Community Health exam #1

A district health nurse is assigned to two rural counties in the state. To achieve the best outcomes possible in reducing the health disparities for the large number of frail older clients in the two counties, the nurse should consider using what community-oriented nursing skill? Assessment Case management Geriatrics Tertiary prevention

Case management

coordinating

Conscious activity of assembling and directing the work efforts of a group of health providers so that they can function harmoniously in the attainment of the objective of client care

A nurse functioning in the role of a case manager performs which of the following functions in the care delivery process? Select all that apply. Risk analysis Data mapping Provision of illness care Epidemiologic investigation of unexpected illnesses Counseling and education

Risk analysis Data mapping Epidemiologic investigation of unexpected illnesses

Appropriate approaches used by the long-term care nurse to provide education for a 73 year old who has just been diagnosed with diabetes include which of the following? (Select all that apply.) Schedule a visit by another resident who is diabetic. Demonstrate food choices using food photographs. Avoid discussion of the patient's favorite foods. Remind the patient that a lot of damage has already occurred. Encourage the patient's family to participate in teaching sessions. Ask the patient about past experiences with lifestyle changes.

Schedule a visit by another resident who is diabetic. Correct Demonstrate food choices using food photographs. Correct Encourage the patient's family to participate in teaching sessions. Correct Ask the patient about past experiences with lifestyle changes. Correct

care managment

Monitors health status of individuals and community, process developing, planning, interventions, targets evaluation outcomes for the client and program Strategies critical paths, disease management, monitor health status, resources

A new nurse manager is reviewing the attributes of a health care organization. Which of the following attributes would be expected for a health care organization? (Select all that apply.) Providing care for underserved minority patients Providing transportation to work sites Providing child care for unemployed parents seeking work The organizational chart of staffing breakdowns from each department Usage of the facility by surrounding residents

Providing care for underserved minority patients The organizational chart of staffing breakdowns from each department Usage of the facility by surrounding residents

A school nurse is scheduling visits with physical therapist for a child who has cerebral palsy. In which of the following roles is the nurse functioning?

case manager

goal of program planning

ensure that health care services are acceptable, equal, efficient, and effective

. True or False: Persons who are vulnerable experience this because of their personal deficiencies.

false

A school nurse is asked to assess a 13-year-old child because of excessive drowsiness and inattention in class. The nurse determines that this is a child of migrant workers on a local produce farm. Based on the nurse's knowledge of migrant worker families, the nurse should first explore the child's potential involvement in: delinquent behavior. drug use. field work. Migrant Education Program.

field work.

A nurse is conducting a community assessment. Which of the following data collection methods is the nurse using when having direct conversations with individual members of the community?

key informant interviews

Which of these activities exemplify community-oriented nursing practice? Why?

plans a first-aid course for teachers

advocacy

support; active pleading on behalf of someone or something

A nurse is talking to a client who asks for additional information about hospice. Which of the following statements should the nurse make?

A component of hospice care is to control the client's manifestations

The nurse is caring for a Hispanic older adult in the emergency department who is intoxicated and was found unconscious on the ground outside of a local restaurant. The patient has a medical alert bracelet listing diabetes, hypertension, and epilepsy. Which health disparities in this patient does the nurse identify as unavoidable and acceptable? Alcohol use and ethnicity Diabetes and age Hypertension and gender Age and gender

Age and gender

A nurse is presenting a workshop on interpersonal violence prevention. Which is a common risk factor for most interpersonal violence incidents that should be addressed? Poor working conditions Hypertension medications Alcohol use Poor self-esteem

Alcohol use

After patient teaching, the patient is able to verbalize that which occurrence can delay wound healing after surgery? Adequate arterial blood flow to the wound Supplemental oxygen therapy A healthy diet An increased hospital stay

An increased hospital stay

The nurse conducting research on health disparities applies the idea that the reality of life is based on a mental representation developed from socially shared understandings within a society. Which theoretical framework model is the nurse using? Cultural competence Structural-constructivist Cultural awareness Cultural proficiency

Structural-constructivist

Immunity to disease through vaccination is known as: natural immunity. resistance. acquired immunity. herd immunity.

acquired immunity.

The nurse at the adult day care center notices bruises on the wrists of a 90-year-old client. Besides the physical assessment of the client, the nurse should: confront the daughter when she arrives to pick the father up. discuss the findings with the caregivers to determine the cause of the injuries. educate the staff about indications of elder abuse. make a referral to the primary care provider for follow-up.

discuss the findings with the caregivers to determine the cause of the injuries.

summative

evaluating after the program is completed

A strategy that may improve compliance with tuberculosis (TB) treatment is the: expansion of directly observed therapy. increased tuberculosis testing protocols. increased confirmatory testing protocols. treatment compliance education.

expansion of directly observed therapy.

A community health nurse involved in care management would most likely: develop, conduct, and evaluate health teaching programs in primary care. manage the staff at a free clinic. monitor the health status, resources, and outcomes for an aggregate. provide immunizations to migrant workers.

monitor the health status, resources, and outcomes for an aggregate.

A nurse and a student nurse are talking about health care coordination. Which of the following statements would the nurse make about the subject? "Patients have needs beyond the health care system." "Patients should coordinate their own care." "Physicians are the only ones who coordinate care." "Community health nurses coordinate care for the patient."

"Patients have needs beyond the health care system."

A nurse is caring for a client who is experiencing alcohol withdrawal. Which of the following findings should the nurse identify as a manifestation of withdrawal?

Diaphoresis

Health education is often used as a strategy in working with vulnerable populations. The benefits of health education can be greatly affected by: dependency cycle. health literacy. income level. race and ethnicity.

Health Literacy

1. A variety of symptoms and diseases in migrant farm workers, such as tuberculosis, gastroenteritis, and hepatitis, are highly correlated with which of the following? a. Crowded living conditions b. Poor field sanitation c. Pesticide exposure d. Automated machinery

a. Crowded living conditions

1. A nurse at an urban community health agency is developing an education program for city leaders about homelessness. Which of the following should the nurse include as the fastest growing segment of the homeless populations? a. Families with children b. Adolescent runaways c. Intimate partner abuse victims d. Older adults

a. Families with children

A nurse in community health directly contacts a mammography clinic to arrange an appointment for a female migrant worker with limited English language abilities. The nurse communicates with the client through an interpreter to ensure that the client's appointment is scheduled to meet her needs and that the client understands the procedure to be performed. This strategy used with vulnerable populations can best be described as: advocacy. culturally competent care. partnership. social justice.

advocacy.

1. Your client is best defined as a laborer whose principal employment is in agriculture on a seasonal basis, who has been so employed in the last 24 months, and who lives where work is found. Your client can be described as which of the following? a. Seasonal farm worker b. Migrant farm worker c. Transient worker d. Sharecropper

b. Migrant farm worker

A CHN is determining available needed supplies in the event of a bioterrorism attack. The nurse should be aware that community members exposed to anthrax will need access to which of the following medications? a. metronidazole (flagyl) b. ciproflaxin (Cipro) c. zanamivir (Relenza) d. fluconazole (diflucan)

b. ciproflaxin (Cipro)

A case manager submits documentation that a nursing visit was completed at a client's home, but it was never performed. According to the general areas of legal risk, how would this action best be categorized? a. liability for managing care b. fraud / abuse c. negligent referral d. confidentiality / security

b. fraud / abuse

A nurse is completing a needs assessment and beginning analysis of data. Which of the following actions should the nurse take first?

compile collected data into database

formative

evaluating while the plan/program is occurring

True or False: Rural environments are similar to those in urban areas.

false

A nurse in community health becomes aware that a teen smoking cessation program offered at the health department is a demonstration project. In evaluating this program, the nurse would be concerned with the program's: efficiency. impact. relevance. sustainability

sustainability

The nurse must ask about violence at each prenatal and postpartum visit, especially with vulnerable populations such as teenagers, as well as observe for signs of violence on each visit. The nurse should be aware that the peak for postpartum intimate partner violence may be observed at various times according to ethnic group, such as: 6 months for white mothers. 10 months for white mothers. 3 months for African-American and Hispanic/Latino mothers. 12 months for African-American and Hispanic/Latino mothers.

