Chapter 30 Community

A nurse is working with incarcerated adults who are being released from prison. Which of the following nursing interventions would be most appropriate to implement?

Connect offenders with community-based mental health programs Connecting offenders with community-based mental health programs at the time of release from prison can decrease recidivism rates, as many incarcerated adults experience major psychiatric disorders. It would be impossible for the nurse to supervise all mentally ill offenders in the community. Increased prison time is not shown to decrease recidivism rates and education about available state resources is not the most important nursing intervention to provide for this population.

A nurse is planning to implement Wagner's CCM. Which of the following essential elements should be considered by the nurse?

Clinical information systems Self-management support Community The essential elements of CCM are: the community, the health system, self-management support, delivery system design, decision support, and clinical information systems. Evidence-based change concepts are found under each of the essential elements and help to foster productive interactions between clients and providers.

A nurse is caring for a client who is considered obese. Which of the following best describes this client?

An individual with a BMI of 30 A person is considered obese when the BMI reaches 30. A person is considered overweight with a BMI of 25 to 29.9. A BMI of 18.5 to 24.9 is considered of healthy weight. An individual with a BMI of less than 18.5 is considered to be underweight.

An elderly person is living independently in a single room in a full-service life care community. Which of the following terms best describes this living arrangement?

Assisted living An elderly person living independently in a single room in a full-service life care community is a client of an assisted living facility. Adult day health care is for individuals whose mental or physical function requires them to obtain more health care and supervision; it serves as more of a medical model than the senior center, and often individuals return home to their caregivers at night. Nursing home facilities provide treatment for those needing rehabilitation. Home care provides individual and environmental assessments, direct skilled care and treatment, and short-term guidance for individuals in the home.

A nurse is investigating the overall health status of a population. Which of the following indicators would most likely be used by the nurse?

Life expectancy Life expectancy is a measure that is often used to gauge the overall health of a population. Health status indicators are the quantitative or qualitative measures used to describe the level of well-being or illness present in a defined population or to describe related attributes or risk factors. Morbidity measures rate of disability or illness. Prevalence is the proportion of the population that has a specific disease or illness.

Which statement about eating disorders is correct?

Most women with bulimia are concerned with the shape and weight of their body. Those with bulimia are usually concerned with the shape and weight of their body. Those with anorexia view themselves as normal or overweight; purging is associated with bulimia; and anorexia is considered to have more complications than bulimia.

Testicular cancer is commonly found in which age-group?

15 to 40 years Testicular cancer is commonly found in men 15 to 40 years old, with the peak incidence between the ages of 18 and 40 years

A nurse is caring for a client who has designated someone else to make health care decisions when he or she is unable to do so. Which of the following is being used by the client?

A durable medical power of attorney Durable medical power of attorney is the legal way for a client to designate someone else to make health care decisions when he or she is unable to do so. An advanced medical directive includes both a living will and a durable medical power of attorney. A living will allows the client to express the wishes regarding the use of medical treatments in the event of a terminal illness. The Patient Safe Determination Act requires those providers receiving Medicare and Medicaid funds to give clients written information regarding their legal options for treatment choices if they become incapacitated.

A nurse is providing home care for several elderly clients in the community. Which of the following situations would most likely be indicative of elder abuse?

A young man repeatedly steals money from his grandmother. Theft or mismanagement of money or resources is an element of abuse. Recognition of abuse includes these other possibilities as well: willful infliction of physical pain or injury, inflection of debilitating mental anguish and fear, or unreasonable confinement or the depriving of services. The other examples do not describe these elements of abuse.

A nurse is educating a community women's group about the importance of monthly breast self-exam and annual mammograms. Which of the following best describes why this community health education is important?

Early detection of breast cancer typically leads to a better prognosis. Secondary prevention measures, including screening techniques, make a difference in the death rates for breast cancer. Early detection often means cure, whereas late detection typically results in an unfavorable prognosis. A potential harm from screening does not exist

A nurse is implementing Wagner's Chronic Care Model (CCM). Which of the following actions would most likely be taken by the nurse?

Educate a community group about hypertension control Use of electronic health records, provider reminders for key evidence-based care components, interprofessional teams communicating regularly, and community health classes to educate people with chronic diseases are various ways the CCM is being implemented. Creating a budget is not a way to use CCM. Administration of immunizations and conducting depression screenings do not address the management of the most common and costly chronic diseases: heart disease, diabetes, stroke, cancer, and arthritis.

A nurse plans to address the increasing prevalence of depression in the community. Which of the following would be the best strategy to implement?

Educate the community about how depression affects men Depression between men and women is recognized differently in the community. More women than men are classified as having depression. Men with depression often go unrecognized and underreported. Men tend to be stoic and do not verbalize how they feel, are reluctant to talk about health issues, and often do not have positive relationship with their health care provider. Recognition is key in order to get those with depression the necessary services that they need. Once depression has been detected, these individuals can be referred to the appropriate resources. Health policy changes and the understanding of free clinics would not provide the most immediate solution to the community.

A nurse is providing contraceptive counseling to a female. Which of the following goals does the nurse plan to obtain?

Ensure the individual is educated to make an informed choice about reproduction The goal of contraceptive counseling is to ensure that women have appropriate instruction to make informed choices about reproduction. The nurse should provide a nonjudgmental approach during counseling and allow the woman to choose the appropriate contraceptive method. Nurses do advocate for reproductive services for women, but that is not a goal of contraceptive counseling. Reduction in the health risks of the individual is a goal of preconceptual counseling.

