NRS 460 Exam #3

Ms. L is being treated for depression. Which of the following statements by her indicates a need for further education? A. "My medication will cure me of my depression." B. "A side effect of my medication (Prozac) may be gastrointestinal upset." C. "I need to keep my follow-up appointment for medication management." D. "I should not stop taking my medication without checking with my doctor first."

A. "My medication will cure me of my depression." Psychotherapeutic medications do not cure mental illness; rather, they act by controlling symptoms. The other statements are correct.

Which one of the following statements best defines epidemiological transition? A. A change from mainly infectious diseases to mainly chronic diseases. B. A change from morbidity due to a particular infectious disease to a different infectious disease. C. A change in life spans of various age groups in a specific country. D. A change in infectious diseases caused by a difference in agent, host, or environment.

A. A change from mainly infectious diseases to mainly chronic diseases.

A school nurse evaluates the implementation of health promotion in a high school staff. Which of the following indicates a need for more education? A. A flyer advertising an ice cream and pizza party for the student awards program B. Condoms being provided in all restrooms of the school C. A decrease in missed days at school D. The discontinuation of the availability of soft drinks and candy in vending machines during school instructional hours

A. A flyer advertising an ice cream and pizza party for the student awards program School nurses facilitate positive student responses to normal development; promote health and safety, including a healthy environment; intervene with actual and potential health problems; provide case management services; and actively collaborate with others to build student and family capacity for adaptation, self-management, self-advocacy, and learning. REF: Page 596

Public health policy in the United States is influenced by two types of justice, market justice and social justice. Examples of market justice include which of the following? (Select all that apply.) A. All people are entitled to the status they create for themselves. B. All people are entitled to a livable minimum wage. C. All people are entitled to happiness if they put forth enough effort. D. All people are entitled to the income they work for. E. All people are entitled to access to health care.

A. All people are entitled to the status they create for themselves. C. All people are entitled to happiness if they put forth enough effort. D. All people are entitled to the income they work for. Market justice has been the dominant model in the United States and purports that people are entitled to valued ends (i.e., status, income, and happiness) according to their own individual efforts. Moreover, this model stresses individual responsibility, minimal collective action, and freedom from collective obligations other than respect for another person's fundamental rights. In contrast, under a social justice model, all people are equally entitled to key ends (i.e., access to health care and minimum standards of income). REF: Page 439

When assisting specific aggregates, which of the following should be included in the community health nurse's outcomes? A. Helping people learn from their own experiences and analyzing the world with the intention to change it B. Honesty, fairness, and mutuality in the interactions C. Intervening in mutual exchanges with community members and citing the current literature D. Asking critical questions of the aggregates involved

A. Helping people learn from their own experiences and analyzing the world with the intention to change it Nursing's role in the community is to create a context from which people can learn and identify health-damaging problems from within their environment. It is essential that the affected people participate in the process of identifying and working to solve environmental problems. The other options do not allow the people to participate in the process that affects their ability to learn and thus make change. REF: Page 265

Which of the following statements about homicide in the United States is false? A. Most homicides are caused by stabbings. B. Homicide is the third leading cause of death for 1- to 4-year-old children. C. Blacks are more likely to be the victims of homicide than whites. D. Over 50% of homicide victims are killed by someone they knew.

A. Most homicides are caused by stabbings. Most homicides are caused by firearms. The other statements are true. REF: Page 547

Which of the following occupational health nursing interventions is an appropriate tertiary level strategy? A. Negotiation of workplace accommodation for a worker with a disability B. Work with an employer to build an onsite fitness center C. Providing health-screening programs to detect conditions that could aggravate the disability of worker D. Get automated external defibrillators AEDs for the workplace and train workers on how to use them

A. Negotiation of workplace accommodation for a worker with a disability On a tertiary level, the occupational health nurse plays a key role in the rehabilitation of a worker to the optimal level of functioning and includes such strategies as negotiation of workplace accommodation and counseling and support for workers who will continue to be affected by chronic disease. The other options are primary level strategies. REF: Page 610

By the middle of the 21st century, the world population is expected to do which of the following? A. Reach 10 to 12 billion B. Reach 8 billion C. Be largely unchanged from the 20th century D. Show a slight decline

A. Reach 10 to 12 billion The world's population soared to 4 billion between 1960 and 1974 and then to 5 billion between 1974 and 1987. In 1999, the world population was 6 billion; in 2005, it was nearly 7 billion. The population is projected to reach 8 billion by 2025 and 10 to 12 billion by midcentury. REF: Page 273

An essential strategy to deal with the complexities of the workplace and workforce is for the occupational health nurse to do which of the following? A. Recognize the need to work as a part of an interdisciplinary team. B. Seek legal counsel to stay informed of the legislative mandates influencing the workforce. C. Engage in political action in order to have input into the revision of the Healthy People 2020 document. D. Participate in program planning to develop a model to ensure advanced education for all workers.

A. Recognize the need to work as a part of an interdisciplinary team. As workplaces have continued to change over the past few decades, the role of the occupational health nurse had become even more diversified and complex. It is essential that the occupational health nurse functions as a part of an interdisciplinary team collaborating with workers, employers, and other professionals to identify health needs, prioritize interventions, develop and implement programs, and evaluate services delivered. REF: Page 615

Tony, age 16 years, comes to see you, the school nurse, with complaints of abdominal pain. You note that Tony exhibits signs and symptoms of depression, states he wishes he did not wake up today, and exhibits signs of anxiety. You would do which of the following? A. Refer him immediately for evaluation. B. See him back in your office next week. C. Refer him next month for evaluation. D. Do nothing; this is normal in a 16-year-old boy.

A. Refer him immediately for evaluation. It should be noted that suicide is the third leading cause of death among persons 15 to 25 years of age and that the rate of suicide among young men is five times that among young women. Thus, it is important that all community health nurses become familiar with assessing for suicide warning signs and accessing appropriate resources. Whenever individuals exhibit suicide warning signs, nurses should refer the person to a mental health clinic or provider as soon as possible

Mr. T has been admitted to the mental health floor for evaluation. You, the nurse, note that he has displayed hallucinations, disorganized thinking and speech, and bizarre behavior. He has a flat affect, lack of energy, and poor attention. You know that these are symptoms of what disorder? A. Schizophrenia B. Depression C. Anxiety D. Panic disorder

A. Schizophrenia Diagnostic criteria for schizophrenia are two or more of the following (each present for a significant portion of a 1-month period): delusions, hallucinations, disorganized speech (e.g., frequent derailment or incoherence), grossly disorganized or catatonic behavior, or negative symptoms (e.g., affective flattening, alogia, avolition).

