topic 9 (ch. 29, 31, 32)

A group of parish nurses affiliated with a number of faith-based communities located in different regions across the state are attending a quarterly meeting. Which of the following statements made by one of them indicates a lack of understanding of parish nursing?

"Because I work for and within the church, I am immune from civil laws."

The school health nurse has enlisted the assistance of high school role models in the areas of sports and scholarship to provide an antidrug presentation to their peers. Which of the following levels of prevention is being implemented?

Primary

The parish nurse is working with the wellness committee to develop health programming for the congregation. Which of the following activities would the nurse most likely completed? (Select all that apply.)

Provide regular blood pressure screening for members of the congregation. Create a bulletin board to display information about the signs and symptoms of stroke. Implement a program to speak with adolescents about stress management.

A school nurse is administering medications at the school. Which of the following guidelines should be followed?

A current drug reference should be available in case information is needed

A disaster has occurred in the community. Which of the following actions should be taken by the school nurse?

Continue to assess for shock and stress

Which of the following best explains why the federal government is beginning to fund school-based health centers? (Select all that apply.)

Attendance and learning are higher in schools with health clinics. Many children have no other source of health care services.

A school nurse would like to improve the safety of everyone at the school by creating policies to decrease the likelihood that violence will occur. Which of the following actions would the nurse likely take? (Select all that apply.)

Engaging parents in school activities Creating a zero tolerance police for weapons on school property Developing mentoring programs for at-risk youth

Which of the following describes how occupational health nursing differs from other nursing specialties? (Select all that apply.)

It is autonomous, because the occupational nurse works independently. The major focus is on the environment.

Which of the following best explains why school nurses are involved in helping teachers with the task of teaching children how to practice problem solving, communication, and other life skills?

Nurses have been enlisted in this role to help reduce risk factors for future health problems in school children.

A young woman had been away from home several years before she returned home sick and disheartened. Her mother called a nurse to help. Which of the following behaviors would suggest that the caregiver who arrived was a parish nurse?

Offered a prayer with the daughter and mother

Which of the following statements suggests that faith community nursing is a nationally recognized specialty of nursing?

Scope and standards of faith community practice have been developed and revised.

An occupational health nurse is removing a foreign body from a patient's eye. Which of the following levels of prevention is being implemented?

Secondary prevention

An occupational health nurse periodically conducts spirometry testing of employees who work around hazardous gases. Which of the following levels of prevention is being implemented?

Secondary prevention

A school nurse suggests to teachers that they have a session on coping strategies and stress management techniques. The nurse also sets up a peer counseling program. Which of the following is the school nurse most likely trying to prevent?

Suicide

A parish nurse is implementing a primary prevention measure related to obesity among the school-age members of the church. Which of the following activities is most likely being used by the nurse?

Partnering with youth camp cooks to ensure that food is nutritious

The school nurse has arranged for volunteers to help check each child's hearing and vision. Any child that the volunteers feel did not "pass" will be sent to the nurse for follow-up. The nurse will then send a note to the parents that a physician should be seen. Which of the following levels of prevention is being implemented?

Secondary Because secondary prevention involves caring for children when they need health care, this is the largest responsibility for the school nurse.

Which of the following principles is central to the role of the parish nurse?

Spiritual dimension of care

Which of the following is the most common disabling condition when measured by days away from work?

Sprains and strains

An occupational health nurse should be aware of which of the following trends in the marketplace? (Select all that apply.)

A majority of new jobs will be in service-oriented employment. Employees will often have compressed work weeks, shift work, and reduced job security. Many employees will be older and suffer chronic health problems.

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Which of the following activities are expectations for a school health nurse?

Giving emergency care in the school or during school events School nursing responsibilities include making sure that children get the health care they need, including emergency care in the school; keeping track of the state-required vaccinations that children have received; carrying out the required screening of the children based on state law; and ensuring that children with health problems are able to learn in the classroom.

Which of the following statements best describes how clients and parish nurses typically perceive spiritual health?

It is part of an ongoing dynamic process.

Which of the following is the primary reason that large companies are becoming more involved in their employees' personal health and well-being?

It provides a cost savings to the company.

Which of the following statements best explains why many school nurses are not able to ensure that all children receive needed health care in the schools?

Most school districts are unable to afford a nurse in every school.

