HumDev Ch. 22 quiz

The nurse working with the young adult population often take on the role of ___ assessing stressors as prolonged stress, anxiety or depression can negatively affect the health of the individual

Counselor

A community health nurse has received a grant to present a program about violence prevention. Which of the following individuals has a higher than average risk of homicide? (select all that apply) a. 33-year-old woman who served 5 years in prison b. 20-year-old homeless man c. 28-year-old man with a history of bipolar disorder d. 24-year-old woman who has a female partner

a. 33-year-old woman who served 5 years in prison b. 20-year-old homeless man c. 28-year-old man with a history of bipolar disorder Homicide is closely associated with alcohol and drug abuse and frequently is related to other violent acts, such as robbery. Other risk factors for homicide include a history of loss of employment, detention or prison experience, access to firearms, abuse in the home, mental illness, social isolation, and homelessness.

An occupational health nurse is conducting a blood pressure screening. Which of the following clients is at greatest risk of mortality from cardiac disease? (select all that apply) a. Black man with a blood pressure of 130/80 b. Mexican American man with a blood pressure of 110/60 c. White woman with a bold pressure of 120/80 d. Black woman with a blood pressure of 128/78

a. Black man with a blood pressure of 130/80 d. Black woman with a blood pressure of 128/78 According to the JNC VII, the risk for cardiovascular events rises when blood pressure is greater than 115/75. Blacks have a higher death rate from heart disease than do Whites. Mexican Americans have the lowest rate of hypertension.

A nurse is conducting a community health education program for Hispanic women ages 18 to 35. Which of the following items should the nurse recommend that they increase in their diet on a daily basis? (select all that apply) a. Calcium b. Folic acid c. Iron d. Sodium

a. Calcium b. Folic acid c. Iron Women of childbearing age frequently consume a diet deficient in calcium, iron, and folic acid.

A nurse is planning health care for young adults. Which of the following factors about the interventions should be recognized by the nurse as having the greatest impact on whether they are effective? a. Culturally sensitive b. Match the persons health care beliefs c. Cost effective d. Gender neutral

a. Culturally sensitive Unless the interventions are culturally sensitive, they are not likely to be successful. Although the other factors are important, the priority consideration is cultural sensitivity.

Nurses caring for the young adult population maintain awareness about screening for hypertension. Which of the following statements are true about hypertension in young adults? (select all that apply) a. The Mexican American population has the lowest percentage of individuals with high blood pressure. b. African Americans have the highest rates of high blood pressure. c. Health insurance has a direct correlation with hypertension control. d. Adopting healthy behaviors after being diagnosed with hypertension will not reduce the incidence. e. The prevalence of treatment and control of hypertension is lowest in young adults.

a. The Mexican American population has the lowest percentage of individuals with high blood pressure. b. African Americans have the highest rates of high blood pressure. e. The prevalence of treatment and control of hypertension is lowest in young adults. There are also noticeable disparities in the development of hypertension in various population subgroups. Data from 2009 to 2012 indicate the Mexican American and the white-only/non-Hispanic populations have the lowest percentage of high blood pressure individuals (27%); and the non-Hispanic/black African American population has the highest (42%) level of hypertension. The prevalence of control of hypertension was also lowest in young adults (39%). This may be related to lack of a usual source of care, but most surveyed had health insurance, so health insurance alone is not sufficient to correlate with better hypertension control. Gillespie and colleagues also report that adoption of healthy behaviors in young adults, particularly of reducing dietary salt intake from an average of 3400 to 2300 mg daily, could dramatically reduce the incidence of hypertension.

A nurse is working in the community to prevent bicycle and motorcycle fatalities. Which of the following measures would be most effective for the nurse to promote? a. Use of helmets b. Increasing the minimum age for motorcycle licensure c. Construction of bike paths along busy roads d. Right-of-way laws for bicyclists

a. Use of helmets Head injury is the major cause of death related to bicycle or motorcycle accidents. Bicycle helmets are believed to be the single most effective preventive measure available to decrease the incidence of brain and head injury.

