Public Health Nursing
. A community health nurse is serving as a case manager for premature infants receiving home health care. The case manager arranges for an in-home apnea monitor and daily home visits by a registered nurse who specializes in high-risk pediatrics. The case manager is demonstrating which of the following case manager roles
. Coordinator
The community-oriented nurse best exemplifies the application of feminist ethics when the nurse does which of the following?
. Design health care programs that incorporate social justice, respect and equity, and address social and political power
An occupational health nurse is conducting employee toxic exposure histories at a dog food manufacturing plant. Using the I PREPARE model, what question does the nurse ask?
. Does your job include soldering any metals?
A truck driver says, "At first I was just using 'meth' at parties, but now I think about it all the time and how am I going to get some." What term best describes this individual's use behavior?
. Drug addiction
A client receiving morphine on a regular basis for pain management must be gradually weaned off the drug to avoid withdrawal symptoms. What state of neuroadaptation does this illustrate?
. Drug dependence
A politically active nurse is working to have a passed in the state of residence to open and fund several substance abuse recovery centers. What action by the nurse would be most effective?
. Educating lawmakers that substance abuse is a health problem
What was the most significant impact The Family and Medical Leave Act (FMLA) of 1993 has had on families?
. Enabled individuals to have both a family and a career
A nurse is planning an activity for older congregants. After reading Healthy People 2020 goals for older adults, which activity does the nurse design?
. Exercise program integrating movements from a sitting or standing position
A 6 year old is brought to the emergency department with a full-body rash and fever. During the nursing assessment, which of the following findings would be most relevant to recognizing the case as potential smallpox rather than varicella?
. Fever of 101°F was present for several days before the rash appeared
The community-oriented nurse who uses the principle of justice would demonstrate that ethical principle best when doing which of the following
. Has a permanent "navigation booth" to help people learn how to contact elected officials.
Which action by the community-oriented nurse best illustrates a partnership for health
. Helping a group of citizens collect relevant health data and develop interventions related to potential environmental hazards
A community-oriented nurse wants to develop strategies to reduce the effects of toxic stress on children. What activity would the nurse make a priority?
. Hiring a full-time lactation consultant
A nurse is among the first responders to a disaster. What action by the nurse takes priority?
. Immediately developing plans for effective triage and client management.
A nurse has decided to use a bottom-up approach of HCC to meet Healthy People 2020 goals for elders in the community setting. Which would be the most appropriate intervention?
. Include community members in multisectoral meetings to choose, design, and implement a culturally appropriate health-promotion activity for older adults
A faith community nurse has entered into a written contract to provide spiritual care at two local nursing homes and the community hospital. This best represents the implementation of which model of faith community nursing?
. Institutional model
The Healthy Communities and Cities (HCC) movement can best be described as which of the following?
. International movement of communities and cities focused on mobilizing local resources to improve the health of the community
How does virtue ethics differ from other ethical theories or principles
. It focuses on character development.
The sexual assault nurse examiner (SANE) works in collaboration with the emergency department providers and which other community partner?
. Law enforcement
A forensic nurse who provides expert consultation regarding back injury disabilities and functional limitations on a workman's compensation case in a civil hearing but did not provide direct client care, is practicing in what role?
. Legal nurse consultant
A community health nurse is prioritizing health-promotion activities with the local rural community. An understanding of the health status and health risks of the rural community would lead the nurse to give priority to which activity
. Motor vehicle and farm accident prevention
. In an effort to address West Nile virus, a community increased livestock immunization, began a vector control program, and initiated a community campaign to eliminate standing water reservoirs. Which approach to communicable disease control does this approach exemplify?
. Multisystem approach
An extensive train derailment occurs in the suburbs of a large metropolitan area. First responders determine that although no fatalities occurred, the derailed cars contain a noxious gas that diffuses readily into the air. The event easily overwhelms the capability of the local responders and hazmat teams are required. The local office of emergency management would coordinate through the emergency operation center to request assistance through which of the following?
. Mutual aid agreement
Nurses working with victims of incest must be aware of the incidence of incest, its signs and symptoms, and the psychological and physical trauma it causes. Which statement is one fact about incest relevant to comprehensive nursing assessment
. Occurs in all races, religious groups, and socioeconomic classes.
. To develop a baseline for a presentation at the local women's club about the status of women's health in the community, a community-oriented nurse researches national vital statistics to establish the leading cause of women's deaths in the United States. In the United States, the leading cause of death for women is
. heart disease
A business executive develops flu-like symptoms 1 day after returning by air from a trans-Atlantic 2-day conference that involved lengthy meetings. The scenario best illustrates the interaction of:
. host, agent, and environment
A terrorist bombing at a local church has sent many victims to the local emergency department and resulted in several deaths. Following the event, an emergency department nurse seeks out other nurses who are having difficulty performing their jobs to speak about the event. The nurse is demonstrating the disaster response strategy of:
. identifying feelings that individuals may be experiencing
After consulting with the health department director, a PHN collaborates with a housing advocate service and legal counsel on behalf of the nurse's clients who live in substandard housing under fear of eviction. The nurse is applying the _______ component of the nursing process to a _______ level of practice.
. implementation; systems
. A rural community health nurse has made sure that CHWs are involved in the health department's migrant worker outreach program. The nurse believes this intervention strategy is important because the nurse knows that such individuals can be
. influential with their insider status to engage community members.
The nurse is establishing a secondary prevention program for adolescents at risk for ATOD. The nurse will include a focus on:
. screening and referring for psychiatric disorders
A nurse teaches an asthmatic client to recognize and avoid exposure to asthma triggers and assists the client's family in implementing specific protection strategies in the home, such as removing carpets and avoiding pets. This nurse's activities can best be described as:
. secondary prevention
Case fatality from breast cancer has decreased in recent years, although the incidence of breast cancer has increased. Descriptive epidemiology would use the component of time to explain this change in terms of
. secular trends.
The intervention used to influence the knowledge, attitudes, values, beliefs, behaviors, and practices of the population of interest is referred to as:
. social marketing.
Promoting the creation of immunization registries that combine immunization information from different sources into a single electronic record to provide official immunization records for schools, daycare centers, health departments, and clinics is a goal of:
. systems-level practice
During a home visit, a nurse teaches a client who is recovering from a stroke and the spouse how to modify their home environment to prevent falls. This education represents:
. tertiary prevention
Healthy People 2020 has a number of objectives aimed at reducing which trend in infectious diseases?
