Community 2

In the host agent environment model of epidemiology, the nurse identifies which of the following as the environment? 1. A herd of infected cattle 2. Waste products dumped into a nearby lake 3. Individuals living in a "crack house" 4. Water contaminated with E. Coli

Explanation: 1. host; susceptible humans or animals that harbor and nourish a disease - causing agent 2. factor that causes/contributes to a health problem or condition 3. host; susceptible humans or animals that harbor and nourish a disease - causing agent such as Hepatitis/HIV 4. CORRECT - refers to all external factors surrounding the host that might influence vulnerability or resistance

A nurse designs a project to investigate the use of smokeless tobacco of male graduates from a local high school and their incidence of oral cancer ten years later. This represents what type of study? 1. Experimental 2. Prospective 3. Cross-sectional 4. Retrospective

Explanation: 1. involves the investigator controlling or changing factors suspected of causing the condition and observing the results. 2. CORRECT - looks forward to find a causal relationship. 3. explores a health condition's relationship to other variables in a specified population at specific point in time. 4. looks backward in time to find a causal relationship.

The nurse is aware the concept of causality is likely present in which of the following events? 1. An executive gets a job promotion and suffers a myocardial infarction. 2. Two of four siblings are born with cleft palates 3. A male with a history of childhood asthma performed poorly on a college entrance exam. 4. Following the use of marijuana, a construction worker falls off a roof.

Explanation: 1. long-standing cardiovascular disease was the likely cause rather than new position. 2. has a genetic origin 3. uncertain whether the asthma history played a role. 4. CORRECT - research supports illicit drug use affects cognitive and physical functioning.

Which factors influence a community's potential for violence? 1. Large populations of children, elderly, and developmentally disabled people. 2. Implementing group norms to promote civility 3. Previous exposure to and participation in violent acts 4. Social conditions and multiple demands on the population's economic conditions.`

Explanation: 1. not a known set of factors 2. not a known set of factors 3. not a known set of factors for a community; perhaps in a family structure. 4. CORRECT - unemployment, social isolation, media influence, rigid religious beliefs, population density and many others

Which of the following scenarios BEST portrays enabling behavior? 1. A mother who drives 150 miles a week to visit her son who is in prison for stealing controlled substances 2. A father who buys a leather jacket for his son which is similar to what local gang members wear. 3. A wife who calls in sick for her husband who has been binge drinking all weekend 4. A husband who does the majority of cooking since the wife has been on anti-depressants.

Explanation: 1. not an enabling behavior 2. not an enabling behavior 3. CORRECT - enabler is a person who shields or prevents the addict from experiencing the consequences of the addiction 4. not an enabling behavior

A community health nurse meets with residents of a small town. To best assess the goals of the community, the nurse obtains an answer to which of the following questions? 1. "What are the most important features of your community?" 2. "What is the purpose of the community?" 3. "Tell me about your community activities?" 4. "How well does your community meet the needs of its members?"

Explanation: 1. not the initial questions for assessment 2. CORRECT - goals of a community are focused on maximizing the well-being of members, promoting survival, and meeting the needs of the community members. Inquiring about the purpose of the community would be the first step of assessment 3. not the initial focus for assessment 4. important information, conducted later in the assessment

A nurse receives a large grant for the purpose of educating a state about the leading cause of death due to infectious disease in the United States. The nurse develops a television-based public service announcement focused on which of the following? 1. HIV 2. Tuberculosis 3. Hepatitis 4. Pneumonia

Explanation: 1. not the leading cause of death 2. not the leading cause of death 3. not the leading cause of death 4 CORRECT - community acquired is the major type

Which of the following activities best represents population-focused practice by the community nurse? 1. Assessing a family of victims involved in an apartment fire 2. Examining sixth-graders for the presence of scoliosis 3. Counseling a young couple regarding parenting skills 4. Addressing a town council regarding a flu vaccination program

Explanation: 1. providing direct care to a small group reflects secondary level nursing 2. represents screening for an isolated group 3. reflects individual nursing through 1:1 teaching 4. CORRECT - primary mission of population-focused practice is working with groups in the community.