Which of the following circumstances accounts for one of the leading cause of death in young adults? a. Tobacco use b. Binge drinking and driving c. Illegal drug use d. HIV infection

b. Binge drinking and driving Alcohol-related accidents among individuals ages 15 to 24 continue to be a leading cause of preventable morbidity, disability, and death.

The parents of a young adult female have recently divorced. Which of the following is the young adult most likely to experience? a. Relief b. Depression c. Unemployment d. Inability to sustain own relationships

b. Depression Although dissatisfaction and unhappiness are frequent precursors to separation and divorce, the decision to dissolve a marriage is not easy. Divorced young adults frequently suffer severe emotional strain and depression. Some young adults are unable to adjust to role and status changes and to threats of self-concept. Young adults whose parents divorce have an increased rate of divorce, but that does not mean that they are unable to sustain their own relationships.

The nurse working in the college health center is planning a program about sexually transmitted diseases (STDs). Which of the following information should the nurse include in the program? a. STDs are the third most common infection in young adults. b. STDs can be transmitted by any intimate contact, not just sexual intercourse. c. STDs usually occur as a single infection. d. STDs are the most common reason for a visit to the health center.

b. STDs can be transmitted by any intimate contact, not just sexual intercourse. STDs can be transmitted from oral and anal sex, not just vaginal intercourse, and many young adults do not understand this. STDs are the most common infection in persons age 15 to 24. A person may have multiple STDs. STDs are generally unreported and not treated.

A 32-year-old woman visits the occupational health nurse because of malaise. Which of the following assessment data indicates that the client may be experiencing achievement-oriented stress? a. Sleeping 10 hours per day b. Unintentional loss of 10 pounds in the past 3 weeks c. Expressed fear of company layoffs d. Calling in sick once every 2 weeks for the past month

b. Unintentional loss of 10 pounds in the past 3 weeks Achievement-oriented stress is characterized by lack of sleep, skipping meals, and workaholic habits. It differs from situational stress, which would be caused by changes in job function for example.

A nurse is working in a domestic violence shelter. Which of the following individuals would the nurse expect to encounter? (select all that apply) a. 34-year-old White woman who is vice president of a communications company b. 26-year-old Black woman who has a live-in boyfriend c. 29-year-old Hispanic man who has been married for 2 years d. 21-year-old unemployed White woman who has been with her boyfriend for 3 years

a. 34-year-old White woman who is vice president of a communications company b. 26-year-old Black woman who has a live-in boyfriend c. 29-year-old Hispanic man who has been married for 2 years d. 21-year-old unemployed White woman who has been with her boyfriend for 3 years Abusive behavior victims come from all racial, ethnic, and socioeconomic levels.

A 30-year-old woman with a BMI of 36 is counseled by the nurse regarding interventions to assist with weight reduction. In which order would the nurse discuss the implementation of these interventions? 1. Gastric stapling 2. Medication to reduce appetite 3. Nutrition and exercise education 4. Assessment of lipid profile and blood pressure a. 4, 3, 2, 1 b. 4, 2, 3, 1 c. 3, 4, 2, 1 d. 3, 2, 1, 4

a. 4, 3, 2, 1 Assessment data must be complete before intervention. Diet and exercise are used first, and then pharmaceutical agents to reduce appetite. Bariatric surgery is used when all other options have failed.