A rapid and serious rise in health care-associated infections
Genes that carry genetic instructions for making living organisms are subject to alterations in which of the following components? (Select all that apply.)
a. Chromosomal structure b. Deoxyribonucleic acid c. Ribonucleic acid d. Sequences of bases e. Epigenetic characteristics
A nurse is the school district's single nurse overseeing 15 schools. Since the nurse cannot be at all schools on any given day, the district has asked for a cart with supplies for staff to use. What items does the nurse include in the cart? (Select all that apply
a. Blunt scissors c. Disposable blankets d. Non-latex gloves e. Sharps container
Community and public health nurses (PHNs) practicing in rural locales consistently note which of the following characteristic of their practice environments?
a. Broad scope of practice b. Independence and autonomy c. Inter-generational practice d. Opportunity for community involvement e. Respect and visibility
A small business employer desires to control company benefit expenditures by turning health care decision-making control over to the employees. Which insurance reform mechanism best addresses the shifting of responsibility, knowledge, and decision-making involvement to the individual receiving care?
Medical savings account (MSA)
The nurse knows that which individual would be considered correctly defined
Migrant farmworker: Travels to do farm work unable to return to a permanent home in the same day
One step in the ethical decision-making framework is to place an ethical issue within a meaningful context. What is the rationale for this step
Multiple factors affect the formulation and justification of ethical issues and dilemmas
Categorical Congressional funding has had which effect on health care?
Negative as the national preference service model neglects emerging problems
Members of an extended family are in conflict over the treatment plan for the family's 90-year-old matriarch, who has advanced dementia. The case manager is using conflict resolution strategies to allow the parties involved to develop trust, credibility, and distance from the issue at hand, as well as to retain personal dignity. What strategic process is the nurse demonstrating?
Negotiating
. Which of the following is a very toxic drug that is a stimulant, causes tolerance to develop within hours, and has dangerous health impacts for those in the vicinity during use?
Nicotine
Collaboration is an intervention that would be located where in the Intervention Wheel?
Orange wedge at the community level of practice
Which of the following are important concepts related community-as-client nursing? (Select all that apply
a. Change for the benefit of the community-client must often occur at several levels. b. Changes in the health of individuals will affect the health of their communities. c. The idea of providing health-related care within the community is not new. d. The impact of the environment on health has long been established.
The most important aspect of the nursing community assessment phase can best be described as:
. formulating a community nursing diagnosis
. In the late 1950s, Down syndrome was discovered to be caused by an extra copy of chromosome 21. This early breakthrough best describes
. genetics.
A community-based HIV/AIDS clinic would be concerned about which aspects of the Public Health Code of Ethics? (Select all that apply.)
. Confidentiality, when possible Advocacy for disenfranchised persons
A state public health region reported 39 cases of meningitis in children 15 years of age and younger to date this year. Seven of those children died. The total population of the region is 780,000, of whom 84,000 are children 15 years old and younger. What is the age-specific meningitis death rate for children age 15 years and younger for this region to date this year?
. 0.08/1000
A local health department in the Midwest reports cases of certain diseases to the state health department for inclusion in the National Notifiable Diseases Surveillance System (NNDSS). From the perspective of community-level disease monitoring, which of the following 3-year trends in incidence rates for hepatitis A would be of local, state, and national interest?
. 2016 = 12/100,000; 2017 = 8/100,000; 2018 = 31/100,000
A state public health region reported 39 cases of meningitis in children 15 years of age and younger to date this year. Seven of those children died. The total population of the region is 780,000, of whom 84,000 are children age 15 years old and younger. What is the prevalence proportion of meningitis in this region thus far in the current year?
. 46/100,000
. A clinic has received funds to pay for clinic visits for farm residents who live in frontier or rural, non-metropolitan statistical areas. Which of the following client(s) would qualify to receive this special funding?
. 70-year-old client residing in an assisted living facility in a rural area
. During an Individuals with Disabilities Education Act (IDEA) screening to detect mental or psychological conditions in young school-age children, a child is identified as having a cognitive disability. The school nurse should now consider this child to be at greatest risk for which potential problem?
. Abuse or neglect
. When working as content experts or clinician advisers to develop injury prevention programs, the forensic nurse is doing which of the following?
. Addressing injury as a public health concern
Community health nurses conducting health education among populations vulnerable to HIV infection explain the natural history of the infection, including the fact that HIV infection may go undetected during the primary infection stage because of which issue
. Antibody test results are typically negative.
. Primary health care seeks to provide affordable social, biomedical, and health services that are relevant and acceptable in terms of the individual's health, needs, and concerns. Which principle does is this model of primary health care incorporate?
. Appropriate technology
A nurse is caring for a rape victim/survivor who is initially displayed emotional withdrawal and silence, but now is repeatedly giving a description of the event. What action by the nurse is most beneficial?
. Assure the client that these reactions are normal for this event
A case manager employed by a health maintenance organization is charged with discontinuing home health services for a disabled home-bound elderly client in an effort to reduce costs. The case manager reviews the client's record and determines that home health services are still indicated for this client. What ethical dilemma does the case manager facing?
. Beneficence
The transmission of tuberculosis (TB) in health care settings has reemerged as a major public health problem. In terms of the host-agent-environment epidemiologic triad, it can best be described as involving which type of workplace agent?
. Biological
During an assessment of a family of four, the nurse completes a genogram. What does the nurse use this assessment tool to identify
. Biological health risk
The overarching themes conceptualized in the vision for the Human Genome Project embrace the relationship of genomes to which of the following
. Biology, health, and society
As the nature of work has changed over time, the nature of work-related illness and injury has also changed. Which is the best example of a work-related illness/injury associated with the change from an agrarian economy to a highly technological workplace?
. Byssinosis (brown lung disease
In case management, it is unlikely that any single professional has the expertise, knowledge, or skills required to achieve success. The synergy produced by all involved parties (client, providers, payers, family/significant others, and community organizations) can result in successful outcomes. What process does this refer to?
. Collaboration
. A public health nurse leader is working with community leaders and interested citizens to improve access to services for the underserved by planning an expansion of the local community health clinic. This is an example of which type of community partnership model?
. Community member-professional
. A nurse performing home hospice case management notes the increasing number of hospice clients who lack caregivers in the home environment. The nurse identifies the potential need for a hospice house facility to meet the needs of these clients. The case management process frequently reveals larger picture issues such as which of the following? (Select all that apply.)
. Community weaknesses in quality of services e. Community weaknesses in quantity of services
The HCC model process relies on a problem-solving approach to achieve goals. The best example of this approach is which of the following?