3 months for African-American and Hispanic/Latino mothers.

Which of the following patients is at greatest risk for contracting a primary bacterial infection? A patient with newly diagnosed diabetes mellitus A patient whose lab results reveal leukopenia A patient receiving broad-spectrum antibiotics A patient following laparoscopic cholecystectomy

A patient whose lab results reveal leukopenia

A nurse manager feels that the overall work environment of his hospital is positive, and he recommends that the organization apply for Magnet© status, which recognizes excellence in nursing practice. Which of the following is an internal environmental factor present in a unit that would need to be changed to qualify for Magnet status? A setting where staff are creative in meeting quality care indicators A unit where new programs are researched, implemented, and evaluated by staff A unit where collaboration among disciplines is encouraged and reinforced in evaluations A unit where feedback on staff concerns is given anonymously

A unit where feedback on staff concerns is given anonymously

The nurse is teaching a patient with a new diagnosis of systemic lupus erythematosus (SLE) about her disease. The nurse recognizes that the patient understands the information when making which statement? "I need to avoid getting infections because they will increase the immune response in my body, which can make my SLE worse." "I need to be sure to take all the available immunizations to keep me from getting sick." "Because of my SLE, my immune system is already diminished, so I need to avoid people with the flu." "As long as I take all my prescribed medications, I won't have to make any lifestyle changes as a result of my SLE."

"I need to avoid getting infections because they will increase the immune response in my body, which can make my SLE worse."

A patient has come to the health clinic for an annual checkup. He reports an increase of stress at work and having to work a lot of mandatory overtime hours. He has not been able to do his usual daily exercise for several weeks. What is the best response by the nurse? "There are other ways you can reduce your stress, such as cutting back on your work hours." "Have you considered a medication to help you sleep at night?" "Including exercise in your schedule will just increase the stress from work." "Regular exercise would be good because it helps the body deal with stress."

"Regular exercise would be good because it helps the body deal with stress."

Select all the organs from the following list that are part of the immune system. Adenoids Appendix Bone marrow Gallbladder Liver Thyroid gland

Adenoids Appendix Bone marrow

What is the first step in the assessment process?

Define your boundaries

The goal of deinstitutionalization was to improve the quality of life for people with mental disorders by providing services in the communities where they lived rather than in large institutions. At what program level did this change in locus of care fail? Assessment level Design level Evaluation level Implementation level

Implementation level

Which of the following interventions are priorities in a plan of care for a patient who had a stroke 30 days ago and is now in home care rehabilitation? (Select all that apply.) Promoting rest and sleep Promoting a diet rich in protein Promoting exercise and ambulation Assisting the patient with ADLs Limiting visitors and social contacts

Promoting rest and sleep Promoting exercise and ambulation

A client diagnosed with human papillomavirus (HPV) states to the nurse, "I'm not concerned; I know the lesions disappear after a while." The nurse should counsel the client on which of the following? Select all that apply. The link between HPV and cervical cancer The fact that HPV is a reportable disease The need to surgically remove tumors, if present The serious complications for men The lack of a cure

The link between HPV and cervical cancer The need to surgically remove tumors, if present The lack of a cure

A nurse in community health contacts three individuals who have had sexual encounters with an individual recently diagnosed with syphilis. The concept basic to community-oriented nursing practice that is best described by this intervention is: community. community as client. individual as client. partnership.

community as client.

A poor, older Native Alaskan woman lives in a small, remote village near the Canadian border. She has been diagnosed with hypertension and diabetes but rarely makes it to the regional clinic in a distant town for checkups. This woman is most at risk for: disenfranchisement. health disparities. loss of independence. resilience.

health disparities.

autonomy

independence

For the homeless, health care is usually crisis oriented and sought in emergency departments. The most difficult challenge for nurses treating this vulnerable population is to recognize the client's: limitations in following treatment protocols. limited number of transient treatment facilities. transition to persistent poverty. use and abuse of tobacco, alcohol, and illicit drugs.

limitations in following treatment protocols.

The general approach to quality improvement known as licensure that grants control over who can enter into and who exists in a profession can best be described as a contract between the: consumers and the profession. legislature and the state board. profession and the state. public and the professional associations.

profession and the state.

The nurse in community health reviews the monthly and year-to-date health service use report for the local community to monitor trends as correlates of the community's health. The nurse is viewing community health through the dimension of: partnership. process. status. structure

structure

The most critical strategy that can be used by nurses in community health to improve the health status of migrant workers that spend only a few months in a geographic location is to: conduct a comprehensive assessment and formulate a plan for treatment. establish a long-term trust relationship to prevent disappointment. schedule appointments for appropriate immunizations for the children. use every opportunity to teach about preventive health care.

use every opportunity to teach about preventive health care.

A young adult with a history of prior parental abuse recently has been diagnosed with a stress-related illness. The individual works at a local convenience store, earning a little more than the federal poverty level, but receives no health benefits. This individual is predisposed to the development of: poverty. resilience. risk. vulnerability.

vulnerability.

A city uses the local media (radio, television, and newspapers) to post ratings of air quality on days when the air quality is poor. This notification is directed toward older adults, very young members of the community, and those with chronic breathing problems. These groups are an example of: disenfranchised populations. disadvantaged populations. vulnerability. vulnerable populations.

vulnerable populations.

a newly hired occupational health nurse at an inductrail facility is performing an initial workplace assessment. Which of the following information should the nurse determine when conducting a work site survey?

work practices of emplyees

The nurse is assessing a group of patients to determine their risk of vitamin D deficiency. Which of the following patients has the highest risk for vitamin D deficiency? A Caucasian female who is 39 weeks gestation An African-American female who is breastfeeding An Asian female diagnosed with hypoglycemia A Hispanic female who has a BMI of 24.1

An African-American female who is breastfeeding

A recent movie release portrays a criminal as a black female drug user whose abusive boyfriend has two children by different women. She lives in the riot-torn inner city of a large metropolitan area. This best demonstrates what type of factor that influences poverty? Cultural Environmental Political Social

Cultural

A nurse mentor is explaining the benefits of collaborative practice to a nurse new to a facility. Which of the following research-based benefits is the nurse likely to identify as positive outcomes of collaboration? (Select all that apply.) Decreased length of stay for patients Decreased staff resignations Decreased use of pain medications Increased reimbursement from insurance carriers Increased patient follow-up appointments after discharge Increased job satisfaction of the staff

Decreased length of stay for patients Decreased staff resignations Increased job satisfaction of the staff

The nurse is assessing a 4-year-old child in a health clinic. Which of the following situations would cause the nurse to explore for possible abuse? Being brought to the clinic from daycare Recent scrapes and bruises on both knees The caregiver reporting angry outbursts from the child while they were in a store Different explanations of the injury from the child's parents

Different explanations of the injury from the child's parents

The nurse is caring for a patient with a diagnosis of multiple sclerosis (MS). The nurse should be aware of which associated response? Primary immunodeficiency Secondary immunodeficiency Optimal immune response Exaggerated immune response

Exaggerated immune response

Which of the following are factors that may contribute to vulnerability? Select all that apply. Exercise habits Crime Peeling lead paint Social isolation Illiteracy

Exercise habits Crime Peeling lead paint Social isolation Illiteracy

1. Public health nursing emphasizes prevention of disease. What are the challenges associated with such a goal (select all that apply)? 1. Increased costs and decreased funding. 2. Independence of problem solving and decision making. 3. It is easier to measure the effects of prevention. 4. It is more difficult to measure the effects of prevention than the effects of treatment. 5. Emerging communicable diseases continue to be a health threat.

Increased costs and decreased funding.; It is more difficult to measure the effects of prevention than the effects of treatment.; Emerging communicable diseases continue to be a health threat.

