online question bank starting with chapter 25-17

A nurse is reviewing the provisions of the Affordable Care Act with a class. The nurse asks the class about the purpose of this law. What is an appropriate response?

To improve access to and costs of quality health care

A major outbreak of influenza has occurred and the CDC has established Point of Dispensing (POD) sites for rapid vaccination against this virus. A nurse is assisting her local hospital in setting up a POD site in their community clinic. Place the steps for providing care at one of these POD sites in order (1-4):

Triage and medical assessment Screening for eligibility and epidemiological background Vaccination Registering each patient as they arrive at the POD

A nurse is starting a new job at the local public health agency. During training, the nurse learns that he or she will be responsible for which of the following tasks?

Water fluoridation Restaurant inspection

A student nurse is taking a class about the impact of poverty on health outcomes. Which of the following statements about poverty is incorrect?

We are at the highest percentage of people living in poverty in American history.

A graduate nurse is contemplating a career in the public school setting. A former instructor says that school nursing not only advances the health of students but it also advances their:

Well-being, academic success, and lifelong achievement

A nurse is holding a class that is discussing the issues of homelessness in the urban environment. A student asks whether homeless people living in rural environments. How does the nurse respond?

Yes, there are homeless people living in rural environments, but they are generally more difficult to locate and help.

a nurses working with a group of new CNA's to discuss the need for cultural humility in caring for patients. Which of the following traits is characteristic of cultural humility?

a process of understanding that the multitude of cultures makes it too difficult to understand each and every one

a group of public health nurses is working with a Southern community to reduce the rate of diabetes and obesity. The community members seem very unhappy with their suggestions to change long-held traditions and are resisting the proposed changes. How should the nurse proceed?

ffind someone to act as a mediator and help foster a relationship between the nurse and the community members.

a public health nurse has been assigned to evaluate the community in the deep South has been experiencing a particularly high rate of chronic heart disease. Upon arrival in the community, she begins her community assessment. Which of the following factors is likely relevant and should be explored further?

food plays a large role in family and community gatherings. There is a lack of primary health providers in a strong distrust toward people not born in the community. The community is very spread out, with many miles between homes.

a group of public health nurses has been dispatched to a community with an abnormally high lung cancer rate in non-smokers. The goal is to identify risk factors and develop programs to address the lung cancer risk. What is the first step when they arrive?

gather basic information about the community including income, socioeconomic status, average level of education, and other information about the environment and community members.

a nurse has become concerned about the rate of domestic abuse in the community and wants to investigate ways to increase outreach to women in violent relationships. Upon performing a community assessment, the nurse decides in which of the following settings would be the best place to increase her outreach efforts?

hair and nail salons

a nurse is revising the hospital admission forms to change the ethnicity question from multiple-choice style to a version in which the patient can fill in their own response. What is the benefit or harm to that change?

it allows for more accurate answers sense patients are able to fill in how they identify themselves.

a nurses training a new nurse on the unit. They are discussing the importance of providing culturally appropriate care and the consequences of not doing so. The trainee asks how culture could possibly have an impact on providing appropriate care. How should the nurse respond?

it can play a huge role. Sometimes what looks inappropriate in American culture is actually very normal in a different one.

a nurse has been caring for patients in her community clinic for many years. Recently there has been an increase in the number of families to have emigrated from the Caribbean. After receiving a few patient complaints about insensitive care for medical assistance, the nurse decides that organizational wide changes needed. How should the nurse proceed?

perform a cultural assessment on Caribbean Americans.

a home care nurse is visiting with the Chinese-American family. While sitting with them, they seem uninterested in learning how to care for their mother and aren't engaged in the process. The nurse had been warned that the family was not interested in receiving home care services by the nurse who visited with them last week. How should the nurse Percy?

perform a full cultural assessment to see if the previous nurse missed something important in her initial assessment.

a public health nurse has noticed a significant rise of cellulitis infections in young men and women in her community. After performing her community assessment, public health nurse learned that most of the people with this infection were intravenous drug users. The public health nurse also learned that the community had an established needle exchange program but that it wasn't used by many of the intravenous drug users. Upon further interviews, the public health nurse learned that the users were not aware that they could not reuse their own needles. Which of the following is a possible intervention that the nurse could implement?

place flyers and highly traffic it areas for informing users of the need to change needles every time, even if they are not sharing needles.

a nurse educator is reviewing the principles of cultural competence with her students when a student nurse asks what the difference is between stereotyping and racism. How does the nurse respond?

racism is assigning common traits to everyone with a cultural group, while stereotyping is a judgment of inferiority or superiority based on a person's race.

a nurses caring for an elderly Indian woman with a new diagnosis of esophageal cancer. Despite the woman's assistance that she understands her new dietary restrictions, the nurse still finds her eating extremely spicy food, which has been painful for the woman. How should the nurse proceed?

recognize that eating heavily spiced foods are integral to her culture and find ways to encourage the family to bring her food that is flavored with other, less caustic, spices.

a nurse is moving with her family to an Army base in Japan where she will be working in a hospital as a maternity nurse. She has 15 years of experience in working on the labor and delivery floor in the United States. How should she prepare for this position?

