Community Final Exam Evolve

The nurse is assisting Sargeant Earl in applying for VA benefits. Which statement made by Sargeant Earl indicates he understands VA benefits? a. "This is a wonderful health insurance program that will cover all of my health care needs." b. "I can see any provider I wish under the VA health insurance plan." c. "I still need to carry private insurance to assist with the most expensive treatments." d. "My primary care copay is $15 a visit and outpatient specialist copays are $50 per visit."

d. "My primary care copay is $15 a visit and outpatient specialist copays are $50 per visit."

Which does not accurately describe home health nursing as "officially" defined by the U.S. Department of Health and Human Services (USDHHS)? a. Home health care is a system of comprehensive health care for people in their homes. b. Home health care is provided to homebound or disabled people in any residence or medical facility. c. Home health care has as its purpose to promote, maintain, or restore a client's health. d. Home health care requires a coordinated plan of care provided by professional health care providers.

b. Home health care is provided to homebound or disabled people in any residence or medical facility.

Which activity implemented by an occupational health nurse would be considered primary prevention? a. Annual blood pressure, cholesterol, and diabetes screenings b. Negotiation with an employer for an onsite fitness program for all employees c. Scheduling a mobile mammography van to see employees older than age 40 and their wives d. Overseeing a weight loss competition among workers who are considered to be morbidly obese

b. Negotiation with an employer for an onsite fitness program for all employees

Legislation passed in 1970 that requires employers to provide a place of employment free from recognized hazards to the employees is correctly referred to as the a. Americans with Disabilities Act. b. Occupational Safety and Health Act. c. Workers' Compensation Act. d. Occupational Health and Safety Administration.

b. Occupational Safety and Health Act.

A veteran was awarded VA disability compensation for a medical condition he contracted in 1965 while serving in Vietnam. Which condition did this veteran most likely have? a. Cardiac dysrhythmia b. Parkinson disease c. Diabetes type 1 d. Irritable bowel syndrome

b. Parkinson disease

Agricultural workers are at high risk for occupational injuries and illnesses. To reduce the most common cause of fatalities among youth on farms, which is the most important strategy for the community nurse to implement? a. Planning a community media campaign advocating the use of helmets b. Partnering with the county extension agent to offer tractor safety classes c. Working with local health care providers to encourage use of personal protective equipment, such as hearing and respiratory protection d. Offering a class for local health care providers addressing the signs and symptoms of pesticide toxicity

b. Partnering with the county extension agent to offer tractor safety classes

According to the American Nurses Association's (ANA) Scope and Standards of Home Health Nursing Practice, basic preparation for the generalist home health nurse is a. an associate degree in nursing. b. a baccalaureate degree in nursing (BSN). c. a diploma in nursing. d. a master of science degree in nursing.

b. a baccalaureate degree in nursing (BSN).

The primary purpose of hospice care is to a. provide anticipatory grief support to the patient and family. b. improve the quality of life for the terminally ill patients. c. decrease the cost of traditional home health services. d. coordinate the services reimbursed by Medicare for terminally ill patients.

b. improve the quality of life for the terminally ill patients.

A school nurse knows that under the Family Educational Rights and Privacy Act, a student's health record can be released a. if the student is not a minor. b. in an emergency. c. to educators not involved in the student's education. d. without the student's or guardian's permission.

b. in an emergency.

Joanne, a 37-year-old incarcerated woman, is reluctant to seek medical attention for a routine Pap smear. The correctional nurse knows a. this is usual; women do not seek health services as much as men in this setting. b. other factors may be influencing Joanne's hesitancy in seeking medical attention. c. Joanne is delaying the visit because she probably has a sexually transmitted disease or HIV. d. because she is not sexually active, Joanne is not in need of a Pap smear at this time.

b. other factors may be influencing Joanne's hesitancy in seeking medical attention.

Occupational health nursing is best described as a specialty practice that focuses on a. providing comprehensive health care service to workers and their families. b. promoting, preventing, and restoring health within the context of a safe and healthy environment. c. preventing adverse effects from occupational and environmental hazards at the workplace. d. planning, implementing, and evaluating safety programs for workers at the workplace.

b. promoting, preventing, and restoring health within the context of a safe and healthy environment.

