C2

Which of the following best describes countries that bear the greatest burden of disasters? a. Arid regions that are prone to drought b. Developing countries with limited resources c. Industrialized countries with much to lose d. Water-boundary regions that are prone to floods and hurricanes

b. Developing countries with limited resources

A nurse is using the problem identification phase of the case management process. To which of the following phases of the nursing process does this correspond? a. Assessment phase b. Diagnosis phase c. Planning phase d. Implementation phase

b. Diagnosis phase

Which of the following disasters would implement disaster medical assistance teams (DMATs)? (Select all that apply.) a. Disaster that covers a broad geographic area b. Disaster that is beyond the coping capabilities of the affected state c. Disaster that may result in substantial health and medical problems d. Disaster that may cause a large number of deaths e. Disaster that may cause a large number of injuries both physical and psychosocial

b. Disaster that is beyond the coping capabilities of the affected state c. Disaster that may result in substantial health and medical problems d. Disaster that may cause a large number of deaths

A school nurse is developing a primary prevention strategy for school-aged children. Which of the following interventions would the nurse most likely implement? a. Developing individualized exercise programs for overweight children b. Drafting policy for increases in noncompetitive physical activity programs c. Monitoring body mass index (BMI) in children to identify elevations before they become difficult to manage d. Notifying parents and/or guardians of their child's height-weight scale in comparison with national norms

b. Drafting policy for increases in noncompetitive physical activity programs

Which of the following best explains why evaluation of client outcomes resulting from nursing intervention is so difficult? a. Client records may not include appropriate data. b. Few tools exist to measure client outcomes. c. Many other factors can also affect client outcomes. d. Measuring client outcomes is extremely time consuming.

c. Many other factors can also affect client outcomes.

A nurse just finished teaching breast self-examination to a large group of women at a professional conference. During the session, the nurse distributed literature and used culturally appropriate visual aids. However, the session was not as effective as it could have been. Which of the following was the most important thing omitted by the nurse? a. Time for audience members to ask questions and clarify the information b. Explanation of why culturally appropriate images are more acceptable c. Opportunity for the women to practice what they learned d. Use of simple language instead of printed material

c. Opportunity for the women to practice what they learned

A nurse uses lecturing as the primary method of educating clients. Which part of the education process is missing? a. Evaluation b. Experience c. Participation d. Understanding

c. Participation

Based on projected increases in the number of older US citizens, a planning committee wants to establish a day care program for the community's older adult population. During which stage is the need for this program being assessed? a. Inactive stage b. Interactive stage c. Preactive stage d. Reactive stage

c. Preactive stage

A nursing administrator wants to develop a work environment conducive to the implementation of evidence-based practice (EBP). Which of the following actions would best achieve this goal? a. Conducting market research to determine customer satisfaction with EBP b. Eliciting opinions from nurses on how EBP will affect workload c. Purchasing computers and Internet access for use by employees d. Sending staff to conferences related to incorporation of EBP into practice

c. Purchasing computers and Internet access for use by employees

The quality improvement team reviews the records of clients on a monthly basis to determine whether protocols for pain assessment were followed. Which of the following best describes this activity? a. Accreditation review b. Concurrent audit c. Retrospective audit d. Utilization review

c. Retrospective audit

In which of the following situations would the nurse most likely use an active surveillance system? a. A newspaper wants to know the incidence of asthma in the community. b. A real-time ongoing communication channel is established to monitor a particular symptom. c. Several children become ill with gastrointestinal (GI) upset at one local school. d. The nurse is asked to report the incidence of a specific nonreportable common problem in the community.

c. Several children become ill with gastrointestinal (GI) upset at one local school.

A nurse has invited community members to participate as full partners in creating changes to improve the health of the community. Which of the following may be an unexpected consequence of this action? a. A change in the distribution or redistribution of power and influence b. An increase in awareness of the importance of health c. Continued ongoing interest in community health activities d. Improved family functioning and involvement in health activities

a. A change in the distribution or redistribution of power and influence

A group of teenagers with diabetes become upset and angry because they cannot agree on whether or not to have meetings during summer vacation. Which of the following should the nurse do to be effective in helping the teenagers resolve the conflict? a. Admit that it is difficult for everyone to agree on everything; then ask whether the group can try to decide how to agree on the issue. b. Assume adult authority and announce that meetings will be suspended until fall. c. Recognize that most of the teenagers want to have the meetings, but two are being stubborn; ask the two deviant members to leave the group. d. Suggest that the group avoid discussing it further but rather think about it over the next week and try to discuss the situation more rationally next week.

a. Admit that it is difficult for everyone to agree on everything; then ask whether the group can try to decide how to agree on the issue.

The nurse is scheduled to teach carbohydrate counting to middle-aged adults newly diagnosed with diabetes. Which of the following actions will the nurse need to take when teaching this population? (Select all that apply.) a. Appeal to the need for autonomy and choice. b. Emphasize that anyone with diabetes must know this information. c. Explain how to cope with being a guest at a dinner. d. Recognize that this audience will depend on the instructor to set goals for learning. e. Reinforce learning with handouts.

a. Appeal to the need for autonomy and choice. c. Explain how to cope with being a guest at a dinner.

A community health nurse is beginning to work with a newly assigned community. Which of the following would be appropriate actions for the nurse to take to help ensure acceptance? (Select all that apply.) a. Asking those with whom the nurse interacts in the course of daily living their perception of the community (e.g., clerks in grocery stores or pharmacies) b. Attending community events such as festivals or fairs and interacting with participants c. Becoming involved in and contributing to volunteer community organizations d. Completing a comprehensive physical assessment on nearby neighbors e. Arranging to meet with the community's governing body

a. Asking those with whom the nurse interacts in the course of daily living their perception of the community (e.g., clerks in grocery stores or pharmacies) b. Attending community events such as festivals or fairs and interacting with participants e. Arranging to meet with the community's governing body

Staff members have agreed to implement evidence-based practice; they have chosen a specific problem and searched the literature. The group has selected the interventions that seem the easiest to implement. Which of the following actions would the staff take next? a. Assess the quality of the evidence in the literature. b. Decide how best to orient the staff and community to the proposed changes. c. Eliminate all nursing interventions that are not evidence based. d. Choose another specific problem for the next literature search.

a. Assess the quality of the evidence in the literature.

Which of the following best describes the steps in program management? a. Assess, plan, implement, evaluate b. Identify, initiate, implement c. Organize, operationalize, mobilize, subsidize d. Substantiate, negotiate, evaluate

a. Assess, plan, implement, evaluate

A nurse is familiar with evidence-based practice (EBP) and wants to implement it into the care of clients. Which of the following would present the biggest challenge? a. Assessing one's current practice and accessing evidence-based resources b. Convincing administration that EBP is beneficial c. Distinguishing EBP from practice based on old standards d. Showing clients that EBP will improve their health outcomes

a. Assessing one's current practice and accessing evidence-based resources

The quality improvement team reviews the records of clients on a monthly basis to determine whether protocols for pain assessment were followed. Which of the following best describes the major drawback to the team's approach? a. The client is no longer under the agency's care. b. It is difficult to compare documentation of care to standards of care. c. Records can be inaccurate or incomplete. d. Team members may disagree on whether the standards of care were met.

a. The client is no longer under the agency's care.