. Community-oriented nurses using the nine-step Community Health Promotion Model (CHPM) to encourage and empower community members to take responsibility for change
A nurse is assessing a family's ability to provide home care for their 6 year old, who is a quadriplegic as a result of an automobile crash. The nurse teaches the parents body mechanics and transfer techniques. The nurse also determines the parents' physical ability to safely lift the child. The nurse's actions relate to which of the five interacting variables of Neuman's Systems Model?
. Physiological
Which of the following best describes faith community nurses
. Professional nurses partnering with faith communities focusing on spiritual and holistic care, and illness prevention
A state health department nurse with budgetary responsibility for a population health framework would allocate priority funding to which activity?
. Promoting healthy lifestyles or improvement of social and physical environments
. Occupational and environmental health nursing can best be described as which of the following?
. Promotion, prevention, and restoration of health in the workforce aggregate
The public health nurse is concerned about a possible multi-state outbreak of a foodborne illness. What resource will the nurse consult
. PulseNet
A nurse designing a program to improve the health of frail elderly. What does the nurse need to address in this program?
. Racial/ethnic and sociological disparities
Which of the following best represents the concept of homelessness as transitional
. Recently unemployed man evicted from his apartment
A nurse wishes to become actively involved in disaster management and is extremely interested in providing first aid and delivering aggregate health promotion, disease prevention, and emotional support. It would be ideal for the nurse to train and volunteer as which of the following?
. Red Cross shelter manager
What does the nurse understand when considering whether a geographic area is rural or urban?
. Rural and urban areas occur on a continuum
What causes nurses practicing in rural communities to often observe that protecting client confidentiality is a unique challenge?
. Social informality and respect
The WHO initiative Health for All in the 21st Century can best be described as which of the following?
. Social justice initiative
A rural county public health nurse is in the first phase of a community assessment to determine the health status characteristics of the local county. This initial data gathering should most likely begin with which agency?
. State vital statistics bureau
The collaborative partnership best practice of "identifying specific community and system changes to be sought to effect widespread behavior change and community health improvement" would best apply to which concept of the Ottawa Charter for Health Promotion strategic framework?
. Strengthening community action
A nurse sees many clients who use multiple medications or other substances to relieve or mask anxiety, tension, fatigue, and physical or emotional pain. When working with these clients, what myth does the nurse attempt to correct?
. There are good drugs and bad drugs
After establishing trust with a homeless LGBTQ youth, what assessment by the nurse takes priority?
. Trauma screening
. John Snow played a critical role in the development of modern disease surveillance when he did which of the following?
. Used geographic mapping to demonstrate the connection between water supply and cholera
The nurse assesses a client with paraplegia and cataracts. The client holds a full-time job and engages in several hobbies. What does the nurse document about this client
. Visual and physical limitations
A young female client is concerned about her risk for developing ovarian cancer and needs information that might affect her health decisions. She requests that her elderly grandmother be tested for genetic mutations. One significant challenge faced by a family member in responding to such a request is:
. carrier guilt.
When working with battered women, the nurse needs to know that research suggests that the response to abuse is a process that moves from:
. commitment to the relationship to leaving
When the association between maternal alcohol use and low birth weight is being studied, the nurse investigator's failure to consider the variable of smoking could introduce bias into the observed association, because smoking has a correlation with both factors. This effect could best be described as:
. confounding
A nurse practitioner is seeking support from a community health and hospital system to open a nurse-managed and nurse-staffed clinic. The nurse provides data demonstrating the role of the clinic in reducing non-urgent emergency department visits and in improving access to services for clients with chronic illness, management of caseloads, and service flow. This best demonstrates application of the techniques of:
. cost-effectiveness analysis
A school nurse notes that 60 children have missed days of high school because of pertussis this past year and this rate has been relatively constant for the past 5 years. The nurse plans to work with the community to increase awareness of the seriousness of this disease for children younger than 6 months of age and to raise and maintain the immunization rates, because in this community the pertussis is:
. endemic
. Monitoring and public reporting of air quality in a local community to assist individuals with asthma or other respiratory conditions best illustrates the application of:
. environmental epidemiology
A state public health region reported 39 cases of meningitis in children 15 years of age and younger to date this year. Seven of those children died. The total population of the region is 780,000, of whom 84,000 are children age 15 years old and younger. Only four cases of meningitis were reported in the public health region during the previous year. No other public health region in the state has an incidence of meningitis that is higher than expected for that region. Based on the information given, the relative frequency of meningitis in the region at this time can best be described as:
. epidemic.
Nurses working with communities to implement the CHPM are most effective when they do which of the following
Begin where the community is and then work to facilitate implementation of all nine steps.
What is the underlying reason for the use of universal precautions?
Blood and body fluids of all clients need to be handled as if they were infected
Caring and the ethic of care were developed in the mid-1980s and early 1990s in response to and the desire of nurses to do which of the following?
Differentiate nursing practice from medical practice
An American spends several days in Mexico eating fresh raspberries from a nearby vendor and drinking bottled water. What entity is potentially being altered?
Agent-host-environment interaction
A family with a small child lives in a home on a Brownfield site. What action does the public health nurse take when conducting a home visit
Assess the child for meeting developmental milestones
During a family crisis, the visiting nurse helps the family with coping mechanisms. Which action does the nurse take to help the family use external resources for coping
Assist the family in reaching out to their religious leader
A community health nurse seeks to enhance the health promotion and health-service-seeking behaviors of the migrant farmworkers in local apple orchards. What evidence-based action by the nurse would be best?
Educating migrant lay health workers
. A nurse studying health care economics asks why businesses would want to spend money on employee health care, such as insurance premiums. What answer by the professor is best?
Investing in human capital is good for the company and the economy
A nurse new to community-oriented nursing expresses concern about traveling to a specific area of town. What response by the nursing manager is best
It is safe during the daytime but expect people loitering around
The impact of poverty on the onset of disability can best be expressed by which of the following statements
Low income can increase the risk of preventable disability.
Which of the following are facts about marijuana of which the nurse should be aware? (Select all that apply.)
Can be a safe therapeutic agent May cause hyperemesis.
. A district health nurse is assigned to two rural communities in the state. To achieve the best outcomes possible in reducing the health disparities for the large number of frail elderly clients in the two counties, the nurse should consider using what community-oriented nursing approach?
Case management
A low-vision client with very early dementia takes pride in her independence. The client, who lives alone in an apartment, tells her nurse she has always enjoyed using scented candles. Which is the most appropriate intervention for the nurse
Collaborates with the client to give the candles and matches to a family member who brings them during visits.
