Comm T2

A student nurse studying substance use learns that in addition to stimulants, inhalants, depressants, and cannabis, psychoactive substances include which of the following? A. Dissociative anesthetics B. Both 1 and 3 C. Hallucinogens D. Non-narcotics

ANS: B Feedback A Dissociative anesthetics are psychoactive substances. B Dissociative anesthetics, narcotics, and hallucinogens are among the classes of psychoactive substances. C Hallucinogens are psychoactive substances. D This is incorrect. Narcotics are psychoactive substances; non-narcotics are not.

When a nurse at a community clinic is checking a patient for the effects of psychoactive substances, he or she looks for which of the following signs? A. Altered mood B. Both 1 and 3 C. Level of consciousness D. None of the above

ANS: B Feedback A Altered mood may be evidence of psychoactive substances. B Checking for psychoactive substance use includes assessing for altered mood and level of consciousness. C Level of consciousness may indicate psychoactive substance use. D This is incorrect. Checking for psychoactive substance use includes assessing for altered mood and level of consciousness.

During a class lecture, a nursing student learned that which of the following are considered psychoactive substances? A. Depressants B. Stimulants C. Both 1 and 2 D. Antidepressants

ANS: C Feedback A Depressants are psychoactive substances. B Stimulants are psychoactive substances. C Depressants and stimulants are psychoactive substances. D This is incorrect. Antidepressants are not psychoactive substances.

A nurse is working in an emergency room and caring for a young woman who was admitted to the hospital after a motor vehicle accident. The policeman who accompanied the nurse requests a blood alcohol level and toxicology screen. The nurse knows that what minimum blood alcohol level is considered to be driving while impaired? ___________________

ANS: 0.08 Feedback: Driving with a blood alcohol level of 0.08 or above is considered to be driving while impaired. This is illegal and the young woman will likely be arrested and charged if her blood level comes back above that level.

A nurse decides to use a Haddon Matrix to evaluate factors that may contribute to patient falls on the medical units of the hospital. What is the minimum number of boxes that should be drawn on the grid to be filled out? ___________________

ANS: 12 Feedback: A Haddon Matrix has a minimum of 12 boxes in three rows and four columns. The designated rows refer to the time associated with the event: pre-event, event, and post-event. The columns relate to the constructs included in the Epidemiological Triangle and on preventative measures, and include the host, agent, environment, and levels of prevention.

A nurse is reviewing the disaster preparedness cycle with other nurses in the hospital. The nurse explains that the following steps must occur. Place them in the correct order (1-4): _____ 1. Recovery _____ 2. Preparedness _____ 3. Mitigation _____ 4. Response

ANS: 4, 1, 2, 3 Feedback: The disaster preparedness cycle is the steps needed to properly prepare for and manage a disaster in the community. The first step is preparedness, or the process of proactively planning for disasters and emergency situations. The second step is mitigation, the process of planning for the harm or impact of a disaster, and also the steps needed to lessen those effects. Next is the response step, which is the actual response to the disaster. Finally, recovery is the process of returning the community back to its prior state. This may include rebuilding infrastructure or relocating populations.

A PHN treats a patient who may be depressed. To verify suspicions, the PHN checks ____, the definitive clinical guide for diagnosing mental disorders and providing consistency and accuracy in the screening for mental disorders. A. The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) B. The Center for Epidemiological Studies Depression Scale (CESD-10) C. Patient Health Questionnaire 2 D. Brief System Checklist-18 of the My Mood Monitor

ANS: A Feedback A DSM-5 guides diagnostic decision making and provides consistency and accuracy for clinicians screening for mental disorders. B This is incorrect. DSM-5 guides diagnostic decision making and provides consistency and accuracy for clinicians screening for mental disorders. CESD-10 is a screening tool for depression. C This is incorrect. DSM-5 guides diagnostic decision making and provides consistency and accuracy for clinicians screening for mental disorders. The Patient Health Questionnaire 2 is a screening tool for depression. D This is incorrect. DSM-5 guides diagnostic decision making and provides consistency and accuracy for clinicians screening for mental disorders. The Brief System Checklist-18 of the My Mood Monitor is a screening tool for anxiety.

A nurse is assessing a young woman who recently lost her job. She has no way to support her family and has found herself living on the streets because she doesn't have any other family in the area. Which of the following is the best way to proceed? A. Look at the broader picture and see if there are any opportunities for policy change. B. Refer her to a shelter and document. C. Offer her a job-training program. D. Ask her to come back in 6 months for a reevaluation.

ANS: A Feedback A This is correct. There is great opportunity to help more people than this one young woman through policy change. Many people suffered during the recent economic down turn and are in need of assistance as well. B This is incorrect. Simply referring her to a shelter does not address the larger problem. There is great opportunity to help more people than this one young woman through policy change. Many people suffered during the recent economic down turn and are in need of assistance as well. C This is incorrect. Simply referring her to a job-training program does not address the larger problem. There is great opportunity to help more people than this one young woman through policy change. Many people suffered during the recent economic down turn and are in need of assistance as well. D This is incorrect. Simply having her come back in six months does not address the larger problem. There is great opportunity to help more people than this one young woman through policy change. Many people suffered during the recent economic down turn and are in need of assistance as well.

A young woman presents to a community clinic. She states that she is having severe anxiety and insomnia after suffering an acquaintance rape at school last year. She is unable to go back to college and her grades are suffering as a result. What does the nurse suspect that this young woman is suffering from? A. Post-traumatic stress disorder B. Generalized anxiety disorder C. Major depression D. Personality Disorder

ANS: A Feedback A This is correct. This young woman is probably suffering from post-traumatic stress disorder, a type of anxiety disorder that occurs after a traumatic event. B This is incorrect. This young woman is probably suffering from post-traumatic stress disorder, a type of anxiety disorder that occurs after a traumatic event. C This is incorrect. This young woman is probably suffering from post-traumatic stress disorder, a type of anxiety disorder that occurs after a traumatic event. D This is incorrect. This young woman is probably suffering from post-traumatic stress disorder, a type of anxiety disorder that occurs after a traumatic event.

A nurse is reviewing car accident data to see how a city's statistics compare with state and national data. Which of the following would provide the most comprehensive database of information? A. National Violent Death Reporting System B. Vital Statistics C. Department of Motor Vehicles D. Department of Transportation

ANS: A Feedback A This is correct. While Vital Statistics, The Department of Motor Vehicles, and the Department of Transportation all track motor vehicle accidents, the National Violent Death Reporting System is a centralized system that compiles the data from all of these sources. This database is especially helpful to look at injury and violence at the state and population level. B This is incorrect. While Vital Statistics tracks motor vehicle accidents, the National Violent Death Reporting System is a centralized system that compiles the data from this and other sources. This database is especially helpful to look at injury and violence at the state and population level. C This is incorrect. While the Department of Motor Vehicles tracks motor vehicle accidents, the National Violent Death Reporting System is a centralized system that compiles the data from this and other sources. This database is especially helpful to look at injury and violence at the state and population level. D This is incorrect. While the Department of Transportation tracks motor vehicle accidents, the National Violent Death Reporting System is a centralized system that compiles the data from this and other sources. This database is especially helpful to look at injury and violence at the state and population level.

A nurse is caring for a young man who is squatting in an old factory a mile away. The nurse documents that he is experiencing what type of homelessness? A. Primary B. Secondary C. Tertiary D. He is not homeless because he has an indoor shelter in which to sleep.

ANS: A Feedback A This young man is experiencing primary homelessness because he is living in an abandoned building, which is not suitable for living. B This is incorrect. Secondary homelessness is when someone is staying in a temporary housing situation, such as in a shelter or with a family member or friend. C This is incorrect. Tertiary homelessness is when someone is renting a single room without the security of a fixed place to live. D This young man is homeless because he doesn't have a safe and reliable place to stay. He is experiencing primary homelessness because he is living in an abandoned building, which is not suitable for living.

A nurse is teaching a class about emergency preparedness and violence. Which of the following factors is associated with an increased risk of being the victim of violence or intentional harm? Select all that apply. A. Age between 15 and 44 B. Poor mental health C. Substance abuse D. Male gender E. Low socioeconomic status

ANS: A, B, C Feedback 1 This is correct. Increased risk for violence is associated with people between the ages of 15 and 44, poor mental health, and substance abuse. It is a community-wide issue and affects people of both genders and all socioeconomic status equally. 2 This is correct. Increased risk for violence is associated with people between the ages of 15 and 44, poor mental health, and substance abuse. It is a community-wide issue and affects people of both genders and all socioeconomic status equally. 3 This is correct. Increased risk for violence is associated with people between the ages of 15 and 44, poor mental health, and substance abuse. It is a community-wide issue and affects people of both genders and all socioeconomic status equally. 4 This is incorrect. Increased risk for violence is associated with people between the ages of 15 and 44, poor mental health, and substance abuse. It is a community-wide issue and affects people of both genders and all socioeconomic status equally. 5 This is incorrect. Increased risk for violence is associated with people between the ages of 15 and 44, poor mental health, and substance abuse. It is a community-wide issue and affects people of both genders and all socioeconomic status equally.

A nurse is training for a new job at a community clinic after moving to Central California, an area rich in agriculture and migrant workers. The nurse asks about specific social and health issues that the migrant worker population faces and the nurse supervisor replies: Select all that apply. A. They have difficulty establishing residency in a single location, making them ineligible for government benefits. B. Most of them lack access to workers compensation or disability insurance. C. Frequent travel and location changes make it difficult for them to establish continuity of care with a single provider. D. Illegal immigration status is often a problem. E. Language is often a barrier.

ANS: A, B, C, E Feedback 1 This answer is correct. Migrant workers tend to "follow the job," meaning that they travel around the country looking for work, which is usually agriculturally based. This can make establishing a residency, and accessing government benefits, difficult. 2 This is correct. Migrant workers usually work long hours and don't have access to disability insurance or workers compensation. 3 This is correct. When traveling around the country for work, it becomes difficult to establish continuity of care with a single provider. 4 Some migrant workers may be illegal immigrants, but most are legal citizens or residents. 5 Many migrant workers do not speak English or speak English as a second language. This can lead to difficulties in obtaining culturally appropriate health care.

A nurse is speaking with politicians about the need to modify the poverty threshold to be fairer to people living in poverty and people living just over the poverty line. Which of the following are potential ways that the poverty threshold could be amended to be more accurate or fair? Select all that apply. A. Amend it to reflect increased spending on health care and transportation. B. Amend it to reflect increased housing costs. C. Amend it to reflect increased need and cost of childcare. D. Amend it to reflect increased spending on food. E. Amend it to reflect regional cost of living.

ANS: A, B, C, E Feedback 1 This is correct. The old poverty threshold calculations do not reflect recent increases in spending on health care and transportation. Adjusting for these expenses would make the poverty threshold fairer. 2 This is correct. The old poverty threshold calculations do not reflect recent increases in spending on housing (rentals and purchases). Adjusting for these expenses would make the poverty threshold fairer. 3 This is correct. The old poverty threshold calculations do not reflect the increased need for and increased cost of childcare. Adjusting for these expenses would make the poverty threshold fairer. 4 This is incorrect. Food spending has actually decreased in recent years. 5 This is correct. The old poverty threshold calculations do not reflect regional differences in cost of living.