she should study Japanese culture and how it impacts childbirth customs.

a nurse manager is disciplining a nurse after a Buddhist patient complained that the nurse refused to serve meet with his meal, even though the patient never mentioned that he was a vegetarian. The manager explains the nurse that this type of behavior is?

stereotyping

a nurse manager is developing a formal set of culturally appropriate standard operating procedures for the private practice. The manager is uncertain where to find the guide to ethical standards for healthcare providers and consults with the previous professor. Where does the professor recommend?

the US Department of Health and Human Services

a nurse is holding an in-service for other clinical staff members about the need to provide culturally competent care. She asked the nurse to compare and contrast race and ethnicity. how should they respond?

while there is a lot of overlap between the two terms, race is a social construct, while ethnicity is a shared heritage.

The nursing instructor is giving a lecture on older adults and the concept of aging in place. The instructor realizes some students need further instruction when they make the following statement:

"Aging in place is difficult since many older adults live in nursing homes."

A PHN is speaking with a man at a community health fair in rural Kansas. He recently had a stroke as a result of undiagnosed hypertension. When the PHN asks the man why he was not diagnosed sooner, his response most likely will be:

"I have no car and the nearest health-care center is 35 miles away."

An employee health nurse is evaluating a health promotion program in her company. Which of the following statements, if made by a majority of employees, would indicate the program was not entirely successful?

"My health insurance premiums have not gone down."

A pediatric hospital is running a lecture series on child safety. When the mother of a 3-year-old asks the nurse which lecture she should attend, the nurse tells her:

"Preventing Accidents in the Home"

Katie is a 15-year-old high school student taking a class in health education. Which of the following statements would you expect Katie to make regarding her health class?

"The best way to prevent diabetes is to eat healthily and exercise."

A 65-year-old man is assessed by a PHN at a community health fair. Based on the man's age, what services and screenings does the PHN recommend for this man?

-Depression screening -Blood pressure screening

Telehealth provides health related services where there is distance between the patient and provider using electronic information and telecommunication technology. Which of the following patients would benefit most from using telehealth?

A farmer with chronic obstructive pulmonary disease (COPD)

The PHN is putting together an education program on the risk factors associated with maternal mortality. After collecting data on maternal mortality rates (MMRs), the PHN decides all the following women should be targeted except:

A woman with a BMI of 24

It is the year 2050 and the nurse is caring for an 86-years-old patient. What generation does the patient belong to?

Baby boomers

A group of hospital officials and pediatric nurses are discussing possible infant exposure to environmental hazards in the NICU. In particular, they are concerned about exposure to the chemical bisphenol A (BPA). What is the most likely source of BPA in the NICU?

Baby bottles

A public health nurse (PHN) is planning a lecture on teen pregnancy at the local YMCA. Because pregnancy risks differ for each population, the PHN is sure to include information on all the following except:

Down's syndrome

A hospital nurse is preparing to do a dressing change on a patient diagnosed with MRSA in his draining wound. What should the nurse wear to safely prepare herself for this task?

Gloves, disposable gown, and face shield

Over the summer, a school nurse writes a letter to parents recommending their middle school age children get vaccinated before the start of the school year. Which of the following vaccinations does the nurse recommend?

HPV for girls and boys

Mike has been a construction worker for 20 years. In that time, he has suffered some of the injuries often associated with his profession. Which of the following is the least likely injury Mike would have experienced?

Hepatitis B

A hospital is managing an extreme epidemic of a new virus. The nurse who has been assigned to collect and report emergency information during an emergency is noticing that hospital supplies are dwindling. How does the nurse proceed?

Inform the local department of health that they need to access the strategic national stockpile.

A nurse is teaching a class about the emergency response protocols and explains that there are a series of steps that should be performed when preparing for and responding to an emergency. Place the following steps in the order in which they should occur (1-4):

Mitigation, Response, Recovery, Evaluation

A nurse has been working with her local congressman to restrict the sale of inhalants to minors. The bill they created was approved in both Congress and the House of Representatives and is currently awaiting the President's signature. It has now been 15 days since the bill went to the President and Congress is adjourning next week. What is their next step?

Nothing; the bill has become law

A PHN is speaking with a Nigerian woman at a prenatal clinic. The woman tells the PHN her 3-year-old died before she came to the United States. What was the child's most likely cause of death?

Pneumonia

A nurse happens to be in a mall parking lot when a large explosion rips through the building. The nurse is unhurt and runs to the scene to help provide medial care. After calling 9-1-1, what should the nurse do next?

Start sorting victims according to the principles of triage.

A nurse is preparing a pamphlet about the danger of mudslides to send to residents living in a small mountainous town and mentions that mudslides can occur after:

Wildfire Heavy rains Earthquakes

An OEHN addresses a local business leaders meeting on the importance of creating more green jobs to help build a clean energy economy. The OEHN tells them the most important goals of a clean energy economy include all the following except:

They help move jobs overseas.

a nurse is presenting an international lecture about the cultural history of the United States. Which of the following statements is correct?

different regions in the country are often culturally diverse.

