exam 3

A nurse is establishing health promotion goal for a female client who smokes cigarettes, has hypertension, and has a BMI of 26. Which of the following goals should the nurse include? A. The client will list foods that are high in Calcium, which should be avoided B. The client will walk for 30 min 5 days a week. C. The client will increase calorie intake by 200 cal per day D. The client will replace cigarettes with smokeless tobacco products.

B. The client will walk for 30 min 5 days a week.

A community health nurse is conducting an educational program on various environmental pollutants. The nurse should emphasize that clients who have which of the following disorders are especially vulnerable to ozone effects? A. Osteoarthritis B. Basal cell carcinoma C. Asthma D. Hypothyroidism

C. Asthma

A nurse is appraising health risks. Which of the following questions would most likely be asked by the nurse? a. "Does your 4-year-old have a booster seat in the car?" b. "Have you noticed any physical problems as you go about your daily routine?" c. "What concerns do you have today?" d. "Why did you decide to come in for a checkup?"

a. "Does your 4-year-old have a booster seat in the car?"

A nurse is reviewing information about the Health Insurance Portability and Accountability Act (HIPAA) with a newly licensed nurse. Which of the following statements by the newly licensed nurse indicates a need for further teaching? a. "Information about a client can be disclosed to family members at any time." b. "A client's address would be an example of personally identifiable information." c. "HIPAA established regulations of individually identifiable health information in verbal, electronic, or written form." d. "HIPAA is a federal law, not a state law."

a. "Information about a client can be disclosed to family members at any time."

Which of the following statements, made by a caregiver of an older client, should alert the nurse to assess for evidence of elder abuse? a. "Mom is always into something and can't seem to stay still, so I've been giving her half a Valium to get her to relax so I can get some rest." b. "Mom wanted to stay at her home, but we were scared for her safety, so we moved some of her personal things into our home and brought her to live with us." c. "She has not been having incontinence problems since we have been taking her to the toilet every 2 to 3 hours when she is awake." d. "We have to feed Mom baby food now because she has trouble chewing and swallowing regular food."

a. "Mom is always into something and can't seem to stay still, so I've been giving her half a Valium to get her to relax so I can get some rest."

Which of the following children is most at risk for being abused? a. A 1-year-old b. A 6-year-old c. A 9-year-old d. A teenager

a. A 1-year-old

A nurse is assisting with the teaching about breaches in nursing practice with the newly licensed nurse. Which of the following examples should the nurse include? a. A nurse smells alcohol on a colleague's breath who is on duty and keeps quiet about it. b. a nurse refuses to give out personal information over the phone to the friend of a client c. a nurse takes a 15 minute nap while on lunchbreak d. a medication that was scheduled to be given at 9 is documented at 9:15

a. A nurse smells alcohol on a colleague's breath who is on duty and keeps quiet about it.

A 13-year-old resident in a rural community has been diagnosed with asthma. Which of the following providers will most likely provide care to this client? a. Advanced nurse practitioner b. Allergist c. Pediatrician d. Pulmonologist

a. Advanced nurse practitioner

A nurse is concerned about stress related to the heavy caregiving burden assumed by adult children of older clients. Which of the following actions by the nurse demonstrates the use of secondary prevention to limit caregiver stress? a. Asking caregivers how they are doing and suggesting coping strategies b. Encouraging caregivers to periodically leave the house for a couple of hours c. Establishing support groups for caregivers of older parents d. Referring some activities to neighbors and friends

a. Asking caregivers how they are doing and suggesting coping strategies

A nurse is completing a tertiary prevention activity in a predominantly poor community, where eating clay (pica) is a common practice. Which of the following actions would the nurse most likely take? a. Assist those who eat large amounts of clay to obtain food stamps after explaining that clay, although filling, does not provide necessary nutrients. b. Initiate early intervention in the school system through education programs designed to focus on healthy food choices. c. Provide laboratory testing and physical assessments to assess for nutritional deficits resulting from clay intake. d. Survey families in the community to determine whether they eat clay and how much clay they eat.

a. Assist those who eat large amounts of clay to obtain food stamps after explaining that clay, although filling, does not provide necessary nutrients.

