Community Health Exam One Review

________ are the fastest growing healthcare expenditure in the United States.

Prescription medications

_____________ is the measure of the number of people in a given population who have an existing condition at a given point in time for example if a nurse is concerned there has been an increase in the number of influenza cases in the county over the past year when compared with last year.

Prevalence rate

_________ is defined by the Institute of Medicine as the degree to which health services for individuals and populations increase the likelihood of desired outcomes and are consistent with current knowledge

Quality of care

As a nursing student, close to graduation, you are exploring the various options for employment. Which option should you prioritize if becoming involved with a bilateral agency?

USAID

The _____________ defines health as "a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity."

World Health Organization

______________________ may progress from low to high levels and include the following: high fertility and high mortality, resulting in slow population growth; improvement in hygiene and nutrition, leading to a decreased burden of infectious disease; declines in mortality and, later, declines in fertility.

Demographic transitions

Creating social and physical environments that promote good health for all is a goal from the _________________ that public health nurses would utilize to lead a discussion at the local library centering on improving health in the local community.

Healthy People 2020

____________ is utilized when the nurse wishes to measure the number of cases of staph infections that occur in a hospital over the course of 1 year per total client days during that year.

Incidence density

____________ is the measure of the probability that people without a certain condition will develop that condition over a period of time.

Incidence rate

. It is predicted that in the near future the number of community health nurses will:

Increase substantially

case manager for a 10-year-old female who is obese and prediabetic. To help the client develop a diet that will promote weight loss and control of his glucose level, the case manager decides to consult with a dietitian, who provides several current journal articles that present findings on various diets

Interdisciplinary collaboration

___A___ is the process of selecting the policy that will be implemented. ___B___ is the stage in which various policy options are identified and explored. __C__ is the stage in which the selected policy is carried out by using human and financial resources. __D__ is the stage in which the implemented policy is evaluated in terms of its compliance with statuary requirements and effectiveness.

A Policy Adaptation B Policy formulation C Policy implementation D Policy assessment

41) The nurse works with 68 year old client who is having great difficulty managing his blood glucose level. The nurse finds that the client is not following the diet that he had agreed to follow and is eating portions that are far too large. He apologizes and explains that he is grieving the loss of his wife, who died 2 weeks ago. The nurse shares condolences with him on his loss and explains that it is perfectly understandable to have trouble following a new diet while grieving. In this scenario, the nurse is utilizing which principal approach in motivational interviewing? A) expressing empathy b) supporting self-efficacy c) rolling with resistance

A) expressing empathy

_______________ is the statistical procedure that removes the effects of differences in the composition of a population, such as age, when comparing one with another.

Adjusted rate

9) A nurse is preparing a poster for a health fair depicting the cost of healthcare around the world. Which country should the nurse prioritize as the one who spends the most? a. Canada b. England c. Japan d. United States

d. United States

12) The nurse has just finished providing teaching and care to a child with type 1 diabetes. Which indicators of quality care should be apparent after this teaching? a. safely self-injected insulin in the office b. has maintained an appropriate blood glucose level consistently for 6 months c. received care that was identical to that provided to 6 other clients of various racial backgrounds and received instructions directly from the nurse in the office d. all of the above

d. all of the above

2) A nurse performs a variety of tasks as part of the nurse's position at a hospital. Which task best exemplifies public health? a. reading current nursing journal and integrating the latest research into daily practice b. instructing a client on how to best care for a suture site at home c. participating a videoconference call with a client who lives in a remote area d. facilitating a community-wide smoking cessation program

d. facilitating a community-wide smoking cessation program

Public health nursing is distinguished from other specialties by adherence to _________________. It is important to know the principle how a public health nurse will prioritize when providing care.

eight principles

. The shorter length of stay in acute care (not long-term care) facilities, as well as the increase in ambulatory surgery and outpatient clinics....

has resulted in more acute and chronically ill people residing in the community who need professional nursing care.

Missed 24

missed

Missed 27

missed

Missed 28

missed

Missed 29

missed

Missed 31

missed

Missed 42

missed

. A ____________ is one that receives funding from both governmental and nongovernmental sources.

multilateral agency

In the intervention of ______________, the nurse locates populations at risk, provides information, identifies possible actions, and identifies access to services, which is what the nurse is doing in this situation.

outreach

___________ holds that health involves a fit between people and social roles

role performance model

. The American Nurses Association (ANA)

sets the scope and standards for all professional practice

. A 34-year-old client is recovering from a below-the-knee amputation secondary to a motor vehicle accident. The nurse meets with the client to update the care plan, and client states that he knows that he will walk again. He asks for physical therapy schedules and timelines for prosthetics on the basis of the healing process. Which attitude will the nurse determine the client is exhibiting by his behavior when considering the theory of reasoned action?

states that a person's given behavior is primarily determined by his or her intention to perform that behavior

The United States and its system of healthcare have historically given and continue to give ___________________ and _____________.

stronger support to individuals rather than community care and cure rather than prevention.