A primary care nurse is going over the chart of a new patient. The patient says she is here to see the doctor because she is has numbness and tingling in her hands and fingers. The nurse may know what the patient has, but to confirm suspicions, the nurse asks which one of the following questions?

"Are you a musician?

A PHN is speaking to a group of mothers of infant children at a pediatric health clinic. The topic of her lecture is child safety. What is the most likely title of this lecture?

"Back to Sleep"

The parents of 6-year-old boy tell the school nurse they are worried about their son's safety since he has a severe allergy to peanuts. What can the nurse say that would most likely ease the parents' concerns?

"Bring in an EpiPen for your son so we are prepared for an emergency."

A 68-year-old man is in the hospital being treated for peripheral vascular disease (PVD). What question should the nurse ask the man that would most likely tell her how he developed PVD?

"Do you use tobacco products?"

A PHN visits the family of a 3-year-old boy with recurring ear infections. What question could the PHN ask the mother that may help determine the cause of the boy's recurring infections?

"Does his father smoke?"

A hospital nurse is discharging a 78-year-old women who fractured her hip after a fall in her home. The nurse gives which specific discharge instructions to make sure the woman does not have a second fall?

"Get rid of small throw rugs."

A pediatric nurse is speaking with a Cambodian woman about her 4-year-old son. Which of the following statements would the mother most likely make regarding the unusual birth of her son?

"I gave birth to him after only 30 weeks."

The primary care nurse is speaking with a 72-year-old woman with uncontrolled diabetes. Despite the nurse giving instructions on how to manage her diabetes in the past, the woman has yet to take the nurse's suggestions. What is the least likely reason the woman would give for being non-compliant in her diabetes management?

"My diabetes doctor is in this building."

A nurse is working at a call center answering questions about the Affordable Care Act. A call comes in from a 33-year-old woman who carries private health insurance provided by her employer, a small business owner. She is very nervous about what the ACA will do to her current insurance policy. How should the nurse respond?

"There should be no change to your policy, coverage, or cost of insurance."

A nurse has been managing a community center and is working on a grant that would allow for the hire of additional health-care providers. The application asks about their plan for sustainability. How does the nurse answer the question?

"We've received commitments from the local hospital to continue supporting the clinic (assuming the clinic is effective) once the grant funding is completed."

A nurse aide visits employee health complaining of the following symptoms: night sweats, sudden weight loss, and chronic cough with blood tinged sputum. The occupational health nurse has an idea what the nurse aide may have and asks what key question to determine how the exposure came about?

"Were you fitted for an N95 mask?"

A school nurse begins an assessment on a 12-year-old boy. The nurse notes the boy is inattentive, fidgety, and has a history of starting fights with other students. His medical records show no history of medical or psychological problems. What should the nurse tell the boy's parents?

"You son may have ADHD. I suggest you make an appointment with his primary care provider (PCP)."

Terry is a 10-year-old boy who weighs 36 kg, putting him in the 75th percentile for weight status. How should the school nurse explain this information to Terry's parents?

"Your son is at a healthy weight. You must be providing him with a good diet."

An 80-year-old woman is brought to the emergency room by her son, who says his mother broke her arm in a fall. The ER nurse suspects the woman is the victim of elder abuse when the son makes which of the following statements?

-"This woman is driving me crazy!" -"I should be out with my friends instead of caring for this old lady." -"She's a handful. No wonder I drink so much!"

A PHN is speaking to a group of women at a prenatal clinic. An obese woman asks the PHN how her excessive weight could affect her pregnancy. The PHN responds by telling the woman the following information. SELECT ALL THAT APPLY.

-"You may develop gestational diabetes during pregnancy." -"You are more likely to have a cesarean section." -"Your baby may develop a neurological birth defect." -"Your blood pressure may go up while you are pregnant."

An OEHN learns three long-time employees have been diagnosed with bladder cancer. After some research, the OEHN discovers that exposure to benzidine dyes and ß-naphthylamine can lead to bladder cancer. Which of the following industries could these men have worked in?

-A tire manufacturing company -A textile mill

A pediatric hospital is planning an intervention program to reduce the number of babies born prematurely. After collecting and analyzing data on premature births, they determine who their target audience will be. Which of the following women would most likely be targeted for this program? SELECT ALL THAT APPLY.

-A woman who developed a staph infection during pregnancy -A woman whose boyfriend hit her while she was pregnant -A woman who plans to have a labor-induced pregnancy

Camden New Jersey is an example of the concept known as broken window theory. A PHN doing a community assessment on Camden would expect to find which of the following?

-Abandoned buildings -Street violence and gang activity -Increased marijuana use

A nurse is presenting a lecture about the effect that socioeconomic status plays in health disparities. The teacher asks the students why people of lower socioeconomic status would still be at risk for health disparities despite having access to several government programs. How should the students respond?

-Decreased health literacy -Less access to transportation -Poor access to fresh food -Increased exposure to -chronic stress

Jane is on her first day of work as an OEHN. To help guide her practice, she uses the American Association of Occupational Health Nurses (AAOHN) Code of Ethics. What are the principles Jane must adhere to?

