412 Exam 1 modules

T/F: The terms community, aggregate, and population are interchangeable.

F A community is a form of an aggregate, but an aggregate lacks interaction with one another. An aggregate is a group of people with common characteristics.

T/F: Community organizing is an intervention that seeks to generate solutions to problems through interactive problem solving.

F Consultation is an intervention that seeks to generate solutions to problems through interactive problem solving. Community organizing helps community groups to identify common problems or goals

T/F: Social learning is a client-centered communication style for eliciting behavior change by helping clients and groups explore and resolve ambivalence.

F Motivational interviewing is a client-centered communication style for eliciting behavior change by helping clients and groups explore and resolve ambivalence. Social learning is a behavior change model that considers environmental influences, personal factors, and behavior as key components to change.

T/F: The most important measure of a country's health is the amount of money spent on healthcare.

F Outcome data is a more important measure of a country's health.

T/F: Secondary prevention is maximizing health and wellness through strategies that are set in place before illness or injury is present.

F Primary prevention is maximizing health and wellness through strategies that are set in place before illness or injury is present. Secondary prevention is maximizing health and wellness through strategies that are set in place at the early and active chronic stages of pathogenesis of illness and injury.

T/F: The social determinants of health are not related to the health status of a client.

F The social determinants of health reflect social factors and the physical conditions in the environment in which people are born, live, learn, play, work, and age. Social determinants of health impact a wide range of health, functioning, and quality of life outcomes.

T/F: Advocacy is a moral and professional responsibility and a fundamental role of nursing.

T

T/F: Health teaching is used in conjunction with virtually all interventions. It is frequently implemented in conjunction with, or sequentially to, counseling and/or consultation.

T

T/F: Process evaluations focus on how well the program was implemented and looks at the processes, activities, and capacity building.

T

T/F: The Learning Model is a behavior change model emphasizing reinforcement of social competence, problem solving, autonomy, and sense of purpose.

T

T/F The evaluation step of the disaster management continuum involves learning from the past and preparing for the future.

T Evaluation is the foundation for evidence-based disaster response.

T/F Stabilization takes place in the recovery step of the disaster management continuum.

T In the recovery step, public health nurses help the community to stabilize and return to normal status.

T/F The Federal Emergency Management Agency (FEMA) is responsible for assessing and responding to disaster events in the United States.

T FEMA develops training programs for disaster response, including planning for execution and deactivation of points of distribution

T or F: When preparing a disaster management plan, it is necessary to assess the resources that would be available for a response to a disaster.

T It is necessary to assess resources available for disaster response, in addition to resources available for ongoing community health needs.

T/F: State Children's Health Insurance Plan (SCHIP) was put into place to provide coverage for children who were ineligible for Medicaid due to poverty requirements but unable to access health care with affordable private insurance.

T State Children's Health Insurance Plan (SCHIP) was put into place to provide coverage for children who were ineligible for Medicaid due to poverty requirements but unable to access health care with affordable private insurance.

T/F The agency that protects public health by developing guidelines that promote health and quality of life by preventing and controlling disease, injury, and disability is the Centers for Disease Control (CDC).

T The CDC also offers online training for disaster management.

In the 1900s, which entity was considered to be responsible for public health nursing? a. The government b. Religious institutions c. Insurance companies d. Charitable institutions

a

Which nation pays the greatest amount of money and is among the worst performers for health care among the 15 nations that are members of the Organisation for Economic Co-operation and Development (OECD)? a. United States b. Netherlands c. France d. Canada

a

Which publicly funded health care program is aimed to assist families with children who are living in poverty? a. Medicare b. Veteran's Administration c. TRICARE d. Medicaid

a

The nurse planning a breast cancer intervention aimed at reducing mortality for African American women should first: a. collect data on when and how clients are screened. b. teach clients to understand the TNM classification system. c. let clients know that no matter the stage, diagnosis is what is most important. d. reassure clients that they have a better prognosis than white women.

a African American women are more likely to be diagnosed with breast cancer at later stages than white women. Assessment is always the first part of the nursing process, and collecting data on when and how African American women are screened may provide information leading to an increase in early diagnoses.

A community health nurse is partnering with several community members to resolve an identified problem of homelessness. One of the community members questions why there are so many homeless people when the unemployment rate is below 3% in the community and surrounding area. What would be the nurse's best response to this question? a. "There are several interrelating systems that lead to homelessness, including social, environmental, and personal biology." b. "Many people are unable to work due to other issues, even though jobs are available in an area." c. "Homelessness is a problem that will take more social support rather than economic support to resolve." d. "A job is just one step toward reducing homelessness; there are many other issues that must be resolved in order to reduce the problem."

a Although poverty increases the risk for homelessness, it is not the only factor that can lead to this problem. Many homeless have multiple factors that interrelate including social factors such as poor support from families and other support systems, biological factors such as mental health problems and substance use, and environmental issues such as adequate affordable housing.

What characteristic will the nurse consider when developing interventions for an aggregate group? a. People may not interact with each other b. The group shares the same health resources c. Individuals live in the same geographical areas d. Group individuals have values and beliefs in common

a An aggregate is a mass grouping of individuals sharing a common problem who may not interact with one another

A tornado has destroyed an area of the local community and destroyed the local water plant. The public health nurses in that area mobilize and coordinate care with the hospital, emergency medical services, and the fire department. What core public health function does this action represent? a. Policy development b. Assessment c. Assurance d. Personal services

a At the community level, health nurses collaborate with leaders in the preparation of an emergency preparedness plan under the core function of assurance.

A client will require dialysis. If the client lived in a country like Canada where the National Health Insurance Model was used, what would health care cost the family for the new treatment? a. Treatment would be covered, as the employer and employee pay for insurance b. A small amount, but the single payer can negotiate for lower prices c. No cost, as the treatment would be covered by taxes paid d. If they had insurance, they would pay approximately 30% of the cost

a Canadians pay 46% less than Americans in health care costs, as they can negotiate for lower prices

What intervention addresses the building of alliances among groups of people in the community, aligned toward a common purpose of well-being? a. Coalition Building b. Community Organizing c. Consultation d. Collaboration

a Coalition building addresses the building of alliances among groups of people in the community, aligned toward a common purpose of well-being. This includes building social networks among existing infrastructure and enabling local leaders to promote awareness about health risks.

A patient requests information concerning how to isolate ourselves against the exposure to environmental contaminates. Which statement is the basis for the nurse's response? a. It is not likely to protect themselves from contact with some form of environmental contaminate. b. The number of potentially dangerous environmental contaminates has decreased over the last 20 years. c. The initial step is to become educated about what environmental contaminates you are exposed to. d. Protection from environmental contaminates depends on one's own immune system.

a In the modern world, it is nearly impossible to isolate people from all of the exposures they have every day. The other options are based on the idea that it may be possible to isolate oneself from such contaminates.

The public health nurse has identified obesity as a health problem in the community. Which action taken by the nurse demonstrate the core policy development function of public health at the community level? a. Attending a school board meeting to present current data b. Tracking rates of obesity in each of the community schools c. Formal interviews with the director of school nursing d. Identifying financial resources for nutrition education programs

a In the policy development function at the community level, the public health nurse recommends training and raises awareness of the issue by bringing information forward to key policy makers.

Which model is an insurance system financed jointly by employers and employees through payroll deduction? a. Bismarck b. National Health Insurance c. The Out-of-Pocket d. Beveridge

a In this model, health insurance is funded through government-mandated payroll taxes

Which statement is true? a. The use of alcohol is categorized as a lifestyle choice. b. Lifestyle choices do not expose the wider community to health risks. c. Exposure to pesticides falls into the community sphere of environmental health. d. Genetics are part of the lifestyle sphere of environmental health.

a Lifestyle choices expose individuals and the community to environmental risk actors. By making different lifestyle choices exposure to factors can be limited. The use of tobacco, alcohol and other drugs fall into this category.

What was the name for the agency founded in the lower east side of New York in 1893? a. Henry Street Settlement b. Women's Branch of the New York Mission c. Sisters of Charity d. Visiting Nurses Association

a Lillian Wald and Mary Brewster founded the Henry Street Settlement on the lower east side of New York in 1893

Identify one of the six challenges faced in the studying of epidemiology from the choices below. a. Limited availability of data on many contaminants and their effect on health. b. Too many subjects could be harmed in the epidemiological studies. c. There are not enough volunteers in order to conduct the necessary research. d. Epidemiology studies are too complicated to conduct.

a Major challenges to most environmental epidemiology studies include the following: Limited availability of data on many contaminants and their effect on health, limited understanding about how exposures to multiple contaminants may sicken people, and latency between exposure and illness can be very long, e.g., even decades

Which publicly funded health care program receives funding primarily through the state government? a. Medicaid b. TRICARE c. Medicare d. Veteran's Administration

a Medicaid receives funding primarily through the state government. Medicare is federally funded, TRICARE is a program for active duty military and their families, and Veteran's Administration is a program for veterans and both are federally.

A senior client with Medicare for health care insurance is in the clinic for a checkup of a leg wound that does not seem to be getting better. The health care provider determines the client needs home health services for wound care. The client is concerned about the cost and asks what part of Medicare covers home health services. What would the nurse's best response be? a. "Part A" b. "Part C" c. "Part B" d. "Part C"

a Medicare Part A covers in-patient hospitalization, some skilled nursing services, short-term home health, and hospice services to eligible clients. Part B is a supplemental and voluntary medical insurance program paid by the participants. Part C is part of the Medicare policy and allows private insurance companies to provide Medicare benefits. Part D is a prescription benefit plan.

Which is true of epidemiological studies? a. Epidemiological studies are often impeded by the limited availability of data. b. Epidemiological studies are reliably time efficient to conduct. c. Epidemiological studies are a guaranteed way to obtain conclusive results. d. Epidemiological studies are known for providing a complete picture of how multiple contaminants may sicken people.

a One of the challenges of epidemiological studies is the limited availability of data on many contaminants and their short-term and long-term effects on health. Other challenges of epidemical studies include their time-intensive nature and their sometimes inconclusive results in demonstrating casual connections between contaminants and illnesses.

A nurse is talking with a client about the current health care system and scheduling a wellness checkup. The client asks the nurse why people who now have insurance do not take advantage of preventative health measures. What is the nurse's best response to the client? a. "Some people may not have transportation or easy access to a health care provider." b. "I don't really know, but I am sure they have their reasons." c. "People can have insurance and still not take care of themselves as they should." d. "We are here to talk about your health, so let's make that appointment."

a Research has been conducted to examine the issues related to prevention. There remain barriers to access for some people living rurally as transportation is not available or other access issues exists.

Of the selected steps below, what is the correct order in developing an evaluation plan for community-level interventions? a. Develop evaluation questions, identify where you will find the data you need, and plan how you will analyze your data. b. Identify where you will find the data you need, develop evaluation questions, and plan how you will analyze your data. c. Plan how you will analyze your data, develop evaluation questions, and identify where you will find the data you need. d. Identify where you will find the data you need, plan how you will analyze your data, and develop evaluation questions.

a Steps in developing the evaluation plan include the following: 1. Develop evaluation questions "focused on what happened, how well it happened, why it happened the way it did, and what the results were." 2. Determine indicators or measures you will use to answer your evaluation questions. 3. Identify where you will find the data you need to measure your indicators and answer your questions. 4. Decide what method you will use to collect data. 5. Specify the time frame for when you will collect data.

The nurse is asked why it is important to teach psychomotor skills. What statement is the best answer? a. "Most health topics involve some sort of "self-care" that the learner will need to do be able to do following the class." b. "Cognitive skills are reinforced with psychomotor skills." c. "Psychomotor skills take more time to teach and it is good use of class time." d. "It is easier to teach psychomotor skills versus cognitive skills."

a Teaching psychomotor skills will make the learner more successful after the class ends. Examples include changing diet and exercise, giving injections, and conducting self-exams.

What is an operational incident management or resource allocation plan? a. Incident Command System b. Federal Emergency Management Agency c. National Incident Management System d. Department of Homeland Security

a The Incident Command System is an operational incident management and resources allocation plan involving five functional areas. The National Incident Management System is not an operational incident management or resource allocation plan. It represents a core set of doctrines, concepts, principles, terminology, and organizational processes that enable effective, efficient, and collaborative incident management. The other choices are agencies not systems.

