Exam 3 - Ch. 8, 9, 10, 11, 12, 13
A 26-year-old man presents to the ER with the following symptoms: bilateral ulcers on his lower extremities, a temperature of 103.2°F, anorexia, and a 20% weight loss in the last month. An ER nurse determines what is wrong when the man answers yes to which question?
"Did you fight in Iraq?" - The man's symptoms indicate he may have leishmaniasis, a parasitic disease spread by sand flies. Symptoms include skin ulcers, loss of appetite, severe weight loss, and high fever. Many cases have been reported by soldiers returning from Iraq and Afghanistan.
The nurse is counseling a client about the risk for heart disease. Which statement indicates the need for further teaching?
"My weight doesn't matter if I exercise and eat better." - The client needs further teaching. Overweight and obesity are modifiable risk factors that reduce risk for heart disease.
A client who is planning a trip to the Dominican Republic expresses fear of getting malaria. What is the nurse's best response?
"Take this medication exactly as prescribed." - Malaria is preventable. Malarial infections in the United States are primarily the result of travelers who did not adhere to recommended malaria prophylaxis.
What is the focus of prevention strategies to reverse the increasing prevalence of type 2 diabetes?
Behavioral change - Behavioral change is the main focus of public health efforts to reduce individual risk of developing type 2 diabetes.
What term describes "the overall impact of diseases and injuries at individual and societal levels or to the economic costs of diseases"?
Burden of 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 to the economic costs of diseases.
The community health nurse knows women represent a vulnerable population due to which of the following factors?
Child-rearing responsibilities - Women represent a vulnerable population because of child-rearing responsibilities.
The nurse is giving a presentation about binge drinking. Which population is the nurse addressing?
College students - 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 2010, the rate of binge drinking among young adults 18 to 25 years of age was 40.6%.
According to Healthy People 2020, which of the following communicable diseases are targeted for elimination through vaccination?
Congenital rubella syndrome, Hepatitis B, Acute paralytic poliomyelitis - The four communicable diseases targeted for elimination through vaccination are congenital rubella syndrome, rubella, hepatitis B, and acute paralytic poliomyelitis.
The nurse is assessing clients at the homeless shelter. The nurse recognizes the following have risk factors for mental illness:
Feedback 1: Answer 1 is correct. Family history of mental illness is a risk factor for mental illness. Suicide indicates the client's mother had a serious mental disorder. Feedback 2: Answer 2 is correct. Living with a chronic medical condition is a risk factor for mental illness. Feedback 3: Answer 3 is correct. Traumatic events are risk factors for mental illness. Feedback 4: Answer 4 is correct. Rural populations include migrant farm workers and are at risk for mental illness. Feedback 5: Answer 5 is correct. Military combat is a risk factor for mental illness.
The nurse determined that a common cause of hospitalization among clients with excessive alcohol use is
Pancreatitis - Pancreatitis is a common cause of hospitalization among clients with excessive alcohol use.
A parent tells the clinic nurse he does not want his child to get chickenpox. The nurse counsels the parent his child should receive the varicella vaccine because this will enable the child to develop
Passive immunity. - vaccination is one form of passive immunity. Passive immunity 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.
The community health nursing student tells the nursing instructor the screening tool most often used by primary care providers to screen for major depressive disorder is:
Patient Health Questionnaire 2. - The Patient Health Questionnaire 2 is one of the most commonly used tool used by primary care providers to screen for depression.
The nurse recognizes substance use negatively impacts individuals, families, and communities. Which of the following represents adverse effects at all three levels?
Risk for unintentional injury and suicide - Substance use increases risk for unintentional injury and suicide at all three levels.
One of the goals of Healthy People 2020 is to reduce the risk for disease and economic burden of diabetes mellitus (DM). Which type of DM results from a combination of insulin resistance and insufficient insulin production?
Type 2 diabetes - Type 2 diabetes results from a combination of resistance to the action of insulin and insufficient insulin production.
A registered nurse volunteering at a clinic in Africa is responsible for providing mosquito nets to the local population to protect them from malaria. What is the nurse's next most effective prevention strategy?