The nurse is assessing a patient's ability to perform instrumental activities of daily living (IADLs). Which of the following activities are considered in the IADLs assessment? (Select all that apply.) Feeding oneself Preparing a meal Balancing a checkbook Walking Toileting Grocery shopping

Preparing a meal Balancing a checkbook Grocery shopping

A 3-year smoking cessation program for teens has just concluded. The type of evaluation the staff will conduct is: a formative evaluation. an informal evaluation. an ongoing evaluation. a summative evaluation.

a summative evaluation.

A nurse is preparing a community health program on communicable diseases. When discussing modes of transmission, the nurse should include which of the following as an airborne illness? a. cholera b. malaria c. influenza d. salmonella

c. influenza

A community health nurse is educating the public on the agents of bioterrorism. Which of the following are Category A biological agents? (SELECT ALL THAT APPLY) a. hantavirus b. typhus c. plague d. tularemia e. botulism

c. plague d. tularemia e. botulism

In case management, it is unlikely that any single professional has the expertise, knowledge, or skills required to achieve success. The synergy produced by all involved parties (client, providers, payers, family/significant others, and community organizations) can result in successful outcomes. This statement relates to the sequential process of: collaboration. communication. cooperation. negotiation.

collaboration.

A general approach to quality improvement where a qualified agent designates formal recognition to individuals or institutions that have met minimum standards of performance is best described as: accreditation. charter. credentialing. licensing.

credentialing.

1. An intervention to improve access to health care for vulnerable populations would be: a. Create partnerships to provide free or reduced health care services b. Coordinate services at a central location c. Ensure the availability of translators with medical training d. All other options

d. All other options

Which of the following IS NOT an example of a public health core function? a. Systematically collecting data on the population such as incidence of disease b. Providing leadership to develop a policy that includes provision of prenatal services c. Ensuring services are available by coordinating home visits for those who cannot come to clinic for care d. Documenting that the community is a food desert area

d. Documenting that the community is a food desert area

A public health nurse employed by the Department of Health is working on a team developing local health policy. The nurse recognizes which of the following about policy development? a. It is based on the Socratic method b. It is important that the policy has been approved by the American Nurses Association c. It is primarily up to politicians to plan for health care d. It is very similar to the nursing process

d. It is very similar to the nursing process

Society bears the burden of infectious disease. That burden includes the effects of morbidity and mortality as well as the staggering: economic burden. fear burden. incidence burden. vulnerability burden.

economic burden.

True or False: Approximately 50% of rural families live below the poverty level.

false

The nurse in community health is meeting with staff to systematically plan for a new outreach program. Doing so helps them to: assess the needs of potential outreach clients. recognize the special needs of vulnerable people in the area. identify how the problems of similar programs will not be repeated. identify the resources and activities that will help them meet their program objectives.

identify the resources and activities that will help them meet their program objectives.

A multidisciplinary quality assurance team has reviewed an organization's stated philosophy and objectives and developed a conceptual model for appraisal that integrates peer review and client satisfaction. The quality assurance program component that should be addressed next would be: action. process. structure. outcome.

outcome.

A young female client visits a local clinic, seeking treatment for a urinary tract infection (UTI). During the assessment, the nurse conducts an extensive sexual history/activity screening to determine the risk for a sexually transmitted disease and potential complication of: genital warts. herpes simplex virus 1. pelvic inflammatory disease (PID). primary syphilis.

pelvic inflammatory disease (PID).

A nurse in community health is working in a rural setting. In planning for programs to address the population's needs, the nurse should be aware that, in general, rural populations: engage in physical activity during leisure time. engage in preventive behaviors. perceive their overall health as less favorable. use seat belts.

perceive their overall health as less favorable.

A nurse working with a Hispanic client explains the referral options available for the client to receive a mammogram. One option is free and has limited Spanish language resources. The other option has a nominal fee and comprehensive Spanish language resources. The nurse supports the client's decision to choose the provider that the client feels would best meet her needs. This advocacy role is best described as: intercessor. mediator. obstructer. promoter

promoter

During the last stage of AIDS, many opportunistic infections proliferate in persons with weakened immune systems. HIV-infected individuals who live near one another in long-term care facilities, drug treatment facilities, and prisons should be carefully screened before admission because they are at greater risk for acquiring: fungal disease. invasive cervical cancer. oral candidiasis. pulmonary tuberculosis (TB).

pulmonary tuberculosis (TB).

The purpose of record keeping in public health agencies is to maintain complete information on clients served and the extent and quality of service provided to those clients. The records also provide information for education and research. Another important use of the records is to: determine raises for personnel. explain cost overruns. foster independence in clinical practice. resolve legal issues in malpractice suits.

resolve legal issues in malpractice suits.

Many behaviors place individuals of all ages, genders, ethnicities, or any other factors at greater risk for sexually transmitted diseases (STDs). The nurse should include primary prevention interventions in all client encounters through the discussion of: partner notification. safer sex. standard precautions. STD testing.

safer sex.

True or False: Health disparities refer to the wide variations in health services and health status among certain population groups

true

Which of the following statements by a nursing student demonstrates an understanding of collaboration? "Collaboration is a new way of interacting with physicians." "Collaboration means that the care team can make all of the decisions for the patient." "Collaboration with patients has been used by nurses throughout the history of nursing." "Collaboration is an outdated concept that has been replaced by managed care."

"Collaboration with patients has been used by nurses throughout the history of nursing."

A student nurse asks why care coordination is now a top priority for health system redesign. What is the nursing instructor's best response? "Patients like to be cared for by more than one service agency." "Care coordination increases confusion about who is responsible for the patient." "Community services are lacking, and care coordination helps to fill the void." "Every patient will need coordinated care services at some time in life.

"Every patient will need coordinated care services at some time in life.

The nurse is teaching a class of junior high school students about infection control through effective hand washing. Which statement made by a student indicates the need for further teaching? "Hand sanitizer works just as well as washing with soap and water." "If I sing the song "Happy Birthday" twice through while scrubbing my hands, that should be long enough." "I need to read the label on the hand sanitizer to be sure that it's at least 60% alcohol." "We should all wash our hands before eating lunch every day."

"Hand sanitizer works just as well as washing with soap and water."

The nurse is assessing the coping abilities of a patient recently diagnosed with a degenerative neuromuscular disease with no known cure. Which statement by the patient alerts the nurse that more intervention is needed? "I have decided to take some art lessons at the community center." "I am sleeping much better when I have two drinks and smoke before bed." "I am scheduling a family reunion for the upcoming holiday." "I have decided to sell my house and move into an apartment with my son."

"I am sleeping much better when I have two drinks and smoke before bed."

1. Many of the varied and challenging public health nursing roles which originated in the late 1800s continue to be an issue today. Which factors continue to challenge public health nurses (select all that apply)? 1. Control of sanitation 2. Care of the aged in the hospital setting 3. Environmental pollution control 4. Natural disasters 5. Emerging communicable diseases

3. Environmental pollution control 4. Natural disasters 5. Emerging communicable diseases

A patient presents to the clinic with observable edema and erythema of the left forearm. A brief history reveals no exposure to potential irritating agents. On palpation, the nurse finds the area very warm and tender. What is the most likely cause of the patient's symptoms? An allergic reaction A complement cascade IgE reactions Clonal diversity

A complement cascade

1. Which of the following factors has had an influence on the need to provide nurse volunteers at the influenza vaccination clinic? 1. A reduction in federal and state funds 2. The nursing shortage 3. Immunizations provided in primary care offices 4. The Affordable Care Act of 2010

A reduction in federal and state funds

A nurse manager is describing the type of employee typically employed by a health care organization. In addition to knowledge and skills, which of the following characteristics is common in health care professionals? A strong allegiance to professional values A strong desire to meet organizational goals A strong ability to follow lines of authority A strong preference for following rules

A strong allegiance to professional values

A nurse manager is reviewing patient satisfaction surveys and notices several comments that the unit environment is "cold" and "uncaring." Which of the following actions by the manager would best help the organization to improve its image with the public? Forward the surveys to housekeeping with a request to keep the rooms less cluttered. Request that patients be admitted to newer sections of the hospital. Ask staff for suggestions to improve the unit environment. Send copies of the surveys to the administration and wait for directions on how and what to do.

Ask staff for suggestions to improve the unit environment.

