Community Health exam 3
which unit in the hospital would be the priority for implementation and evaluation of a workplace violence protection plan as one component of a hospital disaster plan? a. medical unti b. surgical unti c. ED d. maternity
c. ED
outcomes and assessment information set (OASIS)
measures the outcome for quality improvement and client satisfaction care OASIS assessment needs to be done at certain points during care: -admission -after rehospitalization -every 60 days -at D/C
side stream smoke:
no filter and you inhale toxins (this is more dangerous than mainstream)
what is a perpetrator:
person who carries out abuse or harm
battery:
physical harm
direct care:
refers to the actual physical aspects of nursing care- anything requiring physical contact and face to dace interaction ex. perfirming a physical assessment on the client or changing a dressing on a wound
what are the signs of opioid overdose and what interventions would you implement?
s/s: -respiratory depression -lethargy -LOC we would want to maintain airway and administer naloxone
mainstream smoking:
smoke goes directly into the lungs but is filtered
who is more likely to abuse?
a person who has been previously abused themselves
tertiary prevention for substance abuse:
-addiction treatment -smoking cessation programs -support groups like AA, NA, al-anon etc. -detoxification
tertiary prevention for substance abuse:
-addiction treatment -smoking cessation programs -support groups: AA. Al, anonymous, NA, etc
secondary prevention for abuse:
-assess during routine examination -assess for marital discord -counsel for at-risk parents -assist with controlling anger
secondary prevention for substance abuse:
-assess for ATOD problems -drug testing kits
secondary prevention for substance abuse?
-assessing for ATOD problems -drug testing
for a women who has injuries that indicates possible abuse. list the nursing interventions in the priority order 1. gather info about current injuries 2. provide info about safe houses 3. assist in the treatment of her physical injuries 4. encourage the client to express her feelings 5. assess her plans for maintaining safety 6. obtain an in depth hx of the pattern of abuse
1.assist in the treatment of her physical injuries 2.gather info about current injuries 3.encourage the client to express her feelings 4.obtain an in depth hx of the pattern of abuse 5.assess her plans for maintaining safety 6.provide info about safe houses
purpose of family health care nursing:
help families promote their health, meet family health needs, coping with health problems within the context of existing family structure and community
which client would be appropriate for a home health care service? select all a. a client with a new ostomy b. a client requiring wound care c. a client receiving IV antibiotics d. a client receiving IV chemo e. a client recently diagnosed w/ diabetes requiring insulin e. a client needing physical therapy after a total knee replacement
a. a client with a new ostomy b. a client requiring wound care c. a client receiving IV antibiotics d. a client receiving IV chemo e. a client recently diagnosed w/ diabetes requiring insulin e. a client needing physical therapy after a total knee replacement
which is not a sign of elder abuse? a. addition to bank accounts b. broken eye glasses c. broken bones d. depletion of bank accounts
a. addition to bank accounts
what is narcan?
the antidote for morphine and opioid overdosing
why is it so dangerous to mis energy drinks with alcohol?
the bodys natural way to stop alcohol use is by making pt sleepy, when combing with energy drinks it will not make the client feel sleepy and they will continue to drink putting them at an increased risk for alcohol poisoning
homicide
the killing of one person by another
the 5 I's of chronic health conditions:
- intellectual impairment: dementia, delirium, depression -immobility -instability -incontinence -iatrogenic drug reactions
a pt who is unconscious arrives in the ED with clammy skin and constricted pupils. the nurse assesses a RR of 8-10 breaths/ min. the paramedics report obvious sings of drug abuse in the pts home. the nurse suspects that this pt has had an overdose of which substance? a. an opioid b. alcohol c. meth d. LSD
a. an opioid
a school nurse is working with the parent teacher orginization (PTO) to improve the health status of preschool students in lower socioeconomic urban community. given the demographics of the community, the nurse is aware that this population us at great risk for: a. childhood obesity b. ADHD c. poisoning d. asthma
a. childhood obesity
which rationale would explain the reason a client abuses alcohol? a. to blunt reality b. to precipitate euphoria c. to promote social interaction d. to stimulate the CNS
a. to blunt reality
which factor will the home health nurse use to assess an adolescents safety in the home environment? select all a. use of helmets b. drug and alcohol use c. presence of weapons d. vehicle safety restraints e. number of people in home f. nutrition and food consumption
a. use of helmets b. drug and alcohol use c. presence of weapons d. vehicle safety restraints
which action is best for the community health nurse to take if the nurse suspects that an infant is being physically abused? a. report suspicions to the local child abuse reporting hotline b, follow agency protocols to report suspected abuse c. educate the child care givers about growth and development of issues d. call the police department to have a child removed from the home
b, follow agency protocols to report suspected abuse
the most common from of violence in schools today is: a. attendance b. bullying c. dress code d. gun
b. bullying
what 2 areas of a house are abuse most dangerous?