Use understandable terms to teach how malaria is spread - Providing health education is a key role for nurses. The most effective prevention strategy is to educate the population about malaria. Understanding how malaria is spread and how the mosquito nets help prevent mosquito bites increase the likelihood the community will use the nets.
A woman is brought to the emergency department with a fractured nose and facial contusions. She tells the nurse, "My husband did this to me." What is the nurse's best response?
"Do you have a safe place to stay tonight?" - The patient's safety is the highest priority. The nurse must assess whether the woman has a safe place to go.
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?
"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.
A nurse volunteering at a health clinic in rural India is assessing a 1-year-old child with acute lower respiratory pneumonia. Which of the mother's statements indicates how the child may have become ill?
"I cook my food over an open fire." - Increased pollution from burning biomass fuels for cooking in enclosed spaces without proper ventilation have the greatest health impact on children under age 5. Children's airways are small and narrow because they are still developing. Pollutants are easily trapped resulting in acute lower respiratory pneumonia.
The nurse is conducting a screening for mental disorders. Which statement indicates a need for follow up?
"I have trouble getting up most mornings and am late for work a lot." - This statement indicates a need for further evaluation. Sleep disturbances are a symptom of major depressive disorder, and the client's functioning at work is disrupted.
During a community health fair, the public health nurse is educating a woman about unintentional poisonings in children. Which statement indicates the need for further teaching?
"I keep toilet bowl cleaner under the bathroom sink." - This statement indicates the need for further teaching. Keeping household cleaners under the bathroom sink places a child at high risk for unintentional poisoning as it allows a child easy access to poisonous substances.
The occupational health nurse is assessing an employee who reports feeling stressed by his job and financial responsibilities. Which statement indicates he may be at risk for suicide?
"It's hopeless. I just want to take my bottle of Percocet." - This statement indicates the man is at high risk for suicide. He reported feelings of hopelessness, a desire to harm himself, and he has the means to do so.
Pediatric nurses at Community North Hospital are evaluating health education materials about infant drowning. Which brochure is the most appropriate?
"Make Bath Time Safe Time" - "Make Bath Time Safe Time" is the most appropriate brochure. The most common sites for infant drowning are bathtubs and 5-gallon buckets.
The clinic nurse is talking with a client who was recently diagnosed with bipolar disorder. Which statement indicates the client may not return?
"My friends can't know I come here." - This statement indicates the client may not return due to the stigma related to mental disorders. The client is concerned about rejection by friends.
A patient recently diagnosed with dengue or "breakbone fever" asks the nurse, "How do you cure dengue?" What is the nurse's best response?
"There is no current treatment for dengue." - There is no current treatment for dengue.
A young man asks the nurse how he can prevent getting a sexually transmitted infection (STI). What is the nurse's best response?
"Wear a condom for all sexual contact." - This is the best response, as unprotected sexual contact is the main risk factor for STIs.
Which of the following is among the population with the higher prevalence of HIV and AIDS?
A 27-year-old Puerto Rican male - The prevalence of HIV and AIDS is higher among males ages 5 to 44 years.
The nurse recognizes which of the following clients as most likely to be diagnosed with posttraumatic stress disorder (PTSD)?
A 60-year-old Aleut man - Aleuts are Alaskan Natives. American Indians/Alaskan Natives have a higher rate of lifetime PTSD than others in the U.S. population.
The public health nurse is speaking at a college campus on the topic of acquaintance violence. Which is an example of acquaintance violence?
A college student is sexually assaulted by a classmate she knows from high school. - Acquaintance violence is a type of community violence that occurs between individuals who know each other. The college student was a victim of acquaintance violence because she knew the person who sexually assaulted her.
A nursing instructor overhears two students quizzing each other for an upcoming community health exam. One students asks the other to give an example of a fomite. Which example is correct?
A paper tissue carrying rhinovirus - A fomite is a mode of transmission of infectious diseases. It is an inanimate object. An infected person or host touches the object and sheds the agent onto the object. The agent is transmitted to the next person who touches that object. The paper tissue carrying rhinovirus is a fomite.
In the 21st century, the term epidemic means:
A significant increase in the number of cases of a disease that usually occur. - In the 21st century, the term epidemic refers to a significant increase in the number of cases of a disease that usually occur.
