Community Midterm

The nurse must ask about violence at each prenatal and postpartum visit, especially with vulnerable populations such as teenagers, as well as observe for signs of violence on each visit. The nurse should be aware that the peak for postpartum intimate partner violence may be observed at various times according to ethnic group, such as: 6 months for white mothers. 10 months for white mothers. 3 months for African American and Hispanic/Latino mothers. 12 months for African American and Hispanic/Latino mothers.

3 months for African American and Hispanic/Latino mothers.

0830: The community health nurse reviews the 6-month log report for cases in a large urban district. The report includes the following: 36% decrease in readmissions for hypertension 32% increase in sexually transmitted infections (STIs) 27% increase in readmissions for chronic obstructive pulmonary disease (COPD) 24% decrease in influenza 11% decrease in teen pregnancy 28% increase in older adults using the walking trail 13% increase in use of tobacco cessation program 22% increase in missed appointments for the tuberculosis directly observed therapy (DOT)

32% increase in sexually transmitted infections (STIs) 27% increase in readmissions for chronic obstructive pulmonary disease (COPD) 22% increase in missed appointments for the tuberculosis directly observed therapy (DOT)

Finding resources to implement evidence-based practice (EBP) in community health will continue to be a challenge because of the emphasis on quality care, equal distribution of health care resources, and cost control. Which of the following would demonstrate a creative strategy to implementing EBP? Adopting quality indicators for evaluating websites claiming to contain EBP Avoiding the issue of community politics Creating the role of a knowledge manager Making decisions on behalf of the community

Adopting quality indicators for evaluating websites claiming to contain EBP

Which type of crisis has occurred when a sudden terrorist act causes the deaths of thousands of adults and children and negatively affects their families, friends, communities, and the nation? Situation-maturational Situational Maturational Adventitious

Adventitious

Evidence-based public health utilizes which of the following guidelines? Select all that apply. Decision making for the community served Application of program planning frameworks Judicious use of the Internet for use of evidence Conducting evaluations Disseminating what has been learned

Application of program planning frameworks Conducting evaluations Disseminating what has been learned

For each of the school nurse's actions, click to indicate whether the action is generally associated with primary, secondary, or tertiary prevention. Each row must have only 1 response option selected. Assesses two students who were in a physical altercation Presents safe sex practices Assesses student who presents with a cough and sore throat Cares for student who has a sprained ankle Cleans and dresses a leaking feeding tube for a student Assists in screening for depression and/or anxiety at a health fair

Assesses two students who were in a physical altercation - Secondary Presents safe sex practices - Primary Assesses student who presents with a cough and sore throat - Secondary Cares for student who has a sprained ankle - Secondary Cleans and dresses a leaking feeding tube for a student - Tertiary Assists in screening for depression and/or anxiety at a health fair - Secondary

Which of the following social science theories is used by public health nursing to describe how environments and systems outside of the family influence the development of a child over time? Life-cycle theory Family developmental theory Family systems theory Bioecological systems theory

Bioecological systems theory

The public health nurse deals with the examination of a community setting to determine the community's health status. Which of the following activities should be considered in the assessment phase? Select all that apply. Assisting communities to implement and evaluate plans and projects Building constituencies to work with the community Collecting, analyzing, and disseminating information Evaluating the social, economic, and environmental characteristics of the population Questioning the availability of health services to the community

Collecting, analyzing, and disseminating information Evaluating the social, economic, and environmental characteristics of the population Questioning the availability of health services to the community

Which avoidance instruction would the public health clinic nurse use to teach prevention of toxoplasmosis? Contact with cat feces Exposure to heavy metals Ingestion of freshwater fish Excessive radiation exposure

Contact with cat feces

Which action by a client who lives with family and has an upper respiratory infection indicates that infection- control-related teaching was effective? Select all that apply. One, some, or all responses may be correct. Covering mouth with a forearm when coughing or sneezing Putting tissues in a plastic bag after using them to cough Avoiding talking or spending time with family members Asking the health care provider for an antibiotic prescription Using an alcohol-based hand sanitizer to clean hands Abstain from sharing eating utensils with others Clean high-touch surfaces frequently Wash fresh fruits under clean running water

Covering mouth with a forearm when coughing or sneezing Putting tissues in a plastic bag after using them to cough Using an alcohol-based hand sanitizer to clean hands Abstain from sharing eating utensils with others Clean high-touch surfaces frequently

The community health nurse performs an assessment of violence by observing which of the following community characteristics? Select all that apply. Presence of social support networks Crime rates Levels of unemployment Presence of physical disabilities in individuals Presence of family violence

Crime rates Levels of unemployment

A recent movie release portrays a criminal as a black female drug user whose abusive boyfriend has two children by different women. She lives in the riot-torn inner city of a large metropolitan area. This best demonstrates what type of factor that influences poverty? Cultural Environmental Political Social

Cultural

Based upon the report, which strategies would the nurse include for the community? Select all that apply. Determine the population group affected by STIs Include key stakeholders to provide input Obtain numbers of roseola cases Encourage human papillomavirus immunizations Hold an emergency health screening event for high blood pressure Contact/visit clients who missed observed medication therapy Place emphasis on providing meningococcal vaccines to freshman college students Continue contraception education

Determine the population group affected by STIs Include key stakeholders to provide input Encourage human papillomavirus immunizations Contact/visit clients who missed observed medication therapy Continue contraception education

Which of the following best support the concept of community-oriented nursing practice? Select all that apply. Direct nursing care of individuals with tuberculosis (TB) Hospice home care for a terminally ill individual and family Nursing interventions to stop elder abuse Nutrition education programs for teenagers and their families Wound care for a homebound individual

Direct nursing care of individuals with tuberculosis (TB) Nursing interventions to stop elder abuse Nutrition education programs for teenagers and their families

Which of these actions would the nurse perform to provide preventive and primary care to adults during a health camp? Select all that apply. One, some, or all responses may be correct. Discussing vaccinations Discussing family planning Mentioning adult daycare services Instructing the health camp about self-care at home Instructing the health camp about road safety measures

Discussing vaccinations Discussing family planning Instructing the health camp about road safety measures

Which points would the nurse remember when caring for a client who has a history of suicide attempts? Select all that apply. One, some, or all responses may be correct. Document the measures taken to prevent suicides. If the client makes a suicide attempt in the hospital, this action may lead to a lawsuit. The client may be detained for 21 days if a judge grants an involuntary detention. The primary health care provider may be responsible for failing to provide adequate supervision. File paperwork with the court within 96 hours of the client's admission to the facility.

