Exam 4: Community

A woman and man who have come to the health clinic begin to argue loudly. "You gave me an STD!" the man yells. The woman screams back, "Not me. I don't have an STD!" Which of the following statements would be most appropriate for the nurse to say to them? (Select all that apply.) a. "Actually, you're very fortunate to have been tested so you and your partner can begin treatment before more serious damage is done." b. "Some STDs may not have any symptoms, so you need to be tested for other conditions and treated if necessary." c. "Sometimes the test is inaccurate, so before getting too upset, you should ask to be tested again." d. "You may be able to get treatment from your pharmacist so you won't have to be embarrassed like this again."

a. "Actually, you're very fortunate to have been tested so you and your partner can begin treatment before more serious damage is done." b. "Some STDs may not have any symptoms, so you need to be tested for other conditions and treated if necessary." c. "Sometimes the test is inaccurate, so before getting too upset, you should ask to be tested again."

A nurse is working with a family member to reduce his health risk. Which of the following recommendations would most likely be made by the nurse? a. "Be sure to take a 30-minute walk each day." b. "Call our office if you have any questions or concerns at all." c. "Come back in 2 weeks for follow-up on your surgery." d. "Continue to take the drug until it is gone, even if you're feeling better earlier.

a. "Be sure to take a 30-minute walk each day."

A nurse tells her nursing supervisor that her family is moving from the urban area where they both live to a rural area to be near her spouse's parents, who are becoming less independent. Which of the following suggestions would the nursing supervisor provide to the nurse? (Select all that apply.) a. "Community members will probably hold you in higher regard and will look up to you." b. "Expect to have less autonomy in a small town than you have working as a nurse in a medical center." c. "You may feel like an isolated outsider, because the community may not immediately accept you." d. "You will have to be very sensitive about the differences in the rural lifestyle."

a. "Community members will probably hold you in higher regard and will look up to you." c. "You may feel like an isolated outsider, because the community may not immediately accept you." d. "You will have to be very sensitive about the differences in the rural lifestyle."

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 helping a client's family prepare to have an intervention that hopefully will encourage the alcoholic father to realize the need for change. Which of the following instructions by the nurse to the client's family members would be most effective? (Select all that apply.) a. "Express your love and your belief that he can change." b. "Point out that his behavior is his choice and his responsibility." c. "Let him know that you understand how much he loves being with his drinking pals and that you agree that their friendship is important." d. "Remind him that entering treatment is better than going to prison."

a. "Express your love and your belief that he can change." b. "Point out that his behavior is his choice and his responsibility."

Which statements by a nurse demonstrate understanding of the unique needs of vulnerable groups? (Select all that apply.) a. "I always address the problem that the client believes is the most important." b. "I avoid asking clients for income or financial information, because this is an invasion of privacy." c. "I try to observe the client's cultural traditions as I complete my assessment." d. "I make sure to do a complete assessment, since we often don't know when the person will return to the clinic."

a. "I always address the problem that the client believes is the most important." c. "I try to observe the client's cultural traditions as I complete my assessment."

A school nurse asks a class about the ways HIV can be transmitted. Which of the following comments by a student indicates a need for additional teaching? a. "I wouldn't sit next to someone with HIV." b. "Having unprotected sex with someone who is infected spreads HIV." c. "Sharing needles when shooting up drugs spreads HIV." d. "Transfusions of blood products that are contaminated can spread HIV.

a. "I wouldn't sit next to someone with HIV."

Three women were brought to the emergency department by ambulance after a two-car accident at a busy intersection. Which of the following tests should automatically be done under such circumstances? a. Alcohol blood level b. Cardiac workup c. Pregnancy test d. STD tests

a. Alcohol blood level

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."

A nurse explained to a new mother that because she had tested positive for the hepatitis B virus, her newborn son would need the hepatitis B vaccine immediately and then also an immune globulin injection. "Wait," said the new mother. "Why is my son getting two shots?" Which of the following statements would be the best response by the nurse? a. "One injection protects your son, while the other encourages his body to build up immunity." b. "One shot keeps your son from getting sick, while the other is a typical vaccine to prevent you from accidentally infecting him." c. "Since you've already been infected with the virus, your son needs twice as much protection." d. "The second shot is just to make sure the first one works."

a. "One injection protects your son, while the other encourages his body to build up immunity."

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

Which of the following adolescent(s) would receive care from the advanced practice nurse without parental consent? (Select all that apply.) a. A 16-year-old who is living on his own (not with his parents) b. A pregnant adolescent c. An adolescent in an emergency situation d. An adolescent whose diagnosis has a serious prognosis

a. A 16-year-old who is living on his own (not with his parents) b. A pregnant adolescent c. An adolescent in an emergency situation

A client is using a primary prevention strategy to prevent infectious disease. Which of the following actions is the client most likely taking? a. A client receives a tetanus booster every 10 years. b. A client receives a tetanus booster after stepping on a nail. c. A client receives tetanus immunoglobulin after stepping on a nail. d. A client with tetanus is given antibiotics and is placed on seizure precautions

a. A client receives a tetanus booster every 10 years.

A client requests help to stop smoking. Which of the following methods would be the best for the nurse to suggest to the client? a. A combination of interventions, beginning with changing the environment b. Acupuncture to reduce the nicotine cravings c. Behavior modification through hypnosis d. Nicotine replacement products

a. A combination of interventions, beginning with changing the environment

Which of the following persons is most likely to be assaulted? a. A young man b. A young woman c. An older man d. An older woman

a. A young man

Which of the following best describes why health professionals would be particularly concerned about the health needs of residents in rural areas? (Select all that apply.) a. About 25% of all US residents live in rural settings. b. People in rural areas are especially susceptible to acute illnesses rather than chronic diseases. c. Diagnoses in rural areas are usually for physical injuries, not mental health concerns. d. A high prevalence of poverty exists among rural families.

a. About 25% of all US residents live in rural settings. d. A high prevalence of poverty exists among rural families.

In addition to those barriers faced by many residents in rural areas, what additional barrier to health care is a Hispanic migrant farmworker likely to encounter? a. Absence of culturally competent care b. Availability of specialists c. Distance of health care facilities from the place of residence d. High cost of health care

a. Absence of culturally competent care

A nurse wants to establish a program to decrease the death rate among children. Which of the following health problems should be the target of this program? a. Accidents and injuries b. AIDS c. Childhood obesity d. Vaccine-preventable diseases

a. Accidents and injuries

Which of the following is the most probable cause of the increase in new emerging infectious diseases? a. Activities or behavior of humans, including changes in the environment b. Increasing urbanization and growth in new housing materials c. New infectious agents are evolving throughout the world d. Overpopulation in many areas, creating a need to reduce global population

a. Activities or behavior of humans, including changes in the environment

A client explains to the nurse that it is just impossible for her and her husband to continue to have his mother in the home alone during the day while they work because the woman becomes confused and has fallen twice. Which of the following community resources should the nurse recommend? a. Adult day health b. Home health c. Long-term care d. Senior center

a. Adult day health

A 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

Which of the following factor(s) may help determine how many home visits are made to a particular family? (Select all that apply.) a. Agency's policies regarding eligibility for services b. Family's feelings about the home visit and willingness to continue c. Nurse's perception of the amount of time needed to complete required tasks d. Reimbursement policies of third-party payers

a. Agency's policies regarding eligibility for services b. Family's feelings about the home visit and willingness to continue d. Reimbursement policies of third-party payers

A nurse is providing care to a pregnant teenager. Which of the following principles is the most important for the nurse to consider when providing care? a. All teen pregnancies are considered high-risk. b. Limited self-care knowledge can lead to pregnancy complications. c. Pregnant teens are likely to receive prenatal care late in the pregnancy. d. Pregnant teens may have limited financial resources to pay for care

a. All teen pregnancies are considered high-risk.

A nurse has completed health risk appraisals with several different families. Which of the following families would be of most concern to the nurse? a. An older couple who has just retired and sold their house, who talk about their new condo in a retirement community. b. Newlyweds who have been saving their money, who want to discuss birth control and family planning in preparation for future pregnancies. c. Parents who come with their child for his prekindergarten physical exam and want to be sure all the child's immunizations are up to date. d. A woman who is very pleased with her new position at the hospital and wants to have her preemployment exam and drug screen.

a. An older couple who has just retired and sold their house, who talk about their new condo in a retirement community.

Which of the following biological warfare agents poses the greatest bioterrorism threat to a community? a. Anthrax b. Botulism c. Smallpox d. Tularemia

a. Anthrax

A nurse would like to increase the accessibility to health care services for mentally ill homeless clients in the community. Which of the following actions should be taken by the nurse? a. Apply for a grant to fund a mobile clinic to take health care to the clients. b. Distribute flyers to the homeless that detail the location of various types of health care services. c. Refer homeless clients to areas that provide temporary housing. d. Solicit donations for food and clothing to be distributed to the homeless.

a. Apply for a grant to fund a mobile clinic to take health care to the clients.

Which of the following places best describes where the incidence of Vancomycin-resistant Staphylococcus aureus (VRSA) and methicillin-resistant S. aureus (MRSA) is currently rising? a. Areas where people share dressing or bathing facilities b. Daycare centers and schools c. Long-term care facilities d. Senior citizen centers

a. Areas where people share dressing or bathing facilities

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

Which of the following interventions would the nurse most likely implement when addressing the problem of asthma among school-aged children? (Select all that apply.) a. Assess schools and day care centers for environmental "friendliness." b. Share nutritional information with all students in the school. c. Develop home and environmental assessment guides. d. Teach all school personnel how to use rescue inhalers.

a. Assess schools and day care centers for environmental "friendliness." c. Develop home and environmental assessment guides.