The nurse is conducting a home visit to screen for substance use with an adult client whose blood alcohol concentration (BAC) was above the legal limit following a motor vehicle accident. What is the best screening tool?
AUDIT - The AUDIT is the best screening tool. It is used to screen for at-risk alcohol use as well as use of alcohol use disorders. The motor vehicle accident may have been related to an alcohol use disorder.
According to the Consortium of Universities, the term global health is defined as an area for study, research, and practice that places a priority on improving health and:
Achieving equity in health for all people worldwide. - According to the Consortium of Universities, the definition of global health includes a priority on achieving equity in health for all people worldwide.
A patient is admitted to the hospital with tuberculosis and requires a negative pressure room because the mode of transmission is:
Airborne - The mode of transmission of tuberculosis is through the air. The bacteria causing tuberculosis (Mycobacterium tuberculosis) is an airborne agent. Patients with or suspected of having tuberculosis require a negative pressure room so that air from the patient's room is ventilated to the outside.
The nurse knows optimal mental health of communities depends on which of the following?
An environment that supports a strong social network - Optimal mental health of a community depends on the provision of an environment that encourages a strong social network and a safe place to work and live.
The nurse recognizes that the ability of a disease to produce antibodies in the human host is called:
Antigenicity. - Antigenicity is the ability of a pathogen to produce antibodies in the human host.
The client tells the nurse she has decided to quit smoking. What is the nurse's next action?
Assist the client in making an appointment with the smoking cessation counselor. - The nurse's next action is to provide the appropriate tobacco dependence treatment by scheduling an appointment with the smoking cessation counselor.
The nurse plans to utilize an evidence-based intervention to address binge drinking. Which intervention uses the Harm Reduction Model?
Brief Alcohol Screening and Intervention for College Students (BASICS) - The Brief Alcohol Screening and Intervention for College Students (BASICS) is a harm reduction approach to reduce binge drinking among college students.
What is the most commonly reported sexually transmitted infection (STI) in the United States?
Chlamydia - Chlamydia was 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 the rate in men.
The nurse is teaching a small group of pregnant adolescents who have substance use disorders. What is this group at highest risk for?
Chlamydia - Pregnant adolescents with substance use disorders have a higher risk for chlamydia.
There has been a significant increase in drive-by shootings and assaults in the community due to gang actions. The nurse recognizes this as what type of violence?
Collective - Violence that occurs when a large group of people engage in violent behavior is collective violence. Gang violence is an example of collective violence.
Following the fire chief's lesson on fire safety, the nurse recognizes the lesson was successful when students:
Demonstrate how to stop, drop, and roll. - The lesson was successful when students demonstrate how to stop, drop, and roll if their clothes are on fire.
A community health nursing student is preparing a presentation about injuries related to motor vehicle crashes (MVCs). What is the best source for data regarding MVCs?
Department of Transportation - The Department of Transportation (DOT) monitors MVCs and is the best place for the student to obtain data regarding MVCs.
The community nurse's goal is to protect the community from a disease outbreak. What is the nurse's best action?
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 it is achieved through exposure or vaccination. The community nurse can determine the community's threshold of immunity using the vaccination rate and plan the percentage of the community needing to be immunized.
The nurse is creating a Haddon Matrix for motor vehicle crashes (MVCs). Which factor is placed in the "post-event" row?
EMS response time - EMS response time is placed in the "post-event" row since emergency personnel arrive after the crash (post-event).
Community leaders in Camden, New Jersey are implementing a violence prevention program focused on developing positive relationships between youth and adults. The nurse knows the best intervention is to:
Establish a mentoring program. - A mentoring program meets the objective of decreasing violence. It provides youth with adult role models and focuses on positive relationships between youths and adults.
According to the Centers for Disease Control and Prevention (CDC), how should public health professionals utilize data from the Health-Related Quality of Life (HRQoL)?
Evaluate outcomes in health of populations - The CDC's recommends the HRQoL should be used to evaluate outcomes in health of populations. The HRQoL is one of the main indicators for monitoring health in populations.
The nurse is a guest speaker during health education class at the high school. The nurse explains the serious results of alcohol use. Which of the following does the nurse include?
