Community Textbook Questions

Stigma related to psychoactive substance use is pervasive in the medical community. Which statement indicates the nurse understands stigma? 1) "The man I just admitted for back pain is a drug seeker." 2) "We had to call security to remove the druggie husband." 3) "The drunk lady says she wants Vicodin for a headache." 4) "The patient has a history of substance abuse but states that he has been sober."

"The patient has a history of substance abuse but states that he has been sober." This statement best represents an understanding of stigma. Professional literature uses the phrases "person living with (recovering from) a substance use disorder" or "person engaged in the risky use of substances" instead of labels such as addict, alcoholic, or druggie.

A young man asks the nurse how he can prevent a sexually transmitted infection (STI) other than practicing abstinence. What is the nurse's best response? 1) "Eat healthy foods and exercise regularly." 2) "Wear a condom for all sexual contact." 3) "Avoid multiple sexual partners." 4) "Do not have sexual contact with someone who has an STI."

"Wear a condom for all sexual contact." This is the best response, as unprotected sexual contact is the main risk factor for STIs.

A nurse is preparing a hepatitis B injection for which at-risk patient? 1) A school social worker 2) A migrant farm worker 3) A first semester nursing student 4) A patient with type 2 diabetes

A first-semester nursing student is at high risk of exposure to hepatitis B.

A nursing instructor overhears two students quizzing each other for an upcoming community health exam. One student asks the other to give an example of a fomite. Which of the following is considered a fomite? 1) A paper tissue carrying rhinovirus 2) A mosquito carrying a parasite 3) A human ill with H1N1 influenza 4) A raccoon carrying the rabies virus

A fomite is a mode of transmission of infectious disease. It is an inanimate object. An infected person or host touches the object and sheds the infectious agent onto the object. The agent is transmitted to the next person who touches that object. The paper tissue carrying rhinovirus is a fomite.

A nurse is working at a community fair and talking with community members about being ready for an earthquake. What is the most important piece of advice the nurse can share with the community members? 1) Have emergency phone numbers programmed into their cell phones. 2) Have an emergency preparedness plan ready. 3) Make their houses earthquake-ready and stable. 4) Have a two-week supply of food and water

A full preparedness plan is a crucial step in being prepared for an earthquake or other emergency or disaster.

Which of the following clients has the highest risk for heart disease? 1) An African-American man whose body mass index (BMI) is 22 2) A Latino woman whose BMI is 26 3) A non-Latino woman with diabetes and a BMI of 26 4) A Latino man who smokes and has a BMI of 18

A non-Latino woman with diabetes and a BMI of 26 has the highest risk. She has two risk factors for heart disease: diabetes and a BMI of 26, which is in the "overweight" category.

The use of psychoactive drugs is a major public health issue affecting all populations and countries. The nurse recognizes that "a maladaptive pattern of substance use leading to clinically significant impairment" is the definition of which of the following? 1) Physiological dependence 2) Substance use disorder 3) Addiction 4) Illegal substance use

A substance use disorder is a maladaptive pattern of substance use leading to clinically significant impairment or distress.

A nursing student is writing a report about global health issues among children in low-income countries. She learns that 1 in 4 deaths of children under the age of five is caused by what? 1) Starvation and malaria 2) Pneumonia and diarrhea 3) HIV/AIDS and prematurity 4) Congenital anomalies and other noncommunicable diseases

According to the UNICEF State of the World's Children 2017 report, pneumonia and diarrhea, both treatable and preventable conditions, still claim 1.4 million young children every year. The organization reports that one in four deaths among children under five is caused by pneumonia or diarrhea. Low-income and lower middle-income countries are home to 62% of the world's under-five population but account for 90% of global pneumonia and diarrhea deaths

A nurse happens to be in a mall parking lot when a large explosion rips through the building. The nurse is unhurt and runs to the scene to help provide medical care. After calling 9-1-1, what should the nurse do? 1) Call the local television station so it can start filming and assist in bringing volunteers and supplies to the scene. 2) Start sorting victims according to the principles of triage. 3) Search for the origin of the explosion and determine if it is safe to proceed. 4) Notify the Department of Homeland Security so it can begin to investigate the scene.

After calling for help, the nurse should begin treating or rescuing victims. This should be done according to the principles of triage, where victims are sorted according to the severity of their injuries.

What is the most commonly reported sexually transmitted infection (STI) in the United States? 1) Chlamydia 2) Pelvic inflammatory disease 3) Gonorrhea 4) Syphilis

Chlamydia is the most commonly reported STI in the United States. In 2010, the incidence rate of chlamydia was 426 per 100,000. The rate in women was double that of men.

A nurse is performing a blood pressure screening at a community health fair and identifies a woman whose blood pressure is 140/81 mm Hg. When the nurse tells her she may have hypertension, the woman replies, "I just lost my job. I can't afford to pay for blood pressure medication." Which is the best response? 1) "Ask your doctor to prescribe a less expensive blood pressure medication." 2) "The stress of losing your job will make your blood pressure higher. You need the medication." 3) "The local pharmacist will know where you can find the lowest-priced medication." 4) "Here is the phone number of a clinic that provides health care and medication based on income."

An ethical dilemma arises when a screening is positive but treatment is not accessible. Referring the woman to the clinic where she can obtain care and medication provides medical assessment, treatment, and follow-up.

The nurse recognizes that the ability of a disease to produce antibodies in the human host is called: 1) Virulence 2) Antigenicity 3) Toxigenicity 4) Pathogenicity

Antigenicity is the ability of a pathogen to produce antibodies in the human host.

What is the focus of prevention strategies to reverse the increasing prevalence of type 2 diabetes?

Behavioral change is the main focus of public health efforts to reduce individual risk of developing type 2 diabetes.

The nurse is reviewing a 45-year-old client's history during his annual physical and learns the client works as a carpenter. What is the nurse's best response? 1) "You need the shingles vaccine." 2) "When was your last tetanus shot?" 3) "You should get a flu shot today." 4) "It's time for the third hepatitis B shot."

Carpenters are at risk for tetanus due to the nature of their work with sharp tools and metal objects that can cause lacerations and puncture wounds. The bacterium that causes tetanus can enter the body through such wounds. The tetanus diphtheria (Td) booster is given every 10 years

Local primary care nurses want to improve the community's health by addressing childhood obesity from a population health perspective. Which best represents a population-focused intervention? 1) Referring parents of overweight children to the dietitian 2) Outreach to community leaders to plan a health fair 3) Monitoring height, weight, and HbA1C levels of overweight children 4) Requesting a public health nurse (PHN) to educate parents during home visits

Community outreach is a population-focused intervention. A health fair provides health education for a large group at one time in one place.

The community nurse's goal is to protect the community from a disease outbreak. Which of the following measures assist the nurse in reaching this goal? 1) Determine the vaccination rate in the community. 2) Identify susceptible individuals in the community. 3) Vaccinate a percentage of the community. 4) Provide antibiotics for a percentage of the community.

Determine the vaccination rate in the community. To achieve herd immunity to a specific agent, a certain percentage of the population must be immune. This is referred to as the threshold of immunity and is achieved through exposure or vaccination. The nurse can determine the community's threshold of immunity using the vaccination rate and then plan the percentage of the community needing to be immunized.

A nurse is working in the emergency department of a large urban hospital. The nurse is responsible for managing the emergency response and disaster management team. The hospital is just returning to normal functioning after caring for victims of a building explosion. Which priority action should the nurse take next? 1) Schedule a quality improvement meeting with key staff members to discuss what went well and what needs to be addressed. 2) Address the staff and congratulate them on meeting the objectives. 3) Plan a training seminar for new staff to review emergency response protocols. 4) Contact the public relations department to schedule interviews with key members of the senior staff.

