CHAPTER 15,16,26 AND 28
Which of the following symptoms suggests smallpox as opposed to the more common and much less dangerous chickenpox? (Select all that apply.) A-Child appears only mildly ill until late stages in smallpox. B-Lesions appear in various stages in the same area of the body rather than all at once. C-Rash lesions are most abundant on the face and extremities, not on the trunk. D-Rash occurs 2 to 4 days after sudden onset of fever rather than with the fever.
C,D
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
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 hand washing. D-The daycare center room was much warmer on three sides in comparison to the side with the floor to ceiling windows.
A
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
A client is using a primary prevention strategy to prevent infectious disease. Which of the following actions is the client most likely taking? A- A client receives a tetanus booster every 10 years. B- A client receives a tetanus booster after stepping on a nail. C- A client receives tetanus immunoglobulin after stepping on a nail. D- A client with tetanus is given antibiotics and is placed on seizure precautions.
A
A nurse at a migrant clinic assists clients with completing the application process to receive supplemental food assistance. Which of the following roles of the nurse is being used? A-Advocate B-Case manager C-Outreach worker D-Primary caregiver
A
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
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
A nurse's Mantoux test is positive for exposure to tuberculosis. Which of the following conclusions should be drawn by the nurse? A-The nurse has been exposed to tuberculosis. B-The nurse has tuberculosis. C-The positive test result probably is due to a problem in the testing process. D-The test is inaccurate and needs to be repeated.
A
An instructor is reviewing Salmonella infections with her class. Which of the following comments indicates that the student needs further review on how Salmonella is spread? A-"Certain pets and farm animals may be Salmonella carriers." B-"It is possible to transmit Salmonella by person-to-person contact." C-"Salmonella may be spread by spores that form once contaminated blood is exposed to the air." D- "Salmonella outbreaks are usually due to contaminated meat, poultry, and eggs."
C
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
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
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
A nurse attends a conference to learn more about public health surveillance. Why is it so NURSINGTB.COM 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
A nurse is considering applying for a public health nurse position at a local health department. Which of the following minimum levels of educational preparation should the nurse have obtained? A-Associate degree in nursing B-Baccalaureate degree in nursing C-Master of science degree in nursing D-Training as a licensed practical nurse
B
What did events after September 11, 2001, clearly demonstrate? (Select all that apply.) A- A strong public health structure ready to respond effectively to a crisis B- Public health's need for additional funding and resources C- The unrecognized importance of nurses in lowering health care costs D- Lack of adequate vaccines to meet community's needs
B, C, D
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 and reduce the incidence of chronic diseases D-To note and help prevent occupational exposure and diseases
B,C,D
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.
B,D
Six students order meals at a local restaurant. Which of the following students are at highest risk for illness? (Select all that apply.) A- The first student asks for a salad with chicken strips and dressing on the side. B- The second student asks for a hamburger, very rare. C- The third student orders a tuna salad sandwich with extra mayonnaise. D- The fourth student orders a breakfast meal with two very soft-poached eggs and toast
B,D
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
Which of the following agencies are responsible for implementing and enforcing local, state, and federal public health codes and ordinances and providing essential public health programs to a community? A- Community health clinics U S N T O B- Federal health agencies C- Local health agencies D- State health agencies
C
Which of the following best describes how public health nurses (PHNs) differed from other health care professions in the early twentieth century? A-PHNs contributed without receiving any salary for doing so. B-PHNs created new settings where health care could be given. c. PHNs gave care to powerless groups. NURSINGTB.COM d. PHNs worked outside any organized health care system.
C
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
Which of the following data would most likely be collected in a syndromic surveillance system? A-Incidence of bioterrorism attacks B-Number of air travelers C-Incidence of school absenteeism D-Number of influenza vaccines administered
C
Which of the following federal agencies is most influential in public health activities? A- The Agency for Healthcare, Research, and Quality B- Centers for Disease Control and Prevention C- Department of Health and Human Services D- Food and Drug Administration
C
Which of the following is the most common vector-borne disease in the United States? A-Babesiosis B-Ehrlichiosis C-Lyme disease D-Rocky Mountain spotted fever
C
In January, a nurse is listening to colleagues talk about the increase in depressed patients asking for help from their physicians recently. The incidence of complaints 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 the beginning of an epidemic and should be investigated.
