Principles in Community and Public Health Nursing, ATI Community Historical Influences on Community and Public Health, ATI Community Population, Public, and Global Health, Environmental Influences, RN Economic Influences

A nurse in a community clinic is teaching a parent about the Children's HEalth Insurance Program (CHIP). Which of the following client statements indicates an understanding of the teaching? Select all that apply

"My 18-year-old is eligible for CHIP" is correct. Uninsured children under the age of 19 years are eligible for CHIP. "Medicaid is for elderly people only" is incorrect. CHIP provides health insurance coverage for children ages 19 and younger. "My employer will withhold a portion of my pay for CHIP" is incorrect. A health savings account (HSA), rather than CHIP, involves withholding of an employee's pay to establish an account for out-of-pocket expenses. "We have to enroll in Medicaid to be eligible for CHIP" is incorrect. CHIP provides health insurance to children in families who cannot afford private insurance but whose incomes are greater than the limit to qualify for Medicaid. "We can use CHIP for primary care and hospital care" is correct. The CHIP program coverage includes primary care, specialty care, emergency care, and hospitalizations.

A nurse case manager is teaching a client about Health Savings Accounts (HSA). Which of the following client statements indicates an understanding of the teaching?

"The HSA can be used for out-of-pocket medical expenses" An HSA is provided through an employer or health insurance plan to cover out-of-pocket health care expenses, such as co-pays and costs counted toward deductibles.

A nurse is researching an electronic database for the cost of taxpayer funded Medicare expenses. Which of the following should the nurse identify as the amount of taxpayer funded Medicare expenses in 2019?

$799.4 Billion In 2019, the cost of the Medicare program was 799.4 billion dollars.

The nurse is preparing a presentation about health care delivery in the U.S. for a group of newly licensed nurses. Which of the following statements should the nurse include in the presentation to describe the U.S. health care system? 1. "The U.S. spends more on health care than other developed countries." 2. "The U.S. has better health outcomes than other developed countries." 3. "The U.S. health care delivery system is population-focused." 4. "The U.S. nursing workforce is expected to increase over the next decade."

1. "The U.S. spends more on health care than other developed countries."

A nurse is providing a presentation about telehealth to a group of community health nurses who will soon be implementing telehealth practices within their community. Which of the following statements by one of the community health nurses indicates an understanding of the information? 1. "We can use video conferences as a method of telehealth to hold remote meetings with staff and clients." 2. "Text messaging can be used as a method of telehealth." 3. Faxing prescriptions to the pharmacy is an example of telehealth." 4. Sending email messages through commonly used email servers is one way to use telehealth."

1. "We can use video conferences as a method of telehealth to hold remote meetings with staff and clients."

A nursing program director is discussing the integration of the Quality and Safety Education for Nurses (QSEN) competencies into the curriculum with faculty. Which of the following competencies should the director include in the discussion as the competency that most student are the least prepared to address? 1. Quality Improvement 2. Patient-Centered Care 3. Informatics 4. Teamwork and Collaboration

1. Quality Improvement The director should include in the discussion that quality improvement is the QSEN competency that most students report as being the least prepared to address.

A public health nurse is discussing strategies to increase the number of nurses who are interested in working in public health with another nurse. Which of the following strategies should the nurse include in the discussion as an approach to increase the supply of public health nurses? 1. Adding telehealth-related content to the nursing curricula. 2. Restructuring pay and rewards for nurses who practice outside of acute care settings 3. Increasing nursing representation on community planning boards 4. Providing incentives for nurses nearing retirement age to continue working.

2. Restructuring pay and rewards for nurses who practice outside of acute care settings

A school nurse assesses a few students for injuries after they have been fighting. The nurse finds bruises in various stages of healing on one of the students. Which of the following interventions on the secondary level of prevention should the nurse implement? 1. Notify the parents that the student has been in a fight 2. Apply bandages to the cuts found on assessment 3. Report the findings to Child Protective Services (CPS) 4. Ask social services to arrange for extensive counseling for the student

3. Report the findings to Child Protective Services (CPS)

A community health nurse is reporting to community leaders about the effects of health policies that have been implemented. Which statement should the nurse make when describing the purpose of health policies?

A health policy involves intentional actions to influence health outcomes in the community The nurse should discuss health policy as influencing the achievement of specific health outcomes through intentional actions.

A public health nurse is researching information from governmental organizations to guide evidence-based practice. Which of the following should the nurse identify as a governmental organization?

Centers for Disease Control and Prevention (CDC) The nurse should identify that the CDC is a governmental organization.

A nurse is discussing strategies for achieving optimal health in their community with a group of nurses. Which of the following interventions should the nurse include in the discussion? (Select all that apply.)

Collaborate with community leaders. Measure levels of radon in community buildings. Promote immunization in the community.

A nurse is reviewing the history of government-funded health programs in the US. Which of the following should the nurse identify as the president who enacted law to create the Medicare program in 1965?

Lyndon B. Johnson The nurse should identify Lyndon B. Johnson as the president who enacted law to create the Medicare program.

A nurse is reviewing private sector health insurance options. Which of the following should the nurse identify as an example of private sector health insurance?

Employer-sponsored health plan An employer-sponsored health plan is an example of a private sector insurance program.

A nurse manager is discussing primary preventive measures to reduce infection rates with another nurse. Which of the following actions should the nurse identify as an example of a primary preventative measure? Select all that apply

Ensure that hand sanitizer is located throughout the facility is correct. The nurse manager should discuss implementing the availability of hand sanitizer throughout the facility as a primary prevention intervention. Promote social distancing during activities is correct. The nurse manager should discuss implementing the promotion of social distancing during activities as a primary prevention intervention. Educate about the use of personal protective equipment (PPE) is correct. The nurse manager should discuss implementing education about the use of PPE as a primary prevention intervention. Isolate individuals who have illness is incorrect. The nurse manager should discuss implementing the isolation of individuals who have illness as a secondary prevention intervention. Test individuals who have been exposed to the infection is incorrect. The nurse manager should discuss implementing screening, such as testing individuals who have been exposed, as a secondary prevention intervention.