A student nurse demonstrates effective understanding of health disparities when stating that which disparity is the most significant contributing factor to poor quality of care? Language barrier Lack of transportation Lack of health insurance Provider-patient communication

Lack of health insurance

The community health nurse performs an assessment of violence by observing which of the following community characteristics? Select all that apply. Presence of social support networks Crime rates Levels of unemployment Presence of physical disabilities in individuals Presence of family violence

Crime rates Levels of unemployment

A nurse in a home setting is assessing a 79-year-old male patient's risk for malnutrition. The nurse suspects malnutrition when reviewing which laboratory results? (Select all that apply.) Body mass index (BMI) of 17 Waist-to-hip ratio of 1.0 Weight loss of 6% since last month's visit Prealbumin level of 16 mg/dL Hematocrit level of 50% Hemoglobin level of 8.2 g/dL

Body mass index (BMI) of 17 Hemoglobin level of 8.2 g/dL Weight loss of 6% since last month's visit

The nurse is assessing a patient's ability to perform basic activities of daily living (BADLs). Which of the following activities are considered in the BADLs assessment? (Select all that apply.) Brushing teeth or dentures Dressing oneself in the mornings Washing, drying, and folding laundry Counting own pulse and taking heart pill Taking the bus to the park Calling family members

Brushing teeth or dentures Dressing oneself in the mornings

A nurse performing home hospice case management notes the increasing number of hospice clients that lack caregivers in the home environment. The nurse identifies the potential need for a hospice house facility to meet the needs of these clients. The case management process frequently reveals such larger picture issues as: (select all that apply) Select all that apply. Community cost concerns Community conflict-resolution skills Community satisfaction Community weaknesses in quality of services Community weaknesses in quantity of services

Community weaknesses in quality of services Community weaknesses in quantity of services

When utilizing the social-ecological model, the nurse classifies physiological effects of aging within which system? Microsystem Mesosystem Chronosystem Exosystem

Chronosystem

The public health nurse deals with the examination of a community setting to determine the community's health status. Which of the following activities should be considered in the assessment phase? Select all that apply. Assisting communities to implement and evaluate plans and projects Building constituencies to work with the community Collecting, analyzing, and disseminating information Evaluating the social, economic, and environmental characteristics of the population Questioning the availability of health services to the community

Collecting, analyzing, and disseminating information Evaluating the social, economic, and environmental characteristics of the population Questioning the availability of health services to the community

The nurse is completing a care plan for a patient who is exhibiting poor coping after receiving a serious medical diagnosis. Which interventions would the nurse consider? (Select all that apply.) Recommend a glass of wine before dinner each night for relaxation. Compile a list of activities that are of interest to the patient. Review pamphlets about treatment options with the patient. Identify positive aspects of the illness, such as the chance to spend more time with family. Reinforce the fact that the medical team can make treatment decisions, so the patient does not need to worry

Compile a list of activities that are of interest to the patient. Review pamphlets about treatment options with the patient. Identify positive aspects of the illness, such as the chance to spend more time with family.

conflict managment

Limit negative aspects and make more positive experiences, helps clients manage conflict and sources resources, Negotiation, assertiveness, cooperative

Violence is a major public health problem in our communities that causes premature mortality and lifelong disability. Violence-related morbidity is a significant factor in: community deterioration. health care costs. juvenile delinquency. population density.

health care costs.

Which of the following examples best illustrates collaboration and partnership for health? Explain your answer. A. Telling interagency council members that teenage pregnancy is the major health problem in their service area B. Helping a rural community council survey area water supplies C. Developing a volunteer program for local health and welfare agencies D. Helping a high school counselor and school nurse determine students' health education needs

D. Helping a high school counselor and school nurse determine students' health education needs

Health education is often used as a strategy in working with vulnerable populations. The benefits of health education can be greatly affected by: dependency cycle. health literacy. income level.

health literacy.

Which of the following communication terms can be applied to this statement: How messages are received and interpreted would include personal states such as mood disturbance, environmental stimuli related to the setting of the communication, and contextual variables? Therapeutic communication Metacommunication Vigor communication Internal noise

Metacommunication

The nurse is caring for a patient experiencing an immune response. She assesses the patient for development of a hyperimmune response while knowing that cytotoxic T cells are responsible for which action? May kill healthy cells along with foreign antigens. Are the most prevalent type of T lymphocyte. Can suppress the immune response. Diminish dendritic cell function.

May kill healthy cells along with foreign antigens.

A community health nurse is developing strategies to prevent or improve mental health issues in the local area. In which of the following situations is the nurse implementing a tertiary prevention strategy?

teaching a client who has schizophrenia about medication interactions

Which of the following best supports the concept of community-oriented nursing practice? Select all that apply. Direct nursing care of individuals with tuberculosis (TB) Hospice home care for a terminally ill individual and family Nursing interventions to stop elder abuse Nutrition education programs for teenagers and their families Wound care for a homebound individual

Direct nursing care of individuals with tuberculosis (TB) Nursing interventions to stop elder abuse Nutrition education programs for teenagers and their families

A nurse in community health conducting a home visit notices a 4-year-old girl sitting on a stool in an adjoining room. The girl is quiet and withdrawn, rarely makes eye contact, and does not leave the room. The nurse proceeds to ask about the child and attempts to engage the child in conversation. The nurse is assessing for what indicators of child abuse? Emotional abuse Emotional neglect Physical abuse Physical neglect

Emotional neglect

The nurse is caring for an 85-year-old woman 6 weeks following a hysterectomy secondary to ovarian cancer. The patient will need chemotherapy and irradiation on an outpatient basis. The nurse should identify and address which barriers to healing? (Select all that apply.) Can feed herself and prepare meals but cannot drive to the store Lives on a fixed income and can balance her checkbook Experiences stress incontinence Cannot participate in activities at the senior center Lives alone and has no nearby relatives Has no transportation to the oncology clinic Correct

Experiences stress incontinence Lives alone and has no nearby relatives Has no transportation to the oncology clinic

A nurse is an urban community health agency is developing an education program for city leaders about homelessness. Which of the following groups should the nurse include as the fastest-growing segment of the homeless population?

Families with children

Rural residents appear to have a more persistent, endemic level of depression. The factors that may contribute to this level of depression may be related to which of the following? Select all that apply. Crisis intervention Gaps in continuum of mental health services Sufficient number of mental health services Tolerance for destructive coping behaviors Trust in the health care professionals

Gaps in continuum of mental health services Tolerance for destructive coping behaviors

A patient is in contact isolation for a bacterial infection. The nurse is going to implement which of the following interventions for this patient? Prevent all visitors from entering the room at any time during hospitalization. Use personal protective equipment only when knowingly coming into contact with pathogens. Help to ensure adequate social interaction and support. Communicate with the patient over the call light whenever possible.

Help to ensure adequate social interaction and support.

A nurse working in a free clinic has recognized that health promotion for teenagers who are pregnant is needed. The nurse works to develop a team of health care experts in several disciplines from across the region to work toward improving the nutrition of pregnant teenagers. This is an example of what type of collaboration? Nurse-patient collaboration Nurse-nurse collaboration Intraprofessional collaboration Interorganizational collaboration

Interorganizational collaboration

Coordination of health care services is complicated by which of the following? (Select all that apply.) Involving one or more services Too many community resources Poorly funded social programs Authority for managing services Too many nurses Lack of health care systems

Involving one or more services Poorly funded social programs Authority for managing services Lack of health care systems

A nurse in community health located in Virginia is conducting an assessment on a Hispanic worker currently working in a local apple orchard for the season. The nurse determines that the worker originates from Florida and is living in temporary housing with other orchard workers. Based on this information, the nurse should integrate the special needs of what vulnerable population? Migrant farmworkers Seasonal farmworkers Underinsured Undocumented aliens

Migrant farmworkers

A nurse in community health is participating in a community service board strategic team that is currently assessing the community's strengths, the local public mental health system, the community's mental health status, and other variables. This best describes what strategic program planning model used today in the public health arena? Assessment Protocol for Excellence in Public Health (APEXPH) Health Evaluation Data Information System (HEDIS) Mobilizing for Action Through Planning and Partnership (MAPP) Planning Approach to Community Health (PATCH)

Mobilizing for Action Through Planning and Partnership (MAPP)

When using the health measure of death rates for working-age adults, the nurse could expect to find the highest rates in which areas? Large metropolitan areas Most rural and highly populated urban areas Most rural and suburban areas Small suburban and all urban areas

Most rural and highly populated urban areas

In treating a worker injured at a construction site, the nurse interviews the worker, the foreman, and several of the co-workers. Does this exemplify community-oriented nursing practice? Why or why not?