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.

Nursing students have been assigned to set up a health fair for the homeless population in a large urban setting. Without any funds to pay for space, where should the health fair be located, assuming that all of the following sites are available at no cost? a. At the city's homeless shelter, which is, by policy, vacant during the day b. At a large medical center, where the students could get permission to use an empty clinic in the evening c. At the largest inner-city police station, where there was a large empty space available d. At the local community college, where there are plenty of tables and chairs

a. At the city's homeless shelter, which is, by policy, vacant during the day

After seeing a public education program on the need for screening colonoscopy and the dangers of colorectal cancer, an older friend asks the nurse, "I'm really scared of getting cancer. What can I do to avoid that kind of cancer?" Which of the following recommendations should be made by the nurse? (Select all that apply.) a. Avoid smoking or much alcohol. b. Choose poultry or fish rather than red or processed meat. c. Eat lots of fruits, vegetables, and fiber every day. d. Try to get at least 8 hours of sleep a night

a. Avoid smoking or much alcohol. b. Choose poultry or fish rather than red or processed meat. c. Eat lots of fruits, vegetables, and fiber every day.

A nurse is working as a case manager with a vulnerable population. Which of the following actions should the nurse do when providing care? a. Be willing to enter into a long-term relationship with families. b. Direct and control the client's care because the nurse knows what is most needed. c. Encourage families to become self-sufficient and less dependent on nursing personnel for advice and referrals. d. Rotate assignments periodically to prevent attachment and codependency

a. Be willing to enter into a long-term relationship with families.

A homeless family brought their father to the public health clinic after he reported bleeding when he went to the bathroom. Which of the following nursing actions would be most appropriate? a. Begin tests to determine the cause of the bleeding while asking about other family concerns from nutrition to shelter for the night. b. Refer the man to a urologist to address the urinary bleeding. c. Suggest that the family take him to an urgent care center immediately. d. Treat the urinary infection and give the man medication to take to prevent the return of infection.

a. Begin tests to determine the cause of the bleeding while asking about other family concerns from nutrition to shelter for the night.

Which of the following best represents an example of infectious disease spreading via a vector? a. Being bitten by an infected mosquito b. Disease spreading from infected mother to infant via the placenta c. A group of partygoers hugging and shaking hands d. Two persons, one of whom is infected, sharing a glass of soda

a. Being bitten by an infected mosquito

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

Which of the following is the best way to ensure good nutrition in infants? a. Breastfeeding only b. Feed them brand-name baby foods c. Feed them only homemade cereals d. Supplement breastfeeding with brand-name formulas

a. Breastfeeding only

A nurse is caring for a migrant farm worker who has been working in the agricultural industry for the past 10 years. When questioned about environmental hazards, the client reports regular exposure to pesticides. Which of the following disorders is the client most at risk to develop? a. Cancer b. Memory loss c. Skin rashes d. Headaches

a. Cancer

Toward whom is the TLC model targeted? a. Caregivers of older persons with health problems b. Community organizations that offer services for the elderly c. Elderly clients with health problems d. Nurses who care for older clients

a. Caregivers of older persons with health problems

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 do these actions represent? a. Case management b. Client advocacy c. Holistic care d. Wrap-around services

a. Case management

A nurse notes that the community has an unusually high prevalence of sexually transmitted infections among teens. Which of the following best describes a secondary prevention action the nurse could take? a. Conducting a sexual behavior survey with the adolescents b. Establishing in-school education related to transmission of sexual infections c. Providing free condoms at schools and universities d. Providing follow-up educational programs for those diagnosed with an STI

a. Conducting a sexual behavior survey with the adolescents

A nurse has just witnessed the signing of an agreement between two parents in which the parents pledge not to yell at each other in the presence of their children. Which of the following is being demonstrated through this action? a. Contracting b. Family crisis c. Empowerment d. Health risk reduction

a. Contracting

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.

A nurse is implementing Wagner's Chronic Care Model (CCM). Which of the following actions would the nurse most likely take? a. Educate a community group about hypertension control. b. Create a budget for chronic disease management. c. Administer immunizations to community members. d. Conduct depression screenings in the community

a. Educate a community group about hypertension control.

A migrant farmworker has been injured while working on the farm. Which of the following would provide assistance to care for this injury? a. Emergency department for immediate care b. Migrant Health Act clinics c. OSHA, because the man was injured by farm machinery d. Workers' Compensation, because injury was at work

a. Emergency department for immediate care

A nurse wants to promote improved health for obese children in the community. Which of the following best describes a tertiary prevention measure that the nurse would implement? a. Establish lifestyle improvement programs through local youth organizations. b. Evaluate the food intake of a group of children for a 48-hour period. c. Provide education programs to overweight expectant parents. d. Evaluate the body mass index of children at regularly scheduled well-child exams

a. Establish lifestyle improvement programs through local youth organizations.

A Mexican immigrant mother tells the nurse she is concerned that people in the community will give her daughter mal de ojo. To which of the following folk illnesses is the nurse referring? a. Evil eye b. Fallen fontanel c. Fright d. Indigestion

a. Evil eye

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.

A male client visits the clinic office complaining of a yellow, green discharge from his penis. Which of the following STDs has the client most likely contracted? a. Gonorrhea b. Syphilis c. Herpes simplex virus 2 d. Human papillomavirus

a. Gonorrhea

Which of the following best describes the current research findings related to the use of hormone replacement therapy (HRT)? a. HRT does not prevent heart disease. b. Use of HRT is recommended to prevent osteoporosis. c. When used with complementary therapies, HRT is most effective. d. HRT is a contributing cause of breast cancer

a. HRT does not prevent heart disease.

Which of the following statements best explains why HSV-2 infection is more challenging for a client than gonorrhea infection? a. HSV-2 is a viral infection that is both chronic and incurable. b. HSV-2 is extremely expensive to treat. c. HSV-2, like HIV, is almost impossible to diagnosis in the early stages. d. Once a person has been treated for HSV-2, the person is immune to further outbreaks.

a. HSV-2 is a viral infection that is both chronic and incurable.

A nurse's family has moved to a rural area to be near her spouse's aging parents. Which of the following would the nurse most likely notice about the family's new environment? (Select all that apply.) a. It is very difficult to obtain continuing education, except for online programs. b. Neighbors seem to expect the nurse to know everything about all health care and illness conditions. c. Neighbors ask questions about health concerns any time they see the nurse, regardless of where they are. d. People come to the health clinic before their situation becomes relatively serious.

a. It is very difficult to obtain continuing education, except for online programs. b. Neighbors seem to expect the nurse to know everything about all health care and illness conditions. c. Neighbors ask questions about health concerns any time they see the nurse, regardless of where they are.

A nurse would like to learn more about the overall health of a population. Which of the following indicators would the nurse most likely use? a. Life expectancy b. Mortality rate c. Morbidity rate d. Health status

a. Life expectancy

A nurse's Mantoux test is positive for exposure to tuberculosis. Which of the following conclusions should be drawn by the nurse? a. The nurse has been exposed to tuberculosis. b. The nurse has tuberculosis. c. The positive test result probably is due to a problem in the testing process. d. The test is inaccurate and needs to be repeated

a. The nurse has been exposed to tuberculosis.

A mother is concerned that her daughter may be considering experimentation with drugs and alcohol. Which of the following strategies would the nurse suggest the mother implement? (Select all that apply.) a. Provide opportunities for her daughter to develop her talents. b. Provide realistic feedback to the daughter about her performance at school. c. Encourage her daughter to become involved in extracurricular activities. d. Encourage her daughter to develop new friendships.

a. Provide opportunities for her daughter to develop her talents. b. Provide realistic feedback to the daughter about her performance at school. c. Encourage her daughter to become involved in extracurricular activities.

A nurse has been successful in creating improvement in a family's health. Which of the following characteristics is most likely displayed by the nurse? a. Skilled at recognizing and strengthening the family's competencies b. Skilled at obtaining referrals and resources for the family c. Skilled at communication and interpersonal relationships d. Skilled at assessing the family's main problems

a. Skilled at recognizing and strengthening the family's competencies

A nurse is developing a community-based activity aimed at preventing substance abuse in the community. Which of the following interventions would the nurse most likely implement? (Select all that apply.) a. Support an increase in the availability of recreational facilities. b. Lobby to state legislators to approve a higher cigarette tax. c. Educate preschoolers about the long-term side effects of drugs and alcohol. d. Provide general screenings for substance abuse

a. Support an increase in the availability of recreational facilities. d. Provide general screenings for substance abuse

A family asks the nurse to please meet at their home rather than at the clinic. Which of the following best describes why the family prefers to meet in their home? (Select all that apply.) a. The family won't have to travel. b. It is cheaper for the family because of reimbursement requirements. c. Meeting at home is much more convenient for the family. d. The nurse won't be distracted by other clients or responsibilities. e. It would save money for the nurse and the clinic

a. The family won't have to travel. c. Meeting at home is much more convenient for the family.

A nurse requests to meet a newly referred family in their home. Which of the following best explains the rationale for this request? (Select all that apply.) a. The nurse can assess the family environment. b. The family will feel more comfortable. c. Families typically welcome others into their home. d. More family members can typically be involved.

a. The nurse can assess the family environment. b. The family will feel more comfortable. d. More family members can typically be involved.