A community health nurse is asking a client about any potential lead exposure that could affect children in the community. Which of the following techniques is the nurse using?

Environmental health assessment

A community health nurse is educating a community group about regulation of health care in the public sector. Which of the following entities should the nurse describe as making the majority of decision about health care regulation in the public sector?

Federal Government The nurse should describe the federal government as the entity that makes the majority of decisions about health care spending in the public sector.

Paris is reviewing potential environmental exposures with a group of public health nurses. Which of the following immunization should the nurse include in the review as recommended by the CDC due to these exposures? Hepatitis B Hepatitis A Influenza MMR Pneumonia.

Hepatitis B is correct Influenza is correct. MMR is correct

A public health nurse discovers that a low-income community is lacking access to primary care and health insurance. Which of the following actions should the nurse take to address this concern?

Host an educational session in the community for health care registration and screenings.

A community health nurse is leading a group of nurse volunteers to help with a mass casualty disaster. Which of the following actions is the priority for the volunteers to take?

Keep individuals safe and remove those in harm's way.

A public health nurse is conducting research about the scope of practice for public health nurses. Which of the following is responsible for establishing the scope of practice for nurses?

Lawmakers The nurse should identify that lawmakers are responsible for the legislation that defines the scope of practice for nurses.

A nurse is speaking with a client who is preparing to go on vacation in Africa. The client wants to know the name of the disease that is passed from mosquitos to humans. Which of the following diseases should the nurse identify?

Malaria

A nurse is reviewing the harmful effects the environment can have on human health. Which of the following health conditions should the nurse attribute to environmental factors? (Select all that apply.)

Malaria Asthma Lead poisoning

A community health nurse is researching health policy administration. The nurse should identify that which of the following is administered at the state government level?

Medicaid The nurse should identify Medicaid is managed and funded by each state's government.

A nurse is teaching about health insurance options with a young adult client who has recently become disabled. The nurse should identify that the client's disability might make them eligible for which of the following health insurance programs?

Medicare The nurse should identify that Medicare is a public sector program established to provide health care coverage for individuals over 65 years old, and that has recently been expanded to include coverage for people with disabilities.

A nurse is reviewing health coverage programs with a newly licensed nurse. Which of the following should the nurse identify as a public sector health care program that provides coverage to clients over 65 years old?

Medicare The nurse should identify that Medicare is a public sector program established to provide health care coverage for individuals over 65 years old.

An occupational health nurse is developing workplace wellness programs for which employees can use their health savings account as form of payment. Which of the following programs should the nurse identify as an example of a secondary prevention intervention?

Online nutrition education for employees who have new onset of hypertension The nurse should include an online nutrition education to prevent complications for employees who have new onset of hypertension as a secondary prevention intervention. The employees can receive further guidance in order to manage their condition.

A home care nurse is visiting a client and conducting an environmental assessment of their home. Which of the following should lead the nurse to be concerned about lead poisoning?

Peeling or flaking paint in the residence

A community health nurse is giving a presentation to a group of students about collecting data on a community's environments. Which of the following environments should the nurse include? (Select all that apply.)

Physical Social Occupational

A nurse is teaching a client about Medicare Part D. the nurse should include that this program covers which of the following?

Prescription medications Medicare Part D provides coverage for prescription medications.

An occupational health nurse is evaluating the cost-effectiveness of interventions that were implemented to decrease sick days during flu season. Which of the following actions should the nurse identify as a secondary prevention intervention?

Provide testing for influenza at the employee health clinic Providing testing for influenza at the employee health clinic is an example of a secondary prevention intervention. This allows for early identification of the condition and prevents the spread to others.

A nurse is speaking with a client who wants to know the name of the chemical compound used to kill mice. Which of the following terms should the nurse provide?

Rodenticide

A public health nurse is collaborating with city officials to implement community sponsored programs to decrease health care costs for all. Which of the following types of health program services should the nurse recommend? Select all that apply

Secondary prevention interventions is correct. Secondary prevention intervention programs decrease health care costs by preventing complications of a disease or condition. Tertiary prevention interventions is correct. Tertiary prevention intervention programs decrease health care costs by limiting complications of a disease or condition. Primary prevention interventions is correct. Primary prevention intervention programs decrease health care costs by preventing the development of a disease or condition.

A public health nurse is delivering a presentation about health care resources. Which of the following organizations should the nurse include as an example of a health care resource in the private sector?

St. Jude Children's Network St. Jude Children's Network is a nongovernment organization. Therefore, the nurse should include St. Jude Children's Network as an example of a private sector health care resource.

A nurse is sharing information with a group of newly licensed nurses about public sector health programs. Which of the following should the nurse identify as the source of funding for Medicare?

Taxpayer contributions The nurse should identify that Medicare is federally funded by U.S. taxpayers through entitlements.

A home health nurse is preparing to make a referral to a diabetes educator for a client who has had several hospital readmissions regarding their diabetes and has developed a diabetic foot ulcer. The nurse should identify that this is an example of which of the following types of prevention?

Tertiary prevention The nurse should recognize that a referral for a tertiary prevention intervention would be made to keep limit future complications and prevent problems from getting worse. A diabetes educator would be able to provide education to client regarding diabetes and its management and prevent further complications.

A public health nurse is preparing a presentation about health care resources. Which of the following organizations should the nurse include as an example of a health care resource in the public sector?