Directly after an emergency or disaster, the nurse's priority is to schedule a quality improvement meeting with key members of the staff to evaluate efforts after the emergency or disaster.

Joe is an unemployed 30-year-old man who lives in an urban neighborhood. He has hypertension and type 2 diabetes, and his BMI is 32. He pays rent and other living expenses with disability income he receives from Medicare. Which would benefit him most? 1) The Home Delivered Meals program 2) A patient-centered medical home (PCMH) 3) A federally funded health clinic 4) A private home health aide

Due to Joe's numerous medical problems and limited income, he would benefit from a PCMH. It provides comprehensive physical and mental health care and includes personal physicians, advanced practice nurses, pharmacists, nutritionists, social workers, educators, and care coordinators.

A nurse is preparing a pamphlet about the dangers of mudslides for residents living in a small mountainous town. The nurse mentions that mudslides can occur after which of the following? 1) Wildfires 2) Tropical depressions 3) Epidemics 4) Waterspout tornadoes

Earthquakes, heavy rains, and wildfires are all associated with mudslides. They all can destabilize the soil or remove ground cover, which can cause rocks and debris to slide down a slope.

A nurse is working in a community clinic on the coast of Indonesia when a strong earthquake occurs. There is no damage to the clinic, and everyone is safe. What should the nurse do next? 1) Go outside and start treating victims who may have wandered into the street. 2) Open the clinic and prepare for incoming trauma victims. 3) Immediately start evacuating clients to higher ground. 4) Continue treating clients in the clinic as usual.

Earthquakes, particularly in the South Pacific region, are associated with tsunamis, huge waves that come on shore and can be very destructive. The coastline where the clinic is located is at risk for a tsunami event, so it is crucial to begin evacuating the clinic.

A primary care nurse who does not speak Spanish has noticed an increase in the number of patients who only speak Spanish. The nurse wants patients to understand how to manage their health. Which is the best option? 1) Provide educational materials written in Spanish. 2) Take a Spanish immersion class. 3) Smile and be friendly while assessing patients. 4) Ask the clinic manager to hire a translator.

Educational materials written in Spanish provide understandable health information patients can refer to at home.

A large EF-4 tornado has struck in a downtown area in the Midwest. The state has asked for assistance in dealing with the massive response needed. The public health nurse informs the staff that which government agency will take over the disaster response? 1) Federal Emergency Management Agency (FEMA) 2) American Red Cross 3) Department of Homeland Security 4) National Incident Management System (NIMS)

FEMA, or the Federal Emergency Management Agency, is the lead agency that will assume responsibility for managing the disaster response.

A nurse working in a pediatric office notices an increase in the number of obese children. During a windshield assessment of the neighborhood, the nurse determines which of the following as a contributing factor? 1) Numerous fast food restaurants 2) Athletic sports facilities 3) A variety of grocery stores 4) Well-maintained parks and playgrounds

Fast food restaurants serve high-fat, high-calorie foods that have little nutritional value. Consumption of fast food contributes to obesity.

Jaime is a 70-year-old Latino male who speaks Spanish. He has type 2 diabetes, had a right below-the-knee amputation, and is dependent on his wheelchair for mobility. Jaime has two sons who live in different states; they visit two or three times a year. How might a primary care medical home (PCMH) benefit him? SELECT ALL THAT APPLY. 1) A Spanish-speaking care coordinator will discuss Jaime's needs with him. 2) A pharmacy will dispense his insulin and glucose testing strips. 3) A 24-hour telephone helpline will be available for health counseling. 4) A Spanish-speaking home health aide can visit him twice a week. 5) A Spanish-speaking social worker will provide behavioral health care.

Feedback 1: Answer 1 is correct. A PCMH provides comprehensive primary care that respects a patient's unique needs and culture. The Spanish-speaking care coordinator will meet Jaime's communication, cultural, and health-care needs.Feedback 2: Answer 2 is correct. Jaime will receive medication and supplies to manage his diabetes and prevent further complications.Feedback 3: Answer 3 is correct. The 24-hour telephone helpline for health counseling provides continuous access to care when he cannot leave his home.Feedback 4: Answer 4 is correct. A PCMH coordinates care across all elements of the broader health-care system, including home health care. A home health aide will assist Jaime with activities of daily living (ADLs) such as bathing and eating.Feedback 5: Answer 5 is correct. Comprehensive care includes mental health care. A social worker or therapist will work with Jaime to address feelings of isolation and loneliness and monitor for symptoms requiring psychiatric evaluation.

The nurse is a guest speaker during a health education class at the high school. The nurse explains the serious consequences of alcohol use. Which of the following does the nurse include?SELECT ALL THAT APPLY. 1) Death related to motor vehicle crashes 2) Alcohol poisoning 3) Drowning 4) Violence 5) Fetal alcohol syndrome

Feedback 1: Answer 1 is correct. Alcohol use is responsible for 29% of motor vehicle-related deaths.Feedback 2: Answer 2 is correct. Alcohol poisoning can occur after one episode of at-risk or heavy alcohol use.Feedback 3: Answer 3 is correct. Drowning can occur after one episode of at-risk or heavy alcohol use.Feedback 4: Answer 4 is correct. Alcohol use is associated with increased violence and emergency department use.Feedback 5: Answer 5 is correct. Fetal alcohol syndrome can occur with alcohol use during pregnancy.

The nurse recognizes that which statements indicate psychosocial consequences related to alcohol use?SELECT ALL THAT APPLY. 1) "I've been late to work three times this week." 2) "My wife has a restraining order against me." 3) "The doctor says I need a liver function test." 4) "If I get one more impaired driving citation, I'll lose my license." 5) "I've worked at the same company for 20 years."

Feedback 1: Answer 1 is correct. Arriving late to work is an employment problem, a psychosocial consequence of alcohol use.Feedback 2: Answer 2 is correct. The restraining order is a likely sign of domestic violence and represents family dysfunction, a psychosocial consequence of alcohol use.Feedback 3: Answer 3 is incorrect. The need for a liver function test is not a psychosocial consequence. Liver tests help diagnose liver diseases, which often occur with chronic alcohol use.Feedback 4: Answer 4 is correct. Risk of losing a driver's license is a legal problem, a psychosocial consequence of alcohol use.Feedback 5: Answer 5 is incorrect. Chronic unemployment is a psychosocial consequence of alcohol use.

A nurse working at a prenatal clinic is selecting patient educational materials. Which are most appropriate? SELECT ALL THAT APPLY. 1) Childhood vaccination schedules 2) Type 2 diabetes brochures 3) Information on signs of miscarriage 4) Information on RhoGAM 5) Information on Percocet side effects

Feedback 1: Answer 1 is correct. Childhood vaccination schedules are appropriate for prenatal clients.Feedback 2: Answer 2 is incorrect. Educational materials about type 2 diabetes are not appropriate for prenatal clients. They should be educated about gestational diabetes.Feedback 3: Answer 3 is correct. Educational materials about signs of miscarriage are appropriate for prenatal clients.Feedback 4: Answer 4 is correct. Educational materials about RhoGAM are appropriate for prenatal clients. RhoGAM is given to pregnant women whose blood type is Rh-negative. The injection contains antibodies that prevent the baby's Rh-positive blood cells from triggering an immune response in the mother.Feedback 5: Answer 5 is incorrect. Educational materials about Percocet are not appropriate for prenatal clients. Percocet is a narcotic analgesic. Effects of narcotics on the fetus are not well understood.