Feedback 1: Answer 1 is correct. Alcohol use is responsible for 32% of motor vehicle crashes. Feedback 2: Answer 2 is correct. Alcohol poisoning can occur with one episode of at-risk or heavy alcohol use. Feedback 3: Answer 3 is correct. Drowning can occur with 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 which statements indicate psychosocial consequences related to alcohol use?
Feedback 1: Answer 1 is correct. Arriving late to work is an employment problem, which is a psychosocial consequence of alcohol use. Feedback 2: Answer 2 is correct. The restraining order is a 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 group of American nurses learned about Chagas disease before volunteering at a clinic in rural Mexico. Which patients do the nurses recognize have increased risk for Chagas disease?
Feedback 1: Answer 1 is correct. Chagas disease can be transmitted through blood transfusions. Feedback 2: Answer 2 is correct. People with a compromised immune system are at increased risk for Chagas disease. Feedback 3: Answer 3 is incorrect. A pregnant woman can transfer Chagas disease to her fetus. A mother in good health is not at increased risk for transmitting Chagas disease. Feedback 4: Answer 4 is correct. Chagas disease can be transmitted through an organ transplant. Feedback 5: Answer 5 is incorrect. Constipation is a not symptom of Chagas disease. Diarrhea is a symptom of Chagas disease.
According to the Centers for Disease Control and Prevention (CDC), which of the following are among the top five leading causes of death in the United States?
Feedback 1: Answer 1 is correct. Chronic lower respiratory diseases are among the top five leading causes of death in the United States: heart disease, cancer, stroke, chronic lower respiratory diseases, and accidents. Feedback 2: Answer 2 is correct. Heart disease is among the top five leading causes of death in the United States: heart disease, cancer, chronic lower respiratory diseases, stroke, and accidents. Feedback 3: Answer 3 is correct. Accidents are among the top five leading causes of death in the United States: heart disease, cancer, chronic lower respiratory diseases, stroke, and accidents. Feedback 4: Answer 4 is incorrect. Alzheimer's disease is not among the top five leading causes of death in the United States. Feedback 5: Answer 5 is incorrect. Diabetes is not among the top five leading causes of death in the United States.
A nurse performs home inspections to look for risk factors related to unintentional poisonings. Which findings indicate a need for further teaching?
Feedback 1: Answer 1 is correct. Further teaching is needed. Cleaning products should be stored out of the reach of children. Keeping them in an unlocked cabinet provides easy access to poisonous substances. Feedback 2: Answer 2 is correct. Further teaching is needed. Open medicine bottles on the bathroom sink are a significant risk factor for pediatric unintentional poisonings. The greatest morbidity is related to ingestion of prescription medications, especially opioids, sedatives, and cardiovascular agents. Feedback 3: Answer 3 is correct. Further teaching is needed. A nonworking carbon monoxide detector puts everyone in the home at risk for unintentional poisoning. Carbon monoxide is an odorless, colorless gas that is lethal in higher concentrations. Feedback 4: Answer 4 is incorrect. The answer refers to burn injuries, not unintentional poisonings. Feedback 5: Answer 5 is incorrect. Lead was banned from paint in 1973, but many homes built before then still have walls and ceilings painted with lead-based paint. A newly painted older home would be not be painted with lead-based paint.
The local YMCA is providing free swim lessons for local residents. During the first lesson the instructor teaches safety measures to prevent drowning. Which statements indicate a need for further teaching?
Feedback 1: Answer 1 is correct. Further teaching is needed. Ninety percent of drowning victims in boating accidents were not wearing a life jacket. Feedback 2: Answer 2 is incorrect. Children should always swim with a buddy. Feedback 3: Answer 3 is incorrect. Parents should provide continuos supervision of small children when at pools and anywhere near water, including bathtubs. Most young children who drowned in pools had been out of sight of their parents less than 5 minutes and were in the care of one or both at the same time. Feedback 4: Answer 4 is correct. Further teaching is needed. Learning CPR can help improve outcomes in drowning victims. Feedback 5: Answer 5 is incorrect. Children should always swim under the supervision of a lifeguard.