International Refugee and Disaster-Relief Assistance is recovery assistance offered to any person who is unwilling or unable to return to their country of origin. What is the agency that helps the vulnerable populations to have safety, food, and shelter? a. UNHCR b. MDG c. PICM d. NIMS

a The United Nations High Commissioner for Refugees (UNHCR) was established by the International Refugee Organization, an organization that was founded on April 20, 1946, to deal with the mas-sive refugee problem created by World War II.

Given a list of nursing interventions, identify the best intervention that facilitates capacity building among the vulnerable populations and their communities. a. Patient advocate b. Individual assessment c. Safety planner d. Serving as confidants

a The faith community nurse's role as patient advocate may be unique because the faith community nurse has an ongoing relationship with the congregation member, may know family members, and can directly follow-up on recommendations and additional referrals.

Which is a strategy the nurse can use for improving wellness in a community? a. Enhancing awareness b. Encouraging dependency c. Enacting personal barriers d. Ensuring the status quo

a The public health nurse provides awareness through outreach and education in the community. While it's easy to wish people had healthy behaviors, they will not change if they lack awareness of such behaviors.

Residents in the community have voiced concerns regarding a local pond. The pond is stagnant and residents report a higher than normal number of mosquitoes in the neighborhood surrounding the pond. What is the best legal or legislative resource the nurse can access to reduce or eliminate this problem? a. Contact the local health department legal advisor. b. Call local policy makers. c. Search the Internet for information on county ordinances. d. Email the state attorney for public health.

a This issue is a local issue and the local health department would be the best resource to contact in deciding what actions can be taken to reduce or eliminate this potential health risk.

A new client is inquiring about mental health services. The client has recently been discharged from the military. What reason would the client seek health care outside of the Veterans Affairs (VA) services offered post-military discharge? (Select all that apply.) a. A person must apply for benefits b. Extended wait times to be seen c. Co-payment cost is high d. Services are for retired military personnel e. Mental health services are not covered

a, b Clients may seek other health services because of access. Former military personnel must apply for Tricare (formally called CHAMPUS) benefits after they have been discharged. Due to the recent Iraq and Afghanistan conflicts, there are a high number of former military veterans. This has created a burden on already strained resources, causing greater wait times to be seen for services.

The nurse wants to use the domains of effective teaching to help organize a teaching plan. What domains should the nurse consider? (Select all that apply.) a. Psychomotor b. Affective c. Cognitive d. Physical e. Spatial

a, b, c Learning occurs in three areas or domains: cognitive, affective, and psychomotor. The cognitive domain deals with intellectual development, the affective domain deals with values, emotions and beliefs, and the psychomotor domain deals with the actual performance of a new skill.

What are some characteristics of motivational interviewing (MI)? (Select all that apply.). a. Specifically targeted for change b. Respectful and honors the client's autonomy c. Evokes the client's own motivation for change d. Uses signs of resistance as an opportunity to use assertive counseling e. Nurse-centered

a, b, c MI is respectful, client-centered, empathetic, specifically targeted for change, and evokes the client's own motivation. MI is not coercive or confrontational. Rather, MI supports change in a manner congruent with the client's own values and concerns. Lastly, MI rolls with resistance. This means that the nurse uses resistance as an opportunity for understanding and avoids taking an adversarial stance with the client.

The nurse is aware that environmental factors can mitigate or exacerbate disasters. What are environmental factors? (Select all that apply.) a. Building stability b. Political unrest c. Coastal flooding d. Air temperature e. Scope and intensity

a, b, c, d Climate factors, political factors, and building structures are all environmental components that can affect the amount of destruction during a disaster. Scope and intensity describe the destruction of a disaster but are not a part of the environment.

When working with a patient who is attempting to change a health-related behavior, what will the nurse reinforce? (Select all that apply.) a. The health-related benefits of changing the behavior b. The patient's ability to make the change c. Problem-solving techniques needed to achieve the change d. The amount of time it will take to make the change in behavior e. The need for the actual change in behavior

a, b, c, e Learning model is a behavior change model emphasizing reinforcement of social competence, problem solving, autonomy, and sense of purpose. Setting a time table is not typically a focus.

Which is a factor that shapes policy development? select all. a. Economic conditions b. Available resources c. Technology d. Education level e. Public opinion

a, b, c, e Public policy development is a complex and multifaceted process that involves the interplay of many individuals and groups or parties. Public opinion, economic conditions, available resources, and technological change are each factors that can shape policy.

The U.S. Department of Health and Human Services maintains supervision over data collection associated with which vital statistics? (Select all that apply.) a. Cardiovascular disease b. Diabetes c. Immunizations d. Asthma e. Infant mortality

a, b, c, e The U.S. Department of Health and Human Services has identified six areas for which it has oversight. These areas are (1) infant mortality, (2) cancer screening, (3) cardiovascular disease, (4) diabetes, (5) HIV/AIDS, and (6) immunizations. Asthma is not included in their oversight.

What principles can the nurse apply to maximize the teaching-learning process? (Select all that apply.) a. Make subject matter relevant to the client's interests. b. Adapt teaching to the client readiness level. c. Limit the use of practical application. d. Determine client attitudes toward the subject matter. e. Discourage interaction among learners

a, b, d Determining the attitudes of clients to the subject matter, adapting teaching to the clients' level of readiness, and making the subject matter relevant to the clients' interests are helpful for the health teaching setting. Practical application should also be incorporated, and interaction among learners should be encouraged.

A public health nurse is assigned a new area. In order to become more familiar with the area, the nurse will collect data regarding the health of the community. What sources of existing data will the nurse use to gather initial health-related data about the community? (Select all that apply.) a. Reportable diseases b. Vital statistics c. Hospital records d. Disease registries e. Census data

a, b, d Vital statistics are collected in every state and contain information on births, deaths, adoptions, divorces, and marriages. The nurse can look specifically at births and deaths to gain valuable information. States have developed laws or regulations to require health organizations and health care providers to report to the local health authority certain communicable infectious diseases.

A public health nurse is assessing the community for health needs, health risks, and environmental problems that may affect health. How can the nurse best obtain this data? (Select all that apply.) a. Conducting a windshield survey of the community environment b. Survey state and national policy makers c. Reviewing records from local hospitals d. Searching public records for health statistics related to the community e. Interviews of people in the community

a, b, d, e

What are the risk factors for susceptibility to disease in vulnerable populations? (Select all that apply.) a. Income b. Resource availability c. Character flaws d. Relative risk e. Health status

a, b, d, e Flaskerud and Winslow developed a model of vulnerability to demonstrate the web of vulnerability causation, which includes resource availability, relative risk, and health status. Vulnerable groups or populations have a disproportionately greater risk of poor health.

What are strategies from the Public Health Intervention Wheel? (Select all that apply.) a. Case management b. Health Teaching c. Planning d. Screening e. Advocacy

a, b, d, e Surveillance, referral, health teaching, collaboration, and advocacy are components of the Public Health Intervention Wheel, which help improve health outcomes in communities

Which nations provide coverage for all of their citizens? (Select all that apply.) a. Canada b. United Kingdom c. United States d. France e. Germany

a, b, d, e The United States is the only country in the developed world, except for South Africa, that does not provide health care for all of its citizens.

What characteristics define a community? (Select all that apply.) a. Encompasses a sense of member belonging b. A group that shares a common interest c. Share the same moral values d. Acting together to solve a common problem e. Interaction among a group of people

a, b, e Community refers to a group of people who interact and share common interest and characteristics that form a sense of unity and belonging. A community of solution is everyone coming together to solve a common problem.

In 1918, nursing care shifted from providing care in the home or community to providing client care in hospitals. What factors were instrumental in this shift to acute care? (Select all that apply.) a. Technological advancements and improvements b. The building of new hospitals and better roads c. The continuation of World War I d. The economic boost from the war effort e. Increased number of women in the workforce

a, c

Which of these accurately describes the Beveridge model of health care used by the United Kingdom, Spain, New Zealand, and Hong Kong? (Select all that apply.) a. Health care is financed by the government by tax payments b. Covers medical treatment and select outpatient diagnostics c. Controls what providers can do and what they charge d. Single payers have market power to negotiate for lower prices e. Providers and hospitals tend to be private

a, c Health care is tax-funded and consumers pay no additional cost. They have the ability to control what health care providers can charge.

The nurse is planning to conduct a needs assessment. What methods might the nurse employ to make an assessment? (Select all that apply.) a. Reviewing published literature b. Making observations c. Conducting a survey d. Organizing a task force e. Holding a closed forum

a, c, d Conducting a survey, organizing a task force, and reviewing published literature are all reliable assessment methods. An open forum, rather than a closed forum, is another assessment tool that allows group members to hear each other's concerns, as well as to voice their own concerns or answers.

What categories are considered when determining a nation's health indicators? (Select all that apply.) a. Morbidity b. Cost of health system resources c. Risk factors d. Mortality e. Health service coverage

a, c, d, e Health indicators are descriptors of the general health of a nation that are grouped into four categories: morbidity and mortality, risk factors, health service coverage, and health system resources. The cost of the health resources are not considered.

Which factor contributes to the possibility of relapse back into a negative health behavior? (Select all that apply.) a. Dealing with a high degree of personal stress b. Being in the early stages of change c. Experiencing a poor support system d. Lacking effective coping skills e. Being depressed

a, c, d, e Relapse often occurs because of (1) negative emotional states; (2) lack of, or limited, coping skills; (3) decreased motivation; (4) stress; and (5) high-risk experiences. Being in the early stages of change is not considered a relapse factor.

The public health nurse is preparing a care plan for a client in the community. What factors in the community environment should the nurse consider that can impact a client's potential for health and wellness? (Select all that apply.) a. level of safety to walk or play outside b. Distance between individual homes c. Access to fresh foods and groceries d. Air quality and number of pollutants e. Size of health care facilities

a, c, d, e The environment's healthiness directly influences the health of individuals who work and live within the environment. A number of environmental factors have been identified as potentially detrimental to health such as air quality, food, soil, chemicals ,and elements of the built environment such as ability to access to recreation and parks.

Which variables are characteristics of an aggregate? (Select all that apply.) a. Are considered as a whole b. Are related by blood or marriage c. A group of distinct individuals d. Share a sense of belonging to the group e. Are loosely associated with each other

a, c, e An aggregate is defined as a group of distinct individuals who are considered as a whole and are loosely associated with each other. Families are related by blood or marriage, and communities share a sense of belonging to the group

The nurse is considering the psychosocial factors that could affect a client's readiness to learn. Which factors fit this category? (Select all that apply). a. Family b. Gender c. Support persons d. Home e. Occupation

a, c, e The client's family, occupation, and support persons are psychosocial factors that influence the client's readiness to learn. The client's home is an environmental factor, and the client's gender is a physiological factor.

How can the nurse create an environment that is conducive to learning? (Select all that apply.) a. Restrict free expression. ? b. Assert authority and discipline. c. Ensure that the environment is not too comfortable. d. Create an atmosphere of helpfulness.

a, d The best way to create an environment that is conducive to learning is to make the environment physically comfortable, and instill an atmosphere of helpfulness, trust, and respect that promotes free expression.

The nurse is considering the qualities of effective adult learners. What qualities are most common among this group? (Select all that apply.) a. Practical b. Family-focused c. Fiscally conscious d. Goal-oriented e. Self-directed

a, d, e Adult learners are generally self-directed, goal-oriented, and practical. They bring prior knowledge to the learning sessions, and want to understand how the new information is relevant to their situation or needs.

A community health nurse is at the local recreation center attending a community meeting where members are expressing concern about an upcoming bill on allowing fracking in their community. The community has requested the nurse assist them in preventing the bill from passing. How can the nurse use advocacy to assist the community with this issue? (Select all that apply.) a. Research problems associated with fracking in communities and provide examples. b. Develop a policy restricting fracking in community. c. Locate advocacy groups against fracking and connect the community members with the group. d. Write local policy makers regarding the communities' feelings about the issue. e. Collaborate with community representatives to develop a form letter to contact policy makers

a, d, e The community health nurse in the role as advocate performs actions on the behalf of the community they serve. Functions include guiding community members in identifying policy makers and influential people in the community, identifying ways to make healthier environments for communities through research, and collaborating with community members on community health issues.