According to the Centers for Disease Control and Prevention (CDC), which of the following are among the five leading causes of death in the United States?SELECT ALL THAT APPLY. 1) Chronic lower respiratory disease 2) Heart disease 3) Accidents 4) Alzheimer disease 5) Diabetes

Feedback 1: Answer 1 is correct. Chronic lower respiratory disease is among the five leading causes of death in the United States; the others are heart disease, cancer, stroke, and accidents.Feedback 2: Answer 2 is correct. Heart disease is among the five leading causes of death in the United States; the others are cancer, chronic lower respiratory disease, stroke, and accidents.Feedback 3: Answer 3 is correct. Accidents are among the five leading causes of death in the United States; the others are heart disease, cancer, chronic lower respiratory disease, and stroke.Feedback 4: Answer 4 is incorrect. Alzheimer disease is not among the five leading causes of death in the United States.Feedback 5: Answer 5 is incorrect. Diabetes is not among the five leading causes of death in the United States.

A nurse is working with a local television station to create a public service announcement to educate the public about the dangers of heat stroke. The nurse includes which of the following suggestions for preventing heat stroke? SELECT ALL THAT APPLY. 1) Stay inside in an air-conditioned room, if possible. 2) Limit activity during the heatwave. 3) Drink extra water throughout the day. 4) Wear dark clothing to reflect light and heat. 5) Seek prompt medical attention if you start feeling weak, dizzy, or fatigued.

Feedback 1: Answer 1 is correct. During extreme heatwaves, it is important to stay inside and in an air-conditioned room if possible. Limit activity, especially during the hottest part of the day.Feedback 2: Answer 2 is correct. During extreme heatwaves, it is important to stay inside and in an air-conditioned room if possible. Limit activity, especially during the hottest part of the day.Feedback 3: Answer 3 is correct. Heat exhaustion and heat stroke are often complicated by dehydration. It is important to drink a lot of water or electrolyte replacement fluids to prevent dehydration.Feedback 4: Answer 4 is incorrect. During heatwaves, it is important to wear lightweight, loose-fitting, light-colored cotton clothing because it reflects heat. Dark clothing absorbs heat from the sun.Feedback 5: Answer 5 is correct. It is important to seek prompt medical attention if you or someone you are with starts to experience signs of heat stroke or heat exhaustion. Symptoms include fatigue, dizziness, loss of consciousness, and confusion.

Which of the following reduces or prevents transmission of infectious agents? SELECT ALL THAT APPLY. 1) Hand washing 2) Vaccines 3) Pasteurization 4) Refrigeration 5) Surveillance

Feedback 1: Answer 1 is correct. Hand washing prevents disease transmission by removal of infectious agents from hands, thereby decreasing person-to-person contact. Feedback 2: Answer 2 is correct. Vaccines increase host resistance by creating passive immunity. It protects a person from acquiring a disease, which helps break the cycle of transmission and controls the spread of a disease. Feedback 3: Answer 3 is correct. Pasteurization uses heat (physical agent) to inactivate infectious agents. Feedback 4: Answer 4 is correct. Refrigeration uses cold (physical agent) to inactivate infectious agents. Feedback 5: Answer 5 is incorrect. Surveillance is an epidemiological technique for monitoring disease trends in the community.

A patient is prescribed an opioid after surgery. The nurse knows that opioid addiction is a serious problem in the United States. Which of the following statements are true? SELECT ALL THAT APPLY. 1) Every day, more than 90 Americans die from an opioid overdose. 2) Addiction is hereditary. 3) In primary care, it is important to screen appropriately, prescribe appropriately and help patients recognize potential problems. 4) It is necessary to note any increases in medication requests or unscheduled refills.

Feedback 1: Answer 1 is correct. It is a fact that every day, more than 90 Americans die from an opioid overdose.Feedback 2: Answer 2 is incorrect. Addiction is not hereditary.Feedback 3: Answer 3 is correct. To reduce risk of opioid abuse, it is important for the nurse to screen appropriately, prescribe appropriately, and help patients recognize potential problems related to opioid use.Feedback 4: Answer 4 is correct. Multiple requests for medication refills could indicate an opioid addiction

The nurse is educating parents and teachers about signs of psychoactive drug use. What are the nurse's teaching points? SELECT ALL THAT APPLY. 1) Euphoric mood 2) Very rapid heart rate 3) Decreased need for sleep 4) Improved decisionmaking 5) Enhanced memory

Feedback 1: Answer 1 is correct. Narcotics (e.g., codeine combined with acetaminophen), opiates (e.g., morphine, hydromorphone, heroin), inhalants (e.g., propellants in aerosol cans), and cannabinoids induce euphoria.Feedback 2: Answer 2 is correct. Stimulants (e.g., amphetamines, methylphenidate, cocaine, caffeine) cause tachycardia.Feedback 3: Answer 3 is correct. Stimulants (e.g., amphetamines, methylphenidate, cocaine, caffeine) cause difficulty sleeping.Feedback 4: Answer 4 is incorrect. Cannabinoids (marijuana) impair decisionmaking.Feedback 5: Answer 5 is incorrect. Depressants and cannabinoids cause memory impairment.

The school nurse is assessing a student who reported shortness of breath during physical education class. The nurse's assessment follows: temperature 98.2 °F, blood pressure 102/64 mm Hg, heart rate 88, respirations 20 and shallow. Lung sounds are diminished with expiratory wheezes in the lower right base. Body mass index (BMI) is above normal limits. Additional information from the student database includes the following: Lives in apartment with mother and two siblings; family pays reduced tuition and fees; no health-care provider identified. Student has missed approximately 10% of the days school has been in session. Which factors indicate the student may be at risk for premature death? SELECT ALL THAT APPLY. 1) BMI 2) Lack of immunizations 3) Poor asthma management 4) Economic disparity 5) Tobacco use

Feedback 1: Answer 1 is correct. Obesity is a risk factor for premature death related to heart disease and diabetes.Feedback 2: Answer 2 is incorrect. There is no information indicating the student has not been immunized.Feedback 3: Answer 3 is correct. The assessment indicates the student is experiencing shortness of breath related to asthma. Excessive school absences and lack of a health-care provider indicate poor asthma control.Feedback 4: Answer 4 is correct. The family pays reduced tuition and fees, indicating a possible economic disparity.Feedback 5: Answer 5 is incorrect. There is no information indicating the student uses tobacco.

Which actions should the nurse take in the preparedness phase of disaster management? SELECT ALL THAT APPLY. 1) Perform tabletop exercises. 2) Monitor medical health status of survivors. 3) Establish disease surveillance. 4) Identify educational needs of all nurses. 5) Participate in community risk assessment.

Feedback 1: Answer 1 is correct. Performing tabletop exercises is an action in the preparedness phase.Feedback 2: Answer 2 is incorrect. Monitoring medical health status of survivors is in the recovery phase.Feedback 3: Answer 3 is incorrect. Establishing disease surveillance is performed in the response and mitigation phases.Feedback 4: Answer 4 is correct. Identifying educational needs of all nurses occurs in the preparedness phase.Feedback 5: Answer 5 is correct. Participating in community risk assessment is performed in the preparedness phase.

The World Health Organization has developed policy strategies to minimize the harms associated with alcohol misuse. In the U.S., alcohol policies focus on five main areas. Which of the following are among those five main areas?SELECT ALL THAT APPLY. 1) Regulation of the physical availability of alcohol (e.g., minimum age; restrictions on sites that sell it) 2) Altering the drinking context (e.g., serving intoxicated clients) 3) Developing policies related to treatment and early intervention 4) Only allowing hard alcohol promotion on certain television channels after 5 p.m.

