exam 4 practice questions

A community health nurse is reviewing the results of SIPP (Survey of Income and Program Participation) used by the U.S. Census Bureau to collect disability data. Which will the nurse find classified as an instrumental activity of daily living?

preparing meals Instrumental activities of daily living involve such things as going outside the home, shopping, tracking money or bills, light housecleaning, and preparing meals. Seeing and walking are functional activities. Dressing is an activity of daily living.

One strategy for the community health nurse in caring for people with disabilities is becoming a powerful advocate. This involves

providing information but allowing the person to make the decision.

A pathogen lives and multiplies in a __________ and transfers from one host to another by a __________.

reservoir, mode of transmission

The school nurse is interviewing a student who has been assaulted by another student. Both students proclaim to be gang members. The nurse understands the reasons most youth give for joining a gang include the following: (Select all that apply.)

sense of belonging peer pressure need for respect

What official national organization provides financial housing assistance to low-income families?

Department of Housing and Urban Development (HUD) HUD, in cooperation with state and local governments and nonprofit housing organizations, operates programs that provide financial housing assistance to low-income families. The WHO is an organization that is concerned with international public health. FEANTSA is a European organization that works to prevent and alleviate poverty and homelessness in Europe. The Robert Wood Johnson Foundation provides funding for nursing education.

A female veteran has just given birth to her first child. Which resource is most appropriate for this veteran at this time?

PC3 Patient-Centered Community Care (PC3) is a program for veterans needing certain primary care or inpatient-related care, particularly for female veterans after delivery and requiring limited newborn care. Civilian Health and Medical Program of the Department of Veterans Affairs (CHAMPVA) is a program in which the costs of some health care services for eligible civilian beneficiaries are covered by the VA. TRICARE is sponsored by the Department of Defense (DoD) and provides health care for active duty military personnel, their families, and their survivors. VHA is the Veterans Health Administration, which provides health care to veterans.

The nurse is assisting Sargeant Earl in applying for VA benefits. Which statement made by Sargeant Earl indicates he understands VA benefits?

"My primary care copay is $15 a visit and outpatient specialist copays are $50 per visit." VA primary care copays are $15 per visit, and outpatient specialist copays are $50 per visit. VA benefits are not a health insurance plan where the veteran has to "pay into" the system. VA benefits are rewarded in exchange for the veteran's service to the country. The "coverage" received in the form of VA benefits is not transferable to other non-VA providers, except through formal contracts deemed appropriate by the VA and its providers. The VA always bills an individual's private insurance for medical care, supplies, and prescriptions provided for nonservice-connected conditions. Any monies collected from a veteran's private insurance offsets his or her copayments, and furthermore, the veteran is not responsible for any balance the private insurance does not cover.

In which era were people with mental disabilities labeled as "feebleminded" because they could not reach the minimum educational level?

19th century During the 19th century, the Industrial Revolution stimulated a societal need for better education. Those who could not reach the equivalent of a contemporary third-grade education were labeled as "feebleminded." In Biblical times, people with disabilities were often viewed as unclean or sinful. In the 18th and 19th centuries, people saw disability as an irreparable condition caused by supernatural agency. Special interest groups for people with disabilities began to develop in the 20th century.

A survey done by The National Institute on Drug Abuse (NIDA) found that the most commonly abused prescription drug among high-school seniors is

Vicodin (hydrocodone)

Rural residents in the United States compose more than _____% of the nation's poor.

50% More than 50% of the nation's poor live in rural areas, while 15% of the nation's elderly live in rural areas.

The landmark civil rights legislation that uses the authority of the federal government to guarantee equal opportunities for people with disabilities related to employment, transportation, public accommodations, public services, and telecommunications is the

ADA The ADA is landmark civil rights legislation that provides a clear and comprehensive mandate against discrimination toward people with disabilities in everyday activities. The IDEA addresses the educational needs of children with disabilities. The TWWIIA reduced people with disabilities' disincentives to work by increasing access to vocational services and provided new methods for retaining health insurance after returning to work. The Civil Rights Act prohibits discrimination based on race, ethnicity, religion, and sex.

