community health exam 4

3. A PHN is working with a team doing a community assessment. She has been tasked with evaluating the community's access to grocery stores, accessible transportation, outside activities, and the maintenance of its neighborhood buildings. The nurse is evaluating the: 1.Environmental stability. 2.Built environment. 3.Ecological approach. 4.Environmental health.

Built environment.

A school nurse has observed a slight increase in teacher absenteeism due to illness and decides to implement several new programs to boost employee wellness. What is the nurse's first step? 1. Send out questionnaires to all of the staff members to see what type of programs they would be interested in. 2. Set a goal to reduce absenteeism by 5% within the next year. 3. Start a yearly health fair to set goals for the following year. 4. Implement a staff-wide weight loss competition.

Send out questionnaires to all of the staff members to see what type of programs they would be interested in.

5. A nurse is speaking at a city council meeting in a coastal town on the northeastern coast of the United States. The nurse is explaining that, to protect the rest of the town, the city council needs to restrict people from building homes directly adjacent to the beach . A resident stands up, angry, and demands to know why he can't purchase property there. From the perspective of safety for the community as a whole, the nurse replies: 1."People living directly adjacent to the beach are at greater risk for property damage from seawater." 2."Deforestation along the coast can increase risk and severity of strong storm surges during hurricanes or coastal storms." 3."Remote areas can be more difficult to evacuate in case of an emergency." 4."All community members need to be able to access the coastline in case of an emergency evacuation."

"Deforestation along the coast can increase risk and severity of strong storm surges during hurricanes or coastal storms."

A nurse is meeting with a patient with no history of IV drug use after he has spoken with the doctor and received a diagnosis of hepatitis B and E. The patient expresses concern that someone will find out about his diagnosis. How does the nurse respond? "I can understand that you are concerned about this. ___________________." 1. "You do not need to worry because this patient information is protected by HIPAA, and I am not allowed to provide this information to anyone who is not responsible for your clinical care." 2. "However, it is your responsibility to inform all of your previous sexual partners." 3. "However, this is a reportable disease in this state. This means the public health department will ask you for all your possible contacts that might requiring counseling and/or post-exposure prophylaxis." 4. None of the above.

"However, this is a reportable disease in this state. This means the public health department will ask you for all your possible contacts that might requiring counseling and/or post-exposure prophylaxis."

2. An occupational nurse is starting a new position with a company with 35 employees. The nurse asks to see the OSHA 300 form but is told that the company is not required to use that form. How does the nurse reply? 1."You're right. The OSHA 300 logs are voluntary." 2."You're right. The OSHA 300 logs should be kept when a company has 50 employees." 3."That's incorrect. The OSHA 300 logs should be kept when a company has at least 10 employees." 4."Each employee is required to keep their own logs and report injuries as applicable."

"That's incorrect. The OSHA 300 logs should be kept when a company has at least 10 employees."

17. A nurse is starting a position with a large agricultural farm in the central California valley, where most of the employees are migrant workers. This farm has never before employed an OEHN, and so the nurse wants to establish a healthy living program tailored to the migrant workers. What information and assistance would be particularly helpful for this population? (Select all that apply.) 1.Information on exposure to pesticides 2.Information on reducing risk for skin cancer 3.Financial assistance for education 4.Signage in the workplace in their native language 5.Immigration assistance

1.Information on exposure to pesticides 2.Information on reducing risk for skin cancer 4.Signage in the workplace in their native language

18. To aid a lower income family who is struggling with a pest problem in their home, a PHN recommends a program known as integrated pest management, which offers methods to deter pests. Some of these methods include which of the following? (Select all that apply.) 1.Caulking and sealing cracks and holes in the home 2.Eating in one place 3.Getting rid of clutter 4.Storing food in sealed containers 5.Making sure the family is vaccinated

1.Caulking and sealing cracks and holes in the home 2.Eating in one place 3.Getting rid of clutter 4.Storing food in sealed containers

17. The PHN understands that the toxicity of chemicals in children is more severe than that in older populations because of which of the following reasons? (SATA) 1.Children play in outdoor soil, which can be contaminated. 2.Children may ingest substances from unlabeled, repurposed food containers. 3.Children have faster rates of absorption of toxic substances. 4.In urban settings, children may not have adequate places to play. 5.Children have less developed immune systems.

1.Children play in outdoor soil, which can be contaminated. 2.Children may ingest substances from unlabeled, repurposed food containers. 3.Children have faster rates of absorption of toxic substances. 4.In urban settings, children may not have adequate places to play. 5.Children have less developed immune systems.

18. An OEHN is performing an employee health evaluation for a new female worker who will be working on a construction site. What information is particularly relevant to the assessment? (Select all that apply.) 1.Fit of PPE 2.Hearing and vision assessment 3.Family situation 4.Previous medical records 5.Job description

1.Fit of PPE 2.Hearing and vision assessment 3.Family situation 5.Job description

Jacob has worked as a PHN in urban areas and has just now moved to a rural area and taken a job in the public health department in charge of county outreach programs. Based on data he recently reviewed from the Federal Office of Rural Health Policy, the following might be programs he should consider except: 1. An oral health program. 2. A chronic disease self-management program. 3. An internet-based health education program. 4. A mobile pharmacy program.

A chronic disease self-management program.

9. A nurse is working at a hospital in Hawaii. A neighboring island has been evacuated due to a volcanic eruption. The hospital has been put on alert that they will be receiving injured people from the evacuated island. What types of injuries or illnesses should the nurse and other staff be prepared to treat? 1.Burns 2.Respiratory disease 3.Severe lacerations or other traumatic injuries 4.All of the above

All of the above

A public health nurse (PHN) has been tasked with addressing the rise in teen pregnancies in her communities. She wishes to create linkages among agencies that provide care to teens and/or obstetrical care generally. Which would be her first step based on the six-step guide created by The Center on Education and Training for Employment at The Ohio State University? 1. State the key challenges, articulate why they are better addressed by multiple agencies, and name potential key players. 2. Create a harmonious planning environment among agencies. 3. Assess the need to work in partnership with other agencies. 4. Make sure the members of the partnership are equally representative of the community-at-large in terms of culture, race, and perspective.

