Interactive Module 4
What are some characteristics of motivational interviewing (MI)? (Select all that apply) A) Uses signs of resistance as an opportunity to use assertive counseling B) Specifically targeted for change C) Nurse-centered D) Evokes the client's own motivation for change E) Respectful and honors the client's autonomy
B) Specifically targeted for change D) Evokes the client's own motivation for change E) Respectful and honors the client's autonomy
What question should be asked to help identify a community committee's stakeholders? (Select all that apply) A) Who can assist in providing resources needed to proposed changes? B) Who is most affected by the issue being considered? C) Who has been a long-term member of the community? D) Who can best successfully affect public opinion regarding proposed changes? E) Who has the greatest amount to lose by the proposed change?
A) Who can assist in providing resources needed to proposed changes? B) Who is most affected by the issue being considered? D) Who can best successfully affect public opinion regarding proposed changes? E) Who has the greatest amount to lose by the proposed change?
When considering social learning theory, what patient focused issue is considered most important for a person considering a change in a health-related behavior? A) How difficult it is to make the change B) The impact the change will have on health C) Ability to make the change D) Support of family and friends
C) Ability to make the change
A public health nurse is developing an educational brochure on diabetes for the community clinic. Which group has a higher propensity toward the health disparities of cancer and diabetes? A) Asian B) Algerian C) African American D) Alaskan Natives
C) African American
When considering motivational interviewing, what is a primary goal of this client-centered communication style? A) Clinician-imposed change B) Resistance minimization C) Ambivalence resolution D) Suppressing autonomy
C) Ambivalence resolution
What is an example of an intrinsic motivational factor? A) Encouragement from a loved one B) Praise from a health care provider C) A promise of a prize D) A personal feeling of accomplishment
D) A personal feeling of accomplishment
While providing in-home wound care, the nurse notes the client is frequently vocal and screams at relatives when in pain. In performing a cultural assessment, in what area would the nurse document the frequent outbursts and vocalizations? A) Family dynamics B) Cultural identification C) Communication D) Biological variations
D) Biological variations
What stage of Lewin's Change Theory represents the period when the desire for change develops due to motivation either intrinsically or by some external force, causing disequilibrium? A) Refreezing B) Changing C) Thawing E) Unfreezing
E) Unfreezing
What are the categories of faculty structure evaluation? (Select all that apply) A) State teachers' teacher review B) Self-evaluation C) Peer evaluation D) Learner evaluation E) Parents' review
B) Self-evaluation C) Peer evaluation D) Learner evaluation
In preparing a health and wellness care plan for the local senior citizen center, the nurse ensures the consideration of the three universal needs. What are the three universal human needs of the community? A) Satisfaction in life transitions B) Sense of belonging C) Support for decisions D) Safety and security E) Social relationship
B) Sense of belonging D) Safety and security
The nurse is asked what advantage there is in including measurable objectives in a health education program. What is the best answer? A) Measurable objectives ensure easier evaluation B) Measurable objectives provide a greater diversity of opinions C) Measurable objectives draw from a wide range of resources D) Measurable objectives decrease meeting time
A) Measurable objectives ensure easier evaluation
The nurse wants to use the domains of effective teaching to help organize a teaching plan. What domains should the nurse consider? (Select all that apply) A) Psychomotor B) Affective C) Physical D) Spatial E) Cognitive
A) Psychomotor B) Affective E) Cognitive
While working in the free clinic, the public health nurse is assessing a migrant farm worker who has an infection of the right hand. The nurse cleans the wound, applies antibiotic cream, and wraps the area to keep it clean. The nurse is conducting an assessment to determine if the client has any contributing factors related to health disparities. Which of these are contributing factors to health disparities? (select all that apply) A) No means of transportation B) Educational obtainment C) Language barriers D) A diagnosis of schizophrenia E) Part-time employment
A) No means of transportation C) Language barriers D) A diagnosis of schizophrenia
The nurse is conducting a summative evaluation of a learning experience. This is also known as: A) Outcome evaluation B) Intervention evaluation C) Structural evaluation D) Process evaluation
A) Outcome evaluation
During a family assessment, the community health nurse must examine both the internal and external structure of the family. What factors will be assessed to determine the internal structure of the family? (Select all that apply) A) The family composition B) Where individuals work C) What religion the individuals observe D) Where the family goes to exercise E) Each member' gender