The ______________ de-emphasizes the agent as the sole cause of disease while emphasizing the interplay of physical, biologic, and social environments.

wheel of causation

22) In researching cases of West Nile virus in the community, the nurse explores how the interactions among people infected with this virus, mosquitoes, and the environment they shared contribute to outbreaks of the disease. Which epidemiologic model is the nurse prioritizing in this case? a) Epidemiologic triad b) Wheel of causation c) Web of causation d) Natural history

a) Epidemiologic triad

38) The nurse discusses home care options with an 85 year old client who recently fractured her humerus in a fall in her house. The client is recovering well now but says the experience has made her see that it is time for her to changer her living arrangements. The client can still bathe herself and cook meals on occasion but says she would like to live where nursing care is available onsite and where communal dining and recreation options are offered. Which living arrangements should the nurse point out will best fit the situation? a) assisted living facility b) independent living in their own home c) nursing home d) apartment located near a hospital

a) assisted living facility

32) ....nurse basing this decision on? a) subjective data

a) subjective data

3) During the Civil War, a nurse made history by distributing supplies to wounded soldiers and caring for the casualties with the help of a team of nurses. Which individual accomplished this and, in the process, changed the course of nursing practice a. clara barton b. Dorothea dix c. Lemuel shattuk d. Lillian wald

a. clara barton

15) Absenteeism due to illness has increased recently in the local middle school. The increase is noted to be related to exacerbation of asthma symptoms in the student population. Which would be the most effective approach in decreasing absenteeism among this population? a. develop an asthma education and surveillance program that addresses student, families and faculty members b. develop a policy to exclude students with a diagnosis of asthma from admission to the school c. create an asthma prevention plan within the school environment based in the school nurses office d. create an education program for faculty related to the prevention of exacerbation of asthma systems

a. develop an asthma education and surveillance program that addresses student, families and faculty members

11) A family member receives Medicaid. Which factor would the nurse predict will most likely limit access of the person to healthcare? a. inability to find a provider who accepts Medicaid b. pre-existing conditions c. lack of insurance

a. inability to find a provider who accepts Medicaid

16) The local clinic is dedicated to the well adult and child. It has evening hours and offers varied programs for the community. The programs include immunizations and class on fire safety, health education and car safety, to name a few. How would the nurse best explain the level of prevention used in this setting in your colleagues? a. primary b. secondary c. tertiary d. quaternary

a. primary

7) A nurse is coordinating an initiative in the community to make sure that the healthcare needs of the local refugee and asylees are recognized and addressed. Which federal agency should this nurse prioritize contacting? a. united states department of health and human services b. national institutes of health c. agency for healthcare research and quality d. centers for disease control and prevention

a. united states department of health and human services

19) A woman arrives at the clinic for a routine appointment. She has been HIV positive for 3 years and states she is doing well. She currently is involved in a relationship with a man who is HIV positive. She states that she is not consistent with safe sex practices due to her significant other's preferences and feels uncomfortable asking him to wear a condom. Which is the nurse's best response to promote the client's health? a) "You won't become pregnant as long as you are taking your drug cocktail." b) "You will not be protected against other strains of HIV or sexually transmitted infections (STIs)." c) "You will both be safe because you both already have HIV." d) "Let's have you both tested for STIs."

b) "You will not be protected against other strains of HIV or sexually transmitted infections (STIs)."

40) The home care agency has just received a client referral from a healthcare provider and assigned the case. How soon should the client expect to be contacted by the nurse for the initial visit? a) 12 hours b) 24 hours c) 36 hours d) 48 hours

b) 24 hours

17) An immigrant from Guatemala, age 47, is admitted to the coronary care unit with congestive heart failure. This is the fourth admission for this client, and the healthcare provider believes that the client's inability to adhere to his diet and medication regimen is the reason for his frequent admissions. The healthcare provider refers the client to the local community health nurse, on discharge from the hospital. Which would be most appropriate for the nurse to include in this client's plan of care? a) Insisting that the client adhere to his diet b) Developing culturally relevant and gender-sensitive interventions c) Teaching the family to adapt their cultural dietary plans to the client's diagnosis d) Assessing the client's financial needs and obtaining financial assistance as needed

b) Developing culturally relevant and gender-sensitive interventions

30) The nurse has been asked to join the team which will be conducting a community assessment. How will becoming involved with this group potentially affect the future of the community? a) Identify the need for a community commission b) Identify a method to improve the health of at-risk clients c) provide a means of grant funding for clinics

b) Identify a method to improve the health of at-risk clients

34) There are 12 students with confirmed cases of H1N1 flu in grades 6 to 8at the local middle school in the community. The community nurse advises the caregivers of the ill children to keep the children home for a minimum of 5 to 7 days. Which should be the nurse's next step? a) recommend closing the school for 6 weeks b) Implement education in the school setting regarding respiratory and hand hygiene c) require each child in the school to undergo a physical evaluation by the school nurse d) initiate a system of discipline in the school setting for improper hang washing

b) Implement education in the school setting regarding respiratory and hand hygiene