The primary goal that the community health nurse is trying to accomplish by acting as a client advocate is which of the following? 1. Efficient referral system 2. Coordination of team members 3. Effective discharge planning 4. Client independence

Explanation: 1. referral may be part of the primary goal 2. reflects role of the consultant 3. discharge planning may be part of the primary goal 4. CORRECT - advocacy consists of nursing actions that inform, support and affirm clients in their goal of self-determination.

In order to understand the rate of growth of a community, the nurse requires which of the following pieces of data? 1. Number of migrant workers present in the summer months. 2. Age, gender, marital status and occupation of the residents 3. Estimate the full-time residents over a period of time 4. Number of residents in the physical space of land available

Explanation: 1. represents mobility; the people moving in and out of a community on a seasonal basis 2. specific characteristics represent composition 3. CORRECT - rate of growth is based on the number of full-time residents over a specified time frame. 4. this data is associated with the density

In an effort to develop an education program to lower the incidence of Lyme disease in a New England town, the nurse begins with studying the prevalence. Which of the following reflects this concept? 1. The percentage of persons who died as a result of Lyme disease 2. How the disease was spread from person to person 3. Looking at the number of reported cases over the past three years. 4. The factors which contributed to contraction Lyme disease

Explanation: 1. represents the case fatality rate 2. represents the transmission 3. CORRECT - prevalence is the number of cases of a specific disease at a given point in time, in a given population. 4. represents the susceptibility

The community nurse cares for a client who has experienced blindness as a result of diabetes. In the natural history of diabetes mellitus, the nurse identifies the onset of blindness reflects which of the following stages? 1. Susceptibility 2. Exposure 3. Clinical 4. Early pathogenesis

Explanation: 1. stage where disease is not present and individuals have not been exposed 2. occurs when individuals have been exposed to a disease but are asymptomatic. 3. CORRECT - also know as the culmination stage, the disease or health condition causes sufficient anatomic or functional changes to produce recognizable signs and symptoms 4. stage where signs and symptoms actually begin to develop

Which of the following represents a form of secondary prevention? 1. Meals on Wheels for the homebound 2. Breast self-exam 3. Use of seat belts 4. Flu vaccine

Explanation: 1. tertiary - health status warrants assistance with nutrition. 2. CORRECT - secondary prevention of developing chronic disease 3. primary prevention 4. primary prevention

The nurse is providing teaching to clients about first-time medication prescriptions. Which represents primary prevention? 1. Use of a soft toothbrush while on warfarin (Coumadin) for atrial fibrillation 2. Avoiding smoking while on NuvaRing for contraception 3. How to properly use a metered dose inhaler for ipatroprium (Atrovent). 4. Correct procedure for drawing up two different insulins in one syringe.

Explanation: 1. tertiary prevention 2. CORRECT - family planning is a form of primary prevention. 3. secondary prevention 4. secondary prevention

A public health nurse visits an undergraduate nursing program as a guest speaker. Which statement made by a student indicates further learning is necessary on the topic of epidemiology? 1. "Tracks the incidence of communicable diseases." 2. "Involves health care reform to lower medical costs." 3. "Searches for causal relationships in health and illness." 4. "Reduces debilitating injuries in the workplace."

Explanation: 1. true component 2. CORRECT - not a focus of the field of epidemiology 3. overall definition of epidemiology 4. true component

A predominantly rural town of 25,000 residents has an annual influx of 5000 migrant workers from May to September. The nurse identifies which aspect of the population perspective is represented by this incidence? 1. Mobility 2. Composition 3. Rate of growth 4. Density

Explanation: 1. CORRECT - people moving in and out of a community on a seasonal basis 2. reflects the age, sex, marital status, occupation, etc. of the residents 3. represents the number of full-time residents over a period of time. 4. represents the numb of residents in the physical space of land available

Which of the following scenarios BEST reflects a biophysical factor for contributing to family's state of homelessness? 1. Following a kidney transplant, 40% of family income was required for anti-rejection medications 2. Both parents of four siblings experience post traumatic stress syndrome following a fire that destroyed their home 3. Due to urban redevelopment, a family-owned grocery store was closed down permanently. 4. A counseling center two blocks from a family's home was closed due to funding shortages.