Which of the following groups should the occupational health nurse devote the most time to regarding education and follow-up evaluation?

New workers employed less than 1 year The population group at greatest risk for experiencing work-related accidents with subsequent injuries is new workers with less than 1 year of experience on the current job.

A school nurse listens as one student talks about another student being upset because his father frequently spanks him with a leather belt that leaves big marks on the student's back. But the student begs the nurse not to tell anyone because he promised the friend that the information would never be shared. Which of the following actions should be taken by the nurse?

Notify the legal authorities. When the nurse identifies a child who may be abused or who receives information from someone else that a child may have been abused, the nurse must contact the appropriate legal authorities and the school's principal.

A parish nurse is using the institution-based model to plan care for a client with a chronic illness. Which of the following activities would the nurse most likely implement?

Partnering with outlying health care centers for coordinating optimal care The institution-based model includes greater collaboration and partnerships.

A nurse makes the suggestion that the 2-week shift rotations should be set up so that the next rotation in shifts is later rather than earlier. Which of the following is the nurse attempting to prevent through this suggestion?

Anxiety, depression, and exhaustion

A nurse is considering accepting the parish nursing position within his congregation. Which of the following educational preparation is crucial for the nurse to have received?

Baccalaureate education including community health nursing experience

A group of nursing students are scheduled to present a program on healthy hearts to various community groups, with a daycare center being the first location. What of the following advice should be given to them by their instructor?

Base the program on the audience's development and maturity.

Which of the following best describes the primary reason that school health nurses spend so much time on educational programs that teach children the importance of water and fire safety, using a seatbelt in the car, and wearing a helmet when biking or skateboarding?

Because injuries are the leading cause of death in children and most injuries are preventable

A pregnant teen asks the school nurse to provide information on abortion and a list of health care providers who offer such services. If the school nurse has very strong personal beliefs against abortion, which of the following actions should be taken by the nurse?

Call in another nurse to care for this client.

A new student's parents had not yet submitted an immunization record, although the nurse had sent a reminder home with the student twice. Which of the following actions should be taken by the nurse to keep the child in school? (Select all that apply.)

Call the parents or mail another reminder. Suggest to the parents that if they don't have health care insurance, they may qualify for programs that provide immunizations free.

Which of the following supplies or equipment should a nurse have available in the school health office? (Select all that apply.)

Cervical spine collars Epinephrine autoinjector kit Material for splints

At the annual community health fair, the school health nurse displays a science booth that examines the hazards of ineffective hand washing. Which of the following best describes the nurse's role in this scenario?

Community outreach When participating in community outreach, nurses reach out to residents in the community. One common way this occurs is when nurses are involved in activities such as community health fairs or festivals in the schools.

Which of the following is most important for school nurses to master in order to prepare for health care delivery in the future?

Computer and technology use In the future, school nursing will use telehealth and telecounseling to teach health education.

A nurse would like to maximize her autonomy in her parish nursing practice. Which of the following models would most likely be preferred by the nurse?

Congregation-based model In the congregation-based model, the nurse is usually autonomous.

A school health nurse is requested by the board of education to assist in choosing new playground equipment for an elementary school that meets safety standards. Which of the following best describes the nurse's role in this scenario?

Consultant The school nurse is the person best able to provide health information to school administrators, teachers, and parent-teacher groups.

A parish nurse organizes the annual health fair for the congregation, inviting community agencies to attend the event and display the health resources that are available in the community. What function of the parish nurse is being demonstrated?

Coordinator of volunteers As the coordinator of volunteers, the parish nurse recruits, trains, and supervises volunteers to expand ministry and outreach; organizes a health ministry team to guide and direct faith and health initiatives; and utilizes the gifts and talents of congregation and community members.

Which of the following would be the best way for the school nurse to fulfill his or her responsibilities in an emergency situation?

Create and share an emergency plan with all teachers and staff. The American Health Association recommends that the school nurse create an emergency plan with at least two different staff members identified and responsible for implementing the plan if the nurse is not in the building at the time of the emergency.

Which of the following explains why some occupational health specialists are very concerned about chemicals in the workplace? (Select all that apply.)

Effects of chemicals can be cumulative. Interactions of chemicals are typically unknown.