The Department of Health and Human Services (HHS) The HHS provides regulation and services at a governmental level. Therefore, the nurse should include the HHS as an example of a health care resource in the public sector.

A public health nurse is reviewing newly approved vaccines for prevention of a communicable disease. The nurse should identify that which of the following entities is responsible for the approval of manufactured pharmaceuticals?

The Food and Drug Administration (FDA) The nurse should identify that the FDA is responsible for the approval of manufactured pharmaceuticals.

A team of public health nurses is discussing a new health care law. The nurses should identify that which of the following entities is responsible for passing laws related to health care?

The Legislative branch The nurses should recognize that rules and regulations of health care laws are proposed, debated, and passed by the legislative branch of government.

A public health nurse is reviewing characteristics common to health care organizations in both the public and private sector. Which of the following should the nurse identify as a similarity between public and private health care organizations?

They are subject to governmental oversight Public and private sector health care organizations are subject to governmental regulation and oversight.

A nurse is caring for a client who frequently uses pesticides. The nurse should understand that which of the following is true about pesticides? (Select all that apply.)

They can cause illness through genetic mutations or cancer development. They can enter the air and cause lung irritation when inhaled. Their residue seeps into the ground and can harm drinking water.

A team of public health nurses is delivering a presentation to community leaders about funding for health care programs. Which of the following organization's data should the team include during the presentation as having a direct effect on funding?

US Census Bureau The U.S. Census Bureau is an organization that has direct effects on funding allocations for public health programs because of the data that is collected. After data is collected, the U.S. Census Bureau can identify needs and determine use of funds.

A nurse is discussing terms used to describe environmental influences with a client. The nurse should include that which of the following terms describes an environmental influence that occurs prior to an agent reaching a host?

Upstream

A public health nurse is working with a group of clients who are concerned about malaria in their town. They ask the nurse about effective ways to help prevent the spread of malaria. Which of the following strategies should the nurse suggest?

Use insecticide-treated mosquito nets.

A nurse is reinforcing teaching to community nurses about the scope of nursing practice in the community. Which of the following statements by a nurse indicates understanding of the "what" part of the American Nursing Associations's (ANA) description of the scope of practice? a. "I will focus on being committed as I provide care to protect the health and well-being of my clients." b. "I understand that scope of practice refers to staff such as LPNs, RNs, and APNs." c. "It is important that I remember that nursing care is to be provided wherever it is needed." d. "My goal is to collaborate with my colleagues effectively to create positive client outcomes."

a. "I will focus on being committed as I provide care to protect the health and well-being of my clients." Rationale: This statement shows the nurse has effectively understood the teaching. The "what" part is indicated by the care and commitment the nurse shows to protect and promote the health and well-being of their clients.

A nurse is reinforcing teaching to a newly licensed nurse about client advocacy. Which of the following statements by the newly licensed nurse indicates an understanding of the teaching? a. "I will make sure clients understand treatment options before they sign a consent form." b. "I will make sure to speak to my client's adult children on deciding if a surgical procedure should be conducted." c. "I will inform clients they should research health information so they do not bother providers with questions." d. "I will not alert my client that they have access to their medical records via the patient portal."

a. "I will make sure clients understand treatment options before they sign a consent form." Rationale: One of the duties of a nurse advocating for clients is to ensure that the client understands treatment options, risks, and outcomes so that they are able to give informed consent before procedures.

A nurse is requesting a referral for a case manager for a client who requires financial assistance for their medications. Which of the following forms of advocacy is the nurse demonstrating? a. Client advocacy b. Professional advocacy c. Political advocacy d. Community advocacy

a. Client advocacy Rationale: The nurse is demonstrating client advocacy by requesting a referral for a case manager to assist with the client's financial concerns regarding affording their medications.

A nurse is reviewing a client's medical record with a dietician who is part of the client's interdisciplinary team. Which of the following elements of Nursing's Social Contract is the nurse demonstrating? a. Collaboration b. Responsibility and accountability c. Progress and Development d. Ethical Practice

a. Collaboration Rationale: The nurse is discussing the client's medical record with the dietitian, which is a demonstration of Collaboration. Collaboration with members of the interdisciplinary team is critical in providing effective care so that each aspect of the client's needs will be met.

A nurse is teaching a client who has asthma on the use of an inhaler. Which of the following resources should the nurse include in the teaching? a. Give a demonstration of how to use the inhaler followed by the teach-back approach. b. Provide only a video teaching about asthma. c. Offer the phone number of the manufacturer of the inhaler. d. Provide the client with a brochure to learn more about asthma.

a. Give a demonstration of how to use the inhaler followed by the teach-back approach. Rationale: The nurse should use informative communication, including effective verbal and nonverbal skills, when teaching a client who has asthma on the proper use of an inhaler. Teaching the information and then asking the client to demonstrate the use of an inhaler will ensure understanding of the instructions.

A community health nurse reports that some families are in desperate need of basic preventative health care services. Which of the following principles supports providing resources to families in the community that are in need? a. Justice b. Beneficence c. Autonomy d. Nonmaleficence

b. Beneficence Rationale: The nurse is demonstrating the ethical principle of beneficence. Beneficence is doing what is in the best interest of the client and protecting them from harm.

A nurse is caring for a client who does not have proper understanding of a surgical procedure that is scheduled for the next day. The nurse notifies the client's provider. Which of the following concepts is the nurse demonstrating? a. Client education b. Client advocacy c. Accountability d. Autonomy

b. Client advocacy Rationale: The nurse is demonstrating the concept of client advocacy. Client advocacy protects the client's rights and provides assistance in asserting these rights if the need arises. In this instance, the nurse is protecting the client by notifying the client's provider to ensure the client completely understands their surgery and questions are addressed.