It is the first day of class for new graduate public health nursing students. The professor explains that as PHNs, they will need to fill many roles, including which of the following? Select all that apply. A. Educator B. Advocate C. Administrator D. Researcher E. Social worker

ANS: A, B, D Feedback 1 PHNs must fill many roles, including that of educator. They are responsible for educating patients, their families, and other health-care workers about public health issues. 2 PHNs are expected to work as advocates for their patients and their communities. 3 Some public health workers may begin working in administrative capacities, but that is not a typical part of being a PHN. 4 PHNs must be proficient researchers. Their research skills are needed during community assessments as they thoroughly research the community in which they are working. 5 Social workers are specially trained case managers. PHNs are not social workers, nor do they act like them professionally.

A nurse is organizing a disaster drill for the hospital. Which factors should the nurse consider while organizing the drill? Select all that apply. A. They should be scheduled twice a year. B. The materials should be specific to the expected surge at that facility during a disaster. C. They should only involve a few key staff members. D. They should practice the organizational structure of the facility. E. In addition to the actual drill, the entire staff and volunteers should undergo a continuing education in-service.

ANS: A, B, D, E Feedback 1 This is correct. Training drills should be conducted regularly, so as to allow new staff to participate and current staff to improve their skills. 2 This is correct. The materials and drill should aim to be specific to the actual number of patients that would be expected in case of an actual emergency. 3 This is incorrect. The drill should involve many people, from many different departments. It should allow observers to get an idea of exactly how an actual emergency will run within the organization. 4 This is correct. Good disaster plans will maintain the organizational structure of the facility and prevent confusion between senior staff members. 5 This is correct. It is important for everyone in the organization to undergo continuing education training so that they understand their role in an emergency.

According to Healthy People 2020, which of the following are characteristics of mental health? Select all that apply. A. Engaging in productive activities B. Having fulfilling relationships C. Experiencing alterations in thinking D. Adapting to change E. Coping with challenges

ANS: A, B, D, E Feedback 1. Mental health is a state of successful performance of mental function, including engagement in productive activities. 2. Mental health is a state of successful performance of mental function, including being able to form fulfilling relationships with other people. 3. This is incorrect; it is an example of a mental disorder. Mental disorders are health conditions that are characterized by alterations in thinking, mood, or behavior that are associated with distress or impaired functioning. 4. Mental health is a state of successful performance of mental function, including the ability to adapt to change. 5. Mental health is a state of successful performance of mental function, including the ability to cope with challenges.

A nurse has just been promoted to serve on the disaster preparedness committee of the hospital. The nurse's role during a disaster is to collect emergency information and distribute it to public health officials as required. What information should the nurse collect? Select all that apply. A. Staffing needs B. Supply inventory and shortages C. Name, social security number, and phone number of every employee responding to the disaster D. Budget needs of the hospital E. The number of patients who have already been treated and who still need care

ANS: A, B, E Feedback 1 This is correct. The nurse should collect information about staffing needs or shortages. 2 This is correct. The nurse should collect information about what supplies or staff is needed to continue to provide emergency care. 3 This is incorrect. During an emergency, the public health officials do not need all of this information about the staff working at the hospital. They may need information about how many staff (and what degree of qualifications). 4 This is incorrect. Budget needs of the hospital should not be included in the information provided to the public health officials. It can be addressed as needed during the recovery phase. 5 This is correct. The nurse should track the number and names of all the patients who have already received care, and those who are still waiting for care. The nurse needs to include information about the number of available beds, and how many patients they could accommodate in an emergency situation.

A nurse is working with parents and community members to develop a chemical and medication safety class in their community. Techniques that they should discuss include which of the following? Select all that apply. A. Proper labeling of all household chemicals and medications B. Keeping household chemicals outside C. Storing all cleaning materials and medications out of the reach of children D. Encouraging disposal of medications into the toilet E. Informing parents not to share any medications with anyone whom the medication is not prescribed

ANS: A, C, E Feedback 1 This is correct. There are several measures that parents can take to prevent accidental poisonings in their children or other household members. These include proper labeling of all household chemicals and medications, storing all cleaning materials and other chemicals out of the reach of children and how the manufacturer intends, encouraging the proper disposal of medications (e.g., not into the toilet due to environmental hazards) and other chemicals, and not sharing any medications with other people. 2 This is incorrect. There are several measures that parents can take to prevent accidental poisonings in their children or other household members. These include proper labeling of all household chemicals and medications, storing all cleaning materials and other chemicals out of the reach of children and how the manufacturer intends, encouraging the proper disposal of medications (e.g., not into the toilet due to environmental hazards) and other chemicals, and not sharing any medications with other people. 3 This is correct. There are several measures that parents can take to prevent accidental poisonings in their children or other household members. These include proper labeling of all household chemicals and medications, storing all cleaning materials and other chemicals out of the reach of children and how the manufacturer intends, encouraging the proper disposal of medications (e.g., not into the toilet due to environmental hazards) and other chemicals, and not sharing any medications with other people. 4 This is incorrect. There are several measures that parents can take to prevent accidental poisonings in their children or other household members. These include proper labeling of all household chemicals and medications, storing all cleaning materials and other chemicals out of the reach of children and how the manufacturer intends, encouraging the proper disposal of medications (e.g., not into the toilet due to environmental hazards) and other chemicals, and not sharing any medications with other people. 5 This is correct. There are several measures that parents can take to prevent accidental poisonings in their children or other household members. These include proper labeling of all household chemicals and medications, storing all cleaning materials and other chemicals out of the reach of children and how the manufacturer intends, encouraging the proper disposal of medications (e.g., not into the toilet due to environmental hazards) and other chemicals, and not sharing any medications with other people.

A nurse suspects one of the emergency room patients is an illicit drug user. Which screening methods should the nurse use to verify this conclusion? A. A clinician's guide B. Both 1 and 3 C. National Institute on Drug Abuse (NIDA) ASSIST tool D. Diagnostic and Statistical Manual of Mental Disorders (DSM-5)

ANS: B Feedback A A clinician's guide is used to screen for illicit drug use. B A clinician's guide and the NIDA ASSIST tool are used to screen for illicit drug use. C The NIDA ASSIST tool is used to screen for illicit drug use. D This is incorrect. The DSM-5 is not used to screen for illicit drug use.

A nurse encounters a young woman with her child in the community. They do not speak English, but the nurse is fluent in Spanish and is able to communicate with them in their native language. The woman is very frightened and states that she can't go back to her country because the local government will harm her and her child if she does not convert to Catholicism. The nurse takes the woman to the local immigration office to apply for what status? A. Asylee B. Refugee C. Immigrant D. Permanent Resident

ANS: A Feedback A An asylee is a person who is looking to escape an oppressive situation in her own country, but who has already made it to the United States. A refugee is someone who is looking to escape their country but who still is living in their home country. B A refugee is someone who is looking to escape their country but who still is living in their home country. This woman is an asylee because she has already made it to the United States. C She should be applying for asylee status. An asylee is a person who is looking to escape an oppressive situation in her own country, but who has already made it to the United States. D She should be applying for asylee status. An asylee is a person who is looking to escape an oppressive situation in her own country, but who has already made it to the United States.

A 20-year-old man brought to the emergency room with hallucinations appeared euphoric, tremulous, and anorexic and had dilated pupils. The nurse who examined him found that the culprit was ____ use. A. Methamphetamine B. Cocaine C. Alcohol D. None of the above

ANS: A Feedback A Methamphetamine use may cause a person to be euphoric, tremulous, and anorexic and to present with dilated pupils. B This is incorrect. Methamphetamine use may cause a person to be euphoric, tremulous, and anorexic and to present with dilated pupils. C This is incorrect. Methamphetamine use may cause a person to be euphoric, tremulous, and anorexic and to present with dilated pupils. D This is incorrect. Methamphetamine use may cause a person to be euphoric, tremulous, and anorexic and to present with dilated pupils.

A nurse working in the emergency department is treating a substance use disorder patient with accelerated heart rate and blood pressure. The nurse determines that which of the following substances is the culprit? A. Stimulants B. Narcotics C. Depressants D. Hallucinogens

ANS: A Feedback A Stimulants are associated with accelerated heart rate and blood pressure because these substances affect the central nervous system (CNS). B This is incorrect. Stimulants are associated with accelerated heart rate and blood pressure because these substances affect the CNS. C This is incorrect. Stimulants are associated with accelerated heart rate and blood pressure because these substances affect the CNS. D This is incorrect. Stimulants are associated with accelerated heart rate and blood pressure because these substances affect the CNS.

A PHN considering a career in mental health nursing learns that the ____ mandates that group health plans of 50 or more persons, which cover mental health and substance use disorders, must provide benefits equivalent to or better than those benefits provided for medical or surgical benefits. A. Mental Health Parity Act B. Community Mental Health Centers Act C. Affordable Care Act D. None of the above

ANS: A Feedback A The Mental Health Parity Act was signed into law in 2008 and mandates that group health plans of 50 or more persons, which cover mental health and substance use disorders, must provide benefits equivalent to or better than those benefits provided for medical or surgical benefits. B This is incorrect. The Community Mental Health Centers Act was signed in 1963 and opened the way for a network of community mental health centers to provide comprehensive services and continuity of care. C This is incorrect. The Affordable Care Act signed into law in 2010 fills in some gaps by requiring Medicaid and plans purchased by small businesses include mental health and substance abuse coverage starting in 2014. D This is incorrect. The Mental Health Parity Act was signed into law in 2008 and mandates that group health plans of 50 or more persons, which cover mental health and substance use disorders, must provide benefits equivalent to or better than those benefits provided for medical or surgical benefits.

A nurse is working in a prison health center with many of the older prisoners. The nurse is anticipating having to manage which of the following conditions that tends to be more prevalent in the aging prison population? A. Cognitive disorders B. Cancer C. Dental problems D. Mental disorders

ANS: A Feedback A This is correct. Aging prisoners are more likely to face cognitive disorders such as Alzheimer's and dementia. B This is incorrect. Aging prisoners are more likely to face cognitive disorders such as Alzheimer's and dementia. C While the rate of dental problems is higher in the prison population, the aging prisoners are more likely to face cognitive disorders such as Alzheimer's and dementia. D While the rate of mental disease is higher in the prison population, the aging prisoners are more likely to face cognitive disorders such as Alzheimer's and dementia.

A nurse is working at a suicide prevention hotline and is training new staff members. He or she informs the new nurses that the most important questions to ask callers include: A. Whether they have a means or a plan to commit suicide, including whether they have access to a weapon, such as a gun B. If they have been diagnosed with a mental illness C. If they suffer from addiction D. None of the above

ANS: A Feedback A This is correct. Having a plan and access to a weapon is one of the biggest risk factors for committing suicide. B This is incorrect. Having a plan and access to a weapon is one of the biggest risk factors for committing suicide. C This is incorrect. Having a plan and access to a weapon is one of the biggest risk factors for committing suicide. D The correct answer is whether they have a plan and mean to commit suicide. Having a plan and access to a weapon is one of the biggest risk factors for committing suicide.