Document the measures taken to prevent suicides. If the client makes a suicide attempt in the hospital, this action may lead to a lawsuit. The primary health care provider may be responsible for failing to provide adequate supervision.

There are many barriers that affect the actual implementation of evidence-based practice (EBP) in a nursing environment. Which statements reflect the most significant concerns of nurses in the community-focused setting? Select all that apply. EBP requires compliance by the client. EBP requires little support. EBP demands change. EBP questions long-standing nursing practice. Lack of resources

EBP requires compliance by the client. EBP questions long-standing nursing practice. Lack of resources

A community-oriented nurse convenes a support group for teenage mothers. The nurse understands that this strategy fosters cohesiveness among members and allows the members to learn from one another. What other benefit specific to group teaching will be achieved? Cultural sensitivity Efficiency in client service Learning of new skills Distraction-free surroundings

Efficiency in client service

Which competencies are important in the rural setting? Select all that apply. One, some, or all responses may be correct. Spiritual values Emergency care Family dynamics Physical assessment Clinical decision-making

Emergency care Physical assessment Clinical decision-making

A nurse in community health conducting a home visit notices a 4-year-old girl sitting on a stool in an adjoining room. The girl is quiet and withdrawn, rarely makes eye contact, and does not leave the room. The nurse proceeds to ask about the child and attempts to engage the child in conversation. The nurse is assessing for what indicators of child abuse? Emotional abuse Emotional neglect Physical abuse Physical neglect

Emotional neglect

Two siblings who live in a camp for migrant workers have contracted measles. The nurse, trying to determine which individuals had contact with the children, identifies those with immunity and assesses the probability of containing the measles to the camp. Which technique has the nurse used in managing this situation? Nursing process Incidence process Probability process Epidemiological process

Epidemiological process

Which role is the nurse expected to have in a community-based nursing practice if there is a sudden spread of malaria? Educator Collaborator Epidemiologist Client advocate

Epidemiologist

The nurse is analyzing and explaining the demographics of a population under research. Which phase of the nursing process is the nurse exercising when analyzing and explaining the demographics of a population under research? Diagnosis phase Evaluation phase Assessment phase Implementation phase

Evaluation phase

Which of the following are factors that may contribute to vulnerability? Select all that apply. Exercise habits Crime Peeling lead paint Social isolation Illiteracy

Exercise habits Crime Peeling lead paint Social isolation Illiteracy

What terms are used to describe healthy families? Select all that apply. Families with strengths Dysfunctional Functional families Resilient families Resistant families

Families with strengths Functional families Resilient families

Family health can be defined as a dynamic, changing, relative state of well-being that includes the biological, psychological, sociological, cultural, and spiritual factors of a family system. This family health approach would best include which of the following underlying principles? Select all that apply. Assessment of the individual's health does not determine the overall family system's health. Family functioning affects the health of individuals. Family system assessment specifically addresses the individual's health. The individual's health affects family functioning. Simultaneous assessment of individual family members and the family system as a whole is important to family health.

Family functioning affects the health of individuals. The individual's health affects family functioning. Simultaneous assessment of individual family members and the family system as a whole is important to family health.

Which of the following barriers are specific to the educator? Select all that apply. Fear of public speaking Low literacy Limited experience with the topic Lack of motivation Lack of experience with gaining participation

Fear of public speaking Limited experience with the topic Lack of experience with gaining participation

Which of the following statements are true regarding the health-related vulnerabilities of men? Select all that apply. More males die at birth. Fewer health services are emphasized for men. Men are less likely to be honest about their symptoms. More males die from suicide. Men do not participate in health care at the same level as women.

Fewer health services are emphasized for men. Men are less likely to be honest about their symptoms. Men do not participate in health care at the same level as women.

The family systems theory encourages nurses to view both the individual clients as participating members of a whole family. What is the major weakness of the systems framework? Views families from both a subsystem and a suprasystem approach. Defines the direction of interactions. Views the family as an agent of change. Focuses on the interaction of the family with other systems.

Focuses on the interaction of the family with other systems.

The nurse is instructing a community group regarding risk factors for coronary artery disease. Which risk factor cannot be modified? Heredity Hypertension Cigarette smoking Diabetes mellitus

Hereditary

For each report finding, click to specify if the finding indicates that the community's health has improved, has not changed, or has declined. Each row must have only 1 response option selected. Report Finding - Improved - No Change - Declined Hypertension readmissions decreased another 2% STIs decreased in the 27-31-year-old group COPD readmissions decreased 5% Influenza cases increased 24% Teen pregnancy decrease remains at 11% Citizens asked for an additional walking trail Subway/bus tokens provided to DOT participants

Hypertension readmissions decreased another 2% - Improved STIs decreased in the 27-31-year-old group - Improved COPD readmissions decreased 5% - Improved Influenza cases increased 24% - Declined Teen pregnancy decrease remains at 11% - No Change Citizens asked for an additional walking trail - Improved Subway/bus tokens provided to DOT participants - Improved

The goal of deinstitutionalization was to improve the quality of life for people with mental disorders by providing services in the communities where they lived rather than in large institutions. At what program level did this change in locus of care fail? Assessment level Design level Evaluation level Implementation level

Implementation level

The nurse advises the client who drinks large amounts of coffee to avoid coffee because caffeine can have adverse effects on health. Arrange the responses in the order that the client might demonstrate while passing through the stages of health behavior change.