A nurse is caring for a client who asks how their food choices might affect their blood pressure. To which of the following members of the interprofessional team should the nurse refer this client? a. Kinesiologist b. Dietitian c. Social worker d. Pharmacist

b. Dietitian Rationale: The nurse should request a referral for the client to see a dietitian. A dietitian is part of the interprofessional team and can go through the client's list of foods to determine if they are affecting their blood pressure.

A public health nurse is providing an explanation to newly hired public health nurses on the standards of care along with the policies and procedures that reflect Nurse Practice Acts. Which of the following is imperative that the new nurses know about Nurse Practice Acts? a. Nurse Practice Acts specify the scope and standards of practice for student nurses. b. Nurse Practice Acts are the laws governing nursing practice. c. Nurse Practice Acts specify the code of ethics to be used in hospital settings. d. Nurse Practice Acts are governed by the federal government, not state law.

b. Nurse Practice Acts are the laws governing nursing practice. Rationale: A Nurse Practice Act is a state law that outlines standards of care and provides guidance to nurses in safe and effective practice.

A nurse is speaking with the nursing supervisor about a staffing shortage and its implications for staff on their unit. Which of the following forms of advocacy is the nurse demonstrating? a. Political and legislative advocacy b. Professional advocacy c. Community advocacy d. Client advocacy

b. Professional advocacy Rationale: The nurse is demonstrating professional advocacy by speaking with the nursing supervisor regarding the staffing shortage on their unit and its implications for staff, such as burnout and safety concerns.

A nurse is preparing an orientation for newly licensed community health nurses on the standards of professional practice. Which of the following is a critical thinking model that describes a competent level of nursing care? a. Elements and Standards Model b. The nursing process c. The Minnesota Model for Public Health Nursing Practice d.Professional Nursing Model

b. The nursing process Rationale: The nursing process is a critical thinking model describing a competent level of nursing care. When the nursing process is applied in community health settings, the nurse has the opportunity to employ systematic strategies when caring for clients. The nurse will use interpersonal and intellectual skills in combination with clinical judgment to promote client health and safety of the populations involved.

A nurse working at a community health center is caring for a client that reports disappointment and feeling ashamed of their weight. Which of the following responses should the nurse give? a. "How about if you start tracking your caloric intake?" b. "Many people struggle with weight loss." c. "What has been bothering you the most about your weight?" d. "Medications may be able to help you lose a lot of weight if you'd like to try that."

c. "What has been bothering you the most about your weight?" Rationale: This is the most appropriate response by the nurse because it acknowledges the client's expressed concerns, is open-ended, and encourages further discussion.

A nurse is caring for a client who is dying and wishes to discontinue taking their medications. Which of the following ethical principles is the nurse demonstrating by respecting the client's decision? a. Nonmaleficence b. Beneficence c. Autonomy d. Justice

c. Autonomy Rationale: The nurse is demonstrating the ethical principle of autonomy by respecting the client's wishes. Autonomy is the ability to be able to make informed decisions independently.

A community health nurse is reinforcing education on insulin administration to a client who has diabetes mellitus. Which of the following elements of Nursing's Social Contract is the nurse demonstrating? a. Collaboration b. Ethical practice c. Autonomy of practice d. Promotion of the health of the public

c. Autonomy of practice Rationale: The nurse is demonstrating the element of autonomy of practice of nursing's social contract. Autonomy of practice involves providing education of disease management and insulin administration within the scope and standards of practice for a community health nurse.

A nurse working in the family planning clinic is working with an adolescent client who has expressed interest in birth control options. Which of the following is an example of how the nurse can practice with compassion and value the inherent dignity, worth, and unique attributes of the client? a. Take responsibility for recommending that the client use hormonal contraception. b. Advocate for the right of the minor's parents to authorize prescribed birth control medication. c. Establish a rapport by respecting the client's interests and providing education on all birth control options. d. Promote the use of contraception among the client's peers at a community event.

c. Establish a rapport by respecting the client's interests and providing education on all birth control options. Rationale: Provision 1 of the American Nurses Association (ANA)Code of Ethics is when the nurse practices with compassion and respect for the inherent dignity, worth, and unique attributes of every person.

Due to a rise in whooping cough cases among middle school-age students, the school board requires an additional dose of Tdap vaccine to attend the 7th grade. Which of the following community outreach actions should the school nurse use to promote this updated policy? a. Recruit teachers to help spread the word about the immunization requirement. b. Establish one-on-one counseling sessions for each of the students' families about immunizations. c. Organize virtual educational sessions on immunizations within the school district. d. Inform the students who will enter 7th grade of the required additional vaccine.

c. Organize virtual educational sessions on immunizations within the school district. Rationale: The school nurse should realize that a public policy measure, such as increased immunizations for school attendance, is to promote the safety and well-being of clients in the school population. Therefore, it is appropriate for the school nurse to advocate for the approach that would be best suited to motivate the student population and inform their families of the new vaccine requirement.

A nurse working at a community health clinic is reviewing the staff schedule and notices the clinic has been working short staffed for the past 3 months. Which of the following actions should the nurse take to address this issue? a. Cancel and reschedule client appointments to times when staff are available. b. Speak to clients and get feedback about the scheduling challenges. c. Speak to the manager and advocate for a strategy that ensures adequate staffing. d. Close the clinic early due to staffing concerns.

c. Speak to the manager and advocate for a strategy that ensures adequate staffing. Rationale: By speaking to the stakeholder and advocating for better staffing considerations, the nurse is demonstrating an ability to help shape and inform policy making for this important issue.

A public health nurse has been assigned to call a client who speaks a different language than the nurse. Which of the following actions by the nurse demonstrates cultural competency? a. Ask the client's family member to help with interpretation. b. Ask the office receptionist who can speak multiple languages to help with interpretation. c. Use the organization's interpretation or translation service for this call. d. Speak slowly and use simple terms.

c. Use the organization's interpretation or translation service for this call. Rationale: Language barriers can lead to miscommunication, and use of an interpretation or translation service can help to improve satisfaction, quality, and safety of care.

