Exam 4 (Final)
The four overarching goals for Healthy People 2020 are the following:
- Attain high-quality, longer lives free of preventable disease, disability, injury, and premature death. - Achieve health equity, eliminate disparities, and improve the health of all groups. - Create social and physical environments that promote good health for all. - Promote quality of life, healthy development, and healthy behaviors across all ages.
Chain of Causation
- Characteristics of the Organism (pathogen) - Portal of Entry - Reservoir - Portal of Exit - Mode of Transmission - Characteristics of the Host - Characteristics of the Organism (pathogen)
Agent
A factor that causes or contributes to a health problem or condition
The public health nurse is concerned that a community is being threatened of contamination by a category A biologic agent. What action with the nurse conduct to support primary prevention? A. Prepare an instruction sheet identifying the effects of the category A biologic agents. B. Meet with local hospital officials to ensure adequate medical supplies to treat the infections. C. Identify community regions to establish quarantines D. Teach hospital nurses methods to disinfect used hospital equipment.
ANSWER: A A primary prevention strategy for a category A biologic agent would be something done to prepare the community before a disaster would occur. This would include preparing an instruction sheet identifying the effects of category A biologic agents. Meeting with local hospital officials to ensure medical supplies and teaching hospital nurses disinfection techniques are examples of secondary prevention strategies because the disaster has already occurred and treatment is being implemented. Identifying community regions to establish quarantines would be a way to separate people during the recovery period (an example of tertiary prevention).
An individual who regularly spends the night at a homeless shelter reports fatigue and trouble sleeping. Which response by the nurse indicates a poor understanding of the importance of a comprehensive assessment. A. "I think it's safe to assume that your symptoms result from a lack of sound sleep." B. "I'd like to arrange for you to come to the free clinic for a complete physical." C. "How many hours of sleep do you usually get a night?" D. "Have you been experiencing any other symptoms like night sweats or coughing?"
ANSWER: A Assessment must be comprehensive, producing physical, social and environmental data. There is no place for assumptions regarding lack of sound sleep.
Why is it important to determine the causality of a contagious disease process? A. Provide effective protection to prevent the spread of the disease B. Prevent the disease from having an effective reservoir in which to grow C. Alert the at-risk population that an epidemic is possible D. Assure sufficient nursing care to help the infected individual regain health
ANSWER: A Causality refers to the relationship between a cause and its effect. A purpose of epidemiologic study has been to discover causal relationships to understand why conditions develop and offer effective prevention and protection. Altering the at-risk population, preventing the disease from having a reservoir and assuring sufficient nursing care to the infected are necessary actions but do not address the importance of determining causality, which can assist in providing protection.
A corrections nurse engaged in which intervention is best addressing the mental health needs of the prison population? A. Performing a depression screening as part of each inmate's annual physical examination B. Indicating a support group for inmates with a history of alcohol abuse C. Supervising the administration of an inmate's psychotic medication D. Educating staff to the early signs of obsessive-compulsive disorder
ANSWER: A Corrections nurses provide a good deal of mental health nursing care and assist in identifying undiagnosed conditions. Supervising medication administration, staff education and support groups are also appropriate interventions, however screening for depression is addressing the problem of underdiagnosis.
In comparing Healthy People 2010 with Healthy People 2020, the nurse notes that in 2010, the focus was on: A. Diabetes as the only area related to disability and chronic illness B. Health promotion and disease prevention C. Improving the health of people with disabilities D. Disaster management processes
ANSWER: A In Healthy People 2010 only 1 priority area, diabetes, was devoted to disability and chronic illness. Both 2010 and 2020 goals address health promotion and disease prevention, and disaster management; and supported health of people with disabilities.
Which statement concerning the effect of immunizations on the health of older adults is true? A. The severity of an illness is usually reduced by immunization B. Complications resulting from the illness are seldom affected by immunization C. Immunization is extremely effective in preventing illness D. Mortality from the illness appears to be unaffected by immunization
ANSWER: A In the elderly, immunization may be less effective in preventing illness, but may reduce the severity of the disease. With immunization, the incidence of complications and death among the elderly is reduced.
Which is one way to address inequities of distribution of resources among people with disabilities? A. Increase access to necessary technology B. Encourage living in their own private apartment C. Limit social interactions D. Actively assist with a career focus and job search
ANSWER: A Increasing access to necessary technology will help clients with disabilities to live and work in their new environment. Limiting social interactions and living independently will not address this concern. Assisting with career and job search would affect the individual's resources.
Nurse managed clinics have much more to offer toward resolving the national health care crisis for vulnerable uninsured or underinsured populations. In contrast the difficulty with nurse managed clinics is A. Their inability to remain financially sound B. Their inability to qualify for grants C. Physicians unable to assist D. Limited nurse practitioners
ANSWER: A Nurse managed clinics can help resolve the health care crisis but have limited ability to remain financially sound, or sustainable. Grants are available, however difficult to obtain, nurse practitioners are available and can practice independent of physicians.