Feedback 1: Answer 1 is correct. Regulation of the physical availability of alcohol (e.g., minimum age; restrictions on sites) is one of the focus areas.Feedback 2: Answer 2 is correct. Altering the drinking context (e.g., serving intoxicated clients) is one of the focus areas.Feedback 3: Answer 3 is correct. Developing policies related to treatment and early intervention is one of the focus areas.Feedback 4: Answer 4 is incorrect. Only allowing hard alcohol promotion on certain television channels after 5 p.m. is not one of the focus areas.

Every year, diarrheal disease is a leading cause of death among children younger than 5 years of age. Which of the following actions would significantly reduce the incidence of diarrheal disease?SELECT ALL THAT APPLY. 1) Safe drinking water 2) Hand hygiene/hand washing 3) Immunizations 4) Oral rehydration 5) Antidiarrheal medication

Feedback 1: Answer 1 is correct. Safe drinking water and efficient sanitation significantly reduce the incidence of diarrheal disease. Feedback 2: Answer 2 is correct. Good hand hygiene, especially hand washing with soap, can reduce the incidence of diarrheal disease by as much as 48%. Feedback 3: Answer 3 is incorrect. The rotavirus vaccine has decreased the incidence of rotavirus infections. Feedback 4: Answer 4 is incorrect. Oral rehydration is used to treat dehydration resulting from diarrheal disease. Feedback 5: Answer 5 is incorrect. Antidiarrheal medication is used to treat diarrhea and does not reduce the incidence of disease.

Which activities are the four most common risk factors for noncommunicable disease in the United States? SELECT ALL THAT APPLY. 1) Smoking a pack of cigarettes daily 2) Binge drinking two days a month 3) Having a parent with diabetes 4) Eating high-fat, high-sugar foods 5) Having a sedentary lifestyle

Feedback 1: Answer 1 is correct. The four common risk factors are nutrition, physical activity, tobacco use, and alcohol use. Smoking constitutes tobacco use.Feedback 2: Answer 2 is correct. Alcohol use is one of the four common risk factors.Feedback 3: Answer 3 is incorrect. Having a parent with diabetes is not one of the four most common risk factors. Family history is a nonmodifiable risk factor for some noncommunicable diseases.Feedback 4: Answer 4 is correct. Nutrition is one of the four common risk factors. A high-fat, high-sugar diet is one of the common risk factors.Feedback 5: Answer 5 is correct. Lack of physical activity is one of the four common risk factors. Increasing physical activity reduces the risk of developing a noncommunicable disease.

According to Healthy People 2020, which of the following communicable diseases are targeted for elimination through vaccination? SELECT ALL THAT APPLY. 1) Congenital rubella syndrome 2) Tuberculosis 3) Hepatitis C 4) Hepatitis B 5) Acute paralytic poliomyelitis

Feedback 1: Answer 1 is correct. The four communicable diseases targeted for elimination through vaccination are congenital rubella syndrome, rubella, hepatitis B, and acute paralytic poliomyelitis. Feedback 2: Answer 2 is incorrect. Tuberculosis is not one of the four communicable diseases targeted for elimination through vaccination. Feedback 3: Answer 3 is incorrect. Hepatitis B, not hepatitis C, is one of the four communicable diseases targeted for elimination through vaccination. Feedback 4: Answer 4 is correct. This is one of the four communicable diseases targeted for elimination through vaccination. Feedback 5: Answer 5 is correct. This is one of the four communicable diseases targeted for elimination through vaccination.

A public health nurse (PHN) working at the community health clinic is developing a health education program about HIV. Which interventions should the nurse include? SELECT ALL THAT APPLY. 1) Distribute free condoms at the clinic. 2) Perform free monthly HIV screenings. 3) Distribute brochures about sexually transmitted infections (STIs) at the local college. 4) Establish a clean needle exchange program. 5) Teach abstinence-only sex education classes at the high school.

Feedback 1: Answer 1 is correct. The goal of primary prevention is to keep a person free of disease. A free condom distribution program reduces the risk of acquiring HIV.Feedback 2: Answer 2 is correct. The goal of secondary prevention is early detection and treatment of disease. Free monthly HIV screenings detect the virus early so treatment can be initiated.Feedback 3: Answer 3 is correct. Distributing brochures about STIs is primary prevention that targets a population at high risk for STIs and HIV. The Centers for Disease Control and Prevention (CDC) reported that one in four people with HIV are between the ages of 13 and 24. Individuals with STIs are two to five times more likely to acquire HIV.Feedback 4: Answer 4 is correct. The goal of primary prevention is to keep a person free of disease. A clean needle exchange program decreases the risk of acquiring HIV.Feedback 5: Answer 5 is incorrect. The American Academy of Pediatrics reported sex education programs that teach abstinence only are more likely to result in adolescents' having unprotected sexual intercourse, which increases their risk for STIs, including HIV/AIDS.

The public health nurse plans to educate the community about incidence rates of different cancers. Which of the following cancers are increasing in the United States?SELECT ALL THAT APPLY. 1) Pancreas 2) Breast 3) Liver 4) Esophagus 5) Melanoma of the skin

Feedback 1: Answer 1 is correct. The incidence rate for pancreatic cancer is increasing.Feedback 2: Answer 2 is incorrect. The incidence rate for breast cancer is not increasing.Feedback 3: Answer 3 is correct. The incidence rate for liver cancer is increasing.Feedback 4: Answer 4 is correct. The incidence rate for cancer of the esophagus is increasing.Feedback 5: Answer 5 is correct. The incidence rate for melanoma of the skin is increasing.

Following a recent outbreak of shingles, a primary care nurse decides to educate people about the benefits of getting the shingles vaccine. Who is most in need of education? SELECT ALL THAT APPLY. 1) A 65-year-old retiree 2) A mother with HIV 3) A carpenter 4) A 10-year-old who never had chicken pox 5) A sexually active college student

Feedback 1: Answer 1 is correct. The shingles vaccine is recommended for people over the age of 50.Feedback 2: Answer 2 is correct. The nurse should educate the mother with HIV. People with HIV/AIDS have compromised immune systems and are more likely to develop shingles.Feedback 3: Answer 3 is incorrect. A carpenter is not at highest risk for shingles. The nurse can educate the carpenter after those at highest risk have been educated.Feedback 4: Answer 4 is incorrect. A 10-year-old boy is not at risk for shingles.Feedback 5: Answer 5 is incorrect. Sexual activity is not a risk factor for shingles.

UNICEF launched a global strategy for children's, adolescents', and women's health in 2016 through 2030. It aims to transform societies so that women, children, and adolescents everywhere can reach the highest attainable standards of health and well-being. What are the objectives of this strategy? SELECT ALL THAT APPLY. 1) Transform: Expand enabling environments 2) Achieve: Obtain universal no-cost health care 3) Survive: End preventable deaths 4) Thrive: Ensure health and well-being 5) End: Eradicate hunger and poverty

Feedback 1: Answer 1 is correct. The three overarching objectives of the updated Global Strategy are Survive, Thrive, and Transform. Following its full implementation, no woman, child, or adolescent should face a greater risk of preventable death because of where they live or who they are.Feedback 2: Answer 2 is incorrect. Obtaining universal, no-cost health care is not one of the objectives.Feedback 3: Answer 3 is correct. The three overarching objectives of the updated Global Strategy are Survive, Thrive, and Transform. Following its full implementation, no woman, child, or adolescent should face a greater risk of preventable death because of where they live or who they are.Feedback 4: Answer 4 is correct. The three overarching objectives of the updated Global Strategy are Survive, Thrive, and Transform. Following its full implementation, no woman, child, or adolescent should face a greater risk of preventable death because of where they live or who they are.Feedback 5: Answer 5 is incorrect. Eradicating hunger and poverty is not one of the objectives.