Assess the need to work in partnership with other agencies.

A parent has called the school nurse's office to discuss her daughter's new diagnosis of type 1 diabetes. The parent is inquiring about what role the nurse will play in managing her care while the girl is in school. The key role of the nurse is to: 1. Encourage self-care. 2. Administer insulin. 3. Manage the student's dietary intake. 4. Provide daily blood glucose monitoring.

Encourage self-care.

A primary care nurse works at the Native American Health Center, a nonprofit organization serving the California Bay Area Native Population. The center has asked her to put together a comprehensive prevention plan related to type 2 diabetes. Which of the following interventions is an example of a primary intervention? 1. Regular foot and eye care 2. Encouraging a healthy diet and weight loss if appropriate 3. Tight blood sugar control with every meal 4. Screening blood glucose yearly

Encouraging a healthy diet and weight loss if appropriate

10. A nurse is volunteering with the local fire department and is sitting in on a class about dealing with wildfires. The instructor is talking about strategies for fighting a fire that is burning below the forest floor in the humus layer of the soil. This is known as what type of fire? 1.Wildfire 2.Ground fire 3.Surface fire 4.Crown fire

Ground fire

A nurse is looking to address teen gang violence in a nearby community using the principles of community organizing. The nurse has spent a great deal of time in the community performing a community assessment and getting to know residents and key stakeholders. What is the next step? 1. Identify core leaders to organize the community around the main issue. 2. Identify clear goals that relate to the overarching goal of reducing teen gang violence. 3. Identify available resources. 4. Create a plan to evaluate their actions.

Identify core leaders to organize the community around the main issue.

8. A nurse is working with a local television station on a public service announcement meant to educate residents on how to prepare for tornadoes. What advice does the nurse give in the event that a tornado is imminent? 1.Watch for the coming storm at the windows. 2.Immediately take shelter in a basement away from any windows. 3.Take shelter in a large room under a blanket. 4.As soon as the alarm goes off, gather your emergency supplies and head to the nearest community shelter.

Immediately take shelter in a basement away from any windows.

A school nurse has just been promoted to overseeing the nursing care provided in the school district. She is reviewing the vaccination compliance level across all grades. Based on her review of vaccine recommendations from the Advisory Committee on Immunization Practices, she is updating the parent information sheet to include the recommendation that all children the age of 6 months of age or older receive the vaccine for___________ yearly. 1. Influenza 2. Measles-Mumps-Rubella 3. Varicella 4. There are no recommendations for a yearly vaccine.

Influenza

A school nurse is beginning work at a new elementary charter school. As the nurse is developing screening policies for the students in the school, which of the following must be included? 1. Scoliosis screening 2. Hearing and vision screening 3. Both scoliosis and hearing and vision screening 4. It depends on what the state mandates.

It depends on what the state mandates.

11. A nurse is preparing to perform physical exams for a group of new employees. What information is the most crucial to the proper evaluation of the new employees' health? 1.Medical records 2.Job description 3.Latest blood test results 4.Vaccination records

Job description

A new high school nurse is reviewing the sex education materials and finds them completely outdated, without any mention of contraception or sexually transmitted infections. What should the nurse do first? 1. Revise the materials and begin implementing the new program. 2. Look into state and local regulations that might impact the development of a new program. 3. Leave the materials as is, but create a new presentation that includes the omitted topics. 4. Schedule a meeting with parent representatives to discuss changing the program.

Look into state and local regulations that might impact the development of a new program.

A nursing professor is looking to give students clinical experience in relation to health program planning with a focus on implementation. The professor proposes which of the following projects to the curriculum committee? 1. A community assessment of three different neighborhoods 2. A mock community assessment and health policy development for a hypothetical community 3. A requirement that each student complete a paper about the history of health policy in the United States 4. Placement of students in a local community center that has requested the school partner with them on population-level health interventions they would like to put in place

Placement of students in a local community center that has requested the school partner with them on population-level health interventions they would like to put in place

11. A PH is helping to manage a decrease in air quality due to emissions from a chemical plant. Which term best describes the source of the decrease in air quality? 1.Point source 2.Mobile source 3.Area source 4.Community Source

Point source

A school nurse is updating the designated medical emergency response plan. Once the plan is in place, it is recommend that she should do all of the following except: 1. Identify who within the system is authorized to make emergency medical decisions. 2. Practice the plan once each year. 3. Make sure AEDs are available in the school 4. Teach multiple staff members first aid and cardiopulmonary resuscitation.

Practice the plan once each year.

6. A family survived a dangerous weather event, but now they are suffering through another part of environmental risk: stress, pain, and anxiety. The nurse recognizes that these are the: 1.Physical agents. 2.Mixed exposures. 3.Psychosocial factors. 4.Biological agents.

Psychosocial factors.

A nurse has worked at a community health center for many years. Over the last several months, the nurse has noticed a significant decline in community members using the resources available at the clinic. What is the first thing the nurse should do? 1. Begin offering day care services and free transportation to the clinic to make it more convenient. 2. Reach out to former patients to determine why they are no longer returning to the clinic. 3. Perform a community assessment. 4. Begin offering a new patient reduced fee rate.

Reach out to former patients to determine why they are no longer returning to the clinic.

A primary care nurse is volunteering at lead screening clinic for children living in an inner-city community. After performing the screening tests, what is the most important thing for the nurse to do for the children with a positive screen?1. Conduct a home visit. 2. Refer them to a pediatric specialist for further screening and possible treatment. 3. Offer parents educational materials related to reducing lead exposure in children. 4. Conduct a community-wide environmental assessment to determine the source of the lead exposure.

Refer them to a pediatric specialist for further screening and possible treatment.

3. A nurse is working at a high school serving as a community shelter during a hurricane. In the surge after the storm, the basement starts filling with floodwaters and then the power shuts off. As a result, the nurse, as indicated in the plan in the event of flooding, contacts the local coast guard to assist in relocating people in the shelter to an unaffected elementary school across town. This is an example of: 1.Mitigation. 2.Response. 3.Triage. 4.Recovery.