The nurse is preparing a class on young adult risk factors for violence. The nurse includes content on which of the following? (select all that apply) a. Homicide is the second leading cause of death in young adults. b. Alcohol but not drug abuse is frequently related to violence. c. Homicide is the leading cause of death for black young men. d. Firearms are involved in less than half of homicides. e. The presence of firearms in the home is associated with the increased risk of firearm injury to children.

a. Homicide is the second leading cause of death in young adults. c. Homicide is the leading cause of death for black young men. e. The presence of firearms in the home is associated with the increased risk of firearm injury to children. In the United States, there are about 51,000 violent deaths a year, and these deaths affect all Americans not only in emotional terms but also through additional medical costs and lost employment productivity. Domestically, in the United States, the recipients of violence may be older adults, children, and women with whom they are familiar. Identification, education, and strategies to prevent bullying, dating violence, and sexual violence among young adults require federal and community attention. Homicide (assault) is the second leading cause of death in the 15- to 24-year-old age group and the leading cause of death for black men in the same age category. Between 1999 and 2008, the homicide rate has remained fairly static around 5.4 deaths/100,000 population; this is a significant decline from the rate seen in the early 1990s and there are ongoing efforts to understand what has contributed to the improvement. Firearms are involved in approximately two thirds of these deaths, and men have twice the risk of dying as do women.When compared with the general population, death rates are higher for men in poorer populations, in urban areas, and with less formal education. Homicide is closely associated with alcohol and drug abuse and frequently is related to other violent acts, such as assaults and robbery. Other risk factors include history of loss of employment, detention or prison experience, access to firearms, abuse in the home, mental illness, social isolation, and homelessness. The presence of firearms in the home is associated with the increased risk of unintentional and intentional injury to children. A target in Healthy People 2020 is to reduce firearm-related deaths from 10.5 per 100,000 population in 2012 to 9.3 per 100,000 population and to reduce the number of nonfatal firearm-related injuries from 20.9 per 100,000 in 2010 to 18.6/100,000. The firearm-related death rate for young black men and boys was nearly 5 times the rate for young white men and boys.

The university health services nurse is preparing a disease prevention program for college students. Which of the following information should the nurse include in the program? a. Living in the dorm increases ones risk of developing meningococcal disease. b. The mortality rate from meningococcal disease is very low. c. There are no antiviral medications that can treat meningococcal outbreaks. d. A vaccine for meningococcal disease has not been developed.

a. Living in the dorm increases ones risk of developing meningococcal disease. Although most outbreaks of meningococcal disease are sporadic, young adults living in dormitories or crowded conditions may be more susceptible than young adults not living in close settings. Meningococcal disease has a high mortality rate. It is caused by a bacterium, not a virus, and antibiotics to treat the disease are readily available. A preventive vaccine is available.

A nurse is planning community health programming for young adults. Based on the objectives for Healthy People 2020, which of the following topics would be priority areas for programming? (select all that apply) a. Prenatal care b. Physical activity c. HIV d. Suicide

a. Prenatal care b. Physical activity Healthy People 2020 objectives targeted for the young adult include increasing the proportion of adults who engage in regular aerobic activity of moderate intensity and increasing the proportion of women who receive early and adequate prenatal care. HIV and suicide rates are not mentioned in the target areas for young adults.

According to Piaget's theory of cognitive development, the young adult is in the stage of formal operational thought and demonstrates abilities to: a. analyze concepts. b. manipulate concrete objects. c. participate in cooperative interactions. d. perceive specific examples.

a. analyze concepts. Several stage theorists describe the growth of young adult thought and moral development. It is important to note that these stages are fluid and individual differences occur. Within Jean Piaget's cognitive-developmental theory, formal operational thought evolves from concrete operational thought in adolescence and extends through the reasoning process of young adults. Although more recent developmental theorists dispute Piaget's findings, this scheme of cognitive development assists the nurse in learning about and understanding young adult reasoning. Achievement of formal operational thinking allows young adults to analyze all combinations of possibilities and construct hypotheses. Young adult thought becomes more perceptive and insightful; issues can therefore be evaluated realistically and objectively. Young adults are energetic and can therefore contribute substantially to social and occupational decision-making. Although they tend to take greater risks, young adults typically demonstrate the use of appropriate reasoning, anticipation, and analytical approaches.