A 6-year-old child fails a routine vision screening on a Snellen chart at a school-based health center. The appropriate action by the nurse is to a. rescreen the child in the following year. b. refer the child to an eye specialist. c. use a Rosenbaum chart instead of a Snellen chart. d. do an internal ophthalmologic examination.

b. refer the child to an eye specialist.

Louisiana Health Care is a multistate home health organization consisting of 60 home health agencies. The company is a public company with stocks available on the open market. This is an example of what type of home health agency? a. Official agency b. Nonprofit agency c. Proprietary agency d. Certified agency

c. Proprietary agency

Which statement differentiating hospice and traditional home health is not true? a. Hospice patients need not be homebound but must be certified as within the last months of life by a physician. b. Hospice services may be provided in the home, hospital, nursing home, or other health care site as appropriate. c. The type of hospice services are limited as in home health care to skilled nursing, social services, physical therapy, occupational therapy, and speech therapy. d. The hospice plan of care includes caring for the caregiver during and after the death of the patient.

c. The type of hospice services are limited as in home health care to skilled nursing, social services, physical therapy, occupational therapy, and speech therapy.

Which is true of adolescents who have been convicted and incarcerated in adult facilities rather than in a juvenile facility? a. They are less likely to be sexually assaulted. b. They are usually not attacked by other inmates. c. They are more likely to commit suicide. d. They are less likely to be diagnosed with a mental illness.

c. They are more likely to commit suicide.

A week before finals, a school nurse assesses a 15-year-old girl complaining of vague symptoms. All symptoms or behaviors should result in an immediate request for parent or guardian conference and referral to a physician for further evaluation except a. problems eating or sleeping. b. problems making decisions. c. frequent requests for a visit to the school nurse. d. inability to concentrate.

c. frequent requests for a visit to the school nurse.

In the CIRCLE Model of Spiritual Care, the L represents a. love. b. language. c. listening. d. life.

c. listening.

A comprehensive school health program should include all except a. health promotion for staff and health education. b. health services and health education. c. physical examinations and comprehensive health history. d. nutrition services and counseling.

c. physical examinations and comprehensive health history

The greatest promise for improving health outcomes for rural residents is a. the increase in health care providers migrating to rural areas. b. the expansion in Medicare services to rural hospitals and clinics. c. the increase in distribution of technology, providing more education and health services. d. the expansion of public transportation, allowing rural residents to travel to tertiary care hospitals for specialty services.

c. the increase in distribution of technology, providing more education and health services.

It is vital that the forensic psychiatric nurse be knowledgeable about mental illnesses and personality disorders because a. the nurse will be diagnosing many of the illnesses. b. the nurse will work in psychiatric facilities. c. the nurse may be an expert witness in court. e. the nurse will be identifying new cases.

c. the nurse may be an expert witness in court.

The home health nurse receives a referral for an evaluation visit for a patient. The nurse notes that the patient's primary diagnosis is end-stage lung cancer and that the patient is currently receiving daily palliative radiation treatments for pain management. This is not an appropriate home health referral because a. the patient is receiving palliative care. b. the patient's needs are too complex. c. the patient is not homebound. d. the patient does not have a skilled need.

c. the patient is not homebound.

Rural residents in the United States compose more than _____% of the nation's poor. a. 50 b. 35 c. 20 d. 18

a. 50

A school nurse evaluates the implementation of health promotion in a high school staff. Which indicates a need for more education? a. A flyer advertising an ice cream and pizza party for the student awards program b. Condoms being provided in all restrooms of the school c. A decrease in missed days at school d. The discontinuation of the availability of soft drinks and candy in vending machines during school instructional hours

a. A flyer advertising an ice cream and pizza party for the student awards program

The home health care nurse is measuring the quality of the home health care patient's outcomes. Which elements are included when measuring structural outcomes? (Select all that apply.) a. Client b. Family c. Health status d. Health team e. Intervention

a. Client b. Family d. Health team

A single white male veteran served two tours in Afghanistan. The veteran has returned home from Afghanistan where he lives alone, begins drinking alcohol daily around 11 am, and watches television from rising until bedtime. This veteran is at high risk for a. suicide. b. cognitive impairment c. chronic pain d. unresolved conflict

a. suicide.