A Ugandan man is speaking with a nurse about how his wife died shortly after child birth. What statements made by his wife indicate her death was preventable?
Feedback 1: Answer 1 is correct. Many pregnant women do not seek treatment due to the "three delays" - delays in seeking care, delays in arriving at the healthcare center, and delays in adequate care once at the health center. Delaying care due to finances may have contributed to the woman's death. Feedback 2: Answer 2 is incorrect. An active fetus is a sign of a healthy pregnancy. Feedback 3: Answer 3 is correct. The woman experienced a delay in arriving at the health center because she had to walk 10 miles to get there. This fact may have discouraged her from making future trips and may have contributed to her death. Feedback 4: Answer 4 is correct. Severe headache and visual disturbances indicate pregnancy induced hypertension (PIH), or preeclampsia, a potentially fatal complication of pregnancy. The three delays prevented the healthcare provider from monitoring her blood pressure and from teaching about warning signs. If the family recognized warning signs, then a delay in getting to the health center would have contributed to her death. Feedback 5: Answer 5 is incorrect. Nausea and vomiting are common during the first trimester of pregnancy and would not have contributed to the woman's death.
The nurse is teaching parents and teachers signs of psychoactive drug use. What are the nurse's teaching points?
Feedback 1: Answer 1 is correct. Narcotics (e.g., acetaminophen with codeine), opiates (e.g., morphine, hydroporphone, 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 decision making. 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) above normal limits. Additional information from student database includes: Lives in apartment with mother and two siblings; family pays reduced tuition and fees; no healthcare 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?
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 healthcare provider indicate poor asthma control. Feedback 4: Answer 4 is correct. The family pays reduced tuition and fees, indicating an economic disparity may exist. Feedback 5: Answer 5 is incorrect. There is no information indicating the student uses tobacco.
Which of the following characterize serious mental illness (SMI)?
Feedback 1: Answer 1 is correct. SMI disrupts a person's ability to obtain and maintain employment. Feedback 2: Answer 2 is correct. SMI disrupts a person's ability to have adequate financial resources. Feedback 3: Answer 3 is incorrect. Living in a dangerous neighborhood is not an indicator of SMI. Feedback 4: Answer 4 is correct. SMI disrupts a person's ability to function socially. Feedback 5: Answer 5 is incorrect. An incomplete high school education is not an indicator of SMI.
Which activities represent the four most common risk factors for noncommunicable diseases in the United States?
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.
The public health nurse plans to educate the community that the incidence rates of which of the following cancers are increasing in the United States?
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.
Which of the following describe reactions related to stigma of mental disorders?
Feedback 1: Answer 1 is correct. The stigma of mental illness may cause an individual to believe nothing is wrong with him and thus will never seek treatment. Feedback 2: Answer 2 is incorrect. The stigma of mental illness may cause an individual to refuse to seek treatment, not actively seek it out. Feedback 3: Answer 3 is incorrect. The stigma of mental illness may lead to rejection by family and friends, not acceptance. Feedback 4: Answer 4 is correct. The stigma of mental illness may result in not having adequate health insurance coverage for mental illness. Feedback 5: Answer 5 is correct. The stigma of mental illness may cause an individual to refuse to seek treatment.
A community health nursing student who recently completed a mental health clinical experience is volunteering at a behavioral health clinic. The student recognizes which people are at increased risk for suicide?
Feedback 1: Answer 1 is correct. The woman has MDD, a diagnosable mental health disorder, which increases her risk for suicide. Over 90% of people who die by suicide have a diagnosable mental health disorder at the time of death. Feedback 2: Answer 2 is correct. The man's wife died in a car accident only one week ago. Those who have experienced a crisis in the preceding two weeks are at increased risk for suicide. Feedback 3: Answer 3 is incorrect. People with physical health problems are at increased risk for suicide. The man has no indication of current health problems and he has been cancer free for 10 years. Feedback 4: Answer 4 is incorrect. The man is receiving treatment for schizophrenia, reducing his risk for suicide. Over 90% of people who die by suicide have a diagnosable mental health disorder at the time of death, yet only 33.8% are receiving treatment. Feedback 5: Answer 5 is correct. Intimate partner violence is a significant risk factor for suicide. The woman is at increased risk because she is being abused by her partner.