A) The family composition E) Each members' gender
A public health nurse is developing a program based on the goals of the government initiative Healthy People 2020. What is a health indicator the nurse may use as a part of the program? (Select all that apply.) A) Tobacco usage B) Substance abuse C) Technology usage D) Exercise frequency E) Environmental quality
A) Tobacco usage B) Substance abuse D) Exercise frequency
A new client is scheduled at the clinic. During the assessment, the nurse notes a circular, dark-pink indention on the client's abdomen. The nurse is aware the client is not from the United States. What is the nurse's next nest action in assessing this client A) Assess the indention and ask the client the origins of the circular mark on the abdomen B) Assume the client performs the cultural practice of cupping and ask when the client last did this C) Ask the client to describe usual health beliefs and practices when the client becomes sick D) Apply pressure to the area to determine if it blanches, then proceed with the assessment
C) Ask the client to describe usual health beliefs and practices when the client becomes sick
A community health nurse is working with the nearby American Indian reservation to develop a program to reduce health disparities. What is a known health disparity of the American Indian that the nurse will want to address. A) Hypertension B) Heart disease C) Diabetes D) Stroke
C) Diabetes
Which grand nursing theory presents the goal of identifying family health patterns for the purpose of making positive changes? A) Health as expanding consciousness B) Science of unitary beings C) Self-care agency D) Roy adaptation model
B) Science of unitary beings
What is the source for established national objectives and health outcomes that guide health promotion in the United States? A) World health organization (WHO) B) National Prevention Counsel C) The Millennium Development Goals D) Healthy People 2020
D) Healthy People 2020
Which group is more susceptible to health disparities and and discrimination in health care systems? (select all that apply) A) Runaway teenagers B) Individuals in drug treatment programs C) Ethnic or racial minorities D) People who did not finish high school E) Unemployed persons
A) Runaway teenagers C) Ethnic or racial minorities E) Unemployed persons
When considering health behavioral change, what fundamental right does the individual have during the process? A) Emotional wellness resulting from the behavioral change B) Physical health as a result of implementing the change C) Involvement in decision making regarding the change D) Financial support for the expenses incurred by the change
C) Involvement in decision making regarding the change
The patient is inquired about several different smoking cessation programs. When considering the transtheoretical model, in which stage of change is the patient currently? A) Action B) Maintenance C) Preparation D) Precontemplation
C) Preparation
What activities can the nurse use when performing a summative evaluation at a home visit? (Select all that apply) A) An observation of skills obtained, such as diabetes insulin administration B) A final role-play that incorporates elements taught during the home visits C) A discussion of changes the individual or family has made over the course of the home visits D) A needs assessment during the first interaction with the client E) A final verbal quiz that incorporates elements taught during the home visits
A) An observation of skills obtained, such as diabetes insulin administration B) A final role-play that incorporates elements taught during the home visits C) A discussion of changes the individual or family has made over the course of the home visits E) A final verbal quiz that incorporates elements taught during the home visits
Which factor is considered when determining social determinants of health? (Select all that apply.) A) Childhood experiences B) Age C) Social policies D) Employment history E) Place of birth
A) Childhood experiences B) Age D) Employment history E) Place of birth
The nurse is considering a client's readiness to learn. Which are considered cognitive factors? (Select all that apply.) A) Motivation B) Age C) Occupation D) Gender E) Reading ability
A) Motivation E) Reading abilily
Which points are relevant to leading an effective coalition meeting focused on community needs? (Select all that apply) A) Show respect for the expertise of the individual members B) Maintain focus on the purpose of the meeting C) Assume responsibility for any resulting conflicts D) Begin and end the meeting on time E) Distribute background materials in advance of the meeting
A) Show respect for the expertise of the individual members B) Maintain focus on the purpose of the meeting D) Begin and end the meeting on time E) Distribute background materials in advance of the meeting
The nurse is considering the psychosocial factors that could affect a client's readiness to learn. Which factors fit this category? (Select all that apply.) A) Support persons B) Home C) Gender D) Family E) Occupation