bathroom and kitchen
domestic means: a. dealing with school b.dealing with your job c. dealing with mall issue d. dealing with family issues
d. dealing with family issues
which of the following would be the best question to ask a child about a suspicious injury that you have observed? a. did someone hurt you b. who did that to you c. did your father do that to you d. how did you get hurt
d. how did you get hurt
which is NOT true of hospice care? a. focuses on symptom relief b. is delivered as an outpatient c. is delivered in hospitals d. is for patients with less than 1 yr to live
d. is for patients with less than 1 yr to live
the first step in getting help with anger issues is to _____. a. punch a wall b. not take responsibility c. let is build up d. recognize it is a problem
d. recognize it is a problem
a nurse in community health is working with a single parent of three children, ages 4,6, and 8. the 6 yr old has cerebral palsy. the 4 yr old has asthma. the maternal grandmother lives with the family and has diabetes. the nurse understands the importance of working within the context of the existing family structure and community resources because family's are: a. unable to manage the stress of complex health needs b. resistive to outside interventions or involvement c. restricted in the ability to identify interventions d. responsible for providing/ managing the care off their members
d. responsible for providing/ managing the care off their members
drug dependance:
psychological changes in the CNS caused by chronic, regular administration of a drug in which use become necessary to prevent withdrawal symtoms
harm reduction for substance abuse:
recognizes that: -addiction is a health problem -any psychoactive drug can be abused -accurate info can help people make responsible decisions about drug use -people who have ATOD problems can be helped
primary prevention for substance abuse:
-assisting clients to achieve optimal health -teaching assertiveness and decision making skills -teaching stress reduction and relaxation techniques -emphasize that no drug is completely safe and that any drug can be abuse -helps clients identify community resources -safe drug disposal (mixing with coffee grounds/ litter, take back programs, sharp disposal in the home)
tertiary prevention for abuse:
-treat for substance abuse
what is enabling?
act of shielding an addict or preventing them from experiencing consequences of the addiction ex: calling them out of work because they are drunk and cant do it themselves
indirect care:
activities a nurse does on behalf of a client to improve or coordinate care ex. consulting with other nurses and health providers in a multidisciplinary approach to care
which client communication shows progress in the working stage of the nurse-client relationship with an addiction problem? select all a. describes how others have caused the addiction b. identifies personal strengths and weaknesses c. expresses uncertainty about meeting with the nurse d. acknowledge the effects of the addiction on the family e. addressed how to addiction has contributes to family distress
b. identifies personal strengths and weaknesses d. acknowledge the effects of the addiction on the family e. addressed how to addiction has contributes to family distress
medicaid home health care:
does not have to be homebound -will cover skilled and/or custodial services
who should get care managers 1st?
elderly with multiple comorbidities
where do you report abuse of minors, elders and disabled individuals?
elders: to BEAS bureau of elderly and adult services disabled: NH disability rights center, MA to disabled persons protection commission minors: division for children, youth and families (DCYF) and child protection services
family structure:
the structure of a family defines the roles and the positions of family members
what does ATOD stand for?