In the precontemplation stage, the client may become defensive when confronted with information about the benefits of changes in the health behavior. In this scenario, the client tells the nurse that has not experienced any health issues even while drinking coffee for a long time. In the contemplation stage, the client is more likely to accept information because the client is developing a greater belief in the value of change. In the preparation stage, the client believes that the advantages outweigh the disadvantages of behavior change. In the action stage, the client may find that old habits make it hard to adopt new behaviors. In the maintenance stage, the client needs to integrate the changes into their lifestyle.

Which of the following factors has influenced the implementation of evidence-based practice in health care? Select all that apply. Increased expectations of consumers Advances in technology Nursing shortages Increases in lawsuits Implementation of electronic health records

Increased expectations of consumers Advances in technology Increases in lawsuits

The nurse is teaching campfire safety to a group of community members and includes information about what to do if a person catches on fire. The nurse teaches the most effective method for putting out the flames. Which information from the group members indicates successful learning? Wrap hand with towel and slap at the flames. Instruct the victim to roll on the ground. Pour cold liquid over the flames. Remove the victim's burning clothes.

Instruct the victim to roll on the ground.

Which information associated with type 1 diabetes disease management will the school nurse include in a teaching plan for an adolescent? Select all that apply. One, some, or all responses may be correct. Insulin therapy purpose Prophylactic antibiotics use Blood glucose monitoring Oral hypoglycemic agent importance Appropriate weight maintenance Diabetic diet planning Regular exercise performance Treatment regimen adherence

Insulin therapy purpose Blood glucose monitoring Appropriate weight maintenance Diabetic diet planning Regular exercise performance Treatment regimen adherence

Which educational method has been shown to be most effective in fostering treatment adherence? Internet-based education In-person counseling Telephone counseling Self-directed learning

Internet-based education

Which information would the nurse provide to adolescent boys regarding testicular self-examination and normal findings? Select all that apply. One, some, or all responses may be correct. It is performed during or after a warm shower. Each testicle is examined individually after relaxing the scrotal skin. A firm, smooth, egg-shaped organ can be palpated. A hard mass can be palpated on the anterior or lateral aspect of the testicle. The thumb and fingers of both hands can be used to apply firm and gentle pressure. Slight discomfort is felt with scrotal or testicular palpation. A raised swelling that can be palpated on the superior aspect of the testicle is the epididymis. One testicle may be slightly larger or smaller than the other.

It is performed during or after a warm shower. Each testicle is examined individually after relaxing the scrotal skin. A firm, smooth, egg-shaped organ can be palpated. The thumb and fingers of both hands can be used to apply firm and gentle pressure. A raised swelling that can be palpated on the superior aspect of the testicle is the epididymis. One testicle may be slightly larger or smaller than the other.

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 principle to support this broader definition? Families are defined by genetic ties. Family names are needed to confer status. Members of a family are self-defined. Traditional family functions have been redefined.

Members of a family are self-defined.

Which clinical manifestation associated with altered mental health function will the home health nurse assess for in a client with acquired immunodeficiency syndrome (AIDS)? Select all that apply. One, some, or all responses may be correct. Memory loss Hopelessness Delusions Hyperactivity Impaired judgment Paranoid thinking Speech pattern changes Racing thoughts

Memory loss Hopelessness Delusions Paranoid thinking

Which purpose does a community health center serve in preventive and primary care services? Outpatient clinics that provide primary care to a specific population Aim to increase worker productivity, decrease absenteeism, and reduce the use of costly medical care Emphasize program management, interdisciplinary collaboration, and community health principles Include a complete program designed for health promotion and accident or illness prevention in the workplace

Outpatient clinics that provide primary care to a specific population

The community health nurse is aware that lesbian, gay, bisexual, and transgender (LGBT) adults are more likely to experience which of the following conditions? Cardiovascular disease Poor mental health Obesity Poverty

Poor mental health

Which education should the nurse provide to enhance the well-being of a community-dwelling older adult with hypertension? Select all that apply. One, some, or all responses may be correct. Suggest that the client have annual Papanicolaou (Pap) smears. Promote dietary modifications by using varied techniques. Assess the client's current lifestyle and promote lifestyle changes. Encourage the individual to have routine mammograms. Monitor the client's blood pressure and weight regularly. Establish blood pressure screening programs. Teach the client about correct body mechanics. Advise them on the availability of mechanical appliances.

Promote dietary modifications by using varied techniques. Assess the client's current lifestyle and promote lifestyle changes. Monitor the client's blood pressure and weight regularly. Establish blood pressure screening programs.

Which characteristic makes a crisis access hospital (CAH) different from an intensive care unit (ICU)? Offers 24-hour emergency care Offers health care to acutely ill people Provides temporary care for 96 hours or less Provides the most expensive health care delivery

Provides temporary care for 96 hours or less

A home health nurse receives a referral to educate an older adult client with diabetes in proper foot care. The nurse's assessment of the client determines that the client has poor eyesight that may affect the client's ability to learn and perform certain skills. Which educational principle is being examined? Cognitive domain Events of instruction Principles of effective instruction Psychomotor domain

Psychomotor domain

A nurse is caring for a client attending a community-based health center and reviews the client's medical record. Which recommendation would the nurse provide to the client? CLIENT CHART Healthcare provider progress note Client has stage Ill rheumatoid arthritis, which is progressively causing more joint deformity, stiffness, and pain. Nurse's history and physical assessment Client has ulnar drift on both hands and hallux valgus deformity of both feet. Client reports pain when walking and joint stiffness for several hours in the morning, particularly the small joints of the hands and feet. Joints of the hand reflect signs and symptoms of inflammation (heat, swelling, tenderness). Laboratory results Rheumatoid factor (RF): 1:70 (positive for RA) Erythrocyte sedimentation rate (ESR): 40 mm/hour C-reactive protein (CRP): 20 mg/dL WBC: 13,000/ul Wring a sponge repeatedly when washing dishes. Install faucets that re

Push with the palms rather than the fingers when rising from a chair.