A nurse working in a community health clinic is caring for a client who reports they have not slept for several days. Which of the following responses should the nurse give? a. "Have you tried melatonin?" b. "I have issues falling asleep every night as well." c. "You need to stop drinking coffee." d. "What has made it difficult for you to sleep lately?"

d. "What has made it difficult for you to sleep lately?" Rationale: The nurse should provide a response that demonstrates acknowledgment of the client's concern and that is open-ended as well as genuine. This provides an opportunity for the client to discuss their situation and emotions further.

A nurse is preparing to discharge a client with a newborn who has a tracheostomy and will require apnea monitoring at home. Which of the following resources should the nurse recommend to the client to assist with tracheostomy care and apnea monitoring? a. Community center clinic b. Ambulatory care center c. Occupational health center d. Home health care

d. Home health care Rationale: The home health care agency will provide services to the client by assisting with education on tracheostomy care and on using the apnea machine properly for the newborn.

A community health nurse is caring for a client who informs the nurse that they need a kidney transplant but their insurance has been discontinued. Which ethical principle should the nurse be aware of to provide resources for this client? a. Veracity b. Autonomy c. Accountability d. Justice

d. Justice Rationale: The nurse is demonstrating the ethical principle of justice, which refers to fairness. Community and public health nursing agree to strive for justice in health care and resources for all clients' well-being.

A public health nurse working in the community center asks the nurse manager where nurses can obtain information on the competencies that public health nurses should possess. Which document should the nurse manager recommend? a. The Minnesota Model for Public Health Nursing Practice b. Nurse Practice Act (NPA) c. American Nurses Association (ANA): Code of Ethics d. Public Health Nursing Competencies

d. Public Health Nursing Competencies Rationale: The nurse manager should direct the public health nurses to the Public Health Nursing Competencies, which provide guidance on the competencies for public health nurses.

A public health nurse is providing an explanation to newly hired public health nurses on the concept of community health nursing as a population-based service. Which of the following interventions should the nurse include in the explanation? a. Physical assessment prior to hospital admission b. Intake interviews for long-term care placement c. Develop policies for health benefits at a local factory d. Screening and surveillance of communicable diseases

d. Screening and surveillance of communicable diseases Rationale: A key role of the community/public health nurse involves disease and health event investigation, as well as surveillance, screening, and community outreach for diseases including communicable and non-communicable diseases. Surveillance involves assessment of the population health prior to and following health events. Screening is employed to identify disease cases within the population.

A community health nurse is reinforcing teaching to new nures on a scenario in which a nurse has forgotten to refer a client to a social worker, causing a delay in medication coverage for the client. Which of the following actions by the nurse demonstrates the element of responsibility and accountability under nursing's social contract? a. The nurse requests to speak to their supervisor to discuss workload. b. The nurse explains the reason why the delay occurred. c. The nurse makes excuses for the delay. d. The nurse accepts fault in the delay of the client's medication coverage.

d. The nurse accepts fault in the delay of the client's medication coverage. Rationale: In accepting the fault for the situation, the nurse is demonstrating the element of responsibility and accountability of nursing's social contract. The nurse has accepted fault and is transparent about the situation.

A nurse is interacting with a client who has a new diagnosis of diabetes mellitus. The client has attended multiple workshops about managing their condition but still has an A1C of 9 and admits to not using the meal plans to help with nutritional needs. Which of the following could the nurse at the community-based clinic do first to assist the client in adhering to the medical regimen. 1. Ask the client to discuss what barriers they perceive that prevent compliance 2. Refer the client to the diabetic educator for more instructions 3. Ask the case manager for community resources for programs like Meals on Wheels 4. Assess the client's neighborhood to see if there is access to fresh fruits and vegetables

1. Ask the client to discuss what barriers they perceive that prevent compliance

Which of the following are stages of change in the transtheoretical model? (Select all that apply.) 1. Precontemplation 2. Maintenance 3. Interpersonal Relationships 4. Action 5. Planning

1. Precontemplation 2. Maintenance 4. Action 5. Planning

A public health nurse is providing care for a client who has a recent diagnosis of active tuberculosis. Which of the following actions should the nurse take to assist this client with managing their own health care? 1. Review the client's laboratory results before having the client take medication 2. Review precautions to decrease risk of infecting members of the client's household 3. Reinforce the information concerning the medications' adverse effects 4. Make a referral for the client to the Directly Observed Therapy (DOT) program in the community.

4. Make a referral for the client to the Directly Observed Therapy (DOT) program in the community

A nurse is providing a presentation about individuals who made early contributions to public health nursing. Which of the following contributions should the nurse credit to Lillian Wald? 1. Establishment of the Henry Street Settlement 2. Establishment of the Stillman House 3. Establishment of the Frontier Nursing Service (FNS) 4. Establishment of the American Red Cross

1. Establishment of the Henry Street Settlement.

A nurse is arranging for flu vaccines to be administered to anyone who consents to it. Which of the following levels of prevention are guiding the nurse's actions? 1. Primary prevention 2. Secondary prevention 3. Tertiary prevention 4. Primordial prevention

1. Primary prevention

A nurse is using an electronic database to research government funding of health care. What percentage of public health care in the United States should the nurse identify as being funded by the gross domestic product (GDP)?

17% The nurse should identify that the federal government spends approximately 17% of the annual GDP on public health.