A
The public health administrator is in the process of hiring a new public health nurse. Which of the following statements made by an applicant would most likely result in the applicant not being hired? A-"I like to be the only person working on a project because individuals in teams have their own ideas and plans and the resulting debate slows progress." B-"I prefer to work in teams because no single person has too much responsibility because the burden is shared." C-"Teamwork is better than work done by individuals because teamwork incorporates different perspectives." D- "Whether teamwork is better than work done by individuals depends on the nature of the work being performed."
A
Which of the following best describes the role of nursing in community health? A-Application of nursing and public health theory in promoting, preserving, and maintaining health of individuals, families, or communities B-Health care provision offered in primary and secondary institutions or in the client's home C-Provision of health care services in institutions located in the community but outside the hospital D-Use of the nursing process and evidence-based practice to meet Healthy People 2020 objectives for community health improvement
A
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
Which of the following best represents an example of infectious disease spreading via a vector? A-Being bitten by an infected mosquito B-Disease spreading from infected mother to infant via the placenta C-A group of partygoers hugging and shaking hands D-Two persons, one of whom is infected, sharing a glass of soda
A
Which of the following biological warfare agents poses the greatest bioterrorism threat to a community? a. Anthrax b. Botulism c. Smallpox d. Tularemia
A
Which of the following factors is causing nursing to change so quickly? A-Economic issues B-Increases in medical and nursing knowledge C-Legislative issues D-Technology changes
A
Which of the following is the most probable cause of the increase in new emerging infectious diseases? A-Activities or behavior of humans, including changes in the environment B-Increasing urbanization and growth in new housing materials C-New infectious agents are evolving throughout the world D-Overpopulation in many areas, creating a need to reduce global population
A
Which of the following places best describes where the incidence of Vancomycin-resistant Staphylococcus aureus (VRSA) and methicillin-resistant S. aureus (MRSA) is currently rising? A-Areas where people share dressing or bathing facilities B-Daycare centers and schools C-Long-term care facilities D-Senior citizen centers
A
A nurse is employed by a state public health department. Which of the following functions would most likely be completed by this agency? (Select all that apply.) A-Delegating power to engage in certain activities such as quarantine B-Enforcing laws and regulations that protect public health C-Filing birth and death certificates whenever these occur within the state D-Monitoring health status of citizens within its geographic boundaries
A,B,D
Which of the following are elements of the MAPP (Mobilizing for Action Through Planning and Partnership) Program Planning Model? (Select all that apply.) A-Generate shared visions and common values. B-Assess priorities in health problems. C-Develop a framework for long-range planning. D-Choose health priorities.
A,C
Which of the following activities are addressed by most public health departments on the federal, state, and local levels? (Select all that apply.) A-Collecting and analyzing various health statistics B-Fining and terminating business at any facility that engages in unsafe commercial practices C-Identifying and planning for high-risk populations D-Planning for and responding to emergencies
A,C,D
A nurse is implementing a primary prevention activity to decrease the incidence of communicable disease. Which of the following actions is the nurse most likely taking? A-Identifying and treating clients in a sexually transmitted disease clinic B-Partnering with schoolteachers to teach and observe hand washing techniques in elementary school children c. Providing case management services that link clients with communicable diseases to health care and community support services d. Performing directly observed therapy (DOT) for clients with active tuberculosis
B
A nurse is working at a local health department. Which of the following would most likely be completed by this agency? A-Enforcement of laws and regulations related to public health nationwide B-Filing of a certificate for any birth or death in a community C-Providing experts in various specialties to answer questions and respond as needed D-Surveying the state's public health needs
B
A public health nurse traces sexual contacts of clients with sexually transmitted diseases for screening and treatment. Which of the following levels of prevention is being implemented? A-Primary prevention B-Secondary prevention C-Tertiary prevention D-Secondary and tertiary prevention
B
A student comes to the college health clinic with typical cold symptoms of fever, sneezing, and coughing, but the nurse also notes small white spots on the inside of the student's cheeks. Which of the following actions should be taken by the college health nurse? a. Inform all students, staff, and faculty of a possible rubella epidemic. B-Inform all students, staff, and faculty of a possible measles epidemic. C-Reassure the student that it is just a bad cold and will soon pass. D-Tell the student to take two acetaminophen and drink lots of fluids.