-Do not lie. -Do no harm. -Treat clients fairly and without discrimination.

A small group of parents of disabled children are speaking at a school board meeting. They say school buildings are not properly accommodating their children's needs and ask for several changes to be made. What are some of the changes the school nurse might hear these parents ask for?

-Install elevators. -Make a dedicated space for special health accommodations -Purchase special furniture.

The school nurse tells the parents of a teenage girl to have her doctor complete an asthma action plan and bring it to the school. When the parents ask how an asthma action plan will help their daughter, the nurse tells them the following information. SELECT ALL THAT APPLY.

-It will indicate which medicines to give and when to give them. -It will list signs of an asthmatic episode. -It will increase the use of the peak flow meter.

A nurse is interested in becoming more politically active to advocate for more effective public health policies. What does the nurse's mentor recommend?

-Join a nursing organization -Run for local office. -Volunteer with the campaign for a local candidate. -Contact her local policy maker about issues that are important to her. -Learn more about the political process.

A woman is shocked when she finds out her 78-year-old mother has gonorrhea. "How is this possible?" she asks the nurse. "Isn't she too old for that?" The nurse explains to the woman how and why rates of HIV and sexually transmitted infections (STIs) are actually on the rise in older adults using which of the following statements?

-Many older adults do not use condoms. -Divorce rates are higher for older adults today. -Older adults are changing partners more often.

A group of L&D nurses from a local hospital want to put together an educational program on gestational diabetes. Place the following actions in order of how the L&D nurses will develop this program

-Organize an interdisciplinary team including the local chapter of the American Diabetes Association (ADA). -Collect data on gestational diabetes and determine the needs of their population. -Create program interventions with the goal to reduce rates of gestational diabetes by 20 percent in six months. -Begin to execute the program on expecting mothers at their hospital.

Americans are living longer today than at any time in history. What are some of the main reasons for greater population aging in the United States?

-Penicillin -Improved prenatal and obstetrical care -Flush toilets -Cancer screenings

A local high school is holding a lecture for parents on bullying and how to tell if your child is a victim. The school nurse explains to parents that bullying can cause which of the following?

-Poor self-esteem -Thoughts of and attempts at suicide -Headaches

A PHN visits the home of a single mother who is pregnant with her second child. When the mother lights a cigarette, the PHN begins to explain that which of the following risks and complications are associated with tobacco use during pregnancy? SELECT ALL THAT APPLY.

-Premature birth -Increased risk for SIDS

A nursing student is about to begin a clinical rotation at a homeless shelter downtown. At the pre-class meeting, the instructor gives the student which of the following suggestions for providing appropriate care?

-Put follow-up instructions in writing so they can take the instructions with them. -Choose words carefully so that the patient does not feel bias or discrimination from the nurse. -Include screening for addiction, mental health, and domestic violence as part of the initial assessment. -Discuss housing and other government support programs where they may be able to access more services.

The Board of Education in one urban town is taking steps to provide school-age children with proper nutritional meals. They coordinate with school nurses to make what changes in their school lunch program?

-Replace candy bars with 100 calorie granola bars in vending machines. -Encourage eligible families to participate in the School Breakfast Program. -Increase the number of fruits and vegetables available in school meals.

A PHN presents a lecture on suicide prevention at an urban high school. Her goal is to educate students on the signs that someone is contemplating suicide. Which of the following signs, if identified by a student, would indicate her lecture was effective?

-The person gives away their favorite CDs. -The person is thinking about buying a gun. -The person expresses a specific plan on how to commit suicide.

The OEHN is updating her company's disaster preparedness plan. The OEHN lists the four phases of disaster preparedness and the issues that would be addressed in each phase. What are some of the issues that could be listed under the response phase?

-Triage efforts -Search and rescue efforts

a public health student nurse is working on a thesis project. Part of the project is performing a comprehensive community assessment of a nearby town with a high rate of breast cancer in young women. As part of the assessment, the student nurse wishes to perform interviews with key community members. Who would be ideal candidates for the interview?

-a woman who was diagnosed with breast cancer last year -an oncologist who specializes in treating breast cancer -the reverend of the largest community church -a young female teacher who has lived in the community her entire life

in order to improve the cultural competency of the staff members in her hospital, the director of nursing has decided to focus on implementing the guiding principles established by the national quality forum. Which of the following statements were included in this set of standards?

-cultural competency relies on healthcare equity -an organizational commitment to cultural competencies necessary to achieve true patient centered, culturally appropriate care -cultural competence should be an ongoing process with frequent assessments and interventions as necessary -cultural competency is not sufficient in attaining equity

a nurse is preparing to give a lecture on cultural humility. The nurse knows that cultural humility

-is a lifelong process -begins with the nurse performing a cultural self evaluation -is the recognition that the understanding of all the cultures is not possible given the degree of diversity in today's world

A nurse is working with her local department of health to institute a new public policy. Unfortunately, after last year's housing market collapse, their budget has decreased dramatically. What are some reasons why this might have happened?

1) A significant portion of their funding comes from tax revenue, which has also decreased significantly. 2) The federal government has cut funding to local health departments. 3) Fewer private grants are available to aid local health departments.