A case manager is concerned about exposure to possible lawsuits. Which of the following are appropriate actions to take to minimize this risk? (Select all that apply.) a. Assure clients they can appeal any decision. b. Carefully document client involvement and reasons for decisions. c. Share client information with the other involved providers and agencies. d. Confirm credentials and capabilities of providers or agencies to give care. e. Being mindful to maintain effective lines of communication with all clients.

a. Assure clients they can appeal any decision. b. Carefully document client involvement and reasons for decisions. d. Confirm credentials and capabilities of providers or agencies to give care. e. Being mindful to maintain effective lines of communication with all clients.

When does disaster management begin? a. Before the disaster occurs b. During the disaster c. Immediately following the disaster d. During the recovery period

a. Before the disaster occurs

A nurse is planning a program to teach cardiac health at the senior citizens' center. Which of the following is an effectively written objective for the program? a. By the end of the program, each participant will report walking at least 30 minutes a day at least 5 days each week. b. By the end of the program, each participant will voice a commitment to walk at least 30 minutes a day. c. By the end of the program, each participant will understand the need for physical exercise. d. Each participant will voice a commitment to engage in physical exercise each day.

a. By the end of the program, each participant will report walking at least 30 minutes a day at least 5 days each week.

Which of the following best explains why every client doesn't receive care from a case manager? a. Case management time is demanding; thus it is restricted to complex cases. b. Many health agencies do not employ case managers. c. Most clients would not benefit from case management. d. Most nurses do not know how to function as case managers.

a. Case management time is demanding; thus it is restricted to complex cases.

A nurse is conducting program evaluation. Which of the following would be the first action the nurse would take? a. Choose the type of evaluation to be done. b. Determine who will be involved in the evaluation. c. Identify the goal and objectives for the evaluation. d. Obtain answers to specific questions related to the program being evaluated.

a. Choose the type of evaluation to be done.

A nursing committee is responsible for evaluating the process of health care agency in their quality assurance efforts. Which of the following techniques would most likely be used by the committee members? (Select all that apply.) a. Client satisfaction survey data b. Confirmation of credentials of all health care providers employed c. Patient discharge data over the past one year d. Direct observation by individuals e. Peer review committee audit

a. Client satisfaction survey data e. Peer review committee audit

A nurse has decided to increase the evidence base of current nursing practice in an agency. Which of the following describes a barrier that could be encountered by the nurse? (Select all that apply.) a. Colleagues who do not know how to search the literature or critique research b. Dedication to the history and tradition of the agency c. Little or no research published in the clinical area of concern d. Several meta-analyses in the literature with inconsistent results e. The agency is unable to provide sufficient funds to support the plan

a. Colleagues who do not know how to search the literature or critique research b. Dedication to the history and tradition of the agency c. Little or no research published in the clinical area of concern

A child came to school coughing almost constantly. The next day, six other children in the same school room were coughing. Which of the following types of outbreak would the nurse suspect? a. Common source b. Mixed c. Propagated d. Intermittent

a. Common source

A community health nurse has been recently hired to work in an unfamiliar community. Which of the following persons would be the effective key informants for the nurse? (Select all that apply.) a. Community's immigrant group activist b. Federal senators and representatives c. Health board members d. The town mayor e. Local Clergy

a. Community's immigrant group activist d. The town mayor e. Local Clergy

Which of the following statements regarding the Health Belief Model is accurate? a. Cues to action are an important component of the model. b. Multiple methods of education should be used when implementing this model. c. The first stage experienced in this model is the pre-contemplation stage. d. To successfully implement this model, ongoing maintenance of the behavior must be considered.

a. Cues to action are an important component of the model.

Which of the following activities are considered to be part of the core competencies for public health professionals? (Select all that apply.) a. Defining variables relevant to current public health problems b. Obtaining and interpreting information regarding risks and benefits to the community c. Implementing nursing care and subsequent evaluation outcomes d. Maintaining public health departments throughout the United States e. Focusing on health concerns of the individuals residing within the community

a. Defining variables relevant to current public health problems b. Obtaining and interpreting information regarding risks and benefits to the community

A nurse is attempting to minimize damage following a bioterrorism attack in the community. Which of the following would be the most crucial aspect for the nurse to consider? a. Detecting an increase in people with similar signs and symptoms b. Identifying typical chemical or biological agents c. Identifying factors that put people at risk d. Recognizing areas of vulnerability within an area

a. Detecting an increase in people with similar signs and symptoms

When evaluating an educational program, the nurse discovers that only 25% of community members met the learning objectives. Which of the following parts of the program should be improved? a. Educator b. Content c. Learners d. Objectives

a. Educator

An agency has not created a continuous quality improvement program. Which of the following actions should the agency take to help ensure quality care within the institution? a. Ensure appropriate policies and procedures are followed. b. Employ highly recommended and credentialed professionals to give care. c. Use administrative action to ensure that quality care is given to clients. d. Write quality care plans for the most typical problems of clients.

a. Ensure appropriate policies and procedures are followed.

A nurse implements an education program that incorporates computer games to reinforce learning for a group of older adults. Although the research demonstrates evidence of improved retention of this information, the nurse experiences exactly the opposite with this group. Which of the following is the most likely cause of such poor outcomes? a. Failure to consider client and setting differences b. Inadequate incorporation of evidence into practice c. Inferior quality of the available research evidence d. Lack of skills when evaluating the evidence

a. Failure to consider client and setting differences

Which of the following are elements of the MAPP (Mobilizing for Action Through Planning and Partnership) Program Planning Model? (Select all that apply.) a. Generating shared visions and common values b. Assessing priorities in health problems c. Developing a framework for long-range planning d. Choosing health priorities e. Conducting a needs assessment related to community change

a. Generating shared visions and common values c. Developing a framework for long-range planning

A nurse has identified a need to increase the quality assurance efforts within the home care agency. Which of the following has most likely occurred? a. Increased number of client complaints and injuries b. Increased costs of providing care c. Reduced number of incident reports d. Reduced government reimbursement (Medicare and Medicaid)

a. Increased number of client complaints and injuries

In which of the following ways does licensing differ from accreditation? (Select all that apply.) a. Licensing applies to the individual, whereas accreditation applies to a program. b. Licensing is required to practice, whereas accreditation is by choice. c. Licensing is required by state law, whereas accreditation is required by federal law. d. Licensing is required for all professions, whereas accreditation is only available for some. e. Licensing is a cost to the individual, whereas agencies pay for accreditation.

a. Licensing applies to the individual, whereas accreditation applies to a program. b. Licensing is required to practice, whereas accreditation is by choice. e. Licensing is a cost to the individual, whereas agencies pay for accreditation.

In January, a nurse is listening to colleagues talk about the increase in depressed patients asking for help from their primary care providers recently. The incidence of reports of depression was higher in the last month than in the previous 3 months. Based on this data, which of the following would be the next step for the nurse to take? a. No further action is necessary because depression is known to worsen during the shorter darker days of winter. b. No further action is necessary because this short-term increase may just be a statistical error or even just a mistaken impression by the involved nurses. c. Action should be taken because there must be some cause for this noted increase. d. Action should be taken because this increase may be the beginning of an epidemic and should be investigated.

a. No further action is necessary because depression is known to worsen during the shorter darker days of winter.