What service is a community health nurse employed by the Department of Health and Human Services likely to perform? A. Managing a federal health related program B. Advocating for increased federal funding for a particular state's free clinic system C. Contributing to the creation of health policies for rural communities D. Identifying health risks among the elderly attending a privately owned senior care center
ANSWER: A Nurses working at the federal levels tend to have consultant, or oversight type roles, and some nurse head programs that are specifically funded at the state and/or federal levels (i.e., HIV/AIDS, immunization programs). The CHN could also be involved in health policies but not only for rural communities, and generally policy comes from the legislative branch. Identifying health risks and advocating would be activities at the local level.
How will a community health nurse most effectively use research data? A. To prioritize interventions in order to effectively minimize the health risks of the community B. To expand the knowledge base of nursing in general and community health nursing in particular C. To evaluate outcomes of the care provided to communities by the community and public health nurse D. To provide a basis for continuing education in those areas identified as risk factors to community health
ANSWER: A PH nurses use data to prioritize their interventions to stop the spread of diseases, such as measles and also to intercede with other concerns such as childhood obesity. To expand the knowledge base of nursing, to continue education and to evaluate outcome care are also uses of research data, however for the PH nurse PRIORITIZATION of interventions is key.
Which statement regarding illness is an example of prevalence? A. Fifty residents of an assisted living facility that is home to 200 residents have shown symptoms of scabies in the last month. B. Fifty of 50 children who received varicella vaccine have not acquired the disease. C. Out of a population of 50 clients diagnosed with bladder cancer, 5 have died. D. A classroom of 25 children were exposed to the chickenpox 2 weeks ago. Five children have developed symptoms this week.
ANSWER: A Prevalence refers to all of the people with a particular health condition existing in a given population at a given point in time. Answer C is an example of mortality rate. Answer D is an example of an incidence rate. Answer B is an example of a success rate.
The nurse is responsible for interviewing an individual concerning a contagious disease exposure report. Which must the nurse do first? A. Review the information provided by the mandated reporter B. Select the specific questionnaire to use during the interview C. Secure confirmation that the exposure actually occurred D. Develop a trusting nurse-client relationship
ANSWER: A Prior to contacting an individual to interview, the nurse should first review the information received by the mandated reporters for completeness. Selecting questionnaire, developing trust, and securing confirmation of exposure occur during the actual interview.
A male client is diagnosed with high cholesterol. He is placed on medication and given a consultation with a dietician. The consultation with the dietician is an example of: A. Secondary prevention B. Primary prevention C. Tertiary prevention D. Outpatient prevention
ANSWER: A Secondary prevention focuses on the early detection and treatment before complications arise. A dietary consult will be aimed at helping to prevent complications from the elevated hypercholesterolemia. Tertiary prevention would include interventions after CAD has developed. There is no primary prevention in this case. Outpatient prevention is not an applicable term.
The director of nursing is working with other hospital leaders to finalize the organization's disaster plan. What should be included in this plan? A. Support for survivors and families B. List of recommended immunizations for victims C. Education to improve community awareness D. Assessment forms for acute stress disorder
ANSWER: A Survivor and family support is a part of the disaster plan. Assessment forms for acute stress disorder would be a tertiary prevention strategy after a disaster. Education to improve community awareness and a list of recommended immunizations for victims would be primary prevention strategies for a disaster.
Which has the American Nurses Association (ANA) publicly stated as recommended for an entry level public health nurse (PHN) to have? A. bachelor's of science in nursing (BSN) B. Either rural or urban health care experience within the last 3 years C. Two to 4 years of acute care nursing experience prior to entering PHN D. Familiarity with a variety of ethnic and geographic locations
ANSWER: A The ANA recommends that the entry level PHN should have a bachelor's degree in nursing. This is important because baccalaureate programs provide additional training in public health and leadership. The other experiences would be of benefit however a BSN should be the minimum entry level according to the ANA.
The community health nurse is educating the target population regarding the benefits of childhood immunizations. Which should the nurse focus on first? A. The educational level of the typical parent represented by the population B. Identifying any barriers that would affect their willingness to immunize their children C. Whether television or printed information will be most effective D. Securing the resources to provide immunizations for those who cannot pay
ANSWER: A To affectively deliver a health promotion and disease prevention message, the message must reach the target (at risk) population. This requires correct identification of the characteristics of the target audience in terms of education level. Deciding on delivery of information, barriers, and securing resources follows understanding the target population.
