Community Health Final

The natural reservoir for plague is/are:

Rodents, such as squirrels and prairie dogs

Which action represents secondary prevention to reduce environmental health risks?

Collecting blood specimens from preschool children to check for lead levels

Which economic prevention strategy by the nurse is considered primary prevention?

Persuading legislators to pass a bill offering health care financial aid to families at risk

Life expectancy increased dramatically during the twentieth century, primarily because of:

Sanitation and other public health activities

The reservoir for smallpox is:

The human skin or respiratory exposure

Following injection of a MMR (measles, mumps and rubella) vaccine, the nurse should make a priority assessment for which possible client manifestation?

Wheezing

A terminally ill client questions the nurse about the difference between a living will and power of attorney. What is the nurse's best response?

"A living will allows you to indicate treatments to be omitted, while durable power or attorney legally appoints another to make those decisions on your behalf."

The nurse who reads the results of a client's tuberculin (TB) test notes that an induration is apparent. The client asks what this means. What is the nurse's best response?

"A positive test means that you have been exposed to the TB organism. It does not mean that you currently have active bacteria. Further testing will be needed."

Which recommendation by the nurse would be aimed toward reducing a family member's health risk?

"Be sure to take a 30 minute walk each day before you leave for work or when you get home."

A nurse who works at the local hospital asks a colleague in the health department what might be causing her hands to become very sore and sensitive. How should the colleague reply?

"Check the material safety data sheet on any chemicals you have used recently."

A nurse is teaching a class about aging at a senior citizen center. The nurse concludes that a client needs further instruction if the client made which statement?

"Deterioration of body systems occurs at the same rate."

As part of the admission process, the nurse is conducting a social assessment of a client. The nurse should ask which question during this part of the assessment?

"Do you have any culturally based practices that you would like continued in the hospital?"

A 4-year old child has been exposed to chickenpox. After providing information about chickenpox, the nurse asks the mother to repeat back the information. Which response by the mother indicates a need for additional information?

"During the prodromal period, my child will have pox all over his body."

A client with tuberculosis asks the nurse if visitors will need to wear masks. What response by the nurse is most accurate?

"Everyone who enters your room must wear a mask to protect themselves from tuberculosis."

The family of a client diagnosed with terminal cancer has been informed the client is not expected to live more than 2 months. Which statement made by a family member indicates to the nurse that the family understands the client's prognosis?

"Hospice nurses are going to help care for him to make him more comfortable."

The nurse is conducting a daily nursing assessment on a client with gambling and alcohol addictions who is in the outpatient addiction program. Which client statement reflects a need for more teaching?

"I am going to have a night out with some friends at an area night club."

A nurse evaluates that a teaching plan related to normal physiologic changes of aging has been effective for a 70-year old client if he makes which statement?

"I have less joint cartilage than I used to."

During a group counseling session for perpetrators of intimate partner violence, which of the following statements made by a client indicates a lack of insight into his violent behavior?

"I love my girlfriend and did not want to hurt her, it was an accident."

The nurse concludes client teaching about infection control measures had been effective when a client with tuberculosis makes which statement?

"I need to wear a special mask when I go to x-ray"

Which statement by the parent indicates a need for increased learning regarding appropriate (non-abusive) discipline of a child?

"I never hit or spank: I yell at them to stop being stupid, and if they don't, I tell them no one is ever going to love them if they act like that."

A staff member is orienting a new nurse to a health clinic that serves primarily vulnerable populations. Which statement indicates a need for additional staff education?

"You will like working with Hispanic immigrants because they have close-knit family structures."

The nurse is teaching a class in the community on common myths regarding fertility and infertility. Which statement made by a class participant indicates teaching has been successful?

"If my husband sits in the ot tub every night, his sperm count will decrease."

A woman has just delivered a baby and is lamenting that the baby's father is not with her. She shares with you that he became involved with drugs and is now in prison for theft. The new mother says, "It's so sad. He's clearly no good." What might be your response?

"Is there anyone to help you with the baby until the baby's father can be released and encouraged to get treatment for his addiction?"

A mother overhears two nurses discussing the incubation period for a measles outbreak. The mother asks the nurses why it is important to know this. The nurses' reply would include which statement about the incubation period?

"It describes a period when the child might be contagious."

After conducting a training seminar to a group of Red Cross volunteers about Vibrio Cholera, the community health nurse determine the group needs further instruction when he hears one of the participants make which statement?

"It's okay to drink the water in countries where Vibrio Cholera is endemic as long as its clear looking."

What statement by a client indicates a lack of understanding regarding an appropriate reason to sue for malpractice?

"My daughter wasn't given a call light, and for a whole shift no one checked on her condition."

A mother brings her 15-month old son to the community health clinic. During the nursing assessment, the mother makes the following comments. Which comment merits further investigation?

"My son is not crawling yet."

A nursing student states, "But why do I have to be involved in politics? I just want to be the very best clinical nurse I can." What is the best response?

"Political action is the way you try to fulfill your ethical responsibilities to clients."