A nurse is providing fire prevention education to families in the community. Which of the following groups in the United States is not at a higher risk for suffering burns from a fire at home? A. Men B. Women C. Children D. Older adults

ANS: A Feedback A This is correct. In the United States, women, children, and older adults are at higher risk for suffering burns from a fire at home. In most situations, children suffer from burns when they are not being supervised by an adult. B This is incorrect. In the United States, women, children, and older adults are at higher risk for suffering burns from a fire at home. In most situations, children suffer from burns when they are not supervised by an adult. C This is incorrect. In the United States, women, children, and older adults are at higher risk for suffering burns from a fire at home. In most situations, children suffer from burns when they are not supervised by an adult. D This is incorrect. In the United States, women, children, and older adults are at higher risk for suffering burns from a fire at home. In most situations, children suffer from burns when they are not supervised by an adult.

A PHN preparing a report on substance abuse would find that which of the following are true? A. Substance use, especially use of tobacco and alcohol, is a serious public health issue, and policy initiatives exist at the global, national, state, and local levels aimed at reducing the harm associated with at-risk substance use. B. Both 1 and 3 C. The cultural context for substance use has shifted overtime, but stigma continues to be a barrier for entrance into treatment for the person with at-risk use or a substance use disorder. D. At-risk substance use does not affect the overall health of the individual, the family, or the community.

ANS: B Feedback A Substance use, especially use of tobacco and alcohol, is serious public health issues and policy initiatives exist at the global, national, state, and local levels aimed at reducing the harm associated with at-risk substance use. B Substance abuse is a serious public health issue affecting the overall health of the individual, the family, and the community. Barriers to seeking treatment include stigma associated with use. C The cultural context for substance use has shifted overtime, but stigma continues to be a barrier for entrance into treatment for the person with at-risk use or a substance use disorder. D This is incorrect. At-risk substance use affects the overall health of the individual, the family, and the community.

Nurses in a student health clinic used a program called Brief Alcohol Screening and Intervention for College Students (BASICS) to help students make better alcohol use decisions. The BASICS program consists of: A. Two one-hour interviews B. Both 1 and 3 C. A feedback profile D. An alcohol breathalyzer test

ANS: B Feedback A The BASICS program includes two one-hour interviews as well as a feedback profile. B The BASICS program includes two one-hour interviews and a feedback profile. C The BASICS program includes a feedback profile as well as two one-hour interviews. D This is incorrect The BASICS program does not include a breathalyzer test.

A nurse is responding to the scene of a small plane crash in the community. First responders are on the scene treating victims, but they have asked the nurse to notify the appropriate federal authorities. The nurse informs: A. The FBI B. The FAA C. FEMA D. The Department of Homeland Security

ANS: B Feedback A This is incorrect. The FAA, or Federal Aviation Administration, has jurisdiction over all airplane crashes and accidents. B This is correct. The FAA has jurisdiction over all airplane crashes and accidents. C This is incorrect. The FAA has jurisdiction over all airplane crashes and accidents. D This is incorrect. The FAA has jurisdiction over all airplane crashes and accidents.

A nurse is assisting paramedics at the site of a large accident with many injured people. During the initial response, it is especially important to: A. Notify the media so they can assist in informing the community of what happened. B. Triage victims according to the severity of their injuries. C. Interview victims and witnesses to determine what happened. D. Notify clergy and mental health professionals to assist survivors at the site.

ANS: B Feedback A This is incorrect. The first priority is to treat victims in the most efficient manner possible, by using the principles of triage. B This is correct. Triage is the most effective way to sort patients according to the severity of their treatment. It allows first responders to appropriately manage the care of a large number of people, and help get patients to where they will receive the best care. C This is incorrect. The first priority is to treat victims in the most efficient manner possible, by using the principles of triage. D Attending to the mental health and religious needs of the victims, survivors and workers is important. However, the first priority is to treat victims in the most efficient manner possible, by using the principles of triage.

A nurse is working with a local television station to work on a public service announcement meant to educate residents on how to prepare for tornados. What advice does the nurse give in the event that a tornado is imminent? A. Watch for the coming storm at the windows. B. Immediately take shelter in a basement away from any windows. C. Take shelter in a large room under a blanket. D. As soon as the alarm goes off, gather your emergency supplies and head to the nearest community shelter.

ANS: B Feedback A This is incorrect. When a tornado may be coming through, it is important to immediately get into the emergency shelter and listen to a radio or TV for news and updates. It is important to stay away from the windows in case flying debris breaks the glass. B This is correct. The best place to take shelter is in the basement or in a designated storm shelter. If neither is available, people should take shelter in an inside closet or bathroom with sometime heavy protecting the head. C This is incorrect. The best place to take shelter is in the basement or in a designated storm shelter. If neither is available, people should take shelter in an inside closet or bathroom with sometime heavy protecting the head. D This is incorrect. Waiting until the sirens go off to start gathering supplies is dangerous. People should immediately take shelter in a basement away from any windows.

A nurse is volunteering with the local fire department and is sitting in on a class about dealing with wildfires. The instructor is talking about strategies for fighting a fire that is burning below the forest floor in the humus layer of the soil. This is known as what type of fire? A. Wildfire B. Ground fire C. Surface fire D. Crown fire

ANS: B Feedback A This is incorrect. Wildfire is a generic title for a fire that is burning out of control in the forest or across large areas of land. B This is correct. A ground fire burns below the forest floor, usually down in the humus layer of the soil. These fires are usually started by lightning strikes. C This is incorrect. A surface fire burns along the forest floor. It typically moves very slowly, but can be extremely damaging. D This is incorrect. A crown fire burns along the tops of the trees, and easily jumps from tree to tree.

A nurse is speaking at a city council meeting in a coastal town on the northeastern coast of the United States. The nurse is explaining that in order to protect the rest of the town, the city council needs to restrict people from building homes along the immediate coastline. A resident stands up, angry, and demands to know why he can't purchase property there. The nurse replies: A. "People living along the coastline are at greater risk for property damage from seawater." B. "Deforestation along the coast can increase risk and severity of strong storm surges during hurricanes or coastal storms." C. "Remote areas can be more difficult to evacuate in case of an emergency." D. "All community members need to be able to access the coastline in case of an emergency evacuation."

ANS: B Feedback A While this fact may be correct, it does not impact the entire town. Deforestation along the coast can increase risk and severity of strong storm surges during hurricanes or coastal storms. B This is correct. Deforestation along the coast can increase risk and severity of strong storm surges during hurricanes or coastal storms. C While this fact may be correct, it does not impact the entire town. Deforestation along the coast can increase risk and severity of strong storm surges during hurricanes or coastal storms. D This is incorrect. Deforestation along the coast can increase risk and severity of strong storm surges during hurricanes or coastal storms. The coast would be an extremely dangerous place to be during a hurricane or large coastal storm.

A public health nurse (PHN) is starting a study of different populations in the community to see which groups have face marginalization, and to what degree. The PHN is looking for evidence that: A. A group has been discriminated against based on their race or ethnicity. B. A group has been treated as if they are not important or of little consequence to the rest of society. C. A group has been labeled by society as possessing a particular characteristic that is not valued, leading to a loss of status. D. A group has been assigned a negative or positive belief that is believed to apply to the entire group.

ANS: B Feedback A Being discriminated against based on race or ethnicity is called racism or discrimination. B This is correct. Being treated as if they are of little consequence or not important is called marginalization. C Having been labeled by society as possessing a particular characteristic that is not valued, leading to a loss of status is called stigmatization, not marginalization. D Assigning a negative or positive belief that is believed to apply to the entire group is called stereotyping, not marginalization.

A nurse is working with the local government to determine where best to spend money obtained from a new funding program. The nurse is looking for particularly vulnerable communities. Which of the following communities might be best served by the increased funding? A. A primarily Hispanic community that is rich in culture and community B. A low socioeconomic Caucasian community that is facing abnormally high levels of lung cancer C. A middle class African American community with an obesity rate of 15 percent D. An upper class community where there is an outbreak of Hand, Foot, and Mouth Disease

ANS: B Feedback A Having a strong tie to community and culture decreases a population's risk for medical vulnerability. B This community is the most medically vulnerable. Having low Socioeconomic status SES and facing a serious medical conditions makes them more at risk for poor outcomes. C Middle class communities may face some vulnerabilities, but residents are generally able to afford adequate health care. Ethnicity does play a role and in fact, the primarily African American population does face a higher risk of health vulnerability. An obesity rate of 15 percent is under the national average. D An upper class community does not usually face health disparities, since residents are more able to afford health care. Hand, Foot, and Mouth Disease is a very common childhood disease that does not need special intervention.

A nurse has volunteered with an organization treating women who were the victims of rape as a weapon of war in the Congo. This violence is considered: A. Community violence B. Collective violence C. Stranger violence D. Interpersonal violence

ANS: B Feedback A This is incorrect. Community violence occurs within the community and includes stranger and acquaintance violence. The correct answer is collective violence, which describes violence that occurs when a large group of people engages in violence, such as with war crimes. B This is correct. Collective violence occurs when a large group of people engages in violence, such as with war crimes. C This is incorrect. Stranger violence occurs between strangers within the context of the community. The correct answer is collective violence, which describes violence that occurs when a large group of people engages in violence, such as with war crimes. D This is incorrect. Interpersonal violence occurs between two individuals within the context of the family or the community. The correct answer is collective violence, which describes violence that occurs when a large group of people engages in violence, such as with war crimes.

A group of nurses is looking to design a home visitation program for parents who are at high risk for child maltreatment. What factors should the nurses focus on? A. Parenting skills and access to educational support B. Promoting family relationships and increasing child monitoring C. Increasing access to nutrition and wellness programs D. Assisting with parental education and financial assistance programs as needed

ANS: B Feedback A This is incorrect. Home visitation programs seeking to lower child maltreatment rates are most effective when they not only nurture parenting skills, but also promote family relationships, support the development of household rules, and increase child monitoring. B This is correct. Home visitation programs seeking to lower child maltreatment rates are most effective when they nurture parenting skills, promote family relationships, support development of household rules, and increase child monitoring. C This is incorrect. Home visitation programs seeking to lower child maltreatment rates are most effective when they nurture parenting skills, promote family relationships, support development of household rules, and increase child monitoring. D This is incorrect. Home visitation programs seeking to lower child maltreatment rates are most effective when they nurture parenting skills, promote family relationships, support development of household rules, and increase child monitoring.

A PHN learns in a behavioral health class that the relationship between physiology and mental health plays an important role in mental disorders. Which of the following physiological factors may contribute to the development of mental disorders? A. Conditions that affect brain chemistry, such as medication side effects or toxins B. Physical trauma C. 1 and 2 D. Unstable family life

ANS: C Feedback A Both conditions that affect brain chemistry and physical trauma are the physiological factors that may contribute to the development of mental disorders. B Both physical trauma and conditions that affect brain chemistry are physiological factors that may contribute to the development of mental disorders. C Conditions that affect brain chemistry and physical trauma are two of the physiological factors that may contribute to the development of mental disorders. D This is incorrect. Conditions that affect brain chemistry and physical trauma are two of the physiological factors that may contribute to the development of mental disorders. An unstable family life is not a physiological factor, although it may also contribute to the development of mental disorders.

Which of the following community environment factors play a role in the development of mental disorders? A. Living in high crime areas B. Poverty C. Both 1 and 2 D. Family instability

ANS: C Feedback A Living in high crime areas is a factor, along with poverty. B Both poverty and living in high crime areas play a role in the development of mental disorders. C Both poverty and living in high crime areas play a role in the development of mental disorders. D This is incorrect. Although family instability often contributes to the development of mental disorders, it is not considered a community environment factor.