A nurse calls a family to arrange for the first home visit. Which of the following information should the nurse share with the family? (Select all that apply.) a. The reason for the visit b. Everything the nurse knows about the family c. How many visits will be planned d. The cost of the visit and how this may be paid

a. The reason for the visit d. The cost of the visit and how this may be paid

A home health nurse who is visiting a family for the first time asks, "Could we review your extended family and other persons or groups with whom you interact each week?" Which of the following provides the best rationale for the nurse asking this question? a. To assess the family's environment and social resources and risks b. To communicate with relevant others as needed c. To determine financial assets available to the family in case of serious need d. To understand the extended family relationships

a. To assess the family's environment and social resources and risks

Which of the following must be firmly established before beginning a family assessment? (Select all that apply.) a. Why the data are needed b. How best to interview each individual in the family c. The most convenient time for you to visit the family d. The rationale or purpose of the visit

a. Why the data are needed c. The most convenient time for you to visit the family d. The rationale or purpose of the visit

A home health client has been taking acetaminophen with codeine, a narcotic analgesic, every 4 hours for pain following a hip arthroplasty. Which of the following statements made by a nurse to the client's physician indicates a need for further education on narcotics? (Select all that apply.) a. "You need to decrease the time interval between doses to every 3 hours so that my client will maintain pain relief." b. "You need to discontinue that order before my client becomes addicted." c. "You need to prescribe a different medication so that my client will achieve adequate pain relief." d. "You need to give my client something in addition to this medication."

acd

An occupational health nurse is developing an educational program to address the importance of healthy personal health habits. Which of the following topics would be most important for the nurse to address? a. Avoidance of alcohol b. Regular physical exercise c. Daily consumption of calcium-rich foods d. Monthly self-breast and testicular exams

b

A mother felt very guilty that her baby was born HIV positive. When the nurse suggested the usual DPT and MMR immunizations, the mother was extremely upset. "Don't you know HIV children are immunosuppressed?" she exclaimed. Which of the following would be the nurse's best response? a. "All children have to have these immunizations before they can attend school." b. "Being HIV positive, your child is more likely to catch an infection and be very ill if not immunized." c. "I'm so sorry; I forgot for a moment your child was HIV positive." d. "The American Pediatric Association requires all health care providers to offer these immunizations to all parents; it is your choice whether or not to accept them."

b. "Being HIV positive, your child is more likely to catch an infection and be very ill if not immunized."

When a nurse discovers that a woman has been treated for cervical cancer, the nurse asks the woman whether she has ever been tested for HIV or other STDs. The woman is offended and asks why the nurse would ask her such a thing. Which of the following statements would be the best response from the nurse? a. "Cervical cancer treatments may decrease immunity, so that it is easier to acquire STDs." b. "Cervical cancer usually is caused by HPV, and often the presence of one STD is accompanied by other STDs." c. "The presence of an STD in women with cervical cancer may lead to congenital defects in offspring." d. "The presence of an STD in a woman with a history of cervical cancer has been associated with a relapse of the cancer after treatment.

b. "Cervical cancer usually is caused by HPV, and often the presence of one STD is accompanied by other STDs."

During a group counseling session for perpetrators of intimate partner violence, which of the following statements made by a client indicates a lack of insight into his violent behavior? a. "I have been taking out my frustrations with work on my girlfriend." b. "I love my girlfriend and didn't want to hurt her; it was an accident." c. "It might be a good idea for me to temporarily leave the house when I feel myself becoming angry." d. "When I drink alcohol, I become more abusive toward my girlfriend."

b. "I love my girlfriend and didn't want to hurt her; it was an accident."

Which of the following statements by a parent indicates a need for increased learning regarding appropriate (nonabusive) discipline of a child? a. "I have stopped using a switch on my child, and I am learning to count to 10 before reacting." b. "I never spank or hit; I yell at them to stop being stupid, and if they don't, I tell them no one is ever going to love them if they act like that." c. "I use time-outs when my child acts out or is naughty. Sometimes my child doesn't cope well with this, but I am persistent." d. "When my child misbehaves, I distract him and focus his attention on other things. If he throws a tantrum, I have been known to just pick him up and leave from wherever we are."

b. "I never spank or hit; I yell at them to stop being stupid, and if they don't, I tell them no one is ever going to love them if they act like that."

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 school health nurse presents a program on preventing teen pregnancy to a group of parents. Following the presentation, which of the following comments by a parent would cause concern? a. "I do not know if my son is sexually active; however, I have decided I'm going to talk to him about it." b. "My daughter is too intelligent to get involved with boys, even if her friends do sleep around." c. "My daughter and I have often discussed sexuality, and when she's ready, I'll pay for her birth control pills. d. "I have spoken to my son about birth control. He says he's not ready to be a father and support a baby. He wants to go to college."

b. "My daughter is too intelligent to get involved with boys, even if her friends do sleep around."

A client with tuberculosis (TB) asks why the nurse is required to watch the client swallow the medication each day. Which of the following statements is the best response by the nurse? a. "Clients with TB are often noncompliant, so if I directly observe, you will be sure to take the drugs that have been ordered." b. "This therapy is recommended to make sure that you receive the treatment you need and the infection doesn't become resistant to the drugs." c. "This is to make sure you take your medication if your condition becomes so advanced that you do not have enough cerebral oxygenation to remember." d. "Tuberculosis medications are very expensive so this method ensures that government money doesn't get wasted on those who will not take the drugs."

b. "This therapy is recommended to make sure that you receive the treatment you need and the infection doesn't become resistant to the drugs."

The public health nurse comes to the hospital to see a client just diagnosed with hepatitis A. The nurse says, "I'm sorry to bother you when you're not feeling well, but I need to ask you a few questions." Which of the following questions would be most appropriate for the nurse to ask the client? (Select all that apply.) a. "Do you know how you got this infection?" b. "Who lives with you?" c. "Where are you employed?" d. "Where do you usually eat?

b. "Who lives with you?" c. "Where are you employed?"

A student complains 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."

According to the Federal Register, which of the following is the minimum income needed by a family of four to meet the basic needs for healthy living (that is, an income below this amount is considered insufficient to provide the food, shelter and clothing needed to preserve health)? a. $16,020 b. $24,300 c. $32,580 d. $40,890

b. $24,300

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

A school health nurse is asked by a parent group to explain risk factors for alcoholism. Which of the following information should the nurse include? a. Alcoholism is determined primarily by the family environment. b. Alcoholism is determined partly by genetic factors. c. Persons who are alcoholics are usually women. d. Persons born with fetal alcohol syndrome are alcoholics from birth

b. Alcoholism is determined partly by genetic factors.

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 child care 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

A teacher sends a student to the school nurse because the student does not seem to be thinking clearly. The nurse notes that the student is having palpitations, as well as elevated pulse, blood pressure, temperature. Which of the following would most likely cause these symptoms? a. Alcohol b. Bath salts c. Heroin d. Marijuana

b. Bath salts

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

Which of the following addictive drugs is both legal and culturally acceptable throughout almost all of the United States? a. Beer b. Caffeine c. Cigarettes (nicotine) d. Mixed alcoholic beverages

b. Caffeine

A nurse is working with Mexican immigrants. Which of the following behaviors would most likely lead to a positive interaction for the nurse? a. Avoiding touching the client except when necessary as part of the physical examination b. Calling the client by name, socializing before addressing the problem, and being very respectful c. Keeping all interactions direct, to the point, and targeted on the reason for presentation d. Maintaining a non-confrontational relationship by avoiding any disagreement even if the nurse does disagree with what the client is saying

b. Calling the client by name, socializing before addressing the problem, and being very respectful

Which of the following best explains why some health clinics allow clients to be tested for HIV anonymously with no record of the client's name, address, or contact information? a. Client doesn't actually ever have to be told the results of the test. b. Client may be engaged in illegal activities (drug use). c. Client plans on not paying for the test and collection agencies will not be able to harass them. d. Client wants to be sure care providers don't share results with their family.

b. Client may be engaged in illegal activities (drug use).

A nurse enters a family's home for the first time. Which of the following goals should the nurse have? (Select all that apply.) a. Assessing each family member in detail both physically and psychologically b. Collaborating with the family to establish goals and a plan for meeting them c. Determining the exact relationship between each member of the family d. Exploring the family's perception of their problems and needs

b. Collaborating with the family to establish goals and a plan for meeting them d. Exploring the family's perception of their problems and needs

A school nurse was talking to the teacher of an 8-year-old child who was living with her mother in their car. Which of the following concerns would lead the nurse to talk to the teacher about the child? a. Concern that the child is being mistreated by other children b. Concern that the child has developmental delays c. Concern that the child is given adequate food during lunch d. Concern that the child may need to sit in the front in order to be able to see well

b. Concern that the child has developmental delays

A nurse's mother leans forward and says, "My best friend fell the other day and now she's in the hospital. I'm really worried about getting osteoporosis. What do you think I should do?" What should the nurse recommend? (Select all that apply.) a. Ask your doctor for hormone replacement therapy. b. Continue to abstain from alcohol and not use tobacco. c. Eat foods high in calcium such as fortified skim milk. d. Eat lots of green leafy vegetables.

b. Continue to abstain from alcohol and not use tobacco. c. Eat foods high in calcium such as fortified skim milk.