Which of the following activities are included in the Centers for Disease Control and Prevention's school health program? (Select all that apply.)

Ensuring a healthy school environment Assisting teachers with education related to health Encouraging nutritious school meals

A parish nurse is evaluating health programs that provide holistic care across the life span. Which of the following methods would be the most appropriate approach?

Establishing a wellness committee to assist in the evaluation process

Which of the following would most likely be one of the first steps taken in employer disaster planning?

Exhaustive inventory of chemicals and industrial hazards is completed. The potential for disaster must be identified; this is best achieved by completing an exhaustive chemical and hazard inventory of the workplace.

Which of the following best describes services that are offered at a school-based health center?

Family-centered care for preK-12 grade students These are family-centered, community-based clinics that are run within school, often in low income populations.

A parish nurse has been using pastoral activities when providing care to clients. Which of the following interventions is the nurse most likely using? (Select all that apply.)

Using hymns and scripture as a source of guidance and comfort Helping identify spiritual strengths that may assist in coping

Which of the following is the leading cause of children being absent from school because of a chronic illness?

asthma

Which of the following statements best describes how workers' compensation legislation has changed employer behavior?

Companies have improved safety of working conditions because worker's compensation insurance premiums are now based on previous claims.

A nurse would like to implement a primary prevention effort to decrease the leading cause of death among children and teenagers. Which of the following actions would the nurse most likely take?

Educate students about injury prevention measures.

Which of the following best describes why it is helpful to be a member of a faith community?

Belief and traditions help with coping.

In which of the following settings have nurses most often reported being the victims of violence, especially by patients and their families?

Emergency departments and psychiatric units

Which of the following best describes the primary difference between parish nursing and all other nursing positions?

Affiliation with a church or congregation

The mother of a high school student newly diagnosed with a condition that will require special health care services is concerned that the student will be required to be home-schooled away from the friends he has developed. Which of the following would be the most appropriate response by the school nurse?

"Federal legislation requires that the school make provisions for those with various challenges, so your child will be able to remain in school as long as he is able."

An upset mother calls the school nurse and says, "How dare you say my child has lice? My child is clean and I keep a clean house! You've obviously made an error." Which of the following would be the best response by the nurse?

"Most lice are found in clean hair. Children often share combs. Let me tell you how to fix the problem."

The principal of a school was upset over a rumor that one of the children had engaged in a violent activity that injured a younger sibling. The principal asked the nurse who the children were so that the involved teachers could both support the injured child and guard other children from the violent child. Which of the following would be the best response by the nurse?

"Rumors are often inaccurate; let me follow up and see what happened and what needs to be done."

A family shared their concerns, including sexual issues, in strictest confidence with a faith community nurse. When the nurse returned to the church office, the pastor asked why the family wanted to see her. Which of the following statements would be the best response by the nurse?

"The family had some issues they wanted to discuss in confidence, which I will keep in confidence."

Which of the following statements by a parish nurse exhibits a lack of understanding of the concept of pastoral care?

"To incorporate pastoral care, I should involve the pastor in ministering to the members of the congregation." Pastoral care is a service ministry formalized by a church or faith community, not necessarily involving the pastor.

A nurse is completing a health history on a client during a routine physical exam. Which of the following questions, which is often omitted, should be asked by the nurse?

"Where do you work and what do you do there?"

A nurse is interviewing a person who has stated on her entry health form that she is retired. Which of the following is the most crucial question for the nurse to ask?

"Where were you previously employed and what did you do there?"

A nurse who works for a hospital in employee health notes that several nurses from one unit have missed work after contracting a communicable disease from a patient. Which of the following best describes the host factor?

Each sick nurse

Which of the following interventions regarding worker safety would be the least effective?

Having employees use safety measures and personal protective equipment

To help congregation members better meet their nutritional needs, the parish nurse organized members to participate in activities that focused on fellowship while providing healthy meals to homebound members and serving "healthy heart" church suppers. Which of the following activities is being completed?

Health ministries Health ministries are those activities and programs in faith communities organized around health and healing to promote wholeness in health across the life span.

A faith community nurse is partnering with a local public health department to develop programs for primary, secondary, and tertiary prevention activities. Which of the following should be used as the primary guide for development?

Healthy People 2020 goals and objectives

Which of the following hospital employees are most at risk for being exposed to and possibly developing active drug-resistant TB?