alcohol, tobacco, and other drugs
during a family nursing assessment a parent questions whether god is punishing the family, because one of the children has been diagnosed with leukemia. the most facilitative response by the nurse would be: a. why do you think your family needed to be punished b. tell me more about your family's spiritual beliefs c. that is not part of my religious belief system, so i dont know d. god is loving and doesnt punish people
b. tell me more about your family's spiritual beliefs
a pt who has hx of chronic back pain requires a higher dose of opioid meds in order to achieve adequate pain relief. the HCP suspects that thee findings are results of which of the following? a. dependence b. tolerance c. pseudoaddiction d. addiction
b. tolerance
when the nurse is making a home visit to a family with a toddler, which finding indicated a need for education about home safety? a. fire extinguishers b. unlocked cabinets c. house built in 2000 d. front facing care seat
b. unlocked cabinets
a nurse in a community health is conduction an assessment on a family of 4. during the course of the assessment the nurse collects info about previous generations of the family and siblings. the results are used to create a diagram for the family that displays the family unit across generations. further dicusssions occur regarding the patterns of health and illness that relate to biological health risks. the diagram is called: a. an ecomap b. a risk plot c. a genogram d. a family plan
c. a genogram
while assessing an older adult during a regular health checkup, the nurse finds sign of elder abuse, which physical findings would confirm the nurses suspicion? select all a. presence of hyoid bone damage b. presence of cognitive impairment c. presence of burns from cigs d. presence of bedsores e. presence of unexplained bruises on the wrists
c. presence of burns from cigs d. presence of bedsores e. presence of unexplained bruises on the wrists
the nurse is caring for a pt who is chronically irritable and anxious and prone to violent behaviors. the pt has several teeth missing and has dental caries in the remaining teeth, the nurse suspects previous chronic use of which drug? a. cocaine b. alcohol c. LSD d. meth
d. meth
which action would the school nurse take for a child who tells the nurse. "my father has been getting into bed with me at night and touching me" a. ask the child to describe the touching b. talk to the teacher about any inapropriate behavior c. contact the father to come to the school immediately d. report the childs conversation to child protective services
d. report the childs conversation to child protective services
palliative care:
treats anyone with a serious illness -provides symptom relief -you are able to continue treatments to cure illness people who may receive palliative care are those with illnesses like: -cancer, heart disease, lung disease, kidney failure, dementia, HIV, ALS
mandatory reporting of abuse:
when a health care provider suspects that there is abuse of a: -elderly person -child -person with a disability
What is codependency?
when people in a close relationship with an addict develop unhealthy coping mechanisms to continue to relationship
what is the #1 chronic illness that kids miss school for?
asthma
the nurse is teaching a pt who has completed detoxification for alcohol who will be discharge home with a prescription for disulfiram. which statement by the patient indicates understanding of the teaching? a. this drug acts by blocking the pleasurable effects of alcohol b. even topical products containing alcohol can have serious adverse effects when im taking this drug c. it is safe to take a product containing alcohol one week after the last dose of disulfiram d. if i experience drowsiness or skin rash i should discontinue this drug immediately
b. even topical products containing alcohol can have serious adverse effects when im taking this drug
the multidisciplinary home healthcare team is discussing a female client diagnosed with parkinsons. the home health nurse reports the client is getting worse and her husband is no longer able to care for her in the home. which action should the nurse implement first? a. assign a home health care aid to provide daily care b. request chaplain to counsel the couple c. talk to the husband about placing his wife in a nursing home d. contact the clients children to discuss the situation
a. assign a home health care aid to provide daily care
which behavioral findings corresponds to intimate partner violence in adolescents? select all a. attempting suicide b. sexually acting out c. pattern of substance abuse d. fear of certain people and places e. preoccupation with others or ones own genitals
a. attempting suicide c. pattern of substance abuse
which behavior indicated codependence for the spouse of a partner who abuses multiple drugs? a. attempts to cover up the partners drug use b. shows inability to delay gratification c. lacks awareness of the dangers of drug addiction d. threatens to leave if the partner wont quit drug use
a. attempts to cover up the partners drug use
which similarity exists between medicare and medicaid? select all a. both programs assist in older adults b. medicare and medicaid pay for home care services c. both programs pay full cost of services provided d. low income families are recipients of both programs e. medicare and medicaid finance individuals who are poor and pregnant
a. both programs assist in older adults b. medicare and medicaid pay for home care services
which right of case management is necessary for the public health nurse consider when using case management in practice? select all a. care b. time c. provider d. setting e. outcomes f. price/ value
a. care b. time c. provider d. setting e. outcomes f. price/ value
which would the nurse consider when caring for a family with three school aged children as the unit of service? a. certain members of the family may be capable of giving more support than the nurse b. assessing each family member is not necessary to plan care for the family as a whole c. family values are not as important as other facotors regarding how assistance is perceived d. helping the family requires separating health problems from other aspects of the familys life
a. certain members of the family may be capable of giving more support than the nurse
which action would be included in the assessment process by a nurse working in a school health promotion program for adolescents? select all a. conducts a school violence assessment b. assess the sleep pattern of the students c. try identifying individuals at risk for substance abuse d. identify the need for fluoride supplements to prevent dental carries e. inquire about the presence of guns in the home to reduce the incidence of homicide