The nurse teaches community health nursing students about the evolution of tobacco use in the United States. Key content includes:
Feedback 1: Answer 1 is correct. Tobacco use increased approximately 300% from 1934-1945. Feedback 2: Answer 2 is incorrect. The Fair Trade Act of 1949 provided free and equal time to antismoking initiatives as was purchased by the cigarette industry and is associated with decreased tobacco use. Feedback 3: Answer 3 is correct. Cigarette consumption has consistently declined since the first Surgeon General's Report on Smoking and Health was released. Feedback 4: Answer 4 is correct. The FDA controls the development of a safer cigarette. Feedback 5: Answer 5 is correct. Cigarette consumption dropped in the mid-1950s, when the first evidence of the association between cigarette smoking and cancer was found.
The overall life expectancy in the United States in 1910 was 48 years old for a man. In 2013, it was 78.62. What advancements in public health practices are helping Americans live longer?
Feedback 1: Answer 1 is correct. Vaccinations have decreased the prevalence of many communicable diseases. Feedback 2: Answer 2 is incorrect. Clean water and sanitation help control communicable diseases, but not noncommunicable diseases. Feedback 3: Answer 3 is incorrect. Foods with high sugar and fat content are increasing morbidity and mortality of Americans. Feedback 4: Answer 4 is correct. Awareness of the dangers of tobacco decreased smoking rates and the deaths attributed to smoking. Tobacco use is a major cause of lung cancer and can lead to chronic respiratory diseases such as COPD. Feedback 5: Answer 5 is incorrect. Adding fluoride to water improved dental health by decreasing cavities and mouth abscesses.
It is critical for the public health nurse to understand characteristics of infectious agents and the cycle of transmision. Characteristics of infectious agents include?
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.
The nurse is using the RADAR (Routine, Ask, Document, Assess, Review) to screen for intimate partner violence. Which statements indicate the nurse is using the tool appropriately?
Feedback 1: Answer 1 is incorrect. The letters in the RADAR screening tool refer to actions to screen for intimate partner violence. The D indicates the screener must Document the findings. Feedback 2: Answer 2 is correct. The letters in the RADAR screening tool refer to actions to screen for intimate partner violence. The second A indicates the screener should Assess for patient safety. Feedback 3: Answer 3 is incorrect. The statement is not part of RADAR screening, and it is inappropriate. Feedback 4: Answer 4 is correct. The letters in the RADAR screening tool refer to actions to screen for intimate partner violence. The first A indicates the screener must Ask direct questions. Feedback 5: Answer 5 is correct. The letters in the RADAR screening tool refer to actions to screen for intimate partner violence. The second R indicates the screener must Review the patient's options and provide referrals.
Nurses around the world are working to achieve the United Nation's Millennium Development Goals (MDGs). What is the best intervention to improve maternal health?
Help build free prenatal care clinics in Honduras - Maternal mortality is mostly caused by delays in seeking treatment. These delays may be due to lack of available resources and lack of financial means to pay for them. Establishing free prenatal clinics in a lower-income country such as Honduras would improve maternal health.
Which of the following is a biological factor in postpartum depression?
Hormonal level changes - Hormonal level changes are a significant biological factor in postpartum depression.
The community health nurse recognizes the primary significance of the term serious mental illness (SMI) is that it:
Implies eligibility for specific kinds of support services. - The primary significance of the term serious mental illness (SMI) is that it implies eligibility for specific kinds of support services. SMI refers to a diagnosable mental disorder that severely disrupts a person's ability to function socially, obtain and maintain employment, to have adequate financial resources, and to access/maintain family supports.
Mary Mallon, known as Typhoid Mary, infected 25 people with typhus without showing symptoms of illness. What type of carrier was she?
Inapparent - Typhoid Mary was an inapparent carrier. An inapparent carrier is someone who is infected but never develops the disease. This type of carrier continues to shed the infectious agent while infected.
A public health nurse determined 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?
Index case - Index case is the term that refers to the first case identified in particular disease outbreak.
It is important for nurses to be particularly aware of times of the year the year when the incidence of specific illnesses is high. Which has a high mortality rate among multiple vulnerable populations?