The wife of an alcoholic client is considering joining a support group to help her respond to her husband's condition in a healthy way. Where should the nurse refer this client?

Al-Anon Substance abuse has been called a family disease because it affects the entire family system and holds potential adverse psychological and physical consequences for the family members in addition to the abuser. Al-Anon and Alateen are support groups for family members of substance abusers. A psychiatrist's referral is not necessary. Alcoholics Anonymous is focused more on the substance abuser than their families.

Based on the Department of Housing and Urban Development (HUD) definitions of homelessness, which individual would be considered homeless?

An individual who spends most nights at public or private places not designed for regular sleeping accommodations HUD defines homelessness in four categories: (1) literally homeless, (2) imminent risk of homelessness, (3) homeless under other federal statutes, and (4) fleeing/attempting to flee intimate partner violence. An individual who spends most nights at public or private places not designed for regular sleeping accommodations is considered literally homeless. Literally homeless is defined as individuals and families who lack a fixed, regular, and adequate nighttime residence and includes a subset for an individual who resided in an emergency shelter or a place not meant for human habitation and who is exiting an institution where he or she temporarily resided. An individual whose residence lacks access to public water and electricity, an individual who has a permanent nighttime residence in the housing for mentally ill people, and an individual imprisoned or detained under an act of Congress or state law are not considered homeless under the HUD definition.

Which are appropriate when working with people with disabilities? (Select all that apply.)

Asking a wheelchair-dependent person if he or she needs help and how you can assist. Sitting or kneeling at eye level whenever possible when talking with someone who is wheelchair dependent. Speaking distinctly and a little slowly to someone who is hearing impaired.

Based on the common illnesses and risky health behaviors among farmers, the community health nurse should implement which health promotion activity?

Collaborate with health care providers and provide support and education for farmers with respiratory conditions and their families. Several types of farming activities are associated with higher than expected occurrences of acute and chronic respiratory conditions. The role of the nurse is to refer patients to appropriate health care providers and provide support and education for affected people and their families. Farmers have a lower rate of cardiovascular disease, use of mental health services, and tobacco use than their urban cohorts.

What element of a community disaster plan investigates the citizen's reliance on telephone systems or cell phones during disasters?

Communication Communication is one of the biggest problems during a disaster. The reliance on telephone systems or cell phones should not be the only plan for communication during a disaster. Authority focuses on the people in charge, logistical includes focuses on storage of equipment and location of key responders, and search and rescue focuses on the search and rescue of victims.

Which agency has a mission to support citizens and first responders to ensure that as a nation everyone works together to build, sustain, and improve the capacity to prepare for, protect against, respond to, recover from, and mitigate all?

FEMA FEMA's mission is to support citizens and first responders to ensure that as a nation everyone works together to build, sustain, and improve the capacity to prepare for, protect against, respond to, recover from, and mitigate all. The other agencies may be peripherally involved in national disasters, but it is not their primary focus.

Which statement regarding sexually transmitted diseases (STDs) is correct?

Half of the STD rate in the United States falls within the 15 to 24 age range

Which statement is true concerning the Individuals with Disabilities Education Act (IDEA)?

It ensures a free public education from preschool through secondary education for children with disabilities. This is the only true statement regarding IDEA. IDEA ensures free appropriate public education in the least restrictive setting. The IEP is developed by parents, student, and professionals. The other option concerns the TWWIIA.

Mental illnesses adversely affect achievement of social justice. Which statement related to marginalization of some populations because of mental illness is false?

Most mental illnesses are caused by genetic factors; therefore, problems associated with them persist across generations Although genetic factors most likely contribute to some mental illnesses and in some individuals there is little information linking a specific gene to a specific disorder. Rather, the major psychiatric disorders are complex, and mental illnesses appear to result from a very complex interaction among neurochemical and metabolic changes and environmental and situational factors. The other statements are all true.nd among certain racial and ethnic groups.

Which statement regarding military sexual trauma (MST) is true?

MST is associated with diabetes

Which is classified as a vector of disease?

Mosquitos Vectors can be animals or arthropods and can transmit disease through biological and mechanical routes. The other options are not vectors.

Which statement about homicide in the United States is false?