a. conducts a school violence assessment c. try identifying individuals at risk for substance abuse e. inquire about the presence of guns in the home to reduce the incidence of homicide
the public health nurse is developing a program geared toward primary prevention of domestic violence. which info would the nurse include in the program for those at high risk? select all a. coping skills b. social support c. care for victims d. stress reduction e. screening programs
a. coping skills b. social support d. stress reduction
while caring for a family, the nurse observes that the family has accepted the shifts of generational roles. which change in the family status would the nurse observe? a. dealing with retirement b. taking on parental roles c. adjusting to a reduction in family size d. refocusing on midlife material and career issues
a. dealing with retirement
which action would the school nurse take after identifying an adolescent at risk for smoking due to peer pressure? select all a. discuss alternatives to smoking b. punish the peer group influencing the adolescent c. mention immediate physiological consequences d. suggest effective arguments to deal with peer pressure e. recommend that the adolescent transfer to a different school
a. discuss alternatives to smoking c. mention immediate physiological consequences d. suggest effective arguments to deal with peer pressure
which activities reflect secondary prevention interventions in relation to health promotion? select all a. encouraging regular dental check ups b. facilitating smoking cessation programs c. administering influenza vaccines to older adults d. teaching the procedure for breast self examination e. referring clients with a chronic illness to a support group
a. encouraging regular dental check ups d. teaching the procedure for breast self examination
which intervention by the home healthcare nurse to the use of safety competency while providing health care? a. ensures the furniture does not obstruct the clients movement b. updates the clients EMR after providing care c. coordinated with the local pharmacy to supply medication for the client d. teaches the family caregiver to assist the client with range of motion exercises
a. ensures the furniture does not obstruct the clients movement
the nurse is community health uses information about family structure, household composition, marriage, divorce, birth, death, adoption and other family life events to forecast and predict stresses and developmental changes experienced by families and identify possible solutions to family challenges. this best described the study of: a. family demographics b. family functions c. family health d. family resilience
a. family demographics
if you are unsure about wether or not to make a child abuse report you should: a. file a report immediately, contact CPS b. tell your site supervisor and let he/she make the final decision c. call the childs parents and asl d. just keep an eye out fo the child and do not report
a. file a report immediately, contact CPS
which statement best describes case management? a. focuses on improving care coordination and reducing service fragmentation for individuals and families b. works with providers and consumers to support self-care, shared decision making, and knowledgeable use of medicines c. promotes optimal use of services including appropriate use of services for in both acute care and community base settings d. includes population level wellness, health promotion, illness prevention through care coordination and community engagement
a. focuses on improving care coordination and reducing service fragmentation for individuals and families
school health nursing programs have which goal? a. health promotion b. disease management c. chronic care management d. environmental surveillance
a. health promotion
which type of continuing care would a client expect if discharged home with an infusion device to continue treatment for a leg wound? a. home care b. rehab c. skilled nursing care d. outpatient therapy
a. home care
which goals of care are associate with the family health system model? select all a. improving family health or well-being b. preparing for family transitions later in life c. providing assistance in family management of illness d. promoting positive family behaviors to achieve essential tasks e. achieving health outcomes related to the family's areas of concern
a. improving family health or well-being c. providing assistance in family management of illness e. achieving health outcomes related to the family's areas of concern
the most important causes of preventable disease, disability and death among children are: a. injuries and accidents b. cardiovascular health c. maintaining a healthful diet d. physical activity
a. injuries and accidents
which risk factors increases a clients risk for infection in the community? select all a. lifestyle b. occupation c. chronic disease d. frequent traveling e. diagnostic procedures
a. lifestyle b. occupation d. frequent traveling
an 8th grade teacher reports to the school nurse that a student has suddenly dropped out of activities, has been receiving bad grades, and cries for no specific reason. which familial factor would the nurse investigate further to identify the cause of this behavior? select all a. parental loss b. unavailable parents c. lack of future options d. social incompetency e. child abuse or neglect
a. parental loss b. unavailable parents e. child abuse or neglect
which factor may influence an adolescent to begin smoking? select all a. peer pressure b. academic success c. involvement in sports d. imitating adult behavior of smoking e. imitating lifestyles portrayed in movies and advertisements
a. peer pressure d. imitating adult behavior of smoking e. imitating lifestyles portrayed in movies and advertisements
which rationale best explains how an addiction to alcohol occurs? a. person eventually requires alcohol for functioning b. person lacks the motivation or will to stop drinking c. person has developed very few coping mechanisms d. person enjoys the social aspect of drinking alcohol
a. person eventually requires alcohol for functioning
the home health nurse is planning a visit to a client who has been discharged home after hospitalization. which action should the nurse implement? a. schedule home visits that take place during the daylight hours b. use a duplicate copy of the clients record to provide cocurrent services c. avoid creating barriers by wearing a name tag in the home d. ensure HIPPA laws are observed by avoiding visits when other homecare providers are present
a. schedule home visits that take place during the daylight hours
the school nurse is interested in providing an antismoking program in a local middle school and is aware that programs are more effective for this age group when they focus on short term versus long term effects of smoking. besides including health risks and cosmetic effects, the nurse should also consider: a. social skills instruction to resist pressure to smoke b. effects on the environment c. laws regarding tobacco sales to minors d. behavior modification on techniques