Which of the following domains are used in evaluating the strength of evidence? Select all that apply. Quality Quantity Cost effectiveness Consistency Usefulness

Quality Quantity Consistency

A nurse in community health integrates new slides into a presentation that will be given to a local elementary school group regarding the techniques of proper hand washing. The new slides will repeat essential points during the presentation. This demonstrates the nurse's understanding of what principle? Repetition Integration Participation Sequencing

Repetition

The son of migrant farm workers has no history of immunizations and is brought to the county health clinic. After measles is diagnosed, the public health nurse goes to the migrant camp to search for people with a greater-than-average chance of contracting the disease. Which terminology is the name of this variable? Risk factor Frequency rate Probability rate Causative factor

Risk factor

Which risk of adolescent pregnancy would the community nurse teach? Risk for premature birth Risk for having a large baby Risk for chromosomal defects Risk for increased weight gain

Risk for premature birth

For each community health parameter, chose the most likely option for Intervention and based upon the intervention, chose the Level of Practice. STIs, COPD readmissions, Tuberculosis DOT program

STIs - Offer free latex condoms in several local clubs, Community COPD readmissions - Contact statewide hospitals to provide flu shot drive-through events, Systems Tuberculosis DOT program - Work with city gas stations to provide gas cards to participants, Community

The nurse determines priorities for the community. Drag from Word Choices to complete the sentence. The nurse determines the top 2 priorities include ____ and ____. Hypertension readmissions STIs COPD readmissions Influenza Teen pregnancy Walking trail usage Smoking cessation Tuberculosis DOT program

STIs and Tuberculosis DOT program

For each community health parameter, click to specify the potential condition/situation(s) that might have caused the increases. Each community health parameter may support more than 1 possible condition/situation. Each category must have at least 1 response option selected. Community Health Parameter - Possible Conditions/Situations STIs: Trichomoniasis infection, Rubella infection, Chlamydia infection Readmissions for COPD: Developed pneumonia, Lack of funds for medications, High motivation level Missed appointments for tuberculosis DOT: Lack of transportation, Contracted an illness, Limited health literacy Healthy lifestyle choices (walking and smoking cessation): Better advertising, Participants asking others to join, Education on heart healthy diets

STIs: Trichomoniasis infection, Chlamydia infection Readmissions for COPD: Developed pneumonia, Lack of funds for medications Missed appointments for tuberculosis DOT: Lack of transportation, Contracted an illness, Limited health literacy Healthy lifestyle choices (walking and smoking cessation): Better advertising, Participants asking others to join

An older adult client states, "Disease occurs when supernatural elements enter the body." Which variable influences the client's health beliefs in this scenario? Spiritual factors Emotional factors Intellectual background Perception of functioning

Spiritual factors

Which resource or facility has enabled rural hospitals to have increased access to specialist consultations? Medicare Medicaid Telemedicine Critical access hospital

Telemedicine

A nurse is conducting an in-service education session on the Centers for Disease Control and Prevention's (CDC's) updates for preventive services for a group of nurses in community health. The nurse would demonstrate the best understanding of the educational process by integrating which planning strategies? Select all that apply. Use of films Small group interaction Use of games Session timing Session space

Use of films Small group interaction Use of games Session timing Session space

Many families have financial resources that allow them to maintain themselves but limit the quality of their purchasing power. Food high in fat and calories may be affordable, whereas fresh fruits and vegetables may not be affordable. A federal program that attempts to promote healthier diets for vulnerable populations is: Medicaid. Medicare. Supplemental Security Income (SSI). Women, Infants, and Children (WIC).

Women, Infants, and Children (WIC).

A nurse in community health is conducting an assessment on a family of four. During the course of the assessment, the nurse collects information 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 discussions occur regarding the patterns of health and illness that relate to biological health risks. The diagram is called: an ecomap. a family plan. a genogram. a risk plot.

a genogram.

In giving care to the survivors of violence, the nurse should demonstrate respect and caring for all family members, insist that safety is the first priority, and demonstrate intolerance for violent behavior. Additionally, the nurse should be: absolutely honest about what will be reported and what the family can expect. authoritarian in approaching the problem. cautious in reporting unconfirmed reports of violence. sincere in concern for the victims.

absolutely honest about what will be reported and what the family can expect.

When applying evidence-based practice (EBP), community-oriented nurses are primarily obligated to ensure that evidence applied to practice is: acceptable to the community. contains cost and reduces legal liability. applied as a universal remedy. limited to research findings.

acceptable to the community.

The later years of life for many older adults mark a period of abruptly changing social dynamics over which the older adult has very little control. The nurse should understand that this phenomenon of later life challenges: adapting and coping responses. intellectual capacity. socioeconomic status. spiritual awareness.

adapting and coping responses.

A nurse in community health directly contacts a mammography clinic to arrange an appointment for a female migrant worker with limited English language abilities. The nurse communicates with the client through an interpreter to ensure that the client's appointment is scheduled to meet her needs and that the client understands the procedure to be performed. This strategy used with vulnerable populations can best be described as: advocacy. culturally competent care. partnership. social justice.

advocacy.