The nurse teaches community health nursing students about the evolution of tobacco use in the United States. Key content includes which of the following? SELECT ALL THAT APPLY. 1) Tobacco use significantly increased from 1934 to 1945. 2) The Fair Trade Act of 1949 increased availability of tobacco products. 3) Tobacco use has declined since the release of the first Surgeon General's Report on Smoking and Health. 4) The WHO Report on the Global Health Epidemic 2017 uses the acronym MPOWER to lay out policy steps to reduce tobacco use. 5) Scientists discovered the association between tobacco use and cancer.

Feedback 1: Answer 1 is correct. Tobacco use increased approximately 300% from 1934 to 1945.Feedback 2: Answer 2 is incorrect. The Fair Trade Act of 1949 provided free and equal advertising time to anti-smoking initiatives and the cigarette industry. The effort is associated with decreased tobacco use.Feedback 3: Answer 3 is correct. Cigarette consumption has declined consistently since the first Surgeon General's Report on Smoking and Health.Feedback 4: Answer 4 is correct. The WHO Report on the Global Health Epidemic 2017 uses the acronym MPOWER to lay out policy steps to reduce tobacco use and includes interventions at the individual and population levels.Feedback 5: Answer 5 is correct. Cigarette consumption dropped in the mid-1950s, when the first evidence was found of the association between cigarette smoking and cancer.

The nurse is teaching a group of pregnant adolescents who have substance use disorders. Which of the following are possible adverse maternal and newborn outcomes for this group? SELECT ALL THAT APPLY. 1) High birth weight 2) Premature labor 3) Withdrawal 4) Bone defects 5) Chlamydia

Feedback 1: Answer 1 is incorrect. High birth weight is not an adverse outcome. Newborns exposed to certain drugs and alcohol while in the womb are more likely to have low birth weight.Feedback 2: Answer 2 is correct. Premature labor is an adverse outcome for both the mother and the newborn.Feedback 3: Answer 3 is correct. Withdrawal is an adverse outcome for a newborn exposed to drugs and alcohol while in the womb.Feedback 4: Answer 4 is correct. Birth defects such as bone defects are adverse newborn outcomes.Feedback 5: Answer 5 is correct. Chlamydia is an adverse maternal outcome. Pregnant adolescents have a higher risk of STIs including chlamydia.

A major plane crash has occurred in a very populated part of town. During the response, a highly respected nurse is designated to be the spokesperson for risk communications to the public. Which techniques should the nurse use? SELECT ALL THAT APPLY. 1) Be honest and closed. 2) Portray dedication and commitment to the population. 3) Meet the needs of the media. 4) Demonstrate competence and expertise. 5) Increase mental noise for the public.

Feedback 1: Answer 1 is incorrect. Risk communications are used to maintain trust among the population and should be honest and open, not closed.Feedback 2: Answer 2 is correct. Risk communications must portray dedication and commitment to the population to maintain trust.Feedback 3: Answer 3 is correct. One of the seven rules of risk communications is meeting the needs of the media.Feedback 4: Answer 4 is correct. Risk communications are used to maintain trust among the population and should demonstrate competence and expertise.Feedback 5: Answer 5 is incorrect. One of the goals of risk communications is to decrease the mental noise associated with a disaster event.

It is critical for the public health nurse to understand characteristics of infectious agents and the cycle of transmission. Which of the following would be considered characteristics of an infectious agent? SELECT ALL THAT APPLY. 1) Specificity 2) Pathogenicity 3) Infectivity 4) Communicability 5) Virulence

Feedback 1: Answer 1 is incorrect. Specificity is not a characteristic of infectious agents. Feedback 2: Answer 2 is correct. Pathogenicity is the capacity of an agent to cause disease in the human host. Feedback 3: Answer 3 is correct. Infectivity is the capacity of an agent to enter and multiply in the host. Feedback 4: Answer 4 is incorrect. Communicability refers to disease transmission. Feedback 5: Answer 5 is correct. Virulence is the ability of a pathogen to cause disease.

A nurse working in an emergency room receives word that several firefighters who were fighting a wildfire nearby will be arriving at the emergency room for care. What should the nurse be prepared to treat? 1) Respiratory distress and burn injuries 2) Traumatic injury 3) Hemorrhage 4) Brain injury

Firefighters and others close to a wildfire are significantly more likely to suffer from exacerbation of asthma or respiratory illness or severe respiratory distress as a result of smoke and debris inhalation.

A nurse is working with lobbyists to fight for increased spending to train health-care providers to detect and manage bioterrorism events. The nurse explains that it is especially important to increase funding at what level for the policy to be most effective? 1) Local 2) State 3) Federal 4) Global

Health-care workers in the local community most likely will be the first people to diagnose, treat, and evaluate cases related to bioterrorism. It is especially important to make sure that they are appropriately trained to detect and manage an attack.

A large tanker truck overturns on a busy highway and the driver is killed. An unknown liquid substance is covering the roadway. How should first responders initially handle the spill? 1) Evacuate the surrounding area. 2) Find the placard that contains the numerical code. 3) Notify the Hazardous Materials unit of the fire department. 4) Wait to respond to the scene until cleared by the police department.

Immediate priorities are to identify the substance and evacuate the immediate area. A plaque containing a numerical code that identifies the chemical or hazardous material being transported is required by the U.S. Department of Transportation. It allows emergency responders to identify the substance in question.

Which type of physician would a client with a foot wound have gone to in 1942? 1) Podiatrist 2) General practitioner 3) Infectious disease specialist 4) Dermatologist

In 1942, a patient with a foot wound would have gone to a general practitioner. Before the end of World War II (1945), general practitioners provided health care from birth to death.

Which correctly defines the term "epidemic" in the 21stcentury? 1) The description of diseases based on their characteristics. 2) A significant increase in the number of cases of a disease. 3) The number of epidemics occurring across the globe. 4) The increased occurrence of a single disease occurring within a population.

In the 21st century, the term epidemic refers to a significant increase in the number of cases of a disease.

An instructor asks a nursing student what the term primary health care means in the United States and the global community. The student is correct when he states which of the following? 1) "In the United States and the global community, primary health care refers to the level of care provided to individuals, families, and populations." 2) "In the United States, primary health care refers to the level of care provided to populations, and in the global community, it refers to the level of care provided to individuals and families." 3) "In the United States, primary health care refers to the level of care provided to individuals and families, and in the global community, it refers to the level of care provided to populations." 4) "In the United States, primary health care refers to the level of care provided to individuals, and in the global community, it refers to the level of care provided to families."

In the United States, primary health care refers to the level of care provided to individuals and families, and in the global community, it refers to the level of care provided to populations.

A public health nurse determines that the current tuberculosis outbreak began when a resident of the homeless shelter was admitted to the hospital. What term is used to refer to the first case identified in a disease outbreak? 1) Transmitting case 2) Secondary case 3) Index case 4) Source point

Index case is the term that refers to the first case identified in a particular disease outbreak.