a. social skills instruction to resist pressure to smoke
which topic should the nurse include in planning a primary prevention class for adolescents? a. suicide risk and prevention b, dietary management of obesity c. coping with stressful situations d. risk factors for heart disease
a. suicide risk and prevention
which guideline would the school nurse include when planning a class on prevention for a group of high school students? select all a. swim with a buddy b. drink beer instead of wine c. use well -traveled walkways d. smoke only in designated areas e. refuse to play "chicken" with others
a. swim with a buddy c. use well -traveled walkways e. refuse to play "chicken" with others
which statement describes the case management method of care delivery? select all a. the case manager advocates for the client and family b. the case manager identifies outcomes and coordinates care activities c. case managers help control the costs for high risk, high cost client populations d. identifying tasks that can be preformed by other care providers is just one activity e. case management includes the client, family, and HCP involvement
a. the case manager advocates for the client and family c. case managers help control the costs for high risk, high cost client populations e. case management includes the client, family, and HCP involvement
the nurse is assessing a toddler and the dynamics of thee childs family in which abuse is suspected. which behavior exhibited would lead the nurse to suspect abuse? select all a. the child cringes when approached b. the parents cannot explain previously healed injuries c. the parents are overly affectionate toward the child d. the child lies still while surveying the environment e. the parents give detailed accounts of the childs injuries
a. the child cringes when approached b. the parents cannot explain previously healed injuries d. the child lies still while surveying the environment
which physical or behavioral signs of substance abuse would a nurse observes for in the adolescent population? select all a. worrying about being addicted b. showing a high performance in social activities c. experiencing an overdose or withdrawl symptoms d. worrying about a friend or family member who is addicted e. manifesting bizarre behavior of confusion
a. worrying about being addicted c. experiencing an overdose or withdrawl symptoms e. manifesting bizarre behavior of confusion
what is the difference between abuse and neglect?
abuse is physcially hurting someone you would see fractures, bruising, cigarette burns neglect is not meeting the needs of someone --> ex. you would see skin breakdown from incontinence, malnutrition from not feeding someone
hospice care:
anyone with a serious illness with a prognosis of 6 months or less to live -provides symptom relief -treatment will be provided to cure the illness will only provide symptom relief -medicare will pay for all hospice charges
which description of family centered care is correct? a. the nursing care is focused on the client as an individual b. a collaborative plan of care is developed to achieve optimal health c. the HCP is the expert in developing a plan of care d. the nursing care is based solely on standards of practice
b. a collaborative plan of care is developed to achieve optimal health
which interventions would the nurse implement for a dying client and the family? select all a. arrange for restorative care b. help the family set up home care if required c. refrain from telling the family that the client is dying d. determine the client and family's strengths and weaknesses e. arrange for church or community support for the family
b. help the family set up home care if required d. determine the client and family's strengths and weaknesses e. arrange for church or community support for the family
a 58 yr old client is planning to retire. which assessment would be appropriate in this situation? a. activity level b. issues related to income c. familys ability to conduct an environmental check d. options of public transportation and number of community activities
b. issues related to income
a pt presents to the clinic with a report of fatigue and difficulty concentrating. which additional statement made by the pt would alert the HCO to possible marijuana use? a. i feel anxious and have trouble sleeping b. ive noticed that my eyes are red lately c. i feel nauseous and dont feel like eating d. i keep having really vivid and scary nightmares
b. ive noticed that my eyes are red lately
identify the factors associated with an increased incidence of abuse within a family. select all a. acute illness b. pregnancy c. drug abuse d. chronic illness e. sexual orientation
b. pregnancy c. drug abuse e. sexual orientation
attendance at a community health clinic is rising and clients have long waits for service. the charge nurse believes that a computer system would be helpful to decrease the time to conduct initial intake and exit processing. what is the best way for the nurse to introduce the idea of obtaining a computer system for the clinic? a. ask the medical director to take to the board of director about obtaining funds to implement computer system b. submit a written proposal to the board of directors about hardware and software improvement needs c. send a signed letter to the editor of the local newspaper describing the benefit to the community d. meet informally with some board members to enlist their support for the idea of implementing a computer system
b. submit a written proposal to the board of directors about hardware and software improvement needs
a pt with asthma has been using a nicotine transdermal patch for 24 hrs for 3 weeks to quit smoking. the pt reports having difficulty sleeping. what action will the nurse take? a. the the pt to stop the patch and join a support group b. suggest using an 18 hr patch instead c. recommend removing the patch at bedtime d. ask the provider for a prescription for nicotrol NS
b. suggest using an 18 hr patch instead
which question would the nurse ask to determine impact of a community level education program to prevent and reduce drug use among youth when collecting data during summative evaluation? select all a. are money and resources available to continue the program b. how many youth referrals have been made to drug counseling services c. are fewer youths initiating use of marijuana after one year of programming? d. are local schools and other youth providers satisfied with the progrem design e, is the program offering enough services to make a positive difference in youth substance use
c. are fewer youths initiating use of marijuana after one year of programming?