A nurse considers how the environment outside of the family influences the development of a child when planning care for a family. Which of the following theories is being used by the nurse? a. Bioecological systems theory b. Family systems approach c. Family developmental theory d. Family nursing theory

a. Bioecological systems theory

A nurse who is providing diabetes screening at a community clinic discovers that a new client has type 2 diabetes mellitus. The nurse provides counseling, refers the client to an endocrinologist for initial assessment and treatment, arranges for the client to see someone regarding financial assistance, contacts the mobile van to arrange transportation, and sets up a follow-up appointment. Which of the following types of service does these actions represent? a. Case management b. Client advocacy c. Holistic care d. Wrap-around services

a. Case management

Which of the following best explains why every client doesn't receive care from a case manager? a. Case management time is demanding; thus it is restricted to complex cases. b. Many health agencies do not employ case managers. c. Most clients would not benefit from case management. d. Most nurses do not know how to function as case managers.

a. Case management time is demanding; thus it is restricted to complex cases.

A new mother is a full-time college student who lives with her parents, because the baby's father has been imprisoned related to theft and drug abuse. The infant's grandmother, although also employed, cares for the child while the young mother attends classes. Which of the following theoretical frameworks would be most helpful to the nurse when assessing this family's needs? a. Developmental b. Family nursing c. Bioecological d. Systems

a. Developmental

A community health nurse would like to implement an intervention to increase lasting resilience among new immigrants. Which of the following actions should be taken by the nurse? a. Direct clients to English-as-second-language courses. b. Give immigrant clients money to help them get settled. c. Identify areas in the city where housing is less expensive. d. Solicit donations for food, clothing, and other needs.

a. Direct clients to English-as-second-language courses.

Which of the following statements best explains why family functions and structures create unique challenges in family nursing? a. Function and structure change over time. b. Function and structure do not apply to all family units. c. Some clients do not have families. d. Traditional families are rare in society.

a. Function and structure change over time.

1. Which of the following are the primary goals of case management? (Select all that apply.) a. To ensure that care coordination occurs across the continuum b. To emphasize evidence-based clinical decision-making c. To manage resource use and control expenses d. To stress the advantages and benefits of community-based care e. To reduce institutional care as a means of achieving wellness

a. To ensure that care coordination occurs across the continuum b. To emphasize evidence-based clinical decision-making c. To manage resource use and control expenses e. To reduce institutional care as a means of achieving wellness

A nurse is preparing to complete an occurrence report for a client who fell at the facility. Which of the following actions should the nurse take? a. Use objective terminology when documenting b. document completion of the report in the client's medical record c. omit the name of the individuals involved d. wait at least 12 hours to report the occurrence

a. Use objective terminology when documenting

A nurse was preparing for a home visit to a family where the mother had just been discharged from trauma care after being hit by a drunk driver. The nurse hoped the family was able to care for her. Which of the following comments from the husband would suggest an energized family? a. "I make most of the decisions so the kids don't notice much difference." b. "My daughter is pretty independent; she's active in both sports and theater." c. "My son is old enough to get a job and help pay all these medical bills." d. "My wife taught our daughter how to cook simple meals."

b. "My daughter is pretty independent; she's active in both sports and theater."

A student reports to the college health nurse that her academic work has been going downhill because of lack of sleep. "My 3-year-old probably misses her babysitter since she has started going to the big daycare center. She hasn't been sleeping well and keeps scratching her bottom. Hopefully, she'll adapt to daycare soon." Which of the following information should the nurse provide to the student? a. "Dry skin in winter weather can cause itchiness; try to put on lotion before bedtime." b. "Your daughter may have pinworms; let me teach you how to check for this." c. "Perhaps your child is not developmentally ready for group play." d. "Try to arrange more one-on-one time with your 3-year-old."

b. "Your daughter may have pinworms; let me teach you how to check for this."

Which of the following public health nurse applicants is the least qualified for a position of case manager in a rural county? a. A 24-year-old who has a master's degree in public health b. A 34-year-old who will be moving from a large city c. A 44-year-old who was born and raised in the community d. A 54-year-old who, until recently, was a member of the community's school board

b. A 34-year-old who will be moving from a large city

Which of the following bills would the nurse lobbyist, who believes strongly in social justice, encourage legislators to support? a. A bill that establishes policies requiring all persons to pay the same cost for services regardless of income b. A bill that promotes universal health insurance coverage c. A bill that requires all health care providers to give care to uninsured persons without charge d. A bill that requires health care workers to report undocumented immigrants who present for treatment

b. A bill that promotes universal health insurance coverage

The nurse is making a postpartum visit to a teenage mother and her month-old infant. Which of the following assessments would be most important? a. Assessing for mother's ability to fulfill her own growth and development tasks b. Assessing for mother's knowledge about normal infant growth and development c. Assessing how much the teenage mother's own mother is helping her cope with childcare d. Assessing whether the baby's father is being helpful to the mother