Which occupational health nursing intervention is an appropriate tertiary level strategy? A. Negotiation of workplace accommodation for a worker with a disability B. Work with an employer to build an onsite fitness center C. Providing health-screening programs to detect conditions that could aggravate the disability of worker D. Get automated external defibrillators AEDs for the workplace and train workers on how to use them

A. Negotiation of workplace accommodation for a worker with a disability

Which action of the occupational health nurse is not mandated by state or federal regulations? A. Maintaining confidentiality of medical records B. Reporting accusations of sexual harassment to local police C. Recording and reporting occupational injuries and illnesses d. Providing personal protective equipment training

B. Reporting accusations of sexual harassment to local police

Which occupational health nursing intervention would be appropriate secondary prevention strategies? A. Arrange for the collection of baseline liver function tests if the employee will be working with a chemical known to cause liver toxicity B. Provide vision, blood pressure, hearing, and cancer screenings on an annual basis C. Coordinate periodic evaluations to ensure workers are placed in the safest worksite setting D. All of the above

D. All of the above

Which faith community nurse role includes lobbying for beneficial health policy? a. Health educator b. Health advocate c. Integrator of health and healing d. Coordinator of volunteers

b. Health advocate

Which statement best describes the demographics of rural America? a. Despite the shrinking number of family farms and full-time farmers, agriculture continues to be an important part of the rural and U.S. economy. b. There has been a shift in the economic base of rural America as more communities are dependent on income generated from mining and construction. c. There has been a decline in diversity in rural America, with more Hispanics and youth moving to urban areas rather than rural communities and small towns. d. There are more positive health behaviors (e.g., less smoking, obesity, and drug use) among residents of rural America when compared with urban America.

a. Despite the shrinking number of family farms and full-time farmers, agriculture continues to be an important part of the rural and U.S. economy.

Faith community nurse activities related to end-of-life care include the following: (Select all that apply.) a. Establishing health care surrogates b. Providing home visits to dying congregational members c. Providing emotional support to grieving family members d. Developing grief support groups e. Drawing up and notarizing living wills

a. Establishing health care surrogates b. Providing home visits to dying congregational members c. Providing emotional support to grieving family members d. Developing grief support groups

Which communicable diseases found in prison inmates is of ongoing concern? (Select all that apply.) a. HIV b. Hepatitis c. Tuberculosis d. Bronchitis e. Chlamydia

a. HIV b. Hepatitis c. Tuberculosis

Which statement regarding the impact of managed care on rural public health departments is true? a. Managed care has expanded the safety-net role of many local health departments by funding primary care services. b. Medicaid's importance for rural areas is likely to decrease. c. The role of rural public health departments may increasingly narrow into areas that are currently without any type of reimbursement. d. Medicaid programs will continue to serve the rural communities on a fee-for-service basis.

a. Managed care has expanded the safety-net role of many local health departments by funding primary care services.

A female veteran has just given birth to her first child. Which resource is most appropriate for this veteran at this time? a. PC3 b. VHA c. CHAMPVA d. TRICARE

a. PC3

Which activites are performed by psychiatric forensic nurses? (Select all that apply.) a. Sanity and competency evaluations b. Parole and probation considerations c. Sexual predator screening d. Assessment of prison health clinics e. Evaluation of prison nurses

a. Sanity and competency evaluations b. Parole and probation considerations c. Sexual predator screening

Which criteria is required in order for veterans to receive U.S. Department of Veterans Affairs(VA)benefits? (Select all that apply.) a. Serving in active duty for 24 consecutive months b. Serving for a half period of call in the Reserves c. Committing to the Guard for 12 months d. Being separated under any condition other than dishonorable e. Being deployed overseas for 6 months

a. Serving in active duty for 24 consecutive months d. Being separated under any condition other than dishonorable

A community health nurse is concerned about reducing the fatal injuries to America's rural children. To address this problem, the nurse organizes a community of solution (see Chapter 1). For this group, it would be important to have representatives from all groups or organizations: (Select all that apply.) a. The Department of Public Highway and Safety b. Emergency department staff (both doctors and nurses) from local hospitals c. Teachers and coaches from area schools d. Area employers e. City or county government

a. The Department of Public Highway and Safety b. Emergency department staff (both doctors and nurses) from local hospitals c. Teachers and coaches from area schools e. City or county government

All are challenges currently facing occupational health nursing practice except a. a younger workforce. b. escalating health care cost. c. increased number of women and minorities in the workforce. d. influence of a competitive international marketplace.

a. a younger workforce.