Local school districts that provide some type of health screening services have the overall goal of promoting early intervention. Screening also provides the school nurse what other opportunities? (select all that apply) A. Provide referral information to parents B. Provide opportunities to teach students and staff C. Provide the child with a break from the classroom to examine his or her health D. Provide job security for the school nurse
ANSWER: A, B Although the goal of all screening is to promote early intervention, screening also provides the school nurse many opportunities to teach students and staff. Referral information resulting from screening results is usually given to parents, and school nurses may contact parents to encourage follow through. Job security and a break from the classroom are not overall goals of screening activities.
Which statements are true about the epidemiologic triangle? (select all that apply) A. host, agent and environment interact to cause a disease or health condition B. Environment factors include physical, psychosocial and psychological C. Agent can be considered as infectious or noninfectious D. A host's susceptibility and response to an agent is influenced only by physical factors
ANSWER: A, B, C Agents have many classifications, one of which is infectious or noninfectious. Host susceptibility and response to an agent are influenced by physical, psychological and lifestyle factors. The host agent and environment interact to cause disease.
A nurse is asked to participate with the planning of disaster preparedness for a local community. On which areas will the nurse focus during this phase of disaster management? (select all that apply) A. Medicine and shelter B. Evacuation process C. Plans for communication D. Rescue and triage E. Availability of personnel
ANSWER: A, B, C, E During the preparedness phase of disaster planning, the focus is on plans for communication, evaluation, victim care and recovery. This plan also includes acquisition of personnel, medicine and shelter. Rescue and triage are activities conducted within the response phase of disaster planning.
Which are examples of a disease that is prevented through passive immunity? (select all that apply) A. Diptheria B. Tetnus C. Small pox D. Polio
ANSWER: A, B, D Passive immunity revers to short term resistance that is acquired either naturally or artificially such as tetanus, polio and diphtheria. Active immunity prevents smallpox.
Which nursing interventions are directed toward addressing a current health risk among school age children? (select all that apply) A. Advocating for increased funding to provide health insurance for uninsured children B. Addressing needs of children with special health care needs C. Serve as a role model for students D. Educating parents regarding the need for regular pediatric checkups E. Providing services to decrease missed days of school
ANSWER: A, B, D E In 2012 7% of US children had no coverage for health insurance and 4% had no usual source of healthcare. Some children access health services only at school and 12% made at least 1 visit to the ED, while 5% had two or more visits. Results from the 2011-2012 National Health Survey indicate that 6.2% of children missed 11 days of school or more in the past year due to illness, and this was more of a problem in children with special health care needs as the proportion increase to 14.9%. Providing services to decrease risk will result in decreasing missed days at school. Serving as a role model is important but does not decrease the health risks for children
The public health nurse is planning a program on self-care strategies for community rescue workers. What should the nurse include in this program? (select all that apply) A. "Use time wisely." B. "Abstain from involvement." C. "Ask for emotional support." D. "Reestablish daily routines." E. "Give yourself time to heal."
ANSWER: A, C, D, E Self care points that the nurse should include in the program include giving yourself time to heal, asking for emotional support, reestablishing daily routines, and using time wisely. These points encourage time to adjust to the disaster, staying connected with others, reestablishing normalcy, and reprioritizing daily events. These participants should be encouraged to give something back to demonstrate gratefulness as being a part of the healing process and not abstain from involvement.
A client asks how to know if he qualifies as disabled. Understanding the ADA, which would be included in the nurse's response? (select all that apply) A. Must substantially limit life activities B. Does not include standing, lifting and bending problems C. Cannot be a mental impairment D. Does include ability to care for self, vision and hearing problems E. Can be either physical or mental impairment
ANSWER: A, D, E The federal law protects those with a disability, which is defined as a physical or mental impairment that substantially limits one or more major life activities with documentation of the impairment or being thought to have the impairment. The ADA does not list specific diagnoses but instead the ADA focuses on the impact the disability is having on daily living. This includes things like the ability to care for self, perform manual tasks, see, hear, eat, sleep, walk, stand, lift, bend, breath, speak, learn, read, concentrate, think, communicate and work. This impacts the function of the immune system, normal cell growth, digestive, bowel bladder, neurological, brain, respiratory, circulator, endocrine and reproductive functions.
The Supreme Court ruling regarding Estelle vs Gamble in 1976 had a tremendous effect on what nursing specialty? A. Indian health nursing B. Correction nursing C. Mental health nursing D. School nursing
ANSWER: B In 1976 the US Supreme Court issued its decision regarding Estelle vs Gamble. The Supreme Court ruled that not providing medical services inflicted pain and denied prison inmates their 8th Amendment rights.