A priority health education topic for school-age children is which of the following? A. Schoolyard safety B. Motor vehicle safety C. Sports safety D. Immunization schedules

A. Schoolyard safety Schoolyard injury accounts for 200,000 injuries yearly and is one of the greatest health concerns for elementary children. Motor vehicle safety should be included in programs for adolescents who are beginning to drive. Sports safety is particularly important among adolescents as participation in sports continues to grow, especially among girls. Immunization schedules are an important topic of education for parents of younger children and babies. REF: Page 587

Which model supports upstream thinking with the purpose to improve homelessness through reduction of structural conditions contributing to homelessness? A. Social justice B. Market justice C. Physical justice D. Mental justice

A. Social justice The social justice model seeks to reduce the structural conditions contributing to homelessness through collective action, thus supporting upstream thinking. REF: Pages 439-440

Of the below, which one of the following is false. (Diamond article on schizophrenia) A. Studies show that positive symptoms are most associated with schizophrenia-related to disability. B. People with schizophrenia are more likely to develop heart disease. C. The four main symptom clusters for schizophrenia are: positive symptoms, negative symptoms, cognitive disfunction, and mood disturbance. D. Differences in training can be a barrier to care coordination between medical and mental health providers.

A. Studies show that positive symptoms are most associated with schizophrenia-related to disability.

Which of the following statements about adolescent substance abuse is FALSE? A. Teen use of cigarettes and smokeless tobacco is increasing. B. Alcohol use among youth declined between 2010 and 2011. C. Most of the movement in teen substance abuse has been in the downward direction. D. Marijuana use among teens is increasing

A. Teen use of cigarettes and smokeless tobacco is increasing. Teen use of cigarettes and smokeless tobacco has declined. The rate of current alcohol use among youths age 12 to 17 was 13.6% in 2010, which was lower than the 2009 rate (14.7%). In fact, although most drug and alcohol use continues to decline or hold steady, marijuana is almost the only licit or illicit drug showing significant 5-year increases. REF: Page 524

Which of the following individuals should be evaluated for intimate partner violence (IPV)? (Select all that apply.) A. The 24-year-old white woman with low self-esteem B. The 33 year-old black divorced single mother C. The 18-year-old Hispanic gay man with multiple sexual partners D. The 50-year-old Asian man who is addicted to methamphetamine E. The 48-year-old black woman who was recently hospitalized for depression

A. The 24-year-old white woman with low self-esteem C. The 18-year-old Hispanic gay man with multiple sexual partners D. The 50-year-old Asian man who is addicted to methamphetamine E. The 48-year-old black woman who was recently hospitalized for depression IPV crosses all ethnic, racial, socioeconomic, and educational lines. Risk factors for victims of IPV include low self-esteem, poverty, risky sexual behavior, eating disorders or depression, substance abuse, and trust and relationship issues. REF: Page 547

Which of the following assessment findings by the community health nurse would suggest that an elderly client may be the survivor of physical abuse by a caregiver? (Select all that apply.) A. The client has a laceration on her forehead that was sutured. B. The client has a flat affect. C. The client has bruises on her forearms in various stages of healing. D. The client withdraws from soft touch. E. The client is not sexually active but has a diagnosis of Chlamydia.

A. The client has a laceration on her forehead that was sutured. C. The client has bruises on her forearms in various stages of healing. E. The client is not sexually active but has a diagnosis of Chlamydia. Signs of physical abuse include bruises, lacerations, fractures, dislocations, untreated injuries in various stages of healing, and STDs in sexually inactive clients. The other options are not indications of physical abuse. REF: Page 553

Which of these statements is true regarding income insufficiency in the United States? A. The poverty rate increased between 2007 and 2010. B. People who make minimum wage would not be categorized as impoverished. C. Alcoholism is the major reason for lack of employment. D. The median household income in 2011 was around $40,000.

A. The poverty rate increased between 2007 and 2010. The poverty rate increased from 2007 to 2010. The median income in 2011 was greater than $50,000. The economy and related issues are the most common reasons for unemployment. Working at minimum wage places a person below the poverty line. REF: Page 435

When building a collective strategy by framing an environmental problem, the community health nurse should ask which of the following questions? A. Who is affected by the problem? B. What individual should I talk to? C. What nursing diagnosis is involved? D. What is my role?

A. Who is affected by the problem? Dialogue from critical thinking should facilitate community involvement and is not focused on a single individual. Asking about role or diagnosis does not facilitate community involvement. REF: Page 264

A community health nurse would include which of the following in her assessment of environmental health? (Select all that apply.) A. Work-related exposures B. Atmospheric quality C. Families D. Job availability E. Radiation risks

A. Work-related exposures B. Atmospheric quality E. Radiation risks Environmental health is a vast field of subcategories, including living patterns, work risks, atmospheric quality, water quality, housing, food quality, waste control, and radiation risks. Families and job availability are not environmentally related. REF: Page 252

The concept of "health for all by the year 2000" was initially introduced by which of the following international organizations? A. World Health Organization (WHO) B. Centers for Disease Control (CDC) C. United Nations International Children Emergency Fund (UNICEF) D. National Institutes of Health (NIH) Healthy People 2000

A. World Health Organization (WHO) The WHO introduced the goal of "health for all." The CDC strives to prevent and control infectious and chronic diseases, injuries, workplace hazards, disabilities, and environmental health threats. UNICEF focuses on child and women's health. REF: Page 275

The U.S. Department of Education defines a homeless child as: A. a child abandoned in a hospital. B. a child in foster care. C. a child in a group home. D. a child living with a grandparent.

A. a child abandoned in a hospital. The definition of a homeless child according to the U.S. Department of Education includes children and youth who are: - Sharing the housing of other persons because of loss of or inadequate housing - Abandoned in hospitals - Awaiting foster care placement REF: Page 432

All of the following are challenges currently facing occupational health nursing practice except: A. a younger workforce. B. escalating health care cost. C. increased number of women and minorities in the workforce. D. influence of a competitive international marketplace.

A. a younger workforce. Escalating health care cost, increased women and minorities in the workforce, and a competitive international marketplace all contribute to the challenges of occupational health nursing practice. In addition, an aging workforce also presents a challenge. REF: Page 617

On discharge after treatment for alcoholism, a client plans to take disulfiram (Antabuse) as prescribed. When teaching the client about this drug, the nurse emphasizes the need to: A. avoid all products containing alcohol. B. adhere to concomitant vitamin B therapy. C. return for monthly blood drug level monitoring. D. limit alcohol consumption to a moderate level.

A. avoid all products containing alcohol. Disulfiram, when combined with any alcohol, produces the classic disulfiram-ethanol reaction of flushing, tachycardia, nausea, headache, chest tightness, and chest pain. Adhering to concomitant vitamin B therapy and returning for monthly blood drug level monitoring are not necessary when taking Antabuse. REF: Page 532

Personality traits associated with an increased risk of alcohol abuse include: (Select all that apply.) A. impulsive. B. shy. C. withdrawn. D. disinhibited. E. aggressive.