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.
Which of the following Healthy People 2020 leading health indicator topics come under behavioral health?
Injury/violence, tobacco, mental health, and substance abuse - The four Healthy People 2020 leading health indicator topics under behavioral health are injury/violence, tobacco, mental health, and substance abuse.
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?
It addresses a population regardless of identified risk. - Universal prevention was selected because it addresses an entire population regardless of identified risk.
Which action demonstrates the nurse's understanding of providing culturally competent care in the era of globalization?
Learn about healthcare delivery systems from lower-income countries (LICs) - Providing culturally competent care in a global era requires an understanding of other countries' healthcare delivery systems. Learning about healthcare delivery systems from LICs demonstrates understanding of culturally competent care.
A student nurse is caring for an 8-year-old child who fell from a window. Based on this fact, the student nurse would not be surprised to learn the child:
Lives in an affordable housing development. - The child lives in an affordable housing development, which is a multidwelling setting. Window falls occur most often in urban, low-income, multidwelling settings.
The public health nurse wants to increase cancer awareness within the community. Which cancer is the leading cause of death in men and women?
Lung - Lung cancer is the leading cause of cancer deaths among men and women in the United States.
Which of the following disorders is a public health priority because it is the leading cause of disability among those ages 15 to 44 years?
Major depressive disorder - Major depressive disorder is the leading cause of disability among those ages 15 to 44 years.
Nurses at Community North Hospital are alarmed when there is a sudden and dramatic increase in the incidence of heat stroke among toddlers left in hot cars. The nurses' best action to prevent further occurrences is to
Mandate a "Look Before You Lock" class before discharge. - Mandating a "Look Before You Lock" class before discharge is the best action since it is a prevention strategy. Health education is provided for parents of newborns about risks of leaving children in hot cars.
The public health nurse recognizes the policy changes at the population level are necessary to improve community mental health. Which of the following laws mandated that insurance benefits for mental health and substance use disorders be equivalent or better than medical and surgical benefits?
Mental Health Parity and Addiction Equity Act - The Mental Health Parity and Addiction Equity Act mandated that insurance benefits for mental health and substance use disorders be equivalent or better than medical and surgical benefits.
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:
Moderate use. - The woman's classification is moderate use (or low risk use). This classification is defined as no more than one drink in a day (7 drinks in a week) for a woman and no more than two drinks in one day (14 drinks in a week) for a man.
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?
National Institute on Drug Abuse (NIDA) ASSIST - The NIDA ASSIST is the appropriate screening instrument. ASSIST screens for different types of drugs of abuse. The clinician's guide provides interventions, pharmacological approaches and behavioral therapies.
Which of the following is the leading cause of death and disability in the United States?
Noncommunicable diseases - Noncommunicable diseases (NCDs) are the number one cause of death and disability in the United States. One fourth of persons in the United States with NCDs have one or more limitations in their daily activities.
A patient was just admitted to the emergency department for an overdose. Which medication is the nurse most likely to find in the patient's pocket?
Percocet - The nurse is most likely to find Percocet, a prescription painkiller. Prescription painkillers are the drugs most commonly involved in an overdose.
A community health nursing student is preparing a presentation about primary prevention. Which examples of primary prevention should the student include?
Planning an immunization clinic - Providing immunizations is an example of primary intervention, which focuses on preventing disease. Immunizations prevent the transmission of communicable diseases.
The proliferation of American fast food restaurants in other countries has caused global dietary changes. As a result, which has occured in global health?
Prevalence of obesity has increased. - The prevalence of obesity has increased.
In lower-income countries (LICs) such as Uganda, there is an effort to increase the number of nurses who provide the essential care needed to have healthy individuals and communities. This essential care is known as:
Primary health care. - From a global perspective, the term primary health care refers to the essential care needed to have healthy individuals and communities.
During a 2-week volunteer trip to Costa Rica, a nurse is helping build an all-girls school. Which Millennium Development Goals (MDG) is the nurse working to achieve?
Promoting gender equality and empowering women; achieving universal primary education - Building an all-girls school promotes gender equality, empowers women, and helps achieve universal primary education.