The "broken window index" was used as a model to help identify factors that contribute to the occurrence of a communicable disease. This is an example of which type of epidemiological study? A. Experimental B. Cross-sectional C. Prospective D. Retrospective
ANSWER: B A cross-sectional study (which explores a health condition's relation to other variables in a specified population at a specific point in time) can show that the factor and the problem coexist. Retrospective study looks backward in time to find a causal relationship. Prospective study looks forward in time to find a causal relationship. The investigator controls or changes factors suspected of causing the condition and observes results in an experimental study.
The nurse is caring for victims of multiple motor vehicle crashes from a landslide caused by a major snow and ice storm. How would the emergency response center classify this disaster? A. Mass casualty incident B. Man-made disaster C. Complex emergency D. Natural disaster
ANSWER: B A man-made disaster is caused by human activity and includes shootings, bombings and riots. Other man-made disasters include vehicular crashes and can follow natural disasters such as a major snow or ice storm. The landslide would be a natural disaster; caring for the victims of the crash a man-made disaster. A complex emergency is a crisis in an area where there is a total breakdown of authority requiring international intervention. A mass casualty incident involves 100 or more casualties. There is not enough information to determine if the motor vehicle crashes involve more than 100 individuals.
How does an epidemiologist determine the relative risk ratio of a child developing rubella? A. Evaluating the severity of the symptoms demonstrated by those children who were exposed to the rubella virus B. Comparing the number of cases that develop in children exposed to the disease with the number of unexposed children who develop the disease C. Determining how many of the children in both the exposed and unexposed groups have a serum blood rubella titer D. Assessing the exposed children to determine how long they were exposed to the rubella virus before actually developing symptoms
ANSWER: B A population at risk has a greater probability of developing a given health problem than other groups do. Epidemiologists measure the difference using the relative risk ratio, which statistically compares the disease occurrence in the population at risk with the occurrence of the same disease in people without that risk factor. Determining the number of children in the exposed and unexposed groups, assessing the time to develop symptoms, and evaluating the severity of symptoms would assist in describing the outbreak.
A group of survivors from a multiple apartment complex fire are sitting in the local school cafeteria awaiting news about their homes. Which action should the nurse use to reduce the survivors' anxiety? A. Ask the survivors to line up to record everyone's name. B. Walk around, talk and hug the survivors C. Refer questions to the appropriate rescue personnel D. Sit quietly to allow the survivors time to rest
ANSWER: B Anxiety is a common emotion after experiencing a disaster. One tip to fight anxiety is to give kindness to others, such as talking. Hugging is a reassuring action that helps demonstrate caring. Asking the survivors to get in line to record names does not demonstrate caring or kindness. Sitting quietly does not help reach out to the survivors. Referring questions to rescue personnel also does not demonstrate kindness or caring to the survivors.
Which has the potential for the indirect transmission of a disease? A. Sharing a bed B. A pool of water C. Being bitten by a mosquito D. Being sneezed on
ANSWER: B Indirect transmission occurs when the infectious agent is transported within contaminated inanimate materials such as air, water or food.
Which is the most threatening biological terrorism, with an 85% fatality rate? A. TB via droplet contact B. Inhaled anthrax C. Cutaneous smallpox D. Syphilis via sexual contact
ANSWER: B Inhaled anthrax has an 85% fatality rate.
The client expresses concern about possibly "getting the flu." What does the nurse suggest to help minimize this concern? A. Staying away from infected individuals is the best way to avoid the flu B. Resistance to a disease can be promoted through a healthy lifestyle C. The flu virus generally causes various degrees of illness from mild to severe D. Getting the flu is dependent of how strong the flu virus is in any particular season
ANSWER: B People who maintain a healthy lifestyle may not contract flu influenza even if exposed to the flu virus. Resistance can be promoted through preventative interventions that promote a healthy lifestyle. Explaining about the strength of the virus or the severity of the illness does not provide information on how to help in "not getting the flu." staying away from the infected individual is not a guarantee of not getting the flu, and this suggestion is not practical.
The nurse is teaching the client on the concept of wellness stages. During which stage should the nurse introduce information on disease prevention? A. Resolution stage B. Susceptibility stage C. Clinical stage D. Subclinical stage
ANSWER: B The 4 stages of the natural history of disease can apply to the understanding of any health condition, including wellness states. In stage 1: susceptibility, disease is not present and have had no exposure; therefore one can become amenable to healthier practices and improved health system organization. In the subclinical stage, there has already been exposure. In the clinical stage and resolution, disease is already present; therefore prevention is not applicable.
The nurse is evaluating the results of an educational campaign to prevent a measles outbreak among the children of recent immigrants in the neighborhood. When is the community health nurse most satisfied? A. The local health department offers to provide the immunizations for free B. All the children in the at-risk population have been immunized C. Every parent can identify the health risks that measles can cause their children D. Every parent agrees to have his or her children immunized
ANSWER: B The goal of such an education program would be that all the children in the focus population would be immunized for measles. Parental agreement, providing immunizations, and awareness of health risk are positive steps, but actual immunization remains the goal.