A. impulsive. D. disinhibited. E. aggressive. Two broad personality dimensions are also associated with an increased risk for alcohol abuse. Impulsivity and ease of disinhibition add to the risks for substance abuse. Being prone to anxiety and depression is also a risk, and these comorbidities are not well understood. The other options are not associated with a risk for alcohol abuse. REF: Page 519

A goal set by Healthy People 2020 includes education to middle, junior, and senior high school students in priority areas. These areas include: (Select all that apply.) A. lack of physical activity. B. poor nutrition. C. alcohol and drug use. D. poor organizational skills. E. injury and violence.

A. lack of physical activity. B. poor nutrition. C. alcohol and drug use. E. injury and violence. An objective of Healthy People 2020 sets a goal that middle, junior, and senior high schools provide health education courses in priority areas. Centers for Disease Control and Prevention (CDC) (2012a) identified six high-risk behaviors that need to be targeted in health education courses. The six behaviors identified by the CDC include: (1) alcohol and drug use, (2) injury and violence (including suicide), (3) tobacco use, (4) poor nutrition, (5) lack of physical activity, and (6) sexual behavior that results in sexually transmitted diseases or unwanted pregnancies. REF: Page 586

All of the following factors contribute to the infection spread rate in a correctional setting: (Select all that apply.) A. overcrowding. B. poor ventilation. C. rapid movement of inmates in and out of jail. D. the number of minorities in the setting. E. an increase in undocumented immigrants in the correctional system.

A. overcrowding. B. poor ventilation. C. rapid movement of inmates in and out of jail. Overcrowding, poor ventilation, and rapid movement of inmates in and out of jail contribute to the rates of an infection spreading. The number of minorities or undocumented immigrants in a correctional setting has not been reported as a factor in infection spread rates. REF: Page 626

There was an increase in the number and voice of occupational health nurses during the years of 1938 to 1943. All of the following occurrences explain the rationale for this change except: A. the U.S. Department of Health and Human Services mandated occupational health nurses be hired for industrial settings that employed more than 350 people. B. a national association for the specialty of occupational health nursing was created. C. more women entered the workforce, changing the demographics of the workplace. D. the government demanded health services for defense contract workers.

A. the U.S. Department of Health and Human Services mandated occupational health nurses be hired for industrial settings that employed more than 350 people. The focus of health care for employees changed as a result of the two world wars, which changed the demographics of the workforce and increased the need for health services for employees, and the birth of the first national association for this specialty. The federal government never required companies to employ occupational health nurses. REF: Page 603

As a school nurse, you know the leading reason cited as the cause of school violence is: A. use of violence to handle disputes. B. an unhappy home life. C. overly protective parental situations. D. poor communication with authority figures.

A. use of violence to handle disputes. Adolescents and children increasingly use violence to settle disputes. Children are often not taught peaceful ways of resolving differences and learn by what they observe at home, on television, and in movies. Consequently, schools have become a common site for violence. The reasons for violence are complicated and multilayered, but the most common reason cited is use of violence to handle disputes. REF: Page 553

Nurses, including public health nurses, are at increased risk for workplace violence. Risk factors for violence in the workplace include all of the following except: A. working in pairs. B. access to medications. C. increased number of mentally ill patients. D. inadequate security.

A. working in pairs. Risk factors for violence in the workplace include increasing number of acute and chronically mentally ill patients, working alone, availability of drugs at worksite, low staffing levels, poorly lit parking areas and corridors, long waits for service, inadequate security, increasing number of substance abusers, and access to firearms. REF: Page 553

A public health nurse is surveying a population of coal miners. Which of the following questions would elicit information about related risk to a miner's children? A. "Do you wear a respirator?" B. "How close do you live to your workplace?" C. "How many accidents has the mine had this year?" D. "Do you have a good rapport with your boss?"

B. "How close do you live to your workplace?" Environmental health effects can be immediate, long term, or intergenerational. Although often overlooked, a parent's occupation may put his or her children in danger. Living close to a coal mine could increase the children's risk for exposure to water or ground contamination from the mine, among other environmental hazards. The other options do not assess the proximity of the environmental hazard. REF: Pages 261-262

Which of the following clients is at highest risk for elder abuse? A. A 75-year-old nursing home client who is alert and has osteoporosis B. A 70-year-old client being with dementia cared for at home C. A 65-year-old client who has just had a hip replacement D. A 72-year-old client on a rehabilitation unit with bilateral above-the-knee amputations

B. A 70-year-old client being with dementia cared for at home The most likely victims of elder abuse are individuals 70 years of age and older who are in poor physical or mental health and dependent on others for physical or financial support; these clients are often confused and depressed. REF: Page 552

A 16-year-old young woman arrives at the local emergency department (ED) early Sunday morning and states, "I was on a date last night, and the last thing I remember was eating dinner with my boyfriend." She comments that she woke up in her bed with her clothes "messed up" and states, "I just don't feel right down there" as she points to her genital area. She appears medically stable. Which of the following health care providers would be most appropriate to conduct the physical examination? A. An experienced obstetrical nurse because the patient could be pregnant B. A SANE (sexual assault nurse examiner) C. The physician on call in the ED department D. An emergency nurse

B. A SANE (sexual assault nurse examiner) Although all of the health care providers listed are able to complete a physical examination on this patient, the SANE would be most appropriate because of the clues that a date rape may have occurred. The SANE is trained specifically to collect evidence in such a case, which is why the emergency nurse would not be most appropriate. The stem includes a statement that the patient is medically stable; therefore, the SANE should be chosen over the physician. REF: Page 620

Which of the following environmental stressors directly assaults human health? A. Global warming B. Air pollution C. Noise D. Litter

B. Air pollution Air pollution and poisoning directly assault human health. Noise and litter affect quality of life. Global warming affects the ecologic balance. REF: Page 273

Important historical events leading to the development of occupational health nursing as a specialty practice include which of the following? (Select all that apply.) A. Lillian Wald, the first public health nurse, established the Visiting Nurse Service of New York. B. Betty Moulder was employed by a group of companies to care for coal miners and their families. C. Ada Mayo Stewart was hired by the Vermont Marble Company to care for the company's workers. D. A nursing service was established for employees of the Frederick Loeser department store in Brooklyn, New York. E. Anna B. Duncan was employed by the John Wanamaker Company to visit sick employees at home.

B. Betty Moulder was employed by a group of companies to care for coal miners and their families. C. Ada Mayo Stewart was hired by the Vermont Marble Company to care for the company's workers. D. A nursing service was established for employees of the Frederick Loeser department store in Brooklyn, New York. E. Anna B. Duncan was employed by the John Wanamaker Company to visit sick employees at home. Occupational health nursing dates to the late 1800s with the employment of Betty Moulder by a coal mining company and Ada Mayo Stewart by a marble company. After that, the Fredrick Loeser department store hired a nursing service for employees and Anna B. Duncan was employed by the John Wanamaker Company to visit sick employees at home. Lillian Wald was instrumental in the development of public health nursing. REF: Page 602

Mr. S was recently hospitalized for a stroke. While in the hospital, he was also diagnosed with diabetes. As his nurse, you know he is at risk for which of the following? A. Panic disorder B. Depression C. Schizophrenia D. Bipolar disorder

B. Depression Depression is often a complication of serious physical disorders such as heart attack, stroke, diabetes, and cancer. The other options are usually not complications of other physical disorders.