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 and hold the baby while smiling and gazing into the baby's eyes. 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

b. Cuddle and hold the baby while smiling and gazing into the baby's eyes. d. Sing to baby with different melodies until baby seems to listen and shows a preference for certain tunes

Which of the following best describes a principle of care that the nurse should abide by when working with abusive families? a. Confront the abuser and shame him into penitence and a desire to change. b. Demonstrate respect for all family members, including the abuser. c. Exclude the abuser from family meetings because the abuser is the one creating problems. d. Notify the abuser's clergyman, boss, and others who can exert pressure for change.

b. Demonstrate respect for all family members, including the abuser.

The wife of an abusive husband reports to the nurse that her husband has been increasingly more abusive over the past year. Which of the following should be the first action that is taken by the nurse? a. Arrange for the couple to attend marital counseling. b. Develop a plan for the wife's escape if the violence starts again. c. Teach the client how to avoid initiating her husband's anger. d. Work with the client on development of self-esteem

b. Develop a plan for the wife's escape if the violence starts again.

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.

A nurse is caring for a child who has been diagnosed with a chronic health condition. Which of the following conditions would the child most likely have? a. Heart disease b. Down syndrome c. Emphysema d. Arthritis

b. Down syndrome

Which of the following best describes where health care dollars in the United States be focused to improve breast cancer cure rates? a. Education for women about breast cancer b. Early detection programs with referral to ongoing access to a care provider c. Primary prevention programs d. Tertiary care through long-term follow-up

b. Early detection programs with referral to ongoing access to a care provider

Which of the following best describes the characteristic appearance of lesions of human papillomavirus (HPV)? a. Solitary growth with elevated borders and a central depression b. Elevated growths with a "cauliflower" appearance c. Thin-walled pustules that rupture to form honey-colored crusts d. Vesicles that ulcerate and crust within 1 to 4 days

b. Elevated growths with a "cauliflower" appearance

A nurse is providing contraceptive counseling to a female client. Which of the following is the most appropriate outcome of this counseling? a. Encourage the individual to choose abstinence. b. Ensure the individual is educated to make an informed choice about reproduction. c. Advocate for increased funding for reproductive services. d. Reduce the health risks of the individual.

b. Ensure the individual is educated to make an informed choice about reproduction.

Which of the following components of the epidemiologic triangle contributes most to a female client developing a vaginal infection caused by fungi after successful treatment of her strep throat with antibiotics? a. Agent b. Environment c. Host d. Agent and host

b. Environment

Which of the following is the most rapidly growing group of homeless? a. Adolescents b. Families with children c. Persons in crisis d. Single men

b. Families with children

A nurse is conducting a screening for type 2 diabetes for children attending a local school. In addition to an elevated BMI, which of the following risk factors should the nurse consider? a. Caucasian descent b. Family history of type 2 diabetes c. Birthweight greater than 9 pounds d. Poverty

b. Family history of type 2 diabetes

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.

Which of the following factors may lead to increased violence? (Select all that apply.) a. Adequate social support b. Feelings of powerlessness c. Violence shown in the media d. Living in a crowded environment

b. Feelings of powerlessness c. Violence shown in the media d. Living in a crowded environment

Which of the following is the most likely reason for a man to rape a woman? a. Because the woman was asking for it b. For power and control c. Provoked by the woman's dress and behavior d. Sexual pleasure and release

b. For power and control

Which of the following approaches has research suggested is the most effective way to approach drug addiction? a. Criminal justice system b. Harm reduction c. Punishment approach d. Substance abuse education

b. Harm reduction

Nurses at a homeless clinic are concerned that homeless clients rarely return to have the nurses assess the findings of their tuberculosis (TB) skin tests. Which of the following is the most appropriate policy for the clinic to have regarding the screening test findings? a. Call all homeless clients 48 hours after TB skin testing to remind them to return to the clinic for test interpretation. b. Have homeless individuals read their TB skin test, if necessary, and mail in results on a postage-paid card coded to protect privacy. c. Readminister the TB skin test if the client returns later than scheduled for test interpretation. d. Routinely refer all homeless clients for chest X-rays

b. Have homeless individuals read their TB skin test, if necessary, and mail in results on a postage-paid card coded to protect privacy.

A nurse was shocked when late one night she saw a former high school friend going through a trash bin outside a fast-food restaurant and pulling out half-eaten food. Which of the following is the most likely explanation for a healthy young adult engaging in such behavior? a. He ate his meal but wanted more and had no more money. b. He had full-time employment, but with such a low salary it was inadequate to meet basic expenses. c. A friend had thrown his meal away, and he thought he could find his friend's untouched food. d. He was doing this to fulfill an obligation of fraternity initiation at the college

b. He had full-time employment, but with such a low salary it was inadequate to meet basic expenses.

A nurse is caring for Mexican migrant farmworkers. Which of the following conditions are of greatest importance for the nurse to assess? (Select all that apply.) a. Cholera b. Hepatitis c. High blood level of lead d. Malaria

b. Hepatitis c. High blood level of lead

Which of the following is the number-one cause of death worldwide? a. Chronic diseases (heart disease, cancer, stroke) b. Infectious diseases c. Injuries (accidental or purposeful) d. Terrorism

b. Infectious diseases

A student comes to the college health clinic with typical cold symptoms of fever, sneezing, and coughing, but the nurse also notes small white spots on the inside of the student's cheeks. Which of the following actions should be taken by the college health nurse? a. Inform all students, staff, and faculty of a possible rubella epidemic. b. Inform all students, staff, and faculty of a possible measles epidemic. c. Reassure the student that it is just a bad cold and will soon pass. d. Tell the student to take two acetaminophen and drink lots of fluids

b. Inform all students, staff, and faculty of a possible measles epidemic.

A nurse is concerned about the prevalence of tuberculosis among migrant farmworkers. Which of the following activities would be best to use when implementing tertiary prevention? a. Administer purified protein derivative (PPD) to contacts of those with tuberculosis. b. Initiate directly observed therapy (DOT) for tuberculosis treatment. c. Provide education about the prevention of tuberculosis to members of the migrant community. d. Use skin tests to screen migrant health workers for tuberculosis infection.

b. Initiate directly observed therapy (DOT) for tuberculosis treatment.

Which of the following conditions of the rural environment provides increased opportunities for teaching? a. Increased interaction among residents due to neighbors visiting neighbors on the family farms b. Involvement in rural community activities provides more contact with community residents than in urban areas c. Nursing responsibilities in these areas stress the importance of primary, secondary, and tertiary prevention d. Increased illnesses and injuries of rural residents require that they see nurses more often

b. Involvement in rural community activities provides more contact with community residents than in urban areas

Which of the following best explains why chlamydia is a major focus of public health efforts? a. It has more serious long-term outcomes than other STDs. b. It can cause problems in infants born to infected mothers. c. It is not frequently seen in the United States. d. It is so difficult and expensive to treat.

b. It can cause problems in infants born to infected mothers.

A nurse is making an appointment with a family for a nursing visit. Which of the following describes a potential barrier the nurse may encounter? a. The assessment cannot be done unless the extended family is present. b. It may be difficult to find a convenient time for all family members to be present. c. Nurses have limited time to do home visits. d. Families are often scattered over a large area, making access difficult.

b. It may be difficult to find a convenient time for all family members to be present.

A nurse is in the termination phase of the nurse-family relationship. Which of the following strategies would the nurse most likely implement? a. Increasing sessions with the nurse b. Making referrals when appropriate c. Providing a formative evaluation of the relationship d. Refusing additional communication with the family

b. Making referrals when appropriate

Which of the following is the most common vector-borne disease worldwide? a. Dengue b. Malaria c. Onchocerciasis (river blindness) d. Yellow fever

b. Malaria

Which of the following is an accurate concern about the use of marijuana? a. Marijuana has painful withdrawal symptoms. b. Marijuana may damage the respiratory tract. c. Marijuana can often reduce pain but physicians refuse to prescribe it. d. Marijuana quickly leads to psychological and physiological dependence

b. Marijuana may damage the respiratory tract.

Which of the following groups is most at risk for suicide? a. Adolescents under age 20 b. Men over age 85 c. Females 25 to 45 years of age d. Women over age 65

b. Men over age 85

Which of the following statements accurately describes why methadone is used to treat heroin addiction? a. Addicts come to prefer methadone instead of heroin. b. Methadone blocks the effects of heroin and reduces the craving. c. Methadone prevents further dependence on drugs. d. Methadone gives an enjoyable high, so addicts continue treatment.

b. Methadone blocks the effects of heroin and reduces the craving.

Which of the following is of the greatest concern for the nurse who works with high school students? a. Alcohol use b. Motor vehicle accidents c. Sports-related injuries d. Unprotected sex

b. Motor vehicle accidents

The nurse who works at a homeless clinic wants to improve healing of chronic wounds in clients living on the streets. Which of the following would be the best action to take to improve client outcomes? a. Provide antibiotics to all homeless persons with chronic, nonhealing wounds b. Offer daily access to a room with soap, water, and bandages c. Hand out free bandaging supplies following each clinic visit d. Perform regular monitoring of the client's wound condition

b. Offer daily access to a room with soap, water, and bandages

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 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

In which of the following cases would the school nurse be correct to advise the parents of an HIV-infected child to keep the child home from school? (Select all that apply.) a. The child develops allergies with sneezing. b. The child persists in biting behavior or is unable to control body secretions. c. The nurse is not comfortable with being responsible for the child. d. There is an outbreak of chickenpox in the school.

b. The child persists in biting behavior or is unable to control body secretions. d. There is an outbreak of chickenpox in the school.

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.