. Recent trends indicate that which of the following carries the highest portion of third-party health care financing?
Combined public sources
Long-term consequences of victimization indicate that violence must be addressed as which of the following?
Community and public health problem
. When conducting an environmental risk assessment, the nurse explores the economic risk and social risk of the family. To capture social risk assessment data, the nurse can best use which of the following?
Community assessment and ecomap
The case manager role of the school nurse can best be described as which of the following?
Coordinating health care for children with complex health problems
Several faith communities are jointly operating and staffing a food pantry for community members in need that coordinates assistance with the local health department's Women, Infants, and Children program. The faith community nurse in one of the faith communities coordinates the overall partnership and the care teams to staff the project. This best demonstrates which role of the parish nurse?
Coordinator
In evaluation of a program to prevent teen pregnancy, analysis of the net direct and indirect costs, the improvements in the community attributable to the program (such as lower high school dropout rates), and the costs that would result if the program were not implemented (such as the cost of care for low-birth-weight infants) is an example of which of the following?
Cost-effectiveness analysis
. Which statement is true regarding Holistic health care as an approach to nursing care
Critical to a successful faith community nursing health ministry
. During the Depression, which of the following created a negative effect on public health nursing?
Decrease in focus on the community as the unit of service
One challenge of using the capacity-building practice model potentially occurs when nurses do which of the following
Define the problem
. A nurse case manager working with a 1 year old with special needs living in an impoverished neighborhood identifies a potential health outcomes concern. What assessment by the nurse takes priority?
Developmental milestones
A nurse will be starting a new job serving a rural, Native American reservation. What supplies or equipment does the nurse anticipate having the highest need for
Diabetic testing supplies
The Social Security Act of 1935 was designed to prevent the reoccurrence of the problems of the depression. Title VI of this act provided funding for expanded opportunities for health protection and promotion. The most relevant strategy of Title VI of the Social Security Act (1935) related to public health nursing was funding which of the following?
Employment and education of nurses
. A nurse is leading an effort to get desperately needed medical supplies and equipment to an impoverished and war-torn country. Materiel is being gathered according to the recipient country's stated needs. Before shipping the equipment, what would the nurse do?
Enlist the help of an NGO to provide security services for the delivery.
A nurse takes a new position as a community health nurse. Her first assignment is to perform an assessment of the community's migrant farmworker population. What is the most appropriate step for the nurse to take first?
Enroll in a college course to learn community research, measurement, and analysis techniques.
Campaigns to decrease the inequitable burden of environmental risks on the poor and people of color in the United States strive to apply which ethical principle?
Environmental justice
. The most important contribution made by Florence Nightingale to community-oriented nursing was which of the following?
Expanding the role of nursing to include health-promotion practices
Which of the following is the best example of action by a case manager that might be associated with potential liability risk related to experimental treatment and technology?
Failing to apply the contractual definition of "experimental" treatment found in the client's insurance policy
A community-oriented nurse using the principles for effective advocacy would do which of the following?
Follow the clients' wishes and directions tenaciously in all related activities.
. A client acknowledges that cocaine use is damaging career and marriage, but the client has not investigated local treatment options. Understanding change theory, what action would be best?
Have the client weigh the pros and cons of drug use
. The local hospital emergency department has recently noted an increase in gastroenteritis cases among migrant farmworkers. The local health department is informed of the rise in cases and schedules an assessment of which of the following
Housing for migrant workers
When applying the nursing process to environmental health, which action would the nurse take?
Include outcome measures to mitigate and eliminate the contributing factors
What impact will the baby boomer generation have on the future of health care
Increase in demand because of increased life expectancy
What are recent trends in the characteristics of the U.S. workforce that will present new challenges to protecting worker safety and health
Increase in people with chronic illness, women, older workers, and racial diversity
In following the principles of nursing interventions with violent families, which action by the nurse takes priority?
Indicate zero tolerance for any further violence, degradation, or exploitation
Which is an example of tertiary prevention related to HCC
Initiating an evaluation of a program to address endemic hepatitis A in a community
A college health nurse is working to improve environmental air quality on campus. Using the precautionary principal, what action does the nurse take?
Install "smart thermostats" and motion-generated lights in buildings
What was one of Mary Breckenridge's innovative contributions to health care in the United States?
Introducing the first nurse-midwifery training
A community health nurse is the case manager for a home-bound client recovering from a hip replacement. The nurse works with the client and his family to prioritize needs and services, and to address these care needs. These activities represent which step in the nursing process?
Planning/outcome
1. An assessment reveals a high incidence of alcohol-related chronic liver disease and cirrhosis in the local community. A primary prevention harm-reduction program would focus primarily on which of the following?
Polysubstance abuse
An occupational health nurse establishes a local business-sponsored smoking cessation clinic that incorporates the use of nicotine replacement therapy, behavioral treatments, and support groups. What description fits this program most appropriately?
Population-focused tertiary prevention
A nurse takes the time to read and understand the community's disaster plans and participates in mock disaster drills as a leader of the triage team. The nurse obtained disaster management training through the local Red Cross chapter and registered with the state as a disaster management nurse. Which description of the nurse's activities is accurate?
Professional preparedness
Commitment to which of the following best demonstrates nursing's advocacy role in primary health care initiatives in developed countries
Provision of direct client care
Which is an example of secondary prevention of infectious disease
Quarantine
Changes to Title XIX of Medicaid in 1989 ensured adequate access to health care providers by which mechanism?
Reimbursing for treatment by pediatric and family nurse practitioners
A public health nurse has been recruited to lead a community environmental lead exposure reduction program. What action by this nurse is best?
Research the number of houses likely to contain lead-based paint
One seminal event that significantly shifted nursing's focus to ethical decision making was the emergence of the field of bioethics. In conjunction with bioethics, what other event occurred to shape this agenda?
Returning ethics courses to nursing programs in institutions of higher education
The nurse teaches all clients primary prevention for STDs. Which topic does the nurse include
Safer sex
A nurse is concerned about the accuracy of the purified protein derivative (tuberculin) test in screening individuals with tuberculosis exposure for follow-up chest radiography. The nurse's concern is related to which aspect of the test's validity?
Sensitivity
What connection does the nurse make between the older adult and poverty?
Staying out of poverty is a near-daily challenge.
A nurse is assigned to provide community outreach to a small town that was partially destroyed by a tornado 3 years earlier and has been rebuilt. The first client is a family who lost their home and their best friend in the tornado. Which intervention by the nurse is best?