A congregational health nurse is trying to establish a health program that is balanced across all levels of prevention (primary, secondary, and tertiary). An example of a secondary health intervention the nurse might consider would be a. arranging for a mobile mammography unit to come to the church to provide low-cost mammograms. b. organizing a support group for widows and widowers. c. providing vaccinations against influenza to interested parishioners. d. setting up a system that would facilitate referrals to community providers for primary care.

a. arranging for a mobile mammography unit to come to the church to provide low-cost mammograms.

The number one health concern identified by the majority of rural health care leaders is a. lack of health insurance. b. limited access to health care. c. increase in communicable diseases. d. social isolation of rural dwellers.

a. lack of health insurance.

A goal set by Healthy People 2020 includes education to middle, junior, and senior high school students in priority areas. These areas include (Select all that apply.) a. lack of physical activity. b. poor nutrition. c. alcohol and drug use. d. poor organizational skills. e. injury and violence.

a. lack of physical activity. b. poor nutrition. c. alcohol and drug use. e. injury and violence.

A veteran has a traumatic brain injury (TBI), hearing impairment, and an amputated arm. The nurse knows that this patient is suffering from a. polytrauma. b. posttraumatic stress disorder. c. military sexual trauma. d. substance use disorder.

a. polytrauma.

An essential strategy to deal with the complexities of the workplace and workforce is for the occupational health nurse to a. recognize the need to work as a part of an interdisciplinary team. b. seek legal counsel to stay informed of the legislative mandates influencing the workforce. c. engage in political action in order to have input into the revision of the Healthy People 2020 document. d. participate in program planning to develop a model to ensure advanced education for all workers.

a. recognize the need to work as a part of an interdisciplinary team.

A priority health education topic for school-age children is a. schoolyard safety. b. motor vehicle safety. c. sports safety. d. immunization schedules.

a. schoolyard safety.

There was an increase in the number and voice of occupational health nurses during the years of 1938 to 1943. All occurrences explain the rationale for this change except a. the U.S. Department of Health and Human Services mandated occupational health nurses be hired for industrial settings that employed more than 350 people. b. a national association for the specialty of occupational health nursing was created. c. more women entered the workforce, changing the demographics of the workplace. d. the government demanded health services for defense contract workers.

a. the U.S. Department of Health and Human Services mandated occupational health nurses be hired for industrial settings that employed more than 350 people.

A 16-year-old young woman arrives at the local emergency department (ED) early Sunday morning and states, "I was on a date last night, and the last thing I remember was eating dinner with my boyfriend." She comments that she woke up in her bed with her clothes "messed up" and states, "I just don't feel right down there" as she points to her genital area. She appears medically stable. Which health care provider would be most appropriate to conduct the physical examination? a. An experienced obstetrical nurse because the patient could be pregnant b. A SANE (sexual assault nurse examiner) c. The physician on call in the ED department d. An emergency nurse

b. A SANE (sexual assault nurse examiner)

Which intervention is an example of primary prevention in parish nurse practice? a. Identifying individuals and families at risk b. Assessment and teaching about parenting c. Providing education programs d. Providing resources for rehabilitation

b. Assessment and teaching about parenting

Important historical events leading to the development of occupational health nursing as a specialty practice include: (Select all that apply.) a. Lillian Wald, the first public health nurse, established the Visiting Nurse Service of New York. b. Betty Moulder was employed by a group of companies to care for coal miners and their families. c. Ada Mayo Stewart was hired by the Vermont Marble Company to care for the company's workers. d. A nursing service was established for employees of the Frederick Loeser department store in Brooklyn, New York. e. Anna B. Duncan was employed by the John Wanamaker Company to visit sick employees at home.

b. Betty Moulder was employed by a group of companies to care for coal miners and their families. c. Ada Mayo Stewart was hired by the Vermont Marble Company to care for the company's workers. d. A nursing service was established for employees of the Frederick Loeser department store in Brooklyn, New York. e. Anna B. Duncan was employed by the John Wanamaker Company to visit sick employees at home.