Most homicides are caused by stabbings. Most homicides are caused by firearms.

A veteran was awarded VA disability compensation for a medical condition he contracted in 1965 while serving in Vietnam. Which condition did this veteran most likely have?

Parkinson's The VA awards disability compensation for the following conditions to anyone who served in the Republic of Vietnam from 1962 to 1975: AL amyloidosis, chronic B-cell leukemia, chloracne, diabetes mellitus type 2, hodgkin disease, ischemic heart disease, multiple myeloma, non-Hodgkin lymphoma, Parkinson disease, peripheral neuropathy, porphyria cutanea tarda, prostate cancer, respiratory cancers, soft tissue sarcomas, and Lou Gehrig disease (or AML).

Agricultural workers are at high risk for occupational injuries and illnesses. To reduce the most common cause of fatalities among youth on farms, which is the most important strategy for the community nurse to implement?

Partnering with the county extension agent to offer tractor safety classes Tractor-related accidents, especially overturns, are the most frequent cause of farm accidents. Encouraging the use of helmets is important, but the most important measure would be to offer tractor safety education. Working with local health care providers to encourage use of personal protective equipment, such as hearing and respiratory protection and offering a class for local health care providers addressing the signs and symptoms of pesticide toxicity are less important measures.

Which model supports upstream thinking with the purpose to improve homelessness through reduction of structural conditions contributing to homelessness?

Social justice

Which statement about adolescent substance abuse is false?

Teen use of cigarrets and smokeless tobacco is increasing Teen use of cigarettes and smokeless tobacco has declined. Youth (ages 12 to 20) binge and heavy drinking rates in 2015 (13.4% and 3.3%, respectively) were higher than rates in 2010 (7.8% and 1.7%, respectively). The percentage aged 12 to 17 years who perceived great risk in smoking marijuana once or twice a week decreased from 47.5% in 2010 to 40.6% in 2015. Teen substance abuse, overall, is increasing.

A community health nurse is concerned about reducing the fatal injuries to America's rural children. To address this problem, the nurse organizes a community of solution (see Chapter 1). For this group, it would be important to have representatives from all groups or organizations: (Select all that apply.)

The Department of Public Highway and Safety Emergency department staff (both doctors and nurses) from local hospitals Teachers and coaches from area schools City or County Government Limited resources are available in rural areas, and more can be accomplished when resources are pooled. Also, to ensure a more successful outcome, all players with a vested interest in the problem should have a voice in the problem-solving approach. This would include public personnel (city and county government, police, teachers) and private groups (RNs and MDs). Less important for looking at children's issues, however, would be private employers.

Which assessment findings by the community health nurse would suggest that an elderly client may be the survivor of physical abuse by a caregiver? (Select all that apply.)

The client has a laceration on her forehead that was sutured. The client has bruises on her forearms in various stages of healing. he client is not sexually active but has a diagnosis of Chlamydia. Signs of physical abuse include bruises, lacerations, fractures, dislocations, untreated injuries in various stages of healing, and STDs in sexually inactive clients. The other options are not indications of physical abuse.

Which statement regarding the impact of managed care on rural public health departments is true?

The role of rural public health departments may increasingly narrow into areas that are currently without any type of reimbursement. Correct The evolution of managed care into rural environments has limited the safety-net role of some local health departments to provide primary care by preventing fee-for-service reimbursement and contracting care to networks of providers or organizations. This is especially true for Medicaid managed care, which serves that same population of people that are traditionally served with primary care services through local public health departments. Medicaid's importance for rural areas is likely to grow as broader health care developments, such as declining inpatient use of rural hospitals and reductions in Medicare reimbursement, provoke more interest in using the Medicaid system to support threatened rural infrastructure. Consequently, the administration of the Medicaid program will increasingly seek the cost savings promised by managed care, and the role of rural public health departments may increasingly narrow into areas that are currently without any type of reimbursement.

A veteran is a person who has served in the military. Which statement about veterans is correct?