To help smoking patients improve their health, a nurse uses which of the following smoking cessation strategies? A. Advise all tobacco users to quit. B. Assist tobacco users with a quit plan. C. Both 1 and 2 D. None of the above

ANS: C Feedback A The nurse will advise the patients to quit smoking. B The nurse will assist the patients with a quit plan. C The nurse will advise the patients to quit smoking and assist them with a plan to quit. D This is incorrect. The nurse will advise the patients to quit smoking and assist them with a quit plan.

A nurse is reviewing the disaster and emergency plans for the hospital before updating them. What characteristic needs to be addressed, as it is not helpful in a disaster preparedness plan? A. The plan is broad in scope and able to address multiple types of disasters. B. The plan is comprehensive and contains plans for advanced preparation, disaster management and post-disaster evaluation. C. The plan stresses autonomy and independence from nearby organizations. D. The plan includes information about long-term management of the after effects of the disaster.

ANS: C Feedback A This is a correct statement. A disaster preparedness plan should be broad in scope and able to address multiple types of disasters, yet also comprehensive and contain plans for advanced preparation, disaster management, and post-disaster evaluation. It should also include information about long-term management of the after effects of the disaster. Finally, the plan should stress collaboration and cooperation with nearby organizations. B This is a correct statement. A disaster preparedness plan should be broad in scope and able to address multiple types of disasters, yet comprehensive and contain plans for advanced preparation, disaster management, and post-disaster evaluation. It should also include information about long-term management of the after effects of the disaster. Finally, the plan should stress collaboration and cooperation with nearby organizations. C This is an incorrect statement. The plan should stress collaboration and cooperation with nearby organizations. In addition, a disaster preparedness plan should be broad in scope and able to address multiple types of disasters, yet comprehensive and contain plans for advanced preparation, disaster management, and post-disaster evaluation. It should also include information about long-term management of the after effects of the disaster. D This is a correct statement. A disaster preparedness plan should be broad in scope and able to address multiple types of disasters, yet comprehensive and contain plans for advanced preparation, disaster management, and post-disaster evaluation. It should also include information about long-term management of the after effects of the disaster. Finally, the plan should stress collaboration and cooperation with nearby organizations.

A student nurse is studying stress and mental health. The student nurse learns that ____ is based on an individual's ability to access protective factors that exist at different levels in order to withstand chronic stress or recover from traumatic life events. A. Intervention B. Support C. Resilience D. Therapy

ANS: C Feedback A This is incorrect. Resilience is based on an individual's ability to access protective factors that exist at different levels in order to withstand chronic stress or recover from traumatic life events. Preventive and treatment interventions are useful tools to build on an individual's natural resilience to promote positive outcomes. B This is incorrect. Resilience is based on an individual's ability to access protective factors that exist at different levels in order to withstand chronic stress or recover from traumatic life events. Support from family, friends, and community is an important part of strengthening an individual's resilience. C Resilience is based on an individual's ability to access protective factors that exist at different levels in order to withstand chronic stress or recover from traumatic life events. D This is incorrect. Resilience is based on an individual's ability to access protective factors that exist at different levels in order to withstand chronic stress or recover from traumatic life events. Therapy is an important part of an overall treatment plan, in conjunction with intervention, support, and an individual's capacity for resilience.

A nurse is performing a home visit for a young mother that lives in the projects in Brooklyn, New York. There is a young child who is three years old living in the apartment as well. The nurse notices that the window guards on the bedroom window are hanging off the building. How does the nurse proceed? A. Encourage the woman to call the landlord after the nurse leaves. B. Call Child Protective Services to report an unsafe living situation. C. Call the landlord directly to ensure the timely repair of the window guards and encourage the woman to keep the windows closed in the meantime. D. Call the city to report a bad landlord.

ANS: C Feedback A This is incorrect. The nurse has no way of knowing whether the woman is following up with the landlord appropriately. The nurse can call the landlord directly and use the opportunity to provide education about fall prevention. B This is incorrect. The woman may not realize the importance of the window guards, or she may have reported them to the landlord several times without response. C This is correct. It is better for the nurse to call the landlord directly, since it conveys the importance of the situation and also ensures that the landlord is called. In addition to keeping the windows closed, the nurse should remove from the room items that the child could climb on to access the window, and also encourage constant supervision until the window guards are repaired. D This is incorrect. The nurse should give the landlord a chance to repair the window guards, since it is possible that the landlord was unaware of the needed repair.

A nurse whose teenage patient is showing signs of alcohol abuse reviews which of the following first to help the patient? A. Universal level of prevention B. Selective level of prevention C. Indicated level of prevention D. None of the above

ANS: C Feedback A This is incorrect. The universal level of prevention addresses populations regardless of identified risk. B This is incorrect. The selective level of prevention addresses specific subgroups that are known to be at risk for substance abuse by virtue of biological, psychological, social, or environmental factors. C The indicated level of prevention addresses specific subgroups at highest risk for development of a substance use disorder, or those that are showing early signs of substance use disorders. The teenager fits this category because he is already showing signs of alcohol abuse. D The indicated level of prevention addresses specific subgroups at highest risk for development of a substance use disorder, or those that are showing early signs of substance use disorders. The teenager fits this category because he is already showing signs of alcohol abuse.

A nurse is working at a high school when a young woman comes down to the nursing office concerned about her boyfriend whom she states is making suicidal comments. How does the nurse proceed? A. Counsel the young woman about relationship issues. B. Call the young woman's parents about her concerns. C. Inform the school psychologist immediately and notify the boyfriend's parents. D. Call the young man down to the nurse's office for a mental health evaluation.

ANS: C Feedback A This is incorrect. This does not validate the young woman's concerns about her boyfriend. Every suicide threat needs to be taken seriously, and so it is appropriate for the nurse to refer the young man to the school psychologist. B This is incorrect. This does not address the potential mental health issues of the young man who is making the suicidal threats. It also potentially alienates the trust of the young woman. C This is correct. The nurse should make the appropriate referral and notify his parents about her concerns. Every threat of suicide must be taken seriously, and it is appropriate for the nurse to intervene. D This is incorrect. It is not appropriate for the nurse to perform the mental health evaluation. It is better that the nurse refer the student to a mental health professional and inform his parents about her concerns.

A nurse is looking to implement new preventative measures to address the rate of drowning in young children in the community. All of the following policies are examples of primary prevention, except: A. Swimming instruction for every child B. Mandatory installation of locked child-safety fences around all community and private pools C. Community-wide CPR instruction D. Mandatory use of life jackets for all children on boats

ANS: C Feedback A This is incorrect. Use of life jackets, installation of child-safety fences around all community and private pools, and swimming instruction for every child are all examples of primary prevention because they aim to prevent drowning in the first place. B This is incorrect. Use of life jackets, installation of child-safety fences around all community and private pools, and swimming instruction for every child are all examples of primary prevention because they aim to prevent drowning in the first place. C This is correct. Use of life jackets, installation of child-safety fences around all community and private pools, and swimming instruction for every child are all examples of primary prevention because they aim to prevent drowning in the first place. Secondary prevention includes treating the medical issues associated with drowning, such as with CPR. D This is incorrect. Use of life jackets, installation of child-safety fences around all community and private pools, and swimming instruction for every child are all examples of primary prevention because they aim to prevent drowning in the first place.

A nurse is working within a community clinic on the Mexican-Californian border. The nurse frequently takes care of refugee families when they first arrive in the United States. When meeting with a new family, the nurse makes sure to inform them that they are eligible for which of the following services? A. Medicaid eligibility B. Free health insurance for 1 year C. Housing and food support D. Free English classes

ANS: C Feedback A This is incorrect. When refugees first arrive in the United States, they are given food and housing support, health insurance for the first 8 months and employment training or job placement assistance. They are encouraged to apply for Medicaid at the end of the 8 months, but they would still need to apply and qualify. B This is incorrect. Refugees are given health insurance for 8 months when they first arrive. They are encouraged to apply for Medicaid at the end of the 8 months, but they still need to apply and qualify. C This is correct. When refugees first arrive in the United States, they are given food and housing support, health insurance for the first 8 months and employment training or job placement assistance. D This is incorrect. When refugees first arrive in the United States, they are given food and housing support, health insurance for the first 8 months and employment training or job placement assistance.

A nurse is educating new staff in the emergency department about the types of injuries and illness they might be treating. The nurse mentions that which population is at greatest risk for unintentional injuries? A. Women under the age of 45 B. Women over the age of 45 C. Men under the age of 45 D. Men over the age of 45

ANS: C Feedback A This is incorrect. Young men, under the age of 45 are at highest risk for unintentional injuries. In addition, children under the age of 19 are also at high risk for unintentional injuries and in fact, it is the fifth leading cause of death in this population. B This is incorrect. Young men, under the age of 45 are at highest risk for unintentional injuries. In addition, children under the age of 19 are also at high risk for unintentional injuries and in fact, it is the fifth leading cause of death in this population. C This is correct. Young men, under the age of 45 are at highest risk for unintentional injuries. In addition, children under the age of 19 are also at high risk for unintentional injuries and in fact, it is the fifth leading cause of death in this population. D This is incorrect. Young men, under the age of 45 are at highest risk for unintentional injuries. In addition, children under the age of 19 are also at high risk for unintentional injuries and in fact, it is the fifth leading cause of death in this population.

A school nurse has observed an increase in bully behavior in her school. The nurse has noticed that a lot of it seems to be directed toward two gay students and wonders if a school policy change is required to change this behavior. How should the school nurse proceed? A. Institute a zero tolerance policy for any bully behavior. B. Set goals for zero incidents of bullying next year. C. Perform a community assessment to see why the bully behavior has increased. D. Get the teachers involved in teaching anti-bully behavior in the classroom.

ANS: C Feedback A This is likely a good intervention to establish within the school. However, the nurse should assess the school population first to see what is causing the increase in bully behavior. The results of that assessment will guide the plan. B This is a good goal for the school to set. However, the nurse should assess the school population first to see what is causing the increase in bully behavior. The results of that assessment will guide the plan. C The nurse should assess the school population first to see what is causing the increase in bully behavior. The results of that assessment will guide the plan. D This is likely a good intervention to establish within the school. However, the nurse should assess the school population first to see what is causing the increase in bully behavior. The results of that assessment will guide the plan.

A nurse is preparing a class on caring for the homeless population. The nurse asks the class to brainstorm some risk factors for becoming homeless. Which of the following should the class list as known risk factors for homelessness? Select all that apply. A. Young families B. Caucasians C. Single men D. African Americans E. Having mental illness

ANS: C, D, E Feedback 1 This is incorrect. Single people are significantly more likely to become homeless than families. This may be in part because of the number of safety nets in place to help families and children. 2 Hispanics and African Americans are much more likely to become homeless than Caucasians. 3 This is correct. Single men are much more likely to become homeless than single women or families. 4 Hispanics and African Americans are much more likely to become homeless than Caucasians. 5 Having mental illness is a major risk factor for becoming homeless. In fact, the rate of homelessness is significantly higher in people with mental health issues

A nurse working in labor and delivery requested permission from the nurse manager to conduct a quality improvement project to screen patients that might be susceptible to PPD. After completing the project, which of the following screening guidelines did the unit incorporate? A. All patients will be screened for PPD when they are admitted to the labor and delivery unit. B. Patients at high risk are referred to the attending obstetrician. C. Before being discharged, all new mothers will complete a questionnaire specific to PPD symptoms. D. All of the above

ANS: D Feedback A This is incorrect. Screening, high-risk referrals to the attending obstetrician and completion of a PPD symptom questionnaire were all incorporated. B This is incorrect. Screening, high-risk referrals to the attending obstetrician and completion of a PPD symptom questionnaire were all incorporated. C This is incorrect. Screening, high-risk referrals to the attending obstetrician and completion of a PPD symptom questionnaire were all incorporated. D Screening, high-risk referrals to the attending obstetrician and completion of a PPD symptom questionnaire were all incorporated.

