Community Health Nursing Chapter 23 MC
While working in a community health clinic, a community health nurse interviews a 24- year-old client. Which of the following would lead the nurse to suspect that the client is binge eating? A) Significant weight loss from dieting last year B) Participation in excessive exercise C) Exaggerated concern about body shape D) Severe emaciation
A Binge eating is an eating disorder that is characterized by repeated episodes of uncontrolled eating. It usually starts following significant weight loss from dieting. Typically, individuals with this disorder eat quickly, eat until they are uncomfortably full, eat when they are not hungry, eat large amounts of food alone, have difficulty expressing their feelings, have difficulty controlling impulses and stress, and feel depressed about overeating. Participation in excessive exercise and an exaggerated concern about body shape is usually associated with bulimia. Severe emaciation is associated with anorexia.
Which one of the following statements about coronary heart disease and stroke are most accurate? A) Cardiovascular disease kills more women than men. B) Stroke kills more men than women. C) White persons are more likely to have their first stroke earlier than Black persons. D) Risk factors for cardiovascular disease are not known.
A Feedback: Cardiovascular disease kills more women than men. Stroke kills more women than men. Black persons are more likely to have their first stroke earlier than White persons. Risk factors for cardiovascular disease are known. Some are controllable such as lifestyle, and some are uncontrollable such as heredity.
A community health nurse is working with other professionals to develop preventive programs to address the leading cause of death in men and women. Which of the following would be appropriate? A) Risk reduction for heart disease B) Cancer screening C) Safety education D) Flu vaccine immunization
A Feedback: The leading cause of death for men and women is heart disease. Therefore, risk reduction for heart disease would be most appropriate. Cancer screening, safety education, and flu vaccine immunization would be appropriate for cancer, the second leading cause of death; unintentional injuries, the third leading cause of death in men; and influenza and pneumonia, the eighth leading cause of death in men and women respectively.
A patient comes to the community health clinic with complaints of changes in urination. Which of the following would lead the community health nurse to suspect that the patient has benign prostatic hypertrophy (BPH)? A) Nighttime frequency B) Dysuria C) Hematuria D) Flank pain
A Feedback: The symptoms of BPH vary, but the most common ones involve changes or problems with urination, such as hesitant, interrupted, or weak urinary stream; urgency or leaking of urine; and more frequent urination, especially at night. Dysuria may indicate a urinary tract infection. Hematuria could suggest a variety of problems, such as infection calculi, or cancer. Flank pain may indicate conditions such as pyelonephritis or renal calculi.
When developing a plan of care for a group of male patients experiencing erectile dysfunction, which of the following would the nurse expect to institute first? A) Lifestyle changes B) Adjustments to current medications C) Psychotherapy D) Behavior modification
A Feedback: Treatment for ED usually proceeds from least to most invasive. For some men, making a few healthy lifestyle changes may solve the problem. Smoking cessation, weight loss, and increased physical activity may help some men regain sexual function. Cutting back on any drugs with harmful side effects is considered next. For example, drugs for high blood pressure work in different ways. If a particular drug is causing problems with erection, a different class of blood pressure medicine might work just as well. Medications, psychotherapy and behavior modifications would follow.
Which one of the following statements about life expectancy is most accurate? A) The life expectancy for White women is 4 years greater than for Black women. B) The life expectancy for Black men is 6 years greater than for White men. C) In the United States, life expectancy continues to decline. D) There is a gap in life expectancy between women and men of more than 6 years.
A The life expectancy for White women is 4 years greater than for Black women. The life expectancy for White men is 6 years greater than for Black men. In the United States, life expectancy continues to increase consistently over time. The gap in life expectancy between women and men was 5.0 years in 2007.
A nurse is instructing the adult male members of a family on how to perform testicular self examination. Which of the following would the nurse include? A) Performing the examination every 3 months B) Completing the exam right after a hot shower C) Examining both testicles at the same time D) Reporting a slight difference in size of one testicle
B Feedback: A testicular self-examination should be performed monthly right after a hot shower or bath. One testicle is examined at a time. One testicle, usually the right one, is normally slightly larger than the other.
During a home visit to a family, a community health nurse encourages the mother, aged 42, and grandmother, aged 67, to have a clinical breast exam at which frequency? A) Monthly B) Yearly C) Every 2 years D) Every 3 years
B Feedback: Clinical breast exams, performed by a health care provider should be done every year for each of these women. They should also perform breast self-exam every month. The mother at her current age should have a physical examination every 2 years. Both the mother and grandmother should have a pelvic exam and Pap smear done every 3 years after three consecutive negative Pap smears.