Response.

13. A nurse is responding to the scene of a small plane crash in the community. First responders are on the scene treating victims, but they have asked the nurse to notify the appropriate federal authorities. The nurse informs: 1.The FBI. 2.The FAA. 3.FEMA. 4.The Department of Homeland Security.

The FAA.

A young woman presents to her primary care provider. Her mother has just been diagnosed with Huntington's disease, and several other members of her family have been diagnosed with the condition as well. She wants to know her options regarding testing to see if she is a genetic carrier. From an ethical perspective, what issue would be most important to discuss with the patient? 1. The cost of Huntington's disease screening 2. Whether the test is available at the local lab 3. What will happen when her insurance finds out the results 4. The fact that there is no known treatment that can alter the progression of the disease

The fact that there is no known treatment that can alter the progression of the disease

When providing care within the context of primary health care, the most important person(s) is/are: ______________ .1. The individual/family 2. The population 3. The primary-care physician 4. The medical specialist

The individual/family

The nurse at a community-based primary care organization is educating newly hired nurses about the process used at the clinic for developing public health programs aimed at benefitting community members whether they attend the clinic or not. The nurse explains that even though the primary care offered at the clinic focuses on caring for an individual, the health promotion activities that they are developing for the community are focused on: 1. The family. 2. The health-care provider. 3. The health-care organization. 4. The population.

The population.

4. The PHN realizes that the mere presence of an agent, even if it is known to have toxic properties, does not necessarily mean there is a risk to health. Whether or not there is an adverse response to a toxin is primarily influenced by all but which of the following: 1.Its inherent toxicity, that is, ability to cause harm to humans 2.Whether it enters the body and reaches susceptible organs 3.The amount that is present 4.The route of exposure

The route of exposure

13. Particulate matter varies in size, and the size determines the site of the deposition in the respiratory system. This means: 1.The larger the particulate, the more hazardous it is. 2.The smaller the particulate, the more hazardous it is. 3.The size of the particulate is not important. 4.The lungs and dust masks can take care of the particulates.

The smaller the particulate, the more hazardous it is.

12. A PHN knows that the ambient air standard, which is the highest level of a pollutant in a specific place over a specific period of time that is not hazardous for humans, is most influenced by: 1.Wind patterns. 2.Weather conditions. 3.Population in the area. 4.The surrounding built environment.

The surrounding built environment.

15. A nurse is working with the state department of health. Weather forecasters are anticipating that several communities will be impacted by a severe hurricane that will likely decimate the coastline of their community. The county government has ordered a voluntary evacuation for those living along the coast. Which of the following statements is incorrect? 1.Use of the Emergency Alert System by broadcasters during an emergency is voluntary. 2.The county should consider mandatory evacuations if residents chose to not evacuate as suggested. 3.There should be a legal plan in place to deal with residents who are not complying with instructions. 4.A shelter should be established to help vulnerable residents and people who are not able to find somewhere to stay.

Use of the Emergency Alert System by broadcasters during an emergency is voluntary.

A young college student in a rural community has called the health department to get a recommendation for a health center where she could be seen for a chronic health problem. She is uninsured and can't afford the private clinic in town. The PHN recommends that the student: 1. Visit the local health department for management and treatment of her care. 2. Proceed to the local emergency department. 3. Visit the community health center run by an advanced practice registered nurse (APRN). 4. None of the above.

Visit the community health center run by an advanced practice registered nurse (APRN).

13. An OEHN is speaking with an employee who was injured on the job several weeks ago. It may be several more weeks before he is able to return to work. The nurse refers him to ____ to discuss payment during his time off. 1.Long-term disability 2.Workers' compensation 3.Social security 4.A no-fault attorney

Workers' compensation

7. A nurse is at the beach with friends when one of them begins to complain about dizziness and fatigue. It is a particularly hot day in the middle of a heat wave. How should the nurse react? 1.Call an ambulance. 2.Tell the friend to close her eyes, rest, and have her take some slow deep breaths. 3.Give the friend some cool water. 4.Leave the beach with the friend and have her sit in an air-conditioned car while drinking an electrolyte replacement drink.

.Leave the beach with the friend and have her sit in an air-conditioned car while drinking an electrolyte replacement drink.

A hospital nurse is admitting a new patient and asks him if he has a primary care provider. He asks the nurse about the benefit of having a primary care provider, and the nurse replies with which of the following? (Select all that apply.) 1. Increased access to health care 2. Decreased health-care costs 3. Focused on care of disease during the acute phase 4. Increased patient education and advocacy 5. Physician-focused treatment

Increased access to health care Decreased health-care costs Increased patient education and advocacy

A nurse is looking to develop a coalition of women's health providers and experts in the community. Which of the following strategies would be effective in helping to build a coalition? (Select all that apply.) 1. Create detailed objectives and activities 2. Address diversity among the membership 3. Map assets 4. Convene the coalition prior to drafting a mission statement and structure 5. Maintain and evaluate the vitality of the coalition

1. Create detailed objectives and activities 2. Address diversity among the membership 5. Maintain and evaluate the vitality of the coalition

A school nurse working in a private school is training a new school nurse. Which of the following federal laws influence their practice? (Select all that apply.) 1. Elementary and Secondary Education Act 2. Children's Health Insurance Program (CHIP) 3. Family Educational Rights and Privacy Act 4. Child Abuse Prevention and Treatment Act 5. The School Nurse Act

1. Elementary and Secondary Education Act 2. Children's Health Insurance Program (CHIP) 4. Child Abuse Prevention and Treatment Act

A school nurse is speaking with one of the teachers in the elementary school. The teacher is discussing one of the students who has just transferred to the school from another state. He is disruptive in the classroom, is frequently out of his chair, and not paying attention to what the rest of the class is doing. According to the student's record he has been diagnosed with attention deficit hyperactive disorder (ADHD). The nurse suggests to the teacher that they utilize a care coordination approach to help the student. This approach requires that interventions are: (Select all that apply.) 1. Goal oriented. 2. Based on interventions used for all students with ADHD. 3. Based on the specific needs of the child. 4. Evaluated based on their impact.