It is advantageous for nurse managed health clinics to meet Federally Qualified Health Center standards. Which category must a clinic meet to be federally qualified? A. Have a very low set fee for services provided B. Provide culturally competent comprehensive primary care to all ages C. Have tax exempt non-profit or private sector status D. Have a board of directors made up of members of the medical community
ANSWER: B To meet Federally Qualified Health Care status clinics must provide culturally competent comprehensive primary care to all ages, have a sliding scale or no fee structure (not a low set fee), have a board of directors made up primarily of members of the community the clinic serves, or be a tax exempt, non-profit or public status.
To implement a tertiary prevention program for a person with diabetes complicated by cataracts, which action should the nurse take? A. Provide a dietary consult B. Help the client get any needed assistive devises C. Encourage the client to investigate surgical correction D. Remind the client to keep regular eye exams
ANSWER: B When the client is in need of tertiary prevention the client is already experiencing complications such as cataracts with diabetes. The complication can't be reversed so it is important to provide the client with a device to help them adapt to the disability that is occurring. Reminding the client to keep regular eye exams, providing a dietary consult, and encouraging the client to investigate surgical correction would not address the cataracts.
The community health nurse is triaging victims of a train derailment. Which victim would need to receive medical attention first? A. Conscious, walking and talking, bloody face and extremities. B. Unconscious, thready pulse, respiratory rate of 10, and gaping thigh wound. C. Unconscious, pulse 24 and irregular, piece of metal impaled in the mid-chest region. D. Conscious, talking, fractured arm with exposed bone.
ANSWER: B When triaging victims of disaster, the red, yellow, green and black system can be used. The victim who is unconscious with a thready pulse, respiratory rate of 10 and gaping thigh wound would be classified as red (urgent), because there are injuries that could lead to death if not treated immediately. The victim who is conscious and talking with fx arm and exposed bone would be yellow (the injuries need attention however are not critical to life). The victim who is conscious, walking and talking with a bloody face and extremities would be classified as green. This means the victim has minor injuries and delaying care would not affect the long term outcome. The victim who is unconscious with an irregular pulse of 24 and impalement injury would be classified as black. This means that the victim has suffered a mortal wound and death would be imminent.
The school nurse is planning continuing education to gain further expertise in the field. Conferences and workshops of interest should emphasize which chronic disease and procedures found in highest proportion in schools? A. Depression and gastrostomy tube feedings B. ADHD and wound care C. Asthma and nebulizer treatments/inhaler use D. Diabetes and glucose monitoring
ANSWER: C A recent study of New Jersey school nurses b Krause, Parello & Samms (2011) found that chronic conditions most often seen by the school nurse included allergies (87.3%), asthma (74.6%), ADHD (47.6%), diabetes (20.6%) and depression (9.5%). They also found that most common procedures done by school nurses included first aid (98.4%), nebulizer treatments/inhalers (96.8% and 95.2% respectively), along with wound care (90.5%) and glucose monitoring (87.3%). Urinary catheterization, insulin injections, and gastrostomy tube feedings were less common, but were done by many school nurses.
The community health nurse is planning a secondary prevention strategy for victims of a hurricane. Which session is the nurse most likely planning? A. Resiliency B. Positive stress adaption C. Debriefing D. Manifestations of acute stress disorders
ANSWER: C A secondary prevention strategy is a type of crisis intervention designed to reach large groups who have experienced the same disaster. This approach is often referred to as debriefing. Positive stress adaption and resiliency are examples of primary prevention strategies. A session that focuses on the manifestations of acute stress disorder is an example of tertiary prevention strategy after a disaster.
Which question would gain the most information when assessing the degree of disability a client is experiencing? A. "Are you able to do all you need to do to complete your daily activities?" B. "Tell me what you do on a daily basis?" C. "Can you describe in detail how your life is affected by your disability?" D. "How do you get through your day?"
ANSWER: C Asking for details about how disability affects life will give more specific information than asking yes or no questions or a general question about what a person does on a daily basis or throughout their day.
Which nursing action demonstrates community health nursing affecting primary prevention? A. Screening for TB at a homeless shelter B. Advocating for a client who needs assistance purchasing prescribed medications C. Providing influenza injections at a local community center D. Educating a HIV positive client on how to minimize the risk of spreading the disease
ANSWER: C Community Public Health nurses play a major role in primary prevention. Influenza immunization clinics are frequently planned and organized by or with the local public health agency, with the injections usually being administered by community/public health nurses. Screening for a homeless shelter is secondary prevention. Educating an HIV client and advocating to purchase prescription meds are tertiary activities.
