Community Health Exam 2

The public health nurse is relocating to an area that is currently classified as a medically underserved region. Which situation will the nurse most likely encounter in this new position?

An area with a lack of medical care services as determined by the number of primary medical care healthcare providers 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

Primary, secondary, and tertiary levels of prevention help reduce risk, identify and limit disabilities, and reduce complications of mental health problems. Which exemplifies a tertiary prevention strategy for mental health problems?

Promote support groups for people with mental health disorders

The nurse assesses a homeless adolescent who recently attempted suicide by drug overdose. Which risk factor should the nurse point out is most likely to influence this situation?

Social isolation

The school nurse follows up with a third grader who was recently diagnosed with ADHD to make sure that he takes his prescribed medication. What type of medication would the nurse most predict this client is taking?

Stimulant

The Ask Me 3 question strategy that patients can use when talking with their doctor includes all of the following EXCEPT

Who should I get a second opinion from?

The nurse is caring for a client who refuses the food as served. He states that the food is foreign to him and will make him ill. All food must be blessed. The personal care attendant is upset by this behavior and states that the client should eat the food anyway. Which is most likely the basis for the client's behavior?

Cultural belief

In researching the problem of homelessness in the city, the nurse discovers that the number of mentally ill homeless has steadily grown over the past couple of decades. Which reason can the nurse point out is most likely responsible for this situation?

Deinstitutionalization

The nurse assesses a 7 year old girl who has had problems at school lately with her behavior and mood. On a basis of the description provided by the child's mother, the nurse suspects either attention deficit/hyperactivity disorder (ADHD) or bipolar disorder may be involved. Which behaviors when occurring in all spheres of the child's life would most strongly suggest ADHD rather than bipolar disorder in this client?

Hyperactivity and impulsivity

The nurse works at a clinic in Arizona that provides bilingual (English & Spanish) care to low income immigrant workers from Mexico. Which designation most accurately describes the area or the population this nurse serves?

Medically underserved population

The Healthy People 2020 initiatives strive to improve the health of all individuals. Which group is the focus of special attention and creative solutions to counter the health disparities and social injustice against them?

Mentally ill people

An immigrant form Guatemala, age 47, is admitted to the coronary care unit with congestive heart failure. This is the fourth admission for this client, and the healthcare provider believes that the client's inability to adhere to his diet and medication regimen is the reason for his frequent admissions. The healthcare provider refers the client to the local community health nurse, on discharge from the hospital. Which would be most appropriate for the nurse to include n this client's plan of care?

developing culturally relevant and gender sensitive interventions

A client diagnosed with hypertension is prescribed a no added salt, low fat diet. He agrees and repeats the teaching principles. At the next home visit, the nurse notices salted meat on the counter and the client shows the nurse his food diary. The diet in the past week does not reflect the healthcare provider's orders. What cultural component may have contributed to the noncompliance with the diet order?

diet may not meet the cultural criteria for food choices

The nurse cares for a client in a community health clinic. The nurse is uncomfortable because the client remains very physically close when communicating. This discomfort makes it difficult to concentrate on the interview. Which concept will have occurred if the nurse backs away the client stops speaking and leaves?

differing views of personal space

The Church Health Center, in developing its curriculum for the preparation of faith community nurses, identifies seven specific functions that parish nurses perform in faith community work. Which exemplifies the health advocate function of the faith community nurse?

empowerment of members of the congregation

The nurse decided to use a learning model based on Skinner with a client with diabetes to improve compliance with dietary and blood glucose assessment requirements. Which would be the best way to implement this program?

give rewards for a lower blood sugar level and a food diary that reflects moderate dietary compliance

The Church Health Center, is developing its curriculum for the preparation of faith based nurses, and identifies seven specific functions that parish nurses perform in faith community work. Spiritual care would occur as part of which function?

integrator of faith and health

The nurse provides care covered by Medicare for a client over two hours during the day , three days during the week, for 60 days. Which type of care is the nurse providing?

intermittent

The nurse is reviewing a report detailing the latest statistics concerning the use of congregational health ministers. Which group will the nurse discover has the most experience?