which strategy would the nurse recommend that is most effective for a client who has decided to stay sober after completing alcohol detoxification rehab treatment? a. daily admin of disulfiram b. individual or group psychotherapy c. admission to an alcohol unit in a hospital d. active membership in alcoholics anonymous
d. active membership in alcoholics anonymous
a pt is brought to the ED by a friend. the pt is unresponsive and respirations are slow and shallow. which of the following is the priority intervention? a. check the pts BG b. administer naloxone per protocol c. ask the friend if the were using illicit drugs d. admin 100% oxygen per nasal cannula
d. admin 100% oxygen per nasal cannula
which tertiary interventions would the nurse sue for a young adult who sustained injuries as a result of physical battering by her partner? select all a. contacting family members to provide support b. discussing the legal ramifications of not pressing charges c. offering to discuss the abusive behaviors with her spouse d. identifying the benefits of attending a support group for battered women e. providing her with information regarding local domestic violence shelters
d. identifying the benefits of attending a support group for battered women e. providing her with information regarding local domestic violence shelters
a HCP prescribes disulfiram for a client who abuses alcohol. which action is associated with disulfiram? a. it decreased alcohol cravings b. it decreased the effect of alcohol inebriation c. it allows the client to tolerate only small amounts of alcohol d. it causes severe adverse reaction if alcohol is consumed
d. it causes severe adverse reaction if alcohol is consumed
the current day definition of family refers to two or more individuals who depend on one another for emotional, physical, and/ or financial support. which of the following is the most important principe to support this broader definition? a. families are defined by genetic ties b. family names are needed to confer status c. traditional family functions have been redefined d. members of a family are self defined
d. members of a family are self defined
which situation accurately describes hospice care? a. a residents temporary or permanent home, where the surroundings have been made as homelike as possible b. offers an attractive long-term care setting w/ an environment akin to the client's home which offers the client greater autonomy c. service that provides short-term relief for people providing home care to an ill, disabled, or frail older adult d. system of family-centered care that allows clients to remain at home in comfort while easing the pains of terminal illness
d. system of family-centered care that allows clients to remain at home in comfort while easing the pains of terminal illness
which critical lifestyle dimension is documented based on a familys statement during a health risk assessment: "I know i should try to fix better balanced meals, but when i grew up eating similar items i have done fine"? a. benefits of the behavior b. barriers to prefroming the behavior c. effect of the behavior on the family d. values placed on lifestyle behaviors
d. values placed on lifestyle behaviors
the nurse is caring for a child admitted with suspicious injuries. which action would the nurse ask to obtain further information about possible child abuse? a. what behaviors cause you to get in trouble b. what problems do you have when at school c. what is it about your parents that upsets you the most d. what happens when you do something wrong
d. what happens when you do something wrong
the nurse is planning a community - based project to reduce obesity in a school age population. which outcome statement best supports the goal for this population? a. in the target population 30% of the students with be below the 95th percentile in weight b. student with a BMI above the 95th percentile will decrease c. increase in exercise will decrease obesity in children with a sedentary lifestyle d. within two years the student with a BMI greater than 95% will be reduced by 50%
d. within two years the student with a BMI greater than 95% will be reduced by 50%
what is the best approach for smoking cessation?