1. Goal oriented. 3. Based on the specific needs of the child.4. Evaluated based on their impact.

For the PHN working in a large urban public health department, what are possible health issues facing the population as a whole? (Select all that apply.) 1. Higher crime rates 2. Higher levels of air pollution 3. Lower socioeconomic status 4. Higher incidence of sexually transmitted infections

1. Higher crime rates 2. Higher levels of air pollution

A nurse is working in a primary health-care setting that has had a recent influx of persons immigrating from a West African country. She wants to incorporate cultural components to the care of patients from this country. What are possible aspects of the culture that she should learn more about? (Select all that apply.) 1. Kinship 2. Source of income 3. Gender roles 4. Value of children

1. Kinship 3. Gender roles 4. Value of children

A school nurse has recently noticed an increase in the number of students suffering from asthma attacks while in the school building and suspects it may be due to the school environment. The nurse knows that the school, although cleaned frequently, is in a very old building. What steps could the nurse take? (Select all that apply.) 1. Review student health records and obtain statistics on the number of students being diagnosed with asthma and having asthma attacks while in school over the last 10 years. 2. Instruct the custodial staff to replace the ventilation and furnace systems. 3. Obtain a copy of the EPA Indoor Air Quality Tools for School Action Kit and work with her colleagues within the school to develop a practical plan for addressing air quality in the school. 4. Send letters home to the parents of affected kids requesting follow-up with their pediatricians. 5. Secure funding to increase the number of cleaning personnel for the school.

1. Review student health records and obtain statistics on the number of students being diagnosed with asthma and having asthma attacks while in school over the last 10 years. 3. Obtain a copy of the EPA Indoor Air Quality Tools for School Action Kit and work with her colleagues within the school to develop a practical plan for addressing air quality in the school.

An elementary school nurse is caring for many students in the office. The school nurse has an assistant who is not a registered nurse. The nurse wishes to set up a process for determining which tasks can be delegated to the unlicensed assistive personnel (UAP). What things should the nurse consider when making the decision? (Select all that apply.) 1. The needs of the student 2. The complexity of the task 3. The American Nursing Association scope and standards of nursing practice 4. The state regulations 5. The stability of the student

1. The needs of the student 2. The complexity of the task 4. The state regulations 5. The stability of the student

According to the WHO, efforts to improve health in school-aged children and adolescents will improve health through the reduction of adverse health behaviors. These include: (Select all that apply.) 1. Tobacco use. 2. Alcohol and substance use. 3. Active lifestyle. 4. Dietary and hygienic practices that cause disease. 5. Failure to complete high school.

1. Tobacco use. 2. Alcohol and substance use. 4. Dietary and hygienic practices that cause disease.

A nurse is speaking with members of a community center about using community organization as a process for change. The nurse explains that there are several specific principles for creating change within the community. Which of the following are examples of these principles? (Select all that apply.) 1. Use nonviolence as a tool. 2. Apply downstream assessment principles. 3. The nurse will provide solutions for the community to follow. 4. Increase the community's decision-making ability. 5. Aim to minimize social and economic disparities.

1. Use nonviolence as a tool. 4. Increase the community's decision-making ability. 5. Aim to minimize social and economic disparities.

19. An occupational nurse is asked to perform a walk-through assessment of the factory where he or she works. What type of information should the nurse include in the assessment? (Select all that apply.) 1.Obvious dangers or hazards 2.The presence or absence of safe walkways 3.Observations of noise levels 4.The use of personal protective equipment 5.The physical activity of the workers

1.Obvious dangers or hazards 2.The presence or absence of safe walkways 3.Observations of noise levels 4.The use of personal protective equipment 5.The physical activity of the workers

19.A nurse has just been promoted to serve on the disaster preparedness committee of the hospital. The nurse's role during a disaster is to collect emergency information and distribute it to public health officials as required. What information should the nurse collect? (Select all that apply.) 1.Staffing needs 2.Supply inventory and shortages 3.Name, social security number, and phone number of every employee responding to the disaster 4.Budget needs of the hospital 5.Number of patients who have already been treated and who still need care

1.Staffing needs 2.Supply inventory and shortages 5.Number of patients who have already been treated and who still need care

19. The public health nursing student learns that the need for environmental justice extends to disadvantaged populations, who, as a result of low income, age, health status, race, or other social indices of susceptibility, are at greatest risk of exposure to environmental hazards because of which of the following problems? (Select all that apply.) 1.Substandard housing 2.Lack of access to health care 3.Lack of nutritious food 4.Lack of safe places to play 5.Employment in risky jobs

1.Substandard housing 2.Lack of access to health care 3.Lack of nutritious food 4.Lack of safe places to play 5.Employment in risky jobs

17. A nurse is organizing a disaster drill for the hospital. Which factors should the nurse consider while organizing the drill? (Select all that apply.) 1.They should be scheduled regularly . 2.The materials should be specific to the expected surge at that facility during a disaster. 3.They should only involve a few key staff members. 4.They should maintain the organizational function of the facility. 5.In addition to the actual drill, the entire staff and volunteers should undergo a continuing education in-service.

1.They should be scheduled regularly . 2.The materials should be specific to the expected surge at that facility during a disaster. 4.They should maintain the organizational function of the facility. 5.In addition to the actual drill, the entire staff and volunteers should undergo a continuing education in-service.