b. Assessing for mother's knowledge about normal infant growth and development

Which of the following best describes the use of genomic health care? a. Assists with understanding family relationships b. Assists with determining familial health risks c. Useful in learning about environmental risk factors d. Useful in detecting risk for developing cancer

b. Assists with determining familial health risks

Which of the following best describes why planning care for an individual is so challenging in today's health care system? a. Because today's clients have high expectations of the health care system b. Because multiple providers, payers, and settings have to be coordinated c. Because of the new high technology constantly being created and used for client treatment d. Because so many different health care providers are in the acute care setting today

b. Because multiple providers, payers, and settings have to be coordinated

A nurse is working with a family who is confronting major challenges to their health. Which of the following approaches would be most helpful for the nurse to use? a. Allowing the family to be noncompliant b. Building on the family's strengths and resilience c. Labeling the family as resistant d. Recognizing that the family is dysfunctional

b. Building on the family's strengths and resilience

2. A nurse is concerned about a teenage mother who does not seem to know how to play with an infant. Which of the following behaviors would the nurse want to role-model as good parenting behaviors? (Select all that apply.) a. Allow the baby to cry for 10 or 15 minutes before reacting so that the infant can learn to self-soothe. b. Cuddle the baby often. c. Teach the mother to keep her face about 4 or 5 inches from the baby and to gently blow on the infant's face. d. Sing to baby with different melodies until baby seems to listen and shows a preference for certain tunes. e. During the assessment, smile and gaze into the baby's eyes.

b. Cuddle the baby often. d. Sing to baby with different melodies until baby seems to listen and shows a preference for certain tunes. e. During the assessment, smile and gaze into the baby's eyes.

A nurse is working to ensure long-term positive health outcomes of poor pregnant teens and their children. Which of the following actions would the nurse most likely take? a. Assist teen mothers to learn about their body changes during pregnancy. b. Develop programs that allow teen mothers to complete their education. c. Offer courses in proper care of babies and how to be a parent. d. Monitor pregnant teens to detect early problems with pregnancy.

b. Develop programs that allow teen mothers to complete their education.

Which of the following factors must be considered before deciding on an appropriate plan of action? a. Family agrees to the nurse's plan. b. Family is capable of the required actions. c. Family will learn better coping skills from the nurse's plan. d. Nurse has informed family how to complete the required actions.

b. Family is capable of the required actions.

1. Which of the following is the primary cause of vulnerability to health problems? a. Breakdown of family structures b. Poverty c. Prejudice d. Social isolation

b. Poverty

A nurse offers homeless clients yearly tuberculosis (TB) screening and free treatment for those who test positive for TB. Which of the following levels of prevention is being used? a. Primary prevention b. Secondary prevention c. Tertiary prevention d. Secondary and tertiary prevention

b. Secondary prevention

A school health nurse is conducting drug screening to detect drug use by students before serious problems develop. Which of the following levels of prevention does this action represent? a. Primary prevention b. Secondary prevention c. Tertiary prevention d. Primary and secondary prevention

b. Secondary prevention

The hospital-based nurse has worked with a client at some length regarding appropriate diet. Based on the family systems theory, which of the following will most likely occur when the client returns home? a. The family member who prepares food will probably suggest the newly discharged member eat the meals everyone in the family enjoys. b. The family member who prepares food will probably try to modify family meals without obvious change for the family as a whole. c. The family member who prepares food will probably prepare meals based on the diet plan for all the family. d. The family member who prepares food will probably prepare special meals for the newly discharged member.

b. The family member who prepares food will probably try to modify family meals without obvious change for the family as a whole.

A nurse is completing a health risk appraisal with a client. Which of the following comments would cause the nurse to probe further to determine if the family is in crisis? a. "I can't visit my husband in the hospital when I'm at work all day. How can I be sure he's all right?" b. "My husband always handled our finances. Now that he's gone, I'll have to learn how to do this." c. "I don't know what to do now that my husband is dead. There is no way I can go back to work and also take care of our three children." d. "What am I supposed to do now that everything we own is gone? Are there any agencies that can help me?"

c. "I don't know what to do now that my husband is dead. There is no way I can go back to work and also take care of our three children."

Using the Neuman Systems Model, which of the following questions would the nurse ask a client to assess physiological health? a. "What helps you to cope with situations involving your wife's cancer?" b. "How has your child's illness affected the behavior of your other children?" c. "Tell me about any illnesses your other family members have." d. "Who do you turn to for support outside your immediate family?"

c. "Tell me about any illnesses your other family members have."