A) Support persons D) Family E) Occupation
What is the definition of family in community health? A) A group of individuals who share a common place of living, have formal ties, and share responsibility to provide for all members B) Several people who work together in their environment to meet their basic needs C) Two or more people who identify themselves as a family and rely on each other to some extent to meet basic needs D) People living together who share the same values and beliefs
C) Two or more people who identify themselves as a family and rely on each other to some extent to meet basic needs
What does the term family assessment imply? (select all that apply) A) Focus directed on health protection behaviors B) Assistance with the management of uncontrollable health risk C) Examination of cultural, spiritual and developmental needs D) Holistic appraisal of health care needs E) Recognition of health risks that are controllable
C) Examination of cultural, spiritual and developmental needs D) Holistic appraisal of health care needs
What are factors learners should consider when evaluating a teacher? (Select all that apply) A) Political opinions B) Communication skills C) Use of assessment in class D) Quality of chosen materials E) Preparation F) Listening comprehension
B) Communication skills C) Use of assessment in class D) Quality of chosen materials E) Preparation F) Listening comprehension
What role does the 'opinion-giver' perform within a health education group? A) Frames diverse ideas and opinions into proposals or decisions B) Facilitates the honest and open sharing of diverse views and information C) Ensures that everyone who wants to can make a contribution D) Creates a warm climate of acceptance among group members
B) Facilitates the honest and open sharing of diverse views and information
When considering cultural influences, how would the nurse interpret a chinese patients lack of eye contact during a discussion about a newly prescribed medication as a sign of what? A) Misunderstanding B) Disinterest C) Depression D) Respect
D) Respect
In regards to groups, which role is the group member who helps maintain harmony by conciliating different points of view and suggesting solutions? A) Summarizer B) Gatekeeper C) Encourager D) Mediator
D) Mediator
Which of these techniques should the nurse use for introverted or shy personalities within a group? A) Multi-voting B) Brainstorming C) Active listening D) Nominal group technique
D) Nominal group technique
How can the nurse create an environment that is conducive to learning? (Select all that apply) A) Create an atmosphere of helpfulness B) Restrict free expression C) Assert authority and discipline D) Ensure that the environment is not too comfortable
A) Create an atmosphere of helpfulness B) Restrict free expression
Which is true of Tuckman and Jenson's five stages of group formation? A) Competition and conflict exists at the 'adjourning' stage B) Group cohesion dissolves at the 'norming' stage C) Group members are independent at the 'forming' stage D) Not all groups reach the 'performing' stage
D) Not all groups reach the 'performing' stage
The nurse is asked why it is important to teach psychomotor skills. What statement is the best answer? A) Psychomotor skills take more time to teach and it is good use of class time B) Most health topics involve some sort of 'self care' that the learner will need to do following the class C) Cognitive skills are reinforced with psychomotor skills D) It is easier to teach psychomotor skills vs cognitive skills
B) Most health topics involve some sort of 'self care' that the learner will need to do following the class
Which is true about health education in groups? A) Group members come from homogenous backgrounds and experiences B) The nurse is not the only expert in the group C) Tasks are established that only individuals can accomplish D) The views expressed are narrow and predictable
B) The nurse is not the only expert in the group
In completing a developmental family assessment, what question would the community health nurse include? A) Who settles disputes among the family members? B) How do family members cope with transitions and attachments within the family C) Are there any medical conditions, disabilities or limitations of family members? D) What are the boundaries of roles in this family
B) How do family members cope with transitions and attachments within the family
The nurse is considering the qualities of effective adult learners. What qualities are most common among this group? (Select all that apply.) A) Goal oriented B) Practical C) Family focused D) Fiscally conscious E) Self directed
A) Goal oriented B) Practical E) Self directed
A community nurse who routinely works in the immunization clinic notes an influx of new patients from Russia. The nurse wants to improve self-awareness of this new population. What steps can the nurse take a cultivate cultural sensitivity toward this new client population? (Select all that apply). A) Demonstrate a genuine interest in the lives and culture of the new clients B) Provide care to the new population based on broad cultural values of health C) Acknowledge that differences in culture occur even within a common culture D) Perform an Internet search to improve knowledge on the new client population E) Interview some of the new members and inquire about cultural values