Support of the family in preparing a personal disaster response plan
Health problems exist throughout the world. In the United States, a current health concern is the appearance of new viral strains such as Hantavirus in the Southwest. This is an example of the difference in health care concerns between countries such as
Sweden and Indonesia.
A middle-aged woman, with a history of breast and ovarian cancer in her family, is concerned that a positive finding for BRACA2 gene may result in loss of her insurance coverage. Which of the following does the nurse discuss with the client
The Genetic Information Nondiscrimination Act (GINA)
A home health case manager is charged with identifying opportunities for health promotion and illness prevention. How would the case manager demonstrate fulfillment of this charge?
Tracks the immunization status of clients and facilitates access to immunization when needed.
A nurse wishes to become involved in outreach to migrant farmworkers. What activity by the nurse would be consistent with this service?
Training lay health workers for health education
The United States is engaged in a formal agreement with Indonesia to provide economic incentives and assistance in national defense in return for the protection of U.S. private investments in that region. Which bilateral organization is most likely involved in this agreement?
U.S. Agency for International Development
. A home health nurse is assessing the parents of an infant. What information does the nurse consider most relevant when screening for child abuse
Verbal aggressiveness toward spouse
Professional nursing organizations recommend that all women be routinely screened for domestic violence. When is the most appropriate time for this screening?
When they come to any health care setting
The public health nurse is planning community programs. Which program would the nurse plan to incorporate utilitarianism
Widespread influenza vaccination events
The best example of a government-sponsored program that can promote health and prevent illness for middle-income, subsistence-level families is which of the following
Women, Infants, and Children (WIC
The nurse demonstrating disaster-related recovery competencies would do which of the following
Write and distribute an after-action report.
What emergency support functions do the National Response Framework (NRF) and the National Incident Management System (NIMS) provide?
Written approach, protocol, and common language for responders from federal agencies and other voluntary organizations
The nurse analyzing data from reports of the global burden of disease would learn about which of the following topics?
Years in lost contribution to economic growth
A nurse is planning a women's screening program to detect the presence of the leading causes of disease burden for women in the United States. What items would the nurse include in the program? (Select all that apply.)
a. Blood pressure c. Usual diet e. Smoking
According to Ziebarth (2016), what are the five essential attributes of faith community nursing? (Select all that apply.)
a. Accessing health care b. Coordinating c. Disease managing and health promoting d. Empowering e. Faith integrating
Which of the following are significant barriers to practicing family nursing? (Select all that apply.)
a. Accessing needed resources for clients c. Lack of consensus as to the definition of family e. The large population of un- or under-insured people
. When preparing a report on work-health interactions, the occupational health nurse should include which of the following information? (Select all that apply
a. Accidental deaths and deaths associated with occupationally acquired illness c. Rates and types of injuries that occurred while workers were on the job d. Rates and causative factors for back injuries while working e. Worker illnesses potentially associated with workplace chemical agent exposure
Diabetes mortality rates continue to rise for all ethnic and socioeconomic groups, but evidence shows that which of the following are true? (Select all that apply.)
a. Addressing the diabetic epidemic involves more than a focus on individual factors c. Complications and mortality rates are highest among low-income and minority groups d. Selection of healthy food options is both an availability issue and an education issue
Host factors associated with increased risk of an adverse response to hazardous workplace exposure include which of the following? (Select all that apply
a. Age b. Experience c. Health status d. Male gender e. Work practices
The school nurse is present during an assault by an active shooter. After the crisis is over, what actions by the nurse are most appropriate? (Select all that apply
a. Arrange for grief counseling services in the school. b. Conduct regular assessments for anxiety and post-traumatic stress . Provide open routes of communications with all involved.
. A nurse is planning a training session for a new group of disability determination workers regarding the leading causes of severe disabilities in U.S. adults. What topics will the training address? (Select all that apply
a. Arthritis b. Back problems c. Obesity d. Heart disease
The role of the nurse who wants to become more active in environmental health could include which of the following? (Select all that apply.)
a. Assessing farmworkers for pesticide exposure and providing pesticide risk education b. Conducting epidemiologic investigations as a public health nurse (PHN) c. Developing corporate policy to protect workers from unsafe levels of toxic agents d. Organizing the local community to encourage landlords to remove lead-based paint e. Working as a skilled risk communicator for a local chemical manufacturer
A nurse is designing a tertiary prevention intervention to address the leading cause of school absences related to chronic illness. Which illness does, the school nurse focus on?
a. Asthma
A nurse practicing in a faith community engages in behaviors that support this practice mission. What activities does this nurse participate in? (Select all that apply.)
a. Attend a weekend retreat focusing on developing one's faith. b. Be intentional about taking care of him- or herself. c. Find a faith community nurse to serve as a support system. d. Take time away to refresh and rejuvenate occasionally.
Which are major accomplishments of the National Organization for Public Health Nursing (NOPHN)? (Select all that apply.)
a. Collaborated to secure health insurance reimbursement for nursing services, such as post discharge nursing care at home b. Established public health nursing programs for military outposts in World War I d. Responded to the 1918 worldwide influenza pandemic in the United States
The role of the community-oriented nurse working with the special needs population is largely influenced by which of the following
a. Community awareness of and commitment to meeting the needs of people with disabilities
Which of the following factors assisted community-oriented nursing pioneers, such as Lillian Wald, in developing approaches and programs to solve the health care and social problems of her times? (Select all that apply.)
a. Community health's focus on teaching and prevention b. Establishment of settlement houses e. Middle and upper class fear of diseases
A new nurse asks the mentor what an MSDS is for. What responses by the mentor are most accurate? (Select all that apply.)
a. Contains information on chemical products. b. Describes any special precautions using chemicals requires. c. Details the health risks associated with the products e. Must be written by the product manufacturer
The nurse case manager in a migrant farmworker clinic assesses this population for occupational and environmental risks related to which problems? (Select all that apply.)
a. Contaminated water b. Fear of injury reporting c. Inadequate sewage d. Pesticide exposure
Which arenas might a forensic nurse practice in? (Select all that apply
a. Courtrooms b. Correctional facilities c. Hospital risk-management departments d. Medical examiner offices e. Police departments
The factors that are frequently cited as having caused the increases in total and per capita health care spending in the United States are well exemplified by which of the following health care events? (Select all that apply.)