44) The nurse desires to become more involved with an organization that has not been created by the government. Which factor will set these types of organizations apart from other types? a) based in only one country but provides services to many other countries b) acquires resources to help others from private rather than public sources c) collected data related to healthcare use across a variety of professional and service parameters d) uses endowed funds or private fundraising to address the needs of individuals

b) acquires resources to help others from private rather than public sources

37) The nurse is approached by the health department to investigate and assess the rise in developmental disabilities in an isolated section in the community. To begin the assessment, the nurse should gather objective data from which source? a) client interview - aggregate data b) internet- aggregate evidence base data c) internet- Wikipedia d) direction observation of the area

b) internet- aggregate evidence base data

4) A high school graduate has decided to pursue career in public health nurse. Which represents the minimum educational credential that this student will need to obtain entry into public health nursing practice? a. associates b. baccalaureate c. masters d. doctorate

b. baccalaureate

14) the community health nurse in a low-income country is working to decrease the incidence of diarrheal illnesses. Which intervention would most likely best produce the best results? a. providing fuel alternatives to burning wood b. providing sanitized drinking water c. education regarding contraception use d. distribution of and education on the daily use of insecticide-treated bed nets

b. providing sanitized drinking water

5) Demographic characteristics indicate that people in developed countries are living longer, healthier lives, yet tremendous health and social disparities exist. Which factor best represents these social determinants of health? a. what society does collectively to ensure the conditions exists in which people can be healthy b. social conditions in which people live and work c. context of preventing disease and disability and promoting and protecting the health of the entire community d. comprehensive management of health information

b. social conditions in which people live and work

25) An exhibit displaying the history of epidemiology highlights the various individuals who are credited with the evolution of the epidemiologic field of study. Whose portrait will be highlighted for using statistics to improve public health in England? a) William Farr b) John Graunt c) Florence Nightingale d) John Snow

c) Florence Nightingale

20) A 43-year-old African-American client is HIV positive. She has a personal history of abuse, which ended when her husband died 2 years ago. When counseling the client about adherence to her treatment plan, the nurse finds her intelligent and goal oriented. In addition to her need for education and follow-up regarding her HIV diagnosis and treatment, which associated condition should the nurse most consider when caring for this client? a) Cardiac tamponade b) Chronic obstructive pulmonary disease c) Posttraumatic stress disorder d) Cirrhosis of the liver

c) Posttraumatic stress disorder

21) The early attempts to investigate illness and disease focused on the study of the experiences of individual people. Using this concept, which definition should be prioritized to explain epidemiology? a) An outbreak that occurs when there is an increased incidence of a disease beyond that which is normally found in the population b) Model based on the belief that health status is determined by the interaction of the characteristics of the host, agent, and environment c) Study of the distribution and determinants of states of health and illness in human populations d) Epidemiologic model that strongly emphasizes the concept of multiple causation while de-emphasizing the role of agents in explaining illness

c) Study of the distribution and determinants of states of health and illness in human populations

23) The nurse explores all of the possible factors that contribute to coronary artery disease in the community as links in multiple interrelated chains. Which epidemiologic models is the nurse utilizing in this case? a) Epidemiologic triad b) Wheel of causation c) Web of causation d) Natural history

c) Web of causation

8) A nurse works predominantly with clients who are active military personnel. Which program will these individuals most likely be receiving health benefits through? a. Medicare b. Medicaid c. TRICARE d. CHIP

c. TRICARE

13) The nurse is trying to analyze the various factors within the community. Which risk factor should the nurse point out that is associated with overall health? a. allergy b. traumatic injury c. air pollution d. down syndrome

c. air pollution

18) The nurse conducts a class on the basics of nutrition to a group of obese adults. The nurse counsels the audience, telling them that they need to change their behaviors. By the end of the class the nurse has lost the audience. Which action should the nurse prioritize to enhance audience participation and learning in the next class? a. use consistent methods of persuasion b. offer advice while the participants are passive c. encourage the group to participate in the decision making d. encourage the group to continue ambivalent behaviors

c. encourage the group to participate in the decision making

6) Public Health nursing is distinguished from other specialties by adherence to eight principles. Which principle will a public health nurse priorities in the community? a. focuses policies on the individual's healthcare b. ensures the community has an independent agency to provide care c. focuses efforts on primary prevention of illness in the community d. presents the client with a nursing care plan to follow after completing an assessmen