mainline protestant and roman catholic

The client is admitted to the hospital for new onset hypertension and chest pain. During the admission interview you ask the client if she takes over the counter medications and she states no. She adds she routinely visits a folk healer. Which response should the nurse then prioritize after learning this information?

obtaining a list of the herbs and folk medications that are taken and notifying the healthcare provider

The committee has established the need for a sick child clinic in an impoverished neighborhood. The demographic data have been collected and the committee is ready to meet with a group of local business people who are willing to support the project financially. The plan is for the committee and group to combine to facilitate the establishment of the clinic. Using a transtheoretical model, which level of readiness has the committee achieved?

preparation

The local clinic is dedicated to the well adult and child. It has evening hours and offers varied programs for the community. The programs include immunizations and classes on fire safety, health education, and car safety, to name a few. How would the nurse best explain the level of prevention used in this setting to your colleagues?

primary prevention

The nurse has recently been appointed to a community based advisory board of an agency that is interested in providing fiscally sound, high quality care for clients they decide will be their service population. Any profit margin that is acquired is reinvested in the operations of the home healthcare service. Which type of agency is this?

private/voluntary

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. Which action should the nurse prioritize at this time to best assist the community?

provide access to safe food and water

The nurse is setting up a faith community nursing program at a local synagogue and would like a better understanding of how the overall congregation is structured and organized. Who would be best to ask about the structure of the congregation?

rabbi

A woman arrives at the clinic for a routine appointment. She has been HIV positive for three years and states she is doing well. She currently is involved in a relationship with a man who is HIV positive. She states that she is not consistent with safe sex practices due to her significant other's preferences and feels uncomfortable asking him to wear a condom. Which is the nurse's best response to promote the client's health?

you will not be protected against other strains of HIV or STIs

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. Which classification should the team prioritize for this occurrence?

a natural disaster

An outbreak of foodborne botulism has occurred in the community, and the nurse is on the disaster management team to address it. Which intervention should the nurse predict to be implemented in this situation?

administration of antitoxins

The case manager works with a 10 yer old girl who has asthma. Because the client's family has trouble affording inhalers, the case manager researches client assistance programs through which they could receive free medications. Which aspect of case management is this nurse portraying wit this action?

advocacy

A 34 year old client is recovering from a below the knee amputation secondary to a motor vehicle accident. The nurse meets with the client to update the care plan, and client states that he knows he will walk again. He asks for physical therapy schedules and timeliness for prosthetics. Which attitude will the nurse determine the client is exhibiting by his behavior when considering the theory of reasoned action?

an enhanced ability to meet his goals on the basis of his intention and behaviors

The nurse is developing a preventive strategy plan for the local members of a faith community. Which example would best present a tertiary prevention strategy that a nurse might implement?

an occupational therapy program for clients recovering from strokes

Response to a disaster is in its final phase. Although still in the recovery phase of the response, an evaluation meeting is arranged. Which purpose is the team attempting to fulfill by planning this evaluation meeting?

analyze the strengths and weaknesses of the response and submit a plan to improve response in the future

During an ice storm, people in one neighborhood banded together and shared the home of a neighbor who still had power and heat. Other neighbors provided food, water and bedding. In another neighborhood the neighbors did not know one another and weathered the storm alone. Both neighborhoods are part of the same community. What characteristic did the people in the first neighborhood share that made them a subculture that those in the second neighborhood lacked?

belief in the value of cooperation

A community care nurse at a healthcare agency assists in coordinating a plan for providing health services in the most cost effective way possible to a large number of members living in the region. Which type of work is this nurse exhibiting?

care management

The nurse has reported to the triage center where a natural disaster has occurred. After triaging each victim into a category based on his or her wounds, which individuals should the nurse ensure are evacuated as soon as possible?

1 (level 1=most life-threatening)

Primary, secondary, and tertiary levels of prevention help reduce risk, identify and limit disabilities, and reduce complications of mental health problems. Which exemplifies a primary prevention strategy for mental health problems?

Educate families and community groups about mental health issues, symptoms of stress, and barriers to seeking help

The nurse examines a client who is taking haloperidol for schizophrenia and notices that she habitually twists her tongue and arms. Which side effect should the nurse document in this client's record?

Tardive dyskinesia