In applying the developmental theory, a family nurse determines the developmental stage of the family based on: age of the eldest child. family strengths. individual growth patterns. overall tasks of the family.

age of the eldest child.

A nurse in community health is planning to begin a class to help mothers returning to work better cope with the stresses of multiple roles. The nurse would most likely use: an andragogical approach. a behavioral approach. an operational approach. a pedagogical approach.

an andragogical approach.

The nurse in community health identifies an elder abuse problem related to caregiver stress among families. The nurse further identifies a lack of caregiver support services in the local community. The next step in the community-oriented nursing process would be to: analyze the community problem. establish priorities. establish goals and objectives. identify intervention activities.

analyze the community problem.

The nurse has just taught a client newly diagnosed with diabetes how to administer sliding-scale insulin. The most effective way to evaluate learning is to: provide an online test module. ask whether there are any questions. ask for a return demonstration. give a short paper-and-pencil quiz.

ask for a return demonstration.

A nurse doing a family assessment asks the client, "Have any of your blood relatives had mental illness?" The nurse is asking this question to: determine whether the family is stable. assess for biological risk factors. decide whether this family member needs medication. demonstrate open-mindedness about mental illness.

assess for biological risk factors.

A neighborhood association group has asked the local nurse in community health for a class on environmental hazards. The nurse in community health has seen good information in the community health text and thinks about getting permission to copy some of the information. The most important thing the nurse should do before using copies of this material is to: assess the literacy level of the group. see how many plan to attend. see whether the group is ready to learn. secure a good space for a group meeting.

assess the literacy level of the group.

A community-oriented nurse has identified obesity as a problem in the middle school. The next step in a population-focused practice is to make information available about the health of the middle school students. This describes the public health core function of: assessment. assurance. policy development. research.

assessment.

A state agency has received multiple complaints regarding the availability of elder transportation services to a specific county senior center. The state agency assigns a public health nurse to work with the community to evaluate its program for elder transportation services to publicly sponsored elder care programs. The public health core function applied is: assurance. policy development. primary prevention. public transportation.

assurance.

When a community health nurse uses evidence-based practice (EBP) to evaluate effectiveness, accessibility, and quality of personal and population-based services, the nurse is addressing the core public health function of: assessment. assurance. policy development. research.

assurance.

A nurse in community health is following a pregnant teenager who attends school. The nurse plans to discuss self-care activities that will be important for the teen during her pregnancy. The discussion should include: carrying heavy book bags. changing to home education. decreasing fluid intake to avoid nausea. keeping up her grades.

carrying heavy book bags.

A nurse in community health is invited to work with a coalition of churches to address safety concerns for children in the local community. The nurse provides training in problem-solving skills, manages conflict, facilitates the process, and provides expertise in interpreting data. This nurse has chosen the implementation role of: change agent. change partner. group leader. data collector.

change partner.

A nurse in community health is working with a parent whose spouse has been called up for active duty in the military reserve. The family is experiencing financial strain due to decreased income. The extended family lives at a distance. The parent is struggling to manage the family in the spouse's absence. The family consists of four children (three preschool and one preteen). In this situation, it would be important for the nurse to further explore the potential for: child abuse. depression. intimate partner abuse. parent's resentment of the preteen.

child abuse.

A school nurse is working with the Parent Teacher Organization (PTO) to improve the health status of preschool students in a lower socioeconomic urban community. Given the demographics of the community, the nurse is aware that this population is at greatest risk for: asthma. attention deficit disorder (ADD). childhood obesity. poisoning.

childhood obesity.

A nursing student prepares a treatment plan for a client that draws upon the student's understanding of pathophysiology and nursing practice theory learned in the student's coursework. This application of new information used in a different way demonstrates the educational principle of: affective domain. cognitive domain. events of instruction. principles of effective education.

cognitive domain.

A nurse in community health contacts three individuals who have had sexual encounters with an individual recently diagnosed with syphilis. The concept basic to community-oriented nursing practice that is best described by this intervention is: community. community as client. individual as client. partnership.

community as client.

A Hispanic outreach program works with the nurse in community health to train Hispanic health care workers in providing basic services and education within the local Hispanic community. The concept basic to community-oriented nursing practice that is best described by this intervention is: community. community client. community health. community partnerships.

community partnerships.

A nurse in a clinic that provides direct care services to clients with tuberculosis would be classified as practicing: community-based nursing. community-oriented nursing. institutional nursing. public health nursing.

community-based nursing.

A school nurse teaches three middle school students with asthma conditions techniques to minimize their incidence of bronchial spasms. This is an application of: community-based nursing. community-oriented nursing. institutional nursing. public health nursing.

community-based nursing.

Jennifer is a nurse in a family medicine clinic. Today she is assessing Jose, a 4-year-old who is being seen for an earache. The type of nursing Jennifer practices is: community-oriented nursing. community-based nursing. public health nursing. tertiary health nursing.

community-based nursing.

A nurse planning a smoking cessation clinic for adolescents in the local middle schools and high schools is providing: community-oriented care. community-based care. secondary care. tertiary care.

community-oriented care.

Migrant workers and their families who reside in a specific mobile home park during the summer months would best be classified as a: community. group. setting of practice. target population.

community.

A family nurse is working with a married couple that has decided to remain child-free. The nurse recognizes this decision as a: biological necessity. contemporary family function. religious belief decision. threat to family survival.

contemporary family function.

The nurse who works in the community setting must ensure that the application of the best available evidence to improve practice is also: accessible and diverse. competent and compliant. culturally and financially appropriate. reasonable and deliverable in a timely fashion.

culturally and financially appropriate.

Vulnerable populations may be exposed to more than one hazard at a time. This is known as: cumulative risk. disenfranchised populations. resilience. underserved populations.

cumulative risk.