Explanation: 1. CORRECT - biophysical factor is one affecting health 2. represents a psychosocial factor affecting mental health 3. represents a sociocultural factor (family structure, unemployment, poverty, and urban development). 4. represents a health system factor

Which of the following signs would be expected for the individual experiencing caregiver strain? Select all that apply 1. Crying frequently 2. Feelings of boredom 3. Loss of interest in pleasurable activities 4. Mishandling money 5. Change in sleeping habits 6. Easily angered by the care recipient

Explanation: 1. CORRECT - caregiver role strain is evidenced by feelings of depression which would include crying, decreased interest in activities of pleasure or interest, insomnia, anger of having to provide care. 2. might indicate lack of challenging or meaningful work 3. CORRECT - caregiver role strain is evidenced by feelings of depression which would include crying, decreased interest in activities of pleasure or interest, insomnia, anger, or having to provide care. 4. misappropriation of funds might indicate embezzling 5. CORRECT - caregiver role strain is evidenced by feelings of depression which would include crying, decreased interest in activities of pleasure or interest, insomnia, anger of having to provide care. 6. CORRECT - caregiver role strain is evidenced by feelings of depression which would include crying, decreased interest in activities of pleasure or interest, insomnia, anger of having to provide care.

A community nurse leads a discussion about primary prevention. The example to best reflect this level is which of the following? 1. Teaching parenting classes to women in their second trimester of pregnancy. 2. Instructing older women with osteoporosis about the benefits of walking. 3. Counseling clients with emphysema about pollution indexes. 4. Helping cardiac surgery clients find access to exercise equipment.

Explanation: 1. CORRECT - planning for the future to avoid physical and/or psychological problems. 2. tertiary prevention in the form of rehab. 3. secondary prevention in reaction to a confirmed diagnosis 4. tertiary prevention n the form of rehab

What are the major types of interventions typically planned by community health nurses. 1. Policy setting and implementation. 2. Screening programs 3. Increase community self help 4. Health education programs 5. Designing public green spaces 6. Establishment of service

Explanation: 1. CORRECT - policy development that support health of the population and implementation of theses policies is part of the nursing role; example would be the development of and campaigning for a clean needle exchange program. 2. CORRECT - screening programs wound be part of the assessment done by the nurse; example would be blood pressure screenings at a health fair. 3. CORRECT - by increasing ability of the individuals of the community to care for themselves helps to increase the overall health of the community; example would be program for expectant parents about infant care 4. CORRECT - health education programs assures that the public has been taught important health care issues and its preventative aspects; example would be programs presented at church regarding foods on a low sodium, low fat diet. 5. Community health nurses may take an active role in all health-related areas listed with the exception of planning green spaces. This project would be a local government civic responsibility. 6. CORRECT - part of the nursing role is to guarantee that the services needed to support the health of the community are available; example would be enough nurses to stall the clinics.

The community nurse calculates the rate of H1N1 influenza diagnosed in a high school senior class on a particular day. There are 6 known causes out of a population of 300 students. The nurse determines which of the following prevalence rates is correct? 1. 2% 2. 5% 3. 10% 4 12%

Explanation: 1. CORRECT - prevalence rate is calculated by the number of persons with a characteristic (6) divided by the total number in a population (300). 2. too high 3. too high 4. too high

Which of the following represents a qualitative assessment for a community nurse to use for children's health needs? 1. Attend a meeting with other health care workers to discuss improving the school lunch program 2. Use the internet to determine the number of day care facilities located in the area 3. Assist at an immunization clinic whose goal is to triple the amount of vaccines administered from last year 4. Determine what organized sport teams are available for children under the age of ten

Explanation: 1. CORRECT - qualitative assessment requires discussion, listening, gathering insights and opinions 2. represents a quantitative method - counting facilities 3. represents a quantitative method - assessing the numbers 4. represents a quantitative method - reviewing the numbers

Health promotion programs in the workplace have a focus towards which of the following? 1. Safe work habits 2. Healthy lifestyle choices 3. Treatment of injuries 4. Providing protective equipment.