Based on the common illnesses and risky health behaviors among farmers, the community health nurse should implement which health promotion activity? a. Partner with the local health department to offer smoking cessation classes for farmers and their spouses. b. Collaborate with health care providers and provide support and education for farmers with respiratory conditions and their families. c. Collaborate with health care providers to conduct skin assessments at a meeting of local farmers. d. Work with mental health consultations to outline a community-based program to address the high rate of suicide and depression among farmers. e. Plan, implement, and evaluate an outreach program designed to improve the cardiovascular status of farmers and their families.

b. Collaborate with health care providers and provide support and education for farmers with respiratory conditions and their families.

Migrant and seasonal farm workers constitute a high-risk population because of their low income and migratory status. These workers lack adequate access to preventive services. The most important role of the rural community health nurse in meeting the health care needs of this vulnerable population is to a. address the multiple communicable diseases of these farm workers. b. serve as an advocate working to gain health care access for these farm workers. c. participate in political activities with an emphasis on changing immigration laws. d. learn to speak Spanish to improve communication with this specific population.

b. serve as an advocate working to gain health care access for these farm workers.

In the role of personal health counselor, the faith community nurse would a. explain how to take a prescribed medication. b. teach signs and symptoms of hypertension and stroke to the congregation. c. train volunteers to work with the parish nurse program. d. arrange for health screenings through the local health department.

b. teach signs and symptoms of hypertension and stroke to the congregation.

Posttraumatic stress disorder (PTSD) can develop due to (Select all that apply.) a. having recurring nightmares. b. viewing a dead body. c. having a history of mental illness. d. surviving a natural disaster. e. experiencing chronic pain.

b. viewing a dead body. c. having a history of mental illness. d. surviving a natural disaster.

Which statement would indicate that the hospice patient's caregiver understood the nurse's instructions related to pain management? a. "I didn't wake him (the patient) up last night for the 2:00 AM dose because he was sleeping." b. "I gave him (the patient) the ordered medicine whenever he complained of pain." c. "I gave the pain medicine every 3 hours as we planned even when he (the patient) didn't complain of pain." d. "I'm worried he (the patient) will become hooked on the medicine, so I only gave one-half of the dose."

c. "I gave the pain medicine every 3 hours as we planned even when he (the patient) didn't complain of pain."

The home health care industry has changed significantly in the past 20 years. Which is a factor that is responsible for the change in the home health care industry? a. Failure of traditional home health services to change to meet the needs of clients with new needs such as AIDS patients, terminally ill patients, and increasing numbers of elderly b. Advanced technology that resulted in new procedures and equipment not possible for use in the home c. Changes in reimbursement that resulted from the implementation of the prospective payment system (PPS) for home health care, particularly for Medicare patients d. Nurses lack of knowledge regarding cost-containment strategies

c. Changes in reimbursement that resulted from the implementation of the prospective payment system (PPS) for home health care, particularly for Medicare patients

Which nursing intervention is the most appropriate as an initial intervention for a prison inmate? a. Manage a chronic illness through needed education. b. Administer the routine medication ordered. c. Complete the medical history and physical assessment. d. Test for HIV and tuberculosis.

c. Complete the medical history and physical assessment.

While verifying compliance with immunization requirements, a school nurse notices that three students from the same family have not completed their immunizations. How should the nurse address this problem? a. Discuss with the principal the lack of immunizations. b. Expel the children from school. c. Contact the parents and educate them about the immunization requirements. d. Pull the students from class and immunize them.

c. Contact the parents and educate them about the immunization requirements.

Which statement is true concerning home health nursing? a. Home health nursing is a new nursing specialty originating with the inception of Medicare in the 1960s. b. Florence Nightingale is credited with creating the idea of home health nursing. c. Home health nursing has as a purpose to provide nursing care to individuals and clients in their homes. d. Home health nursing has as a purpose to provide nursing care only for the referred individual patient.

c. Home health nursing has as a purpose to provide nursing care to individuals and clients in their homes.