Housekeeping staff Many workers in these settings are employed as maintenance workers, security guards, aides, or cleaning people, who tend not to be well protected from inadvertent exposures, which include contaminated bed linen in the laundry, soiled equipment, and trash containing contaminated dressings or specimens.

The occupational health nurse continually reminds employees to wear their safety goggles and ear plugs. Which of the following levels of prevention is being implemented?

Primary prevention

The occupational health nurse makes certain all employees have and know how to use personal protective equipment (PPE). Which of the following factors will most likely determine how effective the PPE is in keeping employees safe?

Psychosocial norms of the setting The primary determination of whether the PPE is used correctly and used all the time is the psychosocial norms of the setting. If others are careless in PPE use, then such carelessness is the norm. If everyone is extremely careful to use their PPE, then that is the norm in that setting.

A father confides to the parish nurse that his wife has been hurting their 3-year-old daughter. The nurse examines the daughter and finds evidence of physical abuse. In the parish nurse role, which of the following actions should the nurse take first?

Report the findings to child protective services.

A school nurse is demonstrating the use of a peak flow meter to help children with chronic asthma recognize when they need to use a rescue inhaler. Which of the following levels of prevention is being used by the nurse?

Tertiary Tertiary prevention includes caring for children with long-term health needs, including asthma and disabling conditions.

A school nurse has developed a special class for pregnant teens to teach them everything from anticipated body changes to methods for managing common pregnancy-associated problems. The classes also allow the nurse to be in close frequent contact with the students to monitor their health status. Which of the following levels of prevention is being used by the nurse?

Tertiary prevention Although this may appear to be secondary prevention, it is tertiary prevention because adolescent pregnancies are considered to be high risk.Because the teenager is already pregnant, the nurse is addressing how to assist the teen to achieve the highest level of functioning possible (tertiary prevention).

An employee in a laboratory drops a flask, resulting in a chemical splash into the employee's eyes, which in turn results in burns to the eyes. Which of the following would be considered the agent?

The chemical

A child has multiple disabilities, and caring for the child has been both expensive and time consuming for the school. Once the child turns 16, which of the following actions should be taken by the nurse? (Select all that apply.)

The school must continue to provide needed appropriate education for the child. The school should prepare an updated individualized education plan.

An occupational health nurse sees the various injuries and diseases that persons can acquire from employment. Which of the following recommendations would the nurse most likely provide about safety in the workplace?

There is no "safe" occupation or profession.

A nurse keeps ongoing documentation of all the clients seen at the community health clinic. The nurse enters the demographic data and the primary diagnoses into the computer to have a comprehensive perspective of the clinic's clients. Which of the following best explains why the nurse is collecting this data?

This data will help identify patterns in the risk factors associated with a particular subgroup.

Which of the following are the primary reasons that employers have increasingly focused on ensuring a healthy and safe environment for workers? (Select all that apply.)

To avoid the cost of liability suits, workers' compensation, etc. To meet legislated standards and avoid significant penalties for noncompliance

An occupational health nurse wants to know the NAICS code of a prospective employer. Which of the following best explains why the nurse would be interested in this information? (Select all that apply.)

To compare the prospective employer's injury rate with similar employers' rates To learn more about the usual processes and products of the company as well as typical hazards

The occupational health nurse suggests that an employee work only half-days for three weeks and then return to full-time employment. Which of the following best describes the rationale for this suggestion?

To continue employment and income with limited duty as a rehabilitation effort after an injury

Which of the following best describes the mission of OSHA?

To ensure safe and healthful working conditions

An occupational health nurse is working with the manager to change the assignment of an employee from working with heavy metal to using machinery to assist with loading and unloading boxes at the truck dock. Which of the following best explains the rationale for this change?

To limit disability Interventions aimed at disability limitation are intended to prevent further harm or deterioration, and they include referral for counseling and treatment of an employee with an emotional or mental health problem whose work performance has deteriorated and removal of workers from heavy metal exposure who manifest neurological symptoms.

As the single occupational health employee at a company, a nurse is busy with safety programs and first aid when employees are hurt. However, the nurse still finds time to walk through the entire facility once a day. Which of the following best explains the rationale for this action by the nurse?

To observe effectiveness of safety education and equipment