The nurse is educating an HIV-positive client on the appropriate way to dispose of soiled would dressing. Which is most important for the nurse to stress? A. The risk of transmission is greatest when the dressing is damp with blood or fluids B. The risk of contracting the disease is minimized by wearing gloves when changing dressings C. The container must be sealed in order to prevent contact with blood or fluids D. The container can be any material as long as it has a tight fitting lid
ANSWER: C Handling of the infectious waste must be minimized. Containers should be rigid, leak resistance and impervious to moisture; they should have sufficient strength to prevent rupture or tearing under normal conditions; and they should be sealed to prevent leakage. Gloves help prevent spread, but not the most important , and HIV can live on surfaces for hours even if dry.
Lillian Wald was the founder of A. The first family planning clinic B. The national nursing center consortium C. The Henry Street Settlement D. Duquesne University School of Nursing
ANSWER: C Lillian Wald was the founder of the Henry Street Settlement. Margaret Sanger initiated the first family planning clinic. Duquesne University and the National Nursing Center Consortium were supported by nursing faculties and practicing nurses.
Which is the primary difference between public health nurses (PHN) and the acute care nurse (ACN)? A. PHN are generally more publicly aware regarding environmental issues. B. ACN are more experienced with managing physical illness and trauma. C. PHN both identify and treat problems that are affecting their client populations. D. ACN's client advocacy is generally directed towards other acute care providers.
ANSWER: C Nurses who work in a hospital setting (ACN) address the issues that come to them. PHN's are out in the community identifying the problems and not waiting for problems to come to them. All nurses advocate and are familiar with environmental issues (PHN's in the community environment and ACN's in the hospital environment).
PHN's work for the Indian Health Service as well as for a variety of other federal government agencies carrying out the initiatives of A. State mandates B. Individual communities C. Healthy People 2020 D. Local administrative bodies
ANSWER: C PHN's in various agencies oversee and carry out the initiatives of Healthy People 220, along with other program initiatives. Local, state and individual communities also follow Healthy People 2020 initiatives.
With regard to communicable diseases, the Americans with Disabilities Act assures that an affected individual will be: A. Promptly assessed B. Provided appropriate treatment C. Protected from discrimination D. Assured confidentiality
ANSWER: C People are protected from discrimination under the American with Disabilities Act but not with respect to posing public threat, such as with a contagious disease
Several people are brought to the emergency department after falling 10 feet from an outdoor balcony on an apartment building that collapsed due to poor construction. Which factor does the nurse identify as contributing to this disaster? A. Environmental B. Host C. Agent D. Intensity
ANSWER: C The agent is the element that caused the disaster. In the case of a balcony collapse, the contractor who built the building and the balcony would be the agent of the disaster. The host is the human being who experienced the disaster. The environment is that which would contribute to or mitigate the disaster such as weather, chemicals or temperature. Intensity is not a factor that contributes to a disaster but rather is the level of destruction and devastation that the disaster causes.
When planning to implement aspects of Healthy People 2020, the nurse educator is evaluating 20 mail objectives and determines they all have the main goal of: A. Expanding disability and training opportunities. B. Expanding knowledge base and raising awareness about determinants of health. C. Promoting the health and well-being of people with disabilities. D. Removing barriers in the environment using both physical design concepts.
ANSWER: C The goal of disability and health in Healthy People 2020 is to promote the health and well-being of people with disabilities. Removing barriers in the environment using both physical design concepts, expanding knowledge base and raising awareness about determinants of health, and expanding disability and health training opportunities are activities to meet the main goals.
Community A is experiencing a large number of hand, foot and mouth diseases cases in children that has now spread it into the geographic region. This disease occurrence would be considered: A. A pandemic B. A public health emergency C. Lack of preventative immunization D. An epidemic
ANSWER: D An epidemic refers to a disease that clearly exceeds the normal frequency in a community or region. In a pandemic the distribution is worldwide. Hand foot and mouth disease is not preventable by immunization or a public health emergency, children are ill but few die from the disease.
When considering the elimination and eradication of disease in the United States, it is true to state that A. Measles have been eradicated B. Only natural causes of measles exists C. Only imported cases of smallpox exist D. Smallpox has been eradicated
ANSWER: D An example of elimination is that in the United States there are no natural cases of measles. By maintaining high levels of immunization, only imported cases of measles have occurred for years. An example of eradication of a disease is smallpox.
Of the following steps in a research study which will be addressed last? A. Designing the study B. Collecting data C. Reviewing the literature D. Developing applications
ANSWER: D Epidemiological research includes seven steps. 1. identify the problem, which is usually a threat to the population's health; 2. review the literature to determine what other studies have found; 3. carefully design the study; 4. collect the data; 5. analyze the findings; 6 develop conclusions and applications; 7. disseminate the findings.