A community health nurse encourages members of the community to partner and assist in creating health programs. Which of the following best describes the rationale for this action? (Select all that apply.) a. Partnering results in increased effectiveness b. Involving community members results in contributions of time and money into the program c. Having many partners results in increased publicity for the program d. Participating in planning results in having a vested interest in the outcome e. Involving community partners ensures increased support by the populace

a. Partnering results in increased effectiveness d. Participating in planning results in having a vested interest in the outcome

Which of the following levels of prevention is being used by a nurse who is helping to develop a community-wide disaster management plan? a. Primary prevention b. Secondary prevention c. Tertiary prevention d. All prevention levels

a. Primary prevention

A nurse is focused on mitigation of disasters at the international level. Which of the following activities would the nurse most likely complete? a. Provide community educational programs and training on how to prepare for disasters. b. Request donations be sent to the affected area. c. Develop a notification procedure to be used by the international disaster relief office. d. Recruit volunteers to be a part of the disaster team that will travel to the afflicted area.

a. Provide community educational programs and training on how to prepare for disasters.

How does continuous quality improvement (CQI) differ from quality assurance? a. Quality assurance focuses on client care, whereas CQI focuses on system issues. b. Quality assurance focuses on system issues, whereas CQI focuses on individual client care. c. Quality assurance measures care at one point in time, whereas CQI is an ongoing issue. d. Quality assurance focuses on families, whereas CQI focuses on agency issues.

a. Quality assurance focuses on client care, whereas CQI focuses on system issues.

The staff was informed that a Quality Improvement Organization (QIO) would be making an unannounced visit in a few hours. Which of the following would the hospital nurse expect the QIO team to examine? a. Records of hospital admissions and scheduled procedures b. Nursing care plans of patients with unexpected problems (infections, falls) c. Discharge paperwork of patients discharged in the past 30 days d. Documentation of adherence to nursing standards of care

a. Records of hospital admissions and scheduled procedures

Which of the following is the best way to increase the number of persons who come to their screening test appointments? a. Reminding clients via telephone, e-mail, or mail b. Emphasizing long life and happy family when conditions are caught early and treated successfully c. Pointing out how inexpensive and convenient screening tests are d. Stressing the dangerousness of the condition if not caught early

a. Reminding clients via telephone, e-mail, or mail

A nurse noted that of 18 children in a daycare center room, 5 became ill. Which of the following best describes a host factor that may be associated with this illness and who became ill? a. Some of the children were from very low socioeconomic families. b. Some of the children inhaled car exhaust while playing outside. c. The bacterial cause of the illness was easily removed by handwashing. d. The daycare center room was much warmer on three sides in comparison to the side with the floor to ceiling windows.

a. Some of the children were from very low socioeconomic families.

Which of the following groups is pressuring clinicians the most to use evidence-based practice (EBP)? a. Administrators b. Insurance companies c. Nurses d. Physicians

b. Insurance companies

A nurse is deciding which alternative interventions should be implemented. Which of the following factors must be considered by the nurse when making this decision? (Select all that apply.) a. The expected effect or outcome of each possible intervention b. How interested others are in helping in any particular intervention c. The nurse's own interest in implementing each intervention d. The likelihood that the intervention will resolve the problem e. Change process required to achieve stated objective

a. The expected effect or outcome of each possible intervention b. How interested others are in helping in any particular intervention d. The likelihood that the intervention will resolve the problem e. Change process required to achieve stated objective

A nurse established an ongoing group meeting of teenagers with diabetes. In the early stages, the nurse was very directive in arranging location, providing low-carbohydrate drinks and snacks, steering the discussion, and trying to meet all the teenagers' needs. After the group had been meeting for about 3 months, the nurse noticed that the group members no longer simply accepted everything the nurse suggested. Instead, the teenagers began making decisions themselves, and eventually, the nurse no longer controlled the group. Which of the following most likely happened to cause this shift? a. The group became cohesive enough to share leadership tasks. b. Teenagers don't like feeling dependent on adults with power. c. Teenagers often rebel against adult authority. d. The nurse was overwhelmed and lost control of task process

a. The group became cohesive enough to share leadership tasks.

Which of the following characteristics must a learner possess to successfully master psychomotor learning? (Select all that apply.) a. The necessary ability to perform the skill b. An open mind to learn the new skill c. A sensory image of how to perform the skill d. Opportunities to practice the skill e. Desire to learn the skill

a. The necessary ability to perform the skill c. A sensory image of how to perform the skill d. Opportunities to practice the skill

A nurse, after working 2 weeks at the site of the largest natural disaster to hit the United States, returns home. Which of the following behaviors would suggest the nurse needs professional assistance? a. The nurse becomes angry when family members quit listening to her ongoing stories about the disaster and the problems there. b. The nurse gives a presentation at the local college about the disaster and describes how health professionals were able to assist the victims who were injured. c. The nurse is moody and feels family demands are not really as important as the other members of her family think they are. d. The nurse is very exhausted and asks to have 3 personal days off from employment responsibilities.

a. The nurse becomes angry when family members quit listening to her ongoing stories about the disaster and the problems there.

A nurse just accepted a position in community health and has been assigned to a neighborhood very close to where she lives. Which of the following best describes the rationale for this assignment? a. To allow participant observation by the nurse b. To ensure that the nurse would care about her intervention outcomes c. To maximize convenience and minimize commuting time for the nurse d. To save gasoline in these difficult economic times

a. To allow participant observation by the nurse

Which of the following are the primary goals of case management? (Select all that apply.) a. To ensure that care coordination occurs across the continuum b. To emphasize evidence-based clinical decision-making c. To manage resource use and control expenses d. To stress the advantages and benefits of community-based care e. To reduce institutional care as a means of achieving wellness

a. To ensure that care coordination occurs across the continuum b. To emphasize evidence-based clinical decision-making c. To manage resource use and control expenses e. To reduce institutional care as a means of achieving wellness

A client tells a nurse, "I know all about this already. I read about it on the Internet" and then begins to summarizes what he has learned. Because some of this information seems incorrect, what questions would be effective for the nurse to ask? (Select all that apply.) a. Were you able to find what you wanted easily on the website? b. Did the website say when the information was updated? c. Did the website state who was responsible for the information? d. Did you enjoy reading the material on the website? e. Did the information sound correct to you?

a. Were you able to find what you wanted easily on the website? b. Did the website say when the information was updated? c. Did the website state who was responsible for the information?

Which of the following statements by the client indicates the client is experiencing a learner-related barrier to new information about type 2 diabetes management? a. "I know about diabetes; my sister has it." b. "I Don't like to read' just tell me what I need to know." c. "It won't change my life; it's type 2 diabetes." d. "It can't be that hard to learn; I don't have to take shots."

b. "I Don't like to read' just tell me what I need to know."

Which of the following public health nurse applicants is the least qualified for a position of case manager in a rural county? a. A 24-year-old who has a master's degree in public health b. A 34-year-old who will be moving from a large city c. A 44-year-old who was born and raised in the community d. A 54-year-old who, until recently, was a member of the community's school board

b. A 34-year-old who will be moving from a large city

A home-care nurse is encouraging the administration of the agency to increase their quality assurance efforts. Which of the following best describes a negative outcome from this activity? a. An agency deficiency may become visible. b. An individual may be found at fault and then become fearful of being involved. c. Some agency processes may be questioned. d. Employees at the agency will have to commit extra time to complete this process.

b. An individual may be found at fault and then become fearful of being involved.