Lillian Wald is known as one of the first public health nurses. Her mission was to prevent illness where it started. What action did she take in the 1900s that most specifically demonstrates this focus? a. Advocating for the poor and homeless to lawmakers b. Placing a nurse at school to reduce absenteeism c. Founding a community diet and nutrition program d. Examining sanitary waste disposal policy in a community

b

Which is the payer for the majority of health expenditures in the United States? Direct consumer payment Private coverage Medicare Medicaid

b

Which variable is most likely to influence the health of a community? a. Quality of health care b. Social determinants of health c. Access to health care d. Safety of health care

b

Which is the best description of an aggregate? a. All of the people occupying an area b. A group of individuals who are loosely connected with one another c. A collection of people who live in the same geographic area d. A collection of people who interact with one another

b An aggregate is defined as a group of individuals who are loosely connected with one another. All of the people occupying an area create a population. A collection of people who interact with one another may be a community. A collection of people who live in the same geographic area is a geographic community.

While working in the sexually transmitted infections clinic, the clinic nurse notices a significant increase in chlamydia infections in the teen Hmong population. The nurse began to make some initial inquiries of the Hmong community members about sexual health practices. What type of study is the nurse engaging in? a. Scientific inquiry b. Informal observational c. Direct participation d. Indirect statistical

b Any group encountered by the community health nurse can trigger an informal observational or scientific study. An informal observational study could contain informal inquiries about the increase in infections among community members.

What statement about children and adolescent populations is true? a. Five percent of children younger than age 6 are living in poverty. b. Of all children who are poor, 1/3 are African American. c. Children and adolescents are considered less vulnerable than the elderly. d. Children in single-parent homes are less likely to be poor than those in two-parent homes.

b Children and adolescents are an especially vulnerable population. Twenty percent of children younger than 6 years of age are living in poverty, and children in single-parent homes are twice as likely to be poor than children in two-parent homes. Of all the children who are poor, 1/3 are African American.

What type of disease is the most common, costly, and preventable? a. Infectious b. Chronic c. Sexually transmitted d. Acute

b Chronic conditions are the most common, costly, and preventable. Tobacco and alcohol use, insufficient exercise, and poor eating habits are responsible for much of the illness, disability, and premature death related to chronic disease.

In regards to environmental health risks, how would the genetic predisposition for diabetes be classified? a. Lifestyle b. Personal c. Wider environment d. Community

b Genetics are inherited, including the predisposition for certain diseases. This falls under the personal sphere of environmental health. As people age, genetics interact with the environment, but people cannot change genetics.

What intervention can be used to prevent adverse health consequences and empower vulnerable populations though the sharing of knowledge, skills, and information? a. Case management b. Health teaching c. Referral d. Outreach

b Health teaching can be used to empower vulnerable populations through the sharing of knowledge and information. For instance, by empowering sexually active teens and adolescents with the skills they need to prevent pregnancy and sexually transmitted infections, the nurse can help prevent negative health outcomes before they begin.

A home health nurse is visiting a new client with tuberculosis. The client has refused to take the required medication. What is the nurse's next best action? a. Call the local police to assist in forcing the medication since it is required by the county and state health codes. b. Contact the home health agency attorney to determine the specific regulations governing medication compliance in clients with tuberculosis. c. Notify the health department director and the health department tuberculosis clinic supervisor the client has refused to take the medication. d. Document the medication regimen refusal in the client's chart and let the client know you will be back to check again tomorrow.

b In clients who have active tuberculosis, community health nurse case management is indicated to ensure medication compliance and completion of treatment to prevent the further spread of infection. If a client refuses to comply and is at risk of spreading the infection, then the nurse will need to identify state and local health codes in order to proceed.

A public health nurse is developing an educational program on the Zika virus for a community based on the information found on the county health website and comparing the number of persons (1,237) in the community. The nurse found there were six new cases in the past month in the county. The rate was computed as 0.005%. What type of rate does this measurement represent? a. Mortality b. Incidence c. Count d. Prevalence

b Incidence is determined by the new cases of a disease or health condition at a point in time. The numerator is all the new cases, and the denominator is the population at risk at the time.

A new nurse wants to maximize the opportunities for employment following graduation. Which rationale best supports the nurse in examining employment opportunities in public health nursing? a. The number of health care agencies providing care in the community has increased. b. There has been a shift in providing care to clients in the community. c. Community agencies now offer more programs and have a need for more nurses. d. Hospitals have had a decrease in the number of nurses needed to care for clients.

b Many health care services have shifted from the hospital to the community. Currently more than 14% of RNs work in public health, community health, or home health settings. That percentage is expected to increase significantly due to recent health care reform legislation.

When considering social learning theory, what patient-focused issue is considered most important for a person considering a change in a health-related behavior? a. Support of family and friends b. Ability to make the change c. How difficult it is to make the change d. The impact the change will have on health

b Most importantly, a person must believe in his or her capability to perform the behavior (self-efficacy). Although the other options have impact of the change process, little is achievable is the patient lacks self-confidence.

What statement about policy development is accurate? a. Policy development occurs only at the federal level. b. Agencies can develop policies that affect only individuals using the agency. c. Tobacco usage is off-limits to policy regulation. d. Lobbying for policy legislation is not a right

b Policies developed by an agency may only affect those individuals using the agency, such as a local hospital's policy for visitors during influenza outbreaks

The nurse is asked about the effectiveness of public policy changes. What is the best response the nurse can give? a. Immunizations are more dangerous than the communicable diseases they prevent. b. Policies regulating fluoridation of the water supply reduced tooth decay. c. Seat belts make little difference in the rate of motor vehicle fatalities. d. Facility inspections of restaurants are a poor allocation of public health resources.

b Policy is how standards are implemented, regulated, and enforced. Fluoridated water policies at the state level led to a decrease in tooth decay.

What did the California Nurse Practice Act accomplish? a. Relaxed restrictions on who could perform delegated functions in schools. b. Upheld the requirement for licensed nurses in schools to administer insulin shots. c. Authorized unlicensed school personnel to administer insulin shots. d. Reversed previous ruling requiring insulin shots in schools.

b Requiring licensed nurses in schools to perform delegated functions (like administering insulin shots) was upheld by the California Nurse Practice Act.

Which section of the public health nursing intervention wheel focuses on significant health threats such as contagious diseases but is also used with other health events such as chronic diseases, injury, and violence? a. Consultation b. Surveillance c. Health teaching d. Community organizing

b Surveillance focuses on significant health threats such as contagious diseases but is also used with other health events such as chronic diseases, injury, and violence.

Which characteristic of a system also applies to communities and health? a. That health is not related to an entire system b. That what affects one part of the system, affects the system as a whole c. That systems are not related d. That the sum of the parts is greater than the whole

b The characteristic of a system that also applies to communities and health is that what affects one part of the system, affects the system as a whole. Systems are interrelated. The whole is greater than the sum of its parts, and that health is related to an entire system.

The nurse wants to use an experimental study to determine the effects of exposure to a chemical that is a suspected carcinogen. Which is true of experimental studies in epidemiology? a. They are acceptable if the exposed group gets health benefits. b. It is unethical to expose a person to an environmental risk. c. They are the most widely used type of study. d. They are relatively easy to set up due to access to participants.

b The experimental study is considered the most conclusive form of study, but it is not the most widely used. They are difficult to create due to the fact that it is unethical to expose people to an environmental risk, even if the exposed group may receive health benefits.

The public health nurse found a total of 64 deaths from breast cancer for the year 2015 from a population of 34,000. The nurse determined the rate for the population was 188 deaths per 100,000 people. What does this measure represent? a. Attack b. Mortality c. Count d. Morbidity

b The mortality rate is the relative death rate, or the number of deaths in a population at a specific time.

Which nursing model for behavioral change addresses precontemplation, contemplation, preparation, action, and maintenance? a. Revised health promotion b. Transtheoretical c. Health belief d. Social cognitive

b The transtheorectical model for behavioral change addresses precontemplation, contemplation, preparation, action, and maintenance. This model has been found effective in studies on behavior change including smoking cessation, weight control, sunscreen use, and increased exercise, among others.

The home health nurse is developing a treatment care plan for an elderly retired client with Medicare insurance. What factor will the nurse take into consideration as the plan is developed? a. Treatments and medications may be limited as they are covered by publicly mandated, privately funded health care plans. b. Treatments, if ordered by the provider, are usually covered by publicly funded health care plan. c. Treatments will need to be low-cost and low-technology, as the client will have to pay for all treatments out-of-pocket. d. Treatments will need to predetermined and preapproved by the privately funded health care plan prior to providing service.

b Treatments, if ordered by the provider, are usually covered by publicly funded health care plan.

The nurse admits a client to the emergency room without health insurance. The client is considered part of what type of population? a. Culturally diverse b. Vulnerable c. At risk d. Disenfranchised

b Vulnerable populations are at risk specifically for poor health outcomes. This can be the result of a variety of situations, including homelessness, poverty, and lack of insurance. This person may not be disenfranchised or culturally diverse

What is the role of the nurse when using the adult learning model to bring about a change in a patient's health behaviors? a. Determine the patient's readiness to make the change b. Reinforcement of the goal as the change is being made c. Role modeling for the patient as the behavior is being changed d. Assessment of the patient's understanding of the importance of the goal

b When considering the adult learning model, a goal is established and reinforced by the nurse, with rewards given for partial accomplishment, if necessary. Although the other options may be considered nursing responsibilities, they are not associated with the adult learning model in the change of behaviors.

A recently hired clinic nurse is providing intake on a new client at the clinic. The client states not having any insurance. When the client leaves, the new nurse makes the following comment; "I thought all people had insurance since the Affordable Care Act of 2011." What would be the nursing supervisor's best response to this comment? a. "They may have insurance but choose not to tell us they have insurance because we are a public health agency." b. "Even though there is coverage available, many people in the United States cannot afford health care coverage." c. "There is health care coverage, but some people choose not to use it because it is difficult to apply for and obtain." d. "Some people actually choose not to take the health care coverage offered by the government and prefer to pay out-of-pocket."

b With the Affordable Care Act of 2011, more people than ever are able to obtain health insurance. However, the number of uninsured has recently increased. This increase is felt to be among the working poor. The working poor without insurance usually fall into one of three categories: those who have only one wage earner and cannot afford the insurance offered; those who cannot afford the co-payments for care even if insurance is offered; or those who are not offered insurance by their employer and must seek and pay for it by themselves.

A school nurse is checking the students in the seventh grade for scoliosis. What type of assessment is scoliosis testing? a. Illness b. Screening c. Health d Diagnostic

b he secondary level of prevention is aimed at early detection and includes screenings.

An occupational health nurse is checking employees' blood pressure at the annual benefits fair. The nurse has developed a questionnaire for the employees to complete, including demographic data such as age, gender, and ethnicity, as well as tobacco use. What interrelated system in health is the nurse assessing with this questionnaire? a. Health services b. Personal biology c. Education d. Physical environment

b Demographic and personal biological characteristics can influence health. A person's age, race, and gender are all demographic data that can be collected on individuals and can influence a person's health behaviors.

Which factor is a part of the interrelated environment system? (Select all that apply.) a. Ability to ambulate b. Housing c. Adequate fresh water d. Safety e. Transportation

b, c, d Safety, access to adequate fresh water, and housing all fall under the interrelated system of environment. Environment includes more than the physical structures such as houses, roadways, and parks. It includes other elements such as protection and safety.

With the implementation of the Health Care Reform Act, more persons have insurance than ever before but health care cost continues to rise. What issues are contributing to the rising cost of health care? (Select all that apply.) a. The number of insurance plans available b. Increased unemployment rates c. Increase in available technological equipment d. Uninsured clients' use of resources e. A decrease in the number of preventative services

b, d Unemployment, the increased cost of living, and the uninsured have led to an increase in health care costs.

Which benefits of making exercise a habit could be described as "health promotion"? (Select all that apply.) a. Reduces the risk of lung cancer b. Improves strength and balance c. Reduces the risk of colon cancer d. Increases longevity e. Improves cognitive function

b, d, e All of these benefits could be described as "health promotion," except for reduction of cancer. The benefit of reducing cancer is more aptly described as a form of "disease prevention."

The federally funded program Medicare provides free health care for what groups of individuals? (Select all that apply.) a. Families at 100% poverty b. Individuals with kidney failure c. Children under the age of five d. Legally disabled persons e. Eligible seniors over the age of 65

b, d, e Mandatory federally health insurance program was established in 1965. It provides federally funded health insurance for persons 65 and older who paid into the Social Security system, certain disabled persons and those diagnosed with end-stage renal disease to receive quality health care that would otherwise be unavailable to them.