-provide resources and therapy -try alternative nicotine routes such as a patch of gum
reporting of abuse:
-talk with the adult victim the possibility of filing a mandatory report -consider the safety concerns of filing -determine how the perpetrator may respond to a report being filed -determine if it will be safe to inform the children about the report -identify resources available to victim (family, friends, co-workers) -consider filing in concert with the adult victim -share the concerns of safety with the child protective agency -address safety planning with the non-offending victim
primary prevention for abuse:
-teach stress reduction techniques -teach parenting techniques -educate on developmental stages and needs of children
what home health care services are covered by medicare?
-teaching family -wound care -infusion -post op follow up -med compliance/ teaching must be homebound does NOT include custodial services like bathing, dressing, cooking or cleaning
an occupational health nurse is reviewing a 20 yr old trend in the US that has resulted in an increase in certain medical conditions due to rapid expansion of an urban industrial workforce. which medical condition is specifically identified with this trend? a. lead poisoning b. asthma c. west nile virus d. alcoholism
b. asthma
which rationale supports family involvement in the treatment program for a person who has alcohol abuse problems? a. alcoholism involves the entire family and affects all members b. alcoholics try to hide their drinking from their families c. family members provide insights into the dynamics behind the drinking d. family members have been most successful in providing necessary support
a. alcoholism involves the entire family and affects all members
which finding during a home health visit would prompt the nurse to provide a client with home safety instruction? select all a. area rugs on the floor b. clogged dirty fireplace c. multiple electrical cords d. multiple prescribed meds e. wheeled walker with uneven legs
a. area rugs on the floor b. clogged dirty fireplace c. multiple electrical cords d. multiple prescribed meds e. wheeled walker with uneven legs
we call the person who is violated or hurt in a conflict the: a. victim b. defendant c. bully d. perpetrator
a. victim
which actions would be included in the safety plan for a women in crisis who is emotionally and physically abused by her husband? select all a. limit contact with abuser b. determining a safe place to go in an emergency c. memorizing the domestic violence hotline number d. obtaining a bank loan to finance leaving the abuser e. arranging for a family member to assist her in leaving
b. determining a safe place to go in an emergency c. memorizing the domestic violence hotline number
which recommendations would the nurse provide the family who has a child w/ down syndrome? select all a, suggest the family engage in spiritual activities b. help the family recognize possible stressors c. encourage the use of problem solving strategies d. encourage more out of home activities for the parent e. refer the family to support groups and internet resources
b. help the family recognize possible stressors c. encourage the use of problem solving strategies e. refer the family to support groups and internet resources
which information will the nurse provide to a client in a hospice home care program who is prescribed morphine? a. medication addiction is a concern with this med b. request the med before the pain becomes severe c. dosages of the med will be given automatically at regular intervals around the clock d. intermittent admin of the med is possible after an intermittent lock is inserted
c. dosages of the med will be given automatically at regular intervals around the clock
a 12 yr old female is seen by the school nurse after having difficulty sitting still and paying attention she has increasingly illegible handwriting the nurse observes that the child has protruding eyeballs in the staring expression what action should the nurse take next? a. call the childs parents to schedule for an immediate medical exam b. refer teh child fro psychological eval d/t attention deficit disorder c. gather additional data by taking a health hx and measuring vitals d. collaborate with the teaching to place the child on a behavioral modification program
c. gather additional data by taking a health hx and measuring vitals
which of the following goals would the HCP identify as realistic for a pt with a substance abuse problem? a. explore genetic abnormalities associated with substance abuse b. use the substance only in moderation and in certain situations c. identify situations that trigger desire to use the substance d. focus on how cravings can be eliminated by enhancing will power
c. identify situations that trigger desire to use the substance
the nurse is assisting with the end of life care of a client. which activity is performed when the nurse views family as context? a. assess the resources available to the family b. meet the clients familys comfort and nutritional needs c. meet the clients comfort, hygiene, and nutritional needs d. determine the familys need for rest and their stage of coping
c. meet the clients comfort, hygiene, and nutritional needs
which approach would be most effective when the nurse on the adolescent unit is planning to discuss smoking prevention? a. sharing personal experiences with a smoking cessation program b. showing pictures of the effects of smoking on the cardiopulmonary system c. presenting information on how smoking affects appearance and odor of the breath d. citing statistics about the relationship between smoking and cardiopulmonary disease
c. presenting information on how smoking affects appearance and odor of the breath
the use of telecommunication and info technology to provide nursing care when large distance exist between pt and nurse is? a. medical tourism b. nurse licensure compact (NLC) c. telehealth nursing d. rural nursing