A nurse is teaching a class about vulnerable populations. He instructs that vulnerable populations have been divided into three groups. Which of the following is not one of the three groups that research has identified? A. People suffering as a result of their behavior (for example, drug addicts) B. Children of parents who made bad decisions (for example, illegal immigrants) C. People who became vulnerable through no fault of their own (for example, from cancer) D. Adults that are born into vulnerable populations because of their ethnicity or race

ANS: D Feedback A The three groups of vulnerable populations include people suffering as a result of their behavior, children of parents who made bad decisions, and people who became vulnerable through no fault of their own. B The three groups of vulnerable populations as divided by the community include people suffering as a result of their behavior, children of parents who made bad decisions, and people who became vulnerable through no fault of their own. C The three groups of vulnerable populations as divided by the community include people suffering as a result of their behavior, children of parents who made bad decisions, and people who became vulnerable through no fault of their own. D The three groups of vulnerable populations as divided by the community include people suffering as a result of their behavior, children of parents who made bad decisions, and people who became vulnerable through no fault of their own.

Nurses working for the Indian Health Services at a reservation health clinic note a high rate of suicide among adolescents living on the reservation. In order to reduce the odds, the nurses decide to take which of the following steps? A. Determine what stakeholders should be involved to design a community level intervention. B. Review the national statistics on teen suicide among Native Americans. C. Complete a draft plan of action. D. All of the above

ANS: D Feedback A As part of an overall plan to reduce teen suicides on the reservation, nurses should determine which stakeholders should be involved, review national statistics on teen suicides among Native Americans, and complete a draft plan of action to work toward reducing the incidence. B As part of an overall plan to reduce teen suicides on the reservation, nurses should determine which stakeholders should be involved, review national statistics on teen suicides among Native Americans, and complete a draft plan of action to work toward reducing the incidence. C As part of an overall plan to reduce teen suicides on the reservation, nurses should determine which stakeholders should be involved, review national statistics on teen suicides among Native Americans, and complete a draft plan of action to work toward reducing the incidence. D As part of an overall plan to reduce teen suicides on the reservation, nurses should determine which stakeholders should be involved, review national statistics on teen suicides among Native Americans, and complete a draft plan of action to work toward reducing the incidence.

A nurse treating a new patient learns that he was a smoker. Which of the following questions will help determine if he still smokes and how much he smokes? A. Do you now use tobacco? B. Have you ever used tobacco? C. Are you interested in quitting tobacco use? D. All of the above

ANS: D Feedback A Asking "Do you now use tobacco?" will help the nurse learn more about the patient's current smoking habits. B Asking "Have you ever used tobacco?" will help the nurse learn more about the patient's past smoking habits and whether he will relapse. C Asking "Are you interested in quitting tobacco use?" will help the nurse recommend smoking cessation programs if the smoker is ready to quit. D Questions about current and past tobacco use and interest in quitting are helpful in screening smokers.

A nurse has finished an initial assessment of a community with a high rate of obesity. The nurse has observed that socioeconomic status seems to be linked with poor outcomes in this community. What is the next step? A. Set goals to reduce obesity rate by 5 percent in the next 3 years. B. Set up a community fair to begin educating people in the community about healthy food choices. C. Involve key members of the community in the goal setting and plan formation phase of the nursing process. D. Perform a cultural assessment to see what other factors may be involved in this community.

ANS: D Feedback A Before setting goals, the nurse needs to complete a cultural assessment and look for other variables. B Before creating a plan to address the obesity rate, the nurse needs to complete a cultural assessment and look for other variables. C Before creating a plan to address the obesity rate, the nurse needs to complete a cultural assessment and look for other variables. D Before setting goals or creating a plan to address the obesity rate, the nurse needs to complete a cultural assessment and look for other variables.

When a community health nurse explains the consequences of tobacco use to a patient who smokes, the nurse mentions which of the following adverse health consequences experienced by tobacco users? A. Damage to the oral cavity and teeth B. Chronic obstructive pulmonary disorders C. Cancer D. All of the above

ANS: D Feedback A Damage to the oral cavity and teeth is an adverse health consequence of tobacco use. B Chronic obstructive pulmonary disorder is an adverse health consequence of tobacco use. C Cancer is an adverse health consequence of tobacco use. D Damage to the oral cavity and teeth, chronic obstructive pulmonary disorders, and cancer are a few of the adverse health consequences of tobacco use.

A recent graduate nurse working in an urban labor and delivery unit had a patient who experienced a difficult labor. The mother, suffering from postpartum depression (PPD), committed suicide a year after giving birth. Although the nurse knew the basics about PPD, the nurse immediately studied the condition in depth and learned that PPD: A. Can be triggered by a massive hormone drop following delivery B. Can intensify to cause delusions C. Occurs soon after delivery D. All of the above

ANS: D Feedback A PPD can be triggered by a massive post-delivery hormone drop, intensify enough to cause delusions, and occur soon after delivery. B PPD can be triggered by a massive post-delivery hormone drop, intensify enough to cause delusions, and occur soon after delivery.

To find out how much alcohol a patient uses, a nurse asks about which of the following? A. Quantity of alcohol consumed B. Frequency of alcoholic beverage consumption C. Duration of use D. All of the above

ANS: D Feedback A Quantity of alcohol consumed is an important indicator of substance use. B Frequency of alcoholic beverage consumption is an important indicator of substance use. C How long a person drinks is an important indicator of substance use. D Quantity of alcohol, frequency of consumption, and duration of use may indicate a substance disorder.

A nurse working with mental health outpatients notes that which of the following risk factors are common in the patients? A. Social isolation B. Substance use C. Traumatic life events D. All of the above

ANS: D Feedback A Social isolation, or having few friends or few healthy relationships, is a risk factor for mental health disorders. B Substance use, including illicit drugs, alcohol, medication side effects, and drug interactions, plays a role in the development of mental disorders. C Traumatic life events, such as military combat, being assaulted, or witnessing a violent crime, can have a significant impact on mental health. D In addition to many other risk factors, social isolation, substance use, and traumatic life events can be risk factors for the development of mental health disorders.

Nurses at a local trauma center were involved in evaluating their hospital's screening program for alcohol substance abuse. Which of the following steps were part of their plan? A. Review files on patients admitted with a possible alcohol-related injury. B. Evaluate the current screening system in use on their unit. C. Review current screening techniques used in other hospitals. D. All of the above

ANS: D Feedback A The nurses reviewed files on patients admitted with a possible alcohol-related injury. B The nurses evaluated their unit's current screening system. C The nurses reviewed screening techniques used by other institutions. D Reviewing alcohol-related injury admissions, checking the current screening system, and reviewing screening systems used by other hospitals were some of the steps taken by nurses to improve their unit's alcohol substance use disorder screening program.

A nurse is sitting in a community clinic and chatting with a South American patient. He reports that other members of the community are rude to him and his family and act as if he and his family are not part of the community. He mentions that this is a common experience among the South American population living in town. The nurse knows that: A. This likely plays no role in his health or health status. B. This family is being stigmatized. C. The family needs to focus on bonding with their South American community. D. Marginalization can lead to increased vulnerability and health disparities.

ANS: D Feedback A This family and the rest of the South American community in this town is being marginalized, which can lead to increased vulnerability and health disparities. B This family and the rest of the South American community in this town is being marginalized, not stigmatized, which can lead to increased vulnerability and health disparities. C Bonding with the rest of the South American community in town can be beneficial for the family, but does not negate the harm done by the rest of the community. D This family and the rest of the South American community in this town is being marginalized, which can lead to increased vulnerability and health disparities.

A nurse is teaching water safety at the local community pool and mentions that which of the following is the most significant risk factor for drowning? A. Gender B. Income C. Education D. Age

ANS: D Feedback A This is incorrect. Age is the most significant risk factor for drowning. Young children are more susceptible to falling into water (including toilets, bathtubs, and buckets), and are more likely to be curious around water. In older adults, swimming ability declines with age. B This is incorrect. Age is the most significant risk factor for drowning. Young children are more susceptible to falling into water (including toilets, bathtubs, and buckets), and are more likely to be curious around water. In older adults, swimming ability declines with age. C This is incorrect. Age is the most significant risk factor for drowning. Young children are more susceptible to falling into water (including toilets, bathtubs, and buckets), and are more likely to be curious around water. In older adults, swimming ability declines with age. D This is correct. Age is the most significant risk factor for drowning. Young children are more susceptible to falling into water (including toilets, bathtubs, and buckets), and are more likely to be curious around water. In older adults, swimming ability declines with age.

A nurse is presenting a lecture about providing nursing and medical care during wars and in conflict areas. The nurse is discussing how war has changed in the last few decades. Which of the following statements is correct? A. There are more wars currently than in the past. B. War-related deaths have increased in the past decade. C. Fewer countries have weapons of mass destruction due to increased world condemnation of such weapons. D. Reporting of wars and war crimes has increased.

ANS: D Feedback A This is incorrect. In fact, there were fewer wars at the beginning of this previous decade then at the beginning of the last. B This is incorrect. War-related deaths have actually decreased during the last decade. Increased reporting of war atrocities have made it seem like there are increased deaths, when in fact, the number of deaths has declined. C This is incorrect. More countries have developed weapons of mass destruction, including nuclear, biological, and chemical weapons. D This is correct. There has been an increased reporting of wars and war atrocities. Even in situations where formally trained journalists are not present in an area, the use of social media has allowed citizens to still cover these events.

In 2010, approximately how many people in the United States reported experiencing mental disorders in the previous year? A. 15% B. 50% C. 30% D. 25%

ANS: D Feedback A This is incorrect. In the United States in 2010 an estimated 25% of adults reported having mental disorders in the previous year. B This is incorrect. In the United States in 2010 an estimated 25% of adults reported having mental disorders in the previous year. C This is incorrect. In the United States in 2010 an estimated 25% of adults reported having mental disorders in the previous year. D In the United States in 2010 an estimated 25% of adults reported having mental disorders in the previous year.

Which ethnic group has the highest 12-month prevalence of a mental disorder? A. Hispanics B. African Americans C. Asian Americans D. Non-Hispanic whites

ANS: D Feedback A This is incorrect. Non-Hispanic whites have the highest 12-month prevalence rate for mental disorders at 21% compared with 16% for Hispanics. B This is incorrect. Non-Hispanic whites have the highest 12-month prevalence rate for mental disorders at 21% compared with 15% for African Americans. C This is incorrect. Non-Hispanic whites have the highest 12-month prevalence rate for mental disorders at 21% compared with 9% for Asian Americans. D Non-Hispanic whites have the highest 12-month prevalence rate for mental disorders at 21%.