The nurse is told that a healthy, functional family consisting of a 25-year-old man and a 24-year-old woman, who are expecting their first child, would appreciate a nurse coming to their apartment for anticipatory guidance in preparing themselves and their apartment for the baby. Based on that statement, which of the following assumptions can the nurse safely make about the family? a. The family is lacking a strong support system. b. The family's basic needs are being met. c. The couple's in-laws are unavailable to share their expertise about child care. d. The married couple is excited about their first baby

b. The family's basic needs are being met.

Six students order meals at a local restaurant. Which of the following students are at highest risk for illness? (Select all that apply.) a. The first student asks for a salad with chicken strips and dressing on the side. b. The second student asks for a hamburger, very rare. c. The third student orders a tuna salad sandwich with extra mayonnaise. d. The fourth student orders a breakfast meal with two very soft-poached eggs and toast.

b. The second student asks for a hamburger, very rare. d. The fourth student orders a breakfast meal with two very soft-poached eggs and toast.

A nurse sees the father of a newborn baby push his wife in a wheelchair out onto the patio. The man and woman each smoke a cigarette while the baby sleeps in the mother's arms. Which of the following information should the nurse share with the parents? a. Fetal nicotine syndrome may cause complications in the newborn. b. The sidestream smoke that the baby is exposed to is more dangerous than the mainstream smoke that the parents are inhaling themselves. c. The baby will eventually develop tolerance to tobacco smoke. d. The parents should switch to chewing tobacco as long as the child lives in the home

b. The sidestream smoke that the baby is exposed to is more dangerous than the mainstream smoke that the parents are inhaling themselves.

Which of the following populations experiences the highest incidence of poverty? a. Those between the ages of 18 and 64 b. Those under the age of 18 c. Those over the age of 65 d. Those between the ages of 18 and 25

b. Those under the age of 18

Which of the following best describes the current goal in relation to communicable diseases? a. To control political borders so diseases cannot spread further b. To exterminate specific infectious agents one by one c. To expand health care facilities to improve infectious disease treatment d. To achieve worldwide immunization to control new cases

b. To exterminate specific infectious agents one by one

Which of the following should be the initial consideration made by a nurse who is working with lesbian, gay, bisexual, and transgendered (LGBT) families? a. Understanding of same sex marriage laws within the state b. Understanding of personal feelings of working with members of this community c. Assessment of the family structure within the LGBT family d. Assessment of sexual orientation in a safe environment

b. Understanding of personal feelings of working with members of this community

The advanced practice nurse explains that the client has an upper respiratory infection (URI) and suggests several measures that might make the client more comfortable. Which of the following best describes why the nurse doesn't just prescribe antibiotics as the client repeatedly requests? (Select all that apply.) a. Antibiotics are expensive, whereas the support measures would be almost free of cost. b. Viral diseases are not affected by antibiotics. c. Clinics cannot afford to continually give antibiotics to anyone who asks for them. d. The more antibiotics are prescribed, the more infectious agents develop resistance to such drugs.

b. Viral diseases are not affected by antibiotics. d. The more antibiotics are prescribed, the more infectious agents develop resistance to such drugs.

A mother says, "My son wants me to let him buy a car. I must admit, I certainly get tired of driving him around to all his sports and other activities. Do you think I should let him have a car?" Which of the following statements would be the best response by the nurse? a. "Absolutely, it will help him recognize the cost of gas and maintenance." b. "Certainly. Most young men want their own car, and peer pressure can be painful." c. "It depends on whether you trust your son to drive safely." d. "No, adolescent males cannot be trusted with an automobile."

c

A nurse wants to establish a program to decrease the death rate among adolescents. Which of the following programs should be developed? a. Antialcohol program b. Antismoking program c. Careful driving program d. Safe sex program

c

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."

A woman has just delivered a baby and is lamenting that the baby's father is not with her. She shares with you that he became involved with drugs and is now in prison for theft. The new mother says, "It's so sad. He's clearly no good." Which of the following would be the best response by the nurse? a. "I'm so sorry to hear that. Is your mother able to be with you?" b. "It's good that you and the baby are safe from him." c. "Is there anyone to help you with the baby until the baby's father can be released and encouraged to get treatment for his addiction?" d. "You must hate him for leaving you alone with a new baby!"

c. "Is there anyone to help you with the baby until the baby's father can be released and encouraged to get treatment for his addiction?"

Which of the following public health actions has been particularly instrumental in reducing childhood infectious diseases in the United States? a. Answering parents' questions about the safety and importance of vaccines today b. Educational campaigns to all health care providers about the importance of immunizations whenever a child is seen c. "No shots, no school" legislation, which legally requires children be immunized before school d. Offering all immunizations to all children free of any charge

c. "No shots, no school" legislation, which legally requires children be immunized before school

A man loudly protests his increased property tax bill right after the public health department has made a plea for more funds. "Why," he asks, "should my tax dollars be used to pay for their children to be immunized?" Which of the following would be the best response by the nurse? a. "Immunizations are required by law, and if their parents can't afford it, you and I will have to pay for it." b. "It's just the right thing to do." c. "Only by making sure most kids are immunized can we stop epidemics that might hurt all of us." d. "We're a religious God-fearing community, and we take care of each other.

c. "Only by making sure most kids are immunized can we stop epidemics that might hurt all of us."

An instructor is reviewing Salmonella infections with her class. Which of the following comments indicates that the student needs further review on how Salmonella is spread? a. "Certain pets and farm animals may be Salmonella carriers." b. "It is possible to transmit Salmonella by person-to-person contact." c. "Salmonella may be spread by spores that form once contaminated blood is exposed to the air." d. "Salmonella outbreaks are usually due to contaminated meat, poultry, and eggs."

c. "Salmonella may be spread by spores that form once contaminated blood is exposed to the air."

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 nurse is providing education to a client about the use of PrEP. Which of the following statements would the nurse include as part of this teaching? a. "Side effects of PrEP include extreme lethargy and joint pain." b. "PrEP has been shown to be effective in preventing transmission of the disease from sharing needles." c. "The effectiveness of PrEP will depend on your adherence to the medication regimen." d. "PrEP will prevent you from contracting HIV and Hepatitis B.

c. "The effectiveness of PrEP will depend on your adherence to the medication regimen."

A nurse is implementing risk reduction interventions with a family. Which of the following questions is most important for the nurse to ask? a. "Did any of the hunters in your family kill a deer this year?" b. "How do you keep your rifles safe from curious children?" c. "Where do you shoot with your handguns?" d. "Where do you keep your rifles locked when it is not hunting season?"

c. "Where do you shoot with your handguns?"

A staff member is orienting a new nurse to a health clinic that serves primarily vulnerable populations. Which of the following statements indicates a need for additional staff education? a. "If a client who does not speak English comes in, you must obtain an interpreter right away." b. "We try to take care of as many problems as possible in one visit, so when you interview the client ask about additional concerns." c. "You will like working with Hispanic immigrants because they have close-knit family structures." d. "You will need to assist the client by scheduling any referral or follow-up appointments around their work schedules."

c. "You will like working with Hispanic immigrants because they have close-knit family structures."

A public health nurse is hosting an informational meeting for young parents about how to balance their multiple responsibilities. Which of the following parents in attendance would be most at risk for abusing his or her own child? a. A new mother who has joined a parents' support group b. A father who is overwhelmed and exhausted by overtime work c. A depressed father who was laid off from work and is missing his work colleagues d. A mother who is missing her career challenges and friends but enjoying being home with her baby

c. A depressed father who was laid off from work and is missing his work colleagues

A client has designated someone else to make health care decisions when he or she is unable to do so. Which of the following methods is the client using to make health care decisions? a. An advance directive b. A living will c. A durable power of attorney d. A Do-Not-Resuscitate (DNR) order

c. A durable power of attorney

Which of the following families is at high risk for health problems? a. A man agrees that he needs to eat better and exercise more but also expresses how busy he is at his job. b. A man knows that his grandfather, father, and older brother all died of cardiac disease. c. A man is currently unemployed and despairs about finding a position. d. A man expresses disappointment that, having been laid off as an executive, his new position pays only about two thirds of his original salary

c. A man is currently unemployed and despairs about finding a position.

Which of the following is the most accurate description of a migrant farmworker? a. A person who does farm work as the primary means of employment, although other work may be done when the seasonal work ends b. A person who immigrates to the United States to "follow the crops" in performing seasonal farm work c. A person who moves from place to place to earn money performing seasonal agricultural work d. A person who specializes in the development of rural land for the purpose of farming

c. A person who moves from place to place to earn money performing seasonal agricultural work

Which of the following best describes a health professional shortage area (HPSA)? a. An area with inadequate health care facilities for residents b. An isolated area of underserved populations within an urban region c. A region with insufficient numbers of health care providers d. A rural region of the United States with a population density of less than 10,000

c. A region with insufficient numbers of health care providers

A nurse is drawing a genogram. Which of the following would the nurse use to demonstrate a marriage relationship between two individuals? a. A broken horizontal line b. An X through a circle c. A solid horizontal line d. A solid vertical line

c. A solid horizontal line

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

Which of the following best describes a normative life event that can increase the risk for illness? a. A family is involved in a motor vehicle crash. b. A group of teens experiment with recreational drugs. c. A woman is pregnant with her first child. d. The family wage earner is laid off from his job.

c. A woman is pregnant with her first child.