Emphasis on disease prevention for the young adult, after age 25, is on modifying risk factors related to: a. coronary artery disease. b. cirrhosis of the liver. c. cervical cancer. d. colon cancer.

a. coronary artery disease. After age 25, the preventive emphasis is on modifying coronary disease risk factors. There is evidence that healthy lifestyle changes during young adulthood are associated with decreased cardiovascular risk. Recommendations for screening for young adults are undergoing revision as more information becomes available about the interactive risks of sedentary lifestyle, high cholesterol levels, familial high lipid levels, diabetes mellitus, and smoking. USPSTF makes no recommendations for men 20 to 35 for or against routine screening for lipid disorders unless they are at increased risk for coronary disease. Aging is responsible for some degenerative changes in respiratory and cardiac function, but during the young adult years this decline amounts to less than 1% per year and is largely determined by an individual's fitness level. Cardiovascular assessment of the young adult includes determining the presence of hyperlipidemia, hypertension, diabetes, chest pain, or heart disease. A Healthy People 2020 target is to reduce the mean total blood cholesterol levels among adults to 177.9 mg/dL; the baseline between 1988 and 1994 for adults 20 and older was 197.7 mg/dL.

What are the current recommendations of the US Preventive Services Task Force concerning breast cancer? a. Screening mammograms beginning at age 30 b. Recommends against teaching breast self-examination c. Breast ultrasound screening beginning at age 35 d. Mammogram every 2 years if on birth control pills from age 35

b. Recommends against teaching breast self-examination A physical examination includes measurements of height, weight, body mass index, blood pressure, and blood tests, with an emphasis on the need to avoid inactivity and obesity, which are risk factors for many health problems. The US Preventive Services Task Force currently recommends against teaching breast self-examination and concludes that the current evidence is insufficient to assess the additional benefits and harm of clinical breast examination beyond screening mammography for women 40 and older. Screening is strongly recommended for cervical cancer in women who have been sexually active (Papanicolaou [Pap] smear). Ultrasound is sometimes used to delineate whether a finding on mammogram is a cyst. It is never used as a primary screening modality. Whether a woman takes oral contraceptives is not relevant for purposes of breast cancer screening.

Which of the following interventions are appropriate relative to the nursing diagnosis: Health-Seeking Behaviors Related to Preconceptual Assessment and Preparation for Childbearing? a. Encouraging the consumption of a moderate-fat diet to prepare for pregnancy b. Referral to genetic counseling based on family history c. Counseling to avoid hard liquor d. Substituting a nutritional supplement for a meal so as to assure adequate vitamin intake

b. Referral to genetic counseling based on family history Assessment of biophysical risk factor is an important intervention, which includes review of genetic disorders, nutrition problems, and current medical problems. Before and during pregnancy, the diet should be well-balanced, low in fat and sodium, and high in calcium and iron. Nutritional supplements are not required unless the woman is malnourished. Alcohol in all forms including beer and wine should be avoided

A nurse is planning a community health education program for young adults. Which of the following considerations should be made by the nurse? a. The age span encompassing young adulthood is between 20 to 30 years of age. b. The number one cause of death for young adults is injury. c. The number of young adults in the United States is increasing. d. The maternal mortality rate is at its lowest point since 1980.

b. The number one cause of death for young adults is injury. Young adulthood spans the years between ages 18 to 35. The number of young adults in the United States is declining, and the maternal mortality rate is at its highest level since 1980.

Which of the following young adults exemplifies Kohlbergs postconventional level of moral reasoning? a. 28-year-old person who calls in sick so as to help a friend move to a new location b. 22-year-old man who uses marijuana on the weekends with friends c. 30-year-old woman who volunteers at a soup kitchen one day a month d. 35-year-old who works long hours so as to be considered for a promotion

c. 30-year-old woman who volunteers at a soup kitchen one day a month Someone in Kohlbergs postconventional level of moral reasoning is able to do what is beneficial or right regardless of peer pressure to take another course of action.