c. telehealth nursing
the nurse is caring for a pt who is being treated for chronic alcohol intoxication. the nurse notes that the pts serum alcohol level is 0.40. the patient is awake and talkative even though this is a potential lethal dose. the nurse recognizes this as: a. dependence b. misuse c. tolerance d. addiction
c. tolerance
denial is a primary indication of dependence and can include:
-defensiveness -lying about use -minimizing use -blaming or rationalizing use -itellectualizing -"going with the flow"
which warning sings would the nurse recognize as indicating a child may be victim of abuse? select all a. the child does not want to be touched by anyone b. the child sleeps for an average of 15 hrs a day c. the child frequently visits the ED d. the child suffers from a fever and tenderness in the abdomen e. the child looks at the caregiver before answering questions
a. the child does not want to be touched by anyone c. the child frequently visits the ED e. the child looks at the caregiver before answering questions
which info would the nurse provide a client being discharged from a health care facility with a surgical wound? select all a. prescribed drug-drug interactions b. care of surgical wound c. safe and effective use of meds d. list of appropriate community resources e. need to report any change in surgical area
b. care of surgical wound c. safe and effective use of meds d. list of appropriate community resources
which member of the interprofessional team is appropriate for the nurse to ask for support in informing and consoling the family of a terminally ill pt who has died? a. primary HCP b. pharmacist c. social worker d. occupational therapist
c. social worker
which of the following assessment findings in a pts health hx supports diagnosis of substance dependance? a. impaired judgement and risk taking behaviors b. numerous legal problems and interpersonal conflicts c. withdrawl symptoms when not using the substance d. continued tardiness and absentieeism form work
c. withdrawl symptoms when not using the substance
the adolescent children are having difficulty talking with their mother, who is in the terminal stage of cancer. which rationale best supports initiating a family meeting? a. it is important to make goals for solving family problems before death occurs b. the children will be unable to deal with their feeling until after their mother dies c. a deeper level of knowledge will help the children understand their mothers feelings d. open communication increases ability to work through reactions to the terminal illness
d. open communication increases ability to work through reactions to the terminal illness
what are the principle funding sources for home health care?
medicaid and medicare with third party health insurance providing another major source
manifestations of withdrawal:
-irritability -tremors -nausea -vomiting -headaches -diaphoresis -anxiety -sleep disturbances -tachycardia -elevated BP
primary prevention for substance abuse:
-promote healthy lifestyle and resiliency factors -drug education -help clients identify community resources -safe drug disposal
community care settings for adults:
-senior centers -adult day health -home health and hospice -assisted living -long term care and rehab
the nurse is working with a client who reports intimate partner violence and shares being afraid to leave the partner. which info would the nurse discuss with the client to increase safety? select all a. change the locks on the doors b. avoid local area stores c. develop an escape plan d. obtain a restraining order e. have important phone numbers
c. develop an escape plan e. have important phone numbers
the nurse is teaching a group in the community about drug abuse. which statement by the nurse is correct? a. drug addiction occurs when physical dependence is present b. drug addiction is characterized by emotional. mental, and sometimes physical dependance c. drug abuse and drug addiction are synonymous terms describing dependence on drugs d. cue-induced cravings eventually disappear after long periods of abstinence by the person addicted to drugs
b. drug addiction is characterized by emotional. mental, and sometimes physical dependance
which rationale is the major reason that narcotics anonymous is helpful in treating addictive behavior? a. more behavioral change will take place within the group b. group members are supportive of one another problems c. group members share a common background and hx d. addiction problems are dealt w/ more effectively in a group
b. group members are supportive of one another problems
which action is the professional nurses legal responsibility regarding child abuse? a. honor the request of the parents not to report the suspected abuse b. report any suspected abuse to local law enforcement c. return the child to the legal parent even if they are suspected of abuse d. provide the parents with a copy of the child medical record
b. report any suspected abuse to local law enforcement
which parental behaviors support a suspicion of child abuse? select all a. displaying sensitivity about their child care ability b. taking the initiative in meeting their childs needs c. exhibiting difficulty in showing concern for their child d. demonstrating heightened interest in their child welfare e. procrastinating in obtaining treatment fo their childs injuries
c. exhibiting difficulty in showing concern for their child e. procrastinating in obtaining treatment fo their childs injuries
one member of an older couple has just retired. this is considered a: a. developmental stage that will help the family with stress reduction b. nonnormative event that will have psychological impact of the family c. normative event that can increase the familys risk for illness d. normative event and will have little effect of the familys well being
c. normative event that can increase the familys risk for illness