NO This is community-based nursing practice as it focuses on one incident, if the CHN was doing education to a factory about worker safety that would be community-oriented.

Which of the following behaviors by a nurse indicates the effective use of collaboration with other professionals? Strongly defends own professional role Avoids conflict Negotiates with others Aggressively presents a personal view of a situation

Negotiates with others

A patient does not make eye contact with the nurse and is folding his arms at his chest. Which aspect of communication has the nurse assessed? Nonverbal communication A message filter A cultural barrier Social skills

Nonverbal communication

A patient states that everything has been going great; however, the nurse observes the patient biting his nails and fidgeting. What type of communication does the nurse recognize from the patient's actions and statements? Linguistic Paralinguistic Explicit Inadequate

Paralinguistic

A nurse in community health seeks a low-cost evaluation method to learn the perspectives of the largest number of persons regarding a proposed local safe haven program for unwanted infants. The best evaluation method to meet the criteria would be: community forums. focus groups. key informants. surveys.

community forums.

A nurse manager is presenting an organizational overview to new nurses during orientation. Which of the following features, common to all organizations, would be included in this overview? Policies and procedures for the organization Salaries and benefits for employees Floor plan of each unit Professional development activities

Policies and procedures for the organization

The nurse has provided information about a safe shelter for a patient who is the victim of abuse. Which of the following is an additional intervention that the nurse must perform? Arrange for transportation to the shelter. Report the abuse to the appropriate legal authority. Offer paperwork for medical assistance. Provide food vouchers for the patient's children.

Report the abuse to the appropriate legal authority.

A nurse has begun working in a new unit with high-acuity patients who are scheduled for numerous diagnostic tests before being transferred to the appropriate medical or surgical unit. She also has care responsibilities for her children and her aging parents. The nurse is experiencing signs of being overwhelmed. What counsel might the nurse manager share with the nurse to help her cope with work stress? Take some time off to decide if she really wants to be a nurse. Encourage her to catch up on her documentation responsibilities while taking her lunch break. Enlist the help of other family members in the care of her children so she can focus on work. Request that another nurse help her focus on essential aspects of care rather than optional aspects of care.

Request that another nurse help her focus on essential aspects of care rather than optional aspects of care.

Two nurses are discussing the important attributes of care coordination. They both know that care coordination should be based on which type of care coordination? Community based Hospital based Team based Health insurance based

Team based

A 5-year-old boy with early flu symptoms is at school working with some math blocks. He sneezes into his hand and then continues working with his blocks. An unvaccinated teacher's helper cleans up the blocks when the child leaves them on the table. After touching the blocks, she rubs her nose with her hand. Which represents the most likely mode of transmission? The 5-year-old boy The unvaccinated teacher's helper The hand-to-nose contact The unwashed math blocks

The unwashed math blocks

The nurse is having a therapeutic conversation with a patient who is newly diagnosed with hypertension. Which communication techniques will most likely prove effective for this newly diagnosed patient? (Select all that apply.) The nurse presents a laminated poster to the patient that depicts pictures of foods that would be on the low sodium diet. The nurse and patient engage in a humorous conversation about the top ten "what not to eat when you are being treated for hypertension." The nurse gives the patient a sheet full of information and asks the patient to read the information and let the nurse know if they have any questions. The nurse states the risk factors and statistics of patients who do not take their medications as prescribed. The nurse helps the patient identify weight loss goals that are reasonable. The nurse waits until the patient has been awake for a few hours before beginning the teaching plan.

The nurse presents a laminated poster to the patient that depicts pictures of foods that would be on the low sodium diet. The nurse and patient engage in a humorous conversation about the top ten "what not to eat when you are being treated for hypertension." The nurse helps the patient identify weight loss goals that are reasonable The nurse waits until the patient has been awake for a few hours before beginning the teaching plan.

A female patient arrives at the emergency department visibly upset and tearful. She refuses to have a male caregiver, asks for a room close to an exit door, and does not make eye contact with staff. What does the nurse suspect is happening with the patient? The patient may be having an acute psychotic episode related to her mental illness. The patient may be abusing street drugs and needs a drug screening test. The patient may have been the victim of an acute assault. The patient may be a very demanding and particular person.

The patient may have been the victim of an acute assault.

The nurse is assessing a patient's coping abilities related to expected placement in a long-term care facility. Which risk factor is of most concern to the nurse? The patient's family members all live several hours away. The patient is a retired police officer. The patient was recently diagnosed with Alzheimer's disease. The patient will need assistance in moving from his home.

The patient was recently diagnosed with Alzheimer's disease.

The nurse is admitting a new patient to the psychiatric unit. Which factors will most likely contribute to a positive outcome of the interaction? (Select all that apply.) The patient is in a bad mood. The patient states that he or she is in pain. The unit is quiet. The patient has been admitted to the facility in the past. The patient is awake, alert, and oriented to person, place, and time. There are various interactive sessions going on in the unit today.

The unit is quiet. The patient has been admitted to the facility in the past. The patient is awake, alert, and oriented to person, place, and time.

A nurse is explaining why collaboration is valued to a new nurse during her orientation to the unit. Which of the following outcomes is a key patient care outcome that occurs when collaboration is correctly used? Governmental accrediting agencies give more favorable reviews to the agency. There are fewer errors that occur in patient care. Agencies can offer higher salaries due to the cross-training of staff. Ongoing education is not needed, because other specialties contribute to care decisions.

There are fewer errors that occur in patient care.

A community health nurse is developing an education program on substance use disorders for a group of adolescents. Which of the following information should the nurse include when discussing nicotine and smoking?

Tolerance to nicotine develops quickly

When coordination and continuity of health care are transferred between different locations or different levels of care within the same location, this is identified as which type of care coordination? Health care doctrine Transitional care Transactional care Multilevel care

Transitional care

True or False: Vulnerability results from the cumulative effects of limited physical, environmental, personal, and biopsychosocial resources.

True

A person of Northern heritage is at an increased risk for which of the following? (Select all that apply.) Vitamin C deficiency Type 1 diabetes Celiac disease Type 2 diabetes Hypertension Metabolic syndrome

Type 1 diabetes Celiac disease

A new case management nurse has been hired at a nursing home to investigate several recent resident deaths at the facility. The nurse understands that because there are many kinds of potential abuse, she will need to assess for what type of factors? (Select all that apply.) High ratio of overweight residents Unexplained bruising of residents Altered cognitive function of residents Skin breakdown in residents resulting from poor hygiene Documentation of prescribed physical therapy sessions

Unexplained bruising of residents Altered cognitive function of residents Skin breakdown in residents resulting from poor hygiene

The nurse should identify which potential health disparities when conducting an admission assessment on a hospitalized patient? (Select all that apply.) Unsatisfying, low-paying job Frequent smoker Comprehensive health insurance Recently divorced African-American male

Unsatisfying, low-paying job Frequent smoker Recently divorced African-American male

The nurse is caring for a patient diagnosed with peptic ulcer disease (PUD). The patient was prescribed the proton pump inhibitor Prevacid (lansoprazole). Which of the following supplements may be prescribed to prevent deficiency? Vitamin B12 Vitamin C Vitamin D Omega-3 fatty acids

Vitamin B12

A nurse at a community clinic is conducting a well-child visit with a preschool-age child. The nurse should identify which of the following as a manifestation of child neglect? (Select all that apply) a. Underweight b. Healing spiral fracture of the arm c. Genital irritation d. Burns on the palms of the hands e. Poor hygiene

a. Underweight e. Poor hygiene

. The state agency has received multiple complaints regarding the availability of elder transportation services to a specific county senior center. The state agency assigns a public health nurse to work with the community to evaluate its program for elder transportation services to publicly sponsored elder care programs. The public health core function applied is: a. assurance b. policy development c. primary prevention d. public transportation

a. assurance

In giving care to the survivors of violence, the nurse should demonstrate respect and caring for all family members, insist that safety is the first priority, and demonstrate intolerance for violent behavior. Additionally, the nurse should be: absolutely honest about what will be reported and what the family can expect. authoritarian in approaching the problem. cautious in reporting unconfirmed reports of violence. sincere in concern for the victims.

absolutely honest about what will be reported and what the family can expect.