A nurse studying substance use disorders learns that alcohol is a causal factor in ____ types of diseases and injuries. A. 60 B. 80 C. 20 D. 10

ANS: A Feedback A Alcohol is a causal factor in 60 types of diseases and injuries. B This is incorrect. Alcohol is a causal factor in 60 types of diseases and injuries. C This is incorrect. Alcohol is a causal factor in 60 types of diseases and injuries. D Alcohol is a causal factor in 60 types of diseases and injuries.

The public health nurse (PHN) recognizes that which of the following are used as screening tools for depression? A. Patient Health Questionnaire 2 B. Center for Epidemiological Studies Depression Scale (CESD-10) C. Brief Symptom Checklist-18 of the My Mood Monitor (M-3) D. Both 1 and 2

ANS: D Feedback A Tools to screen for depression include the Patient Health Questionnaire 2 and the CESD-10. B Tools to screen for depression include the Patient Health Questionnaire 2 and the CESD-10. C This is incorrect. Tools to screen for depression include the Patient Health Questionnaire 2 and the CESD-10. Screening tools for anxiety disorders include the Brief Symptom Checklist-18 of the My Mood Monitor (M-3). D Tools to screen for depression include the Patient Health Questionnaire 2 and the CESD-10.

____ addresses specific subgroups at highest risk for development of a mental disorder or those that are showing early signs of a mental disorder. A. Indicated prevention B. Selective prevention C. Universal prevention D. Both 1 and 2

ANS: A Feedback A Indicated prevention addresses specific subgroups at highest risk for development of a mental disorder or those that are showing early signs of a mental disorder. The purpose of indicated techniques is to delay or reduce the severity of a mental disorder. B Selective prevention includes interventions provided to specific subgroups that are known to be at high risk for mental disorders owing to biological, psychological, social, or environmental factors but that have not yet been diagnosed with mental disorders. High-risk subgroups include but are not limited to those with a family history of mental disorders, history of adverse childhood events, or victims of violence. C Universal prevention refers to prevention interventions provided to the entire population, not just those who may be at risk. The interventions include but are not limited to public service announcements provided to the public at large through billboards, media messages (print and electronic), or general health education programs. D Indicated prevention addresses specific subgroups at highest risk for development of a mental disorder or those that are showing early signs of a mental disorder. The purpose of indicated techniques is to delay or reduce the severity of a mental disorder. Selective prevention includes interventions provided to specific subgroups that are known to be at high risk for mental disorders owing to biological, psychological, social, or environmental factors but that have not yet been diagnosed with mental disorders. High-risk subgroups include but are not limited to those with a family history of mental disorders, history of adverse childhood events, or victims of violence.

A nurse is working very closely with a community after a small plane crashed into an apartment complex and killed many of its residents. Now that the crash site has been cleaned and the community is starting to return to normal, what is the priority for this community? A. Screen for and manage depression, anxiety, and post-traumatic stress disorder. B. Establishing an emergency management plan. C. Hold a community debriefing about what happened. D. Encourage residents to get back to their regular routines as soon as possible.

ANS: A Feedback A The mental health affects after a traumatic event can be devastating for individuals and communities. It is important to implement interventions that can assist community members in getting help for depression, anxiety, or post-traumatic stress disorder. B It is important to establish an emergency management plan if the community doesn't have one. However, it is more important for community members to be able to access mental health assistance if needed. C A community debriefing may be painful for the community residents to sit through immediately after the crash. It may be more prudent for the relevant public figures to be involved in the quality improvement and debriefing procedures after the event. D It is important for residents to get back to their regular life. However, it is more important for community members to be able to access mental health assistance if needed.

A nurse is working at a high school that is serving as a community shelter during a hurricane. In the surge after the storm, the basement starts filling with floodwaters and then the power shuts off. As a result, the nurse contacts the local coast guard to assist in relocating people in the shelter to an unaffected elementary school across town. This is an example of: A. Mitigation B. Preparedness C. Triage D. Recovery

ANS: A Feedback A This is correct. Mitigation is the process of planning for the harm or impact of a disaster, and also the steps needed to lessen those effects. B This is incorrect. Preparedness is the process of proactively planning for disasters and emergency situations. C This is incorrect. Triage is the process of sorting victims or situations according to their severity. D This is incorrect. Recovery is the process of returning the community back to its prior state. This may include rebuilding infrastructure or relocating populations.

A nurse is attending a training session on disaster management and is surprised to learn that: A. True emergency preparedness and disaster management is a continuous cycle and has no beginning or end. B. There are four major phases of a disaster life cycle. C. There are three stages of the disaster preparedness framework. D. Emergency preparedness and disaster management must only occur at the local level.

ANS: A Feedback A This is correct. True emergency preparedness and disaster management is a continuous cycle and has no beginning or end. B This is incorrect. There are three phases to a disaster life cycle: pre-incident, trans-incident, and post-incident, which occur along the disaster timeline. C There are five components of the disaster preparedness framework—preparedness, response, recovery, mitigation, and evaluation. D This is incorrect. Emergency preparedness and disaster management must occur at the local (community), state, national, and global levels.

A nurse is working with the state department of health. Weather forecasters are anticipating that several communities will be impacted by a severe hurricane that will likely decimate the coastline of their community. They order a voluntary evacuation for several communities, in particular those that are likely to be most severely impacted. Which of the following statements is incorrect? A. Use of the Emergency Alert System by broadcasters during an emergency is voluntary. B. They should consider mandatory evacuations if residents chose to not evacuate as suggested. C. There should be a legal plan in place to deal with residents who are not complying with instructions. D. A shelter should be established to help vulnerable residents and people who are not able to find somewhere to stay.

ANS: A Feedback A This statement is incorrect. In times of a disaster or emergency, the emergency alert system must be utilized by broadcasting companies to disseminate emergency information to residents. B This statement is correct. If people refuse to heed voluntary evacuation orders, the state should consider mandatory evacuations, to prevent first responders from being put at risk when rescuing people. C This statement is correct. Part of the emergency preparedness plan should include how the police will handle people who refuse to obey evacuation orders. D This statement is correct. The most vulnerable people in the community, who are also the most likely to be impacted by the storm, will probably need assistance in the evacuation.

A public health nurse (PHN) researching risk factors for mortality found that ____ and ____ are among the top ten. A. Alcohol and tobacco B. Inhalants and stimulants C. Cannabis and caffeine D. None of the above

ANS: A Feedback A Alcohol and tobacco are among the top ten risk factors for mortality. B This is incorrect. Inhalants and stimulants are not among the highest risk factors for mortality. C This is incorrect. Cannabis and caffeine are not among the top ten risk factors for mortality. D This is incorrect. Alcohol and tobacco are among the top ten risk factors for mortality.

A nurse interested in working with persons with mental disorders who live in poverty understands that the most effective treatment involves multiple sectors of society, such as government agencies, grass roots groups, nonprofits, and businesses, working in tandem. This interrelationship is called: A. Indicated prevention B. Intersectoral strategies C. Health-Related Quality of Life D. Institute of Medicine Model of Prevention

ANS: B Feedback A This is incorrect. Intersectoral strategies engage more than one sector of society with a shared interest such as government agencies, grass roots citizens groups, nonprofits, and businesses. Indicated prevention addresses specific subgroups at highest risk for development of a mental disorder or those that are showing early signs of a mental disorder. B Intersectoral strategies engage more than one sector of society with a shared interest such as government agencies, grass roots citizens groups, nonprofits, and businesses. C This is incorrect. Intersectoral strategies engage more than one sector of society with a shared interest such as government agencies, grass roots citizens groups, nonprofits, and businesses. Health-Related Quality of Life is the self-perceived impact of physical and emotional health on overall quality of life. D This is incorrect. Intersectoral strategies engage more than one sector of society with a shared interest such as government agencies, grass roots citizens groups, nonprofits, and businesses. The Institute of Medicine Model of Prevention is a framework for mental disorders that clearly separates prevention into three categories with specific interventions at each level.

During the past decade, the morbidity and mortality rate of SMI has increased, showing that persons diagnosed with an SMI die ____ years earlier than those in the general population. A. 5 B. 25 C. 20 D. 10

ANS: B Feedback A This is incorrect. People diagnosed with a SMI die 25 years earlier than the general population, partly due to suicide and injury, chronic disease, and substance abuse. B People diagnosed with a SMI die 25 years earlier than the general population, partly due to suicide and injury, chronic disease, and substance abuse. C This is incorrect. People diagnosed with a SMI die 25 years earlier than the general population, partly due to suicide and injury, chronic disease, and substance abuse. D This is incorrect. People diagnosed with a SMI die 25 years earlier than the general population, partly due to suicide and injury, chronic disease, and substance abuse.

____ is a combination of personal attributes and societal stereotypes related to human characteristics viewed as unacceptable. A. Indicated prevention B. Stigma C. Risk factors D. Transinstitutionalization

ANS: B Feedback A This is incorrect. Stigma is a combination of personal attributes and societal stereotypes related to human characteristics viewed as unacceptable. Indicated prevention addresses specific subgroups at highest risk for development of a mental disorder or those that are showing early signs of a mental disorder. B Stigma is a combination of personal attributes and societal stereotypes related to human characteristics viewed as unacceptable. C This is incorrect. Stigma is a combination of personal attributes and societal stereotypes related to human characteristics viewed as unacceptable. Risk factors increase an individual's chance of developing a mental disorder. D This is incorrect. Stigma is a combination of personal attributes and societal stereotypes related to human characteristics viewed as unacceptable. Transinstitutionalization refers to the growing number of mentally ill persons who are homeless, in jail, in shelters, or in other facilities instead of being home or in a hospital.

While studying the prevalence of mental health disorders worldwide, a PHN learns about the World Mental Health Survey, which is used to determine estimates of human capital costs and prevalence of mental disorders in a wide range of countries. The survey was developed by A. The Centers for Disease Control and Prevention (CDC) B. The World Health Organization (WHO) C. The Institute of Medicine (IOM) D. The World Health Assembly

ANS: B Feedback A This is incorrect. WHO developed the World Mental Health Survey to estimate human capital costs and mental disorders prevalence on a global scale. The CDC conducts many types of surveys on the prevalence of mental disorders but the organization did not develop the World Mental Health Survey. B The WHO developed the World Mental Health Survey to estimate human capital costs and mental disorders prevalence on a global scale. C This is incorrect. WHO developed the World Mental Health Survey to estimate human capital costs and mental disorders prevalence on a global scale. The IOM is involved in screening for mental health disorders and addresses the need for appropriate behavioral health treatment in its report, Improving the Quality of Health Care for Mental and Substance-Use Conditions: Quality Chasm Series. D This is incorrect. WHO developed the World Mental Health Survey to estimate human capital costs and mental disorders prevalence on a global scale. The World Health Assembly issued a resolution on mental health that aims to reduce the global burden of mental disorders and improve overall mental health worldwide.