a. Development of the drug sildenafil b. Increase in hip and knee replacement surgeries c. Increased incidence of ischemic heart disease d. Mandated 2-day maternity hospital stays e. Medicare Part D prescription drug plan
Which term would best describe a person who is limited in independent living skills, economic self-sufficiency, and self-help ability
a. Developmentally disabled
During routine nursing assessments, the nurse should ask clients about their current and past jobs, exposures to any agents that potentially relate to their symptoms and activities at work, and which of the following? (Select all that apply.)
a. Disabling conditions c. Lifestyle history d. Previous injuries e. Underlying illnesses
. Factors related to the determinants of health identified in Healthy People 2020 include which of the following? (Select all that apply.)
a. Education and literacy b. Genetic endowment c. Gender d. Culture e. Social status
. Depression among rural residents appears to be more persistent and endemic. Which of the following factors may contribute to this level of depression? (Select all that apply.)
a. Elevated levels of poverty b. Geographic isolation c. Insufficient mental health services
The aspects of the locality development model or bottom-up approach that have been integrated can best be described as which of the following? (Select all that apply.)
a. Emphasizing consensus and cooperation b. Building a sense of community
To develop effective nursing interventions, the nurse should evaluate clients and populations in which context
a. Environment
Emerging infectious diseases may arise as a result of factors operating singly or in combination, and these factors may include which of the following? (Select all that apply.)
a. Environmental changes b. Host behavior d. Microbial adaptation e. Public health infrastructure deterioration
Which of the following are recommendations of the 1850 Shattuck Report that represented major innovations in public health? (Select all that apply.)
a. Establishment of state health departments and local health boards in every town b. Promotion of environmental sanitation and collection of vital statistics c. Steps to decrease preventable disease and control smoking and alcohol use
. Effects of homelessness on health care outcomes can be devastating and may include which of the following? (Select all that apply.)
a. Higher incidence of acute and chronic disease b. Higher risk of physical trauma c. Crisis-oriented health care, usually in emergency departments e. Lack of awareness of care options
During a home visit, a case manager for a community health center notes marked pitting edema, shortness of breath, and increased fatigue in a 52-year-old male client who lives alone. The client is admitted to the hospital, where he is diagnosed with congestive heart failure. The case manager works with the hospital's utilization manager to devise a discharge plan. What are the case manager's most logical next steps? (Select all that apply.)
a. Identify and arrange for the resources to provide needed services. b. Research the client's health care coverage and its provisions. d. Gather information on local support groups
The nurse educates a group of students that which persons would be most at risk of reactivation of latent infections of tuberculosis (TB)? (Select all that apply.)
a. Immunocompromised b. Substance abusers e. Diabetics
Which of the following measures reduce physical and emotional injury in a community? (Select all that apply.)
a. Improving general health b. Lowering health risks d. Mitigating poverty e. Reducing health disparity
A client diagnosed with HPV infection states, "I'm not concerned, I know the warts disappear after a while." The nurse should counsel the client regarding which of the following? (Select all that apply
a. Link between HPV and cervical cancer c. Need to eliminate the warts e. Lack of cure for HPV infection
4. A woman comes to the community health center complaining of increasing lower abdominal pain, fever, and abnormal menses for several months. During the assessment, the client indicates that she is aware that her husband has had multiple sex partners in the past 2 years. Which interventions by the nurse are most appropriate? (Select all that apply.)
a. Provide comprehensive STD screening c. Educate the client on ceftriaxone and azythromycin. d. Instruct the client on safer sex practices. e. Perform a serum pregnancy test
Nurses have unique skills that can be applied in which of the following aspects of disaster management? (Select all that apply.)
a. Registration as an ARC disaster responder b. Clinical management of blast lung injury d. Monitoring of the environment to contain infectious disease e. Planning and organization of mass prophylaxis and vaccine campaigns
The National Association of School Nurses (NASN) and standards of practice for school nurses set forth which of the following principles? (Select all that apply.)
a. School nurses should have a bachelor's degree in nursing and a specialty certification. b. School nursing uses the nursing process e. School nurses must ensure the safety of the children, including when delegating care.
. Research articles that include epidemiologic determinants and distribution would include which questions? (Select all that apply.)
a. Who is affected most by pesticide exposure? b. Where in the city are lead levels highest? c. How does herbicide runoff affect drinking water? d. What season of the year sees the most trauma? e. Why do children get injured on playgrounds
The National Coalition of Health Professional Education in Genetics (NCHPEG) created a red-flag tool for determining risk in closely related individuals for the most common diseases that includes: (Select all that apply.)
a. close biological relationship between parents. b. condition occurs in the gender that is least expected. c. ethnic predisposition to certain genetic disorders. d. multiple affected family members.
One of the most significant household changes in the second half of the twentieth century in North America was the increase in men and women living together without marrying. Effects of this trend on the children of cohabitating couples include:
a. increased chance of exposure to second-hand smoke c. more behavioral and cognitive problems
. In comparison with women, men
a. incur more work-related injuries
Physical agents associated with workplace hazards can best be addressed through engineering strategies and:
a. practice of safe work habits
Public health nursing practice is guided by the community's priorities as identified by community:
assessment.
A middle school student approaches the school nurse and says, "Can I talk to you about something important?" The school nurse responds affirmatively but should clarify which topic?
b. "If anything you tell me indicates that you or someone else is in danger, I must tell the parents and school officials."
The community health nurse can serve as an advocate for the vulnerable migrant population by engaging in which of the following actions? (Select all that apply.)
b. Collecting necessary data on migrant workers' lifestyle and health status c. Educating communities about the migrant workers in their areas d. Educating policymakers about successful programs for migrant workers
A nurse conducting a home visit for a child with cerebral palsy observes the child gazing out of the window into the neighborhood. The nurse prepares to provide guidance to the parents regarding their child. What topics does the nurse include? (Select all that apply.)
b. Community attitudes about interacting with children with disabilities c. Opportunities and places for organized and spontaneous play d. Legislation regarding access rights for people with disabilities d. Physical activity needs to avoid obesity and its consequences
A nurse is assigned to teach clients STD prevention information. What information will the nurse include in the presentation?
b. Condoms can be effective in preventing infections transmitted by fluids from mucosal surfaces but are not always effective in preventing infections transmitted by skin-to-skin contact.