Which one of the following assumptions underlies the Declaration of the Alma-Ata? A. Public health agencies are responsible to plan and take action to improve health. B. Health is a fundamental human right. C. Gross inequalities and disparities will always exist. D. Communities should be encouraged to cooperate with national health goals.

B. Health is a fundamental human right.

An emergency department nurse assesses a 25-year-old patient with tachycardia, headache, and nausea. The patient denies drug use, heart problems, and smoking. She works from her house and states that everyone in her house has had the "flu" but that she is the only one who has not been feeling better. The nurse notices that the patient lives in the historic section of the town. What environmental hazard should the nurse be primarily concerned about? A. Food quality B. Housing quality C. Water quality D. Occupational risks

B. Housing quality Older homes and buildings often have poor ventilation and harbor hazardous materials. The signs and symptoms this patient is experiencing may be a result of "sick building syndrome." Gastrointestinal symptoms might indicate an issue with food or water quality. Occupational risks do not take into consideration the environmental hazard related to housing. REF: Page 258

Which one of the following statements best describes what tobacco companies have done to counter their losses resulting from U.S. efforts to decrease smoking tobacco? A. Rapidly decreased their tobacco components and focused on other products B. Increased international exports and targeted children C. Begun advertising in more subtle ways such as sponsoring sports programs or building and naming large sport arenas. D. Bought off more restrictions on tobacco through the tobacco settlement funds, which gave a large amount of money to each state

B. Increased international exports and targeted children

The top factors that contribute to homelessness include all of the following except: A. Shortage of affordable housing B. Lack of motivation on the part of the individual C. Insufficient income to meet basic needs D. Inadequate and scarce support services

B. Lack of motivation on the part of the individual

Mr. B has been diagnosed with a severe mental illness. The nurse may expect Mr. B to exhibit which of the following? (Select all that apply.) A. Independence B. Low self-esteem C. Difficulty forming relationships D. Positive self-image

B. Low self-esteem C. Difficulty forming relationships Mentally healthy individuals are independent, have positive self-image, are self-actualized and autonomous, and are able to form meaningful interpersonal relationships. Mental illness, in contrast, refers to maladaptive responses to distress and an inability to mobilize resources. The mentally ill person is often dependent, has low self-esteem, and has difficulty forming interpersonal relationships.

Which of the following activities implemented by an occupational health nurse would be considered primary prevention? A. Annual blood pressure, cholesterol, and diabetes screenings B. Negotiation with an employer for an onsite fitness program for all employees C. Scheduling a mobile mammography van to see employees older than age 40 and their wives D. Overseeing a weight loss competition among workers who are considered to be morbidly obese

B. Negotiation with an employer for an onsite fitness program for all employees Promoting physical activity is an example of health promotion activities at the primary prevention level. Blood pressure, diabetes, and cholesterol screenings and mammograms are all secondary prevention strategies aimed at early diagnosis and early treatment. Weight loss programs for the severely obese would be considered tertiary prevention. REF: Pages 607-608

What is the purpose of the Homeless Information Management System (HIMS)? A. Provides means to feed homeless people B. Obtains national data on homeless individuals C. Serves as a screening tool to obtain any history of criminal activity D. Provides homeless individuals with educational materials

B. Obtains national data on homeless individuals The intent of the HIMS is to obtain national data, including the number of and demographic information on the homeless population. Providing means to feed homeless people, serving as a screening tool to obtain any history of criminal activity, and providing homeless individuals with educational materials are not functions of the HIMS. REF: Page 432

Legislation passed in the early 1970s that requires employers to provide a place of employment free from recognized hazards to the employees is correctly referred to as the: A. Americans with Disabilities Act. B. Occupational Safety and Health Act. C. Workers' Compensation Act. D. Occupational Health and Safety Administration.

B. Occupational Safety and Health Act. The Occupational Safety and Health Act was enacted in 1970. The general clause of the Act states that employers must "furnish a place of employment free from recognized hazards that are causing or likely to cause death or serious physical harm to employees." The Act also identified the role of various government agencies such as the Occupational Safety and Health Administration under the jurisdiction of the Department of Labor. REF: Page 613

Joanne, a 37-year-old incarcerated woman, is reluctant to seek medical attention for a routine Pap smear. The correctional nurse knows which of the following? A. This is usual; women do not seek health services as much as men in this setting. B. Other factors may be influencing Joanne's hesitancy in seeking medical attention. C. Joanne is delaying the visit because she probably has a sexually transmitted disease or HIV. D. Because she is not sexually active, Joanne is not in need of a Pap smear at this time.

B. Other factors may be influencing Joanne's hesitancy in seeking medical attention. Other factors, such as having experienced trauma or victimization, may cause female inmates to delay or never seek medical attention regarding female services. The other statements are incorrect. REF: Page 627

Joe is released from the correctional facility to return to the community. The facility is required to do which of the following? A. Help with job placement. B. Provide his psychotropic medications until he sees his physician. C. Assist in finding housing. D. Provide health care for the first year out of prison.

B. Provide his psychotropic medications until he sees his physician. The correctional facility is only required to provide the psychotropic medications when returning to the community until they are under care of their physician. REF: Page 628

A 6-year-old child fails a routine vision screening on a Snellen chart at a school-based health center. The appropriate action by the nurse is to do which of the following? A. Rescreen the child in the following year. B. Refer the child to an eye specialist. C. Use a Rosenbaum chart instead of a Snellen chart. D. Do an internal ophthalmologic examination.

B. Refer the child to an eye specialist The role of the nurse in a school-based health center includes vision, hearing, and scoliosis screening and first-aid and medication administration, but the nurse should refer the individual to an appropriate specialist for diagnosis and treatment. REF: Page 586

Which of the following actions of the occupational health nurse is NOT mandated by state or federal regulations? A. Maintaining confidentiality of medical records B. Reporting accusations of sexual harassment to local police C. Recording and reporting occupational injuries and illnesses D. Providing personal protective equipment training

B. Reporting accusations of sexual harassment to local police Maintaining confidentiality of medical records, reporting occupational injuries and illnesses, and providing personal protective equipment training are all mandated by law. Sexual harassment allegations are routinely reported to administrative officials. REF: Page 606

A high school student is referred to the school nurse for suspected substance abuse. After the nurse's assessment and interventions, what would be the most desirable outcome? A. The student discusses conflicts over drug use. B. The student accepts a referral to a substance abuse counselor. C. The student agrees to inform his parents of the problem. D. The student reports increased comfort with making choices.

B. The student accepts a referral to a substance abuse counselor. Having a substance abuse problem does not mean that problems are always attributable to the addiction. An evaluation for other problems such as mental illness and depression should be conducted, with specialized attention involving a case management approach. Research demonstrates that treatment for substance abuse can be more effective than no treatment. The other goals may be appropriate but not the most desirable. REF: Page 541

A survey done by The National Institute on Drug Abuse (NIDA) found that the most commonly abused prescription drug among high-school seniors is: A. OxyContin. B. Vicodin. C. Xanax. D. codeine.