Which of the following best describes why planning care for an individual is so challenging in today's health care system? a. Because today's clients have high expectations of the health care system b. Because multiple providers, payers, and settings have to be coordinated c. Because of the new high technology constantly being created and used for client treatment d. Because so many different health care providers are in the acute care setting today

b. Because multiple providers, payers, and settings have to be coordinated

A nurse attends a conference to learn more about public health surveillance. Why is it so important that the nurse be knowledgeable about this topic? a. Because nurses are employed in public health agencies b. Because nurses are often the first to recognize and respond to a problem c. Because nurses are responsible for ensuring that action is taken when necessary d. Because nurses are typically the ones to interact with the public and the media

b. Because nurses are often the first to recognize and respond to a problem

A home health care agency has major problems but does not want consumers to know about these problems while the agency decides what should be done to improve them. Employees are not told to lie, but they are advised not to share information. Which of the following is the most likely outcome of this situation? a. As long as employees do not share what they know, the community will be uninformed. b. By law, comparative information will be available to the public via the Internet. c. Only a few informed persons will know about the problems. d. Secrecy will prevail unless the local newspaper does an investigative report.

b. By law, comparative information will be available to the public via the Internet.

A nurse is using a case management plan to maximize patient care outcomes. Which of the following describes an important consideration that should be made by the nurse? a. Case management plans should be used only by nurses to manage care. b. Case management plans should be individualized for each client. c. Case management plans provide additional expense to the client and family. d. Case management plans focus on the natural progression of the disease.

b. Case management plans should be individualized for each client.

A community is examining which programs are needed within the community, the populations they will target, and how they will be funded. Which of the following would be the least risky decision for the community to make? a. Choose whichever option is the least expensive of agency resources. b. Choose to do nothing. c. Choose whatever the agency administration prefers. d. Choose whatever the majority of clients prefer.

b. Choose to do nothing.

The case manager explains to two disagreeing parties that coming to an agreement will save personnel costs for both of them. Which of the following terms best describes this action? a. Assertiveness b. Collaboration c. Cooperation d. Compromising

b. Collaboration

A school health nurse plans to use evidence-based practice (EBP) to guide the development of health education programs most likely to increase retention of learning in elementary schoolchildren. Which of the following would be the best way to use EBP in this situation? a. Ask other school health nurses what they included in their own education programs. b. Compare and contrast randomized controlled trials related to learning in elementary schoolchildren. c. Develop a series of games to accompany the programs developed to promote health. d. Seek out and examine health education programs for elementary schoolchildren on the Internet.

b. Compare and contrast randomized controlled trials related to learning in elementary schoolchildren.

A nurse reviews with the client what can be expected during the next 3 days, as well as how the client should expect to feel each of those days. The client laughs and says, "You've got my care all mapped out." Which of the following tools is the nurse using to determine what will happen when? a. Care planning b. Critical pathway c. Demand management d. Use management

b. Critical pathway

A health care provider is concerned about the high number of clients with type 2 diabetes mellitus who have poor glucose control. What would be the best reference for the provider to implement evidence-based practice (EBP) in the management of this problem? a. Published protocols b. Current research findings c. Opinions of colleagues d. Nursing journals

b. Current research findings

A nurse wants to determine whether health problems have been improved and interventions have been appropriate and successful over a period of time. Which of the following data should the nurse examine? (Select all that apply.) a. Changes in staffing patterns in the health agency b. Demographic data c. Education and school statistics d. Environmental factors e. Utilization of health services

b. Demographic data d. Environmental factors e. Utilization of health services

Which of the following best defines a disaster? a. Any event that results in multiple deaths b. Devastation that cannot be relieved without assistance c. Devastation that covers a broad geographic area d. When the event results in multiple injuries and deaths as well as property damage

b. Devastation that cannot be relieved without assistance

A public health department becomes aware of an impending health problem before any problem is reported to the agency. Which of the following has most likely occurred within the community? (Select all that apply.) a. Doctors are feeling rushed as they interact with each patient. b. Emergency departments are notably busier than usual. c. Nurses are calling in ill to the local hospital. d. Pharmacists are discussing the increase in medication purchases. e. Orders for diagnostic tests have increased over last year at this time.

b. Emergency departments are notably busier than usual. d. Pharmacists are discussing the increase in medication purchases. e. Orders for diagnostic tests have increased over last year at this time.

A busy school health nurse concerned over the rising incidence of obesity wants to implement evidence-based practice (EBP) but faces barriers because of time constraints. Which of the following actions should the nurse take first? a. Identify students who are obese so that they may be closely monitored for weight control success or failure. b. Evaluate best practices to determine those that have the highest success rates for weight control in children. c. Schedule physician appointments for obese children. d. Develop an obesity management program for children whose body mass index exceeds normal.

b. Evaluate best practices to determine those that have the highest success rates for weight control in children.

The local hospital, health department, and university together planned and implemented a mock casualty drill, with the university's theater and nursing students playing the injured victims. After the drill, which of the following would the nursing students most likely complete? a. Volunteer as leaders in the next casualty drill. b. Evaluate the drill and offer recommendations for more effectiveness in the future. c. Recognize how to respond to a real disaster in the future. d. Write a report on their actions and how they felt during the drill.

b. Evaluate the drill and offer recommendations for more effectiveness in the future.

Which of the following best describes one of the main problems in ensuring quality for health care in the United States? a. Consumers believe American health care is of high quality and the best in the world. b. Every hospital and health care agency has its own approach to data collection and documentation. c. Finances are the basis of clinical decisions, not quality of care. d. We all agree on what quality is but not on how best to measure it.

b. Every hospital and health care agency has its own approach to data collection and documentation.

On the second day after a disaster, a male colleague tells the nurse he has a splitting headache. The nurse notes the colleague is feeling irritable and having difficulty focusing. Which of the following actions should the nurse take in response to the complaint of headache? a. Explain that the headache and problems focusing are probably the result of worry, so he should concentrate on the work at hand and deal with emotions later. b. Explain that he is experiencing signs and symptoms of psychological stress and recommend that he take some time off for a break. c. Explain to the worker that this is a common problem when multitasking under pressure and suggest that he focus on one task at a time. d. Suspect dehydration and encourage the worker to drink more fluids.

b. Explain that he is experiencing signs and symptoms of psychological stress and recommend that he take some time off for a break.

After experiencing a house fire, a 4-year-old child begins sucking his thumb and wetting his bed. Which of the following would be the most appropriate action for the nurse to take? a. Explain to the child that it is important to be strong and not act like a baby. b. Explain to the family that this behavior is a normal reaction to disaster. c. Recommend admission for inpatient psychological counseling. d. Recommend behavior therapy as a means to overcome regression.

b. Explain to the family that this behavior is a normal reaction to disaster.

A nurse planned a presentation about the latest trends in disaster planning for the senior nursing students at the local college. However, when the nurse began to share the information, the students were talking to one another and essentially ignoring the nurse. Which of the following actions should be taken by the nurse? a. Ask the students why they are being so rude. b. Explain why the information is crucial to their current clinical practice. c. Nothing; let the instructor of the course handle the problem. d. Tell a joke to get the students' attention.

b. Explain why the information is crucial to their current clinical practice.