What historical public health achievements have public health nurses contributed to? (Select all that apply.) a. First to identify sanitation as a source of disease b. Improvements in family planning and education c. Implementation of sanitation laws and policies d. An increase in healthier mothers and babies e. A decrease in the spread of infectious diseases

b, d, e Public health nurses have contributed to control of infectious diseases, improved family planning, and an increase healthier mothers and babies through education and early prenatal care. Public health nurses do not implement sanitation laws.

Which are the core functions of government in addressing the health of its citizens that are also the core public health functions? (Select all that apply.) a. Prevention of illness b. It assesses health care problems. c. Paying for all services needed d. It ensures that services are delivered and outcomes achieved. e. It intervenes by developing relevant health care policy.

b, d, e The core functions of government in addressing the health of its citizens that are also the core public health functions are it assesses health care problems (assessment), it intervenes by developing relevant health care policy (policy development), it ensures that services are delivered and outcomes achieved (assurance).

The public health nurse is providing CPR training to day care workers at the local community recreation center. What essential service is the public health nurse providing? a. Link people to needed health services and assure health care is provided. b. Enforce laws and regulations to protect health and ensure safety. c. Inform, educate, and empower people about health issues. d. Ensure competent public and personal health care workforces.

c

This intervention on the Public Health Wheel relates to specific and direct care actions provided by community health nurses, under the direction of a health care practitioner, as allowed by law. This includes any tasks a nurse delegates to appropriate personnel. a. Consultation b. Collaboration c. Delegated Functions d. Case Management

c

Which nurse in history first used the term public health nursing and is considered to be the founder of public health nursing? a. Mary Breckenridge b. Mary Brewster c. Lillian Wald d. Florence Nightingale

c

In the homeless community, the nurse can help individuals with addition by developing grassroots advocacy and policy formation to affect population health by: a. Securing grant money to transport this community to places of worship each week b. Finding grant money to help the addicted homeless relocate to another place c. Applying evidence-based practice in the nursing care of at-risk substance abuse populations d. Educating the addicted homeless community on the horrors of being addicted

c Applying evidence-based practice in the nursing care of populations most at risk for substance use disorders will help nurses develop effective advocacy programs and policies.

The nurse involved in collecting the number of new Zika virus cases and analyzing where they have occurred is participating in: a. rapid clinical appraisal. b. epidemiology. c. biostatistics. d. evidence-based practice.

c Biostatistics is defined as the collection and analysis of public health data for a disease or concerning health issue in the community. Epidemiology examines the data and the variables collected for that health issue. Evidence-based practice would be used to gather information on how to prevent the spread of Zika, and rapid clinical appraisal would be used to evaluate the information gathered.

How does an epidemiologist use biostatics? (Please check the best answer.) a. Advocates for animal studies to help communities overcome illnesses b. Lobbies for education programs to teach communities about disasters and terrorism c. Determines whether there are cancer-clusters in a chosen community d. Determines how many hip replacements occur during a year's time

c Cancer clusters occur when there seem to be an elevated number of cancers in a family, community, or coworkers or classmates. Epidemiologists who have knowledge of disease, biostatistics, and public and environmental health investigate these suspected cancer clusters.

How is it that the risk for lead poisoning is increased for children living in poorer communities? a. Poor diet as a result of limited income b. Limited access to health care services c. State of deteriorating housing d. Lower literacy rates among parents

c In communities with older, deteriorating housing, children can be exposed to lead. In many cases, such housing is found in poorer communities. Although the other options may in some cases contribute to health risks, they are not associated with lead poisoning.

Domestically displaced persons due to disasters in the U.S. to help them in their recovery period. As was seen with Hurricane Katrina, one federal agency assisted victims of this hurricane for months after the event. Which of the following agencies was the recovery agency? a. ASSERT b. PICM c. FEMA d. UNHCR

c In the United States, the DHS is the central organization overseeing many different agencies that focus on the safety and security of the nation. Their many responsibilities include border and transportation security; chemical, biologic, and radiologic countermeasures; informational systems and infra-structure protection; and emergency preparedness and response.

A pregnant woman is in the public health clinic for her first prenatal visit. She is currently single, living alone in federal housing, unemployed, and does not have any type of health care coverage. What health care program will the nurse identify to the client to apply for health care coverage? a. Medicare b. Women, Infants and Children c. Medicaid d. The Children's Health Insurance Program Medicare

c Medicaid is a part of the Social Security Act Amendments of 1965 that provides medical assistance for children, pregnant women or parents with dependent children, and senior and severely disabled persons. Women, Infants and Children is a supplemental nutrition program.

How is Medicare funded by paid taxes? a. Via government subsidies of other programs b. According to employer tax bracket c. Through employers and employees equally d. From employee state withholdings

c Medicare is funded by payroll taxes employers and employees equally pay into the Social Security system along with the interest earned from trust fund investments.

In clients with terminal illness, the nurse can help to develop grassroots advocacy and policy formation to affect population health by: a. Educate the terminally ill community on the issues associated with dying b. Securing strong opiates to relieve the pain of the terminally ill c. Coordinating care in various settings, with high-quality communication among health care providers d. Creating research studies to determine causes of terminal illnesses

c Patients of all ages and their families look to their nurse to educate, support, and guide them throughout serious illness and, if need be, the dying process. This intimate position allows the nurse to advocate for improved quality of life for the person with serious illness.

Which statement best describes policy? a. Nurses must support policies. b. Nurses are powerless to determine policies. c. Policy comprises the actions that are taken to achieve a goal or objective. d. It is a nurse's responsibility to adhere to policies.

c Policy is defined as a plan of action or an agenda that outlines steps or actions to implement a stated goal or objective. Policy is also defined as principles that govern an action to achieve a given outcome.

In checking the absentee roster for the day, a school health nurse has found 26 confirmed cases of viral gastroenteritis in a school population of 326, or approximately 8 percent. What type of rate does this measurement represent? a. Incidence b. Morbidity c. Prevalence d. Count

c Prevalence rate refers to all of the people with a condition in a given population at a specific time point.

Which is an agency that will give assistance to vulnerable population that suffers from alcohol and drug abuse, education, and refers for treatment? a. NIMS b. FEMA c. ASSERT d. PICM

c Project ASSERT (Alcohol and Substance Abuse Services, Education, and Referral to Treatment) is a screening, brief intervention, and referral to treatment (SBIRT) model designed for use in health clinics or emergency departments. Project ASSERT aims to reduce or eliminate unhealthy substance use through collaboration with trained nurses, peer educators, and other health professionals.

The fourth principle of MI, self-efficacy, includes which of these ideas? a. Expressing empathy towards a person shows acceptance and increases the chance of developing rapport. b. Acceptance enhances self-esteem and facilitates change. c. If a client believes that he or she has the ability to change, it is motivating and greatly increases the likelihood of change. d. When the nurse opposes a client's resistance and argues for change, a breakdown in communication occurs and prevents the client from exploring his/her views safely. e. Change is motivated by a perceived discrepancy between present behavior and important personal goals and values.

c Self-efficacy is a crucial component to facilitating change. The nurse's own belief, as well as the client's own belief, in the client's ability to change becomes a self-fulfilling prophecy. The nurse can support the client in taking responsibility for choosing and carrying out change.

What is the best way to help populations and communities avoid environmental health risks? a. Treating individual clients in an acute care setting b. Providing home health care after discharge from acute care facility c. Identifying potential dangers before they occur or worsen d. Performing secondary intervention to avoid further complications.

c The best way to avoid environmental health risks is to identify potential dangers before they occur. The other options can mitigate health risks, but preventing them in the first place is the ideal scenario.

When did district nursing first occur in the United States? a. In the 1700s b. In the 1980s c. In the late 1800s d. In the 1920s

c The first public health nurse in the United States was Francis Root in NYC in 1873. Other district nursing associations were formed in Buffalo, NY, Philadelphia, and Boston in 1885 and 1886. The Henry Street Settlement was started in 1893 in NY, New York.

Which of the following is the professional value that leads nurses to advocacy? a. Self-interest b. Promoting needs of one while denying others c. Social justice d. Treating all people exactly the same

c The guiding values of nursing include social justice and that "nurses should act to change those aspects of society that detract from health and well-being." Nurses are required to hold the responsibility of upholding the values of their society.

What is the most important role of the community health nurse? a. Surrogate b. Advocate c. Educator d. Leader

c The most important role of the community/public health nurse is that of a health educator. The nurse engages and inspires learners to effect change in their lives and move toward better health

What stage of change of Lewin's Change Theory describes when the change is integrated and stabilized into practice? a. Thawing b. Changing c. Refreezing d. Unfreezing

c The third stage of Lewin's theory is refreezing. During this stage, change has been integrated and stabilized into practice

The nurse is asked what is meant by "vulnerability" in the context of community health nursing. What is the best response? a. Vulnerability is the state of mind the nurse possesses when treating the sick. b. Vulnerability is an emotional disposition towards one's environment. c. Vulnerability is any factor that increases the chances for poor health. d. Vulnerability is the likelihood that a population will ignore health interventions.

c Vulnerability is any factor that increases the chances for poor health. Community health nurses care for many types of vulnerable populations, who depend on the nurse for advocacy and support.

When considering health behavioral change, what fundamental right does the individual have during the process? a. Physical health as a result of implementing the change b. Financial support for the expenses incurred by the change c. Involvement in decision making regarding the change d. Emotional wellness resulting from the behavioral change

c Whether individuals or groups represent specific interests in communities, participation in decision making, informed consent, advocacy, and health literacy must be considered in using models of behavior change. None of the remaining options are guaranteed.

One of the main roles of the public health nurse is advocacy. What is included in the process of advocacy? (Select all that apply.) a. Contacting payer sources b. Developing action plans c. Identifying stakeholders d. Taking action e. Collecting information

c, d, e Advocacy is a process where the community health nurse is trying to influence outcomes or championing a cause. Advocacy includes identifying the issue, collecting information, identifying influential people, building support, and taking action

What steps can a community health nurse take to be an effective advocate for clients? (Select all that apply.) a. Developing state health policies b. Conducting health projects c. Championing new health laws d. Recognizing public health problems e. Identifying legal and legislative resources

c, d, e Community health nurses can be effective advocates for their communities by identifying legal and legislative resources, staying current on laws, recognizing public health problems, and supporting new laws.

Which of the health care models have only one system for all people? (Select all that apply.) a. National Health Insurance b. Reform c. Beveridge d. Out-of Pocket e. Bismarck

c, d, e Several countries have one system of health care model for all the residents of that country. This one-system model eliminates the need for other health care programs for the poor such as Medicare and Medicaid. This makes health care benefits more consistent and comprehensible.

What factors does the Health-Belief Model specify that health-related behavior depends on? (Select all that apply.) a. Interpersonal influences b. Perceived seriousness of illness c. Situational influences d. Perceived susceptibility to illness e. Benefits of taking action.

c, d, e The Health-Belief Model is a behavior change model useful for individual, family, or community health-related behavior. Community health nurses use this model to assess individuals and communities regarding their "health beliefs" prior to planning interventions. Interpersonal and situational influences are aspects of the Pender Health-Promotion Model.

The nurse is involved in supervision using the Incident Command System (ICS). The nurse should recognize the following are functional areas of the system. (Select all that apply.) a. Leadership b. Partnering c. Logistics d. Operations e. Command

c, d, e The ICS organizes emergency response in five major functional areas: command, planning, operations, logistics, and finance and administration.

What are the levels of focused practice as noted on the Public Health Intervention Wheel? (Select all that apply.) a. Provider-focused practice b. Nurse-focused practice c. Systems-focused practice d. Community-focused practice e. Individual-focused practice

c, d, e The three levels of practice are Community-, Systems-, and Individual-focused practice. Interventions use a population-based approach at all three levels. For example, interventions may be targeted at the entire populations within a community. They may be directed at a system that affects the health of populations, or at individuals or families within those populations known to be at risk.

When considering motivational interviewing, which strategy would be considered ineffective when working with a group dealing with alcohol dependency? (Select all that apply.) a. Implementing both punishment and praise to provide motivation for change b. Providing advice about change choices the members are considering c. Having the members refer to themselves as alcoholics d. Identifying problems concerning change that the group needs to work on e. Pointing out mistakes the group is making associated with changes

c, d, e This method does not (1) argue with a group or community by insisting it has a problem that needs to change, (2) offer advice without actively encouraging group-identified choices, (3) give advice while the group is put in a passive role, (4) impose diagnostic labels, or (5) use coercive tactics.