. In addition an industrial disaster plan, what other factor helps improve the effectiveness of the community response to a potential industrial disaster?
b. Conducting a response agency worksite walk-through
A nurse volunteering at a local homeless shelter notes that many of the clients have acute and chronic illnesses and are in need of primary health care services. Which strategy would the nurse consider most effective when working with these clients
b. Create a trusting environment and establish a therapeutic relationship
A nurse is evaluating the outcome of a family action plan. The nurse will use which critical thinking processes during this evaluation? (Select all that apply
b. Determining the timeliness of the plan outcome c. Identifying changes in the family story d. Identifying nurse-related barriers
A nurse in Mexico collaborates with the health committee that operates a village-based health post. They intended to discuss the planning for next year's health promotion initiative and evaluate the recent family planning program. This best demonstrates the aim of the Declaration of Alma-Alta to emphasize which of the following? (Select all that apply.)
b. Development of maternal and child health programs c. Involvement and training of community health workers d. Organized approach to health education e. Promotion and acceptance of traditional medicine
A forensic nurse understands that which of the following health risks results from incidents of crime and victimization?
b. Distress
In designing a substance abuse primary prevention education program for the secondary schools in the community, it would be most important for the school nurse to include content related to the latest trend in the use of which drug?
b. Ecstasy
Children with chronic health problems face challenges in school because of which of the following issues?
b. Embarrassment and self-imposed social isolation
A nurse is working at a school that participates in the federal school meal program. What activity does the nurse engage in related to this program?
b. Ensures the school wellness policy is current and reflects best practice
Conditions that may lead to disability typically are the focus of primary prevention activities. However, all three levels of prevention apply to physically compromised clients, primarily because the focus should be on which of the following? (Select all that apply.)
b. Establishing lifelong, health-promoting behaviors c. Integrating appropriate complementary and alternative medicine treatments d. Overcoming barriers to disease prevention activities
When conducting a nursing assessment of a child, the nurse should be aware that indicators of potential or actual child abuse may include which of the following? (Select all that apply.)
b. Evidence of general poor care c. Injuries not mentioned in history d. Seems to need to take care of the parent e. Unusual fear of the nurse and others
Contracting with families represents a shared effort by the client(s) and the community health nurse to increase healthful choices. This method of shared effort and active equal involvement of the nurse and family is appropriate for which types of families? (Select all that apply.)
b. Families capable of taking responsibility c. Families oriented toward self-care
Family health can be defined as a dynamic relative state of well-being that involves the biological, psychological, sociological, cultural, and spiritual aspects of the family system. This approach to family health is consistent with which of the following principles? (Select all that apply.)
b. Family functioning affects the health of individuals. c. Family system assessment specifically addresses the individual's health. d. The individual's health affects the family's functioning
The congregational wellness committee expresses the desire to establish a seasonal shelter for homeless women and children in the community as part of its health ministry. The faith community nurse prepares a resource assessment for the next committee meeting. This intervention reflects the parish nurse's responsibility for which type of practice issues?
b. Financial
The nurse counseling women regarding hormone replacement therapy (HRT) would include which information?
b. HRT should be considered for prevention of osteoporosis in all women
A migrant worker comes to the migrant health clinic holding the abdomen and complaining of empacho. The nurse may encounter this complaint when dealing with migrant workers who are natives of which country?
b. Haiti
A community-oriented nurse is developing goals for a community health center's senior center. The goals should focus on which of the following? (Select all that apply
b. Implementing secondary prevention measures c. Maximizing functional status d. Meeting social needs e. Providing appropriate recreation
What does a community-oriented nurse newly assigned to a rural community learn about the characteristics of rural and small town life?
b. Informal social and professional relationships d. Role of churches as socialization centers e. Work of many residents in high-risk occupations
The focus on the need for safety during periods of emergent trauma, collective violence, or chronic abuse is based on which theoretical framework contribution
b. Maslow's hierarchy of needs
A faith community nurse is planning a strategy to carrying out the health education role. What activity would be most appropriate?
b. Organizing health fairs
A forensic nurse maintains an awareness of human behavior and environment which is then interpreted by knowledge and lived experience in making expert decisions. What concept of forensic nursing theory does this represent?
b. Perceptivity
Which of the following interventions are appropriately matched to the home visit phase? (Select all that apply.)
b. Pre-visit phase: Review referral and/or family recorded. c. In-home phase: Introduce self and professional identity. d. Post-visit phase: Plan for next visit.
A client's concern about hereditary cancer syndrome can be influenced by the limitations of current testing methods and factors related to: (Select all that apply
b. adoption. c. family size.
A community health nurse is working with a single parent with a special needs child and a child with asthma. The maternal grandmother lives with the family and was recently diagnosed with diabetes. The nurse understands the importance of including the grandmother in her assessment and interventions because families are:
b. involved in the health care of their members
Women with disabilities may be at higher risk for abuse because women with disabilities are
b. less likely to have access to resources
. A nurse working in a clinic in an inner city with high poverty and unemployment rates recognizes the need for programs for women because impoverished women are at higher risk for:
b. poorer health status
If the community is where nurses practice and apply the nursing process, and the community is the client in that practice, then nurses will want to analyze and synthesize information about:
boundaries, parts, and dynamic processes
Which of the following are community-level factors that influence violence and human abuse? (Select all that apply.)
c. Diversity d. Population density e. Sense of cohesiveness
In caring for migrant workers and their families, the nurse should first assess the migrant workers' lifestyle and which of the following as the priority?
c. Housing arrangements
Which man would have the highest risk for prostate cancer
c. Is African American
A community health nurse involved in care management would most likely do which of the following
c. Monitor the health status, resources, and outcomes for an aggregate
. The school nurse wishes to provide community outreach. What activity does the nurse plan?
c. Organize a multi-disciplinary health fair
At the request of a local senior women's group, a nurse is developing an osteoporosis primary prevention program. Which of the following is an appropriate strategy the nurse would incorporate in the program?
c. Promote diets rich in calcium and vitamin D and daily weight-bearing exercise
A forensic nurse works to provide care at the secondary level of prevention. What action by the nurse is most representative of this level of prevention?
c. Providing direct care to a victim of sexual assault in the Emergency Department
A client newly diagnosed with herpes simplex virus 2 (HSV-2) infection and syphilis asks, "Okay, so how do I get rid of all this stuff?" In developing a plan of care, the nurse recognizes that which topic is essential to address?
c. Risk of skin-to-skin contact in transmitting the identified STDs
From August through May, an inner city school district provides primary health care services, including mental health and dental care, to children and youth. This is a specific example of which of the following?
c. School-based health center
. An undocumented migrant farmworker has been diagnosed with TB. The local health department initiates treatment by dispensing the first month's supply of medication and educates the client on the need to continue treatment for 6 to 12 months. A major challenge that the client may face to ongoing treatment for TB is:
c. fragmented services.