A nurse is assessing a community's openness to change. Which of the following variables indicate that the community is ready? a. Commitment to current processes and policies b. High socioeconomic status in the community as a whole c. Long history of dependence on the community health agency and its staff d. Minimal level of social participation by community members

b. High socioeconomic status in the community as a whole

A committee of health care professionals would like to establish a countywide program to improve Hispanic immigrant access to culturally competent health care services. Which of the following persons would be most helpful as a key informant? a. Hospital administrator b. Hispanic community leader c. National expert on cultural competency d. Politician or county official

b. Hispanic community leader

Evaluation is under way for a statewide program to decrease teen injury and death associated with teens that drive while under the influence of alcohol. Which of the following questions would best be used for the summative evaluation of the program? a. Are program participants continuing to attend the programs, and do their satisfaction scores indicate that they are pleased with the program? b. How do statistics for injuries and deaths associated with drunk driving compare for teens in the year following the program? c. How does the amount of alcohol intake by teens compare before and after participants enter into the program? d. What problems are identified as the program is implemented?

b. How do statistics for injuries and deaths associated with drunk driving compare for teens in the year following the program?

Which would be an appropriate descriptor that meets all criteria for defining a client to be served by a program? a. All women ages 40 to 50 who have not had a menstrual period for three consecutive months b. Immigrants residing in Central County for less than 5 years who have difficulty understanding care instructions because of limited English proficiency c. Pregnant women who have received nutritional counseling but whose nutritional status did not improve d. Children ages 18 months to 5 years who have been treated for nutritional deficiencies at the Central County Clinic

b. Immigrants residing in Central County for less than 5 years who have difficulty understanding care instructions because of limited English proficiency

The nurse gives a very informative and engaging presentation and then gives everyone in the audience a handout that outlines the presentation. Later, the nurse discovers that many of the handouts were thrown away before the audience left the building. Which of the following educational principles has the nurse forgotten? a. Audiences expect PowerPoint or video presentations, not lectures. b. Many Americans do not have a high reading level. c. People want photographs and images, not wordy outlines. d. The nurse gave them too much information too fast for them to want to cope with it all.

b. Many Americans do not have a high reading level.

After finding several studies related to the clinical problem, a nurse knows the studies must be evaluated. Which of the following characteristics should be present in the literature? a. Federally supported multiagency clinical studies b. Multiple high-quality studies with large sample sizes and consistent findings c. Research studies done by multidisciplinary teams in multiple settings d. Controlled clinical trials

b. Multiple high-quality studies with large sample sizes and consistent findings

A nurse is invited to join the utilization review team to help the agency avoid giving unnecessary care. Which of the following difficulties would the nurse most likely confront as client records are reviewed? a. Alternative care options rather than agency care are often encouraged. b. Not all clients fit the pattern and need more care than guidelines suggest. c. The nurse suggests the agency provide guidelines to professionals giving care. d. The agency is now accountable to its clients and their families.

b. Not all clients fit the pattern and need more care than guidelines suggest.

Which of the following objectives is most appropriate for the development of a community-oriented nursing care plan? a. All monitored patients will receive abortive therapy for lethal dysrhythmias within 3 minutes of dysrhythmia recognition. b. Of mothers receiving nutrition counseling, 80% will identify five sources of calcium by the end of class. c. 95% of children will be immunized by 1 year of age. d. There will be a 25% reduction in health disparities by 2015.

b. Of mothers receiving nutrition counseling, 80% will identify five sources of calcium by the end of class.

Which of the components of the PDCA model and Donabedian's framework is the most crucial? a. Standard b. Outcome c. Process d. Structure

b. Outcome

Which of the following types of surveillance systems is being used when case reports are routinely sent to local health departments by health care providers and laboratories, where the data are then summarized and forwarded to those responsible for monitoring such reports? a. Active b. Passive c. Sentinel d. Special

b. Passive

Stakeholders developing a new community-oriented clinic plan want to include a quality assurance (QA) program. Which of the following would be the first step in measuring the structure component? a. Criteria that will be used to measure quality b. Philosophy and objectives of the organization c. Requirements of accrediting agencies d. Standards the QA program wishes to achieve

b. Philosophy and objectives of the organization

A nurse is working toward an objective to "increase to at least 90% the proportion of all pregnant women who receive first trimester prenatal care." During which of the following phases of the nursing process would determination of the objective occur? a. Assessment phase b. Planning phase c. Implementation phase d. Evaluation phase

b. Planning phase

Which of the following programs demonstrates the use of tertiary prevention? a. Developing an in-school clinic that provides birth control counseling and contraception b. Providing a diabetes management program for persons with diabetes mellitus c. Providing cardiovascular fitness evaluations at annual health fairs d. Setting up free blood pressure screenings at popular department stores and supermarkets

b. Providing a diabetes management program for persons with diabetes mellitus

A community health nurse is determining the best way to address an outbreak of a new infectious disease using evidence-based practice (EBP). Which of the following actions would the nurse most likely take? a. Review policies and procedures. b. Review outcomes of clinical trials. c. Review several nursing textbooks. d. Review reputable sites on the Internet.

b. Review outcomes of clinical trials.

Several children were hospitalized for severe vomiting and diarrhea. Which of the following best explains why the nurse would continue to pursue the cause of the illness even after the children have been discharged from the hospital? a. So that the children's families know the public health department cared about them b. So that action could be taken to avoid any such future episodes c. Because the children's parents need to know whom to sue for their medical expenses d. To confirm that the symptoms were due to an infectious disease

b. So that action could be taken to avoid any such future episodes

A community is experiencing the honeymoon phase following a disaster. Which of the following is most likely to occur in the community? a. First responders work tirelessly to save others. b. Survivors share their stories. c. Medical personnel experience exhaustion. d. Community organizations rebuild the community.

b. Survivors share their stories.

What event led to the development of the National Health Quality Improvement Act? a. A very famous movie and television star died as a result of a medical error. b. The number of malpractice claims had increased. c. Media such as films highlighted the reality of current medical care. d. Publicity about a few unfortunate cases caused consumers to become concerned.

b. The number of malpractice claims had increased.

A nurse was the first on the scene of a disaster and saw people with injuries ranging from minor to serious. Some of those with minor injuries were helping others. Which of the following injured persons would the nurse assist first? a. Those with life-threatening head and chest injuries b. Those who have life-threatening abdominal injuries c. Those who have serious injuries of limbs d. Those who are hurt but still mobile and functioning

b. Those who have life-threatening abdominal injuries

Which of the following information can be gathered by reviewing a community health report card? a. Utilization of health care services in the community b. Demographic information of the community c. Leading causes of morbidity in a community d. Frequency of malpractice claims within a community

c. Leading causes of morbidity in a community

Which of the following describes the purpose of surveillance systems today? (Select all that apply.) a. To obtain data used to fight for increased budgets from taxpayers b. To evaluate the effectiveness of public health programs c. To monitor the incidence of chronic diseases among the local population d. To note and help prevent occupational exposure and diseases e. To help formulate interventions to reduce the incidence of chronic diseases

b. To evaluate the effectiveness of public health programs c. To monitor the incidence of chronic diseases among the local population d. To note and help prevent occupational exposure and diseases e. To help formulate interventions to reduce the incidence of chronic diseases

Which of the following best describes the purpose of strategic planning? a. To anticipate client needs now and in the future b. To match client needs, provider strengths, and agency resources c. To maximize effective use of agency resources d. To utilize provider strengths and competencies

b. To match client needs, provider strengths, and agency resources

Which of the following strategies should be used when providing educational programs for children? (Select all that apply.) a. Emphasize how to build learning from previous experiences. b. Use simple words to enhance understanding. c. Use objects to help increase their attention. d. Emphasize the importance of the long-term consequences. e. Use concrete examples to reinforce learning

b. Use simple words to enhance understanding. c. Use objects to help increase their attention. e. Use concrete examples to reinforce learning

A client spends a great deal of time on the Internet or reading articles related to diabetes and its long-term effects. One day, the client asks why the nurse has not suggested a life care plan. Which of the following would be the best response by the nurse? a. "Life care plans are only for young persons who are newly diagnosed." b. "Life care plans are primarily used to determine long-term financial needs for legal reasons." c. "You are receiving appropriate care for your diabetes without serious side effects, so a life care plan isn't currently appropriate." d. "I was waiting for you to express interest in having a life care plan."

c. "You are receiving appropriate care for your diabetes without serious side effects, so a life care plan isn't currently appropriate."