It is important for nurses to be particularly aware of times of the year when the incidence of specific communicable illnesses is more prevalent. Which illness has a higher mortality rate among multiple vulnerable populations? 1) Pneumonia 2) Influenza 3) Rotavirus 4) H1N1

Influenza The incidence of influenza is highest during December and January. There is a high mortality rate among children and the elderly; both are vulnerable populations.

A tornado hits a preschool and grade school in a small community. A nurse is one of the first responders at the scene. Which gold standard should the nurse use for pediatric triage? 1) Healthy People 2020 2) Functional Needs Support Services 3) JumpSTART 4) Model Act

JumpSTART is recognized as the gold standard for pediatric triage during disasters.

Nurses at the community hospital recently implemented a screening program for alcohol use disorders. Due to the increasing incidence of opioid-related deaths in the community, the nurses want to begin screening for psychoactive drug use. What is the appropriate screening instrument for drug use? 1) Clinical Institute Narcotic Assessment (CINA) 2) National Institute on Drug Abuse (NIDA) ASSIST 3) Subjective Opiate Withdrawal Scale (SOWS) 4) Screening, Brief Intervention, and Referral to Treatment (SBIRT)

National Institute on Drug Abuse NIDA ASSIST is the appropriate screening instrument. ASSIST screens for different types of drug use. The clinician's guide provides interventions, pharmacological approaches, and behavioral therapies.

The public health nurse wants to increase cancer awareness in the community. Which type of cancer is the leading cause of death in men and women? 1) Breast 2) Prostate 3) Lung 4) Colon

Lung cancer is the leading cause of cancer death among men and women in the United States.

Which of the following statements made by a client regarding malaria prevention indicates to the nurse that further education is required? 1) "Malaria is preventable." 2) "Malaria is transmitted through the bite of an infected mosquito." 3) "Insect repellent will prevent transmission of malaria even if I am bitten by an infected mosquito." 4) "A sleep net will reduce mosquito bites but does not prevent transmission of disease following a bite by an infected mosquito."Malaria is a protozoan infection transmitted through a mosquito bite. Insect repellant may reduce the likelihood of being bitten by a mosquito but will not prevent disease transmission.

Malaria is a protozoan infection transmitted through a mosquito bite. Insect repellant may reduce the likelihood of being bitten by a mosquito but will not prevent disease transmission.

The nurse knows the best public health approach to noncommunicable chronic diseases (NCDs) is: 1) Long-term management 2) Medication management 3) Vaccination 4) Primary health care

NCDs require long-term management. They cannot be prevented or cured through medication or vaccination

Which of the following explains challenges to advancing researchers' knowledge about genes and disease? 1) Chronic diseases are monogenetic and linked to a single gene mutation. 2) Slow environmental changes do not compensate for rapid genetic changes. 3) Genetic interventions are more likely to be effective in older individuals. 4) Chronic diseases are polygenetic and have multifactorial causes.

Noncommunicable and chronic diseases are polygenetic and have multifactorial causes. Multiple genes act together to cause disease.

Which of the following is the leading cause of death and disability in the United States? 1) Noncommunicable diseases 2) Chronic illnesses 3) Communicable diseases 4) Untreated illnesses

Noncommunicable diseases (NCDs) are the number one cause of death and disability in the United States. One-fourth of persons with NCDs in the United States have one or more limitations on their daily activities.

The nurse knows at least 80% of lung cancer deaths are directly related to tobacco smoking. What is the best population-level behavioral intervention? 1) Provide individual counseling sessions for smokers. 2) Increase taxes on tobacco products. 3) Offer community-based smoking cessation programs. 4) Enforce laws prohibiting indoor smoking.

Offering community-based smoking cessation programs is the best population-level behavioral intervention.

The nurse determined that a common cause of hospitalization among clients with excessive alcohol use is 1) Pancreatitis 2) Peripheral neuropathy 3) Appendicitis 4) Diabetes

Pancreatitis is a common cause of hospitalization among clients with excessive alcohol use.

The nurse is teaching a community group how to improve their health. Which intervention represents primary prevention? 1) Annual mammograms 2) Blood pressure screening 3) Diabetes management 4) MyPlate demonstration

Primary intervention focuses on preventing disease. A MyPlate demonstration is an example of primary prevention. MyPlate illustrates food groups that make up a healthy diet and help people develop better eating habits.

A nurse works at a health-care center in a community where there is a high prevalence of type 2 diabetes among Latinos. Which is the best primary prevention intervention? 1) Talk with school officials about keeping the physical education program. 2) Recommend all community members have an HbA1c blood test. 3) Teach residents with type 2 diabetes to inspect their feet every day. 4) Encourage patients with a BMI > 30 to start a weight loss program.

Primary prevention involves population-level interventions designed to prevent a person from developing a disease. Physical education programs provide the school-aged population with physical activity to reduce obesity, a known risk factor for type 2 diabetes.

A community health nursing student is preparing a presentation about primary prevention. Which examples of primary prevention should the student include? 1) Planning an immunization clinic 2) Conducting cholesterol screening 3) Locating low-cost diabetic supplies 4) Performing Pap smears at a local clinic

Providing immunizations is an example of primary intervention, which focuses on preventing disease. Immunizations prevent the transmission of communicable diseases A pap smear is a form of screening

Leaders of a Haitian Baptist church are concerned about members of their congregation who cannot afford routine health-care services such as annual physicals. What is the best way to provide assistance? 1) Put signs up around the church encouraging members to have their blood pressure checked. 2) Contact the Susan J. Komen Foundation to request funding for breast cancer screening. 3) Recruit volunteer nurses from the community to perform monthly blood pressure screenings. 4) Hire an instructor from the park district to hold weekly exercise classes.

Recruiting volunteer nurses from the community provides health intervention services from providers who are familiar with the community.

Which is an example of a leading cause of death linked to communicable disease? 1) Multidrug-resistant tuberculosis 2) Hepatitis 3) Bacterial meningitis 4) Respiratory influenza

Respiratory influenza is the leading cause of death linked to communicable disease by country and income level.

A nurse is reviewing the disaster response plan for the community clinic. The plan describes preparedness, mitigation, response, and recovery procedures. The nurse knows, however, that one of the most important steps is missing. Which step should the nurse recommend adding to the disaster response plan? 1) Response evaluation 2) Epidemiology 3) Surge procedures 4) Assessment

Response evaluation It is extremely important to meet after an incident to discuss what procedures went well and which ones need revision. This allows officials to improve their disaster plan and address issues that developed during the response.

A nurse in an emergency department notes that several patients have shown up to their appointments smelling like alcohol over the past month. What screening tool does the Substance Abuse and Mental Health Services Administration (SAMHSA) recommend to help providers identify patients whose substance use might place them at risk? 1) Single Question Screening Tool 2) Consumption + CAGE 3) SBIRT 4) CRAFFT

SBIRT is a screening tool to help providers identify patients whose substance use might place them at risk. It stands for Screening, Brief Intervention, and Referral to Treatment. In addition to identifying those who may have an alcohol use disorder, it also helps the health-care provider identify people at risk for adverse consequences related to alcohol use.