A client spends a great deal of time on the Internet or reading articles related to diabetes and its long-term effects. One day, the client asks why the nurse has not suggested a life care plan. Which of the following would be the best response by the nurse? a. "Life care plans are only for young persons who are newly diagnosed." b. "Life care plans are primarily used to determine long-term financial needs for legal reasons." c. "You are receiving appropriate care for your diabetes without serious side effects, so a life care plan isn't currently appropriate." d. "I was waiting for you to express interest in having a life care plan."

c. "You are receiving appropriate care for your diabetes without serious side effects, so a life care plan isn't currently appropriate."

Which of the following Medicaid clients would most likely receive case management? a. An elderly person b. A person receiving rehabilitation following an injury c. A person who has a high-cost chronic disease d. A person with acute illness

c. A person who has a high-cost chronic disease

A nurse asks a family member, "What has changed between you and your spouse since your child's head injury?" Which of the following focuses of the family is the nurse assessing? a. The context b. The client c. A system d. A component of society

c. A system

A nurse focuses on the care of the individual while viewing the client's family as a background resource or possible stressor. Which of the following conceptualizations of family does this nurse's view represent? a. Client b. Component of society c. Context d. System

c. Context

A community health nurse is implementing a tertiary prevention activity related to tuberculosis. Which of the following interventions is the nurse most likely completing? a. Administration of skin tests to identify persons who have been infected with tubercle bacilli b. Assessing for signs and symptoms of active tuberculosis c. Directly observing clients with active tuberculosis as they take their antitubercular medications d. Interpretation of tuberculosis skin test findings

c. Directly observing clients with active tuberculosis as they take their antitubercular medications

A case manager implements a primary prevention activity. Which of the following actions would the nurse most likely complete? a. Advocating for the client whose values conflict with those of the medical service provider b. Collaborating between nursing and occupational health personnel c. Educating a group regarding community services that are available if ever needed d. Resolving conflict between a primary care clinic and a tertiary health care facility

c. Educating a group regarding community services that are available if ever needed

In comparison with traditional norms, which family functions have become increasingly important in modern American society? (Select all that apply.) a. Conferring appropriate social status b. Educating the younger members c. Ensuring physical health and safety d. Fostering interpersonal relationships and support e. Promoting mental health and wellness

c. Ensuring physical health and safety e. Promoting mental health and wellness

A nurse organizes care for a family by focusing on the common tasks of family life and considering a longitudinal view of the family life cycle. Which theory is being applied? a. Family systems b. Bioecological systems c. Family developmental d. Family nursing

c. Family developmental

A nurse is concerned about the possibility of suicide in a teenage boy. Which of the following characteristics has the boy most likely displayed? a. He has threatened harm to his school peers. b. He is between the ages 15 and 19. c. He is depressed and has a history of being sexually abused. d. He has been accused of abusing an animal.

c. He is depressed and has a history of being sexually abused.

Which of the following best describes case management? a. A tool of health maintenance organizations b. Targeted toward a specific segment of the population c. Implemented with individual clients d. Used to monitor the health status, resources, and outcomes for an aggregate

c. Implemented with individual clients

A nurse is implementing a primary prevention strategy to address abuse in the community. Which of the following actions is the nurse most likely taking? a. Encouraging others to interfere when they see children hit or hurt in a public place b. Referring caregivers to community respite centers if abuse is beginning to occur c. Lobbying for passage of legislation to outlaw physical punishment in schools d. Screening each pregnant woman privately for intimate partner abuse

c. Lobbying for passage of legislation to outlaw physical punishment in schools

6. The nurse suggests use of telehealth to assess how a client is progressing. Which of the following resources must be available for continuing care to be implemented? a. A primary care provider who is willing to use wireless prescriptions and plans of care b. Family permission for the nurse to make home visits c. Long-distance telephone service or a computer with Internet access d. Willingness of the caregiver to drive the client to the nearest clinic

c. Long-distance telephone service or a computer with Internet access

The nurse suggests use of telehealth to assess how a client is progressing. Which of the following resources must be available for continuing care to be implemented? a. A primary care provider who is willing to use wireless prescriptions and plans of care b. Family permission for the nurse to make home visits c. Long-distance telephone service or a computer with Internet access d. Willingness of the caregiver to drive the client to the nearest clinic

c. Long-distance telephone service or a computer with Internet access

A nurse is trying to identify the risk for mental health problems among older adults. Which of the following interventions should the nurse implement initially? a. Provide information on mental health resources in the community. b. Teach the elderly to self-monitor for signs and symptoms of depression. c. Organize screening programs offered at senior centers. d. Teach older clients to focus on their strengths rather than their weaknesses.

c. Organize screening programs offered at senior centers.