The nurse working in the college health center is asked about a safe way to obtain a tan. Which of the following would be the best response by the nurse? a. There is no safe way. Be sure to stay out of the sun as much as possible. b. Tanning beds are much safer than exposure to actual sunlight. c. Be sure to use sunblock agents and do not sunbathe between 10 AM and 2 PM. d. Once you apply sunblock, you are protected all day, so be sure to use it before any outdoor activity.

c. Be sure to use sunblock agents and do not sunbathe between 10 AM and 2 PM. Young adults should avoid sunbathing during the 2-hour period before and after noon because two-thirds of the days ultraviolet light comes through the earths atmosphere during this time. There is no need to stay completely out of the sun. Tanning beds are not a safe way to tan. Sunblock should be reapplied if certain outdoor activities are part of the day, such as swimming.

A nurse is counseling a 23-year-old woman about oral, transdermal, injectable, vaginal ring, and implant contraceptive methods. Which of the following risks of using these methods should be stressed by the nurse? a. Toxic shock syndrome b. Nausea c. Blood clots d. Ectopic pregnancy

c. Blood clots Blood clots are a potential risk with using all of these contraceptive methods. Ectopic pregnancy is a possible complication of IUDs. Nausea may occur with the use of Plan B, and toxic shock syndrome may occur with use of a diaphragm.

Nutrition during pregnancy is important as it significantly impacts fetal health. With of the following nutrients should include supplementation in addition to dietary intake? a. Vitamin C b. Niacin c. Folic acid d. Magnesium

c. Folic acid Proper nutrition is particularly necessary for the young adult female during the childbearing years. Contributing factors to iron deficiency in this age group are regular loss of blood (during menses) and pregnancy. The prevalence of anemia in women of childbearing potential was 16.1% in 2003 to 2006 and the 2020 target is 14.5%. A blood loss of 2 to 4 mL per day (1 to 2 mg of iron) can cause iron deficiency anemia; young women who do not eat a healthy diet and have heavy periods or use nonsteroidal anti-inflammatory drugs are specifically at risk for iron deficiency anemia. Iron supplementation is recommended during pregnancy for optimal growth of the fetus and supporting structures.The CDC and USDHHS recommend that all women of childbearing age consume 0.4 mg of folic acid daily to reduce the risk of fetal neural tube defects, including spina bifida. Supplementation should include at least the month before pregnancy and the first trimester during pregnancy. The CDC and Food and Drug Administration also recommend folic acid fortification of food to prevent neural tube defects. In the years 2007 to 2010, only 22.8% of nonpregnant females age 15 to 44 reported a daily intake of folic acid of 400 mcg from fortified foods or dietary supplements and the target for 2020 is 26.2%. Efforts are also being made to reduce health disparities in neural tube defects including the use of better communication modalities with the Hispanic population and other population subgroups that have higher rates of neural tube defects.Most adolescents and adult women fail to meet their calcium requirements, placing them at risk for osteoporosis and bone fractures in later life. Low calcium intake is a direct result of low milk consumption related to soft drink ingestion. An increase in calcium-containing foods is therefore recommended, particularly for teens and young women.

A nurse volunteered to work at a natural disaster site. Which of the following questions should the nurse ask to determine if the 26-year-old individual being screened is depressed or has suicide ideation? a. Tell me about your pets. b. What do you do for work? How has your work been affected by this disaster? c. Have you thought of harming yourself? d. Have you seen your friends since the disaster?

c. Have you thought of harming yourself? Direct questioning about the intent to harm oneself is appropriate for the nurse to ask during screening/counseling sessions.