. A new primary health clinic is established in a predominantly African American neighborhood to address the top causes of mortality in the local adult population. The nurse at the clinic uses a community-focused nursing process to plan interventions aimed at reducing the incidence of:
c. heart disease, stroke, and homicide.
New discoveries in molecular genetics will have the greatest effect on nursing practice in the area of:
collection and use of health histories
When confirmed cases of the mumps, a vaccine-preventable disease, emerged on college campuses in fall 2006, public health nurses (PHNs) conducted outreach at campuses and collaborated with student health officials to increase the number of students with full immunization compliance. This is an example of
community-level practice
When the community health nurse displays pertinent family information in a family tree format, the approach assists the nurse in making clinical judgments relevant to family structure and history. This type of family assessment instrument is referred to as which of the following?
d. Genogram
What is a potential, unanticipated public health issue arising from international trade agreements?
d. Increase in foodborne disease when sanitary conditions differ between countries.
The nurse working with migrant farmworkers and their families understands that which of the following are true statements regarding the health and well-being of the migrant children? (Select all that apply.)
d. May be exposed to "take home" chemicals. e. Often suffer from anxiety-related problems
Identifying occupational and safety hazards and determining recommended exposure limits for occupational hazards is the function of which organization?
d. Occupational Safety and Health Administration (OSHA)
What is a major challenge in the development of social policies that affect families?
d. Ongoing debate as to what constitutes a family
To provide the most effective primary prevention intervention to reduce the incidence of child abuse, the nurse would do which of the following?
d. Providing parenting classes for college students
A unique competency of forensic nursing is the collection of trace evidence to be used in clinical investigations. This competency is related to which standard of practice for the specialty?
d. Scientific process
Which of the following is a population-level tertiary prevention intervention for those with HIV in the community
d. Standard precautions education
. A school nurse is teaching students about the relationship between the risk of sexually transmitted disease (STD) and risk-taking behaviors. Which key point will the nurse include?
d. Use of alcohol and drugs makes a student more likely to make risky decisions.
When applying the bioecological systems theory to families, what major assumption of this model does the nurse understand?
d. What happens outside the family is as equally important as what happens inside the family.
A client comes to the local clinic with acute symptoms of fever, nausea, lack of appetite, malaise, and abdominal discomfort. During the course of the assessment, the nurse inquires as to the client's employment and job duties. Which response would the nurse view as most important?
d. Works in a daycare center and changes diapers.
The nurse working with the family of a child recently diagnosed with juvenile diabetes asks the parents about any changes in their relationship since the child's diagnosis. This family nursing approach can best be described as treating the family as a:
d. system
The nurse knows the Ottawa Charter identified the most effective health-promotion action as:
developing health-promoting public policy
The nurse continues the assessment of a family's ability to provide home care for their 6 year old, who is a quadriplegic as a result of an automobile crash, noting that the parents are in good physical health with no genetic or lifestyle risks, live in a safe neighborhood with caring neighbors, are dealing with grief and stress as they adjust to their child's injury, and are concerned that their insurance benefits may not adequately cover their child's expenses. The family's current health risk appraisal identifies the following risks:
economic and life-event risks
A community health nurse manager has integrated exposure history elements into the assessment practices of the health department that are relevant to the urban industrial community served. This strategy indicates that the nurse manager is aware of the relationship between:
environment and human health/disease.
A community-level intervention designed to increase the sense of belonging among older community residents at risk for social isolation was implemented by opening a senior center every other Wednesday at a local church that provided lunch and social programs. At the end of 6 months, the attendees were surveyed to determine their experience with the program, barriers to attendance, expansion of their social networks, and involvement in other community activities. This survey allowed the community health nurse to _______ the program and design program improvements.
evaluate the effectiveness of
To provide effective care and advocacy for individuals, families, and populations living in poverty, nurses must first:
examine their personal beliefs, values, and experiences
The parish nurse works with a congregant with early stage Alzheimer's disease and with the individual's family to design a progressive quality-of-life plan that addresses the need for legal, financial, health care, and end-of-life decision-making strategies as the disease progresses. This approach to well-being for the individual can best be characterized as an example of the philosophy of faith community nursing that:
focuses on the faith community and its ministry
The community practice nurse is preparing to initiate a community partnership with a neighborhood watch association to address teenager street vandalism. The nurse meets with a local pastor who makes introductions between the nurse and the neighborhood residents who will partner together. The role of the pastor in this example is
gatekeeper
The major factor that has led to sharply increased insurance payouts following disasters in the United States in recent decades has been:
human development
. A nursing diagnosis of increased risk for delayed development, injury, and disease because of inadequate parenting by a primary parent experiencing depression would most likely indicate that the nursing process is being applied at the _______ level of practice and the _______ level of prevention.
individual/family; primary
There is strong evidence to suggest that poverty can be directly related to poor health outcomes. Poorer health outcomes lead to reduced educational outcomes for children; poor nutrition; low productivity in the adult workforce; and unstable economic growth in the population, community, and nation. These concepts reflect the human capital approach of the branch of economics known as:
macroeconomics
Cleft lip and/or palate, a common congenital malformation, is often inherited and influenced by environmental factors, therefore it is referred to as a(n):
multifactorial disease.
The Association of Community Health Nurse Educators has called for increased graduate programs to educate Public Health Nursing leaders, educators, and researchers in such areas as:
natural and human-made disasters
A rural health nurse who is planning programs to address the population's needs should recognize that, in general, rural populations:
perceive their overall health as less favorable
The three components of the Intervention Wheel are
population base, levels of practice, and public health interventions
The primary impetus for the school nurse program established by Lilian Wald was to work with children in the schools and make home visits for the purpose of
providing and obtaining medical treatment for absent students
A shift in general approach from a more reactionary, acute care orientation toward a proactive, primary prevention orientation is necessary to achieve not only a more cost-effective, but also necessary to avoid the need for other less desirable approaches that may compromise access and quality such as:
rationing of health care
. A nurse expands a community exercise program to include a senior exercise program targeted at strength and balance training in response to the HCC initiative to address the needs of free-living elders in the local community. The nurse is most likely applying the Ottawa Charter for Health Promotion priority health-promotion activity of:
reorienting health services
A nurse in a community health clinic reviews a client's health history and includes a family health history across three generations, noting any diseases with a genetic basis. The nurse is detecting or defining risk in low-risk groups for potential referral for diagnostic testing. This is an example of:
secondary prevention