Which of the following situations would most likely indicate elder abuse? a. A daughter refuses to visit her mother due to work commitments. b. A child runs around a grandparent's house breaking items. c. A young man repeatedly steals money from his grandmother. d. An elderly person demands that the family come for dinner.

c. A young man repeatedly steals money from his grandmother.

A nurse is new to the community but wants to begin planning immediately for health promotion programs. Even though the nurse does not yet know the community, which of the following programs would be good to plan first? a. Alcohol and tobacco cessation programs b. Cancer screening programs c. Cardiac health education programs d. Exercise for life program

c. Cardiac health education programs

A migrant farmworker brings his daughter to the clinic with severe heat stroke from being out in the sun. The nurse explains the danger signs and stresses staying cool and drinking lots of water. The man seems to know this already. Which of the following best describes the most likely reason that this happened? a. It was a rare occurrence, which probably won't be repeated. b. The daughter either disobeyed her father and went out to play in the sun or just did not realize how hot she was. c. Children may work on small farms because the family may need the additional income. d. The parents were busy working and didn't realize the child was outside so long.

c. Children may work on small farms because the family may need the additional income.

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 man who takes a prescribed narcotic for pain on a regular basis reports that he does not like the way the medicine makes him feel. He has tried to change to an alternate analgesic but experienced withdrawal symptoms when he stopped taking the narcotic. Which of the following problems is the man experiencing? a. Drug abuse b. Drug addiction c. Drug dependence d. Substance abuse

c. Drug dependence

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 and mental health d. Fostering interpersonal relationships and support

c. Ensuring physical and mental health d. Fostering interpersonal relationships and support

A nurse is completing an initial home visit with a family. Which of the following actions should be taken first by the nurse? a. Assess the family and the home setting for both strengths and problems. b. Determine the family's expectations of a home visit. c. Establish rapport between the nurse and the family. d. Engage in extended social interaction as would be expected from any guest.

c. Establish rapport between the nurse and the family.

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 providing preconceptual counseling to a young woman. Which of the following supplements would the nurse most likely recommend? a. Iron b. Calcium c. Folic acid d. Vitamin C

c. Folic acid

The nurse and the family have agreed on an ambitious goal to improve family functioning, but as the family later expresses with some dismay, they have not been able to change their behavior as easily and quickly as they had hoped. Which of the following must be remembered throughout this process? (Select all that apply.) a. A reassessment of resources should be done if the plan does not work. b. Individual family members must all be willing to make the plan their first priority. c. Goals must be realistic and feasible. d. Ongoing negotiation is central to the process.

c. Goals must be realistic and feasible. d. Ongoing negotiation is central to the process.

Which of the following characteristics indicates a man is at a higher risk for developing prostate cancer? a. Being of Caucasian descent b. Has not had a PSA test c. Has a father or brother who has had prostate cancer d. Has benign prostatic hypertrophy

c. Has a father or brother who has had prostate cancer

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 of 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 sexually transmitted diseases can be prevented through immunization? a. Chlamydia b. Gonorrhea c. Hepatitis B d. Herpes

c. Hepatitis B

A nurse is assessing a young, single pregnant woman. Which of the following findings would be of most concern? a. Elevated blood pressure b. First prenatal visit at 5 months' gestation c. Homelessness d. Positive STD test

c. Homelessness

A nurse is working to improve her self-awareness in order to provide better client-centered care to clients living in poverty. Which of the following questions should the nurse ask herself? a. What would I do if I lived in poverty? b. What can be done to get poor people motivated to work? c. How have the media images of poor persons shaped my image of poverty? d. How can community resources assist those living in poverty

c. How have the media images of poor persons shaped my image of poverty?

Which of the following data would most likely be collected in a syndromic surveillance system? a. Incidence of bioterrorism attacks b. Number of air travelers c. Incidence of school absenteeism d. Number of influenza vaccines administered

c. Incidence of school absenteeism

A school nurse wants to decrease the rate of obesity among children. Which of the following actions in the community would be most effective? a. Lobby legislators to enact stronger legislation regarding school lunches and snack machines in schools. b. Increase nutrition programs in schools that teach children to make healthy food choices. c. Involve the entire family in the planning and managing of nutrition, especially when a child in the family is obese. d. Provide after-school and summer camps that focus on diet and exercise

c. Involve the entire family in the planning and managing of nutrition, especially when a child in the family is obese.

A nurse is providing nutrition counseling to the parents of a 4-year-old. Which of the following recommendations is the nurse most likely to provide? a. It is recommended that the child consume approximately 10 ounces of grains on a daily basis. b. It is recommended that the child consume approximately four cups of dairy on a daily basis. c. It is recommended that the child consume approximately four cups of fruits and vegetables daily. d. It is recommended that the child consume approximately 10 ounces of protein on a daily basis.

c. It is recommended that the child consume approximately four cups of fruits and vegetables daily.

If underlying causes were listed on autopsy reports, which of the following would be the most common cause of unnecessary death in the United States? a. Alcohol b. Guns c. Lack of exercise d. Unprotected sex

c. Lack of exercise

A teacher asks the school health nurse to assess a child for neglect. Which of the following assessment findings could indicate neglect? a. Bruises in various stages of healing b. Failure of parent to attend parent-teacher conferences or return teacher phone calls c. Lack of weight gain and wearing dirty clothes d. Lice in the hair

c. Lack of weight gain and wearing dirty clothes

A nurse arrives at a home at the appointment time established with the client over the phone. However, no one answers the door. Finally a teenager comes out and says, "My mom said she couldn't see you and you should go away." Which of the following actions should be taken by the nurse? a. Demand the teen let the nurse into the home to talk to the mother. b. Interview the child as to how the family is doing. c. Leave a card with information on how to get in touch with the nurse. d. Point out that legally once an appointment has been made the mother needs to be seen.

c. Leave a card with information on how to get in touch with the nurse.

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

Which of the following is the most common vector-borne disease in the United States? a. Babesiosis b. Ehrlichiosis c. Lyme disease d. Rocky Mountain spotted fever

c. Lyme disease

Which of the following is the leading cause of disability for Americans 15 to 44 years of age? a. Accidents b. Arthritis c. Major depression d. Workplace injuries

c. Major depression

A health care provider is working with elderly clients who have ongoing chronic disease. Which of the following strategies can best assist them with healing? (Select all that apply.) a. Advocating for increased support for elderly persons b. Eliminating signs and symptoms of disease c. Managing any chronic diseases to prevent complications and delay deterioration d. Maximizing self-care capacity

c. Managing any chronic diseases to prevent complications and delay deterioration d. Maximizing self-care capacity

A nurse is implementing a tertiary prevention program to promote health among middle-aged women with diabetes. Which of the following best describes the intervention being implemented by the nurse? a. Developing lifestyle improvement programs for women at risk for diabetes b. Presenting lifestyle management presentations at women's conferences c. Monitoring blood glucose levels closely and modifying diet accordingly d. Screening glucose levels of women at risk for development of diabetes

c. Monitoring blood glucose levels closely and modifying diet accordingly

Which statement about eating disorders is correct? a. Individuals with anorexia frequently complain about weight loss. b. Purging is associated with anorexia. c. Most women with bulimia are concerned with the shape and weight of their body. d. Bulimia is considered to have more medical complications than anorexia.

c. Most women with bulimia are concerned with the shape and weight of their body.

A nurse is trying to decrease the risk for depression among older adults. Which of the following interventions should the nurse implement? a. Encourage moving to a nursing home where others of the same age reside. b. Monitor for signs and symptoms of depression. c. Organize an exercise and health promotion program at the local senior citizen center. d. Teach older clients to focus on their strengths rather than their weaknesses.

c. Organize an exercise and health promotion program at the local senior citizen center.

A community mental health nurse is working within the community to help prevent youth violence. Which of the following interventions would most likely be implemented by the nurse? a. Distributing literature that associates violence with a lack of intelligence b. Explaining to youth why youth violence is detrimental to society c. Partnering with associations to provide alternative activities that improve social skills d. Recommending increased funding to prosecute and jail teens associated with violent activity

c. Partnering with associations to provide alternative activities that improve social skills

A migrant farmworker presents to the clinic reporting an acute onset of severe abdominal pain, nausea, vomiting, diarrhea, and headache with difficulty concentrating. Which of the following conditions would cause such symptoms? a. Appendicitis b. Bacterial gastroenteritis c. Pesticide poisoning d. Viral illness

c. Pesticide poisoning

Which of the following is a common factor typically found in those who abuse others? a. Fear and belief that others are "out to get them" b. Poor self-esteem and unawareness of alternatives c. Previous observations of violent behaviors to manage conflict d. Difficulty keeping commitments

c. Previous observations of violent behaviors to manage conflict

Which of the following symptoms suggests smallpox as opposed to the more common and much less dangerous chickenpox? (Select all that apply.) a. Child appears only mildly ill until late stages in smallpox. b. Lesions appear in various stages in the same area of the body rather than all at once. c. Rash lesions are most abundant on the face and extremities, not on the trunk. d. Rash occurs 2 to 4 days after sudden onset of fever rather than with the fever.

c. Rash lesions are most abundant on the face and extremities, not on the trunk. d. Rash occurs 2 to 4 days after sudden onset of fever rather than with the fever.