The nurse is considering a client's readiness to learn. Which are considered cognitive factors? (Select all that apply.) a. Age b. Gender c. Reading ability d. Occupation e. Motivation

c, e Motivation and reading ability are cognitive factors. Age and gender are physiological factors, and occupation is a psychosocial factor.

A client is considering what options are available for her child's health insurance coverage in the free marketplace but is worried because of a preexisting diagnosis of diabetes. What should the nurse tell the client about preexisting conditions and the Affordable Care Act of 2011? a. The free marketplace places insurance companies in competition, so they do not consider preexisting conditions. b. The preexisting condition may cause the insurance premiums and co-payments to be higher. c. Preexisting conditions are only considered by insurance companies when the person has had a recent hospitalization. d. The insurance companies are required to cover an individual regardless of preexisting conditions

d

In the United States, what percentage of health care services is paid for with public funds? 50% 30% 25% 47%

d

Which governmental agency had the goal of health for all by the year 2000 and has stated, "the development of society, rich or poor can be judged by the quality of its population's health, how fairly health is distributed across the social spectrum, and the degree of protection provided from disadvantages as a result of ill-health"? a. U.S. Public Health Service b. Centers for Disease Control and Prevention c. United Nations d. World Health Organization

d

The nurse wants to conduct an assessment that will protect the anonymity of the participants. What is the best tool to use? a. Task force b. Open forum c. Interview d. Survey

d A survey is similar to an interview in that it asks questions. However, instead of being conducted verbally, it is filled out online or on paper. This can be an advantage as it allows respondents to remain anonymous.

A public health nurse has been assigned to develop and coordinate a community of solution group on the issue of childhood obesity. Who should the nurse contact first? a. Health care providers in the bariatric surgical unit at the nearby hospital b. Health educators in the area interested in researching obesity c. Individuals identified in the local community who have obese children d. Local school nurses in the community and the surrounding areas

d Community of solution groups are formed around schools, agencies, or political figures. The public health nurse would first need to contact the school nurses to identify significance of the problem and interventions already in place

A community epidemiologist researcher wishes to conduct a study using the homeless community they specialize in. Which of the following research studies would be appropriate for this researcher to conduct? a. A mixed-methods approach to determining pain levels in premature newborns b. A quantitative study on the numbers of homeless using the emergency rooms for their health care by season c. A qualitative study of the numbers of bees that have died within the last 5 years d. A quantitative study comparing diabetes exacerbations with soup kitchen meals

d Epidemiology is a field of public health science that focuses on the incidence and prevalence of disease or illness in a population.

The nurse studying epidemiology understands that which nurse was the first to use biostatistics to identify patterns of disease, injury, and death for preventative health purposes? a. Clara Barton b. Mary Breckinridge c. Lillian Wald d. Florence Nightingale

d Florence Nightingale was one of the founders of epidemiology and the first health care worker to use biostatistics to identify and track deviations in disease patterns.

The community health nurse has identified a high rate of obesity in school-age children within one community. The nurse completes a community assessment and finds the median income in the area is 28,000 for a family of four. In what interrelated system will the nurse document this finding? a. Health services b. Physical environment c. Social support networks d. Income and social status

d Income is linked to health status. A population-based cohort study found low rates of socioeconomic status are positively correlated to a higher rate of obesity in children.

A client who is employed at a local large manufacturing plant has an appointment at the clinic. What type of insurance plan would the intake nurse expect the client to have? a. Publicly mandated, privately funded b. No insurance for a health care c. Publicly funded health care insurance d. Privately funded health care

d Large companies with more than fifty employees must offer health insurance to their employees. This health insurance is privately-funded. p. 182

What term is used to identify the probability of death? a. Incidence b. Prevalence c. Morbidity d. Mortality

d Mortality rate is the probability of death from any cause among the entire population within a given time frame. Morbidity is the departure from a state of physiologic or psychological well-being. Prevalence rate measures the number of people in a given population who have an existing condition at a given point in time. Incidence rate measures the probability that people without a certain condition will develop that condition over a period of time

When considering motivational interviewing, what is a primary goal of this client-centered communication style? a. Suppressing autonomy b. Clinician-imposed change c. Resistance minimization d. Ambivalence resolution

d Motivational interviewing is defined as a "directive, client-centered communication style for eliciting behavior change by helping clients/[groups] to explore and resolve ambivalence." To address behavior change using this method, the motivation comes from the client and is not imposed by a clinician. The client needs to resolve ambivalence to change a behavior with autonomy. Persuasion on the part of the clinician only intensifies resistance.

What is an example of an intrinsic motivational factor? a. Praise from a health care provider b. A promise of a prize c. Encouragement from a loved one d. A personal feeling of accomplishment

d Praise, encouragement, or prizes are examples of extrinsic rewards for the initial adoption of healthy behaviors. Feelings of accomplishment and changes in person health habits are examples of intrinsic rewards that are often used in the long-term adoption of healthy behaviors.

Which statement regarding the cause of poor health outcomes and exposure to environmental contaminates describes the challenge associated with minimizing the risk to an individual's health? a. The connection between many negative health outcomes and environmental exposure has been established. b. Environmental exposure to contaminants is the greatest factor associated with human illness. c. Medicine has begun to dedicate resources to positively demonstrate the link between environment and health. d. It is very difficult to confirm a link between a person's illness and the environment in which he or she lives.

d Proving causal links between exposure to environmental contaminants and health outcomes, or links between the community environment and health outcomes, is often very difficult. None of the remaining options is true regarding the cause of poor health outcomes

What statement is true about social justice? Social justice refers to: a. advocating health care as a privilege. b. relaxing environmental protection laws. c. abandoning highly polluted areas. d. sharing common burdens and advantages.

d Social justice is a chief principle of public health, and refers to the equitable sharing of both common burdens and advantages. The basis of social justice is a value system in which health care is a right, rather than a privilege. Achieving health equity is a goal.

In the HIV-positive community, the nurse can help to develop grassroots advocacy and policy formation to affect population health by: a. Educating the public on the horrors of HIV b. Requiring mandatory testing of the community c. Creating lists of known infected persons d. Helping to create policy on early screening

d Sometimes, when screening is completed, the client's level of disease or injury is found to be at a more advanced stage and is not considered to have been "caught early."

The nurse is unsure which members of a local community have been affected by exposure to chemical poisoning. What strategy from the Public Health Interventions Wheel should the nurse employ? a. Advocacy b. Counselling c. Surveillance d. Screening

d Targeted screening is a way for the nurse to identify individual cases of chemical poisoning and narrow down which members of the community need help.

A client has asked the nurse who qualifies to receive an income-based subsidy from the government to help with health care coverage. What should the nurse tell the client? a. Anyone can get a subsidy from the government for health care coverage as long as they pay taxes. b. Those who qualify for health care subsidies are over the 200% poverty level. c. Individuals and families below the 100% poverty level are those who receive subsidies. d. The subsidies are given based on incomes within the 100% to 400% poverty level.

d The Affordable Care Act of 2011 includes subsidies for low-income individuals and families to help obtain private insurance.

A nurse wants to better understand the Incident Command System (ICS). Where should the nurse look for courses related to the ICS? a. Department of Homeland Security website b. Department of Health and Human Services website c. Local government seminars d. Federal Emergency Management Agency website

d The Federal Emergency Management Administration (FEMA) website provides free courses for nurses and other health care professionals to educate regarding the ICS.

Which is a good example of a nurse "reflecting" back what a client says using the OARS technique? a. "I think you need to consider walking at least three days a week instead of just one." b. "How do you feel about adding more walks to your weekly exercise routine?" c. "You are doing a great job planning to add more exercise into your weekly routine." d. "I hear you saying that you would like to increase your walks from one day a week to three days a week."

d The acronym OARS stands for "open-ended questions, affirmations, reflections, and summaries." It is a model of interactions that include techniques for verbal and nonverbal responses and behaviors. When using this model, the nurse will "mirror" and reflect back what the client says.

The occupational nurse would like to identify employees who are at risk for heart disease. The nurse has begun taking blood pressures on all new employees, with the intent of identifying early signs and symptoms so effective treatment can be sought. What ethical principle does this represent? a. Health justice b. Fairness c. Non-malfeasance d. Beneficence

d The ethical principle of beneficence means to do good or benefit others. It is the act of being "good" or taking an action to ensure more positive outcomes.

What stage of Lewin's Change Theory represents the period when the desire for change develops due to motivation either intrinsically or by some external force, causing disequilibrium? a. Refreezing b. Thawing c. Changing d. Unfreezing

d The first stage of Lewin's theory is unfreezing. This stage may occur spontaneously and involves initiating the change. For example, a family may request help in solving a problem in alcoholism, or a group may seek assistance in adjusting to retirement.

The patient is inquired about several different smoking cessation programs. When considering the transtheoretical model, which stage of change is the patient currently in? a. Action b. Maintenance c. Precontemplation d. Preparation

d The stages associated with this model of change includes (1) precontemplation (no screening programs scheduled and no intention to schedule screening), (2) contemplation (no screening programs scheduled but intent to start a program soon), (3) preparation (no definite screening program but have taken steps to develop a program), (4) action (a developed screening program and intent to sustain the program), (5) maintenance (have had the program for some time and intend to continue), and (6) relapse (had a program, does not have a program currently, but intends to be active with a program soon).

In regards to the environmental health risks, which of these spheres affects everyone and includes general air or water pollution, exposure to natural or man-made disasters, and/or outbreaks of disease? a. Lifestyle b. Community c. Personal d. Wider environment

d The wider environment affects everyone and can include things like general air or water pollution, exposure to natural or man-made disasters, and outbreaks of disease

What is an example of a biological health risk? a. Pesticides b. Garden and lawn fertilizer c. Loud machinery d. Contaminated drinking water

d Where an individual resides can increase exposure to biological, chemical, physical, and social-environmental health risks. Contaminated drinking water is a biological risk. Garden fertilizer and pesticides present a chemical risk. Loud machinery is an example of a physical risk.

A public health nurse is providing education to pregnant teens on pregnancy nutrition. As part of the education, the nurse also encourages the teens to finish high school and go on to college when possible. What is the rationale for both the nutrition education and encouragement for continued education related to the determinants of health? (Select all that apply.) a. Increased education decreases the likelihood of premature birth b. The determinant social support is being met by the nutrition class c. Personal biology as a health determinant can be eliminated with education d. Low education levels are associated with poorer health and greater stress e. Education on health determinants can facilitate positive action

d, e Many factors can affect an individual's risk for disease. Determinants of health include personal biology, access to health services, income and social status, education, the physical environment, and social support. The community health nurse can facilitate positive change by providing education on the social determinants of health.

Which are examples of public-funded health care in the United States? (Select all that apply.) Employer-provided insurance Commercial insurance plans Nonprofit insurance plans Medicare Medicaid

d, e Medicare and Medicaid are public-funded health care plans in the United States.

T/F Historically, disaster management has been associated with public health nurses

F Historically, disaster management has been associated with police, firefighters, emergency medical technicians, and hazardous materials (HAZMAT). Public health nurses are now seen as having a crucial role in all phases of disaster management.

T or F: Public health nurses' skills vary when they are in daily practice versus reacting to a disaster in the community.

F In both daily practice and disaster situations, public health nurses use the following skills: anticipate problems and emergencies, develop plans, and build system-wide partnerships.

T/F: In the public health intervention wheel, screening includes primary levels of prevention.

F Screening includes secondary levels of prevention because it is a planned effort to minimize the impact of disease once it is in effect.

T/F: Creating on-going program evaluations will assist in identifying gaps and the need for more money to continue the program.

F This information assists in identifying gaps and detecting emerging problems early so that appropriate responses can be facilitated.

The similarities between the nursing process and the epidemiological process include: a. Goals only b. Planning and implementation only c. Entire ADPIE model d. Evaluation only

c The ADPIE module includes assessment, diagnosis, planning, implementation, and evaluation. These steps are common to both the nursing process and the epidemiological process.

T/F In the response step of the disaster management continuum, public health nurses take measures to limit damage, disability, and loss of life.

F In the response step, public health nurses implement a disaster plan. The mitigation step involves measures to limit damage, disability, and loss of life.

T/F: In the public health intervention wheel, health teaching includes tertiary levels of prevention.

F Health teaching includes primary levels of prevention because the goal of teaching is to teach healthy practices that increase resistance to disease.