A PHN has been sent to the site of a nuclear accident to assist in setting up long-term surveillance. The PHN will want to monitor cases of which of the following diseases? Select all that apply. A. Heart disease B. Leukemia C. Mental illness D. Thyroid disease E. Diabetes

ANS: B, C, D Feedback 1 This is incorrect. Exposure to radiation has been linked with increased risk of leukemia, mental illness, thyroid disease and solid cancers. It is especially important to track cases among the people living in the affected communities. 2 This is correct. Exposure to radiation has been linked with increased risk of leukemia, mental illness, thyroid disease and solid cancers. It is especially important to track cases among the people living in the affected communities. 3 This is correct. Exposure to radiation has been linked with increased risk of leukemia, mental illness, thyroid disease and solid cancers. It is especially important to track cases among the people living in the affected communities. 4 This is correct. Exposure to radiation has been linked with increased risk of leukemia, mental illness, thyroid disease and solid cancers. It is especially important to track cases among the people living in the affected communities. 5 This is incorrect. Exposure to radiation has been linked with increased risk of leukemia, mental illness, thyroid disease and solid cancers. It is especially important to track cases among the people living in the affected communities.

A nurse working on a maternity unit became concerned when one of the pregnant patients admitted to smoking. Which of the following adverse effects might eventually affect her unborn child? A. Low birth weight B. Increased risk for Sudden Infant Death Syndrome (SIDS) C. Both 1 and 2 D. Lower rates of asthma

ANS: C Feedback A Babies whose mothers smoke may be smaller than their gestational age. B Babies born to mothers who smoke have a greater risk of SIDS. C Babies born to mothers who smoke are smaller, have a greater risk of SIDS, and may develop asthma more frequently than those born to nonsmoking mothers. D This is incorrect. Babies born to mothers who smoke are at greater risk to develop asthma.

A nurse has been dispatched to communities along the New Madrid fault in Missouri because the area has seen a recent increase in seismic activity. The nurse is attempting to put policies in place that mitigate the potential damages from future earthquakes. Which of the following is an example of an effective policy change? A. Require a post-earthquake meeting to discuss the town's response. B. Create an emergency preparedness plan. C. Update building ordinances to be more resistant to seismic activity. D. Make the Director of the City Health Department in charge of all emergency response needs.

ANS: C Feedback A This is part of the evaluation, or recovery phase of disaster management. Updating building codes and ordinances to require that buildings are more resistant to seismic activity is an example of mitigation because it reduces the impact of the earthquake. B This is part of the emergency preparedness plan and is an example of the preparedness step of the emergency preparedness and disaster plan cycle. Updating building codes and ordinances to require that buildings are more resistant to seismic activity is an example of mitigation because it reduces the impact of the earthquake. C This is correct. Updating building codes and ordinances to require that buildings are more resistant to seismic activity is an example of mitigation because it reduces the impact of the earthquake. D This is part of the emergency preparedness plan and is an example of the preparedness step of the emergency preparedness and disaster plan cycle. Updating building codes and ordinances to require that buildings are more resistant to seismic activity is an example of mitigation because it reduces the impact of the earthquake.

A nurse is performing a pelvic exam on a woman in her mid-twenties. The nurse asks the woman what type of birth control she uses and the woman laughs, saying that she doesn't need birth control because she is a lesbian. How should the nurse respond? A. "That's correct, you do not need contraception." B. "You should consider contraception anyway, just in case you ever decide to be intimate with a man." C. "You still need to use a barrier contraceptive because of the risk of sexually transmitted infections." D. "Hormonal contraceptives might be a good option for you."

ANS: C Feedback A Even though a lesbian may not need contraceptives to prevent pregnancy, it is still important to use barrier contraception to prevent the transmission of sexually transmitted infections. B This is insensitive to the woman's sexual preferences and is not an appropriate thing to say. The woman should still use barrier contraceptives to prevent the transmission of sexually transmitted infections. C Even though a lesbian may not need contraceptives to prevent pregnancy, it is still important to use barrier contraception to prevent the transmission of sexually transmitted infections. D Hormonal contraceptives are not effective against sexually transmitted infections and only prevent pregnancy. The woman should be using barrier contraceptives.

A nurse received funding to start a mobile health unit to serve the needs of the homeless population. In addition to a general nurse staffing the unit, what other type of nurse should be hired to assist? A. Cardiac B. Surgical C. Psychiatric D. Nutrition

ANS: C Feedback A Members of the homeless population are significantly more likely to suffer from mental disorders and drug addiction. It would be helpful to have a psychiatrist or mental health specialist available when working with the homeless population. B Members of the homeless population are significantly more likely to suffer from mental disorders and drug addiction. It would be helpful to have a psychiatrist or mental health specialist available when working with the homeless population. C Members of the homeless population are significantly more likely to suffer from mental disorders and drug addiction. It would be helpful to have a psychiatrist or mental health specialist available when working with the homeless population. D Members of the homeless population are significantly more likely to suffer from mental disorders and drug addiction. It would be helpful to have a psychiatrist or mental health specialist available when working with the homeless population.

A team of nurses for a medical surgical unit have been assigned to develop a Screening and Brief Intervention (SBI) alcohol program for their department. Which of the following steps should they take? A. Review current alcohol SBI recommendations from the Joint Commission on Accreditation. B. Develop a plan to train health-personnel on the use of the alcohol SBI. C. Both 1 and 2 D. Choose not to prepare an evaluation plan.

ANS: C Feedback A The team should review current alcohol SBI recommendations from the Joint Commission on Accreditation. B The team should develop a plan to train health-care personnel on the use of the alcohol SBI. C To develop an alcohol SBI for their department, the team of nurses should review current alcohol SBI recommendations from the Joint Commission on Accreditation, develop a plan to train health-care personnel on the use of the alcohol SBI, and prepare an evaluation plan. D This is incorrect. The team should prepare an evaluation plan.

About 6.7% of the U.S. population is affected by ____ each year. It is the leading cause of disability for people ages 15 to 44 and is more prevalent in women than men. A. Postpartum depression (PPD) B. Schizophrenia C. Major Depressive Disorder (MDD) D. Posttraumatic Stress Disorder (PTSD)

ANS: C Feedback A This is incorrect. MDD occurs in about 6.7% of the population each year. B This is incorrect. MDD occurs in about 6.7% of the population each year. C MDD occurs in about 6.7% of the population each year. D This is incorrect. MDD occurs in about 6.7% of the population each year.

A nurse researching illicit drug use for a new job at a community clinic learns that the number one illicit drug in the United States as of 2010 is: A. Cocaine B. Hallucinogens C. Marijuana D. Inhalants

ANS: C Feedback A This is incorrect. Marijuana is used by 6.9% of Americans. It is the number one illicit drug in the United States. B This is incorrect. Marijuana is used by 6.9% of Americans. It is the number one illicit drug in the United States. C Marijuana is used by 6.9% of Americans. It is the number one illicit drug in the United States. D This is incorrect. Marijuana is used by 6.9% of Americans. It is the number one illicit drug in the United States.

A nurse is reviewing the safety procedures and protections in place at the community center where he or she works. Which of the following should he or she be most concerned about? A. Presence of two regular doors next to the revolving door in the front of the center B. Brightly lit exit signs C. Absence of decorations on the walls D. None of the above

ANS: D Feedback A The correct answer is none of the above. Fire code regulations are very strict and aim to help prevent the spread of a fire and to help people escape from a fire. The presence of two regular doors next to a revolving door prevents the revolving door from being jammed if a lot of people are trying to exit the building. Brightly lit exit signs guide people through the dark smoke toward the exit. Finally, the absence of decorations on the walls keeps a fire from spreading along flammable materials. B The correct answer is none of the above. Fire code regulations are very strict and aim to help prevent the spread of a fire, and to help people escape from a fire. The presence of two regular doors next to a revolving door prevents the revolving door from being jammed if a lot of people are trying to exit the building. Brightly lit exit signs guide people through the dark smoke toward the exit. Finally, the absence of decorations on the walls keeps a fire from spreading along flammable materials. C The correct answer is none of the above. Fire code regulations are very strict and aim to help prevent the spread of a fire, and to help people escape from a fire. The presence of two regular doors next to a revolving door prevents the revolving door from being jammed if a lot of people are trying to exit the building. Brightly lit exit signs guide people through the dark smoke toward the exit. Finally, the absence of decorations on the walls keeps a fire from spreading along flammable materials. D This is correct. Fire code regulations are very strict and aim to help prevent the spread of a fire, and to help people escape from a fire. The presence of two regular doors next to a revolving door prevents the revolving door from being jammed if a lot of people are trying to exit the building. Brightly lit exit signs guide people through the dark smoke toward the exit. Finally, the absence of decorations on the walls keeps a fire from spreading along flammable materials.

A PHN follows which of these guiding principles on harm reduction when helping patients who are substance users? A. Clients are responsive to culturally competent, non-judgmental services delivered in a manner that demonstrates respect for individual dignity, personal strength, and self-determination. B. Service providers are responsible to the wider community for delivering interventions which attempt to reduce the economic, social, and physical consequences of drug- and alcohol-related harm and harms associated with other behaviors or practices that put individuals at risk. C. Because those engaged in unsafe health practices are often difficult to reach through traditional service venues, the service continuum must seek creative opportunities and develop new strategies to engage, motivate, and intervene with potential clients. D. All of the above

ANS: D Feedback A A PHN understands that clients are responsive to culturally competent, non-judgmental services delivered in a manner that demonstrates respect for individual dignity, personal strength, and self-determination. B A PHN understands that service providers are responsible to the wider community for delivering interventions which attempt to reduce the economic, social, and physical consequences of drug- and alcohol-related harm and harms associated with other behaviors or practices that put individuals at risk. C A PHN understands that because those engaged in unsafe health practices are often difficult to reach through traditional service venues, the service continuum must seek creative opportunities and develop new strategies to engage, motivate, and intervene with potential clients. D PHNs know that a nonjudgmental environment, effective interventions, and new strategies have the potential to more effectively engage with substance use patients.

A nurse is at the beach with friends when one of them begins to complain about dizziness and fatigue. It is a particularly hot day in the middle of a heat wave. How should the nurse react? A. Call an ambulance. B. Tell her to close her eyes and rest. C. Give her some cool water. D. Leave the beach with the friend and have her sit in an air-conditioned car while drinking an electrolyte replacement drink.

ANS: D Feedback A An ambulance is not needed at this point, since the friend is likely suffering from heat exhaustion and not heat stroke. However, if the nurse does not act quickly, the friend could become significantly more ill. B This could be very dangerous for the friend. Not getting her out of the heat or rehydrating her could rapidly progress her heat exhaustion to heat stroke. C Drinking cool water can be effective, however, the friend needs to get out of the heat immediately and rehydrate using D This is correct. The friend needs to cool off immediately. She should leave the beach and sit in an air-conditioned car. She also needs to rehydrate by drinking an electrolyte replacement solution.

A prison nurse has received notification that there is a powerful storm system approaching the prison that is likely to cause tornados in the area, putting the prison and prisoners at risk. The nurse is reviewing the emergency response plan, which should include: A. Plans for the safety of first responders B. Plans for the protection and safety of prisoners and staff C. Plans for the safety of the general public D. All of the above

ANS: D Feedback A The correct answer is all of the above. When a prison is faced with a weather or other emergency situation, there is a significant risk to the inmates and staff, to the first responders providing care to the prisoners, and to the community in the event of an inadvertent prisoner release. All of the above must be addressed in the prison emergency plan, as well as mitigation plans in case of an escape. B The correct answer is all of the above. When a prison is faced with weather or other emergency situation, there is a significant risk to the inmates and staff, to the first responders providing care to the prisoners, and to the community in the event of an inadvertent prisoner release. All of the above must be addressed in the prison emergency plan, as well as mitigation plans in case of an escape. C The correct answer is all of the above. When a prison is faced with weather or other emergency situation, there is a significant risk to the inmates and staff, to the first responders providing care to the prisoners, and to the community in the event of an inadvertent prisoner release. All of the above must be addressed in the prison emergency plan, as well as mitigation plans in case of an escape. D The correct answer is all of the above. When a prison is faced with weather or other emergency situation, there is a significant risk to the inmates and staff, to the first responders providing care to the prisoners, and to the community in the event of an inadvertent prisoner release. All of the above must be addressed in the prison emergency plan, as well as mitigation plans in case of an escape.