B
A student complains to the college health nurse that her academic work has been going downhill because of lack of sleep. "My 3-year-old probably misses her babysitter since she has started going to the big daycare center. She hasn't been sleeping well and keeps scratching her bottom. Hopefully, she'll adapt to daycare soon." Which of the following information should the nurse provide to the student? A-"Dry skin in winter weather can cause itchiness; try to put on lotion before bedtime." B-"Your daughter may have pinworms; let me teach you how to check for this." C-"Perhaps your child is not developmentally ready for group play." D-"Try to arrange more one-on-one time with your 3-year-old."
B
Evaluation is under way for a statewide program to decrease teen injury and death associated with teens who 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
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
Which of the following best describes the current goal in relation to communicable diseases? a. To control political borders so diseases cannot spread further B-To exterminate specific infectious agents one by one C-To expand health care facilities to improve infectious disease treatment D-To achieve worldwide immunization to control new cases
B
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
Which of the following components of the epidemiologic triangle contributes most to a female client developing a vaginal infection caused by fungi after successful treatment of her strep throat with antibiotics? A-Agent B-Environment C-Host D-Agent and host
B
Which of the following is the most common vector-borne disease worldwide? A-Dengue B-Malaria C-Onchocerciasis (river blindness) D-Yellow fever
B
Which of the following is the number-one cause of death worldwide? A-Chronic diseases (heart disease, cancer, stroke) B-Infectious diseases C-Injuries (accidental or purposeful) D-Terrorism
B
Which of the following is the underlying science or area of study on which public health is based? A-Biostatistics B-Epidemiology C-Medicine D-Social sciences
B
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
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
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 3 consecutive months B-Immigrants residing in Central County for less than 5 years who have difficulty understanding care instructions because of limited English proficienc c. Pregnant women who have received nutritional counseling but whose nutritional status did not improve d. Children ages 18 months to 5 years old who have been treated for nutritional deficiencies at the Central County Clinic
B
The advanced practice nurse explains that the client has an upper respiratory infection (URI) and suggests several measures that might make the client more comfortable. Which of the following best describes why the nurse doesn't just prescribe antibiotics as the client repeatedly requests? (Select all that apply.) A- Antibiotics are expensive, whereas the support measures would be almost free of cost. B- Viral diseases are not affected by antibiotics. c. Clinics cannot afford to continually give antibiotics to anyone who asks for them. d. The more antibiotics are prescribed, the more infectious agents develop resistance to such drugs.
B,D
A community mental health nurse is implementing a tertiary prevention activity. Which of the following interventions is most likely being completed? A-Disseminating information about mental health to community organizations B-Partnering with school health nurses for early identification of children who have evidence of mental health problems C-Providing case management services that link clients with serious mental illnesses to mental health and community support services D-Screening high-risk clients for the presence of mental disorders
C
A man loudly protests his increased property tax bill right after the public health department has made a plea for more funds. "Why," he asks, "should my tax dollars be used to pay for their children to be immunized?" Which of the following would be the best response by the nurse? A- "Immunizations are required by law, and if their parents can't afford it, you and I will have to pay for it." B- "It's just the right thing to do." C- "Only by making sure most kids are immunized can we stop epidemics that might hurt all of us." D- "We're a religious God-fearing community, and we take care of each other."
C
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
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 it is a waste of time C-To determine a local baseline rate and immediately notice any change D-To determine differences among communities in need for state assistance
C
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? USNT O c. Has obesity in school-age children decreased?d. What is the program cost compared with the program benefit?
C
Which of the following public health actions has been particularly instrumental in reducing childhood infectious diseases in the United States? A-Answering parents' questions about the safety and importance of vaccines today B-Educational campaigns to all health care providers about the importance of immunizations whenever a child is seen C-"No shots, no school" legislation, which legally requires children be immunized before school D-Offering all immunizations to all children free of any charge
C
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 or dispute the apparent increase in asthma. D-Review data with the outpatient clinic staff such as confirming repeat visits versus newly diagnosed cases.