While conducting a community health assessment, a nurse in community health meets with local religious leaders to understand the values, norms, perceived needs, and influence structures within the community. This process of data collection can best be described as: data gathering. data generation. data interpretation. problem identification.

data generation.

It is estimated that one in 11 males becomes a father during his teen years. The nurse should be aware that many young men facing paternity have specific challenges such as: Select all that apply. acting as though they are interested when they are disinterested. avoiding prenatal care involvement. desiring and needing to be involved with their children. being rejected by the young woman's family. rejecting their role as a father.

desiring and needing to be involved with their children. being rejected by the young woman's family.

A case management nurse for a locally funded program for special-needs children is increasingly concerned about a recent referral for a 1-year-old child with a congenital illness residing in a poverty-stricken community. The nurse knows that this child may be at higher risk for the most harmful effects of poverty, including: developmental delays. ear infections. frequent colds and infections. irritability.

developmental delays.

A particular chronic health problem that is a serious public health challenge and results in health complications that double medical costs is: stroke. hypertension. diabetes. cardiovascular disease.

diabetes.

The nurse at the adult daycare center notices bruises on the wrists of a 90-year-old client. Besides the physical assessment of the client, the nurse should: confront the daughter when she arrives to pick the father up. discuss the findings with the caregivers to determine the cause of the injuries. educate the staff about indications of elder abuse. make a referral to the primary-care provider for follow-up.

discuss the findings with the caregivers to determine the cause of the injuries.

The nurse in community health defines goals and measurable objectives during the planning phase of a community health intervention. This also marks the beginning of the: evaluation phase. implementation phase. needs assessment. problem analysis.

evaluation phase.

Elderly clients should be assessed for signs of abuse. The illegal use of a person for another person's profit is known as: neglect. incompetence. exploitation. self-determination.

exploitation.

The nurse in 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 describes the study of: family demographics. family functions. family health. family resilience.

family demographics.

A father brings his stepdaughter to the family clinic for an immunization update before the new school year. The nurse notices the interaction between the young girl and her stepfather. The child appears tense and cautious and wraps her arms around herself in a protective manner. The child startles when touched by the stepfather and pulls away. The stepfather is overheard saying, "I'll leave you here if you don't behave and act nice." In this scenario, it would be important for the nurse to explore in her assessment the possibility of: child neglect. family secrets. father-daughter incest. impaired family functioning.

father-daughter incest.

The family nurse conducts the family nursing assessment with the family as a unit. Using a systematic process, family problems are identified and family strengths are emphasized as building blocks for interventions. Which of the following best completes the statement to demonstrate the importance of assessment to outcomes? Integrating the extended families: fosters equal family and provider commitment to success. facilitates outcomes-oriented family nursing research. decreases the need for nurse contact and intervention. removes barriers to needed services to achieve success.

fosters equal family and provider commitment to success.

A nurse volunteering at the free clinic in her community informs a client seeking treatment for hypertension that the family's children may qualify for enrollment in the State Children's Health Insurance Program (SCHIP). The nurse's intervention can reduce health disparities for these vulnerable children by making a referral to a program that provides: direct financial subsidies for children. funds to insure currently uninsured children. outreach efforts to enroll eligible children in Medicaid. prospective payments for child services.

funds to insure currently uninsured children.

Violence is a major public health problem in our communities that causes premature mortality and lifelong disability. Violence-related morbidity is a significant factor in: community deterioration. health care costs. juvenile delinquency. population density.

health care costs.

A poor, older Native Alaskan woman lives in a small, remote village near the Canadian border. She has been diagnosed with hypertension and diabetes but rarely makes it to the regional clinic in a distant town for checkups. This woman is most at risk for: disenfranchisement. health disparities. loss of independence. resilience.

health disparities.

Health education is often used as a strategy in working with vulnerable populations. The benefits of health education can be greatly affected by: dependency cycle. health literacy. income level. race and ethnicity.

health literacy.

All adults should be assessed for violence in their primary intimate relationships. The abuse of female partners has the most serious community health ramifications because of the greater prevalence, the more serious long-term emotional and physical consequences, and the greater potential for: fleeing to a shelter. homicide. possessive behavior. spontaneous abortion.

homicide.

A nurse new to the community evaluates the resources available to a father that has sought help with his escalating abuse and threats of violence to his family. After making the referral, the nurse approaches the local newspaper about running a series on the nature and extent of human abuse in the community. This strategy would: advocate for government programs to treat survivors. demonstrate the provider's commitment to address the need for services. increase awareness of community resources to address violence and abuse. increase the number of individuals identified as perpetrators.

increase awareness of community resources to address violence and abuse.

In a federally funded preschool program such as Head Start, nursing services that include conducting developmental-level screening for cognitive and psychomotor development of individual children would most likely be considered community-oriented nursing care when: individual results are compared with established standards for children of the same age group. program characteristics are assessed for their effectiveness in making the school population healthier. referral is provided for a child identified with delayed psychomotor development. treatment is initiated for a child with an identified learning disability.

individual results are compared with established standards for children of the same age group.

The most common causes of preventable disease, disability, and death among children are: injuries and accidents. maintaining a healthful diet. physical activity. cardiovascular health.

injuries and accidents.

A nurse participates with a community planning board addressing housing strategies and future community needs. The nurse is aware that the community has a population of homeless families served by local churches. The nurse is also aware that this agricultural community relies on migrant workers during seasonal harvesting of local produce. The nurse is concerned that these disenfranchised populations may be: complicated to address. costly to serve. invisible to the community. resilient to the community.

invisible to the community.

The Patient Self-Determination Act of 1990 requires that providers receiving Medicare and Medicaid funds give clients written information regarding: legal options for treatment choices in the event the person becomes incapacitated. patient rights. the cost of services. patient privacy.

legal options for treatment choices in the event the person becomes incapacitated.