A) Demonstrate a genuine interest in the lives and culture of the new clients E) Interview some of the new members and inquire about cultural values
What is the goal of a community health assessment (CHA)? (Select all that apply) A) Effective assessment of existing community health problems B) Associating health need with possible community resource C) Financing the implementation of the community health interventions D) Identification of community health resources E) Prioritization of community-focused health interventions
A) Effective assessment of existing community health problems B) Associating health need with possible community resource D) Identification of community health resources E) Prioritization of community-focused health interventions
What is the initial nursing intervention when conducting a cultural assessment regarding the health beliefs and values of a member of a non-white American culture? A) Establishing an accepting environment B) Gaining insight into the patients cultural world view C) Determining the presences of any existing language or communication barriers D) Arriving at mutually agreed-upon definitions of health beliefs and values
A) Establishing an accepting environment
Which nursing model used to assess family health needs employs genograms and ecomaps to identify relationships A) Family systems (Anderson) B) Functional health patterns (FHPs) (Gordon) C) Lifespan development (Rankin) D) Rituals and routines (Clausson and Berg)
A) Family systems (Anderson
Which is a good example of a nurse 'reflecting' back what a client says using the OARS technique? A) I hear you saying that you would like to increase your walks from one day a week to three days a week B) I think you need to consider walking at least three days a week instead of just one C) You are doing great job planning to add more exercise into your weekly routine D) How do you feel about adding more walks to your weekly exercise routine?
A) I hear you saying that you would like to increase your walks from one day a week to three days a week
The fourth principle of MI, self-efficacy, includes which of these ideas? A) If a client believes that he or she has the ability to change, it is motivating and greatly increases the likelihood of change B) When the nurse opposes a client's resistance and argues for change, a breakdown in communication occurs and prevents the client from exploring his/her views safely C) Change is motivated by a perceived discrepancy between present behavior and important personal goals and values D) Expressing empathy towards a person shows acceptance and increases the chance of developing rapport. Acceptance enhances self-esteem and facilitates change
A) If a client believes that he or she has the ability to change, it is motivating and greatly increases the likelihood of change
During an intake assessment at the local health department, the nurse asks a Hispanic client where in Mexico they were born. The client becomes angry and reports being born in Colombia. What is the best action for the nurse to take? A) Express regret for the assumption and seek a Hispanic nurse to complete the interview process B) Explain to the client most of the Hispanic individuals who come to the health department are from Mexico C) Ask the client to provide education on the differences between Hispanics from Mexico vs Colombia D) Apologize for the cultural insensitivity and make a mental note to be more careful in the future
D) Apologize for the cultural insensitivity and make a mental note to be more careful in the future
What type of evaluation focuses of whether change objectives have been achieved? A) Process evaluation B) Qualitative evaluation C) Quantitative evaluation D) Outcomes evaluation
D) Outcome evaluation
When considering field change theory, what term is used to identify the stage where stabilization of a change occurs? A) Changing B) Analyzing C) Unfreezing D) Refreezing
D) Refreezing
What is the role of the nurse when using the adult learning model to bring about a change in a patient's health behaviors? A) Role modeling for the patient as the behavior is being changed B) Determine the patient's readiness to make the change C) Assessment of the patient's understanding of the importance of the goal D) Reinforcement of the goal as the change is being made
D) Reinforcement of the goal as the change is being made
The nurse wants to conduct an assessment that will protect the anonymity of the participants. What is the best tool to use? A) Open forum B) Interview C) Task force D) Survey
D) Survey
When considering health views, which statement is the basis for discussion concerning the effects of culture? A) Cultural worldviews are responsible for the different beliefs regarding the cause of illness B) Cultures generally share a worldview regarding how illness should be treated C) Cultural worldviews are seldom concerned with health care issues D) The beliefs concerning the causes of illness are shared by most world cultures.