A new member of a nurse managed clinic does not understand the concept of best practice. Which statement by the supervisor best defines this concept? A. "Nurse practitioner students are monitored for how they perform assessment skills." B. "It is new research projects that are supported in a nurse managed clinic." C. "Clinics that are supported by grants must do research and show evidence of how they apply this to their practice." D. "It is clinical practice that has researched based evidence to support why a specific practice is done in the way it is done."
ANSWER: D Evidence based practice is the process of making clinical decisions based upon the best available research evidence, clinical expertise and client preferences in the context of available resources.
During a home visit before the onset of a winter storm, the nurse reviews the clients plan for staying safe and having enough food, water and medication to last at least 3 days. Which level of disaster prevention is the nurse implementing? A. Tertiary B. Rehabilitation C. Secondary D. Primary
ANSWER: D Primary disaster prevention includes ensuring that community members have enough food, water, and medical supplies to shelter in place for at least 72 hours in the event of a disaster. Secondary disaster prevention focuses on early detection and treatment after a disaster occurs. Tertiary disaster prevention reduces the amount and degree of disability or damage after a disaster has occurred. Rehabilitation is a type of tertiary disaster prevention.
As a health care provider a nurse practitioner understands the importance of knowing classification of disabilities and chronic illnesses. To be consistent with other practitioners, it would be important for the nurse practitioner to use the system published by the World Health Organization in 2001. What is this publication called? A. National Council on Disability (NCD) B. Healthy People 2020 C. Americans with Disabilities Act (ADA) D. International Classification of Functioning, Disability and Health
ANSWER: D The WHO published the International Classification of Functioning, Disabilities and Health in 2001. The NCD is a small, independent federal agency tasked with making recommendations to the President, the U.S. Congress and other federal agencies about issues facing American's with disabilities. Health People 2020 document details the continued impact of chronic and disabling diseases and conditions on Americans. The ADA was signed into law in 1990 to protect the civil liberties of many American's living with disabilities.
A client asks what the term universal design means. Which answer is most accurate? A. "A design that implies accessibility for all disabilities." B. "A way to implement the Fair Housing Accessibility Guidelines." C. "It is applicable to all public buildings but not all personal structures." D. "It intends to promote a healthier lifestyle for those living within the design."
ANSWER: D Universal design provides a built environment that allows free and unencumbered access to all including those in wheelchairs. This unencumbered lifestyle promotes more movement, activities, and the ability to lead a more active lifestyle that increases the health of the disabled.
When planning a new building, which design would meet a specific in the universal design concept? A. Light switches at least 5 feet from the floor B. Installation of standard doors with handles that open with one hand C. Florescent lighting to be sure illumination is adequate D. Wide hallway from entrance through the building
ANSWER: D Wide hallways that continue throughout the building are part of the universal design concept. Doors should be wider than standard to allow wheelchair access, and light switches need to be lower than 5 feet from the floor to allow for easy access by a wheelchair-bound individual. There is no value in florescent lighting over other lighting.
How did Parish Nursing start? A. In the 1950s by Reverend Granger Westberg B. In the 1980s from the concept of faith community nursing C. In the 1980s through grants from the Health Ministries Association D. In the 1990s in Canada, Australia and New Zealand
Answer: B In the 1984 Reverend Granger Westberg began church-based health clinics that were based on the concept of faith community nursing which is hundreds of years old known as Parish Nursing
The occupational health nurse has scheduled times for all employees to receive their flu shots. Providing this service is an example of which type of prevention? A. Limited prevention B. Primary prevention C. Secondary prevention D. Mandatory prevention
Answer: B Providing flu shots in a general population not at risk to prevent illness is an example of primary prevention. Secondary prevention would be administering flu vaccine to a population at risk such as clients with COPD or asthma. There is no such think as limited or mandatory prevention.
A new employee is required to have a hearing test before beginning work in a high noise level workplace. The employee questions why this is necessary because his hearing is fine. Which regulatory agency can be cited for this requirement? A. Centers for Disease Control and Prevention B. Department of Transportation C. Occupational Safety and Health Administration D. Department of Health, Education and Welfare
Answer: C The Occupational Safety and Health Administration (OSHA) require hearing tests for employees exposed to loud noise in the workplace. Department of Transportation requires drivers to pass a physical exam. The CDC sets policies and interventions for communicable diseases. The Department of Health ,Education & Welfare published Healthy People 2020 for health promotion and disease prevention.