B. Vicodin. The NIDA Monitoring the Future survey found that about one in 12 high school seniors reported past-year nonmedical use of the prescription pain reliever Vicodin in 2010, and one in 20 reported abusing OxyContin, making these medications among the most commonly abused drugs by adolescents. The three classes of most commonly abused prescription drugs are: (1) opioids, (2) central nervous system depressants, and (3) stimulants. REF: Page 522

Ms. W, 18 years old, presents at a community clinic describing vague complaints. She explains that she recently dropped out of high school and is having trouble keeping a job. She notes that she has difficulty concentrating and has used drugs (i.e., marijuana and alcohol) when riding motorcycles with friends. When conducting the initial assessment, the RN should include questions and tools that would screen for: A. depression. B. attention-deficit disorder/attention deficit hyperactivity disorder (ADD/ADHD). C. post-traumatic stress disorder. D. obsessive-compulsive disorder.

B. attention-deficit disorder/attention deficit hyperactivity disorder (ADD/ADHD). The reported symptoms best fit ADD/ADHD, although the young woman should also be screened for depression and substance abuse, which can accompany ADD/ADHD.

A primary role of the community health nurse in facilitating community participation and partnership is: A. solving environmental health problems. B. educating about environmental health hazards. C. altering individual behaviors. D. implementing solutions to environmental racism.

B. educating about environmental health hazards. Educating the public about environmental health hazards is the first step in engaging the community problems of the environment. Environmental hazards are complex and interconnected; therefore, increasing the public's knowledge of the hazards leads not only to individual action but also public action. The other options are not the primary focus of the community health nurse. REF: Page 265

A school nurse knows that under the Family Educational Rights and Privacy Act, a student's health record can be released: A. if the student is not a minor. B. in an emergency. C. to educators not involved in the student's education. D. without the student's or guardian's permission.

B. in an emergency. School health records are confidential, and without permission, releasing them is unethical and improper unless in an emergency. REF: Page 592

The Brown family is being evicted from their home and will be moving into a homeless shelter in 3 days. Under the Department of Housing and Urban Development (HUD) definition, the Brown family is: A. literally homeless. B. in imminent risk of homelessness. C. homeless under other federal statutes. D. fleeing or attempting to flee domestic violence.

B. in imminent risk of homelessness. Imminent risk of homelessness defines those who will imminently lose their primary nighttime residence. The literally homeless have no fixed, regular, or adequate nighttime residence. Unaccompanied youth and families with children who are defined as homeless under other federal statues but do not fit into the other HUD defined categories of homeless may be defined as homeless under this HUD definition. Finally, individuals and families who are fleeing or attempting to flee domestic violence or other life-threatening conditions that relate to violence against the individual or family are defined as homeless. REF: Page 431

The life-threatening parasitic disease that causes at least one million deaths annually is: A. AIDS. B. malaria. C. tuberculosis. D. hepatitis.

B. malaria. Malaria is a life-threatening parasitic disease transmitted by mosquitoes. Malaria causes more than 300 million acute illnesses and at least 1 million deaths annually. AIDS is a disease caused by the HIV virus. Tuberculosis is an infectious disease caused by the tubercle bacillus. Hepatitis is inflammation of the liver. REF: Page 274

Occupational health nursing is best described as a specialty practice that focuses on: A. providing comprehensive health care service to workers and their families. B. promoting, preventing, and restoring health within the context of a safe and healthy environment. C. preventing adverse effects from occupational and environmental hazards at the workplace. D. planning, implementing, and evaluating safety programs for workers at the workplace.

B. promoting, preventing, and restoring health within the context of a safe and healthy environment. Occupational health nursing is a specialty practice that focuses on promoting, preventing, and restoring health within the context of a safe and healthy environment. The other options limit the scope of the practice role. REF: Page 601

The school nurse is interviewing a student who has been assaulted by another student. Both students proclaim to be gang members. The nurse understands the reasons most youth give for joining a gang include the following: (Select all that apply.) A. financial gain. B. sense of belonging. C. peer pressure. D. relative is in a gang. E. need for respect.

B. sense of belonging. C. peer pressure. E. need for respect. Reasons that young people give for joining gangs include the belief that gangs will protect them, peer pressure, the need for respect, and a sense of belonging. REF: Page 554

The community health nurse is trying to encourage a client to attend Alcoholics Anonymous meetings. When the client asks the nurse what he must do to become a member, the nurse should respond: A. "You must first stop drinking." B. "Your physician must refer you to this program." C. "Admit you are powerless over alcohol and that you need help." D. "You must bring along a friend who will support you."

C. "Admit you are powerless over alcohol and that you need help." As a nonprofessional ongoing source of assistance, Alcoholics Anonymous is viewed as an invaluable resource to the community. The first step of the 12-step program is the admission of defeat and surrender to a higher power. The other options are false. REF: Page 533

What group of homeless individuals is known for their involvement in survival sex? A. Young adult gay men B. Middle-aged women C. Adolescents D. Elderly men

C. Adolescents Runaway or homeless adolescents make up a large percentage of all youth involved in prostitution. Many become involved because they need money to meet subsistence needs, hence the term survival sex. REF: Pages 438-439

The wife of an alcoholic client is considering joining a support group to help her respond to her husband's condition in a healthy way. Where should the nurse refer this client? A. A psychiatrist for a referral to a suitable group B. Spouses Anonymous C. Al-Anon D. Alcoholics Anonymous

C. Al-Anon Substance abuse has been called a family disease because it affects the entire family system and holds potential adverse psychological and physical consequences for the family members in addition to the abuser. Al-Anon and Alateen are support groups for family members of substance abusers. A psychiatrist's referral is not necessary. Alcoholics Anonymous is focused more on the substance abuser than their families. REF: Page 533

Mr. H is a patient in the primary care center where you work as a staff nurse. He tells you that he is currently participating in a stress management program. You know that this is a form of which of the following? A. Individual therapy B. Couple therapy C. Behavioral therapy D. Family therapy

C. Behavioral therapy Behavioral therapy uses learning principles to change thought patterns and behaviors systematically; it is used to encourage the individual to learn specific skills to obtain rewards and satisfaction. Stress management, biofeedback, and relaxation training are examples of behavior therapy. Individual therapy focuses on the client's current life and relationships within the family, social, and work environments. Couple therapy is used to develop the relationship and minimize problems through understanding how individual conflicts are expressed in the couple's interactions. Family therapy involves problem-solving sessions with members of a family.

Which of the following nursing interventions is the most appropriate as an initial intervention for a prison inmate? A. Manage a chronic illness through needed education. B. Administer the routine medication ordered. C. Complete the medical history and physical assessment. D. Test for HIV and tuberculosis.