A nurse is assessing a previously healthy patient and discovers that she has had unexplained weight loss with vomiting, headaches, and abdominal pain. The patient states that the symptoms started immediately following the tornado that ravaged her town and killed several members of her community. After ruling out medical conditions, the nurse suspects a diagnosis of what mental health disorder? 1) PTSD 2) Somatization 3) ASD 4) Depression

Somatization occurs to persons experiencing psychological stress without a physical problem to explain their symptoms. Survivors of disasters may develop a variety of somatic symptoms affecting their neurological, digestive, and immune systems. Symptoms may include abdominal pain, back pain, chest pain, diarrhea, headaches, impotence, and vomiting

A woman comes to the health clinic and tells the nurse she is scared because her neighbor has a bedbug infestation in her home. Which is the best response? 1) Advise her to call a professional exterminator. 2) Suggest she vacuum the mattresses and launder all bedding in hot water. 3) Tell the woman to apply insect repellent before she goes to bed. 4) Describe what bedbugs look like, where to find them, and how to eradicate them.

The best response is to educate the woman on how to identify and eradicate bedbugs.

The nurse recognizes that substance use negatively impacts individuals, families, and communities. Which of the following represents adverse effects at all three levels? 1) Risk for unintentional injury and suicide 2) Risk for adverse health outcomes 3) Risk for increased crime 4) Increased burden regarding costs of health care

Substance use increases risk for unintentional injury and suicide at all three levels.

A nurse is volunteering on an island where a strong earthquake occurred several days earlier. Most of the residents have been rescued or accounted for, but flooding is now the biggest problem as a result of broken infrastructure. Which action should the nurse take next? 1) Begin to make arrangements to return home. 2) Remain for a few more days until the situation stabilizes. 3) Establish surveillance programs to monitor for diarrheal diseases. 4) Enhance efforts to recruit volunteers.

Surveillance is needed to detect, monitor, and treat diarrheal diseases, which are known to rise significantly after severe flooding. Surveillance should continue until the rate of diarrheal diseases falls below baseline levels.

A client with diabetes has completed a routine appointment with her primary physician. The office nurse notices the client has prescriptions for metformin (Glucophage) and canagliflozin (Invokana). What is the nurse's next question? 1) "Would you like to schedule your 6-month visit now?" 2) "Can you afford the prescriptions?" 3) "Would you like me to write refills for your medications?" 4) "Call for an appointment when you have a concern."

Tertiary prevention minimizes risks associated with existing disease, which includes management of noncommunicable diseases. The client should schedule regular appointments with the health-care provider.

According to the Centers for Disease Control and Prevention (CDC), how should public health professionals use data from the Health-Related Quality of Life (HRQoL) program? 1) Understand factors that influence HRQoL 2) Evaluate population health outcomes 3) Establish evidence-based practice guidelines 4) Reduce morbidity and mortality

The CDC recommends that HRQoL should be used to evaluate population health outcomes. HRQoL is one of the main indicators for monitoring health in populations.

The nurse realizes which of the following represents primary prevention at the policy level? 1) Health-Related Quality of Life (HRQoL) screening 2) Public Health Action Plan to Prevent Heart Disease and Stroke 3) eHealth Behavior Program 4) Behavioral Risk Factor Surveillance System (BRFSS)

The Public Health Action Plan to Prevent Heart Disease and Stroke represents primary prevention at the policy level. It was developed to guide public health and interested health-care providers in creating primary prevention programs aimed at cardiovascular disease prevention.

What term is defined as "the overall impact of diseases and injuries at individual and societal levels or the economic costs of diseases"? 1) Burden of man 2) Burden of disease 3) Economic hardship 4) Chronic disease

The World Health Organization used the term burden of disease to describe the overall impact of diseases and injuries at individual and societal levels or the economic costs of diseases.

A first-grade student arrives at the school nurse's office complaining of stomach pain. The student tells the nurse she did not eat supper the night before, or breakfast today, because Mommy and her boyfriend did not come home until it was time to get ready for school. When the nurse asks the child where her mommy was, the child states, "She went to the place where she can have a beer." What is the nurse's interpretation? 1) The child's needs were neglected due to the mother's alcohol use. 2) The child's mother is buying alcohol instead of food. 3) The mother's boyfriend is abusing the mother and the child. 4) The mother is working as a bartender to pay for alcohol.

The assessment information supports the nurse's interpretation that the child's needs were neglected. Problem drinking can result in child abuse or neglect.

A nurse is caring for a client in the emergency room. The client survived a bomb explosion in a train station and has lost an arm as a result of being thrown by the blast wind. How should the nurse document this injury? 1) Primary 2) Secondary 3) Tertiary 4) Quaternary

The client had a traumatic amputation (loss of an arm), which is a tertiary injury. Tertiary injuries result from the victim being thrown by the blast wind. Fractures, amputations, and brain injuries are examples of tertiary injuries.

The nurse is reviewing a client's health history. When asked about smoking, the client states, "I smoke 1½ packs a day." What is the nurse's best response? 1) "How long have you been smoking 1½ packs a day?" 2) "I'll give you the number for the smoking cessation program." 3) "Have you ever tried to quit before?" 4) "How ready to quit do you think you are?"

The client is a current tobacco user; therefore, the nurse's next step is to determine whether he is ready to quit.

The nurse is counseling a client about risk of heart disease. Which statement indicates the need for further teaching? 1) "Walking three times a week is a good way to exercise." 2) "I think I'll learn to cook more chicken and vegetables." 3) "My weight doesn't matter if I exercise and eat better." 4) "It's a really good thing I quit smoking ten years ago."

The client needs further teaching. Overweight and obesity are modifiable risk factors that reduce risk for heart disease.

While reviewing the health history of a man with lower abdominal pain, the nurse notices the man's father died of colon cancer. Which is the priority assessment? 1) "Do you have a history of diabetes?" 2) "Have you ever had a colonoscopy?" 3) "Have you had any abdominal surgeries?" 4) "How many drinks do you have in a week?"

The man has two risk factors for colon cancer: gender and family history. He needs a colonoscopy to screen for colon cancer.

A client in isolation for tuberculosis asks the nurse why she is in a negative pressure room. What response by the nurse indicates understanding of TB isolation? 1) "Patients who have or are suspected of having tuberculosis require a negative pressure room so that air is ventilated to the outside." 2) "Patients who have or are suspected of having tuberculosis require a negative pressure room so that others are not exposed to the person's body fluids." 3) "Patients who have or are suspected of having tuberculosis require a negative pressure room to avoid person-to-person contact." 4) "Patients who have or are suspected of having tuberculosis require a negative pressure room to avoid exposure to feces."

The mode of transmission of tuberculosis is through the air. The bacteria causing tuberculosis (Mycobacterium tuberculosis) is an airborne agent. Patients who have or are suspected of having tuberculosis require a negative pressure room so that air from the room is ventilated to the outside

A client tells the nurse that he takes his blood pressure pills every other day because he has a fixed income and the prescription lasts longer this way. Which is the best response? 1) "You have to take the pills every day so you won't have a stroke." 2) "Let's complete an application for low-cost blood pressure medication." 3) "Can your son buy your medication for you every other month?" 4) "Ask your doctor to prescribe a medicine you can afford."

The nurse can best assist the client by providing referrals to community resources and guiding him through the application process. Many pharmaceutical companies supply free medication for patients who meet their guidelines. Also, local townships provide intermittent financial assistance.

The nurse is giving a presentation about binge drinking. Which population is the nurse most likely addressing? 1) College students 2) Parents 3) Middle school students 4) Teachers

The nurse is using the selective level of prevention to address college students, a group known to be at risk for developing alcohol use disorders. In 2017, the rate of binge drinking among young adults 18 to 25 years of age was 39%.

The client tells the nurse she has decided to quit smoking. What is the nurse's next action? 1) Ask the client if there is someone she can call when she has an urge to smoke. 2) Inform the client that most people gain weight when they quit smoking. 3) Assist the client in making an appointment with the smoking cessation counselor. 4) Help the client identify ways to stay motivated during the first few weeks.