The nursing process in community health focuses on: (Select all that apply.) a. The population b. The client and family only c. The organization d. The individual only

a The focus of the nursing process is on caring for the client within his or her family; whereas the focus of the epidemiologic process is on caring for the population of the community as a whole

What is the goal for primary disease prevention? a. To avoid disease onset through increase of resilience b. To promote rehabilitation c. To detect disease before symptoms d. To improve the quality of life

a The goal of primary prevention is to avoid illness or injury before it even begins. One way to do this is by increasing resilience and resistance to disease

The ___________ of a disaster is the range of its effect, either geographically or in terms of the number of people impacted. a. scope b. intensity c. complexity d. cause

a The scope of a disaster is the range of its effect, either geographically or in terms of the number of people impacted. The collapse of a 500-unit high-rise apartment building has a greater scope than the collapse of a bridge that occurs while only two cars are crossing. The cause of a disaster is accidental, terroristic, or natural. The intensity and complexity could refer to the types of disruptions the disaster caused.

What action does the nurse perform during the analysis stage of a community health assessment? Identify causal factors for health indicators. Identify key community stakeholders. Identify the best way to conduct an assessment. Identify important survey questions.

a To complete the process of data analysis, the nurse should finalize and prioritize health indicators that will be addressed by the nurse/agency through interventions. For these selected health indicators, the nurse should identify and understand the casual factors.

Health promotion and disease prevention are both focused on which level of intervention? a. Primary b. Tertiary c. Secondary d. Multi-level

a

A nurse wants to help as a result of a recent disaster in the community. In addition to carrying a nursing license and CPR certification cards, what should the nurse first consider when entering the scene? a. Personal safety b. Altruistic intentions c. The governmental structure d. The needs of the community

a It is altruistic to want to help in the event of a disaster. The needs of the community and the governmental structure are important during a disaster in terms of intervention. Yet, the first priority when entering a disaster scene is personal safety. The disaster does not need another victim.

Choose the correct answer below that best describes what the health impact assessment does. a. A process that helps evaluate the potential health effects of a plan, project, or policy before it is built or implemented b. A visual representation of the methods behind the operational evaluation of the program c. The use of marketing principles and practices to change health behaviors or beliefs, social or cultural norms, or community standards to improve health or benefit society d. A process where health status exists at the population level between nations or within nations

a A health impact assessment (HIA) helps communities make informed choices about improving public health through community design. HIA is a process that helps evaluate the potential health effects of a plan, project, or policy before it is built or implemented.

A school nurse has determined there may be an outbreak of salmonella within the school and possibly the community. Who would the school nurse contact to report the possible outbreak? a. The local health department b. The local emergency room c. The state public health nurse d. The school nurse supervisor

a A potential outbreak should be reported to the local health department/agency to begin an investigation.

Which illness state is considered communicable? a. Malaria b. Obesity c. Neurofibromatosis d. Glaucoma

a Communicable diseases are caused by pathogens (e.g., viruses and bacteria) that multiply and enter hosts through a variety of mechanisms and influences. These diseases have the capacity to cause infections across living organisms, with life-threatening and potentially chronic effects. Malaria is considered communicable. None of the remaining options are communicable in nature.

A public health nurse has been assigned the task of finding the cause of a recent salmonella outbreak in the area. The nurse will use an epidemiological method to complete this task. What is the nurse's best rationale for utilizing this method? a. Epidemiology is used to identify patterns and trends in disease occurrence. b. Epidemiology provides a way to identify disease effects on a population. c. Epidemiology is used to identify the virulence of disease in a population. d. Epidemiology provides a framework for determining approaches to outbreaks.

a Epidemiology is used in community health as a method for assessing the health of a population, and it provides a frame of reference for investigating and improving practice. Epidemiology is also a science used to analyze and understand patterns of occurrence.

The immunization clinic nurse is assessing the Mantoux tuberculin skin test a client received two days ago. The result is positive. The client does not have signs or symptoms of active tuberculosis. The client is upset regarding the positive result and asks when to start the tuberculosis medication regimen. What is the nurse's best response to this question? a. "Not all people who are infected with tuberculosis have active tuberculosis; you will need further testing." b. "The tuberculosis medication regimen is started eight to ten weeks after exposure." c. "Usually treatment begins immediately with a positive test result for tuberculosis." d. "False results happen at times; we will send you to the hospital for a blood test and other diagnostic tests next time."

a If the skin test is reactive and no symptoms are noted, then the client may have a non-active case of tuberculosis. The client will need further testing to verify latent TB.

A school nurse implemented a sexual health education program in a high school after finding a high rate of sexually transmitted infections in the student population. The school board is deciding whether to fund the program again in the upcoming school year. What is the best next step in determining the current program's effectiveness? a. Screen the student population to determine the prevalence of sexually transmitted infections. b. Report the number of students who are participated in the program. c. Design and present a plan to reduce costs of the program. d. Report the number of high school students who committed to abstinence.

a Screening to determine the prevalence of disease after the end of a program is the first step in determining the outcomes. Outcome evaluation is crucial in program planning. The cost, number of participants, and the number who are reporting abstinence are certainly vital data to report, but not the best measure of effectiveness.

A nurse is concerned about biological warfare in the United States. Which statement best answers this concern? a. "The United States has stockpiled vaccines and antidotes in the event of biological warfare." b. "We do not need to be concerned about biological warfare in the United States." c. "There are currently plans in place to destroy biological warfare weapons." d. "The United States does not have any plans to combat biological warfare."

a The United States, through the Centers for Disease Control, has stockpiled vaccines and antidotes to commonly used biological warfare weapons, such as anthrax. Biological warfare will be an ongoing problem to prevent.

What issues are addressed in the study of epidemiology? (Select all that apply.) a. Research regarding states of illness b. Methods of sharing illness among humans c. Factors that determine what health is in humans d. Cost of illness versus the benefits of health e. A body of knowledge concerning specific states of health

a, b c, e Epidemiology is the study of the distribution and determinants of states of health and illness in human populations; it is used both as a research methodology to study states of health and illness and as a body of knowledge that results from the study of a specific state of health or illness. Cost versus benefit is not a recognized issue.

What correctly identifies a public health nurse's role in the prevention of a disaster? (Select all that apply.) a. Identifying community risk factors b. Organizing a disaster drill for the community c. Developing a disaster plan d. Triage during the disaster e. Public health disease surveillance

a, b, c Disaster management begins before a disaster occurs. Developing a plan, conducting drills, and being connected to state and nationwide communication systems are crucial for the public health nurse. Disease surveillance and triage should occur during a disaster.

Public health services encompass a wide variety of activities. Which are considered core functions of public health service? (Select all that apply.) a. Assessment b. Assurance c. Public policy d. Community participation e. Sanitation reform

a, b, c The three core public health service functions are public policy, assessment, and assurance. Community participation is crucial, but not an explicit function of public health service. Sanitation reform was a key outcome of early public health services.

Which area of questioning is explored when assessing family health routines? (Select all that apply.) a. Illness care b. Mental health behaviors c. Self-care d. Safety and precaution e. Individual's care

a, b, c, d Denham (2002) identified six categories of family health routines: self-care, safety and precaution, mental health behaviors, illness care, and member caregiving. Family care and not individual care is considered.

Which are components that provide direction for solving problems, managing nursing actions, and improving the health of communities? (Select all that apply.) a. Diagnosis b. Evaluation c. Planning d. Implementation e. Rehabilitation f. Assessment

a, b, c, d, f Assessment, planning, diagnosis, implementation, and evaluation are the five essential components to the nursing process in a community health setting. As a nurse and client maintain a reciprocal exchange of information and trust through interaction, they can effectively assess client needs, diagnose needs, and plan, implement, and evaluate care.

A disease outbreak has been noted in one neighborhood. The community nurse understands a number of actions may be taken by the government to contain the outbreak. What actions could be included in the containment? (Select all that apply.) a. Closing schools and churches until the outbreak is over b. Providing information about signs and symptoms of the illness to health care providers c. Setting up decontamination shelters in the community boundaries for non-sick members d. Setting up clinics for administration of passive immunity measures e. Moving nursing home residents in the infected area to the local hospital

a, b, d In the case of outbreaks schools and other places where people are in close proximity may be closed. Other actions may include alerting and working with health care providers and agencies to identify and reduce the threat of the infectious communicable diseases

The nurse has learned about complex systems developed to intervene in the event of a disaster. What are the responsibilities of the Department of Homeland Security? (Select all that apply.) a. Search and rescue operations b. Disaster housing c. Public health management d. Incident command systems e. Firefighting

a, b, d Many federal departments and agencies work together to mitigate and manage disasters. Firefighting is the responsibility of the Department of Agriculture. Public health management is the responsibility of the Department of Homeland Security. Disaster housing, search and rescue, and the incident command system are all under the jurisdiction of the Department of Homeland Security, which includes FEMA.

What are the benefits of the National Incident Management System (NIMS)? (Select all that apply.) a. To facilitate disaster preparation b. To integrate personnel, facilities, and equipment c. To enable global disaster management d. To allow for a common organizational structure e. To enable state lead disaster management

a, b, d The NIMS is a management system designed to enable effective and efficient domestic incident management by integrating a combination of facilities, equipment, personnel, procedures, and communications operating within a common organizational structure. It does not refer to global disaster management. It is also supposed to lead states in a unified approach to disasters.

What situation is true concerning a patient diagnosed with latent tuberculosis (TB)? (Select all that apply.) a. Has a normal chest x-ray b. Has a normal sputum test c. Can spread the disease to others d. Usually has a positive skin test e. Has a cough that has lasted at least 3 weeks

a, b, d The person with latent TB usually has a positive skin test but a normal chest x-ray and sputum test. The cough and potential to spread the disease is present only with active TB.

Which disease is vaccine-preventable? (Select all that apply.) a. Varicella b. Smallpox c. West Nile d. Measles e. Influenza

a, b, d, e

What factor contributes to the effectiveness of a health screening? (Select all that apply.) a. Ease of administration b. Cost-effectiveness c. No need for repeat screenings d. Acceptance by the community e. Acceptable degree of sensitivity

a, b, d, e To screen effectively for the presence of these conditions, a test should be (1) cost-effective, meaning that the cost of producing and distributing the screening tool is justified by the positive effect on protecting the public; (2) easy to use; (3) available to large sectors of the population at risk; (4) sensitive and specific enough to identify true positives and true negatives; (5) backed by a health care infrastructure that can implement programs of care for people who have a verified risk of disease or physical challenge; and (6) acceptable to clients. The need for periodic screenings is an acceptable factor when necessary.

The nurse determines that vaccination schedules are not being fully met by all children in the clinic. Who would be considered key stakeholders in developing a program targeted at improving vaccination adherence? (Select all that apply.) a. Administrative staff b. Parents c. Specialty care providers d. Government agencies e. Primary care provider

a, b, e Administrative staff and primary care providers, as well as nursing staff, would all be key personnel involved in the flow of vaccination administration. Parents are also involved in bringing their children to clinic and making the decisions about vaccines. As a result, administrative staff, providers, and parents need to considered stakeholders in the process. Governmental agencies provide guidelines to follow, but are not part of the administration. Specialty care providers are not involved.

How is community diagnosis different from individual diagnosis? (Select all that apply.) a. Individual diagnosis creates the goals for individual care. b. Individual diagnosis establishes population, place, and time. c. Community diagnosis creates a tentative hypothesis. d. Community diagnosis defines the individual health care needs.

a, c In individual diagnosis, health care needs and assets are identified and goals and objectives for care are established. In community diagnosis, a problem is described by person, place, and time, a tentative hypothesis is formulated, and data analyzed to test the hypothesis

Which strategies from the Public Health Intervention Wheel would be ideal for the nurse to use in the secondary prevention of disease or injury? (Select all that apply.) a. Community organizing b. Research c. Surveillance d. Case management e. Screening

a, c, d, e Intervention strategies can be applied to secondary prevention. While these interventions are particularly helpful for detecting and stopping disease in its tracks, there is flexibility in how the nurse selects and applies intervention methods. For example, a client in the tertiary stage of disease can still benefit from case management to prevent further deterioration

A nurse needs to identify hazards in a clinic. What are potential dangers in the event of a disaster? (Select all that apply.) a. Medication room b. Exit doors c. Waiting room d. Electricity e. Oxygen

a, d, e Although all of these elements should be included in a disaster plan, only three of them qualify as hazards. Electricity can cause further damage due to fires. Oxygen is also a fire hazard. Medication rooms can become unsecured as well as contain combustible materials.