For the homeless, health care is usually crisis oriented and sought in emergency departments. The most difficult challenge for nurses treating this vulnerable population is to recognize the client's: limitations in following treatment protocols. limited number of transient treatment facilities. transition to persistent poverty. use and abuse of tobacco, alcohol, and illicit drugs.

limitations in following treatment protocols.

A nurse in community health working in an inner city clinic with high poverty and unemployment rates recognizes the need for programs for pregnant women because these women often receive late or no prenatal care and deliver: at home. full term. identical twins or triplets. low-birthweight babies.

low-birthweight babies.

A hospice nurse is working with a cancer client and his family. The client's 7-year-old son has developed recent school and peer problems. Understanding the risk for disruption of normal development, the nurse plans to first screen the child for: developmental disorders. mental health problems. parental neglect. violence potential.

mental health problems.

One member of an older couple has just retired. This is considered a: developmental stage that will help the family with stress reduction. nonnormative event that will have psychological impact on the family. normative event and can increase the family's risk for illness. normative event and will have little effect on the family' well-being.

normative event and can increase the family's risk for illness.

The problem of the working poor and uninsured places a major burden on the current health care system that affects those families and the community in general. Nurses in community health see this as a major: Select all that apply. behavioral issue. policy issue. health risk issue. social issue. nursing issue.

policy issue. health risk issue. social issue.

Public health nursing is a specialty with a distinct focus and scope of practice and requires a special knowledge base different from other specialty areas of nursing. A public health nurse would first be interested in: drug treatments for diabetes. populations with the highest rate of diabetes. educational materials for individuals with diabetes. new technology for diabetic care.

populations with the highest rate of diabetes.

An underlying current throughout the special population groups with health disparities is: poverty. aging. minority groups. children.

poverty.

Nursing interventions and approaches for helping individuals and families to assume an active role in their care should focus on empowerment rather than on enabling. The underlying principle to empowerment is: client dominance. decreased competence. professional dominance. professional-client partnership.

professional-client partnership.

The gold standard of evidence gathering in evidence-based practice is: clinical knowledge and judgment. expert opinions. randomized clinical trials. theories of practice.

randomized clinical trials.

One reason that nursing may be slow in developing evidence-based practice (EBP) in the community setting may be the lack of understanding about the links between EBP and: evidence gathering. research design. research funding. research use.

research use.

A nurse in community health is working with a single parent of three children, ages 4, 6, and 8. The 6-year-old has cerebral palsy. The 4-year-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 families are: resistive to outside intervention or involvement. responsible for providing/managing the care of their members. unable to manage the stress of complex health needs. restricted in their ability to identify interventions.

responsible for providing/managing the care of their members.

A nurse in community health decides to form a contract with a family. The contract states that the family will designate one night as a family night. The nurse is most likely using the contract to: make sure the family does what is expected. encourage the family to put plans in writing. let the family know that this is a legal agreement. shift the responsibility so that it becomes a shared effort.

shift the responsibility so that it becomes a shared effort.

The school nurse is interested in providing an anti-smoking 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: behavior modification techniques. effects on the environment. laws regarding tobacco sales to minors. social skills instruction to resist pressure to smoke.

social skills instruction to resist pressure to smoke.

The nurse in community health reviews the monthly and year-to-date health service use report for the local community to monitor trends as correlates of the community's health. The nurse is viewing community health through the dimension of: partnership. process. status. structure.

structure.

In a community clinic that screens and treats individuals for cardiovascular disorders, the nurse practicing public health/population-focused nursing would most likely ascertain: a holistic treatment plan. a specific clinical diagnosis. individual dietary interventions for cardiovascular disorders. the prevalence rate of cardiovascular disorders among various groups.

the prevalence rate of cardiovascular disorders among various groups.

A nurse in community health is conducting a parenting class for prospective parents that will focus on the development of new skills, identification of needed resources, planning, and other preparations for the arrival of a newborn. This intervention is addressing a potential risk associated with: biology. behavior. environment. transitions.

transitions.

A nurse in community health conducts quarterly mental health-promotion and depression-screening programs at the local senior center. The nurse is aware that older adults are at increased risk for developing depression. Using such an intervention also addresses the older adults': dependence on their primary-care provider. normal sensory losses. reduced social contacts. underutilization of the mental health system.

underutilization of the mental health system.

The most critical strategy that can be used by nurses in community health to improve the health status of migrant workers that spend only a few months in a geographic location is to: conduct a comprehensive assessment and formulate a plan for treatment. establish a long-term trust relationship to prevent disappointment. schedule appointments for appropriate immunizations for the children. use every opportunity to teach about preventive health care.

use every opportunity to teach about preventive health care.

A young adult with a history of prior parental abuse recently has been diagnosed with a stress-related illness. The individual works at a local convenience store, earning a little more than the federal poverty level, but receives no health benefits. This individual is predisposed to the development of: poverty. resilience. risk. vulnerability.

vulnerability.

A city uses the local media (radio, television, and newspapers) to post ratings of air quality on days when the air quality is poor. This notification is directed toward older adults, very young members of the community, and those with chronic breathing problems. These groups are an example of: disenfranchised populations. disadvantaged populations. vulnerability. vulnerable populations.

vulnerable populations.

Two nurses in community health schedule a day to ride through a low-income community to better understand the community and what factors affect the health of that community. This direct data collection method is often referred to as: composite database. participant observation. secondary analysis. windshield survey.

windshield survey.

A large industrial plant has recently laid off a significant portion of its workforce because of scalebacks in production. The occupational health nurse proposes education sessions with the remaining employees about effective strategies for managing stress during economic downturns. This suggestion to management is based on the nurse's understanding that increases in aggression and violence at home and work may be triggered by: competition. unemployment. survivor guilt. work-related stress.

work-related stress.