The nurse explains to a group of community health nursing students which of the following can be used to build community resilience to mental disorders?
Protective factors - Protective factors are used to build community resilience to mental disorders. Protective factors are processes within individuals, families, or communities that exist, can be strengthened, or can be incorporated into interventions to build community resilience.
The nurse realizes which of the following represents primary prevention at the policy level?
Public Health Action Plan to Prevent Heart Disease and Stroke - 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 healthcare providers create primary prevention programs aimed at cardiovascular disease prevention.
Results of a 2-year study on motor vehicle crashes (MVCs) in Smithville indicate injuries can be reduced by addressing environmental risk factors. What is the best recommendation made by the public heath nurse?
Reduce the speed limit during hazardous driving conditions - Hazardous driving conditions, such as icy roads, represent an environmental risk factor that plays a role in MVCs.
Under President Obama, the focus of the Office of National Drug Control Policy (ONDCP) has shifted focus in what way?
Reduced criminal penalties for those who are not engaged in criminal activity related to the production, transportation, or distribution of marijuana - Under President Obama, the ONDCP has shifted its focus to upstream and midstream approaches, which includes reduced criminal penalties for those who are not engaged in criminal activity related to the production, transportation, or distribution of marijuana.
Ensuring environmental sustainability (Millennium Development Goal 7) depends on access to potable water. A fresh, clean water supply directly affects global health in the following ways except:
Reducing disease mortality rates. - A fresh, clean water supply directly affects global health by decreasing the mortality rates of disease such as pneumonia, but it does not directly affect an adrenal disorder such as Addison's disease.
The nurse visiting a family suspected of child maltreatment notices the child is very thin but there are no bruises or injuries. The mother states, "After I pay rent, I often don't have enough money to buy food." What is the nurse's best action?
Refer the mother to the women's resource center for job counseling. - Prevention of childhood maltreatment programs includes access to community resources. Referring the mother to a job counseling program gives her the tools she needs to obtain a employment and the ability to provide housing and food for herself and her son.
Every year, diarrheal disease is a leading cause of death among children younger than 5 years of age. Which would significantly reduce the incidence of diarrheal disease?
Safe drinking water - Safe drinking water and efficient sanitation significantly reduce the incidence of diarrheal disease.
The nurses at the local hospital are conducting free depression screenings for members of the community. Depression screening is:
Secondary prevention. - Screenings are an example of secondary prevention, which focuses on early detection and treatment of disease.
Following a mental health screening at the local middle school, the nurse observes most results were negative, indicating no follow-up was needed. What is the most likely reason for the results?
Students participate in a school activity of their choice. - The middle school community demonstrates resilience. Screening results suggest fewer mental disorders exist among this population. Each student selects and participates in an activity. Autonomy and a sense of connectedness increase resilience.
The use of psychoactive drugs is a major public health issue affecting all populations and countries. The nurse recognizes "a maladaptive pattern of substance use leading to clinically significant impairment" is the definition of which of the following?
Substance use disorder - A substance use disorder is a maladaptive pattern of substance use leading to clinically significant impairment or distress.
After becoming a registered nurse, Denise wants to live and work in Trinidad, her native country. She feels her options and working conditions would be better in the United States. What is the best way for lower-income countries (LICs) to retain nurses like Denise?
Teach nurses best practices with limited resources - LICs may be able to retain skilled nurses by teaching students the best nursing practices with limited resources. Many doctors and nurses from LICs leave and go to other countries for better pay and better work conditions.
The community health nursing instructor asks for examples of how global health can have a negative effect on the United States. Which example indicates a need for further teaching?
The incidence of "mad cow disease" in the United Kingdom decreases. - A reduction in the incidence of "mad cow disease" in the United Kingdom would not have a negative effect on the United States.
A nurse is performing a home safety inspection for a young couple. Which finding provides an opportunity to educate the parents about risk factors for burn injuries?
The water heater temperature is set to 130°F. - This finding indicates a need for further education. The water heater should be set 120°F or lower.
The public health nurse knows the single most preventable cause of morbidity and mortality in the United States is:
Tobacco use. - Tobacco use is the single most preventable cause of morbidity and mortality.