Which of the following Sustainable Development Goals would be achieved if nations implemented a recycling programs in their major cities? 1. Reduction of inequalities 2. Responsible consumption and production 3. Affordable and clean energy 4. Clean water and sanitation

2. Responsible consumption and production

A public health nurse is going to deliver a message to the residents in town about a primary preventive measure to stop the spread of communicable disease during an outbreak. Which of the following could be included in the message? 1. Getting lab work done to screen for the disease 2. Completing the antibiotic regimen as prescribed 3. Speaking about hand hygiene and what kinds of products to use 4. Calling the physician if signs and symptoms return

3. Speaking about hand hygiene and what kinds of products to use

A nurse is working with a community planning board to address the challenge of systemic racism in their community. Which of the following criteria should the nurse identify as essential to the success of a community plan addressing systemic racism? 1. Focusing on the outcomes of racial inequities 2. Placing those with poser and resources in charge of the plan 3. Creating a day of remembrance to raise awareness of racial inequities 4. Budgeting financial resources fairly based on need

4. Budgeting financial resources fairly based on need. Essential to the success of a plan to address systemic racism is budgeting financial resources fairly based on need. Therefore, the nurse should include this as criteria essential for addressing racial inequities.

Which of the following health promotion initiatives were launched to implement interventions for better overall health in the U.S.? 1. Paris Agreement 2. Healthy People 2030 3. Sustainable Development Goals 4. Tennessee Valley Authority

2. Healthy People 2030

Which of the following interventions might the occupational health nurse employ to promote health and safety in the workplace? (Select all that apply.) 1. Offer immunizations such as flu vaccines 2. Do a walkthrough inspection to check for safety in work areas 3. Remind employees to use personal protective equipment when handling harmful chemicals 4. Arrange for the vendor to educate the employees on how to use new heavy-lifting equipment 5. Use I PREPARE to assess for environmental health exposure

1. Offer immunizations such as flu vaccines 2. Do a walkthrough inspection to check for safety in work areas 3. Remind employees to use personal protective equipment when handling harmful chemicals 4. Arrange for the vendor to educate the employees on how to use new heavy-lifting equipment

A nurse is discussing the timing of public health acts with a group of nursing students. The nurse should inform the students that, if placed in chronological order from oldest to newest, the following acts would be listed in what order? The Sheppard-Towner Act The Civil Rights Act The Medicare and Medicaid Act The Social Security Act The Health Insurance Portability and Accountability Act

1. The Sheppard-Towner Act (1921) 2. The Social Security Act (1935) 3. The Civil Rights Act (1964) 4. The Medicare and Medicaid Act (1965) 5. The Health Insurance Portability and Accountability Act (1996)

A home health nurse instructs the caregiver to administer pain medication to a nonverbal client in their home. Which of the following evaluation findings would indicate that the goal of pain relief had been met? 1. The client's face relaxes and stops grimacing 2. The client becomes more restless 3. The client's family says that enough medicine has been given 4. The client is still guarded near the area of pain

1. The client's face relaxes and stops grimacing

A newly hired public health nurse is learning about the various duties of their role. Which of the following activities would the new nurse be involved with? 1. Providing wound care for a burn victim in the hospital 2. Educating the public about hand hygiene during an outbreak 3. Administering insulin to a patient in their home 4. Conducting an addiction therapy group at an outpatient center

2. Educating the public about hand hygiene during an outbreak. Focus is on group health promotion and disease prevention

A nurse in a community health clinic is discussing the impact of current health care costs and quality with the staff. Which of the following trends should the nurse identify as the trend that will likely lower health care costs? 1. Aging of the population 2. Increased use of telehealth 3. Medicalization 4. Decreases in the workforce

2. Increased use of telehealth

A nurse is discussing the impact that current community and public health trends have on health care delivery with a group of nursing students. Which of the following trends should the nurse identify as likely to decrease health care expenditures? 1. The medicalization of treatment for lifestyle-related conditions. 2. The decreasing of the nursing work force 3. The implementation of population health strategies 4. The increasing age of the American population

3. The implementation of population health strategies.

In order to support and mobilize communities and partnerships to improve the overall health of the local area, which of the following interventions might a public health nurse employ? 1. Hiring diverse and highly trained staff for the state health department 2. Posting information about domestic violence on the health department websites 3. Working with a local hospital to become an immunization station during an epidemic 4. Sending a nurse epidemiologist to investigate a suspected outbreak

3. Working with a local hospital to become an immunization station during an epidemic

A client who is in the maintenance phase of the Transtheoretical Model's stages of Change admits to not following their diet plan after binging on salty and sugary snacks the past weekend. Which of the following questions should the nurse ask the client next? 1. "How does that make you feel?" 2. "Why did you do that?" 3. "Did you call someone from your support group before eating the snacks?" 4. "Have you had any stressful events in your life lately?"

4. "Have you had any stressful events in your life lately?"

A public health nurse is discussing climate change with a group of nurses who are interested in learning about global health concerns. Which of the following should the nurse include in the discussion as an issue associated with climate change? 1. Decrease in the mosquito population 2. Exacerbations in respiratory conditions 3. Reduced risk of exposure for clients who live in poverty 4. Improved access to clean water

2. Exacerbations in respiratory conditions Extreme weather and temperatures create significant health risks to all by exacerbating heart and respiratory conditions.

A community health nurse is discussing the Nurse Training Act of 1943 with a group of nursing students. The community health nurse should include in the discussion that which of the following occurred as a direct result of the passage of this legislation? 1. Funding for maternal child care programs 2. Prohibition of racial discrimination in nursing organizations 3. Formation of training programs for school nurses 4. Establishment of the National Center for Nursing Research

2. Prohibition of racial discrimination in nursing organizations. The U.S. Cadet Nurse Corps prohibited discrimination in nursing organizations and was a direct result of the Nurse Training Act of 1943. Therefore, the nurse should include this in the discussion.