In the role of clinician, how can the nurse demonstrate levels of prevention in the field? (Select all that apply.) a. Administering immunizations b. Collaborating with schools and clinics c. Educating ostomy clients on new devices d. Screening children for depression e. Performing scoliosis measurements

a, d, e The community health role of clinician is different in that there is a unique focus on groups and populations rather than individuals and families. In particular, there are three unique emphases of the clinician role of the community nurse, including expanded skills, health promotion, and holistic care. As one of the expanded skills, screening is a useful instrument for early detection of specific problems.

The community health nurse is using epidemiological methods to conduct an investigation of a recent Escherichia coli (E. coli) related sickness causing diarrhea in infants that were fed baby formula. Whio investigated the relationship between sanitation and disease? (Select all that apply.) a. John Snow b. William Far c. Jakob Henle d. Louis Pasteur e. Florence Nightingale

a, e Florence Nightingale focused on the environment, and in particular sanitation. In identifying the source of cholera, John Snow traced the source of disease to an infected water supply.

Which are examples of tertiary levels of prevention? (Select all that apply.) a. Encouraging a client with hypertension to continue a weight loss program b. Providing immunizations to kindergarteners c. Educating new mothers on car seat safety d. Screening teens who are obese for signs and symptom of diabetes e. Developing a post-mastectomy exercise program to preserve function

a, e The primary level of prevention is measures taken to prevent injuries and illness; this includes vaccinations to prevent communicable diseases. Secondary levels of prevention are focused on early detection of existing issues. Tertiary levels of prevention are aimed at preserving and restoring function and reducing impairment.

What statement about false negatives is accurate? a. A false negative is when a patient fails a screening but, in fact, does not truly have the disease. b. A false negative is when a patient passes a screening but, in fact, truly has the disease. c. A false negative can occur from a screening with low specificity and high sensitivity. d. A false negative causes over-referral.

b A false negative is when a patient passes a screening but in reality actually has the disease. This causes under referral. In addition, diseases will not be detected early and can result in individuals suffering from advanced disease. False negative results can occur from a screening test that has high specificity and low sensitivity.

What is the purpose of an epidemiological predictions and probabilities in relationship to health promotion? a. Predictions and probabilities are used to evaluate the effectiveness of health promotion strategies. b. They determine the focus of health promotion strategies. c. Epidemiology relies heavily on predictions and probabilities in its scientific approach to wellness. d. The need for health promotion has created the need for such data.

b Analysis of epidemiologic data allows for the development of predications based on the statistical conclusions (probabilities). These are the basis for determining the possibility of getting a disease or becoming physically or emotionally challenged. It is this possibility that directs health promotion strategy development. Health promotion did not create the need for these forms of information nor are they used to evaluate health promotion strategies.

Which are examples of personal services and home visits for people that are at risk? (Select all that apply.) a. Leadership and policy planning b. Clinical preventive services c. Disease surveillance d. Primary care for unserved and underserved people e. Treatment services for targeted conditions

b, d, e All except leadership and policy planning and disease surveillance are examples of personal services and home visits for people that are at risk. Leadership and policy planning fall under the public policy arm of the public health services core functions. Disease surveillance falls under the assessment core function of public health services.

A client seen at the health department has been diagnosed with a communicable sexually transmitted disease. The nurse realizes the client will need immediate education. What is the best rationale for the needed education? a. Communicable diseases cause death in those they infect and must be treated early. b. Communicable diseases are contagious and easily spread from one person to another. c. Communicable diseases are infections that are easily treated with common antibiotics. d. Communicable diseases are infectious agents that spread through direct contact with others

b Communicable diseases are a threat to public health. They are diseases that can be transmitted from one person to another through direct and indirect contact and are infectious in nature.

Which model asks direct and probing questions to assess family health in 11 different areas? a. Life span development (Rankin) b. Functional health patterns (FHPs) (Gordon) c. Family systems (Anderson) d. Rituals and routines (Clausson and Berg)

b Functional health patterns assess health patterns in 11 areas of family health using direct and probing questions. None of the other models identified rely on this distinctive questioning format.

What is the primary goal of health promotion? a. Developing positive health promotion strategies directed toward individuals and communities b. Affecting positive change to the health and well-being of individuals and communities c. Implementing health promotion strategies at all three levels of disease prevention among all humans d. Providing health care professionals an opportunity to positively affect human health and well-being

b Health promotion's goal is to change health and well-being. Health promotion implements strategies developed in partnership with health professionals, individuals, and communities that includes all three levels of disease prevention.

The community nurse is performing an assessment on a community related to an identified problem of obesity. Which approach is best to use for this type of community assessment? a. General systems b. Problem-oriented c. Comprehensive needs d. Familiarization

b In this type of assessment approach, a single problem is identified and the community is assessed in terms of the specific problem

The nurse administers childhood vaccinations at health clinic. What level of prevention is this? a. Terminal b. Primary c. Tertiary d. Secondary

b Primary prevention involves taking measures to keep illnesses or injuries from occurring. By administering vaccinations, the nurse is preventing the onset of disease

Despite local and state air quality policies, the local steel smelting mill has been emitting toxins at night into the air. The residents are concerned about the potential health ramifications; in particular, lung complications. The community nurse has developed an early detection process that includes a lung function screening test. What level of prevention has the nurse activated? a. Tertiary b. Secondary c. Quaternary d. Primary

b Secondary level of prevention is aimed at early detection and includes screenings. Primary level of prevention is measures taken to keep injuries and illness from occurring. The tertiary level of prevention is focused on restoring or preserving function.

A social history is a vital assessment tool related to which nursing models? a. Functional health patterns (FHPs) (Gordon) b. Life span development (Rankin) c. Family systems (Anderson) d. Rituals and routines (Clausson and Berg)

b Social history provides a background in which to frame particular health behaviors or events within a broader perspective. Application to diverse groups could be difficult without knowledge of their history. None of the other models identified rely on social history as heavily.

What is the fundamental criterion for making a screening mandatory? a. Acceptance by the community being screened b. Degree of physical harm resulting from the lack of screening c. Ease by which the screening can be preformed d. The cost of the screening test

b Some screenings are mandatory because of the physical and economic costs that may result if they are not performed (e.g., newborn screenings). The remaining options may be considerations but is not the fundamental criteria for mandatory screening.

Which federal department bears the most responsibility in the event of a disaster in the United States? a. Department of Defense b. Department of Homeland Security c. Department of Transportation d. Department of Health and Human Services

b The Department of Homeland Security houses the Federal Emergency Management Agency (FEMA). FEMA is responsible for assessing and responding to disaster events in the United States. The other answer choices play a role in disaster management and preparation, but not the primary role in the United States.

The desired outcome of health education is that the learner: a. recites the nurse's words verbatim. b. demonstrates permanent behavioral change. c. passes a written examination. d. suggests alternatives to the nurse's health promotion strategy.

b The goal of health education is for the learner to assimilate new information that promotes a permanent change in behavior. The other options lack evidence of behavioral change as a result of health education.

What is the role of the community health nurse? (Select all that apply.) a. Provision of direct client care b. Community-based health education c. Providing health promotion interventions d. Sterile dressing changes e. Administration of medications

b, c Community health nurses provide both health promotion interventions and community-based health education. Teaching has been a critical part of the community health nurse's role since the origins of the profession, and it frequently is the primary role or function.

The public health nurse is performing a community assessment. What community-specific factors will the nurse consider when performing this assessment? a. Global influences such as foreign trade b. Internal influences such as the local economy c. Physical characteristics d. Purpose of the community e. Boundaries

b, c, d, e In preparing for a community assessment, the nurse will examine community-specific factors such as boundaries of the community, physical characteristics such as geographical location, characteristics of the population, and the purpose of the community.

Which of the following situations would require a disaster response? (Select all that apply.) a. Smoking cessation program b. Ebola outbreak c. Sexually transmitted infections in a college population d. F5 tornado

b, d A disaster response is necessary when there is a natural disaster or an outbreak.

A nurse is performing triage during a disaster. This nurse should identify which client as needing immediate transportation to a hospital? a. A client with multiple broken bones. b. A client who is psychologically distressed. c. A client who is burned over 50% of his body. d. A client who is injured but able to walk.

c A client who is burned over 50% of his body will benefit from immediate treatment at an intensive care unit. Although the other clients will need treatment, perhaps at a hospital, they will not be the priority due to their current stability.

The community nurse is providing education to a group of older teens at the local recreation center on how using chewing tobacco increases the risk of oral, esophageal, and pancreatic cancer. The nurse is utilizing what element of causation of noninfectious disease? a. Plausibility b. Specificity c. Biological gradient d. Strength of association

c Biological gradient refers to the relationship demonstrated with increasing levels of exposure to the causative agent and the corresponding increase in the occurrence of the disease.

A public health nurse is administering a Tuberculin test to a hospital employee. What type of screening is this test? a. Case finding b. Mass c. Selective d. Multiphasic

c A mass screening is the screening of a large number of people to detect signs and symptoms early to prevent the spread of disease or illness.

Which type of disaster happens as the result of circumstantial factors? a. Global b. Natural c. Accidental d. Terrorist

c Accidental disasters happen as a result of circumstantial factors and are usually not deliberate.

When evaluating a program, what is the critical first step that should have been considered in its design? a. Inclusion of risk factors b. Seeking program approval from funding sources c. Input of all community stakeholders, including the participants d. Developing culturally inclusive material

c Community stakeholders must have input into a program's design in order for it to be successful. The other answer choices are informed by the information elicited from the community stakeholders.

What is the data collected through public health surveillance by the U.S. Centers of Disease Control and Prevention (CDC) ultimately used for? a. Distribution to state and local health agencies b. The development of health-related databases c. Reduction of morbidity and mortality among the population Id. dentification of potential health issues presenting in communities

c Data are systematically collected, analyzed, interpreted, and disseminated so that they can be used to develop activities and programs that will reduce morbidity and mortality and improve health. The remaining options are specific foci that bring about the achievement of the goal of improved health.

A nurse working in the immunization clinic is performing research to determine if there has been a decrease in the incidence of human papilloma virus (HPV) since the initiation of the HPV vaccine. In which step of the epidemiological process is the nurse involved? a. Identifying health problems and needs b. Activities and approaches to resolution c. Planning, implementing, and evaluating d. Data collection and analysis

c In the planning, implementation, and evaluation in the epidemiological process, the nurse can conduct research to identify the results of treatment.

What should the nurse consider when selecting health indicators in a community? a. If the indicators are approved by the community stakeholders. b. If the indicators correspond to the nurse's intuition. c. If the indicators relate to standards published by national or state entities. d. If the indicators correspond to the nurse's expectations.

c It is useful for the nurse to select indicators that relate to national standards such as Health People 2020 or other standards published by national or state entities. A state's health department may have state-level health indicators.

Which is a secondary prevention strategy during a disaster that can be performed by a nurse? a. Disaster planning b. Long-term community stabilization c. Victim triage d. Hazardous material cleanup

c Nurses are able to perform triage in the event of a disaster to promote early identification and prompt treatment. The nurse should be trained and be able to remain safe during the triage procedures. Disaster planning is a primary prevention strategy. Long-term community stabilization efforts are considered tertiary prevention. Hazardous material cleanup should not be performed by a nurse.

The community nurse is educating seniors at the local senior center on home safety to prevent falls. What level of prevention is the nurse practicing? a. Tertiary b. Quaternary c. Primary d. Secondary

c Primary level of prevention is measures taken to prevent injuries and illness from occurring. Secondary level of prevention is aimed at early detection and tertiary level of prevention is focused on restoring and preserving function.

Which question is best to ask community members during the program evaluation phase? a. "Who is the best person to lead this initiative?" b. "Who are the key stakeholders in this community?" c. "Did our program accomplish its desired outcomes?" d. "What is the most crucial health need in this community?"

c Program evaluation involves measuring and reporting outcomes. The other responses are best at different points in the community change process.

Public health nurses have a responsibility in disaster management. Identify from the one role that is NOT a responsibility in a disaster. a. Assess the needs of the community as the events unfold b. Maintain communication channels to ensure accurate dissemination of information to colleagues and the public c. Start IVs, administer medications, and stabilize the victims d. Conduct surveillance for communicable disease and unmet needs

c Public health nurses are responsible for providing comprehensive public health services in disaster management, but they are not expected to function as critical care nurses in a disaster setting.