After conducting a community teaching session to a group of poultry farmers about histoplasmosis, the community health nurse knows the teaching has been effective upon hearing which statement?

"Since histoplasmosis is a fungus that lives in the environment, usually in association with large amounts of bird or bat droppings and lung infection can occur after a person inhales airborne, microscopic fungal spores from the environment, to reduce my chances of contracting histoplasmosis I should dampen the flood of my chicken houses before I go in to care for the chickens."

The spouse of a postal worker who contracted cutaneous anthrax asks the visiting nurse whether this communicable disease can be treated. Which response by the nurse is most appropriate?

"Yes, this infection can be treated with antibiotics such as ciprofloxacin or erythromycin."

A family shared their concerns, including sexual issues, in strictest confidence with a faith community nurse. When the nurse returned to the church office, the pastor asked why the family wanted to see her. What should be the nurse's response?

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

The nurse is treating a client who continues to return to a violent relationship saying, "There is nothing I can do." What is the nurses best response?

"You do have some choices, let's sit together and explore them."

A client has just been diagnosed with herpes simplex virus (HSV) type 2. The nurse should share with the client which item of information?

"The initial outbreak of herpes of often the most uncomfortable. Recurrent infections usually present with a tingling and burning sensation prior to outbreak of the vesicle."

A nurse orienting to the home health role states, "I don't understand why we have to collaborate with so many other disciplines. Doesn't this conflict with the concept of nurses engaging in holistic nursing practice?" What would be the best response?

"The nurse still functions holistically; however, interdisciplinary collaboration is necessary to prevent fragmentation of care."

rA nurse invited all the teenagers who were newly diagnosed with diabetes to a group meeting to discuss issues they all had in common. One teenager replied, "I don't know if I want to share all the problems I'm having with strangers." What is the best nurse response?

"The purpos of the group is to have a safe place to share problems with others who may be having similar problems."

Which statement made by a seminar participant indicates that the nurse speaker needs to clarify and possibly repeat information concerning environmental principles?

"The solution to pollution is prosecution."

The community health nurse has completed a comprehensive health assessment of a Hispanic client. Some cultural food practices place the client at risk for cardiovascular disease. Which suggestion by the nurse is appropriate for this client?

"Try to back some foods instead of frying them."

An adult woman is admitted to an isolation unit in the hospital after tuberculosis was detected during a pre-employment physical. Although frightened about her diagnosis, she is anxious to cooperate with the therapeutic regimen. The teaching plan includes information regarding most common means of transmitting the tubercle bacillus from one individual to another. The nurse determines the woman understands the teaching when the woman says the following:

"Tuberculosis is transmitted by infected persons coughing, sneezing and spitting, causing the microscopic particles to get into the air."

A client is crying softly and saying, "What did I do to deserve this punishment, Lord?" What response by the nurse would be appropriate?

"What can I do to be helpful to you right now?"

What question should an environmentally aware nurse ask during a basic health assessment?

"What jobs have you held longest?"

What question reflects a nurse's concern regarding risk reduction?

"Where of you shoot with your handguns?"

A registered nurse (RN) was just employed as a public health nurse. Which question might be very relevant as the nurse begins employment?

"Which groups are at the greatest risk for problems?"

The nurse in community health needs to conduct a family assessment within a commune but is uncertain how to proceed because family lines appear blurred. The best way to determine the family of a mother and her child is to ask the woman which of the following questions?

"Who are the members of you and your child's family?"

A client living in the community and exposed to mycobacterium tuberculosis starts on chemoprophylaxis. The nurse provides which instruction to the client?

"You will take a single drug such as isoniazid (INH) by mouth every day for 6-1 s"

A client living in the community and exposed to Mycobacterium tuberculosis starts on chemoprophylaxis. The nurse provides which instruction to the client?

"You will take a single drug such as isoniazid (INH) by mouth every day for 6-12 months."

A child is exposed to a playmate who contracted chickenpox. Two days later the child is admitted to the hospital for another problem, and the parents inform the nurse of the exposure on admission. How long after the exposure should the child be watched for signs of upper respiratory illness?

10-21 days

The neonatal nurse is providing anticipatory guidance to the mother of a newborn infant. When discussing immunization schedules, the nurse explains that the first dose of inactivated poliovirus vaccine (IPV) is given at which age?

2 months

A public health nurse found that our of the 70 people who ate the potato salad at a school picnic, 63 developed symptoms of food poisoning. What is the attack rate?

90%

A public health nurse found that out of the 70 people who ate the potato salad at the school picnic, 60 developed symptom of food poisoning. What is the attack rate?

90%

Which of the following is the best learning objective for teaching testicular self-examination (TSE)?

90% of the men will correctly demonstrate testicular self-examination

The nurse is providing health teaching to a group of high school students about infectious mononucleosis. When discussing timing of disease transmission, the nurse explains that the incubation period for this infection is up to _____weeks. Provide a numeric answer.

6 weeks

Which of these public health nurse applicants is the least qualified for a position of case manager in a rural county?

A 34-year old who will be moving from a large city

What may be an unexpected side effect of having community members participate as full partners in creating change to improve community health?