C. Complete the medical history and physical assessment. Although all of the interventions are important, the most appropriate initial intervention is to complete the history and assessment. The nursing process is followed by using assessment first, and it is also at this time when medical issues are found for the inmate. REF: Page 626

While verifying compliance with immunization requirements, a school nurse notices that three students from the same family have not completed their immunizations. How should the nurse address this problem? A. Discuss with the principal the lack of immunizations B. Expel the children from school. C. Contact the parents and educate them about the immunization requirements. D. Pull the students from class and immunize them.

C. Contact the parents and educate them about the immunization requirements. All states require proof of current immunization status or evidence of immunity unless there is an exception (religious, moral belief, or medical contraindication). It is the nurse's responsibility to assess the situation and educate the family. The nurse's responsibility is not to expel the students or immunize them herself. REF: Pages 589-590

You work in a community clinic that specializes in pediatric mental health. Joy, age 12 years, has been diagnosed with depression. You know a major risk factor for depression in childhood is which of the following? A. Family history of diabetes B. Family history of abuse C. Family history of depression D. Family history of poverty

C. Family history of depression A family history of depression is a major risk factor for childhood depression. Other associated factors that may increase the risk of depression in children and adolescents include a history of verbal, physical, or sexual abuse; frequent separation from or loss of a loved one; poverty; mental retardation; attention-deficit/hyperactivity disorder; hyperactivity; and chronic illness.

Approaching health at the aggregate level is the initiative of which agency or document? A. Occupational Safety and Health Administration (OSHA) B. Clean Air for All C. Healthy People 2020 D. Centers for Disease Control and Prevention (CDC)

C. Healthy People 2020 An attempt to approach health at the aggregate level is the Healthy People 2020 initiative. It deals with issues ranging from decreasing ozone levels to decreasing Escherichia coli outbreaks. All of these issues deal with the broader environmental origins of disease, not just deleterious personal habits. OSHA, Clean Air for All, and the CDC have a more narrow focus. REF: Page 264

Population overcrowding can result in which of the following? A. Increased productivity B. Improved education C. Increased incidence of disease D. Decreased mortality

C. Increased incidence of disease Overcrowding leads to pollution, stress, disease, and violence. Mortality rates are increased, and quality of life decreases. REF: Page 273

Which of the following interventions would be the most appropriate to implement for a community that has a high risk for environmental health hazards? A. Facilitate the evaluation of ongoing community health interventions. B. Document participation levels of families in environmental issues. C. Involve citizens in decision-making processes about proposed activities that could pose an environmental threat. D. Screen at-risk populations for asthma and test blood levels for air pollutants.

C. Involve citizens in decision-making processes about proposed activities that could pose an environmental threat. Community health nurses have a mandate to assist vulnerable aggregates who have fewer options in protecting themselves from pollution, inadequate housing, toxic poisoning, unsafe products, and other hazards. An appropriate nursing intervention would be to involve citizens in decision-making processes about proposed activities that could pose an environmental threat. Evaluating ongoing health interventions, documenting participation levels of families, and screening at-risk populations are important evaluation methods for determining the needs of the community but are not the most appropriate intervention. REF: Pages 264, 267

The community health nurse is visiting the home of a known substance abuser. The client is talking excessively and is excited and aggressive. The nurse notes that the patient's heart rate is 158 beats/min. The nurse recognizes the client is most likely high on which substance? A. PCP B. Alcohol C. Methamphetamine D. Inhalants

C. Methamphetamine Short-term effects of methamphetamine are increased heart rate, insomnia, excessive talking, excitation, and aggressive behavior. PCP is known for its violent dissociative and anesthetic effect. Alcohol intoxication causes euphoria, disinhibition, and sedation. Inhalants cause euphoria. REF: Page 524

Mental illnesses adversely affect achievement of social justice. Which of the following statements related to marginalization of some populations because of mental illness is FALSE? A. About half of all inmates in jails and prisons have mental health problems B. Mental illnesses can lead to employment difficulties, which adversely affects access to health insurance, thereby limiting treatment options C. Most mental illnesses are cause by genetic factors; therefore, problems associated with them persist across generations and among certain racial and ethnic groups D. Both natural and human-made disasters can adversely affect mental health; those with limited resources appear to be more directly impacted, and the effects persist longer

C. Most mental illnesses are cause by genetic factors; therefore, problems associated with them persist across generations and among certain racial and ethnic groups Although genetic factors most likely contribute to some mental illnesses and in some individuals there is little information linking a specific gene to a specific disorder. Rather, the major psychiatric disorders are complex, and mental illnesses appear to result from a very complex interaction among neurochemical and metabolic changes and environmental and situational factors. The other statements are all true.

How would a community health nurse use Executive Order 12898? A. Recognize that its focus is to decrease urban sprawl. B. Use its definition of sick building syndrome in completing an environmental assessment. C. Recognize that it would help achieve environmental justice. D. Cite it as a law to decrease carbon dioxide emissions for industries regulated by the Environmental Protection Agency.

C. Recognize that it would help achieve environmental justice. Executive Order 12898 (signed by President Clinton in 1994) required all federal agencies to develop comprehensive strategies to achieve environmental justice. The focus of Executive Order 12898 is not to decrease urban sprawl. Sick building syndrome describes a phenomenon in which public structures and homes cause occupants to experience a variety of symptoms, such as headache, fatigue, and exacerbation of allergies. Executive Order 12898 is not citable as law to decrease carbon dioxide emissions. REF: Page 254

Which of the following is true of adolescents who have been convicted and incarcerated in adult facilities rather than in a juvenile facility? A. They are less likely to be sexually assaulted. B. They are usually not attacked by other inmates. C. They are more likely to commit suicide. D. They are less likely to be diagnosed with a mental illness.

C. They are more likely to commit suicide. Adolescents in an adult correctional facility are more likely to be sexually assaulted, attacked by other inmates, or to threaten suicide than adolescents in a juvenile facility. REF: Page 627

The global health organization that works for children's survival, development, and protection is the A. World Health Organization (WHO). B. Centers for Disease Control (CDC). C. United Nations International Children Emergency Fund (UNICEF). D. Pan American Health Organization (PAHO).

C. United Nations International Children Emergency Fund (UNICEF). UNICEF works for children's survival, development, and protection by developing and implementing community-based programs. UNICEF achievements are well documented in child health, nutrition, education, water, sanitation, and progress for women. PAHO is an international public health agency that works to improve the health and living standards of the Americas. The WHO introduced the goal of "health for all." The CDC strives to prevent and control infectious and chronic diseases, injuries, workplace hazards, disabilities, and environmental health threats. REF: Page 277

A week before finals, a school nurse assesses a 15-year-old girl complaining of vague symptoms. All of the following symptoms or behaviors should result in an immediate request for parent or guardian conference and referral to a physician for further evaluation except: A. problems eating or sleeping. B. problems making decisions. C. frequent requests for a visit to the school nurse. Correct D. inability to concentrate.