The nurse's next action is to provide the appropriate tobacco dependence treatment by scheduling an appointment with the smoking cessation counselor.

The nurse is caring for a patient diagnosed with syphilis who is currently presenting with a temperature of 101.1°F, heart rate 88, respirations 16, blood pressure 116/76 mm Hg, generalized skin rash, and enlarged lymph nodes. Determine the patient's stage of syphilis. 1) Early stage 2) Primary stage 3) Secondary stage 4) Late stage

The patient is in the secondary stage, which is part of the acute phase. It is characterized by fever, skin rash, mucous membrane lesions, and swollen lymph nodes. Symptoms will resolve with or without treatment.

Which of the following belongs to the population with the highest prevalence of HIV and AIDS? 1) A 15-year-old Asian girl 2) A 27-year-old Puerto Rican male 3) A 70-year-old African-American woman 4) A 40-year-old male of Italian descent

The prevalence of HIV and AIDS is higher among 25- to 44-year-old African American and Hispanic men.

A nurse focuses on saving lives, providing first aid and care to injured victims during a hurricane. The nurse is in which phase of disaster management? 1) Response 2) Recovery 3) Mitigation 4) Preparedness

The response phase is the actual implementation of the disaster plan and includes a focus on on emergency relief: saving lives, providing first aid, and giving care and basic life requirements to victims.

The nurse is hosting a booth about alcohol use at a community health fair. After reading the display, a woman says, "I usually drink 4 to 5 glasses of wine in a week." The nurse determines the woman's classification of alcohol use is: 1) Abstinence 2) At-risk use 3) Moderate use 4) Harmful use

The woman's classification is moderate or low-risk use. This is defined as no more than one drink in a day (7 per week) for a woman and no more than two drinks in a day (14 per week) for a man

The family nurse practitioner (FNP) at the clinic notes an increase in the number of students newly diagnosed with asthma. After further investigation, the FNP learns the students attend the same school. What is the FNP's priority action? 1) Inform the principal there is a toxin in the school causing students' asthma. 2) Keep students with asthma from attending school until the environment is examined. 3) Request that parents obtain an order from a health-care provider for rescue inhalers. 4) Ask an environmental health specialist from the public health department to assess the school.

There may be an issue with the school building environment. The priority action is to have an environmental health specialist from the public health department assess the school to determine whether there is a health hazard.

A nurse is working in an emergency department when paramedics bring in a family who were stranded in their car on the side of the road during a blizzard. When the family members were found, they were confused and exhibited shallow breathing. The children are stumbling and drowsy. For which condition should the nurse be prepared to treat this family? 1) Hypothermia 2) Carbon monoxide poisoning 3) Dehydration 4) Frostbite

They are likely experiencing hypothermia. Signs include uncontrollable shivering, confusion, shallow respirations, stumbling, and drowsiness.

Which client represents the population most vulnerable to the adverse effects of tobacco use? 1) A 12-year-old male with one parent who smokes 2) A 17-year-old female with no family history of smoking 3) A 65-year-old male 4) A 34-year-old female

Those who are most vulnerable to the adverse effects of tobacco are children of smokers. Youth are also the most vulnerable population for initiation of tobacco use.

Which legal substance or combination of substances is the leading cause of preventable death globally and in the United States? 1) Opioids 2) Alcohol 3) Tobacco and alcohol 4) Opioids and alcohol

Tobacco and alcohol in combination are the leading cause of preventable death globally and in the U.S.

The public health nurse knows the single most preventable cause of morbidity and mortality in the United States is: 1) Poor nutrition 2) Lack of physical activity 3) Alcohol use 4) Tobacco use

Tobacco use is the single most preventable cause of morbidity and mortality.

One of the goals of Healthy People 2020 is to reduce risk of disease and economic burden associated with diabetes mellitus (DM). Which type of DM results from a combination of insulin resistance and insufficient insulin production? 1) Type 1 diabetes 2) Type 2 diabetes 3) Gestational diabetes 4) Childhood diabetes

Type 2 diabetes results from a combination of resistance to the action of insulin and insufficient insulin production.

Mary Mallon, known as Typhoid Mary, infected 25 people with typhus between 1900 and 1907 without showing symptoms of illness. What type of carrier was she? 1) Incubating 2) Inapparent 3) Convalescent 4) Chronic

Typhoid Mary was an inapparent carrier, someone who is infected but never develops the disease. This type of carrier continues to shed the pathogen while infected.

Under President Trump, the focus of the Office of National Drug Control Policy (ONDCP) has shifted focus in what way? 1) Increased criminal penalties for drug use and a "just say no" approach to prevention 2) Adoption of federal laws permitting medical and recreational use of marijuana 3) Increased access to treatment for substance users 4) Reduced criminal penalties for those who are not engaged in criminal activity related to the production, transportation, or distribution of marijuana

Under President Trump, ONDCP has shifted its focus back to a downstream approach by increasing criminal penalties for drug use and a "just say no" attitude to prevention.

The nurse plans to use a universal level of prevention for women regarding substance use during pregnancy. What is the nurse's rationale for choosing this level of prevention? 1) It addresses a subgroup at high risk for developing a substance use disorder. 2) It addresses psychosocial determinants of health. 3) It focuses on reducing adverse consequences of substance use. 4) It addresses a population regardless of identified risk.

Universal prevention was selected because it addresses an entire population regardless of identified risk.

A parent tells the clinic nurse he does not want his child to get chicken pox. The nurse counsels the parent that receiving the varicella vaccine will enable the child to have which type of immunity against the varicella virus? 1) Active immunity 2) Passive immunity 3) Disease immunity 4) Inherent resistance

Vaccination is one form of passive immunity, which develops when the immune system is stimulated to produce antibodies when a synthetic or weakened version of an agent is injected. The varicella vaccine is a weakened form of the varicella virus.

A nurse is volunteering with a nongovernmental organization (NGO) to provide disaster relief to a small community in Haiti after a major earthquake. What is the most important step in preparing for her assignment? 1) Pack a bag and plan on being out of the country for at least 2 weeks. 2) Pack favorite nonperishable food items to hand out to people. 3) Pack antidiarrheal medications because diarrhea is a common problem affecting people after any natural disaster. 4) Start reviewing available cultural information on the people of Haiti.

When a disaster occurs, the immediacy of the situation can result in nongovernmental organizations (NGOs) rushing to provide assistance without taking into account the culture of the people in distress. The absence of ritual can add to the stress of the survivors in the short and long term. It is important to understand a number of key cultural issues including: 1) linguistic affiliation, especially in countries where the population speaks more than one language, 2) social stratification and presence of a formal or informal class system, 3) gender roles, 4) marriage, kinship, and family, 5) religious beliefs, and 6) etiquette.

An immunocompromised female patient is unable to get a flu shot. What action can the nurse recommend the patient take to decrease her chances of getting the flu? 1) Avoid public places during the summer months. 2) Avoid going outside in cold weather. 3) Wash hands often with soap and water for 15 seconds. 4) Have the patient's family members get the flu shot.

Widespread administration of the flu vaccine promotes herd immunity. This means that if a significant proportion of a population is vaccinated (the herd) it provides a measure of protection for individuals who are not able to receive the vaccine. If the client's family is protected, she will be protected because she has less of a chance of exposure.

The community health nurse knows women represent a vulnerable population due to which of the following factors? 1) Access to care 2) Child-rearing responsibilities 3) Food security 4) Education

Women represent a vulnerable population because of child-rearing responsibilities.