A) Cultural worldviews are responsible for the different beliefs regarding the cause of illness
What principle can the nurse apply to maximize the teaching-learning process? (Select all that apply) A) Determine client attitudes toward the subject matter B) Make subject matter relevant to the client's interests C) Discourage interaction among learners D) Limit the use of practical application E) Adapt teaching to the client readiness level
A) Determine client attitudes toward the subject matter B) Make subject matter relevant to the client's interests E) Adapt teaching to the client readiness level
What is the most important role of the community health nurse A) Educator B) Leader C) Surrogate D) Advocate
A) Educator
A community nurse is preparing to develop a plan to work with families as the clients in a local community. What reasons would a family assessment need to be completed with the families prior to developing the plan? (Select all that apply.) A) Families are a significant building block of the local community B) Families often have unique values and needs C) Members usually rally around families to ensure the health of the community D) Community health nurse sometimes make visits to clients and their families E) Community health nurses must first gauge the actual need of all members of the local community
A) Families are a significant building block of the local community B) Families often have unique values and needs D) Community health nurse sometimes make visits to clients and their families
What stage of change of Lewin's Change Theory describes when the change is integrated and stabilized into practice? A) Refreezing B) Unfreezing C) Thawing D) Changing
A) Refreezing
The nurse is planning to conduct a needs assessment. What methods might the nurse employ to make an assessment? (Select all that apply.) A) Reviewing published literature B) Conducting a survey C) Organizing a task force D) Making observations E) Holding a closed forum
A) Reviewing published literature B) Conducting a survey C) Organizing a task force
When working with a patient who is attempting to change a health-related behavior, what will the nurse reinforce? (Select all that apply.) A) The health-related benefits of changing the behavior B) The amount of time it will take to make the change in behavior C) The need for the actual change in behavior D) Problem solving techniques needed to achieve the change E) The patient's ability to make the change
A) The health-related benefits of changing the behavior C) The need for the actual change in behavior E) The patient's ability to make the change
What is the importance of having 'opinion leaders' represented on a community committee focused on making changes to existing health service delivery systems? A) Their points of view are generally well-accepted by the individual community members B) Opinions are important to the information-gathering stage of committee work C) All sectors of the community should be represented on the committee D) Final recommendations of the committee must reflect the opinions of the community
A) Their points of view are generally well-accepted by the individual community members
Which factor contributes to the possibility of relapse back into a negative health beahvior? (Select all that apply.) A) Being in the early stages of change B) Lacking effective coping skills C) Experiencing a poor support system D) Dealing with a high degree of personal stress E) Being depressed
B) Lacking effective coping skills C) Experiencing a poor support system D) Dealing with a high degree of personal stress E) Being depressed
When considering motivational interviewing, which strategy would be considered ineffective when working with a group dealing with alcohol dependency? (Select all that apply) A) Implementing both punishment and praise to provide motivation for change B) Identifying problems concerning change that the group needs to work on C) Providing advice about change choices the members are considering D) Having the members refer to themselves as alcoholics E) Pointing out mistakes the group is making associated with changes
B) Identifying problems concerning change that the group needs to work on D) Having the members refer to themselves as alcoholics E) Pointing out mistakes the group is making associated with change
What technique of group facilitation can the nurse use to encourage creative ideas within a group? A) Multi-voting B) Proactive facilitation C) Brainstorming D) Active listening
C) Brainstorming
When does the evaluation of a community-implemented change begin? A) As soon as implement occurs B) Within the time period regarded for the change to occur C) During the planning stage D) At the initial committee meeting
C) During the planning stage
A home health nurse is creating a care plan for an individual who recently had surgery. Which tasks does the home health nurse understand as health responsibilities of the family? (Select all the apply) A) Providing education about cost containment and when to use the health care system B) Emotional support for the client and guidance during life cycle transitions C) Development of the members sense of caring within the family as a unit D) Socialization of members regarding a sense of duty toward optimal health E) Care provision and management for the chronically ill disabled and aging family members
B) Emotional support for the client and guidance during life cycle transitions E) Care provision and management for the chronically ill disabled and aging family members