Which statement regarding military sexual trauma (MST) is true? a. MST is more common among male veterans. b. MST is always perpetrated by a stranger. c. MST is associated with diabetes. d. MST is associated with mild PTSD.

c. MST is associated with diabetes.

A 10-year-old boy visits the nurse complaining of a headache and nausea. The nurse recognizes the boy from an earlier conference with a teacher about the boy's declining school performance. The nurse has been concerned because the boy's father and mother are recently divorced, and his mother works nights. An appropriate nursing intervention would be to investigate the boy's eligibility for a. The Nutritional Education and Training Program (NET). b. Youth Risk Behavior Surveillance System. c. Adult and Child Protective Services. d. Federally funded breakfast and lunch program.

d. Federally funded breakfast and lunch program.

Who is considered the founder of the modern parish nurse movement? a. John Wesley b. Florence Nightingale c. Jimmy Carter d. Granger Westberg

d. Granger Westberg

Which action is inappropriate for a correctional nurse when testifying in court? a. Looking the jurors in the eye when answering questions b. Asking the attorney to repeat a question when not understood c. Practicing saying difficult medical terms before the court date d. Interrupting when necessary to verbalize correct medical information

d. Interrupting when necessary to verbalize correct medical information

Veterans with a substance use disorder (SUD) are most likely to suffer from a. TBI b. MST c. VHA d. PTSD

d. PTSD

Which is true regarding elder abuse? a. Elder abuse is rare in the United States among elders active in faith communities. b. The parish nurse is not likely to be the first person to identify signs and symptoms of elder abuse in a congregation. c. Misuse of an elder's money is not considered elder abuse. d. Specific nursing interventions should be used by the parish nurse in cases of elder abuse.

d. Specific nursing interventions should be used by the parish nurse in cases of elder abuse.

A 71-year-old man is brought to the emergency department by his daughter and states that he has fallen and appears to have a broken arm. He is alert and oriented and walks alone without difficulty. Which nursing intervention is most appropriate after he is seen and treated by the physician? a. Talk with the daughter about nursing home placement for the patient. b. Discuss the dietary needs and regimen with patient and family. c. Review the patient's current medications. d. Talk with the patient alone and question the possibility of elder abuse.

d. Talk with the patient alone and question the possibility of elder abuse.

A veteran is a person who has served in the military. Which statement about veterans is correct? a. There are 5 million veterans in the United States today. b. Employees of the National Aeronautics and Space Administration (NASA) are considered veterans. c. People who were honorably discharged from the military are still considered veterans. d. Veterans include those that have served in the active military, naval, or air service.

d. Veterans include those that have served in the active military, naval, or air service.

The faith community nurse must recognize which to be correct concerning church law? a. The doctrine of separation of church and state exempts churches from discrimination laws. b. Ministers are required to disclose confidential information in court. c. Parish nurses are not required to document care given. d. Volunteers in a church are held to the same degree of accountability as paid employees.

d. Volunteers in a church are held to the same degree of accountability as paid employees.

Forensic nursing is best defined as a. a field of legal nursing in which the nurse works with or for lawyers. b. a field of correctional nursing in which the nurse works with inmates. c. investigational nursing in which the nurse works with law enforcement. d. a link among the health care system, the investigative process, and courts of law.

d. a link among the health care system, the investigative process, and courts of law.

When providing care to vulnerable populations, the faith community nurse should a. avoid involving the congregation in order to avoid legal issues. b. deal with the issues alone, if possible. c. refer the person to another resource and avoid getting involved. d. assess the needs and work with the congregation to meet the health-related needs of the vulnerable population.

d. assess the needs and work with the congregation to meet the health-related needs of the vulnerable population.

Healthy People 2020 addresses all goals for children and adolescents except a. physical activity. b. sex education and HIV prevention. c. smoking prevention. d. cardiovascular accidents, stroke, and diabetes.

d. cardiovascular accidents, stroke, and diabetes.

In contrast to people who live in urban areas, rural residents frequently describe their health by their ability to a. avoid hospitalizations. b. maintain social connections. c. perform activities of daily living. d. work and be productive.

d. work and be productive.