Explanation: 1. More of a function of OSHA 2. CORRECT - health promotion programs such as smoking cessation, weight reduction, stress management, etc. 3. secondary focus on health 4. employer responsible

The nurse identifies which of the following characteristics BEST serves as an indicator of a community's social index? 1. Suicide rate 2. Ratio of firefighters to residents 3. Location of mental health services 4. Prematurity birth rate

Explanation: 1. Serves as a measure of the community's health status 2. CORRECT - protective services which are available is an example of social index. 3. number, versus the location, serves as a measure or the community's health status. 4. serves as a measure of the community's health status

A community nurse discusses H1N1 with a group of college professors. Which of the following statements reflects the BEST description of an incubation period? 1. "The students do not have the disease, nor have they been exposed." 2. "Exposure to the virus has occurred and the organism is multiplying." 3. "Students may have a cough and low grade fever during this time." 4. "Hospitalization may be necessary at this point."

Explanation: 1. describes susceptibility stage 2. CORRECT - organism multiplies to sufficient numbers to produce a host reaction. 3. known as the onset stage 4. referred to as the clinical disease or culmination stage.

The community nurse plans to address the physical environment within a community through assessing the: 1. amount of theater performances and art shows offered during the previous year. 2. number of homes in the area with in-ground swimming pools. 3. annual per capita use of tobacco products 4. use and adequacy of emergency response systems.

Explanation: 1. example of the sociocultural environment. 2. CORRECT - information about homes represents the physical environment 3. lifestyle choices reflect the behavioral environment. 4. services such as "911", police protection, and civil defense enhances feelings of safety and security to the community, thus the psychological environment.

A nurse is applying for a staff position to provide hospice care. The primary objective of this type of nursing is focused towards which of the following? 1. Offer reassurance to the client's family 2. Keep the client clean, dry and nourished. 3. Help maintain client integrity and comfort 4. Make referrals for a client with spiritual distress

Explanation: 1. focus is client-oriented 2. direct care is part of the nurse's role. 3. CORRECT - dying peacefully while maintaining integrity 4. not the overall objective

The community nurse is aware that health promotion programs are primarily designed to accomplish which goal? 1. Enable individuals to respond positively to environmental stressors. 2. Expand the potential for health and personal development 3. Reduce risks to health from a global perspective 4. Detect early incidence of illness

Explanation: 1. goals for health promotion also includes aggregates of population. 2. CORRECT - health promotion focuses on changing patterns of behavior for individuals and populations 3. represents preventing illness 4. represents preventing illness

A mass screening for hyperlipidemia is being planned by a community nurse. Which of the following represents the best target group for this project. 1. Women with a BMI of 40 or greater 2. Adults who consume fast food daily 3. Employees at a local manufacturing plant. 4. Males who consume three or more servings of alcohol daily.

Explanation: 1. group would not be readily accessible due to potential body image disturbance 2. group would not be easily accessibe. 3. CORRECT - group is accessible and easily identifiable through "contained" place of employment 4. group would not be easily accessible.

When applying the epidemiological triangle to a disaster event, the nurse recognizes the host as which of the following? 1. Efforts utilized to prevent, predict, and control the victim's needs. 2. The physical item actually causing the destruction 3. Human characteristics that influence the severity of the disaster effects 4. Factors that directly affect the outcome of the disaster

Explanation: 1. not considered a part of the triangle (host, agent nor environment) 2. represents the agent involved in the disaster; examples are infectious agents (bacteria, viruses, fungi, parasites, etc.), chemical agents (heavy metals, toxic chemicals, pesticides, etc.), and physical agents (radiation, heat, cold, machinery, power tools). 3. CORRECT - host is represented by the human aspect; examples are genetic susceptibility, immutable characteristics (family history, age, sex, etc.), acquired characteristics (immunologic status, heart disease, obesity, etc.), and lifestyle factors (diet, exercise, drug use, intake of caffeine, use of tobacco products, etc.). 4. represents the environment of the triangle; examples are climate (temperature, rainfall, number of days of sun, etc.), plant and animal life (agents of reservoirs or habitats for agents, types and numbers, etc.), human population distribution (crowding, social support, apartments versus subdivision, number of people per acre/block of land, etc.), socioeconomic factors (education, sources, access to care, income, etc.), and working conditions (levels of stress, noise, satisfaction, factory inside air pollution, etc.).