C. frequent requests for a visit to the school nurse. Problems eating or sleeping, use of alcohol or other substances, problems making decisions, persistent angry or hostile feelings, inability to concentrate, increased boredom, frequent headaches or ailments, and inconsistent school attendance are all warning signs of stress. The nurse should be aware that these symptoms can negatively affect an adolescent's mental and physical health, and the student should be screened for depression and suicide. REF: Page 594

A comprehensive school health program should include all of the following except: A. health promotion for staff and health education. B. health services and health education. C. physical examinations and comprehensive health history. D. nutrition services and counseling.

C. physical examinations and comprehensive health history. The eight components of a comprehensive school health program are health education, physical education, health services, nutrition services, counseling, psychological and social services, healthy school environment, health promotion for staff and family, and community involvement. Physical examinations and comprehensive health history are not included. REF: Page 586

It is vital that the forensic psychiatric nurse be knowledgeable about mental illnesses and personality disorders because: A. the nurse will be diagnosing many of the illnesses. B. the nurse will work in psychiatric facilities. C. the nurse may be an expert witness in court. D. the nurse will be identifying new cases

C. the nurse may be an expert witness in court. The nurse will not be diagnosing or identifying illnesses; that is a physician's role. Although the nurse may be working in a psychiatric facility, the best reason for being knowledgeable about these illnesses is because the forensic psychiatric nurse may be called to be an expert witness in court. REF: Page 625

After the implementation of various policies to reduce tobacco use, the tobacco industry has begun targeting: (Select all that apply.) A. elderly people. B. Hispanics. C. youths and young adults. D. African Americans. E. international markets.

C. youths and young adults. E. international markets. The tobacco industry has now started targeting youths and dramatically increased international exports. Tobacco sales among American adults is down. REF: Page 274

Forensic nursing is best defined as which of the following? A. A field of legal nursing in which the nurse works with or for lawyers B. A field of correctional nursing in which the nurse works with inmates C. Investigational nursing in which the nurse works with law enforcement D. A link among the health care system, the investigative process, and courts of law

D. A link among the health care system, the investigative process, and courts of law Although the other options are somewhat correct, the correct choice includes all three areas in which forensic nursing is involved: (1) health care, (2) investigation, and (3) the court system. REF: Pages 619-620

Which of the following occupational health nursing interventions would be appropriate secondary prevention strategies? A. Arrange for the collection of baseline liver function tests if the employee will be working with a chemical known to cause liver toxicity. B. Provide vision, blood pressure, hearing, and cancer screenings on an annual basis. C. Coordinate periodic evaluations to ensure workers are placed in the safest worksite setting. D. All of the above

D. All of the above Secondary prevention strategies are aimed at early diagnosis, early treatment interventions, and attempts to prevent disability. All three choices focus on identification of health needs, health problems, and employees at risk. REF: Page 609

Based on the Department of Housing and Urban Development (HUD) definitions of homelessness, which one of the following individuals would be considered homeless? A. An individual whose residence lacks access to public water and electricity B. An individual who has a permanent nighttime residence in the housing for mentally ill people C. An individual imprisoned or detained under an act of Congress or state law D. An individual who spends most nights at public or private places not designed for regular sleeping accommodations

D. An individual who spends most nights at public or private places not designed for regular sleeping accommodations HUD defines homelessness in four categories: (1) literally homeless, (2) imminent risk of homelessness, (3) homeless under other federal statutes, and (4) fleeing/attempting to flee domestic violence. An individual who spends most nights at public or private places not designed for regular sleeping accommodations is considered literally homeless. Literally homeless is defined as individuals and families who lack a fixed, regular, and adequate nighttime residence and includes a subset for an individual who resided in an emergency shelter or a place not meant for human habitation and who is exiting an institution where he or she temporarily resided. An individual whose residence lacks access to public water and electricity, an individual who has a permanent nighttime residence in the housing for mentally ill people, and an individual imprisoned or detained under an act of Congress or state law are not considered homeless under the HUD definition. REF: Page 431

What official national organization provides financial housing assistance to low-income families? A. World Health Organization (WHO) B. Federation of National Organizations Working with the Homeless (FEANTSA) C. Robert Wood Johnson Foundation D. Department of Housing and Urban Development (HUD)

D. Department of Housing and Urban Development (HUD) HUD, in cooperation with state and local governments and nonprofit housing organizations, operates programs that provide financial housing assistance to low-income families. The WHO is an organization that is concerned with international public health. FEANTSA is a European organization that works to prevent and alleviate poverty and homelessness in Europe. The Robert Wood Johnson Foundation provides funding for nursing education. REF: Page 431

As a visiting community health nurse, you must take precautions to avoid unsafe situations. To avoid putting yourself in danger, you would do which of the following? A. If you enter a house where a violent act is occurring, call 911 and wait inside for the police to arrive. B. Expect the client to control angry family members. C. Repeat the reason for your visit and stay and continue your task. D. Do not enter a home if you hear sounds of fighting.

D. Do not enter a home if you hear sounds of fighting. When approaching a home, as a community health nurse, you should notice the environment, animals, fences, activities, possible indicators of crime, and places you could go for assistance if necessary. Walk with confidence and maintain a professional attitude. Listen for signs of fighting before knocking. If you hear sounds of fighting, leave. Do not enter a home if you suspect an unsafe situation. REF: Page 556

A 10-year-old boy visits the nurse complaining of a headache and nausea. The nurse recognizes the boy from an earlier conference with a teacher about the boy's declining school performance. The nurse has been concerned because the boy's father and mother are recently divorced, and his mother works nights. An appropriate nursing intervention would be to investigate the boy's eligibility for which of the following? A. The Nutritional Education and Training Program (NET) B. Youth Risk Behavior Surveillance System C. Adult and Child Protective Services D. Federally funded breakfast and lunch program

D. Federally funded breakfast and lunch program The school nurse has several federal resources available to assist children in need. The nurse must be able to recognize children and families that may be eligible for assistance. Options A, B, and C are not appropriate referrals for a child in the specified situation. NET focuses on healthy nutritional choices and health promotion and disease prevention topics in school and child care settings. The Youth Risk Behavior Surveillance System identifies and trends youth risk behavior. Adult and Child Protective Services assesses and protects children from abuse. REF: Page 593

The first nurse to establish international links and networks was: A. Clara Barton. B. Mary Breckenridge. C. Dorothea Dix. D. Florence Nightingale.