A nurse is working in a community health clinic where there is a high migrant worker population that work in the area. Unique health problems faced by this population include:

1) Exposure to pesticides and trauma 2) Communicable diseases such as tuberculosis 3) Malnutrition

A nurse is working with a student nurse who is completing her clinical rotations. They are working at a health clinic at the local community center. Before they see their first patient, the supervising nurse explains that members of the homeless population are at greater risk for developing which of the following conditions?

1) Infectious diseases 2) Dental issues 3) Hypertension 4) Alcoholism 5) Back pain

A L&D nurse reviews her patient's charts to see who would benefit most from Maternal, Infant, Early Child Home Visiting (MIECHV). Which of the following patients would the nurse select as the best candidate for MIECHV?

A 15-year-old who just gave birth

The adult children of an 83-year-old woman want their mother to live as independently as possible but realize she needs some assistance getting around. What is the best and most affordable living situation to help their mother age in place?

A Naturally Occurring Retirement Community (NORC)

An occupational and environmental health nurse (OEHN) is speaking with student nurses at a career fair. When the students ask what types of cases an OEHN deals with, the nurse replies with all the following except:

A construction worker with diabetes

A PHN is working at a battered women's shelter coordinating a program to assist these women with becoming more financially independent. Which of the following would the PHN least likely choose to collaborate with?

A local OB-GYN

To meet the growing need for more primary care providers, nurse-managed primary health centers have become an important part of the health-care system. Which of the following people would benefit most from a nurse-managed primary care center?

A single mother whose 6-month-old needs a well-baby visit

A pediatric nurse is caring for a premature baby in the NICU. The nurse knows the premature baby is most likely to come from a mother who is

A smoker

A public health nurse (PHN) is speaking with hospital staff about elder mistreatment and the role of Adult Protective Services (APS). The PHN explains to staff that when a complaint of possible elder mistreatment has been made, APS must follow this principal:

Allow the client to live at risk of harm provided he or she is capable of making that decision.

A nurse is living in a small community in upstate New York and recently purchased an apartment that used to be a medical office and discovered that it was painted using lead paint. Concerned, the nurse contacted the local health department and discovered that there is no established health policy in the community for restricting the use of lead paint in commercial buildings. The nurse decided to partner with the department to establish such a policy. Which of the following terms best describes this sort of policy?

An upstream policy

An OEHN has decided to initiate a health promotion program for her company. What is the first activity the nurse should implement?

Ask all employees to fill out an HRA questionnaire.

Paul was injured while working in the factory and brought to employee health. The nurse examined him, but said he needs immediate medical attention. Paul becomes upset and says, "I can't miss work. I have bills to pay." How can the nurse best address Paul's concerns?

Assist Paul and his family with filing for worker's compensation.

Community leaders have identified a problem of narcotics abuse among many of their residents. After several informal town meetings, the community is ready and motivated to solve this problem. What key factor does this community now need to incorporate as part of their plan?

Beginning to work with multiple organizations to solve this problem

The school nurse is speaking with a group of high school students on the topic of dating violence and tells them that all of the following behaviors can be associated with dating violence except:

Being sexually active

A major plane crash has occurred in a very populated part of town. During the response, the public health nurses have been diligent about tracking victims and potential victims. Which of the following factors may complicate accurate reporting of victims?

Evacuation to places other than established shelters The dense homeless population in the area

A PHN is involved with an after school program for at-risk teens in an urban community. The children are most likely to say they have a relative involved with all the following activities except:

Excessive alcohol use

A PHN has been working with community members to address the issue of childhood obesity. When the PHN suggests introducing them to a research team, community members are skeptical. The PHN eases their concerns by telling them:

CBPR adds the community to research as an equal partner in the research process.

A nurse has observed that many members in her community struggle financially but are very unaware of the government programs available to assist them. The nurse organized a community fair to help educate citizens about these programs and decided to focus only on income and nutritional assistance programs. Which program should be excluded?

CHIP

A nurse is working in an emergency department when paramedics bring in a family who was stranded in their car on the side of the road during a blizzard. When they were found, they were short of breath and confused. The children reported having headaches and dizziness. What does the nurse suspect?

Carbon monoxide poisoning

A nurse caring for older adults is able to distinguish between changes due to natural aging and changes due to disease. Which of the following would not be an example of changes in the normal aging process?

Changes in long term memory

A group of community organizers are concerned about rising crime rates in their neighborhood. They partnered with police, business owners, and the PHD and identified lack of job opportunities and police presence as key issues that need to be addressed. What would be the next step for this team to take?

Choose who will represent each partner in this team.

According to Healthy People 2020, one of the objectives for early and middle childhood is to increase the population of children who are ready for school. This is measured through all the following developments except:

Extracurricular

A large EF-4 tornado has struck in a downtown area in the Midwest. The state has asked for assistance in dealing with the massive response needed in this town. The public health nurse informs the staff that which government agency will take over the disaster response?

FEMA

A PHN is working with her local health department to develop new community health goals for the coming year. Given that the established priority is to address health disparities, the nurse knows that each of the objectives must:

Consider the cultural make up of their community.