A nurse is providing an educational program about testicular self-examination (TSE). Which of the following would be the best learning objective for this program? a. Each participant will state why TSE is important and explain how to do it. b. Each participant will describe how to do TSE and discuss the dangers of testicular cancer. c. 90% of the men will correctly demonstrate testicular self-examination. d. 100% of the men will do a testicular examination correctly on a model.

c. 90% of the men will correctly demonstrate testicular self-examination.

Which of the following Medicaid clients would most likely receive case management? a. An elderly person b. A person receiving rehabilitation following an injury c. A person who has a high-cost chronic disease d. A person with acute illness

c. A person who has a high-cost chronic disease

A new nurse is overwhelmed with the needs of the community. Which of the following should be the first priority of the nurse? a. A problem that affects the most disadvantaged residents in the community b. A problem that is very easy and inexpensive to address c. A problem that is of high concern to the community d. A problem in an area in which the nurse has a great deal of expertise

c. A problem that is of high concern to the community

A nurse is implementing tertiary prevention strategies as part of the quality management process. Which of the following best describes a strategy the nurse would have used? a. All new employees complete a program on fire safety that details what to do in the event of a fire. b. At the yearly employee picnic, teams compete in putting out trash can fires and in racing while carrying mock victims, using safe evacuation techniques. c. After evaluation of response to an actual fire, new procedures implemented in the fire response protocol are distributed to employees. d. Mock fire drills are carried out twice a year to assess response and readiness in the event of a real fire.

c. After evaluation of response to an actual fire, new procedures implemented in the fire response protocol are distributed to employees.

A nurse is assessing persons arriving at a shelter following a disaster. Which of the following would be the first action the nurse should take? a. Limit the amount of equipment and medications brought into the shelter. b. Determine if the person has a psychological condition requiring special attention. c. Assess if this type of facility is appropriate for the person. d. Provide medical care for persons as if they were in a hospital.

c. Assess if this type of facility is appropriate for the person.

A nurse is completing a case management advocacy activity which corresponds to the implementation phase of the nursing process. Which of the following activities would the nurse most likely use? a. Asking the client what is most important b. Seeking appropriate referrals for the client c. Assuring the client that his wishes will be supported d. Determining the order in which actions will occur

c. Assuring the client that his wishes will be supported

What is the purpose of the National Response Framework? a. Create a new branch of government that deals with bioterrorism. b. Establish a way for the Red Cross to carry out its mission. c. Define roles, responsibilities, and relationships critical to effective emergency preparedness. d. Extend presidential power to act quickly upon weapons of mass destruction.

c. Define roles, responsibilities, and relationships critical to effective emergency preparedness.

The nurse suggests use of telehealth to assess how a client is progressing. Which of the following resources must be available for continuing care to be implemented? a. A primary care provider who is willing to use wireless prescriptions and plans of care b. Family permission for the nurse to make home visits c. Long-distance telephone service or a computer with Internet access d. Willingness of the caregiver to drive the client to the nearest clinic

c. Long-distance telephone service or a computer with Internet access

The leader of an Alzheimer's support group surveys the members of the group to determine the best time for the group to meet. Which of the following norms is being supported through this action? a. Group norms b. Task norms c. Maintenance norms d. Reality norms

c. Maintenance norms

The outpatient health care data show a notable increase in asthma over the numbers treated the previous year. Which of the following actions should the public health nurse take first? (Select all that apply.) a. Analyze educational health programs offered to the public last year. b. Congratulate the public health staff on the success of their asthma awareness program. c. Determine whether there are any other data sources that might confirm the apparent increase in asthma. d. Review data with the outpatient clinic staff such as confirming repeat visits versus newly diagnosed cases. e. Determine whether there are any other data sources that might dispute the apparent increase in asthma.

c. Determine whether there are any other data sources that might confirm the apparent increase in asthma. d. Review data with the outpatient clinic staff such as confirming repeat visits versus newly diagnosed cases. e. Determine whether there are any other data sources that might dispute the apparent increase in asthma.

A community health nurse drives through an assigned community before visiting the community groups scheduled for the day. The nurse then drives through the community again that evening before going home. Which of the following best describes the nurse's reason for driving through the community twice in the same day? a. On the second trip, the nurse can carefully confirm the results of the first assessment. b. Repeating the experience ensures that the nurse absorbed all the relevant details. c. Driving through twice allows the nurse to see the community when many residents are at work or at school and then again when most are at home. d. When leaving in the evening, the nurse has more time to write down the results of the earlier assessment.

c. Driving through twice allows the nurse to see the community when many residents are at work or at school and then again when most are at home.

A case manager implements a primary prevention activity. Which of the following actions would the nurse most likely complete? a. Advocating for the client whose values conflict with those of the medical service provider b. Collaborating between nursing and occupational health personnel c. Educating a group regarding community services that are available if ever needed d. Resolving conflict between a primary care clinic and a tertiary health care facility

c. Educating a group regarding community services that are available if ever needed

Which of the following organizations would direct nurses' response to a countywide disaster? a. American Red Cross b. Centers for Disease Control and Prevention c. Emergency Management Agency d. The local public health department

c. Emergency Management Agency

Which of the following best describes the ultimate goal of program planning? a. Avoid unanticipated conflicts in the program development phase. b. Provide adequate funding to meet the program's resource requirements. c. Ensure that health care services are acceptable, equal, effective, and efficient. d. Prevent unnecessary duplication of services.

c. Ensure that health care services are acceptable, equal, effective, and efficient.

A member of a community weight-loss group has maintained a healthy weight for 2 years through healthy eating and daily exercise. Which of the following steps of the affective domain is this participant demonstrating? a. Analysis b. Application c. Evaluation d. Knowledge

c. Evaluation

A nurse checks health department records to compare the number of new teen clients presenting for birth control counseling and management in the 2 months before and after an education intervention program to decrease teen pregnancy. Which of the following steps of the evaluation process is being completed by the nurse? a. Engage stakeholders b. Justify conclusions c. Gather credible evidence d. Focus on the evaluation design

c. Gather credible evidence

A nurse is completing a summative evaluation of a program designed to decrease obesity in school-age children. Which of the following is the most important question for the nurse to ask? a. Are school-age children satisfied with the program? b. Can parents and guardians support the program requirements? c. Has obesity in school-age children decreased? d. What is the program cost compared with the program benefit?

c. Has obesity in school-age children decreased?