A nurse coordinating care for undocumented minority workers with a high incidence of tuberculosis (TB) conducts a presentation before the local community health board to focus attention on the magnitude of the problem and its potential impact on the local community. The presentation stimulates the community to explore innovative solutions to increase screening for and treatment of TB cases. This scenario is an example of the relationship between: advocacy and case management. advocacy and continuity of care. care management and case management. care management and continuity of care.

advocacy and case management.

An American takes a long-awaited vacation in sunny Mexico, spending days on the beach eating fresh raspberries from a nearby vendor and drinking bottled water. The tourist may be altering: agent-host-environment interaction. circadian rhythms. herd immunity. resistance.

agent-host-environment interaction.

The nurse in community health identifies an elder abuse problem because of caregiver stress among families in the local community resulting from lack of caregiver support services. The next step in the community-oriented nursing process would be to: analyze the community problem. establish priorities. establish goals and objectives. identify intervention activities.

analyze the community problem.

Nurses in community health conducting health education classes for populations vulnerable to HIV/AIDS should explain the natural history of the progression of human immunodeficiency virus (HIV). Of particular importance is the fact that the disease may go undetected during the primary infection phase because: antibody tests are typically negative. the immune system increases antibody production. the incubation period is prolonged. symptoms include myalgias, sore throat, and rash.

antibody tests are typically negative.

A parent involved in conflict resolution with her teenager says, "I know that some of your friends stay out until midnight, but I think it is best if you are in at 10 o'clock." This statement, a behavior seen in conflict situations, is an example of: negotiation. cooperation. assertiveness. aggressiveness.

assertiveness.

A community-oriented nurse has identified obesity as a problem in the middle school. The next step in a population-focused practice is to make information available about the health of the middle school students. This describes the public health core function of: assessment. assurance. policy development. research.

assessment. The three public health core functions are assessment, policy development, and assurance

When acting as a mediator, the nurse advocate would: choose a new health plan for a client with limited funds. assist new parents in communicating with their health plan regarding well-baby coverage. provide health education to teens who need knowledge about sexually transmitted diseases. set up a doctor's appointment for an illiterate adult.

assist new parents in communicating with their health plan regarding well-baby coverage.

A state agency has received multiple complaints regarding the availability of elder transportation services to a specific county senior center. The state agency assigns a public health nurse to work with the community to evaluate its program for elder transportation services to publicly sponsored elder care programs. The public health core function applied is: assurance. policy development. primary prevention. public transportation.

assurance. The public health core function of assurance focuses on the responsibility of public health agencies to be sure that activities are appropriately carried out to meet public health goals and plans.

1. A nurse is caring for a client who is experiencing alcohol withdrawal. Which of the following findings is a manifestation of withdrawal? a. Decreased blood pressure b. Diaphoresis c. Pin-point pupils d. Bradycardia

b. Diaphoresis

. A home health nurse is discussing portals of entry with a group of newly hired assistive personnel. Which of the following are portals of entry the nurse should discuss? SELECT ALL THAT APPLY. a. respiratory secretions b. skin c. genitourinary tract d. saliva e. mucous membranes

b. skin c. genitourinary tract e. mucous membranes

A case manager is concerned that some of the clients at the neighborhood clinic are getting fewer services because of their financial situations. The case manager is confronting the ethical principle of: justice. veracity. deontology. beneficence.

beneficence.

A nurse is collecting data to identify health needs in the local community. Which of the following examples should the nurse identify as secondary data? (select all)

birth statistics, previous health survey, health records

Universal Precautions is a policy for all health care settings, where potential contact with blood or other body fluids exists, and requires that health care workers always perform hand hygiene and wear gloves, masks, protective clothing, and other indicated personal protective barriers. The underlying strategy for this policy requires that: blood and body fluids of all clients be handled as if infected. health care workers effectively use hand hygiene. health care settings are reservoirs of infection. effective infection control surveillance programs are in place.

blood and body fluids of all clients be handled as if infected.

A nursing in community health has determined that there is a need for a program for teenage fathers who want to learn about child care. The next step in the program management process would be to: a. Conduct a survey to determine how many children that fathers have b. Determine whether the fathers have benefitted from this type of program before c. Meet with the community members to form a planning body. d. Provide the fathers with community resources

c. Meet with the community members to form a planning body.

1. The nurse has developed a program to provide group therapy for clients with depression, which of the following issues for the vulnerable population are being addressed? a. Violence b. Poverty c. Mental health issues d. Homelessness

c. Mental health issues

1. A community health nurse is developing strategies to prevent or improve mental health issues in the local area. In which of the following situations is the nurse implementing a tertiary prevention strategy? a. Providing support programs for new parents b. Screening a client whose spouse recently died for suicide risk c. Teaching a client who has schizophrenia about medication interactions d. Discussing stress reduction techniques with employees at an industrial site

c. Teaching a client who has schizophrenia about medication interactions

A nurse in community health is following a pregnant teenager who attends school. The nurse plans to discuss self-care activities that will be important for the teen during her pregnancy. The discussion should include: carrying heavy book bags. changing to home education. decreasing fluid intake to avoid nausea. keeping up her grades.

carrying heavy book bags.

A community health nurse is working with an uninsured family with two children. The nurse assists the parents in applying for SCHIP benefits and securing an appointment for the children with a community pediatrician that participates in SCHIP. The intervention can best be described as: care management. case management. continuity of care. disease management.

case management.

The nurse in community health is aware that HIV-infected children should attend school, because the benefit of attendance far outweighs the risk of transmitting or acquiring infections. School attendance should be reconsidered when there is evidence of: availability of homebound instruction. cases of measles. lack of handicapped access. prejudice of teachers and/or students.

cases of measles.

A nurse in community health is invited to work with a coalition of churches to address safety concerns for children in the local community. The nurse provides training in problem-solving skills, manages conflict, facilitates the process, and provides expertise in interpreting data. This nurse has chosen the implementation role of: change agent. change partner. group leader. data collector.

change partner.

To reach the desired goal of maximizing the full immunization rates for preventable communicable disease and increasing herd immunity levels, it is crucial for the nurse to: assume that the primary care physician has provided all appropriate immunizations. check an individual's immunization status at each and every visit. support parents who are reluctant to immunize their children. understand the difficulties in obtaining and maintaining immunization schedules.

check an individual's immunization status at each and every visit.

A nurse in community health is working with a parent whose spouse has been called up for active duty in the military reserve. The family is experiencing financial strain due to decreased income. The extended family lives at a distance. The parent is struggling to manage the family in the spouse's absence. The family consists of four children (three preschool and one preteen). In this situation, it would be important for the nurse to further explore the potential for: child abuse. depression. intimate partner abuse. parent's resentment of the preteen.

child abuse.

Identification of the discrepancies between the quality standards of the agency and the actual practice of the health care professionals is part of the interpretation component of quality assurance programs. Other factors addressed during this stage are: (select all that apply) Select all that apply. choices of possible courses of action. follow-up evaluation. strengths and weaknesses. taking action.

choices of possible courses of action. strengths and weaknesses.

case managment

collaborative process that assesses, plans, implements, coordinates, monitors, and evaluates the options and services required to meet the client's health and human service needs

A multisystem approach to community disease control would include such interventions as: (select all that apply) Select all that apply. community action programs. control of vectors. improved surveillance systems. legislation. provision of chemotherapy.

community action programs. control of vectors. improved surveillance systems. legislation. provision of chemotherapy.