A large tanker truck gets into an accident and the driver is killed. An unknown substance is covering the roadway. How should first responders initially handle the spill?

Consult the material safety data sheet (MSDS) in the truck to see what the chemical is and how it should be handled.

Mary completes an HRA and is told her BMI is 21. What should the OEHN advise Mary based on these results?

Continue her healthy lifestyle as her BMI reflects a normal weight

A nurse is examining factors that may impact teen pregnancy rate as part of a desire to reduce the high rate in her community. During the initial community assessment, the nurse identifies low socioeconomic status as a potential risk factor for increased rate of teen pregnancy. How should the nurse proceed?

Continue to look for other risk factors to see if they overlap with socioeconomic status.

The PHD asks a PHN to investigate a town's sudden increase in STIs. After the PHN speaks with members of the community, various leaders, and key informants, what should the PHN do next?

Create a core group of local leaders who can organize the community.

A nurse has observed that many of the migrant workers who live and work in the area do not visit the community health clinics for their medical care. After performing a community assessment, the nurse discovers that they don't have a lot of time off or access to transportation to get to the clinics. How should the nurse proceed?

Create a mobile health unit that visits farm sites throughout the day so workers can visit the mobile unit on their breaks.

An 87-year-old man is living in a nursing home. The nurse looks at his chart most likely will not be surprised to see which cognitive disorder in his health history?

Dementia

Mary is being treated by employee health because she may have been exposed to hepatitis C. What is Mary's occupation most likely?

Dental hygienist

A student nurse asks the instructor why people age. The instructor tells the nurse it most likely has to do with biological changes in the body as we get older. Which of the following would not be considered a biological theory of aging?

Disengagement from activities enjoyed earlier in life

A diabetes educator nurse is planning a teaching session with a 68-year-old man. The goal is to provide him with education and interventions to minimize the risks associated with diabetes. What is the first thing the nurse should do before implementing interventions?

Do a focused assessment of her client.

A high school nurse is preparing a diabetes education plan for students and staff. What is the most appropriate way the nurse can involve staff in the management of care for students with diabetes?

Educate staff on the signs and symptoms of hypoglycemia.

A nurse is looking to require nutrition classes to all elementary school students in an effort to promote better food choices. After presenting her suggestion to the school board, they express concern about the cost of the program and how much it would potentially achieve. Which evaluation criteria are they concerned about?

Efficiency

A community health nurse has planned a health fair designed to get the word out about the benefits of the Affordable Care Act. The provision that the nurse is most excited to discuss with community members—typically middle aged, middle-class adults—is:

Increased access to routine preventative health services

A student nurse learns urban areas often have poor air quality which has a negative effect on the health of the population. Based on this information, the student would not be surprised to learn that urban residents are more likely to have which of the following nursing diagnoses?

Ineffective breathing pattern

A local store has a high percentage of older adults working for them. To ensure the safety of their older workers, what changes to the work environment could the PHN suggest be made?

Install audible safety signals

Jeremy is a 16-year-old high school student. During his freshman and sophomore years, he was an honor roll student and member of the football team. Now he is missing homework assignments and falls asleep in class. What would the public health nurse (PHN) expect is the most likely reason for Jeremy's change in behavior?

Jeremy works 25 hours per week at a fast food restaurant.

A nurse is working with lobbyists to fight for increased spending to train health-care providers to manage and detect bioterrorism events. The nurse explains that it is especially important to increase funding at what level for the policy to be most effective?

Local

Over the next four decades, the number of white older adults will decrease by 10 percent while all other ethnic/racial groups will increase. Given this fact, what skills will be considered most essential for nurses caring for older adults in the future?

Maintaining cultural competency and conducting a cultural assessment

A fire breaks out at a local factory. Employees are escorted to the nearest fire exits. The fire department and emergency medical technician arrive to contain the fire and treat the injured. In following the four phases of disaster preparedness, which action would come next?

Make necessary repairs.

Debbie is an OEHN at a large corporation. She tells people the main goal of occupational health is to:

Make sure workers return home safely at the end of the workday.

A new public health nurse (PHN) is working for the State Department of Health. While beginning work on the next fiscal budget the manager reminds the PHN of the need to account for funding for which of the following programs?

Medicaid

A 62-year-old man comes into the emergency department in End Stage Renal Disease (ESRD). He has resisted getting treatment due to the high cost of care but is not able to delay care anymore. The nurse calls the social worker who recommends:

Medicare

An Orthodox Jewish family just moved from their hometown in Brooklyn to the Midwest. They have no family nearby and there are no other Orthodox families in town. The nurse evaluating the family in the clinic knows that:

Members of the family are vulnerable medically and socially due to a lack of connection in their community.

John missed two weeks of work due to acute kidney failure (AKF). He stops by employee health and asks the OEHN how this could happen. The OEHN tells him kidney problems can result from toxic exposure to which of the following chemicals?

Mercury Cadmium

A nurse is appalled at the recent cut in funding for women's health-care services and knows that the most effective way to get support for increasing funding back to previous levels is to:

Organize a day of action where nurses across the country call their Congressman and work on getting signatures for a petition demanding increased spending.