A nurse is preparing to provide a presentation about population-focused care to a group of community health nurses. Which of the following should the nurse plan to include in the presentation as a required competency for nurses who are providing population-focused care? 1. The ability to develop individualized care plans 2. The ability to analyze large data sets 3. The ability to work independently 4. The ability to gather data about a client's personal support system

2. The ability to analyze large data sets. Population-focused care requires nurses to access and analyze large data sets in order to understand the health of specific populations.

A client asks a nurse to help identify resources for a weight loss plan the client is developing. Which of the following theoretical frameworks might the nurse use in this situation? 1. Health Belief Model 2. Transtheoretical Model 3. Social Cognitive Theory 4. Theory of Reasoned Action/Planned Behavior

2. Transtheoretical Model Good for formulating individualized plans for change towards healthier behaviors

Which of the following terms describes a nurse who delivers care to the residents of a community in a local area focusing on disease and injury prevention? 1. Public Health Nurse 2. Population Health Nurse 3. Community Health Nurse 4. Home Health Nurse

3. Community Health Nurse Community health nurse focuses on the community as a whole

A nurse is planning to provide a presentation to a group of community members on how early discoveries in science have influenced the practice of community health. Which of the following individuals should the nurse include in the presentation as being credited with discovering penicillin? 1. Dr John Snow 2. Dr. Edward Jenner 3. Lemuel Shattuck 4. Alexander Fleming

4. Alexander Fleming He discovered Penicillin in 1928 1. Dr John Snow one of the founders of epidemiology because of his work with Cholera epidemic in London 2. Dr Edward Jenner credited with the discovery of the smallpox vaccine 3. Lemuel Shattuck discovered the connection between illness and sanitation.

A nurse educator is teaching a class on nursing history to a group of nursing students. Which of the following nurses should be identified as the first nurse who focused on environmental conditions? 1. Clara Barton 2. Mary Breckinridge 3. Jessie Sleet Scales 4. Florence Nightingale

4. Florence Nightingale The nurse should identify Florence Nightingale as the first nurse who focused on environmental conditions, which improved outcomes of care on battlefields and in hospitals during the 1800s

An occupational nurse is reviewing recent incidence rates and notes an increase in back injuries. Which of the following would be a population health intervention the nurse could employ to address this issue? 1. Require all employees to wear a back brace 2. Provide the worker with information on local pain clinics 3. Meet individually with workers reporting back injury to determine the cause 4. Offer educational sessions to all workers regarding the prevention of back injuries

4. Offer educational sessions to all workers regarding the prevention of back injuries

A client reports that the initial exercise regimen in their weight loss program was ineffective, but that they have seen positive results since adopting a friend's regimen. Which of the following theories explains the client's change? 1. Health Belief Model 2. Theory of Reasoned Action/Planned Behavior 3. Transtheoretical Model 4. Social Cognitive Theory

4. Social Cognitive Theory Explains that individuals will learn and adopt changes in habit when observing others who have mastered the behavior with positive results.

A nurse is providing education to a client who recently became eligible to receive Medicare benefits. The nurse should identify that which of the following statements by the client indicates an understanding of the teaching? 1. "Medicare Part A will cover all of my prescription medications." 2. "I can add dependents to my Medicare plan if needed." 3. "Medicare will pay for me to be in a long-term facility if needed." 4. "I will have to pay for Medicare coverage if I choose to enroll."

3. "I will have to pay for Medicare coverage if I choose to enroll." Medicare is federally funded however, it is not free and clients who choose to enroll pay a monthly premium.

Which of the following actions should a community health nurse take to promote economic stability in the community? 1. Partner with local churches and write grants for childcare funding towards affordable daycares in the area 2. Advocate for more transportation to health care facilities 3. Work with a nonprofit organization for the local farmers' market to sell fresh produce twice a week. 4. Teach residents about the dangers of lead-based paint

1. Partner with local churches and write grants for childcare funding towards affordable daycares in the area.

A faith community nurse is conducting blood pressure screening at a place of worship. Which of the following levels of prevention does this fall under? 1. Secondary 2. Primordial 3. Primary 4.Tertiary

1. Secondary Focused on at-risk population.

A nurse is reviewing the history of US health care reforms. The nurse should identify that the following reforms were implemented in what order?

1. Medicare is the first reform. Title XIX legislated the establishment of Medicare in 1965. 2. Substance Abuse and Mental Health Services Administration (SAMHSA) is the second reform. The Substance Abuse and Mental Health Services Administration (SAMHSA) is a branch of the Department of Health and Human Services that was established by the U.S. Congress in 1992. 3. Children's Health Insurance Program (CHIP) is the third reform. The Children's Health Insurance Program (CHIP) was established in 1997. 4. Affordable Care Act (ACA) is the fourth reform. The Affordable Care Act was passed in March of 2010.

A nurse is working in a campus health center and is developing a smoking cessation program for the student body. Which of the following federal agencies should the nurse include in the program as the agency that regulates tobacco products? 1. Substance Abuse and Mental Health Services Administration (SAMHSA) 2. Agency for Toxic Substances and Disease Registry (ATSDR) 3. Food and Drug Administration (FDA) 4. Occupational Safety and Health Administration (OSHA)

3. Food and Drug Administration (FDA). The nurse should include in the program that the FDA is the federal agency that regulates tobacco products

A community health nurse is partnering with the local library in a small town to hold workshops on filling out paperwork for student funding for trade schools and colleges. The nurse should recognize that this action is supported by which of the following statements about the lack of affordability in higher education? 1. It decreases the residents' access to healthcare 2. It decreases the residents' health literacy 3. It decreases the local residents' chances of gaining skills and knowledge for various job opportunities 4. It decreases the number of job opportunities in the local area

3. It decreases the local residents' chances of gaining skills and knowledge for various job opportunities

A nurse is discussing government organizations with a newly licensed nurse who is interested in working with clients who have been impacted by natural disasters. Which of the following organizations should the nurse include in the discussion as the organization that provides domestic and international disaster relief? 1. U.S. Public Health Services (USPHS) Commissioned Corps 2. Centers for Disease Control and Prevention (CDC) 3. American Red Cross 4. Health Resources and Services Administration (HRSA)

3. American Red Cross The American Red Cross is a nonprofit organization dedicated to providing domestic and international disaster relief. Therefore, the nurse should include the American Red Cross in the discussion.