The major sources of information for program evaluation are: (select all that apply) Select all that apply. community indicators. media reports. program clients. program providers. program record

community indicators. program clients. program record

A Hispanic outreach program works with the nurse in community health to train Hispanic health care workers in providing basic services and education within the local Hispanic community. The concept basic to community-oriented nursing practice that is best described by this intervention is: community. community client. community health. community partnerships.

community partnerships.

A nurse in a clinic that provides direct care services to clients with tuberculosis would be classified as practicing: community-based nursing. community-oriented nursing. institutional nursing. public health nursing.

community-based nursing.

Jennifer is a nurse in a family medicine clinic. Today she is assessing Jose, a 4-year-old who is being seen for an earache. The type of nursing Jennifer practices is: community-oriented nursing. community-based nursing. public health nursing. tertiary health nursing.

community-based nursing. In community-based nursing, the nurse focuses on "illness care" of individuals and families across the life span. The aim is to manage acute and chronic health conditions in the community, and the practice is family-centered illness care.

A school nurse teaches three middle school students with asthma conditions techniques to minimize their incidence of bronchial spasms. This is an application of: community-based nursing. community-oriented nursing. institutional nursing. public health nursing.

community-based nursing. The goal of community-based nursing (CBN) is to manage acute or chronic conditions while promoting self-care among individuals and families.

A nurse planning a smoking cessation clinic for adolescents in the local middle schools and high schools is providing: community-oriented care. community-based care. secondary care. tertiary care.

community-oriented care. Community-oriented nurses emphasize health protection, maintenance, and promotion and disease prevention, as well as self-reliance among clients.

Migrant workers and their families who reside in a specific mobile home park during the summer months would best be classified as a: community. group. setting of practice. target population.

community.

a nurse is planning a community health program. Which of the following actions should the nurse include as part of the evaluation plan?

compare program impact to similar programs

A government agency is conducting an audit of all active clients in the local hospice program to ensure that hospice criteria for care are being applied appropriately. The type of tool being used in this specific approach to quality assurance is: concurrent audit. outcome audit. retrospective audit. peer review.

concurrent audit.

The nurse engaging in formative program evaluation would most likely: conduct medical record audits for quality assurance. make a home visit before a client is discharged from the program. participate in new client evaluation. write policy for risk management.

conduct medical record audits for quality assurance.

Factors that contribute to newly emerging or reemerging infectious disease can be related to microbial adaptation and changes made by the infectious agent. However, most of the emergence factors are related to environmental changes and: consequences of human activities/behaviors. increase in the number of vectors. industrialization and urbanization. unpredictable variances in the climate.

consequences of human activities/behaviors.

One specific approach to quality assurance is the use of Total Quality Management (TQM). A district public health department uses this approach and gives much attention to ensuring that studies are used to improve processes, remove management by objectives, and promote self-improvement. The major TQM guideline that would summarize these efforts would be: create, publish, and distribute aims and purposes. creating a strong customer-oriented philosophy that is process-driven. eliminate barriers to pride of work/performance. understand the purpose of inspection.

creating a strong customer-oriented philosophy that is process-driven.

Vulnerable populations may be exposed to more than one hazard at a time. This is known as: cumulative risk. disenfranchised populations. resilience. underserved populations.

cumulative risk.

Which of the following is a community health structure? a. Infant mortality rate b. Crime rate c. County jail d. Hospital

d. Hospital

1. A community health nurse is developing an education program on substance use disorders for a group of adolescents. Which of the following should the nurse include when discussing nicotine and smoking? a. Smoking is the fifth-most preventable cause of death in the United States b. Nicotine is a central nervous system depressant c. Withdrawal effects from smoking are minimal d. Tolerance to nicotine develops quickly

d. Tolerance to nicotine develops quickly

While conducting a community health assessment, a nurse in community health meets with local religious leaders to understand the values, norms, perceived needs, and influence structures within the community. This process of data collection can best be described as: data gathering. data generation. data interpretation. problem identification.

data generation.

It is estimated that one in 15 males becomes a father during his teen years. The nurse should be aware that many young men facing paternity have specific challenges such as: (select all that apply) Select all that apply. acting as though they are interested when they are disinterested. avoiding prenatal care involvement. desiring and needing to be involved with their children. being rejected by the young woman's family. rejecting their role as a father.

desiring and needing to be involved with their children. being rejected by the young woman's family

A case management nurse for a locally funded program for special-needs children is increasingly concerned about a recent referral for a 1-year-old child with a congenital illness residing in a poverty-stricken community. The nurse knows that this child may be at higher risk for the most harmful effects of poverty, including: developmental delays. ear infections. frequent colds and infections. irritability.

developmental delays.

A nurse volunteering at the free clinic in her community informs a client seeking treatment for hypertension that the family's children may qualify for enrollment in the State Children's Health Insurance Program (SCHIP). The nurse's intervention can reduce health disparities for these vulnerable children by making a referral to a program that provides: direct financial subsidies for children. funds to insure currently uninsured children. outreach efforts to enroll eligible children in Medicaid. prospective payments for child services.

funds to insure currently uninsured children.

Local officials have requested a program evaluation of a comprehensive teen sex education program offered in the local schools in preparation for potential budget discussions. A nurse in community health conducts a program evaluation and determines that the teen pregnancy rate has gradually declined over the years that the program has been in place. The community is measuring the program's: efficiency. progress. relevance. sustainability.

efficiency.

A major evaluation source for a nurse to use to determine the effectiveness of a teen driver safety program is: Centers for Disease Control and Prevention (CDC) reports. epidemiologic data. recent census data. voter registration records.

epidemiologic data.

A nurse is preparing to conduct a windshield survey. Which of the following data should the nurse collect as a component of this assessment? (select all)

ethnicity of community members, natural community boundaries, presence of public protection

The nurse in community health defines goals and measurable objectives during the planning phase of a community health intervention. This also marks the beginning of the: evaluation phase. implementation phase. needs assessment. problem analysis.

evaluation phase.

True or False: More than 50% of migrant farm workers use health services funded by the Migrant Health Act.

false

True or False: Persons who are members of vulnerable groups are not resilient

false

True or False: Vulnerable populations have no better or worse health outcomes than any other population group.

false

A father brings his stepdaughter to the family clinic for an immunization update before the new school year. The nurse notices the interaction between the young girl and her stepfather. The child appears tense and cautious and wraps her arms around herself in a protective manner. The child startles when touched by the stepfather and pulls away. The stepfather is overheard saying, "I'll leave you here if you don't behave and act nice." In this scenario, it would be important for the nurse to explore in her assessment the possibility of: child neglect. family secrets. father-daughter incest. impaired family functioning.

father-daughter incest.

Protecting the nation's food supply from contamination by all the virulent microbes is complex, costly, and time consuming. However, much foodborne illness, regardless of causal organisms, can be prevented through simple changes in: food preparation, handling, and storage. importation regulations. pesticide usage. animal breeding practices.

food preparation, handling, and storage.

An undocumented migrant farmworker has been diagnosed with tuberculosis (TB). The local health department initiates treatment by dispensing the first month's supply of medication and educates the client on the need to continue treatment for 6 to 12 months. A major challenge that the client may face related to ongoing treatment for TB is: affordable care. discrimination. fragmented services. language barriers.

fragmented services.

A client presents at the local clinic with acute symptoms of fever, nausea, lack of appetite, malaise, and abdominal discomfort. During the course of the assessment, the nurse determines that the client is a health care aide working at a day care center. These facts are important because: acute hepatitis B is self-limiting. hepatitis A outbreaks are common in facilities where staff change diapers. hepatitis C is the "silent stalker." persons with chronic liver disease are at greater risk for hepatitis A.

hepatitis A outbreaks are common in facilities where staff change diapers.

All adults should be assessed for violence in their primary intimate relationships. The abuse of female partners has the most serious community health ramifications because of the greater prevalence, the more serious long-term emotional and physical consequences, and the greater potential for: fleeing to a shelter. homicide. possessive behavior. spontaneous abortion.

homicide.