A woman needs to take some time off from work to care for her invalid mother. Which of the following health policies allows her to take an extended leave from work to care for a family member

Family and Medical Leave Act (FMLA) The FMLA provides job protection and continuous health benefits where applicable for eligible employees who need extended leave for their own illness or to care for a family member

A nurse is providing preconceptual counseling to a woman. Which of the following supplements would be recommended to help prevent neural tube defects?

Folic acid 400 µg of folic acid are recommended daily. Supplements of iron and Vitamin C are not recommended during preconceptual counseling. Supplements of calcium may be recommended to prevent bone loss, but not for preconceptual counseling.

Which of the following characteristics indicates a man is at a higher risk for developing prostate cancer?

Has a father or brother who has had prostate cancer Having a father or brother who has had prostate cancer places a man at higher risk for developing prostate cancer. Being of African American descent places a man at higher risk for developing prostate cancer. The PSA test is not accurate in terms of sensitivity or specificity, but it is used as a screening test. BPH can cause an elevated PSA test result.

Which of the following statements about health disparities is accurate?

Health disparities vary among racial/ethnic groups. Improvements have been made in some areas of health disparities among various populations. However, health disparities vary among each racial/ethnic group. African American women have much higher death rates from breast cancer, not necessarily a higher incidence. The awareness of health disparities remains low among the general public. These health disparities are typically not the result of negligent health care practices.

An older person is in the last stages of dying. Which type of care would be the best for him?

Hospice Hospice would be the best form of care for a person in the last stages of dying. Home health care provides individual and environmental assessments, direct skilled care and treatment, and short-term guidance for individuals in the home. Assisted living offers a wide variety of living choices, from a single shared room to a full-service, life-care community. Nursing homes provide care to meet the health care needs of those needing rehabilitation, as well as for those needing a permanent supportive residence.

A nurse is caring for an elderly female population. Which of the following considerations should be made?

Postmenopausal women are more likely than men to experience hypertension. Women use more health services than men. Postmenopausal women are more likely than men to experience hypertension; prior to menopause, the rate is higher among men. Women use more health services than men. Women report higher rates of disability than men. Women and men have different socialization, expectations, and lifestyles

Which of the following factors has the largest impact on health disparities among all populations?

Poverty Poverty is a strong and underlying current factor that affects all special groups. Other factors that may also influence disparities are: education, insurance status, segregation, immigration status, health behaviors and lifestyle choices, health care provider behavior, employment, and the nature and operation of the health system in the community.

Which type of cancer is the second leading cause of cancer deaths in the United States?

Prostate Prostate is the most common non-skin cancer and second leading cause of cancer deaths in the United States. Testicular cancer is rare. Skin cancer and gastrointestinal cancer are not among the leading causes of cancer deaths.

What is the purpose of adult day health centers?

Provide respite care relief for caregivers Adult day health care is for individuals whose mental or physical function requires them to obtain more health care and supervision. It serves as more of a medical model than the senior center, and often individuals return home to their caregivers at night. Hospice provides support of life until death occurs. Assisted living provides assistance to people who may need help with ADLs. Long-term care facilities provide treatment for those needing rehabilitation

A nurse is educating a client about reducing her risk factors for the development of colorectal cancer. Which of the following lifestyle changes should the nurse recommend?

Reduction in consumption of processed meats Obesity, physical inactivity, smoking, heavy alcohol consumption, a diet high in red or processed meats, and insufficient intake of fruits and vegetables are risk factors for colorectal cancer.

Which of the following factors are cited as obstacles to improving men's health?

Reluctance to consult their primary care provider Emphasis of physical strength and competitiveness on masculinity Lack of a primary care provider Obstacles to improving men's health include reluctance to consult their primary care provider, the concept that masculinity emphasizes physical strength and competitiveness, and the fact that many men do not have a primary care provider.

A nurse advises a client who has HIV not to donate blood, plasma, or organs. Which of the following levels of prevention is being used?

Tertiary prevention

A nurse is developing a community-based exercise program for a group of women who have cardiovascular disease. Which of the following levels of prevention is being used?

Tertiary prevention Tertiary prevention includes those interventions aimed at disability limitation and rehabilitation from disease, injury, or disability. Primary prevention focuses on prevention on disease before it occurs. Secondary prevention aims for early detection and screening. Health promotion is not a level of prevention.

The nurse is caring for an elderly client who has written advanced medical directives. Which of the following best describes what this means?

The client has made decisions regarding treatment if he becomes incapacitated. Two parts of advance directives are the living will and a durable power of attorney. An advance directive indicates treatment choices if clients become incapacitated. A living will allows the client to express the wishes regarding the use of medical treatments in the event of a terminal illness. A Do Not Resuscitate order is a specific order from a physician not to use cardiopulmonary resuscitation.

A community health nurse would like to reduce the prevalence of sexually transmitted diseases (STDs) in the community. Which of the following activities would most likely be used?

d. Develop an STD clinic to increase community access to services The goal of Healthy People 2020 is to promote responsible sexual behaviors, strengthen community capacity, and increase access to quality services to prevent STDs and their complications. Nursing activities should align with these goals through development of an STD clinic to increase community access to services. Immunization clinics will not prevent the spread of most STDs. Education without access to services will not assist with reducing the problem.

Current research on hormone replacement therapy (HRT) has found that it:

does not prevent heart disease. HRT does not prevent heart disease. To prevent heart disease, women should avoid smoking, reduce fat and cholesterol intake, limit salt and alcohol, maintain a healthy weight, and be physically active. HRT should be used to prevent osteoporosis only among women who are unable to take nonestrogen medications. HRT is not useful with complementary therapies and does not cause breast cancer.