A home health nurse is preparing to terminate the first home visit with teenage parents and their new baby. Which of the following actions will the nurse take before leaving? a. Determine the family's willingness for another home visit b. Establish the purpose of the visit c. Review the family's learning and other accomplishments of the visit d. Review the family record and reason for referral

c. Review the family's learning and other accomplishments of the visit

A teenager who has just come in for her prenatal visit appears to be about 6 months pregnant. Which of the following best describe why the teenage girl has waited so long to come in for prenatal care? (Select all that apply.) a. Her friends were suggesting ways to make the problem go away. b. She knew she could not be pregnant because her boyfriend said he used a condom. c. She was afraid her parents would pressure her to terminate the pregnancy. d. She kept hoping the pregnancy would just go away.

c. She was afraid her parents would pressure her to terminate the pregnancy. d. She kept hoping the pregnancy would just go away.

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

A nurse has just met a family and is completing their family assessment. Which of the following actions should the nurse take before engaging in self-disclosure? a. Confirm the reason for the appointment. b. Demonstrate cultural awareness. c. Take time to build trust. d. Understand the family dynamics.

c. Take time to build trust.

A nurse advises a client who has HIV not to donate blood, plasma, or organs. Which of the following levels of prevention is being used? a. Primary prevention b. Secondary prevention c. Tertiary prevention d. Health promotion

c. Tertiary prevention

A school nurse was caring for an 8-year-old child who had been hurt on the school playground. During the nurse's assessment, the child admitted that her mother was working but didn't make much money so the girl and her mother were living in their car. Based on this information, which of the following would the nurse most likely suspect? a. The child is accident-prone and clumsy. b. The child is being bullied and pushed around by other children. c. The child is more likely to have school absences. d. The child is in need of a vision screening.

c. The child is more likely to have school absences.

Which of the following clients would cause the nurse the most concern? a. The client who is currently unemployed but actively seeking a position and frequently walking from one interview to another b. The client who is not employed but spending time at the gym keeping fit and studying the benefits of organic natural uncooked foods c. The client who is employed and often works 12 hours a day without moving from the computer desk d. The client who is employed but always leaves promptly at 5:00 to pick up the children from the day care center

c. The client who is employed and often works 12 hours a day without moving from the computer desk

A movie shows a woman and a man having a contest to see who can drink more shots of whiskey. Who is more likely to "win" the drinking contest when the other passes out and cannot continue? a. If their drinks are the same size, they'll both pass out about the same time. b. If they play fair, they'll probably both vomit before passing out. c. The man will win. d. The woman will win

c. The man will win.

Which of the following is the top risk factor for intimate partner homicide? a. There is a gun in the house. b. The husband has made threats against wife before. c. The wife has previously called 911 because of husband's beating her. d. The woman's young daughter also lives with them

c. The wife has previously called 911 because of husband's beating her.

Which of the following provides the best explanation as to why people do not immediately seek medical treatment when they first become ill with HIV? a. They are afraid to get tested for fear results will be positive. b. They avoid the problem (maybe it will go away). c. They don't recognize their symptoms as possibly being due to HIV. d. It is too expensive to get an HIV test.

c. They don't recognize their symptoms as possibly being due to HIV.

In the United States, which group is most affected by a new HIV diagnosis? a. Women having heterosexual relationships b. White IV drug abusers c. Young Black gay and bisexual men d. Men who have sex with other men

c. Young Black gay and bisexual men

A student asks the nurse at the student health clinic how AIDS is diagnosed. Which of the following statements would be the best response by the nurse? a. "A diagnosis of AIDS is made when a screening test called an enzyme-linked immunosorbent assay (ELISA) is confirmed by the Western blot test." b. "A diagnosis of AIDS is made when antibodies to HIV are detected about 6 weeks to 3 months following possible exposure." c. "A diagnosis of AIDS is made when antibodies to HIV reach peak levels of 1000/ml of blood." d. "A diagnosis of AIDS is made when CD4 T lymphocytes drop to less than 200/ml."

d. "A diagnosis of AIDS is made when CD4 T lymphocytes drop to less than 200/ml."

A client who is very upset says to the nurse, "But we always used a condom! How could I have genital warts?" Which of the following would be the best response by the nurse? a. "Are you positive you always used a condom?" b. "Condoms don't always work." c. "The condom might have had a tear in the latex." d. "Contact may have occurred outside the area that the condom covers."

d. "Contact may have occurred outside the area that the condom covers."

A nurse is reviewing with a client the importance of the diabetic diet to maintaining control of blood glucose levels. The client states, "I went to the classes and learned how to count carbohydrates. I have even started to write down what I eat for each meal." Which of the following would be most appropriate response from the nurse? a. "I'm so glad you're beginning to recognize the need to control your blood sugar." b. "Now you just have to make sure you don't give that habit up!" c. "Sounds like you're not ready to really plan your eating yet." d. "That is great. You've started to take action and make changes."

d. "That is great. You've started to take action and make changes."

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?"

A high school student is planning to volunteer at the hospital after school, so she needs to have a Mantoux test before beginning. Which of the following information should the nurse provide to the new volunteer? a. "I will be using tiny tines to administer the TB antigen to the skin on your arm." b. "Notify the clinic immediately if you experience any redness or itching at the test site." c. "The areas should be kept dry until you return; cover it with plastic wrap when bathing." d. "You will need to return in 2 to 3 days to have any reaction interpreted."

d. "You will need to return in 2 to 3 days to have any reaction interpreted."

A mother and her son are in the emergency department. The mother is extremely upset. Earlier, the son had become so angry that he put his hand through a glass window and had to have stitches. The physician suggested a psychiatric consult. Now the mother asks, "Do you think my son is crazy?" Which of the following is the most appropriate response by the nurse? a. "Absolutely not. But a psychiatrist can help your son realize more appropriate ways of displaying anger." b. "Have you had other reasons to think your son is crazy? Perhaps the psychiatrist can reassure you that your son is just an adolescent coping with hormones." c. "Your son is having problems coping with anger. And naturally you're upset. Let the psychiatrist determine whether your son is crazy or not." d. "Your son is having problems with behavior, which is distressing all of you. A psychiatrist may be able to help your son cope with life in a more acceptable way."

d. "Your son is having problems with behavior, which is distressing all of you. A psychiatrist may be able to help your son cope with life in a more acceptable way."

A nurse was reading PPD tests 24 hours after another nurse had administered them. Which of the following findings would cause the nurse to interpret the test as positive? a. 15 mm of erythema in a client with HIV infection b. 5 mm of induration in an immigrant from a country where TB is endemic c. A 5-mm ruptured pustule with purulent drainage in a homeless client d. 10 mm of swelling and increased firmness in a client recently released from a correctional facility

d. 10 mm of swelling and increased firmness in a client recently released from a correctional facility

Which of the following statements best describes an outcome of the Balanced Budget Act of 1997? a. Additional funding was provided to the State Children's Health Insurance Program (SCHIP). b. Individuals were able to keep their health insurance when moving from one place to another. c. Patient privacy and security of health information was enhanced. d. A prospective payment system for home health services was created

d. A prospective payment system for home health services was created

A nurse has just met the parents of a 10-year-old child who has been diagnoses with a congenital heart defect. When interviewing the parents, which of the following would be a priority question for the nurse to ask? a. What are the learning needs of your child? b. What does your child eat on a typical day? c. Does your child have a good peer support network? d. Does your child have a medical home?

d. Does your child have a medical home?

A home health nurse is about to visit a family at their home. However, the nurse is feeling uncomfortable about getting out of her car because a group of young adults across the street are drinking and fighting among themselves. Which of the following actions should be taken by the nurse? a. Call the agency and ask what she should do. b. Call the family, explain the situation, and try to reschedule. c. Fulfill the nurse's commitment to the family and enter the home quickly. d. Drive away and notify the family from a safer location.

d. Drive away and notify the family from a safer location.

A woman needs to take some time off from work to care for her invalid mother. Which of the following health policies allows her to take an extended leave from work to care for a family member? a. Patient Self-Determination Act b. Personal Responsibility and Work Opportunity Reconciliation Act c. Temporary Assistance for Needy Families (TANF) d. Family and Medical Leave Act (FMLA)

d. Family and Medical Leave Act (FMLA)

Which of the following terms refers to government actions that have a direct or indirect effect on families? a. Family funding b. Family legislation c. Family planning d. Family policy

d. Family policy

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

There is great concern in the nurse's community over three local cases of West Nile virus. Which of the following actions should the nurse take to get the community involved in addressing this problem? a. Ask the state department of health for assistance b. Demand that everyone over age 65 become immunized immediately c. Encourage immunization of all children under 12 d. Have an educational campaign to remove any containers of standing water

d. Have an educational campaign to remove any containers of standing water

Which of the following infectious disease interventions best represents the use of secondary prevention? a. Clients with HIV infection are encouraged to use condoms to protect sexual partners. b. Clients with HIV infection are given medications to improve immunological response. c. Health care workers are encouraged to receive annual vaccinations for influenza. d. Health care workers are required to have a tuberculosis skin test or chest X-ray.

d. Health care workers are required to have a tuberculosis skin test or chest X-ray.

A nurse is counseling a woman following a rape. Which of the following feelings is the woman most likely to state she felt while being raped? a. Confusion b. Satisfaction c. Sexual release d. Helplessness

d. Helplessness

An elderly person is in the last stages of dying. Which type of care would be the best for him? a. Home health b. Assisted living c. Nursing home d. Hospice

d. Hospice

A school nurse stops a student in the hall and asks whether the student has been having trouble with her eyes, which look rather red and dry. The female student yawns and says that she hasn't noticed any eye problems. However, she does confess to the school nurse that she has gained 15 pounds since she began smoking "special cigarettes." Which of the following is the student most likely smoking? a. Tobacco b. Crack cocaine c. Ice methamphetamine d. Marijuana

d. Marijuana

Which of the following statements best describes why health care of the homeless is so expensive to the community? a. Health conditions of the homeless require increased preventive services. b. Homeless clients typically make more clinic visits for multiple health problems. c. Homeless people spread contagious diseases to those they pass on the street. d. Most care to homeless people takes place in hospital emergency departments.

d. Most care to homeless people takes place in hospital emergency departments.