A school nurse is working at an elementary school that just cut its physical education program due to budget costs. What is the best way the nurse can provide some physical activity to the students each day?

Organize a walking group that meets after school.

A student nurse is working at a PHD that serves many rural areas. Based on the student's knowledge of rural communities, the PHD would likely be involved in all the following except:

Gun violence education for children

A nurse is beginning a new position as the nurse manager in a maximum-security prison and is surprised to learn that there is no policy mandating infectious disease testing upon admission to the prison nor at specific intervals during incarceration. With the warden's permission, the nurse implements a new policy requiring testing for what two infections?

HIV and Hepatitis C

A labor and delivery nurse (L&D) is reading a report on the mother of a newborn in the neonatal intensive care unit (NICU) who is being treated for neural tube defect (NTD). Based on this information, the L&D nurse would most likely expect to find that the mother:

Has a body mass index (BMI) of 32

A nurse is working at a community fair and talking with community members about being ready for an earthquake. The most important piece of advice is to:

Have an emergency preparedness plan ready.

A primary care nurse is assessing a 65-year-old women whose skin is thin and non-elastic. Based on this finding, what is the best question for the nurse to ask?

Have you had a shingles vaccine?

A nurse is explaining the concepts of Healthy People 2020 to one of her patients, a young woman who is visiting a community health center. The woman asks what role social and physical environments have on our health and why Healthy People is involved in the environment. How does the nurse respond?

Having access to safe food, water, and air is essential to maintaining good health for everyone.

The nurse is performing an assessment on a 75-year-old man. The nurse is impressed with his health status and asks what he did to age so well. The man would most likely attribute his good health and youthfulness to what characteristic?

He reads the newspaper and does his crossword puzzle every day.

The hospitalist is ordering stat blood work on a newly admitted 60-year-old male patient. The nurse would most likely expect the doctor to order a blood test to screen for what disease?

Hepatitis C

The nurse is speaking with the children of a 90-year-old man with advanced lung cancer. The children tell the nurse they want their father to spend his remaining months in as much comfort as possible with as little medications as possible. What could the nurse suggest to this family?

Hospice and palliative care

A mother is concerned when the nurse says her baby has high levels of a phthalate called DEHP in his blood. When the mother asks how this happened, the nurse tells her the most likely source of exposure to DEHP was

IV tubing at the hospital

A group of labor and delivery (L&D) nurses have agreed to participate in a community health fair. To decide which topic to address, they begin to collect local and state population level data for the main purpose of:

Identifying risk factors related to this population

A nurse and begins to suspect that an emergency room patient is suffering from a pandemic strain of the flu that has not yet impacted the community. How does the nurse proceed?

Immediately inform the physician and the nursing supervisor.

A nurse is working in a community clinic on the coast of Indonesia when a strong earthquake occurs. There is no damage to the clinic, and everyone is safe. What should the nurse do?

Immediately start evacuating patients to higher ground.

Community leaders want to address the issue of flu season protection to avoid an epidemic like they had last year. They enlist the help of the PHD who provides them with a PHN. How can the PHN best assist the community and their concerns?

Immerse herself in the community and speak with local residents

A nurse has approached a local college about partnering up to discuss ways to implement a safe alcohol policy on campus. What is the first step?

Perform a full community assessment, including interviews with students, teachers, and alumni.

A school nurse is trying to implement a scoliosis screening protocol for the students at the school. There isn't a similar program at other schools in the district to model the program after. What is her first step?

Perform an assessment of student needs, available resources, and social data.

Community leaders in Jonestown, Pennsylvania want to establish a community partnership that works toward the goal of educating children on the dangers of tobacco use. Which of the following organizations would be the least helpful in this effort?

Planned Parenthood

A nurse is talking with a young man who was recently diagnosed with bipolar disorder. He is talking with the nurse about feeling stigmatized due to his mental illness and is requesting assistance in finding local support. The nurse knows that stigma is:

Possessing a characteristic that is typically thought of as less desirable in society

A local hospital wants to develop a program to teach expecting mothers about the risks associated with preterm birth. They implement all the following strategies except:

Produce a public service announcement (PSA) that stresses abstaining from decaffeinated drinks during pregnancy

A nurse is teaching a class about the economics of health care. They are discussing how similar the health-care system is to the free market economy. The nurse explains that the government must, however, intervene in the health-care system in order to:

Promote fairness for citizens who are unable to afford to pay for their health care.

Company XYZ issued a press release saying they are making their work environment more "woman friendly." Which of the following changes would the PHN not suggest be a part of this "woman friendly" initiative?

Proper ventilation in the chemical laboratories

A nurse is reviewing the disaster response plan for the community clinic. The plan describes preparedness, mitigation, response, and recovery procedures. The nurse knows, however, that one of the most important steps is missing. This step includes procedures for:

Response evaluation

A nurse is teaching a class on the health needs of the homeless population. One of the students asks, what is the most pressing need for homeless men and women? How does the nurse respond?