D. Florence Nightingale. Florence Nightingale's legacy serves as the foundation for community health nursing in the global health care arena. She channeled her energy into all aspects of health from the care of wounded soldiers at Scutari to the broad public policies that affected health in her time. The other three women were instrumental primarily for their contributions in the United States. REF: Page 279

Which ONE of the following was NOT mentioned as a health problem that is experienced by people with schizophrenia. (Diamond article on Schizophrenia) A. Smoking and substance abuse B. Type II diabetes C. Obesity D. Influenza E. Heart disease

D. Influenza

Which of the following actions is inappropriate for a correctional nurse when testifying in court? A. Looking the jurors in the eye when answering questions B. Asking the attorney to repeat a question when not understood C. Practicing saying difficult medical terms before the court date D. Interrupting when necessary to verbalize correct medical information

D. Interrupting when necessary to verbalize correct medical information The correctional nurse should never interrupt when testifying in court. The other actions are appropriate. REF: Page 623

You are working in a mental health facility as a nurse. You are involved with patients who have varied diagnoses. One of your patient's family members asks what biological problem causes all of these people to have mental illness. You respond that most experts believe which of the following? A. Brain structure is the problem. B. Neurotransmitters are the problem. C. Genetics are the problem. D. Many factors cause the problem.

D. Many factors cause the problem. Information from studies to date is insufficient to establish a definitive biological cause for mental illness. Scholars have concluded that mental disorders are multifactorial, complex physiological phenomena.

Chronic stress characterizes the lives of people living with domestic violence. As the community health nurse, you recognize which of the following as a long-term effect of violence? A. Spontaneous disclosure of abuse to health care provider B. Not complaining of physical symptoms C. Having disturbed eating patterns, but sleeping well D. Suffering chronic fatigue and tension

D. Suffering chronic fatigue and tension When subject to repeated abuse, the victim experiences a variety of responses, including shock, denial, confusion, withdrawal, psychological numbing, and fear. He or she lives in anticipatory terror and experiences chronic fatigue and tension, disturbed sleeping and eating patterns, and vague gastrointestinal and genitourinary complaints. The other options are not symptoms of chronic violence. REF: Page 549

A 71-year-old man is brought to the emergency department by his daughter and states that he has fallen and appears to have a broken arm. He is alert and oriented and walks alone without difficulty. Which nursing intervention is most appropriate after he is seen and treated by the physician? A. Talk with the daughter about nursing home placement for the patient. B. Discuss the dietary needs and regimen with patient and family. C. Review the patient's current medications. D. Talk with the patient alone and question the possibility of elder abuse.

D. Talk with the patient alone and question the possibility of elder abuse. Elder abuse is underdiagnosed and underreported. The nurse must assess the possibility of elder abuse occurring. The other interventions are not indicated based on the information provided. REF: Page 624

When a client regularly takes a drug that is a central nervous system (CNS) stimulant, such as cocaine, what symptoms would the nurse expect to see when the client abstains from this substance? A. The client will have symptoms of CNS stimulation. B. The client will experience anxiety, insomnia, and tremors. C. Common symptoms include hallucinations and seizures. D. The client will feel depressed, somnolent, and lethargic.

D. The client will feel depressed, somnolent, and lethargic Symptoms of withdrawal from CNS stimulants are depression, apathy, lethargy, and sleepiness. The client may experience signs of CNS stimulation while high on the CNS stimulant. The client withdrawing from opioids may experience anxiety and tremors. The client withdrawing from alcohol may experience hallucinations and seizures. REF: Page 526

Which of the following best explains why many people decide to move to large urban areas? A. To join family who are already there B. To be with friends C. To be eligible for social aid D. To seek employment

D. To seek employment

According to the vulnerability index, the individual at highest risk for death is: A. a 46-year-old person who has been homeless for 2 months and has HIV. B. a 22-year-old person who lives in a homeless shelter and is addicted to heroin. C. a 65-year-old person who is being evicted from his home after living there for 25 years. D. a 60-year-old person who has been homeless for 9 months.

D. a 60-year-old person who has been homeless for 9 months. Those at high risk for death are individuals who have been homeless for 6 months or more with one or more of the following conditions: - More than three hospitalizations or emergency department (ED) visits in 1 year - More than 3 ED visits in the previous 3 months - 60 years or older - Cirrhosis of the liver - End-stage renal disease - History of frostbite, immersion foot, or hypothermia - HIV/AIDS - Co-occurring psychiatric, substance abuse, and chronic medical conditions REF: Page 439

Using critical theory when exploring issues of environmental health ultimately allows the nurse to: A. develop a community diagnosis. B. raise additional questions related to environmental health and safety. C. design community health interventions. D. alter the precursors of poor health.

D. alter the precursors of poor health. Critical theory is used to help community health nurses think about social, cultural, economic and political factors of health, thereby assisting them to attack the problem at its source and alter community-wide precursors of poor health. The community health nurse can develop a community nursing diagnosis and design interventions by using the nursing process. REF: Page 250

Healthy People 2020 addresses all of the following goals for children and adolescents except: A. physical activity. B. sex education and HIV prevention. C. smoking prevention. D. cardiovascular accidents, stroke, and diabetes.

D. cardiovascular accidents, stroke, and diabetes. Healthy People 2020 does not address cardiovascular accidents, stroke, or diabetes in its objectives for children and adolescents. The other options are addressed. REF: Page 586

Through improved sanitation, developed countries have significantly reduced high mortality rates from: A. respiratory diseases. B. cardiovascular diseases. C. cancer. D. infectious diseases.

D. infectious diseases. Improved sanitation has led to reduced mortality rates from infectious diseases. Respiratory disease, cancer, and cardiovascular diseases are the primary causes of death in developed countries. REF: Page 274

People who live in developing countries are at risk for a variety of health threats as a result of all of the following factors except: A. limited sanitation facilities. B. increased chance of exposure to communicable diseases, including AIDS, tuberculosis, and hepatitis B. C. higher rates of tobacco use compared with most developed countries. D. lack of interest in health issues and health care.

D. lack of interest in health issues and health care. In developing countries, people are more likely to be exposed to communicable diseases as a result of a number of factors, including high population density, lack of accessible health care and treatment, and poor or limited sanitation. In addition, although tobacco use is decreasing in most developed countries, it is increasing in many underdeveloped ones. Although people in developed countries often lack resources and information, they are nonetheless interested in health promotion, disease prevention, and many aspects of health care delivery. REF: Page 274

Child maltreatment cases are most frequently attributed to: A. sexual abuse. B. physical abuse. C. psychological abuse. D. neglect.

D. neglect. Seventy-one percent of all child maltreatment cases are classified as neglect. Approximately 9% of child abuse cases are sexual abuse. Physical abuse accounts for 16% of all child maltreatment cases. Emotional abuse accounts for 7% of child maltreatment cases. REF: Page 550

All of the following outcomes may contribute to the diagnosis of substance abuse except: A. the substance use has placed someone in danger. B. the individual uses the substance despite negative consequences. C. the substance use interferes with the ability to function at work or at home. D. the client is without a job.

D. the client is without a job. The diagnosis of substance abuse includes the continued use of a substance despite the consequences; putting oneself or others in danger because of substance use; or substance use interfering with one's major role obligations, such as family, work, and friends. REF: Page 525

Use of illegal drugs may be the most common form of drug abuse among the elderly. True False

False

Environmental stressors directly impact human health. True False

True

Substance abuse is a complex and multifaceted phenomenon. True False

True