A nurse is conducting a family assessment. Which of the following behaviors would the nurse recognize as suggestive of a family with problems? a. Before eating, the family prayed, expressing gratitude for their blessings. b. During family play, jokes and laughter were heard. c. Each person had a private room with a door for alone time. d. Most of the conversation was between the father and the eldest daughter

d. Most of the conversation was between the father and the eldest daughter

During an outbreak of hepatitis A, nurses are giving injections of hepatitis A immunoglobulin to selected susceptible persons. Which of the following best describes the type of immunity that will follow the administration of these injections? a. Active immunity b. Acquired immunity c. Natural immunity d. Passive immunity

d. Passive immunity

During which phase of the home visit does the nurse document what was accomplished? a. Previsit phase b. In-home phase c. Termination phase d. Postvisit phase

d. Postvisit phase

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 town meeting with public health officials to discuss a communicable disease outbreak, a nurse is asked to explain what is meant by the phrase "a virulent organism." The nurse explains that this means the organism causing the disease is able to do which of the following? a. Bypass normal immunological response mechanisms b. Invade major organ systems c. Produce toxins and poisons that weaken the body d. Produce very severe physical reactions

d. Produce very severe physical reactions

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.

Which of the following behaviors results in men being less healthy than women? a. Concentration on sports, hunting, and other dangerous recreational choices b. Employment in stressful positions more so than women c. Preference to spend money on priorities other than health care d. Reluctance to visit physicians

d. Reluctance to visit physicians

A mother confides to the nurse that her live-in boyfriend knocked down her 2-year-old child because he was crying too much. She begs the nurse not to tell anyone because her boyfriend has agreed to take anger management classes. Which of the following actions should be taken by the nurse? a. Abide by the mother's wishes because this information was provided in confidence. b. Arrange for counseling for the boyfriend at the earliest possible availability. c. Encourage the mother to take the child and find alternate housing right away. d. Report the incident to child protective services or other appropriate legal authority

d. Report the incident to child protective services or other appropriate legal authority

A mother cannot understand why her daughter ran away from home. When the police locate the daughter, she complains of a severe headache, so the police take both of them to the emergency department for assessment. Which of the following potential problems should be assessed by the nurse? a. The daughter's inability to do well in school b. Intimacy problems with the daughter's boyfriend c. The mother's abuse of the daughter over a long period of time d. Sexual abuse by the father

d. Sexual abuse by the father

Which of the following factors predisposes many migrant farmworkers 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

A client is being treated for secondary syphilis. Which of the following signs and symptoms would the nurse anticipate the client would exhibit? a. Chancre at the site of entry b. Jaundice c. Difficulty coordinating muscle movements d. Skin rash without itching

d. Skin rash without itching

A nurse is working with a family to reduce the incidence of home violence. Which of the following actions by the nurse would most likely have a positive effect? a. Being assertive and taking control of decisions because family members cannot be expected to have this ability b. Focusing attention on family weaknesses that need to be fixed before healing can begin c. Pointing out things that victims should do differently to avoid antagonizing the abuser d. Soliciting ideas from the family regarding what they feel will improve their situation

d. Soliciting ideas from the family regarding what they feel will improve their situation

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

A large financial grant was being offered to whichever health facility wanted to accept the responsibility for giving care to local vulnerable populations. Which of the following actions would most likely be taken by the local medical centers? a. Agree to collaboratively apply for the funds in a cooperative proposal. b. Individually compete eagerly for the additional funds now available. c. Reach out enthusiastically to this previously underserved population group. d. Strongly consider not applying, because this population will be expensive to treat.

d. Strongly consider not applying, because this population will be expensive to treat.

A nurse is using the provisions of the Family Medical Leave legislation. Which of the following actions is the nurse most likely to take? a. Resigning from employment, but retaining health insurance b. Sharing family information with colleagues c. Providing Medicaid to a family who cannot afford health insurance d. Taking a defined time off of work for family events without fear of job loss

d. Taking a defined time off of work for family events without fear of job loss

A nurse wants to empower the family of a mother who has been newly diagnosed with breast cancer. Which of the following actions would the nurse most likely take? a. Apply for emergency financial assistance on the family's behalf. b. Arrange for community members to assist with child care. c. Invite the mother to join a cancer support group. d. Teach the family how to navigate the health care system

d. Teach the family how to navigate the health care system

A male IV drug abuser admits to the nurse that he has no desire to stop using drugs, so rather than lecture him on the dangers of drug addiction, the nurse counsels him on 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

Students at first-day orientation at the local community college are discussing alcohol and drug abuse with their freshmen advisor. During a break, some students go outside for soft drinks and snacks. Soon after, the advisor walks by and notices several of these students smoking cigarettes. Based on this, which of the following topics of the drug and alcohol orientation would be most important for the advisor to reemphasize after the break? a. A discussion of which drugs are commonly used on campus b. How students can learn to "just say no" when offered drugs or drinks c. How to recognize and overcome peer pressure to continue bad habits d. The fact that tobacco smoking causes more deaths than any other behavior in the United States

d. The fact that tobacco smoking causes more deaths than any other behavior in the United States

The following people enter the health clinic together: an unmarried man and his 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.

A student engages in unprotected sex under the influence of alcohol. The student decides to have an HIV test completed the next day. Which of the following results will most likely occur? a. The results will probably be negative for HIV. b. The results will probably be positive for HIV. c. The probability of disease is so low there is no reason to be tested. d. The test results won't be reliable so soon after exposure.

d. The test results won't be reliable so soon after exposure.

A client was clearly very relieved when an HIV test came back negative. "Thank goodness. I've had sex several times without a condom, and when one of my friends said he was sick, I think I panicked." Which of the following would be most important to emphasize to the client immediately? a. Abstinence is the only way to be certain you are HIV-free. b. Sex should be restricted to one partner. c. The test could be wrong and the client might still have an HIV infection. d. The test would not cover any recent infection, so if the client has had recent unprotected sex, the test should be repeated in 3 months.

d. The test would not cover any recent infection, so if the client has had recent unprotected sex, the test should be repeated in 3 months

A man is addicted to alcohol. In which of the following scenarios is a family member enabling the man to continue drinking? a. The wife asks the nurse to explain why her husband's continued drinking is dangerous. b. The son threatens to leave home because he finds the father's behavior embarrassing. c. The teenage daughter turns to a favorite teacher for emotional support. d. The wife tells her husband's boss that her husband is sick when he is actually inebriated.

d. The wife tells her husband's boss that her husband is sick when he is actually inebriated.

Which of the following statements best explains why many health care providers are more afraid of getting hepatitis B than HIV? a. Everyone would assume the person infected with hepatitis B is a drug user. b. Having HBV would mean no further employment in health care. c. The fatality rate is higher and occurs sooner with HBV. d. There is no treatment for HBV, which can be a very serious illness.

d. There is no treatment for HBV, which can be a very serious illness.

An employer provides a migrant farm family the day off to visit the health clinic in a nearby community and tells them to take all of the time they need. However, the family arrives at the clinic appearing very stressed. In addition to the health issue, which of the following would most likely be a fear experienced by the family? a. Their personal belongings may be stolen while they are at the clinic. b. Immigration officials will send them back to their home country. c. The clinic personnel will look down on them and be biased against them. d. They weren't getting paid for that day, and continued employment is never certain.

d. They weren't getting paid for that day, and continued employment is never certain.

A nurse is implementing a tertiary prevention strategy related to pesticide exposure. Which of the following activities would the nurse complete? a. Observe farmworkers for evidence of unsafe handling of pesticides. b. Provide teaching on how to handle pesticides to avoid or decrease exposure. c. Teach farmworkers how to recognize signs and symptoms of pesticide poisoning. d. Treat a client who has pesticide exposure to prevent complications

d. Treat a client who has pesticide exposure to prevent complications

The correctional health nurse is doing a quick assessment on a newly admitted inmate who is HIV positive. Which of the following diseases should the inmate receive screening for immediately? a. Herpes zoster b. Hepatitis B c. Hepatitis C d. Tuberculosis

d. Tuberculosis

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

A home health nurse believes a client may be a drug addict. However, the client denies the use of drugs when questioned by the nurse. Which of the following is the most likely cause of the client's denial? a. Confusion resulting from dementia b. History of compulsive lying c. Mental status changes d. Use of addictive drugs

d. Use of addictive drugs

Which of the following statements is the best explanation as to why some countries are more violent than others? a. Civilized societies are less violent than primitive societies. b. Geographical differences are the primary factor. c. Population differences are the main determinant—for example, having more males than females. d. Violence is a learned behavior controlled or allowed by social norms.

d. Violence is a learned behavior controlled or allowed by social norms.

Which of the following statements best explains the primary reason why violence is so high among young African-American men? a. Men tend to be more violent than women. b. They are young and thus lack maturity. c. Unemployment is higher in this population. d. Violent tendencies are transferred genetically along racial lines

d. Violent tendencies are transferred genetically along racial lines

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. Multiproblem families c. Resilient populations d. Vulnerable populations

d. Vulnerable populations