has the exposure pathway been interrupted?" This question would be considered during which phase of the nursing process to examine the impact of the environment on human health? A) Assessment B) Planning C) Intervention D) Evaluation

D) Evaluation

The nurse visits a community along a creek where residents have begun to report upper respiratory illnesses and asthma. After investigating, the nurse learns that several miles upstream is a hazardous material disposal site. In addition, chemicals have leached through the soil into the creek water and have been carried downstream to this community. Although children are not allowed into the creek, they do often play along the bank. Which represents the route of exposure in this situation? A) Creek water B) Chemicals C) Bank of the creek D) Inhalation

D) Inhalation

Environmental justice is most accurately described as the belief that: A) Those who violate the environment should be required to pay significant fines or face extensive prison sentences. B) All the harms humans have committed against the environment will one day result in divine judgment. C) All people should have equal access to the environment. D) No group should suffer more from environmental health consequences than others.

D) No group should suffer more from environmental health consequences than others.

Which is an example of a radiological contaminant? A) Lead B) Mercury C) Ricin D) Radon

D) Radon

There are different methods for conducting risk assessment for environmental contaminants. Which formula determines the amount of risk? A) Hazard = exposure × risk B) Exposure = risk × hazard C) Risk = contaminant presence × exposure D) Risk = hazard × exposure

D) Risk = hazard × exposure

The nurse screens a woman who is 6 months pregnant for alcohol use. Which screening instrument should be used? A) AUDIT-C B) CAGE C) SMAST-G D) T-ACE

D) T-ACE

The nurse counsels a college student who admits to frequent binge drinking. Based on her age and environment, the most likely reason for this student's binge drinking is to: A)Deal with family dysfunction B)Cope with violence C)Escape painful emotions D)Enhance mood or affective state

D)Enhance mood or affective state

The nurse works with a client who is struggling with heroin addiction. Which examination should the nurse perform to screen for a comorbidity that is highly associated with substance use disorders? A)Assessment of blood glucose level B)Bone marrow aspiration C)Magnetic resonance imaging of the brain D)Mental status examination

D)Mental status examination

The nurse works in the ER when a client arrives with respiratory depression associated with a heroin overdose. Which medication should the nurse expect to be ordered for this client? A)Naltrexone B)Acamprosate C)Disulfiram D)Naloxone

D)Naloxone

11. The nurse is responsible for triage in a setting where a natural disaster has occurred. The triage is expected to last for an extended period of time. Which triage model would be most effective in this scenario? A)Simple triage and rapid treatment (START) B)Prehospital triage C)JumpSTART triage D)Start/Save triage

D)Start/Save triage