In taking a family history, the nurse in community health finds that this is the second marriage for the previously divorced parents and that the male partner is the stepparent to the oldest child. For which of the following aspects of the family assessment is data being gathered? a. Dynamics b. Function c. Structure d. System

c. Structure

The nurse in community health needs to conduct a family assessment within a commune but is uncertain how to proceed because family lines appear blurred. The best way to determine the family of a mother and her child is to ask the woman which of the following questions? a. "How many children do you have, and who is the father of each?" b. "Is there a register of families who are members of this commune?" c. "Tell me about your significant other." d. "Who are the members of your and your child's family?"

d. "Who are the members of your and your child's family?"

Which of the following theories views the family as a whole with boundaries that are affected by the environment? a. Family developmental b. Exosystems c. Bioecological systems d. Family systems

d. Family systems

A case manager advocates for a client by helping an insurer understand the client's needs and desires and by helping the client understand programs and benefits offered by the insurer. What role is the nurse? a. Arbitrator b. Systems allocator c. Mediator d. Negotiator

d. Negotiator

22. Which of the following factors has the largest impact on health disparities among all populations? a. Ethnicity b. Education level c. Lifestyle choices d. Poverty

d. Poverty

At a county board meeting, a nurse reports statistics related to the increasing problem of substance abuse in the county . The nurse then requests funding for an after-school recreation program that promotes age-appropriate fun activities and sports. Which of the following objectives is the nurse attempting to meet through this action? a. Help prevent obesity and boredom. b. Offer alternatives to being "on the streets." c. Prevent children from getting in trouble before their parents get home from work. d. Promote healthy lifestyles with physical activity.

d. Promote healthy lifestyles with physical activity.

4. Which of the following factors predisposes many migrant farm workers to disenfranchisement? a. Being a minority group member b. Inability to attend religious services because of work requirements c. Previous experiences of physical abuse d. Short length of time in the community

d. Short length of time in the community

The nurse is trying to determine if a disease occurrence needs to be reported to the state health department. Which of the following resources should the nurse use to answer this question? a. Centers for Disease Control and Prevention Weekly Report b. Communicable Diseases Weekly Report c. Nationally notifiable infectious diseases on the CDC website d. State health department website

d. State health department website

An IV drug abuser admits to the nurse he has no desire to stop using drugs, so rather than lecture the individual on the dangers of drug addiction, the nurse provides information how to sterilize his needles. Which of the following prevention efforts is the nurse attempting to achieve? a. Primary prevention by educating about safe injections b. Primary prevention by avoidance of future legal complications c. Secondary prevention to reduce the risk for infection or other complications d. Tertiary prevention to reduce the transmission of blood-borne diseases

d. Tertiary prevention to reduce the transmission of blood-borne diseases

The following people enter the health clinic together: an unmarried man and his 1-year-old son, an unmarried woman with a year-old daughter, and the man's married brother, who is separated from his wife. During the assessment, it is determined that both men work and contribute to the household, where all of them live. Which of the following best describes the "family?" a. The group consists of three families: the man and his son, the woman and her daughter, and the brother, who is married even though he and his wife are separated. b. There are two families involved: first, the unmarried man and woman and their two children, and second, the brother, who is married even though he and his wife are separated. c. There is no family here, only three adults sharing resources between themselves and two biologically related children. d. The family includes whoever the adults state are family members.

d. The family includes whoever the adults state are family members.

Which of the following best describes the goal or priority of the nurse advocate? a. To gain organizational and governmental support for the promotion of nursing objectives b. To improve community service needs identified by research findings c. To integrate evidence-based practice guidelines in the provision of community nursing service d. To promote the client's rights and self-determination

d. To promote the client's rights and self-determination

A nurse is conducting a health risk appraisal. Which of the following activities is the nurse assessing when using this tool? a. Health promotion activities b. Illness prevention activities c. Risk reduction activities d. Unhealthy activities

d. Unhealthy activities

2. Which of the following terms is used to describe aggregates who are at high risk for having poor health outcomes because of limited resources? a. Disadvantaged families b. Multi-problem families c. Resilient populations d. Vulnerable populations

d. Vulnerable populations