C,D
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
A community health nurse is trying to decrease the incidence of emerging infections caused by drug-resistant organisms. Which of the following actions would be most appropriate for the nurse to implement? A-Lobby for increased use of antibiotics in the treatment and prevention of communicable diseases. B-Notify the Centers for Disease Control regarding any unusual signs and symptoms related to a communicable illness. C-Reinforce the importance of receiving vaccinations according to recommended schedules. D-Teach parents that antibiotics should not be used for treatment of viral infections or for prevention of bacterial infections.
D
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
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
A nurse is employed at the state department of public health. Which of the following is a fundamental principle guiding his practice? A-Decisions are made at the federal level, disseminated at the state level, and carried out at the community level. B-Health of populations is only as good as the health of individuals that live and work in the community. C-Oversight of community health departments is the most important function. D-The interaction of the local-state-federal partnership is critical to success
D
A public health nurse has reviewed the objectives of Healthy People 2020. Which of the following should be the focus for programming in the community related to communicable diseases? A-Encouraging community members to engage in healthy behaviors B-Identifying high-risk sexual behaviors among community members C-Monitoring the sexual activity of adolescents D-Providing information about the hazards of multiple sexual partners
D
A student engages in unprotected sex under the influence of alcohol. The student decides to have an HIV test completed the next day. Which of the following results will most likely occur? a. The results will probably be negative for HIV. b. The results will probably be positive for HIV. c. The probability of disease is so low there is no reason to be tested. d. The test results won't be reliable so soon after exposure.
D
After completing a needs assessment, the nurse is confident that he has identified the highest priority health programming need within the community. He presents his ideas at a community interest meeting, and the attendees show essentially no interest in being involved. Knowing that the health problem must be addressed he 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
At a town meeting with public health officials to discuss a communicable disease outbreak, a nurse is asked to explain what is meant by the phrase "a virulent organism." The nurse explains that this means the organism causing the disease is able to do which of the following? A-Bypass normal immunological response mechanisms B-Invade major organ systems C-Produce toxins and poisons that weaken the body D-Produce very severe physical reactions
D
During an outbreak of hepatitis A, nurses are giving injections of hepatitis A immunoglobulin to selected susceptible persons. Which of the following best describes the type of immunity that will follow the administration of these injections? A-Active immunity B-Acquired immunity C-Natural immunity D-Passive immunity
D
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
The nurse is trying to determine if a disease occurrence needs to be reported to the state health department. Which of the following resources should the nurse use to answer this question? A-Centers for Disease Control and Prevention Weekly Report B-Communicable Diseases Weekly Report C-Nationally notifiable infectious diseases on the CDC website D-State health department website
D
There is great concern in the nurse's community over three local cases of West Nile virus. Which of the following actions should the nurse take to get the community involved in addressing this problem? A-Ask the state department of health for assistance B-Demand that everyone over age 65 become immunized immediately C-Encourage immunization of all children under 12 D-Have an educational campaign to remove any containers of standing water
D
Which aspect of a biological agent is probably the most frightening to those exposed? a. Infectivity b. Invasiveness c. Pathogenicity d. Virulence
D
Which of the following best describes the primary reason life spans have notably lengthened over the past 100 years? A-Advances in hospital care and procedures B-Advances in medicine and medical research C-Advances in nursing practice D-Advances in public health
D
Which of the following infectious disease interventions best represents the use of secondary prevention? A- Clients with HIV infection are encouraged to use condoms to protect sexual partners. B- Clients with HIV infection are given medications to improve immunological response. C- Health care workers are encouraged to receive annual vaccinations for influenza. D- Health care workers are required to have a tuberculosis skin test or chest X-ray.
D
Which of the following is a core competency required of public health nurses? A-Knowledge in the use of high-technology diagnostics B-Knowledge of the implementation of electronic medical records C-Skill in the physical assessment of complex clients D-Skill in developing policy and planning programs
D
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