Which of the following is accomplished through the use of traditional quality assurance? a. Implementation of new techniques to improve outcomes b. Implementation of appropriate interventions for diagnosed problems c. Implementation of change when measured performance does not meet standards d. Implementation of research findings to ensure appropriate clinical treatment

c. Implementation of change when measured performance does not meet standards

Which of the following best describes case management? a. A tool of health maintenance organizations b. Targeted toward a specific segment of the population c. Implemented with individual clients d. Used to monitor the health status, resources, and outcomes for an aggregate

c. Implemented with individual clients

A nurse is focusing on the process dimension of a community's health. Which of the following interventions will the nurse most likely implement? a. Assessing the health care services available in a community b. Establishing screening programs to diagnose diseases as early as possible so that the treatment can begin c. Implementing health promotion activities such as education programs d. Planning for new programs to be developed based on identified needs

c. Implementing health promotion activities such as education programs

A nurse executive is implementing evidence-based practice at a community nursing center that serves a large Cuban immigrant population. Which of the following actions would be the most helpful for the nurse? a. Review clinical policies with cultural competency experts from the local university. b. Conduct weekly staff meetings to discuss which methods work best when helping immigrants. c. Invite Cuban immigrants from the community to serve on the center's advisory board. d. Send personnel to conferences and seminars that focus on treating Hispanic immigrants.

c. Invite Cuban immigrants from the community to serve on the center's advisory board.

A man says, "I just can't get myself to leave the house and go for a 30-minute walk each day. I wish I could think of some way to motivate myself." Which of the following would be the best action for the nurse to take? a. Establish a written contract between him and his employer that states walking is required each day. b. Recognize the reasons why 30 minutes of walking each day is one of the best health promotion activities he can choose. c. Join a group that walks early each morning. d. Set up rewards, such as a nice snack after he gets back from walking.

c. Join a group that walks early each morning.

A nurse is practicing in the community but also has the community as the target of practice. Which of the following best describes the activities of this nurse? a. Providing care to an active caseload of 50 families in the neighborhood b. Inviting all the parents of asthmatic children in the school to meet together for mutual support c. Sharing assessment findings and health goals with every community group that will listen d. Writing articles for the local newspaper highlighting the various programs and services of the local health department

c. Sharing assessment findings and health goals with every community group that will listen

What was the principal problem with early efforts at ensuring quality of care? a. No one knows how to measure quality care. b. Professionals resisted and sabotaged such efforts. c. Standards emphasized structure, not process. d. There were no standards as to what represented quality care.

c. Standards emphasized structure, not process.

An agency is beginning to implement a general approach for quality improvement. Which of the following activities would the agency most likely implement? a. Customer satisfaction is assessed through the use of surveys provided to the client after each appointment. b. The health maintenance organization (HMO) provides incentives to personnel who complete in-house programs on customer service. c. The institution has received accreditation through The Joint Commission. d. The total quality improvement (TQI) team meets to examine how to make the registration process more efficient.

c. The institution has received accreditation through The Joint Commission.

Which of the following older adults is most in need of psychological support? a. The older adult who keeps asking if loans will be available for him to rebuild b. The older adult who keeps asking if he can go back home yet c. The older adult who keeps lamenting the loss of his family photos d. The older adult who keeps talking about how expensive his home theater was and how he will never be able to afford to replace it

c. The older adult who keeps lamenting the loss of his family photos

A nurse considered copying last month's surveillance report and changing the date because the number of occurrences per month had not noticeably changed. Which of the following best explains why the nurse should continue to spend time collecting and reporting data that is always nearly the same? a. Because such data are legally required b. Because it is still part of the nurse's responsibilities, even if on minimal value c. To determine a local baseline rate and immediately notice any change d. To determine differences among communities in need for state assistance

c. To determine a local baseline rate and immediately notice any change

A nurse, client, family, and other care providers meet to discuss what will be the best approach to use to continue care. Which of the following best describes why the nurse suggests changing the goal from obtaining appropriate long-term care placement to ensuring that the client's recovery is beneficial and safe? a. To consider all possible consequences of long-term care placement b. To encourage the group to review the client outcomes in the different settings c. To expand the goal so that different solutions can be generated and considered d. To help the group focus on the critical aspects the client's family considered most important

c. To expand the goal so that different solutions can be generated and considered

What is the primary goal of total quality management? a. To confirm the high standards desired in patient care b. To discover and correct errors in task completion c. To focus on the client and teamwork d. To enable organizations to publicize their quality approach to patient care

c. To focus on the client and teamwork

A community health nurse has invited several agencies in the community to a meeting to discuss the disaster plan for the community. Which of the following best describes the purpose of this meeting? a. To increase stability in the community b. To improve overall community functioning c. To manage response to disasters in the community d. To enhance communication among agencies in the community

c. To manage response to disasters in the community

A nurse invited all the teenagers who were newly diagnosed with diabetes to a group meeting to discuss issues they all had in common. One teenager replied, "I don't know if I want to share all the problems I'm having with strangers." Which of the following is the best nurse response? a. "Don't share anything with anyone until you're comfortable doing so." b. "I can understand what you are saying." c. "No one will require you to do anything you don't want to do." d. "The purpose of the group is to have a safe place to share problems with others who may be having similar problems."

d. "The purpose of the group is to have a safe place to share problems with others who may be having similar problems."

A wealthy factory owner says, "I don't care about the poor. I just want the best care available for me and my family. Why should I care if other people don't get health care?" Which of the following would be the most appropriate response by the nurse? a. "If your employees are ill, who will do the work in your factory?" b. "You might catch a contagious disease from one of your employees." c. "You have a moral obligation to help those less fortunate." d. "Your personal insurance and tax costs will go up if your employees have to use community resources when they're ill."

d. "Your personal insurance and tax costs will go up if your employees have to use community resources when they're ill."

Which of the following is the best brief definition of community? a. A geographic area or political division under common leadership b. A group sharing a common bond such as a profession or occupation c. A group working together to confront a common problem d. A social group with common goals within a geographic area

d. A social group with common goals within a geographic area

The nurse has been reading extensively on a particular clinical problem, using both the closest medical library and the Internet. Which of the following would be the most helpful source? a. A journal with a whole issue devoted to research on that clinical problem b. A randomized controlled clinical trial related to that clinical problem c. A researcher who has built a career on studying that clinical problem d. A systematic review related to the clinical problem

d. A systematic review related to the clinical problem

A nurse is working with a community during the preparedness stage of disaster management. Which of the following events would the nurse anticipate occurring? a. Heightened inspection and increased security in the community b. Incorporation of provision of pets into local disaster plans c. Purchase of personal protective equipment for all citizens d. Assembly of disaster kits for the home, workplace, and car

d. Assembly of disaster kits for the home, workplace, and car

A nurse is conducting an assessment to determine whether participants of an educational program felt the stated objectives were met. Which of the following data sources would the nurse most likely use? a. Community forum b. Interview c. Focus group d. Attitude survey

d. Attitude survey

The nurse admits uncertainty over how to address the needs of a group of clients. The long-term nurse in the area suggests that the nurse review published evidence-based clinical guidelines. How can the nurse know these guidelines are reliable? a. Because the agency supports their use b. Because the guidelines have been published c. Because the long-term nurse trusts them d. Because they are based on research and expert opinion

d. Because they are based on research and expert opinion

A case manager advocates for a client by helping an insurer understand the client's needs and desires and by helping the client understand programs and benefits offered by the insurer. What role is the nurse? a. Arbitrator b. Systems allocator c. Mediator d. Negotiator

d. Negotiator

Which of the following best describes the primary problem that can result from health care today being given by many different care providers? a. Clients are not sure which provider to see first. b. Health care providers have to make referrals to other providers. c. Clients sometimes are not sure who their primary provider is. d. Overuse, underuse, or gaps in care may result.

d. Overuse, underuse, or gaps in care may result.