c. focuses efforts on primary prevention of illness in the community

A nurse successfully persuades an obese client to perform a weekly weigh-in at home using a digital scale and record the weight in a log. Which strategy is the nurse implementing in this case? a. telehealth b. health information c. personal responsibility for health d. evidence based nursing

c. personal responsibility for health

10) The nurse meets with a group of fellow nurses. They discuss the number of children who have died in hot cars and how likely they are to gain support from their state legislators to address the problem. Which step of the policy making process are these nurses prioritizing at this time? a. formulation b. adoption c. setting an agenda d. assessment

c. setting an agenda

Nurse's coordinating a plan to bring vaccinations in a cost-effective way to a rural community that currently lacks access to them uses a ...

case management intervention.

As nurses the best way of providing a client to practice client-centered care in a hospital would be having a client

complete a self-reported functional status indicator and then reviewing it with the client.

36) ...Care is needed for those who are ill, recovering, or in hospice. Which action should the nurse prioritize to provide the most holistic and effective care to the community? a) refer the clients to an outreach center b) consult with the hospice nurse and social worker c) provide care according to the healthcare provider's care d) Collaborate with other healthcare workers and the clients

d) Collaborate with other healthcare workers and the clients

43) A group of public health nurses are meeting to develop some goals for their community with the main goal of improving the health of their community. Which goal should their group prioritize to achieve this outcome? a) to restore the ability of an 80 year old to perform activities of daily living after a stroke b) to lobby for legislation that ensures the accessibility to health insurance on the basis of one's health c) to develop treatments to address symptoms related to chemotherapy d) to establish a free exercise program at a community center to promote fitness in a low-income neighborhood with high obesity rates.

d) to establish a free exercise program at a community center to promote fitness in a low-income neighborhood with high obesity rates.

The case manager works with a 10-year-old girl who has asthma. Because the client's family has trouble affording inhalers, the case manager researches client assistance programs through which they could receive free medications and the case manager through his/her actions is portraying __________.

Advocacy

_____________ is the ratio of the incidence rate in the exposed group to the incidence rate in the non exposed group

Relative risk ratio

The agency known for having nurses visit their patients on horseback is:

The Frontier Nursing Service

The nurse conducts a community assessment. The community is large and the members range from affluent executives to poor migrant workers. Which approach will provide the most accurate assessment for this nurse?

Triangulation

An example of a primary prevention intervention for a community is:

Water fluoride supplementation for children

26) A public health nurse is curious if there has been an increase in the need for hospitalization among reported influenza cases. Which factor should the nurse prioritize for researching to answer this query? a) Rate b) Ratio c) Relative Risk ratio d) Sensitivity

a) Rate

39) The nurse takes care of a dependent family member whose husband is in the military. Which government funding is most likely going to be used for home healthcare services for this client? a) Medicare b) Medicaid c) TRICARE d) Dominican college health center

c) TRICARE

35) The new community health nurse introduces herself to the local minister and attends various neighborhood meetings and a windshield survey. The nurse learns about the ethics, values, and culture of the neighborhood. The community is vocal about the need for public safety and the care of the homeless, especially in the winter. Which is the best rationale for considering all of the influences in the neighborhood affecting their health and well-being? a) the information can be used to obtain funds to create shelters for the homeless b) a neighborhood watch may be created with police support c) The information will help to effectively assess the community d) it will help the nurse create a controlled clinical environment

c) The information will help to effectively assess the community

The most effective way to conduct an initial assessment of a community that you wish to evaluate for the development of a community based nursing care plan is:

Complete a windshield survey

While completing a community assessment, the nurse notes that the computer companies in the community hire a disproportionate number of their employees from local suburban communities rather than the community in which the company is housed. Which individuals should the nurse choose to create an accurate community assessment?

, the nurse should collect data on all of the company's employees and include those living outside the community as part of the aggregate.

_________ is the process of influencing the allocation of scarce resources, including financial resources, human resources, and time.

. Politics

Healthcare provider visits can take ....

15 to 30 minutes.

33) The community health nurse is responsible for the general health of the community on multiple levels. The nurse discovers an increase in the number of sick days used by children aged 7 to 11 years at the local elementary school in recent weeks. Research indicates that the families of asthmatic children tend to be less educated and less likely to comply with current treatment plants. Which step should the nurse employ to continue following the care plan using an epidemiologic approach?

Ans: Develop school based education programs for both the children and their caregivers

The two broad goals of Healthy People 2010/2020 focus on:

Eliminating health disparities and increasing quality years of healthy life

A group of public health nurses are meeting to develop some goals for their community with the main goal of improving the health of their community. Which goal should this group prioritize to achieve this outcome?

The goal of public healthcare is to keep populations healthy through a larger "reach" than connection at the individual level