18. A PHN has been sent to the site of a nuclear accident to assist in setting up long-term surveillance. The PHN will want to monitor cases of which of the following diseases? (Select all that apply.) 1.Heart disease 2.Leukemia 3.Mental illness 4.Thyroid disease 5.Diabetes

2.Leukemia 3.Mental illness 4.Thyroid disease

16. A nursing instructor is giving a lecture on environmental sustainability. The instructor explains that this is a critical issue to the global environment and an important emerging public health issue. Some of the issues addressed within environmental sustainability include which of the following? (Select all that apply.) 1.Preventing environmental exposure 2.Maintaining the funding for research and development for alternative energy 3.The rates in which renewable resources are harvested 4.The rates of depletion of nonrenewable resources 5.The creation of pollution that can continue for an indefinite period of time

3.The rates in which renewable resources are harvested 4.The rates of depletion of nonrenewable resources 5.The creation of pollution that can continue for an indefinite period of time

The public health department (PHD) is concerned about an outbreak of measles that has occurred in a country adjacent to theirs. Although there are currently no reported cases, as one of their actions the PHD reaches out to all the primary care providers to encourage all of their unvaccinated patients to get vaccinated and to encourage the parents of unvaccinated children to get their vaccinations up to date. Such a public health initiative is an example of: 1. A secondary prevention approach related to screening. 2. A primary prevention approach focused on health protection. 3. A primary prevention approach focused on health promotion. 4. A primary prevention approach focused on screening.

A primary prevention approach focused on health protection.

1. A nurse is starting a new job as an occupational and environmental health nurse (OEHN) for a large corporation. The nurse wants to ensure that the company's health and safety practices align with nursing standards of practice in this specialty area. What organization should the nurse check with to determine nursing standards? 1.ABOHN 2.AAOHN 3.NIOSH 4.OSHA

AAOHN

A nurse is working with a community center that primarily serves a nearby Native American tribe. The nurse knows that many of the tribe members suffer from type 2 diabetes. Which of the following interventions is an example of a tertiary prevention? 1. Teaching school-aged children healthy exercise .2. Conducting a blood glucose screening for program for the adults in the community. 3. Actively encouraging patients diagnosed with type 2 diabetes to have foot, eye, and hemoglobin A1C screening tests every 3 months. 4. Publishing a culturally grounded guide about preventing diabetes using input from the tribal leaders and distributing it to all persons who come to the clinic.

Actively encouraging patients diagnosed with type 2 diabetes to have foot, eye, and hemoglobin A1C screening tests every 3 months.

A new strain of flu has emerged, and the CDC has released a new vaccine that is for use in high-risk populations. Which population is most apt to be high-risk? 1. Pregnant women 2. Older adults 3. Children 4. All of the above

All of the above

16. A prison nurse has received notification that there is a powerful storm system approaching the prison that is likely to cause tornados in the area, putting the prison and prisoners at risk. The nurse is reviewing the emergency response plan, which should include: 1.Plans for the safety of first responders. 2.Plans for the protection and safety of prisoners and staff. 3.Plans for the safety of the general public. 4.All of the above.

All of the above.

In response to the increase in opioid overdoses within their community, a primary care clinic could implement which of the following with patients who are experiencing chronic pain?1. Screen appropriately. 2. Prescribe appropriately. 3. Use a statewide automated reporting system. 4. Help patients recognize potential problems. 5. All of the above.

All of the above.

A school nurse is performing a quarterly inspection of the health equipment used in the school health clinic. The nurse's priority is to make sure which piece of equipment is present and working properly? 1. Code cart 2. Automated external defibrillator (AED) 3. Otoscope 4. Flowmeter

Automated external defibrillator (AED)

4. A public health nurse (PHN) is working with a community after a major wildfire. The fire has been completely contained and will be put out shortly. How does the nurse proceed? 1.Return home and allow the local firefighters to finish putting the fire out. 2.Contact the federal government to ask for assistance in managing the wildfire. 3.Wait another day or two until the fire is confirmed to be out and then return home. 4.Begin surveillance and assess for incidences of respiratory disease related to the fires.

Begin surveillance and assess for incidences of respiratory disease related to the fires.

12. A nurse has noticed that the average age of the workers in a factory is starting to increase. In anticipation of the needs of this population of workers, which program would likely be effective in keeping these workers safe? 1.Beginning a fitness program for workers to build muscle, flexibility, and balance. 2.Reducing hours. 3.Decreasing lighting and frightening noises. 4.Implementing an early retirement program.

Beginning a fitness program for workers to build muscle, flexibility, and balance.

8. While doing a physical assessment of an older adult, the nurse is concerned about the patient's history of work exposure to toxic chemicals over his lifetime. Based on reports, the levels of toxin were within normal limits, but the patient had worked in the plant for 50 years. What aspect of the exposure is she most worried about? 1.Half-life 2.Bioaccumulation 3.Latency period 4.Environmental exposure

Bioaccumulation

2. John, the nurse manager in a large urban emergency department, was alerted to a number of patients who had come in with a possible exposure to a toxic substance. He begins with the epidemiological triangle to help understand: 1.How the environment brings an agent and host together. 2.How the environment plays a role in the health of individuals, families, and communities. 3.The role of water, air, and waste in environmental health. 4.Both A and B

Both A and B

One of the roles of the school nurse is health protection for the students. This includes: 1. Monitoring vaccinations among children and adolescents to assure compliance with state mandates. 2. Conducting classes on healthy eating. 3. Administering flu vaccines. 4. Both A and C.

Both A and C.

A nurse has observed that a particular fifth grade student visits the office two to three times each week with stomach aches, headaches, and vague complaints of not feeling well. This has been continuing for several months. What is the most appropriate action for the nurse to take? 1. Refuse to see the child anymore. 2. Call his parents to discuss his symptoms and the need to be evaluated by his pediatrician. 3. Send the child home until he obtains medical clearance to return. 4. Refer him to the school psychiatrist for mental evaluation.

Call his parents to discuss his symptoms and the need to be evaluated by his pediatrician.

The middle school nurse has been asked by one of the teachers about one of the students who always sits in the back of the classroom and never participates in classroom discussions. The teacher also noticed that the student always enters and leaves the classroom by herself. Based on this, the school nurse asks the student to stop in and see her. The student is at first quiet and says little, but then states she has been feeling low. The nurse should: 1. Assure the student that things will seem better soon and send her back to class. 2. Call the students' parents and let them know she is concerned and would like to refer the student for further assessment and possible treatment. 3. Assure the teacher that quiet students aren't necessarily at risk but to keep an eye on the student and let her know if there is any change. 4. Because it is apparent that the other students are avoiding this student, implement a school-wide anti-bullying campaign.