The management team of the Central County Community Health Agency wants to analyze the cost of homebound client services. Which of the following records are most likely to provide useful data? a. Clinical records b. Financial records c. Morbidity and mortality records d. Provider service records

d. Provider service records

Persons often point out that smokers choose to light their cigarettes; alcoholics lift the glass to their mouth, and drug addicts inject or ingest their drugs. Which of the following statements best describes why nurses don't simply focus on helping persons who engage in poor health behaviors to behave appropriately? a. Addicts don't have the willpower to change their behavior. b. It is too rewarding to continue the behavior for a person to be able to change. c. Laws and policies must reward good healthy behaviors and punish unhealthy behaviors to help individuals recognize the importance of change. d. Society must offer healthy choices, offer support, and practice helpful policies.

d. Society must offer healthy choices, offer support, and practice helpful policies.

The nurse contacts participants who completed an educational program on breast self-examinations to see whether they have any questions and to determine whether they are doing breast self-examinations. Which of the following types of evaluation is being implemented by the nurse? a. Final evaluation b. Formative evaluation c. Goal evaluation d. Summative evaluation

d. Summative evaluation

A nurse manager wants to facilitate incorporation of evidence-based practice (EBP) in the clinical setting. Which of the following would be the best strategy to accomplish this goal? a. Eliminate all protocols and standards that are not evidence based. b. Encourage group reflection on the ideals and expectations of nursing care. c. Refer agency nurses to Internet sources of research findings. d. Support nurses using practice-oriented research findings in decision-making

d. Support nurses using practice-oriented research findings in decision-making

A nurse is conducting a needs assessment but has a limited budget. Which of the following data sources would the nurse most likely eliminate? a. Community forums b. Examination of community indicators c. Focus groups d. Surveys

d. Surveys

A committee concludes that a program's objectives were met and that activities received positive ratings from the community; yet the program will be discontinued because cost was triple the amount anticipated. Which of the following program evaluation measures created a problem? a. Adequacy b. Effectiveness c. Impact d. Sustainability

d. Sustainability

A nurse is meeting to discuss problems and solutions with a group of teenagers who have been newly diagnosed with diabetes. One teenager states, "My mom found this particular brand of popcorn that has only 15 carbohydrates in the whole giant bag." Which of the following best describes the group purpose that is being served by the teenager's statement? a. Maintenance function of encouraging everyone to continue the discussion b. Maintenance function of helping everyone feel comfortable talking about food c. Task function of resolving problems about what to nibble during movies d. Task function of sharing information and resources

d. Task function of sharing information and resources

During which of the following activities is the nurse in community health acting as a partner in change? a. Administering vaccinations to preschoolers b. Analyzing community problems to determine the best interventions c. Establishing an elder-care center for older adults living with family members who work d. Teaching anger management skills to a group of teens in a halfway house

d. Teaching anger management skills to a group of teens in a halfway house

The pharmacist sent up the wrong medication for the patient. The nurse filled out an incident report when the error was discovered. Which of the following best describes the likely outcome when the quality improvement team reviews the incident report? a. The nurse will receive a commendation for recognition of the error. b. The pharmacist will be disciplined. c. The pharmacist will be reported to the state pharmacy board. d. The CQI team will try to determine how the error occurred.

d. The CQI team will try to determine how the error occurred.

After completing a needs assessment, the nurse presents ideas at a community interest meeting that focuses on community needs. Unfortunately, attendees show essentially no interest in being involved. Knowing that the health problem must be addressed, the nurse proceeds with implementation as planned. Which of the following is the most likely outcome of the program? a. Community members will become increasingly positive about the new program. b. Others will recognize the importance of the program and become involved. c. The public health agency will both publicize and expand the program. d. The program will fail because of the community's lack of interest.

d. The program will fail because of the community's lack of interest.

A nurse is planning an educational program about cardiovascular disease. Which of the following would be the optimal time for the nurse to elicit feedback from program participants? a. At the beginning of the program b. At the program midpoint c. Immediately following program completion d. Throughout the program

d. Throughout the program

During the assessment phase, the nurse compiles and interprets available data and draws conclusions as to the community's strengths and concerns. Which of the following best describes why the nurse would also conduct interviews with key informants? a. To ensure that others agree with the nurse's plans for interventions b. To confirm the nurse's initial findings and conclusions c. To encourage community partners to feel they "own" the data d. To generate non-statistical data such as values, beliefs, and perceived needs

d. To generate non-statistical data such as values, beliefs, and perceived needs

A rural public health nurse is spending time reviewing death certificates. Which of the following best explains the purpose of this activity? a. To ensure that local causes of death are consistent with national causes of death b. To confirm that no local health problems are beginning c. To evaluate effectiveness of health promotion programs d. To obtain mortality data for the local area

d. To obtain mortality data for the local area

Which of the following best describes the goal or priority of the nurse advocate? a. To gain organizational and governmental support for the promotion of nursing objectives b. To improve community service needs identified by research findings c. To integrate evidence-based practice guidelines in the provision of community nursing service d. To promote the client's rights and self-determination

d. To promote the client's rights and self-determination

Before beginning to survey the community to assess its health needs and strengths, the nurse reviews various documents, including local statistical data and the minutes of the previous meeting of the health care agency. Which of the following best explains why the nurse would start with this activity? a. To avoid confronting the community until the nurse is thoroughly oriented b. To become familiar with previous goals and priorities of the agency c. To help get a better understanding of the assigned community d. To save time and effort and perhaps have new insights

d. To save time and effort and perhaps have new insights

A nurse learns about a huge disaster a few states away. Which of the following actions by the nurse would be most helpful in this situation? a. Donating to any charity that is assisting the victims b. Driving over to the area and volunteering to assist c. Sending clothes and food to the area for distribution d. Training to become a Red Cross disaster volunteer

d. Training to become a Red Cross disaster volunteer

A nurse is assessing the structure of a community's health. Which of the following data will the nurse examine? a. The community's commitment to health b. Health-risk profiles of selected aggregates c. Statistics of morbidity and mortality in comparison with similar communities d. Treatment and service use patterns from local health agencies and care providers

d. Treatment and service use patterns from local health agencies and care providers

Which of the following methods would be the most interactive approach to assessing a community's need? a. Define needs based on the current health status of the community. b. Examine past needs as identified by the agency as well as the community. c. Project future needs based on current trends. d. Use past and current data to project future needs.

d. Use past and current data to project future needs.

Which aspect of a biological agent is probably the most frightening to those exposed? a. Infectivity b. Invasiveness c. Pathogenicity d. Virulence

d. Virulence

A nurse is assessing the status of a community's health. Which of the following will the nurse examine? a. Community awareness b. Health facilities c. Health care manpower d. Vital statistics

d. Vital statistics

Which of the following should family members have readily available to best cope with a disaster? a. Gloves, mask, and other personal protective equipment b. A copy of the nurse's professional license c. A 5-day supply of water d. Where they will meet in case of an emergency

d. Where they will meet in case of an emergency

A nurse is assessing a community to determine the feasibility of implementing a new program on bike safety for youth in the community. Which of the following aspects should the nurse investigate to make this determination? a. Whether the community, especially agency clients, desire a program b. Whether local politicians support the agency's idea for a program c. Whether agency professionals think a program is needed d. Whether all involved support the need for such a program

d. Whether all involved support the need for such a program