A newly licensed nurse is interested in finding information about health care benefits for clients who are disabled or have end-stage renal disease. The newly licensed nurse asks their preceptor where they can find this information. Which of the following organization websites should the preceptor encourage the newly licensed nurse to use to find the desired information? 1. National Institutes of Health (NIH) 2. Centers for Disease Control and Prevention (CDC) 3. Centers for Medicare and Medicaid Services (CMS) 4. United States Public Health Service (USPHS) Commissioned Corps

3. Centers for Medicare and Medicaid Services (CMS) CMS is the organization that oversees Medicare, a federal government-funded health care plan that provides health care benefits to clients age 65 years and older, younger clients who have disabilities, and clients with end-stage renal disease.

A community health nurse is working in a clinic that treats many clients who do not have homes and have mental health needs, but follow-up care is inadequate. How can the nurse implement Provision 9 of the American Nurses Association (ANA) Code of Ethics? a. Take responsibility for improving the safety of mental health care at the community clinic. b. Allow mental health caregivers to address the issue to avoid crossing professional boundaries. c. Improve commitment to providing the best mental health care possible through continuing education. d. Write a letter to the head of the clinic to report the need for mental health follow-up care.

d. Write a letter to the head of the clinic to report the need for mental health follow-up care. Rationale: Provision 9 of the Code of Ethics discusses the need for the nursing profession to address national and global health concerns, as well as be involved with shaping policies through political action, which includes writing a letter to report and address the issue. The nurse is advocating for the need for mental health follow-up care.

A nurse in a community health clinic is providing training to a group of newly hired nurses about partner violence. Which of the following statements made by one of the nurses indicates an understanding of partner violence? 1. "Women and men experience partner violence equally." 2. "Partner violence is the leading cause of death for women." 3. "Partner violence is underreported." 4. "Only physical abuse is considered partner violence."

3. "Partner violence is underreported." This is an accurate statement and should be identified as an understanding of partner violence.

A nurse is discussing eligibility for Medicare coverage with a newly licensed nurse. Which of the following should the nurse identify as an example of a client who would be eligible for Medicare coverage? Select all that apply

A 60-year-old client who has a disability is correct. Medicare provides health coverage to clients who are 65 years of age or older, or who have a chronic condition or disability. Therefore, a client who is 60 years of age and has a disability would be eligible for Medicare. A client who is 70 years of age is correct. Medicare provides health coverage to clients who are 65 years of age or older, have a chronic condition or disability. Therefore, a client who is 70 years old would be eligible for Medicare. A young adult client who has chronic kidney disease is correct. Medicare provides health coverage to clients who are 65 years of age or older, or who have a chronic condition or disability. Therefore, a young adult client who has chronic kidney disease would be eligible for Medicare. A middle adult client who is the head of household and has income below poverty level is incorrect. A client who is the head of household and has income below the poverty level would be potentially eligible to receive health coverage from Medicaid. A 20-year-old client who is seeking asylum is incorrect. A client who is seeking asylum would be potentially eligible to receive health coverage from the Refugee Health Promotion Program (RHP), which is a taxpayer funded grant which supports refugees and asylum seekers with health care.

A nurse is reviewing the impact of US Census Bureau data on health care funding. The nurse should identify that which of the following are affected by census data? Select all that apply

Health savings accounts is incorrect. The nurses should identify that health savings accounts are used by individuals to pay for out-of-pocket health care expenses. They are not affected by data from the U.S. Census Bureau. Medicaid is correct. The nurse should identify that Medicaid is public sector program that is affected by data from the U.S. Census Bureau. Children Health Insurance Program (CHIP) is correct. The nurse should identify that CHIP is public sector program that is affected by data from the U.S. Census Bureau. Medicare is correct. The nurse should identify that Medicare is public sector program that is affected by data from the U.S. Census Bureau. Health Insurance Portability and Accountability Act (HIPAA) is incorrect. The nurses should identify that HIPAA is a legislative act that ensures protection of personal health information. It is not affected by data from the U.S. Census Bureau.

A public health nurse is planning to obtain a grant to implement a community-wide nutrition program. To which of the following organizations should the nurse apply? Select all that apply

National Institutes of Health (NIH) is correct. The nurse should consider applying to the NIH, which funds research and community-focused health care projects. A diagnosis-related group (DRG) is incorrect. The nurse should identify that a DRG is a system used in medical coding to indicate payment for services that should be received by health care professionals and institutions. Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) is incorrect. The nurse should recognize that HCAHPS is a federal monitoring system for quality in health care. Health Insurance Portability and Accountability Act (HIPAA) is incorrect. The nurses should recognize that HIPAA ensures protection of personal health information. United States Health Resources and Services Administration (HRSA) is correct. The nurse should consider applying to the HRSA, which funds research and community-focused health care projects.

A public health nurse is reviewing the Leading Health Indicators (LHIs) developed for the Healthy People 2030 national health goals with a group of nurses. Which of the following LHIs should the nurse identify as pertaining to all age groups? (Select all that apply) 1. Homicides 2. Obesity 3. Colorectal Cancer Screening 4. Drug Overdoses 5. Influenza Immunizations

1. Homicides 4. Drug Overdoses 5. Influenza Immunizations