Call the students' parents and let them know she is concerned and would like to refer the student for further assessment and possible treatment.

10. A nursing instructor is holding a lecture on environmental health and explaining that gene environment interaction: 1.Can directly cause diabetes, pulmonary disease, and breast cancer. 2.Can change the expression of a genetic trait and alter physical aspects. 3.Can have either a protective influence or increase risk for many diseases. 4.Does not demonstrate any noticeable effect from the environment.

Can have either a protective influence or increase risk for many diseases.

A nurse is reviewing top 10 priorities from Rural Healthy People 2020 National Survey. Which of the following is not one of the top 10 priorities? 1. Access to quality health services 2. Diabetes 3. Mental health and mental disorders 4. Cancer

Cancer

A nurse is working with a primary care physician who has made the decision to move to a Patient-Centered Medical Home (PCMH) model of care after reviewing research presented in the latest issue of a prominent medical journal. The nurse is preparing some educational materials to present to the patients and mentions that the benefits of moving to this model of care include which of the following? (Select all that apply.) 1. Care focusing on the whole individual 2. Integrated care 3. Use of highly specialized PCMH physicians 4. Increased access to care 5. Access to private insurance, meaning the patient can move away from Medicaid

Care focusing on the whole individual Integrated care Increased access to care

A new school nurse is reviewing the procedures put in place by the prior nurse, a woman with more than 30 years of experience. The nurse notices that a school-wide scoliosis screening occurs every fall. How does the new nurse proceed? 1. Continue performing the scoliosis screenings each year. 2. Only continue scoliosis screening on students who are symptomatic. 3. Eliminate scoliosis screenings altogether. 4. Check state screening guidelines to see what is required for school nurses in the state.

Check state screening guidelines to see what is required for school nurses in the state.

A nurse is working with several community members in an inner-city environment to help address broken windows and damaged buildings in their community. They've had several residents volunteer to form a group that will repair the damages and keep the community looking well cared for. This is an example of: 1. Community organization. 2. Community empowerment. 3. Community partnerships.

Community organization.

14. A nurse is working in a large primary health-care clinic. Most of the staff members work at their desks and there are always baked goods from patients in the break room. The nurse wishes to implement positive healthy changes for the staff members. What is the first step she should take prior to developing a health promotion program in the office? 1.Conduct a health risk appraisal (HRA). 2.Offer a smoking cessation program. 3.Mandate yearly screenings for hypertension and diabetes. 4.Develop a biggest loser competition.

Conduct a health risk appraisal (HRA).

15. An OEHN at a large electronics factory wishes to implement new programs to improve employee health and well-being. To help identify environmental factors that may place employees at risk for illness or injury, the OEHN should: 1.Conduct a workplace assessment. 2.Conduct physical exams of the employees. 3.Conduct a health risk appraisal (HRA). 4.Conduct an occupational and environmental history of the employees.

Conduct a workplace assessment.

7. A worker has been exposed to a chemical that he is not used to working with. How should the OEHN proceed with treatment? 1.Quickly use water to rinse the chemical off and perform an assessment of the exposed skin. 2.Consult the material safety data sheet (MSDS) for more information on how to treat the exposure. 3.Call an ambulance and have a coworker bring a sample of the chemical with the victim to the hospital. 4.Encourage self-care and have the worker come back if he experiences any other symptoms.

Consult the material safety data sheet (MSDS) for more information on how to treat the exposure.

A primary care clinic has decided to hire a nurse to serve as the clinic's case manager. The essence of case management is the incorporation of the client, the family, and the community into meeting the needs of the patient. Based on current evidence related to this approach, it is primarily hoped that this will lead to: (Select all that apply.) 1. Cost containment. 2. Increased patient satisfaction. 3. Improved patient outcomes. 4. Reduced time needed for each patient to spend with his or her primary health care provider.

Cost containment. Improved patient outcomes.

The state public health department in a large northern state has convened a task force to help optimize the health of the populations living in the state's rural communities by addressing major barriers to promoting optimal health in those rural communities. Which of the following is a major barrier? (Select all that apply. )1. Decreased access health care 2. Lack of funding for safety net programs 3. Difficulty recruiting physicians, physician assistants, and nurse practitioners 4. Migration of people from other areas

Decreased access health care Lack of funding for safety net programs Difficulty recruiting physicians, physician assistants, and nurse practitioners

A nurse is working in a family planning clinic that provides treatment for sexually transmitted infections (STIs). The nurse has noticed a significant increase in the incidence rate of STIs in the young women being seen at the clinic and wonders if this is a community-wide problem. Which of the following techniques would be a helpful first step in answering her question? 1. Develop collaborative relationships with other health-care providers in the area concerned with STIs. 2. Perform a comprehensive community assessment. 3. Interview several key stakeholders in the community. 4. Create a federally qualified health center (FQHC).

Develop collaborative relationships with other health-care providers in the area concerned with STIs.

A nurse is working on his or her first community-based participatory research (CBPR) study. An essential factor specific to CBPR research that the nurse should be careful to address is: 1. The ethical protection of human participants. 2. Making sure that community members aren't directly involved in the research. 3. Ensuring there is a benefit to the community related to the study. 4. Choosing a topic that is neutral to the community.

Ensuring there is a benefit to the community related to the study.

3. A nursing student is doing a project using the Occupational Safety and Health (OSH) program to evaluate a local workplace. What is the first step? 1.Evaluate the workplace, looking for hazards. 2.Perform a community and workplace cultural assessment. 3.Perform medical screening on all employees. 4.Collect routine health data on all employees.

Evaluate the workplace, looking for hazards.