Veterans include those that have served in the active military, naval, or air service. Legally, a veteran is an individual who has served in the active military, naval, or air service and who was discharged or released under conditions other than dishonorable. There were 18.8 million veterans in the United States in 2015. People who have served in the U.S. Public Health Service and some persons employed by the National Oceanic and Atmospheric Administration are also veterans.

According to the vulnerability index, the individual at highest risk for death is

a 60-year-old person who has been homeless for 9 months Those at high risk for death are individuals who have been homeless for 6 months or more with one or more conditions: More than three hospitalizations or emergency department (ED) visits in 1 year? More than 3 ED visits in the previous 3 months? 60 years or older? Cirrhosis of the liver? End-stage renal disease? History of frostbite, immersion foot, or hypothermia? HIV/AIDS? Co-occurring psychiatric, substance abuse, and chronic medical conditions

ou work in a community clinic that specializes in pediatric mental health. Joy, age 12 years, has been diagnosed with depression. You know a major risk factor for depression in childhood is

a family history of depression

Public health policy in the United States is influenced by two types of justice, market justice and social justice. Examples of market justice include (Select all that apply.)

all people are entitled to the status they create for themselves. all people are entitled to happiness if they put forth enough effort all people are entitled to the income they work for. Market justice has been the dominant model in the United States and purports that people are entitled to valued ends (i.e., status, income, and happiness) according to their own individual efforts. Moreover, this model stresses individual responsibility, minimal collective action, and freedom from collective obligations other than respect for another person's fundamental rights. In contrast, under a social justice model, all people are equally entitled to key ends (i.e., access to health care and minimum standards of income).

Transmission of an infectious disease can be efficiently controlled by

breaking only one link in the transmission chain. Breaking just one link of the chain can control transmission of an infectious agent. Destroying all reservoirs of infectious agents and maintaining high levels of herd immunity are two of several ways to break a link in the chain of transmissio

Personality traits associated with an increased risk of alcohol abuse include (Select all that apply.)

impulsive disinhibited Two broad personality dimensions are also associated with an increased risk for alcohol abuse. Impulsivity and ease of disinhibition add to the risks for substance abuse. Being prone to anxiety and depression is also a risk, and these comorbidities are not well understood. The other options are not associated with a risk for alcohol abuse.

Katie, a 2-year-old child, is brought to the doctor's office after 2 days of vomiting and diarrhea. Upon completion of the medical history, the mother tells the nurse that several of the other children at the daycare who played with the same toys as Katie have the same symptoms. The mode of transmission for the pathogen more likely was

indirect The stem of the question indicates that the children played with the same toys. This would indicate the indirect mode of transmission. The other modes of transmission do occur through the sharing of toys.

The number one health concern identified by the majority of rural health care leaders is

lack of health insurance Rural health leaders identified ten priorities for health care in rural America, with access and affordability to care topping the list. Surveys have found rural uninsured people are more likely to have a usual source of care compared with their urban counterparts. An increase in communicable diseases and social isolation of rural dwellers were not listed as a priority health concern identified by rural health leaders.

The greatest promise for improving health outcomes for rural residents is

the increase in distribution of technology, providing more education and health services. Rural patients are able to access specialty services such and radiologic or dermatologic examinations through telemedicine, and rural people are increasingly taking advantage of the Internet to access information to make health decisions. Expansion and increased distribution of technology in rural areas has increased access to health care services and health education through distance programs for rural residents. Health care providers remain scarce in rural areas. Rural hospitals and clinics generally have Medicare services. There is still inadequate public transportation from most rural areas to tertiary hospitals.

As a school nurse, you know the leading reason cited as the cause of school violence is

use of violence to handle disputes

Posttraumatic stress disorder (PTSD) can develop due to (Select all that apply.)

viewing a dead body. having a history of mental illness. surviving a natural disaster. PTSD can develop among those involved in car accidents, natural disaster survivors, and victims of rape or incest. Factors that contribute to an individual developing PTSD include getting injured or seeing another person injured, viewing a dead body, feeling helpless, having little or no social support after a traumatic event, dealing with extra stress after the event (e.g., loss of a loved one, pain, and injury), or having a history of mental illness or substance abuse. Haivng recurring nightmares and experiencing chronic pain are symptoms of, not causes of, PTSD.