A nurse is taking care of a several patients who were injured as a result of a pipe bomb explosion. The current patient has ruptured eardrums and traumatic injuries to his lower extremities due to flying debris. How does the nurse document these injuries? A. Primary B. Secondary C. Tertiary D. Primary and secondary

ANS: D Feedback A The ruptured eardrums are a primary injury, but the injuries to his lower limbs that resulted from flying debris are secondary injuries. B The injuries to his lower extremities are secondary injuries, but the ruptured eardrums are a primary injury. C This is incorrect. The ruptured eardrums are a primary injury, and the injuries to his lower limbs that resulted from flying debris are secondary injuries. D This is correct. The ruptured eardrums are a primary injury, and the injuries to his lower limbs that resulted from flying debris are secondary injuries.

A public health nurse (PHN) is working with a community after a major wildfire. The fire has been completely contained and will be put out shortly. How does the nurse proceed? A. Return home and allow the local firefighters to finish putting the fire out. B. Contact the Federal Government to ask for assistance in managing the wildfire. C. Wait another day or two until the fire is confirmed to be out and then return home. D. Begin surveillance and assess for incidences of respiratory disease related to the fires.

ANS: D Feedback A This is incorrect. It is known that respiratory illnesses increase after a major wildfire. The nurse should remain on site to monitor for and track respiratory disease cases until the numbers of such cases return to the community baseline. B This is incorrect. It is known that respiratory illnesses increase after a major wildfire. The nurse should remain on site to monitor for and track respiratory disease cases until the numbers of such cases return to the community baseline. C This is incorrect. It is known that respiratory illnesses increase after a major wildfire. The nurse should remain on site to monitor for and track respiratory disease cases until the numbers of such cases return to the community baseline. D This is correct. It is known that respiratory illnesses increase after a major wildfire. The nurse should remain on site to monitor for and track respiratory disease cases until the numbers of such cases return to the community baseline.

During a course on mental disorders, a PHN learns that the term serious mental illness (SMI) refers to diagnosable mental disorders that may disrupt a person's ability to function and may qualify that person for support services. The PHN also notes that the mental disorders that can lead to SMI include: A. Mild depression B. Panic disorder C. Schizophrenia D. Both 2 and 3

ANS: D Feedback A This is incorrect. Major depression, however, is one of the mental disorders that can lead to SMI. B Both panic disorder and schizophrenia, among other mental disorders, can lead to SMI. C Both schizophrenia and panic disorder, among other mental disorders, can lead to SMI. D The mental disorders that can lead to SMI include major depression, panic disorder, schizophrenia, bipolar disorder, obsessive compulsive disorder (OCD), post-traumatic stress disorder (PTSD), and borderline personality disorder.

A nurse is caring for a young homeless man on the medical floor of the local hospital. He was admitted several days ago to safely detox from alcohol. He reports having nowhere to go once he is discharged. Who should be involved in his discharge planning? A. Social worker B. Addiction specialist C. Psychiatrist D. All of the above

ANS: D Feedback A Social workers should be involved in his discharge planning. The social worker can help him find rehab programs to help him stay off of alcohol. In addition, the nurse can help him find assistance programs that he might qualify for. Addiction specialists and psychiatrists should also be involved in his care to give him long-term solutions for staying sober. B Social workers should be involved in his discharge planning. The social worker can help him find rehab programs to help him stay off of alcohol. In addition, the nurse can help him find assistance programs that he might qualify for. Addiction specialists and psychiatrists should also be involved in his care to give him long-term solutions for staying sober. C Social workers should be involved in his discharge planning. The social worker can help him find rehab programs to help him stay off of alcohol. In addition, the nurse can help him find assistance programs that he might qualify for. Addiction specialists and psychiatrists should also be involved in his care to give him long-term solutions for staying sober. D Social workers should be involved in his discharge planning. The social worker can help him find rehab programs to help him stay off of alcohol. In addition, the nurse can help him find assistance programs that he might qualify for. Addiction specialists and psychiatrists should also be involved in his care to give him long-term solutions for staying sober.

A nurse is teaching a class about the effect of socioeconomic status on health outcomes. The nurse explains that socioeconomic status is related to: A. Income B. Occupation C. Education D. All of the above

ANS: D Feedback A The correct answer is "All of the above." Socioeconomic status is a reflection of three factors: income, occupation and education. As education increases, so does job stability and income. People with lower levels of education tend to have less stable work with poorer pay. B The correct answer is "All of the above." Socioeconomic status is a reflection of three factors: income, occupation and education. As education increases, so does job stability and income. People with lower levels of education tend to have less stable work with poorer pay. C The correct answer is "All of the above." Socioeconomic status is a reflection of three factors: income, occupation and education. As education increases, so does job stability and income. People with lower levels of education tend to have less stable work with poorer pay. D This is the correct answer. Socioeconomic status is a reflection of three factors: income, occupation and education. As education increases, so does job stability and income. People with lower levels of education tend to have less stable work with poorer pay.

A nurse is performing a community assessment of an inner city neighborhood. The nurse is looking for physical risk factors in the community to determine if they might be contributing to the high level of violence and drug abuse in the neighborhood. Which of the following factors should be evaluated? A. Youth activity B. Dwelling types C. Physical layout of the community D. All of the above

ANS: D Feedback A The correct answer is all of the above. A recent study developed a tool that looks at the physical characteristics of a community to determine the risk of violence and drug and alcohol addiction. The characteristics that the tool looks at include layout of the community, housing types and the other buildings or structures within the community, adult and youth daily activities, and the physical and social order and disorder within the community. B The correct answer is all of the above. A recent study developed a tool that looks at the physical characteristics of a community to determine the risk of violence and drug and alcohol addiction. The characteristics that the tool looks at include layout of the community, housing types and the other buildings or structures within the community, adult and youth daily activities, and the physical and social order and disorder within the community. C The correct answer is all of the above. A recent study developed a tool that looks at the physical characteristics of a community to determine the risk of violence and drug and alcohol addiction. The characteristics that the tool looks at include layout of the community, housing types and the other buildings or structures within the community, adult and youth daily activities, and the physical and social order and disorder within the community. D The correct answer is all of the above. A recent study developed a tool that looks at the physical characteristics of a community to determine the risk of violence and drug and alcohol addiction. The characteristics that the tool looks at include layout of the community, housing types and the other buildings or structures within the community, adult and youth daily activities, and the physical and social order and disorder within the community.

A nurse is working at a hospital in Hawaii. A neighboring island has been evacuated due to a volcanic eruption. The hospital has been put on alert that they will be receiving injured people from the evacuated island. What types of injuries or illnesses should the nurse and other staff be prepared for? A. Burns B. Respiratory disease C. Severe lacerations or other traumatic injuries D. All of the above

ANS: D Feedback A The correct answer is all of the above. People can experience burns or injuries from lateral blasts, or sideways-directed volcanic explosions. Respiratory illnesses due to inhalation of ash and other toxic gases or irritants are also common. B The correct answer is all of the above. People can experience burns or injuries from lateral blasts, or sideways-directed volcanic explosions. Respiratory illnesses due to inhalation of ash and other toxic gases or irritants are also common. C The correct answer is all of the above. People can experience burns or injuries from lateral blasts, or sideways-directed volcanic explosions. Respiratory illnesses due to inhalation of ash and other toxic gases or irritants are also common. D The correct answer is all of the above. People can experience burns or injuries from lateral blasts, or sideways-directed volcanic explosions. Respiratory illnesses due to inhalation of ash and other toxic gases or irritants are also common.

A nurse is working with a group of refugees who recently arrived in the United States after suffering terrible violence in their country. The nurse knows that they should be assessed for: A. Communicable diseases B. Injuries related to torture or sexual assault C. Mental illness such as PTSD D. All of the above

ANS: D Feedback A The correct answer is all of the above. Refugees arriving in the United States have likely faced violence or rape in their refugee camps or on the journey to this country. There is also a significantly increased risk of contracting infectious diseases or developing mental illness secondary to the trauma they survived. B The correct answer is all of the above. Refugees arriving in the United States have likely faced violence or rape in their refugee camps or on the journey to this country. There is also a significantly increased risk of contracting infectious diseases or developing mental illness secondary to the trauma they survived. C The correct answer is all of the above. Refugees arriving in the United States have likely faced violence or rape in their refugee camps or on the journey to this country. There is also a significantly increased risk of contracting infectious diseases or developing mental illness secondary to the trauma they survived. D This is correct. Refugees arriving in the United States have likely faced violence or rape in their refugee camps or on the journey to this country. There is also a significantly increased risk of contracting infectious diseases or developing mental illness secondary to the trauma they survived.

A nurse has seen an increase in infant injuries during motor vehicle accidents due to poor car seat installation. The nurse wants to consider upstream policies at the population level to address this issue but doesn't have the time to take on the project. How should the nurse proceed? A. Reconsider the project at a different time when the workload at his or her primary job lightens. B. Delegate some of the project tasks to an unlicensed assistive personnel (UAP). C. Quit the job to dedicate all of his or her time to the project. D. Consider a collaborative relationship with the public health department and fire and police departments.

ANS: D Feedback A This is incorrect. This is an important community issue that needs to be addressed, especially if children are being injured at an increasing rate. The nurse should consider a collaborative relationship with the public health department and fire and police departments. B This is incorrect. These are not appropriate tasks to delegate to a UAP, especially tasks related to assessment. The nurse should consider a collaborative relationship with the public health department and fire and police departments. C This is incorrect. It is not appropriate to quit a job to work on this project. The nurse should consider a collaborative relationship with the public health department and fire and police departments. D This is correct. The nurse should consider a collaborative relationship with the public health department and fire and police departments. This still addresses the needs of the community, but also helps distribute the workload and responsibilities among different departments.

A nurse is caring for a young woman in a same sex relationship. The woman frequently presents to the ER with vague injuries and the nurse is beginning to suspect that the woman is being physically abused by her partner. How should the nurse proceed? A. Inform the physician. B. Give her a pamphlet about escaping domestic violence. C. Notify the police. D. Refer her to a social worker and engage her in discussion about creating a safety plan.

ANS: D Feedback A This is incorrect. While the physician should be aware of what is going on with the patient, the nurse can make the referral to the social worker independently. The nurse can also start the conversation about available resources and creating a safety plan. B This is incorrect. It may be dangerous for the woman to bring home written information about escaping domestic violence, especially if her partner finds it. The nurse can make the referral to the social worker independently and can also start the conversation about available resources and creating a safety plan. C This is incorrect. If the woman isn't ready to press charges against her partner, it is more important to make the referral to the social worker. The nurse can also start the conversation about available resources and creating a safety plan. D This is correct. The nurse can make the referral to the social worker independently. The nurse can also start the conversation about available resources and creating a safety plan.