9. A nurse is beginning a new position on the medical floor of a hospital. A patient is being admitted with symptoms consistent with tuberculosis. What personal protective equipment does the nurse need when caring for the patient? 1.Gloves 2.Gloves and mask 3.Gloves, mask, and gown 4.Gloves, gown, and respirator

Gloves, gown, and respirator

1. The health effects of the 2018 Camp Fire on the firefighters and residents of the area demonstrate the relationship between environmental health and personal health. According to the World Health Organization (WHO), the definition of environmental health, the factors external to a person, and related factors that impact behaviors that are addressed in environmental health include all but which of the following? 1.Physical 2.Chemical 3.Biological 4.Governmental

Governmental

14.Access to potable water has increased globally over the past decade. The WHO predicts that by 2025 50% of the world's population will: 1.Have access to potable water. 2.Live in water stressed areas. 3.Be at risk for waterborne contaminates. 4.None of the above.

Live in water stressed areas.

A nurse is looking to reduce the number of adolescents in her community that are using tobacco. The nurse implements a community-wide program to raise awareness about the dangers of nicotine use and creates a support group specifically aimed at teens looking to quit smoking. This is an example of: 1. Health protection. 2. Health promotion. 3. Risk reduction. 4. Tertiary prevention.

Health promotion.

A student nurse is reviewing important global communities for ideas about a final research project. The student nurse discovers a movement in Europe that focuses on reducing health disparities and involving the local community in program design and implementation. What program does this describe? 1. Healthy Cities 2. Healthy People 3. Medical Homes 4. Racial and Ethnic Approaches to Community Health

Healthy Cities

A nurse is considering entering the specialty of parish nursing. Nurses working in this field perform which of the following activities specific to that of a parish nurse? 1. Advocating for individuals within the parish. 2. Improving spiritual health through practices such as grief counseling. 3. Providing health education. 4. Performing health screenings of parish members as needed.

Improving spiritual health through practices such as grief counseling.

16. An OEHN is reviewing the disaster preparedness plan of the factory where she works. The OEHN doesn't see any mention of how to handle a catastrophic leak of a dangerous chemical, commonly used in the factory, which could potentially impact the surrounding community. Working together, the managers and the OEHN come up with actions to take to reduce the likelihood of a leak, which included improving the system that stores and delivers the chemical. In what part of the preparedness plan should this information be included? 1.Preparedness 2.Response 3.Mitigation 4.Recovery

Mitigation

5. A nurse working the evening shift in the emergency department has been assigned a patient who arrived with a chief complaint of difficulty breathing after mixing household cleaning products. The nurse recognizes that this patient is suffering from exposure to which type of environmental hazard? 1.Biological 2.Mixed 3.Physical 4.Chemical

Mixed

A nurse is moving to a rural area and beginning work at a health clinic there. The nurse is performing a basic community assessment to prepare for working with this new community. The nurse knows that which of the following is not characteristic of the needs of the rural population? 1. More likely to smoke tobacco and drink alcohol 2. Have less education and higher rate of poverty 3. More likely to have increased dental problems 4. More likely to have a higher life expectancy

More likely to have a higher life expectancy

. A nurse is preparing a lecture about caring for the needs of the American workforce. Which of the following statements is incorrect? 1.The American workforce is becoming more knowledge based. 2.Most Americans are employed at their first job at 18 years of age. 3.The predominant health issue affecting the workforce is diseases associated with a sedentary lifestyle. 4.The American workplace is becoming more diverse.

Most Americans are employed at their first job at 18 years of age.

A primary health nurse has observed an increase in the rate of patients being treated for pertussis in her community. The nurse has seen multiple news reports on the issue and knows that this isn't an isolated problem. The nurse decides to brainstorm strategies to reduce the pertussis rate in her community. First, the nurse should: 1. Consult with local pediatricians about increasing vaccination rates in children. 2. Begin creating patient education materials to distribute in the waiting room. 3. Perform a health and cultural evaluation of her community. 4. Begin offering vaccinations free of charge.

Perform a health and cultural evaluation of her community.

A nurse working in an inner-city community health clinic is concerned that her patient education efforts related to achieving a healthy lifestyle are not resulting in any substantial changes in her patients. When she discussed this with one mother whose children are struggling with obesity, the mother explained that she is unable to find fresh fruits and vegetables in their neighborhood and resorts to the use of fast food. This information makes the nurse wonder if this is true for other families. What should she do next? 1. Ask families she sees to keep a food journal to see what food substitutions could be made. 2. Perform a problem- or health-issue-based assessment beginning with an assessment of sources of healthy foods such as supermarkets and farmers markets available in the community. 3. Arrange for free bussing from the community center to the closest supermarket. 4. Refer them to the local supplemental nutrition assistance program (SNAP) office to help them obtain benefits.

Perform a problem- or health-issue-based assessment beginning with an assessment of sources of healthy foods such as supermarkets and farmers markets available in the community.

15. The nurse epidemiologist at a local health department receives a report that a number of children have elevated lead blood levels. She rules out a number of possible reasons and begins to focus on the local water supply because there had been a change in the water supply. She contacts the epidemiologists that worked on the Flint, Michigan, event. They recommended that she follow the steps they took in their investigation. Their investigation included examining these phases related to the exposure: 1.Prior to the switch, after the switch to the Flint River, after the boil advisory, and after the switch back to the original water source. 2.After the switch to the Flint River, after the boil advisory, after the switch back to the original water source, and after the public health alert. 3.Prior to the switch, after the switch to the Flint River, and after the switch back to the original water source. 4.Prior to the switch, after the boil advisory, and after the switch back to the original water source.

Prior to the switch, after the switch to the Flint River, after the boil advisory, and after the switch back to the original water source.

7. A PHN newly hired by a large urban hospital to run their employee health program decided to take a refresher course on how to do exposure risk assessments, which are used by policy makers and other regulators to evaluate the health effects from an environmental exposure. In these assessments, the final step in the process involves making a judgment about the risk of health problems to those who are exposed. The nurse learns that this is referred to as a(n): 1.Dose-response assessment. 2.Risk characterization. 3.Hazard identification. 4.Exposure assessment.

Risk characterization.