A community health nurse is working with a grant funded project to address stroke prevention nationwide. After reviewing statistics related to stroke, which would the nurse identify as having the greatest need for this type of program? A) North central B) Southeast C) Southwest D) Pacific northwest
B Feedback: The nurse would identify the southeast as the area of greatest need because here. Known as the stroke belt, stroke death rates for both Blacks and Whites are higher than in any other part of the country.
A community health nurse is reviewing research related to women's health. Which of the following would the nurse use to obtain information about postmenopausal women's health? A) The Women's Health Study B) The Women's Health Initiative C) The Nurses' Health Study I D) The Nurses' Health Study II
B Feedback: The nurse would use The Women's Health Initiative. This study was a major 15-year research program addressing the most common causes of death, disability, and poor quality of life in postmenopausal women— CVD, cancer, and osteoporosis. The Women's Health Study evaluated the effects of vitamin E and low-dose aspirin therapy in primary prevention of CVD and cancer in apparently healthy women. The Nurses' Health Study I investigated the potential long-term consequences of the use of oral contraceptives. The Nurses' Health Study II studied oral contraceptives, diet, and lifestyle risk factors in a population younger than the original Nurses' Health Study cohort.
When assessing a population for health disparities, which of the following would the nurse least likely evaluate? A) Race B) Education C) Age D) Sexual orientation
C Feedback: A health disparity is defined as a difference in health status that occurs by sex, race or ethnicity, education or income, disability, geographic location, or sexual orientation. Age would not be used to assess health disparity.
A community health nurse is preparing a presentation about drug use and abuse for a group of adults. Which of the following would the nurse include as the one of the fastest growing forms of drug abuse? A) Cocaine B) Alcohol C) Prescription drugs D) Heroin
C Feedback: Illegal use of prescription drugs is one of the fastest growing forms of drug abuse, and it is becoming a major public health concern. The primary illicit drugs used in the United States, such as cocaine and heroin, have and continue to be a public health problem. Alcohol abuse also is a public health problem and is considered the third leading lifestyle-related cause of death for people living in the United States.
A community health nurse working in a local women's health clinic is planning a teaching session for a group of women about menopause. Which of the following would the nurse include in the session? A) Menopause involves very noticeable and characteristic symptoms. B) The symptoms are usually temporary lasting for a month or two. C) It can occur as early as age 30 but more commonly ages 45 to 55 years. D) Going 6 months without a period signals menopause.
C Feedback: Menopause is a time that marks the permanent cessation of menstrual activity. It usually occurs between the ages of 45 and 55 years. However, it can occur as early as age 30. Symptoms of menopause vary among women and last from months to years. They range from hardly noticeable in some women to very severe in others. Natural menopause is when a woman has not had a period in 12 months (no other apparent causes).
A community health nurse, who is working with a program to foster early detection of prostate cancer, recommends prostate-specific antigen testing and a digital rectal exam for men with average risk starting at which age? A) 40 years B) 45 years C) 50 years D) 55 years
C Feedback: The American Cancer Society recommends that screening of men who are at average risk should begin at age 50 years and should include a blood test to assess PSA levels and a digital rectal examination.
When developing community health programs target to adult men, which of the following would the nurse need to integrate into the plan? A) Improved quality of education programs available for men B) Increased access of health services by men as compared to women C) Limited male-gender specific research D) Increased awareness of men's health issues
C Feedback: The current state of men's health involves a lack of quality health education programs for men, health care services that are only accessed half as much by men when compared to women, and a lack of male gender-specific research. In addition, awareness of men's health issues is lacking. Currently, there is no Office on Men's Health in the U.S. Department of Health and Human Services; legislation to establish such an office has been introduced; however, the bill did not progress out of the congressional subcommittee on health and has not been reintroduced.
The nurse educator is aware that the nursing student has a grasp of the major health problems of adults when the nursing student makes which one of the following statements? A) "Morbidity and mortality among adults does not vary much by age, gender, and race/ ethnicity." B) "The six leading causes of death in adults include suicide, Alzheimer's disease, and homicide." C) "Diseases of the heart and cerebrovascular diseases are the first and third causes of death in adults." D) "Malignant neoplasms, chronic lower respiratory diseases, unintentional injuries, and diabetes mellitus are not among the six leading causes of death in adults."