An occupational health nurse works closely with health and safety teams to monitor the health of employees and advocate for safe work environments. When was there an increase in the employment of what was then called industrial public health nursing? A. The Korean War B. The Vietnam War C. World War II D. The Civil War
Answer: C There was an increase in industrial public health nursing during WWII
Nurses are in a prime role to promote entrepreneurship. According to Bhave (1994), which must the nurse do after recognizing an opportunity? A. Build an active network within the community B. Start and grow the business C. Assume an active role in public policy D. Overcome challenges
Answer: D After recognizing opportunities, overcoming challenges is the next step to entrepreneurship, followed then by developing operational competencies. Building a network, being active in public policy and starting a business are the following steps.
Rapid and fundamental changes in US businesses and the US economy during the 1990s and 2000s have affected the practice of occupational and environmental health nursing. Which step can the occupational and environmental health nurse take to assist with the challenges to this form of nursing practice? A. Find ways to keep up with the industrial competition B. Concentrate on emergency and minor illness care versus educational classes C. Look at newer models of practice to provide quality care D. Broaden health services from a one on one approach
Answer: D Studies have shown that wellness, management and research were more important than a one to one approach. Efforts should focus on wellness-based models of practice. Industrial competition has no bearing on occupational health nursing, and emergency and minor illness care is tertiary care, the goal is to provide primary care.
What type of degree does a school nurse need?
BSN
During which of the following stage would the community health nurse first expect to see signs of a disease via laboratory testing? A. Susceptibility stage B. Subclinical disease stage C. Clinical disease stage D. Resolution stage
C. Clinical disease stage Rationale: During the clinical disease stage, signs and symptoms develop, and in the early phase of this period, they may be evident only through laboratory test findings. In the susceptibility stage, the disease is not present, and individuals have not been exposed. During the subclinical disease stage, individuals have been exposed but are asymptomatic. During the resolution stage, the disease causes sufficient changes to produce recognizable signs and symptoms.
Which activity would the community health nurse be involved with at the primary level of prevention? A. Screening B. Partner notification C. Immunization D. Isolation
C. Immunization Rationale: Primary level of prevention activities would include education and immunization. Screening, partner notification, and case and contact investigation are secondary level of prevention activities.
Which of the following would a corrections nurse expect to face in the future? A. Younger, healthier inmates B. Decreased chronic illnesses C. More women inmates D. Shorter stays for inmates
C. More women inmates Rationale: Future trends include an increase in the population of female inmates, older sicker inmates staying in prison for longer amounts of time, and an increase in chronic illnesses.
You find pertussis is a problem spread over several countries and continents. The magnitude of this problem is classified as: A. Endemic B. Epidemic C. Pandemic D. Hyperendemic
C. Pandemic Endemic is (of a disease or condition) regularly found among particular people or in a certain area. Epidemic is a widespread occurrence of an infectious disease in a community at a particular time.
Which would be considered a mass-casualty incident? A.26 victims B.54 victims C.78 victims D.110 victims
D. 110 victims Rationale: A mass-casualty incident is one in which there are more than 100 victims. A multiple-casualty incident is one in which the number of victims ranges from more than 2 but less than 100.
Triage Color Code System
Dead or eminent death..... Black Priority immediate............. Red Priority urgent.................... Yellow Priority delayed.................. Green
What is Ebola Hemorrhagic Fever?
a globally emerging communicable disease
Analytic epidemiology
attempts to identify associations between a human disease or health problem and its possible causes. Analytic studies include prevalence studies, case-control studies, and cohort studies.
Anthrax and smallpox are infectious diseases associated with what?
bioterrorism
What is the current thinking of epidemiology?
eco-epidemiology, distinguished by transforming global health patterns and technological advances.
What chronic illness does Gerwick have?
fibro myalgia
Chemical warfare
hosgene, cyanide, anhydrous ammonia, and chlorine are used widely
Herd immunity
immunity level present in a population group
Cross-immunity
immunity to one agent providing immunity to another related agent
Where are nurse-managed health centers located?
in a medically underserved area or serve a medically underserved population.
Active immunity
long-term, sometimes lifelong; acquired naturally or artificially
Bioweapons
mustard gas, sarin and VX gas, anthrax
Can an occupational and environmental health nurse fire an employee?
no - no supervisory responsibility
Nuclear agents
radiation producing device, nuclear waste
who went to jail for stealing money and what not?
ray nagin jr
During which phase of disaster does rescue and triage occur?
response phase of disaster
Passive immunity
short-term; acquired naturally or artificially
What was the American with Disabilities Act (ADA) of 1990 designed for?
to help people with disabilities access the same employment opportunities and benefits available to people without disabilities. "...prohibits discrimination on the basis of disability in employment, state and local government, public accommodations, commercial facilities, transportation, and telecommunications [and] also applies to the United States Congress"
Why was the International Classification of Functioning, Disability, and Health (ICF) published by WHO developed?
to provide a universal classification system that used a standardized language.
What type of position do faith community nurses hold?
usually volunteer