The local hospital emergency department has recently experienced an increase in gastroenteritis cases among migrant farmworkers. The local health department is informed of this rise in cases and schedules a case mapping of local: bars frequented by migrant workers. farm fields employing migrant workers. housing for migrant workers. restaurants frequented by migrant workers.

housing for migrant workers.

The Omaha System is a client classification system developed by the Visiting Nurses Association of Omaha, Nebraska, that has the potential to improve the delivery of care by: improving the description of care. minimizing the assessment required. predicting the outcome. decreasing the communication needs

improving the description of care.

A nurse new to the community evaluates the resources available to a father that has sought help with his escalating abuse and threats of violence to his family. After making the referral, the nurse approaches the local newspaper about running a series on the nature and extent of human abuse in the community. This strategy would: advocate for government programs to treat survivors. demonstrate the provider's commitment to address the need for services. increase awareness of community resources to address violence and abuse. increase the number of individuals identified as perpetrators.

increase awareness of community resources to address violence and abuse.

In a federally funded preschool program such as Head Start, nursing services that include conducting developmental-level screening for cognitive and psychomotor development of individual children would most likely be considered community-oriented nursing care when: individual results are compared with established standards for children of the same age group. program characteristics are assessed for their effectiveness in making the school population healthier. referral is provided for a child identified with delayed psychomotor development. treatment is initiated for a child with an identified learning disability.

individual results are compared with established standards for children of the same age group.

A nurse participates with a community planning board addressing housing strategies and future community needs. The nurse is aware that the community has a population of homeless families served by local churches. The nurse is also aware that this agricultural community relies on migrant workers during seasonal harvesting of local produce. The nurse is concerned that these disenfranchised populations may be: complicated to address. costly to serve. invisible to the community. resilient to the community.

invisible to the community.

A nurse in community health working in an inner city clinic with high poverty and unemployment rates recognizes the need for programs for pregnant women because these women often receive late or no prenatal care and deliver: at home. full term. identical twins or triplets. low-birthweight babies.

low-birthweight babies.

For the nurse to fully understand the threat associated with the release of biological agents and participate in an appropriate response, the Centers for Disease Control and Prevention (CDC) has stated that the biological agents most likely to be employed are those that both have a potential for high mortality and can be easily disseminated to produce: immediately severe symptoms. major panic and social disruption. multisyndrome effect. person-to-person transmission.

major panic and social disruption.

Within a state, counties designated as Health Professional Shortage Areas (HPSAs) tend to have a high proportion of racial minorities and fewer specialists. This factor may explain conflicting data within a state related to: adult immunization rates. chronic respiratory illness rates. maternal/infant morbidity rates. obesity rates.

maternal/infant morbidity rates.

A nurse in community health has determined that there is a need for a program for teenage fathers who want to learn about child care. The next step in the program management process would be to: conduct a survey to determine how many children the fathers have. determine whether the fathers have benefited from this type of program before. meet with community members to form a planning body. provide the fathers with community resources.

meet with community members to form a planning body.

A hospice nurse is working with a cancer client and his family. The client's 7-year-old son has developed recent school and peer problems. Understanding the risk for disruption of normal development, the nurse plans to first screen the child for: developmental disorders. mental health problems. parental neglect. violence potential.

mental health problems

a occupational health nurse is consulting with senior management of a local industrial facility. When discussing work-related illness and injury, the nurse should include which of the following factors as physical agents? (select all)

noise, lighting

Public health nursing is a specialty with a distinct focus and scope of practice and requires a special knowledge base different from other specialty areas of nursing. A public health nurse would first be interested in: drug treatments for diabetes. populations with the highest rate of diabetes. educational materials for individuals with diabetes. new technology for diabetic care.

populations with the highest rate of diabetes.

A state health department wants to ensure that the local health departments are delivering quality client care and can demonstrate the degree of excellence attained. The principle that is best defined by this statement is: continuous quality improvement (CQI). quality assurance (QA). risk management. total quality management (TQM).

quality assurance (QA).

An example of secondary prevention for infectious disease prevention is: malaria chemoprophylaxis. Pneumocystis carinii pneumonia (PCP) chemoprophylaxis for people with AIDS. quarantine. restaurant inspections.

quarantine.

A school nurse is planning health promotion and disease prevention activities for the upcoming school year. In which of the following situations is the nurse planning a secondary prevention strategy?

routinely checking students for pediculosis throughout the school year

When determining whether a geographic area is rural or urban, the nurse should recognize that: rural and urban areas, by relative nature, occur on a continuum. rural regions have fewer than six persons per square mile. rural residents feel isolated. rural areas are recreational, retirement, or resort communities.

rural and urban areas, by relative nature, occur on a continuum.

The primary prevention of hepatitis C virus (HCV) includes: counseling and follow-up of infected clients. routine testing for health care workers. screening of blood products. testing of high-risk individuals.

screening of blood products.

A population-level tertiary prevention intervention typically performed by nurses and aimed at controlling communicable diseases is: HIV test counseling. needle-exchange program. partner notification. standard precautions teaching.

standard precautions teaching.

In a community clinic that screens and treats individuals for cardiovascular disorders, the nurse practicing public health/population-focused nursing would most likely ascertain: a holistic treatment plan. a specific clinical diagnosis. individual dietary interventions for cardiovascular disorders. the prevalence rate of cardiovascular disorders among various groups.

the prevalence rate of cardiovascular disorders among various groups.

Instruments such as the Functional Activities Questionnaire (FAQ) for postoperative patients who are at home, the Minimum Data Set for Nursing Facility Resident Assessment and Care Screening (MDS) for nursing home patients, the Functional Status Scale (FSS) for children, and the Edmonton Functional Assessment Tool for cancer patients are used to assess activities of daily living (ADLs). The nurse needs to remember that a disadvantage of these instruments includes: the measurement of efficacy and reliability of the instruments used to assess activities of daily living (ADLs). the variations in assessments and responses may be subjective because of self-reporting of functional activities. the instruments do not show a true measure of ability because of a lack of interactivity during the assessments. the information contained in the instruments is insufficient to make a determination about functional status in these

the variations in assessments and responses may be subjective because of self-reporting of functional activities.

Given recent vaccine shortages for the flu, the local nurses in community health form a group to evaluate the process of scheduling and operating flu vaccination clinics in the community and review the community's complaints from the previous season. The activity best represents the principle of: total quality management (TQM) to achieve continuous quality improvement (CQI). quality assurance (QA) to achieve continuous quality improvement (CQI). risk management to achieve quality. continuous quality improvement (CQI) to achieve total quality management (TQM).

total quality management (TQM) to achieve continuous quality improvement (CQI).

True or False: Nursing assessment of vulnerable populations must be comprehensive while focusing only on information that the nurse needs and the client is willing to provide.

true

True or False: Telehealth uses a variety of technology solutions and can be as simple as nurses in two or more different public health settings consulting over the telephone or via computer video conferencing.

true

A nurse in community health conducts quarterly mental health-promotion and depression-screening programs at the local senior center. The nurse is aware that older adults are at increased risk for developing depression. Using such an intervention also addresses the older adults': dependence on their primary care provider. normal sensory losses. reduced social contacts. underutilization of the mental health system.

underutilization of the mental health system.

A nurse at a community clinic is conducting a well-child visit with a preschool-age child. The nurse should identify which of the following manifestations as a possible indication of child neglect? (select all)

underweight, poor hygiene

Two nurses in community health schedule a day to ride through a low-income community to better understand the community and its boundaries, trends, rhythm, stability, and changes that can affect the health of that community. This direct data collection method is often referred to as: composite database. participant observation. secondary analysis. windshield survey.

windshield survey.

A large industrial plant has recently laid off a significant portion of its workforce because of scalebacks in production. The occupational health nurse proposes education sessions with the remaining employees about effective strategies for managing stress during economic downturns. This suggestion to management is based on the nurse's understanding that increases in aggression and violence at home and work may be triggered by: competition. unemployment. survivor guilt. work-related stress.

work-related stress.