C Feedback: The following statement is true: "Diseases of the heart and cerebrovascular diseases are the first and third causes of death in adults." Morbidity and mortality among adults varies substantially by age, gender, and race/ ethnicity. Malignant neoplasms, chronic lower respiratory diseases, unintentional injuries, and diabetes mellitus are among the six leading causes of death in adults. Causes of death in adults that are not among the six leading causes of death include suicide, Alzheimer's disease, and homicide.
When developing teaching programs for a community of adult men and women, which of the following would the community health nurse identify as a key aspect for this community's ability to follow through with the teaching? A) Life expectancy B) Health disparity C) Health literacy D) Financial ability
C Health literacy is a critical aspect of managing health problems and a key to being able to read and understand health information so that individuals can follow through and make appropriate health decisions. Low health literacy also contributes to health disparities, a difference in health status due to sex, race, or ethnicity. Life expectancy is the average number of years an individual member is projected to live. It is a standard measurement unrelated to the ability to follow through with teaching. Financial ability may impact a person's ability to obtain needed services, but it is not a key aspect.
Which one of the following statements best describes the role of the community health nurse in promoting the health of adult men 35 to 65 years of age? A) Anticipatory guidance to men approaching each stage and help them with ways to manage life more effectively. B) Men of this age do not need to enhance their self-care skills. C) A positive attitude toward aging is not helpful to men at this time in their lives. D) Men of this age should exercise sporadically.
C The community health nurse can provide anticipatory guidance to men approaching this stage and help them with ways to manage life more successfully. Successful navigating this stage of life can be fulfilling but may require a man to enhance his self-care skills. This includes having a positive attitude toward aging, one that examines the benefits of maturity, finds a balance between work and home, and maintains a healthy lifestyle by eating balanced meals and obtaining regular exercise.
The following is a list of the top five causes of unintentional injuries accounting for the majority of adults deaths due to injury. Order these in their proper sequence from first to fifth. A) Fire arms B) Suffocation C) Motor vehicle crashes D) Poisoning E) Falls
C, A, D, E, B Feedback: The top five causes of unintentional injuries include motor vehicle crashes, fire arms, poisoning, falls, and suffocation. Together, these causes account for approximately 80% of all injury deaths. 8.
Which of the following statements by a women's group indicates that they have understood the teaching about heart disease and women? A) "More women die of breast cancer than heart disease." B) "Women experience similar symptoms as men." C) "Hormone replacement therapy protects the heart." D) "Heart disease is the number one killer of women."
D Feedback: Heart disease is the number one killer of women. One in 2.6 female deaths is from cardiovascular disease, compared to 1 in 30 from breast cancer. Women have atypical symptoms or less acute chest pain than men, often leading them to delay care. Hormone therapy does not reduce coronary events.
As part of a health screening program, a community health nurse determines that a client is infected with the human papilloma virus (HPV). The community health nurse encourages the client to do which of the following? A) Get a mammogram immediately B) Have her blood glucose level checked C) Undergo testing for a breast cancer gene D) Have a pelvic examination and Pap smear
D Feedback: Infection with certain types of human papilloma virus is associated with an increase risk for developing cervical cancer. Pap smears have improved early detection and prevention of cervical cancer dramatically. HPV infection is not associated with breast cancer, so there is no need for a mammography or testing for a breast cancer gene. HPV is not associated with diabetes so blood glucose testing is not indicated.
After teaching a group of students about the major types of cancer affecting men and women, the instructor determines that the teaching was successful when the students identify which of the following as the number one cause of cancer deaths among adults? A) Colon B) Pancreatic C) Esophageal D) Lung
D Feedback: Lung and bronchus cancers are the number one cause of cancer deaths among adults. Colon and rectal cancers are the third most common cancers in adults. Pancreatic and esophageal cancers are less common causes of cancer death.
Which of the following would a community health nurse recommend adult men and women over the age of 50 receive yearly? A) Electrocardiogram B) Tetanus booster C) Flexible endoscopy D) Hemoccult stool testing
D Feedback: Men and women over the age of 50 should receive yearly physical exams and hemoccult stool testing, electrocardiograms every 3 years, tetanus booster every 10 years, and flexible endoscopy every 3 to 4 years