A public health nurse is interested in writing a grant to improve vaccination rates of young adults. His focus should be on trying to obtain funding to support which of the following vaccination initiatives? (select all that apply) a. Rubella prevention b. Lyme disease prevention c. Hepatitis B prevention d. Human papilloma virus (HPV) prevention

c. Hepatitis B prevention d. Human papilloma virus (HPV) prevention Rubella in young adults is generally a minor disease; the population at risk is women of childbearing age. There is not a vaccine available for Lyme disease. Hepatitis B and HPV can both be prevented through immunization and young adults are at high risk for contracting these diseases.

A nurse is discussing optimal activity for young adults. Which of the following information should be stressed? a. Forty-five minutes of moderate exercise per day are required to maximize health benefits. b. An increase in heart rate from 70 to 200 beats/min during exercise is optimal. c. Moderately brisk walking is an appropriate aerobic exercise. d. Sixty minutes of exercise three times a week is recommended.

c. Moderately brisk walking is an appropriate aerobic exercise. The Healthy People 2020 goal is to increase the proportion of adults who engage in moderate physical activity for 150 minutes a week (30 minutes five times per week) to 47.9% from 43.5%. Aerobic conditioning achieves cardiovascular fitness through five periods of moderately intense exercise weekly for about 30 minutes or more at a heart rate of approximately 220 minus the age of the person multiplied by 65% to 85%. Young adults are encouraged to engage in fitness activities that increase the heart rate to approximately 150 beats or more per minute. Moderately brisk walking that increases the heart rate is an appropriate aerobic exercise.

Which of the following concepts are accurate regarding the biological changes in the young adult period? (select all that apply) a. Young adulthood sees the highest illness rate of any other age group. b. Physical growth continues into the 30s. c. Most concerns are related to ensuring optimal body functioning. d. Physical abilities of the young adult are at their peak. e. Illness compensatory mechanisms generally operate optimally.

c. Most concerns are related to ensuring optimal body functioning. d. Physical abilities of the young adult are at their peak. e. Illness compensatory mechanisms generally operate optimally. Young adulthood is generally the healthiest time of life. Physical growth is mostly complete by the age of 20; most concerns related to physiological development are focused on ensuring the optimal functioning of body systems. The young adult's physical abilities are in peak condition, and compensatory mechanisms operate optimally during illness to provide minimal disruption in health patterns. Nursing goals for individuals of this age group are oriented toward prolonging this period of optimal physical energy; developing the mental, emotional, spiritual, and social potential; encouraging proper health habits; anticipating and screening for and, therefore, being able to treat the onset of chronic disease at an early stage; and treating disease when appropriate.

A 26-year-old client has a total cholesterol of 206 mg/dL and an LDL of 110. Which of the following conclusions can be drawn by the nurse? a. The client has achieved the target levels for cholesterol in young adults. b. The client has a very low risk of developing heart disease. c. The client requires counseling about cardiac disease risk factors. d. The client has early-onset cardiac disease.

c. The client requires counseling about cardiac disease risk factors. Cardiovascular assessment of the young adult includes determining the presences of hyperlipemia, hypertension, diabetes, chest pain, or heart disease. This client has an elevated cholesterol levels and requires additional education about risk factors that may lead to cardiac disease. The Healthy People 2020 target is to reduce the mean total blood cholesterol levels among adults to 177.9 mg/dL. A diagnosis of heart disease cannot be made on the basis of these lab values.

The public health nurse is conducting a screening of young adults for metabolic syndrome. When asked about the syndrome, which of the following responses should be made by the nurse? a. Anyone who has low blood sugar, high cholesterol, and high blood pressure has this syndrome and is at risk for cardiac disease. b. This syndrome helps predict heart disease. Once it is diagnosed, the correct medication can be prescribed and heart disease avoided. c. This syndrome is a warning sign that the person could develop heart disease. When someone has metabolic syndrome, dietary and activity level changes are recommended. d. Anyone who has high cholesterol, high blood pressure, and high blood sugar has coronary artery disease. Once we make the diagnosis, we can begin to treat the disease.

c. This syndrome is a warning sign that the person could develop heart disease. When someone has metabolic syndrome, dietary and activity level changes are recommended. Metabolic syndrome is diagnosed when a person has high cholesterol, high blood pressure, and high blood sugar. A person with this syndrome is at risk for coronary artery disease. Lifestyle changes are tried before medication is used.