8. A PHN is working as an occupational nurse for a mining company. Which of the following is an example of a secondary prevention policy that the nurses can implement to address the high risk of pulmonary disorders found in miners? 1.Respirator use for everyone working in the mine 2.Routine lung cancer and pulmonary disease screening 3.Job transfers for workers with pulmonary changes from the mine to an administrative position 4.Installation of a high-powered air filtration system in the mine

Routine lung cancer and pulmonary disease screening

14. A nurse is working very closely with a community after a small plane crashed into an apartment complex and killed many of its residents. Now that the crash site is being cleaned in the days after the crash, what is the priority for this community? 1.Screen for and manage depression, anxiety, and post-traumatic stress disorder. 2.Establish an emergency management plan. 3.Hold a community debriefing about what happened. 4.Encourage residents to get back to their regular routines as soon as possible.

Screen for and manage depression, anxiety, and post-traumatic stress disorder.

A nurse has been volunteering at a free clinic located at a community center in a rural area twice a month for several years. Over the last few months, the nurse has noticed that the patient load has increased substantially as the population of this community has aged. It is not feasible for the nurse to spend more time at this center. What might be the most feasible action she could take to continue to serve the needs of the community? 1. Try to hire a nurse to work at the free clinic. 2. Set up a telehealth arrangement so the nurse can answer simple questions from home or while on the road. 3. Set up a scheduling and triage system so the nurse only sees the neediest patients. 4. Consider closing the free clinic and opening a fee-for-service center.

Set up a telehealth arrangement so the nurse can answer simple questions from home or while on the road.

6. A public health nurse (PHN) is volunteering at a clinic that provides care to migrant workers who work in the fields in their community. In addition to routine health assessments, what work-related potential health issue would be important for the nurse to include as part of her routine screening? 1.Hearing loss 2.Skin cancer 3.Diabetes 4.Heart failure

Skin cancer

9. The employee health nurse working for a large urban construction company examines the Air Quality Index (AQI) daily to determine if there are any risks for workers. Today the AQI measures 120 for the city. This means that for employees she will need to: 1.Take no action, because the air quality is good. 2.Take action to inform the employees that the air quality is acceptable, but for some pollutants there may be health concerns. 3.Take action to inform the employees the air quality is hazardous for everyone in the community. 4.Take action to inform employees that air quality is unhealthy for sensitive groups.

Take action to inform employees that air quality is unhealthy for sensitive groups.

A school nurse is assessing the health education component of the Whole School, Whole Community, Whole Child (WSCC) program at one of the elementary schools she covers. Which of the following is not a part of this component of WSCC? 1. A qualified trained person teaches the program. 2. The program is run for children in first through fifth grade. 3. It assists students in maintaining and improving health. 4. The comprehensive health education curriculum addresses the physical, emotional, social, and mental health of its students and families.

The program is run for children in first through fifth grade.

A nurse is speaking with her accountant about opening a free clinic as a 501(C)(3) organization. The accountant advises the nurse: 1. To charge patients his or her regular fees. 2. To waive her professional fees but charge for testing and more advanced care. 3. To charge a nominal fee if the patient can afford to pay but provide services regardless. 4. To charge a small fee, usually around 25% of the service value.

To charge a nominal fee if the patient can afford to pay but provide services regardless.

A school nurse recently accepted a position to run a school-based health center. The school uses the WSCC model. Under the health services component of this model, all but which of the following is a service that she will provide to students? 1. Treatment for TB 2. Acute care evaluation 3. Noncommunicable disease management 4. Health education

Treatment for TB

12. Two nurses are assisting paramedics at the site of a large accident with many injured people. During the initial response, their first priority is to: 1.Notify the media so they can assist in informing the community of what happened. 2.Triage victims according to the severity of their injuries. 3.Interview victims and witnesses to determine what happened. 4.Notify clergy and mental health professionals to assist survivors at the site.

Triage victims according to the severity of their injuries.

1. A nurse is attending a training session on disaster management and is surprised to learn that: 1.True emergency preparedness and disaster management is a continuous cycle and has no beginning or end. 2.There are four stages of the disaster preparedness framework. 3.There are three stages of the disaster preparedness framework. 4.Emergency preparedness and disaster management should only occur at the local level.

True emergency preparedness and disaster management is a continuous cycle and has no beginning or end.

6. A PHN has been dispatched to communities along the New Madrid fault in Missouri because the area has seen a recent increase in seismic activity. The nurse is working with the communities to put policies in place that focus on mitigating the potential damages from future earthquakes. Which of the following is an example of an effective policy change related to mitigation? 1.Require a post-earthquake meeting to discuss the town's response. 2.Create an emergency preparedness plan. 3.Update building ordinances to be more resistant to seismic activity. 4.Make the Director of the City Health Department in charge of all emergency response needs.

Update building ordinances to be more resistant to seismic activity.

A nurse is performing an assessment of a community where the population totals 55,542 persons and has a population density of 1,000 persons per square mile. How does the nurse classify the area? 1. Rural 2. Suburban 3. Urban cluster 4. Urbanized area

Urbanized area

0. A nurse is working as an occupational nurse with a coal mining company. The nurse frequently observes workers sitting next to the entrance of the mine and eating lunch. The nurse knows that this poses a serious health risk. What is the nurse's first step? 1.Speak with several workers to see why they are eating next to the entrance of the mine. 2.Have management install hand-washing stations next to the entrance so workers can wash their hands before eating. 3.Establish a break room in a portable trailer so that workers have a place to go eat lunch. 4.Host a wellness seminar so that the nurse can provide information to the workers.

peak with several workers to see why they are eating next to the entrance of the mine.

11. A nurse is taking care of several patients who were injured as a result of a pipe bomb explosion. The current patient has ruptured eardrums and traumatic injuries to his lower extremities due to flying debris. How does the nurse document these injuries? 1.Primary 2.Secondary 3.Primary and tertiary 4.Primary and secondary

primary and secondary

4. A nurse is describing the employee health prevention measures available to members of the hospital staff. The nurse explains that the use of personal protective equipment is an example of: 1.Primary prevention. 2.Secondary prevention. 3.Tertiary prevention. 4.Quaternary prevention.

primary prevention.