A school nurse has identified a depression screening instrument to use for middle-school students who are referred by the teaching staff. What ethical consideration should the nurse make prior to performing the screening of students? a. If the student will be honest and truthful on the screening instrument b. The likelihood of the student to alert the parents to a positive screen c. The availability of resources if the student has a positive screening d. If the screening instrument is easy for the student to read

c Screenings are only effective if there are resources to which the nurse can refer the client. In providing early treatment, many problems can be reduced or avoided

The nurse is trying to determine which government agency is responsible for rebuilding the physical structures in the community. Which is the nurse's best response? a. The Department of Homeland Security will be responsible for rebuilding the physical structures. b. The Federal Emergency Management Agency will be responsible for rebuilding the physical structures. c. The Department of Defense - Army Corps of Engineers will be responsible for rebuilding the physical structures. d. "No federal agency will be responsible for rebuilding the physical structures."

c The Army Corps of Engineers rebuilds buildings, roads, bridges, and all the infrastructures that make communities function after a disaster. The other agencies described have other functions within a disaster situation.

Which statement is true about the community health nurse? a. Focuses solely on disease prevention in the community. b. Serves as the health expert in the community. c. Facilitates members of the community to take control of their health. d. Delegates the task of health promotion to community leaders.

c The community nurse is not the "expert" but a facilitator, helping community members take responsibility for their health. The nurse will focus on both health promotion and disease prevention and the primary level of prevention.

The disaster management continuum was developed for emergency responders as a framework. What is the correct order of steps in the continuum? a. Preparedness, Mitigation, Recovery, Evaluation, Response b. Evaluation, Preparedness, Response, Mitigation, Recovery c. Preparedness, Mitigation, Response, Recovery, Evaluation d. Response, Evaluation, Mitigation, Preparedness, Recovery

c The steps in the disaster management continuum are preparedness, mitigation, response, recovery, and evaluation.

Which term is used to identify an epidemiologic model that emphasizes the concept of multiple causation? a. Natural history of disease b. Community assessment c. Web of causation d. Epidemiologic triad

c The web of causation is an epidemiologic model that strongly emphasizes the concept of multiple causation while deemphasizing the role of agents in explaining illness. None of the other options has this focus.

What is the final step in the nurse's health assessment of a community? a. Collection b. Interpretation c. Analysis d. Validation

c When conducting a community assessment, the nurse systematically collects information about a community's structure, processes, and dynamics. After collecting the data, the nurse interprets it. Finally, the nurse must analyze the data to form a diagnosis that will address the revealed health needs of the community.

The nurse is employed at a public health clinic in an urban setting. The nurse is in charge of triaging clients when they enter the clinic for walk-in hours. What is the best response by the nurse when describing this role in terms of public health service? a. "I'm functioning as a triage nurse." b. "I'm functioning as assurance personnel." c. "I'm performing assessment of clients." d. "I'm performing triage skills."

c Public health service includes assessment as its first core function. Triage, while a skill and necessary, is part of a greater assessment goal. Assurance occurs after public policy has been implemented to ensure quality and adherence.

What areas is health promotion focused on? (Select all that apply.) a. Studying the causes and effects of disease b. Assisting with discharge from acute care settings c. Developing nursing interventions directed towards people's resources to maintain well-being d. Reducing risks to health and controlling major causes of disease e. Maintaining or improving health of families and communities

c, e Health promotion has two components: 1) maintaining or improving the health of families and communities, and 2) developing nursing interventions directed toward people's resources to maintain and enhance their well-being.

Following a disaster, a nurse assesses high psychological distress among coworkers. What is the best response of the nurse when addressing the nurse's colleagues? a. "We should look to spiritual authorities for support." b. "It's over and I think we should move on from this disaster." c. "I'm sure our fears and anxiety will subside with time." d. "We should look into professional debriefing as a group."

d Disasters leave long-term psychological effects on their victims and the professionals who treat the victims. Professional debriefing can be beneficial to supporting the psychological needs of disaster workers. Ignoring the disaster's effects or only looking to spiritual sources of support will not fully address every colleagues' needs.

During an assessment, the community health nurse is gathering data to determine what characteristics and possible health needs are similar for all community members. Which framework will the nurse choose in approaching this assessment analysis? a. Goal b. Comprehensive needs c. Problem-oriented d. Familiarization

d Familiarization data gathering begins with examining the information already available on the community, and then gathers first-hand data to get a working knowledge of the community. The approach is best used in working with families, groups, organizations, or populations

A nurse is called up to a volunteer emergency disaster response team because a hurricane is devastating the region. The nurse recognizes that this disaster is: a. terrorist. b. biological. c. accidental. d. natural.

d Floods, volcanic eruptions, earthquakes, hurricanes, tsunamis, and other geologic processes are examples of natural disasters. Accidental disasters include nuclear accidents and chemical spills. Acts of terrorism can also be classified as disasters. Biological disasters include the release of bacteria or viruses into the community.

A nurse attempts to quickly determine the needs of the community following a disaster. The nurse identifies clients who are in need of immediate placement in emergency housing. Which term describes emergency housing during a disaster? a. Primary prevention b. Planning c. Evaluating d. Secondary prevention

d In the mitigation phase of a disaster, secondary prevention needs to be employed in order to prevent further death or disability. Emergency housing can be used to mitigate needs.

A community nurse is reviewing the disease statistics of an assigned new area. What assessment framework is the nurse utilizing in assessing this community? a. Developmental b. Structural/functional c. General systems d. Epidemiological

d The epidemiological studies framework is used when assessing a community according to the amount and distribution of disease or health conditions in a population.

A comprehensive assessment must consider the entire community and the various populations living in the community. Which of these indicates a comprehensive assessment? a. Participants of the local YMCA b. Adult males who live in the particular county under assessment c. Individuals with heart disease d. Adults and children living within ten miles of the center of town

d A comprehensive assessment collects all the information relevant to the community's health. It includes the demographics on the whole population and the community boundaries, and identifies resources within the boundaries.

The epidemiologic model, web of causation, was developed as a result of what health-related need? a. Understanding of the role of the host in infectious diseases b. Mapping of the course of a disease from onset to cure c. Identification of risk factors associated with acute illness d. Identification of the multiple factors causing chronic illnesses

d At the time of development of the web of causation, there was a need to create a model that would help describe the multiple factors underlying chronic illnesses. The model does not relate to any of the other options.

What statement is true about community stakeholders? a. Community stakeholders should represent only the weakest members of the community. b. Community stakeholders are exclusively informal leaders from the community. c. Community stakeholders should not have anything to gain or lose in the community. d. Community stakeholders should represent all groups in the community.

d Community stakeholders should represent all groups in the community and not just what is easily accessible to the nurse. They stand to "gain" or "lose" if the community health problem is addressed, and may include formal and informal leaders from faith organizations, schools, and area employers.

A nurse wants to understand the potential intensity of a recent disaster on a community. What is the best question to ask when determining intensity? a. "How big of an area was affected by the disaster?" b. "How big of an area was affected by the disaster?" c. "How many emergency personnel needed to deploy?" d. "How destructive was the disaster to the infrastructure?"

d Disaster intensity refers to the extent of destruction or devastation a community suffers as the result of a disaster. The scope of the disaster refers to the area that is affected. The duration refers to the length of time. Emergency personnel needs will vary according to all of these factors.

A nurse is in a disaster preparedness training course. The nurse best demonstrates knowledge of disasters by which statement? a. "Disasters are only accidental or terroristic in origin." b. "Disasters can vary according to location." c. "Disasters are emergencies requiring services from within a community." d. "Disasters are unexpected events requiring support from outside the community."

d Disasters are unexpected events that require an intense, quick response from personnel, facilities, and resources from outside the community. In a disaster, community resources are either destroyed or quickly depleted. Emergencies are more frequent events that can utilize existing community resources. Disasters can be accidental, terroristic, or natural.

Which is an example of primary prevention of injury? a. Providing prompt care when a head injury occurs b. Providing rehabilitation after a head injury occurs c. Teaching a client about the importance of consuming a balanced diet d. Teaching a client about the importance of wearing head protection when engaging in activities that may lead to head injury

d Primary prevention includes measures taken to prevent injury from occurring. Teaching a client about the importance of consuming a balanced diet is a health promotion activity. Providing prompt care when a head injury occurs is secondary prevention, and providing rehabilitation after a head injury occurs is tertiary prevention.

When would primary prevention be most effective? a. After the disease or injury occurs and the client needs help to regain health b. After the disease or injury occurs but detects it early c. After a disease or injury occurs but before another disease or injury occurs d. Before the disease or injury occurs

d Primary prevention is that which keeps an illness or injury from occurring and is applied to a generally healthy population and precedes disease or dysfunction.

What best describes primary prevention of a disaster? a. Governmental funding for disaster relief b. Recovery=oriented programs c. Hospital-focused programs d. Team-based disaster planning

d Primary prevention occurs before the disease or unwanted event happens. Disaster planning is an example of primary prevention of disasters. Communities, health care, schools, and governments all need to work together to prevent disasters.

The nurse is providing blood pressure screening at the local senior center. This is an example of which level of prevention? a. Primary prevention b. Health promotion c. Tertiary prevention d. Secondary prevention

d Screening is considered secondary prevention because the nurse is identifying the presence of disease. Secondary prevention involves efforts to detect health problems at the earliest possible stage, when disease or impairment is already present.

When considering community health assessment, which intervention is an example of secondary prevention? a. Use of seat belts b. Immunizations c. Using sunscreen d. Screenings

d Secondary prevention is a planned effort to minimize the impact of disease or injury once it is in effect. Secondary prevention is used at an early stage of pathogenesis or physical or emotional challenges. Screening is an example of such prevention. The other options are examples of primary preventions

Which level of prevention has a focus on minimizing disability and restoring function? a. Secondary prevention b. Primary prevention c. Health promotion d. Tertiary prevention

d Tertiary prevention focuses on minimizing disability and restoring function.

Which statement is true about the stages of health prevention? a. Primary prevention detects disease before symptoms appear, b. Tertiary prevention seeks to avoid disease onset through increased resilience. c. Primary prevention prompts intervention to prevent or limit disability. d. Tertiary prevention seeks to improve the quality of life.

d Tertiary prevention seeks to improve the quality of life by reducing the extent and severity of a health problem to its lowest possible level, so as to minimize disability and restore or preserve function.

Which epidemiological causal attribution model was too linear in scope to adequately analyze patterns in disease and wellness. a. Triad b. Multiple causation c. Causation of noninfectious disease d. Chain of causation

d The chain of causation identified as insufficient to understand the causes of disease and wellness, or to determine emerging health threats because of the linear thinking embodied in the model.

A nurse reads a research study involving prenatal education programs and applies it to the community. The study reported that teens aged 12-15 attend prenatal education less often than teens aged 15-18 due to lack of transportation. Which idea would best encourage pregnant teens age 12-15 to attend a prenatal education program? a. Providing literature to pregnant teens b. Opening another prenatal clinic in the community c. Offering more time slots in prenatal education classes d. Offering prenatal education classes in the school

d Using the evidence to support an intervention or program is a crucial step to planning and developing community programs. This evidence pointed towards transportation issues, and therefore bringing prenatal education closer to the teens is best. The other options could be helpful but are not solving the transportation issue

A child has been diagnosed with measles and excluded from school until no longer contagious. A teacher asks the school nurse why the child was infected since the child had received the required immunization. The nurse's best response is based on what fact about immunizations? a. Each vaccine can potentially infect the person who receives it, even if the vaccine is made from non-live organisms. b. Vaccines are produced from the live organism, so there is a small chance it will infect a non-infected person with the disease. c. Vaccines are produced according to the most common strain of organism, so there will be some people who acquire the disease. d. Each person is unique, and occasionally a person who receives a vaccine will not respond and will get the disease.

d Vaccines are a mixture made from either a live or inactivated form of an organism used to create an immune response in the recipient. Vaccines made from an inactivated organism cannot replicate in the recipient.

The community nurse is tending a booth at the county fair to provide informational brochures on how to apply insurance and subsidies related to the Affordable Care Act. What role is the community nurse demonstrating? a. Clinician b. Advisor c. Educator d. Leader e. Advocate

e As the role of the advocate, a community health nurse provides education, guidance, and assistance to help community clients navigate the health care system.