Which of the following adults has transitioned to Eriksons intimacy versus isolation and loneliness stage of development? a. A 21-year-old man who has a part-time job, spends most of his leisure time with his buddies, and has numerous short-term intimate relationships b. A 25-year-old woman who is very concerned with how she is perceived by her coworkers and friends c. A 30-year-old man who just graduated with a PhD and is looking for his first full-time job d. A 26-year-old woman who has a long-term relationship with a female companion

d. A 26-year-old woman who has a long-term relationship with a female companion Eriksons intimacy versus isolation and loneliness stage of development involves reciprocal expressions of affection and trust. Promiscuous behavior is not characteristic of this stage of development. Reliance on a positive perception by friends and coworkers for self-esteem is not characteristic of this stage of development.

A nurse is completing a health counseling session with a 25-year-old woman. Which of the following statements should be made by the nurse during this session? a. A yearly Pap test is recommended for detection of ovarian cancer. b. Research supports that breast self-exams reduce breast cancer mortality. c. The incidence of cervical cancer is very low in your age group. d. Daily physical activity and weight control is one way to stay healthy.

d. Daily physical activity and weight control is one way to stay healthy. Screening is strongly recommended for cervical cancer in women who have been sexually active (Papanicolaou [Pap] smears). The incidence of carcinoma in situ is high in young adults. The US Preventative Services Task Force recommends against teaching breast self-examination and concludes that the current evidence is insufficient to assess the additional benefits and harm of clinical breast examination beyond screening mammography for women 40 and older. After age 25, the preventive emphasis is on modifying coronary disease risk factors, which would be accomplished by discussing activity and weight control.

Which of the following statements is correct concerning intimate partner violence? a. It occurs primarily in lower socioeconomic settings. b. Physical assaults by intimate partners has increased in last decade. c. The risk increases as age of first marriage increases. d. It is the most underreported form of abuse.

d. It is the most underreported form of abuse. Intimate partner violence has serious health consequences for women and men; however, because of social and legal factors, it is probably the most underreported form of abuse (Box 22-5: Diversity Awareness). Abuse crosses all socioeconomic, racial, ethnic, religious, sex, and age boundaries. About 3 in 10 women and 1 in 10 men during their lifetime reported intimate partner violence or abuse. Women reported higher lifetime and more recent-year intimate partner violence than men. Nurses and other primary health care providers assist in detecting or treating violence or abuse in an optimal manner; they can help others to understand the cultural background of abuse. However, more efforts must be made to recognize the scope of the problem and to provide appropriate counseling (Box 22-5: Diversity Awareness). Physical assaults by intimate partners decreased in the last decade; this improvement is attributed to increased economic opportunities for women, increased age at first marriage, and better access to domestic violence services. A target in Healthy People 2020 is to reduce the rate of physical assault to 19.2 assaults per 1000 from 22 assaults recorded in 2012.

According to Healthy People 2020, the leading causes of death among children and young adults are due to injuries from which of the following? a. Homicide b. Suicide c. Burns d. Motor vehicle crashes