Which point about community health nursing made by the student nurse needs correction? "The focus is on preserving, protecting, promoting, or maintaining health. " "The emphasis is to improve the quality of health and life within that community." "Community health nursing does not provide direct or indirect care services to subpopulations in a community." "Community health nursing can be described as nursing practice in the community, with the primary focus being the health care of individuals, families, and groups in that community."

"Community health nursing does not provide direct or indirect care services to subpopulations in a community."

Which instruction is beneficial for an aging Black client with hypertension? "Check the pulse daily." "Have an annual urinalysis." "Record blood pressure weekly." "Visit an ophthalmologist monthly."

"Have an annual urinalysis."

The nurse administers a pneumococcal vaccine to a 70-year-old client. The client asks, "Will I have to get this every year like I do with the flu shot?" How would the nurse respond? "You need to receive the pneumococcal vaccine every other year." "The pneumococcal vaccine should be received in early autumn every year." "You should get the flu and pneumococcal vaccines at your annual physical examination.' "It is unnecessary to have any follow-up injections of the pneumococcal vaccine after this dose."

"It is unnecessary to have any follow-up injections of the pneumococcal vaccine after this dose."

The nurse is teaching a parenting class. Which suggestion would the nurse make about managing the behavior of a young school-age child? Avoid answering questions. Give the child a list of expectations. Be consistent about established rules. Allow the child to plan the day's activities.

Be consistent about established rules.

A senior high school student asks the school nurse which immunizations will be included in the precollege physical. Which vaccine would the nurse tell the student to expect to receive? Hepatitis C (HepC) Influenza type B (HIB) Measles, mumps, rubella (MMR) Diphtheria, tetanus, pertussis (DTaP)

Measles, mumps, rubella (MMR)

A community health care nurse is conducting a survey about homeless children in the community. Which finding helps the nurse distinguish absolute homelessness from relative homelessness? The children are underimmunized and at risk for childhood illnesses. The children are more likely to drop out of school. The children have access to health care only through the emergency department. The children do not have a physical shelter and may sleep outdoors or in vehicles.

The children do not have a physical shelter and may sleep outdoors or in vehicles.

Which goal is the main focus of community health nursing? To meet the acute care needs of a population To improve the quality of health in a population To influence political processes affecting public policies To assess the health care needs of an individual or family

To improve the quality of health in a population

The nurse is teaching first aid to a group of community members. A participant asks which first aid should be administered, after calling 911, to a person who suffers extensive burns. Which response by the nurse is appropriate? "Apply ice to burned areas because this decreases pain." "Cover the burned areas with a bed sheet because this provides protection." "Do nothing because attempting to treat the burned areas may cause further damage." "Use first aid cream to burned areas because this prevents infection and decreases pain."

"Cover the burned areas with a bed sheet because this provides protection."

Which suggestion by the nurse is an example of primary prevention? "Engage in daily physical exercise." "Get yearly physical examinations." "Attend hypertension screening programs." "Read about how to prevent diabetes complications."

"Engage in daily physical exercise."

The nurse notes that a client is in the habit of skipping breakfast and lunch and educates the client on the harmful effects of not getting enough nutrition. Which responses are signs that the client has reached the action stage of health behavior change? Select all that apply. One, some, or all responses may be correct. "I still tend to skip breakfast when I'm in a hurry to get to work." "I can't compromise my career for the sake of good eating habits." "I know that it's not good to skip meals, but my health seems fine." "I've been having my breakfast and lunch on time for the past 6 months "I follow a proper eating schedule, but sometimes it gets in the way of my work."

"I still tend to skip breakfast when I'm in a hurry to get to work." "I follow a proper eating schedule, but sometimes it gets in the way of my work."

A nursing student is listing factors that may improve the quality of life of clients in the community with chronic leg ulcers. Which factor listed by the nursing student needs correction? "Offer suggestions to improve a client's level of independence. "Inform clients that the cost of care may be expensive and that the level of pain may increase. "Instruct clients that as their wounds heal, their capability and desire to socialize with others may increase." "Understand that some clients have depression and anxiety related to the chronic nature of their wounds."

"Inform clients that the cost of care may be expensive and that the level of pain may increase.

A parent with two school-age children has just finished a family health assessment questionnaire. The parent asks the nurse why one of the questions asks whether there is a neighborhood playground. The nurse's best response would be: "Don't worry about it. We are going to talk about all this anyway." "It's important to good health to have adequate recreation resources." "We want to be able to report any dangerous playground equipment to the city." "We want to know what kind of neighborhood you're in so we can assess income."

"It's important to good health to have adequate recreation resources."

Which comment would the nurse say to the client who is not fluent in the language the nurse is speaking to initiate appropriate communication? Select all that apply. One, some, or all responses may be correct. "Please tell me about the health care practices and beliefs of your community." "Let me bring in an interpreter to help you understand the medical procedures better." "I would like to know your personal beliefs regarding health care traditions and practices." "Please let me explain our traditions and cultural practices to help you understand our health care practices." "I have read up extensively about the health care practices of your community and have designed a care plan accordingly.

"Please tell me about the health care practices and beliefs of your community." "Let me bring in an interpreter to help you understand the medical procedures better." "I would like to know your personal beliefs regarding health care traditions and practices."

During a family nursing assessment, a parent questions whether God is punishing the family, because one of the children has just been diagnosed with leukemia. The most facilitative response by the nurse would be: "God is loving and doesn't punish people." "Tell me more about your family's spiritual beliefs." "That is not part of my religious belief system, so I don't know." "Why do you think your family needed to be punished?"

"Tell me more about your family's spiritual beliefs."