Safe and affordable housing

A high school health teacher is preparing his lesson planner over the summer. He contacts the school nurse for advice on which topics he should focus on for a group of 15 and 16 year olds. The nurse tells him that which of the following topic would be most appropriate for his students?

Sexually transmitted infections (STIs)

A nurse is working in the emergency department of a large urban hospital. The nurse is responsible for managing the emergency response and disaster management team and the hospital is just returning to normal functioning after caring for victims of a building explosion. What should the nurse do next?

Schedule a quality improvement meeting with key staff members to discuss what went well and what needs to be addressed.

A nurse is caring for a young woman with two young children. They are currently living in a shelter for families escaping from domestic violence. The nurse recognizes that this family is suffering from what type of homelessness?

Secondary homelessness

A nurse is volunteering on an island where a strong earthquake occurred several days ago. Almost all of the residents have been rescued or accounted for, but flooding is now the biggest problem as a result of broken infrastructure. How should the nurse proceed?

Set up surveillance programs to monitor for diarrheal diseases

A nurse is teaching her first class about vulnerable populations and health disparities. Which of the following are included as characteristics of vulnerable populations?

Sexual orientation Health status Legal immigration status

A public health nurse is teaching a class about medical vulnerability and the risk factors for becoming a vulnerable population. The class starts discussing the need to be able to call on the support of one's family or community when needed. What is the term for this concept?

Social Capital

A middle school nurse wishes to make it a policy that the nursing office distributes free condoms to any student who requests them because of the rising teen pregnancy rate in the school. Why is this likely not going to get implemented?

Social acceptability

A nurse is presenting a guest lecture in an ethics class at her college. The lecture is about ethical issues in public health and health policy. The basic tenet of ethics in health policy is:

Society has the obligation to ensure a healthy environment for its citizens.

A nurse has been assigned for the next three months to a particularly vulnerable community and is beginning to evaluate the social determinants of health there. What characteristics is the nurse looking at?

Socioeconomic status Access to public transportation Level of education

Before the end of the school year, a school nurse begins working on an employee wellness program. What measurable outcome could the nurse use to evaluate the success of her program?

Staff absenteeism will decrease by 25 percent during the next school year.

A PHN is planning a community health fair for residents in a large urban neighborhood. The PHN will most likely hand out all the following the brochures except:

Take Care of Your Teeth!

At a town PTA meeting, some parents are expressing anger over the high school's decision to teach students about birth control methods other than abstinence-only. The school nurse is at the meeting and explains to parents this important fact as to why teaching all birth control methods is vital to their sex education program.

Teen pregnancy rates are highest in states with abstinence-only programs.

A nurse is volunteering at a homeless shelter helping families and individuals get settled. The nurse is sitting with an older gentleman who is visibly intoxicated and continues to sip clear liquid from an unlabeled plastic bottle. How should the nurse proceed?

Tell him that he cannot stay at the shelter while he is intoxicated, but encourage him to come back once he has sobered up.

A student confides in the school nurse that she is being bullied by another student and is afraid to come to school. The nurse is concerned for this student, and wonders how many other students are being bullied but have yet to speak up. What is the best way for the nurse to handle this situation?

Tell the principal what is going on. Then collaborate with staff on an anti-bullying program at the school.

A nurse is working at a community clinic counseling a young woman. The woman's husband was physically abusive, so she took her children and left. She needs assistance in finding housing for a few months until she can leave town to live with her mother. What does the nurse recommend?

Temporary affordable housing

A nurse is caring for a patient in the emergency room. The patient survived a bomb explosion in a train station but has lost her left arm as a result. How does the nurse document those injuries?

Tertiary

A nurse is working with a local town council to figure out ways to alert more young people of disaster situations. The nurse suggests which of the following as the most effective means to achieve this?

Text messages

A nurse is teaching a course about vulnerable populations and is discussing unauthorized immigrants and their unique health needs. Which of the following statements is incorrect?

The Affordable Care Act expanded access to lower-cost health care to all immigrants.

A nurse is preparing a dietary counseling program at a prenatal clinic in a large metropolitan area. Before writing any meal plans, what is the first thing the nurse should consider?

The food preferences for various cultures

The school nurse speaks with the family of an obese 12-year-old boy whom he or she believes may be diabetic. His parents are visibly worried and say, "We can't afford health insurance. How are we going to pay for his treatment?" The nurse reassures the parents by saying:

The nurse can help enroll their son in Medicaid.

A group of L&D nurses are putting together a program to reduce the number of women who develop gestational diabetes. The nurses establish which measurable outcome objective for their program?

There will be a 25 percent reduction in the number of women who develop gestational diabetes

A public health nurse (PHN) conducts a follow-up visit with the family of an autistic boy. The family has enrolled their son in a local special needs program, as the PHN suggested. They also joined a support group for families of autistic children. The work between the PHN and this family is referred to as a:

Community collaboration

The nursing instructor asks a student how to provide a rural community with better access to health care. The instructor realizes the student needs further teaching when he suggests

Accept more students from urban areas into nursing schools

A nurse working in an emergency room has received notification that a firefighter who was fighting a fire nearby will be coming into the emergency room for care. What should they be prepared to treat?

Respiratory distress