d. Motor vehicle crashes Injuries are the highest cause of death in young adults and individuals under age 44. Motor vehicle accidents cause more fatalities than all other causes of death combined. Reducing speed limits contributes to lower fatality rates. Most states have seat belt laws, and all states have seat belt requirements for children. All individuals in the car need to use seat belts, because an unrestrained occupant can cause harm to another passenger in a crash. In 2013, 87% of motor vehicle drivers and front seat occupants used seat belts and the target for 2020 is 92.4%. Distracted driving, texting while driving, and cell phone use are the causes of many motor vehicle crashes. Most states have enacted "hand-free" or "Bluetooth" wireless audio legislation that limits the use of handheld car cell phones. The continued high incidence of vehicle accidents in the young adult age group is related to accessibility of cars to young adults and peer pressure on driving behavior; reckless driving and driving under the influence of alcohol and drugs are now viewed as closely connected to violent and abusive behavior. A number of states have specific rules that limit cell phone use in drivers under 18 years of age.Accident-prevention education, long considered appropriate for young children, is an important part of young adult instruction. Most young licensed drivers have participated in driver education courses, and a number of states have adopted progressive licensing programs. A number of states have "graduated driver licensing" programs which have been shown to reduce younger driver crash rates by 8% to 14%. In 2015, 46 states had banned texting while driving, and two additional states ban texting by novice drivers. The young adult must understand the potentially fatal consequences of aggressive tendencies or thoughtless risk-taking. When young adults are encouraged to reflect on the consequences of their actions, they tend to be more willing to control and change unsafe driving behaviors.

Which of the following reflects Piagets theory as applied to young adults? a. Voting for a candidate based on popularity b. Voting for a candidate based on media advertisements c. Voting for a candidate based on support of the candidate by peers d. Voting for a candidate based on analysis of views about various issues

d. Voting for a candidate based on analysis of views about various issues Young adults are in Piagets formal operational thinking stage during which they analyze issues objectively and insightfully.

Which of the following statements should be considered by a nurse working in occupational health who organizes a stress reduction workshop? a. Women generally experience less workplace stress than do men. b. Ones first job is exciting and leads to numerous opportunities, and therefore causes little stress. c. Young adults adapt easily to changing job demands such as telecommuting and long work hours. d. Work is of primary importance to young adults and helps form their self-image.

d. Work is of primary importance to young adults and helps form their self-image. Employment is more than a source of income to young adults; it provides self-esteem and social interaction. Women experience as much, and sometimes more, stress than do men because of child care issues. The demands of work are stressful and sometimes lead to unhealthy behavior.

A 19-year-old college student is seen by the health services nurse. The young woman is distraught that she had unprotected sex 4 days ago and is afraid she may have become pregnant. Which of the following statements should be made by the nurse? a. Lets talk about your options because you must be 21 years of age to purchase emergency contraception. b. Dont worry; you can purchase Plan B, an emergency contraception drug, without a prescription and it will terminate the pregnancy. c. I know you are upset, but we are in one of the 40 states that allow drugstores to carry Plan B, an emergency contraception drug. Lets talk about how to use the medication. d. You have several options. Lets discuss what would be the best thing for you to do next.

d. You have several options. Lets discuss what would be the best thing for you to do next. Emergency contraception can reduce the number of unintended pregnancies. There is a generic two-dose form Next Choice, and a one-dose form, Plan B One-Step. Both require a prescription for girls under 17. Emergency contraception must be used within three days of unprotected sex. It works by either altering tubal transport of either sperm or ova, inhibiting implantation. It will not terminate an existing pregnancy and does not provide protection against sexually transmitted diseases.

A target goal of Healthy People 2020 is to reduce the incidence of hepatitis C. The nurse focuses on individuals most at risk, which includes persons with: a. hepatitis A. b. Epstein-Barr virus. c. human papilloma virus. d. chronic renal disease on hemodialysis.

d. chronic renal disease on hemodialysis. Another target of Healthy People 2020 is to keep the incidence of hepatitis C stable at 0.2 new symptomatic cases in 100,000 people. Chronic hepatitis became a nationally reportable disease in 2003. Individuals most at risk are those who have injected illicit drugs, are undergoing hemodialysis, are seropositive for human immunodeficiency virus (HIV), or have elevated liver function studies. Recent curative advances in drug treatment for hepatitis C have made better case finding more important. The other diseases listed do not have a positive correlation to hepatitis C.