A change in the distribution or redistribution of power and influence

A child came to school coughing almost constantly. The next day, six other children in the same school room were coughing. What type odd outbreak is this?

A common source outbreak

Statistics clearly demonstrate that there are significantly more cases of a disease in one particular neighborhood than in all the rest of the city. Assuming all else is the same, what is the most likely explanation for a single neighborhood having such a different pattern of illness?

A cultural of ethnic concentration in the neighborhood

A 40-year-old Bosnian Muslim woman who does not speak English presents to a community health center in obvious pain. She requests a female health care provider. Through physical gestures, the woman indicates that the pain is originating in either the pelvic or genital region. Assuming several people are available to interpret, who would be the most appropriate choice?

A female who does not know the client

The nursing educator, who is offering a course on preparing for motherhood, asks the women taking her class to identify what they wish to learn and to write their own learning objectives. What is this method of gaining commitment called?

A learning contact

A new nurse is overwhelmed with the need of the community; in deciding which problem should have first priority, the nurse should choose:

A particular problem that is of high concern to the community

The nurse would implement which of the following as a requirement of care specific to the client who has tuberculosis?

A private room with negative air flow

A client calls the telephone triage nurse to report fever, nausea, chills. And malaise. The nurse instructs the client to come immediately to the emergency department after the client shares which additional data?

A stiff sore neck

The nurse should implement contact precautions with a client who has which health problem?

A wound infection

4. What statement made by the client indicates to the nurse an understanding of genetic screening? Select all that apply. a. "Counseling will be provided at a follow-up appointment." b. "Medicine will be prescribed for me." c. "I need to keep a diary of my activities during the week of screening." d. "My nutritional intake will be recorded." e. "Blood will be drawn from my spouse and I, as well as our children."

A. "Counseling will be provided at a follow-up appointment." E. Blood will be drawn from my spouse and I, as well as out children."

The nurse is caring for a client with hepatitis A. Which client statements indicate that the teaching conducted by the nurse about disease transmission was effective? Select all that apply. a. "We must avoid eating with the same utensils." b. "We must wear masks." c. "We must avoid kissing." d. "We can use the same bath towels." e. "No special precautions are needed."

A. "We must avoid eating with the same utensils." C. "We must avoid kissing."

Which activities are considered core functions of public health nursing? Select all that apply a. Assessment of the health care services available in a community b. Assurance that agreed-upon goals are provided by service or regulation efforts c. Implementation of nursing care and evaluation of nursing intervention outcomes d. Maintenance of public health departments throughout the United States e. Promoting the use of scientific knowledge in decision making and in developing appropriate public policies f. Systemically collecting, assembling, analyzing, and disseminating information on the health of the community

A. Assessment of the health care services available in a community B.Assurance that agreed-upon goals are provided by service or regulation efforts E. Promoting the use of scientific knowledge in decision making and in developing appropriate public policies F. Systemically collecting, assembling, analyzing, and dissemination information on the health of the community

A Chinese-American client is menstruating, a condition considered to be yin (cold). The community health nurse anticipates that which type of food would be eaten by the client who is striving to promote balance? Select all that apply. a. Beef b. Broccoli c. Fried foods d. Eggs e. Honey

A. Beef C. Fried foods D. Eggs

7. A 4-year-old client is coming to the health care provider's office for a well-child visit. For which routine screenings does the nurse plan? Select all that apply. a. Blood pressure b. Lead screening c. Hearing d. Vision e. Urinalysis

A. Blood pressure C. Hearing D. Vision

A nurse and teacher are discussing legal issues related to the practice of their professions. The teacher asks what the functions are of the Nurse Practice Act (NPA) in that state. The nurse would include which thoughts in a response? Select all that apply. A. Define to scope of nursing practice B. Accredit schools of nursing C. Enforce ethical standards of behavior D. Determine liability insurance rates E. Protect the public

A. Define to scope of nursing practice E. Protect the public

A 2-month old client is seen in the pediatric clinic for a well-baby checkup. The nurse anticipates that which routine immunizations will be administered at this time. Select all that apply a. Inactivated poliovirus vaccine (IPV) b. Measles, mumps, and rubella (MMR) c. Varicella zoster vaccine (Verivax) d. Haemophilus influenza B conjugate vaccine (Hib) e. Diptheria, tetanus and acellular pertussis (DTaP)

A. Inactivated poliovirus vaccine (IPV) D. Haemophilus influenza B conjugate vaccine (Hib) E. Diptheria, tetanus and acellular pertussis (DTaP)

While realizing that all clients are unique, the community health nurse would tend to associate which cultural values with clients of African-American descent? Select all that apply. a. Interdependence b. Extended family c. Seclusion d. Religion e. Long-term goals

A. Interdependence B. Extended family D. Religion

Which of the following are evidence that the U.S. health care system is in crisis? Select all that apply. a. Long work hours and provider fatigue are a major factor in medical errors b. Full-time employees may not have health insurance as a benefit c. The United States spends more on health care than any other country in the world d. Incomplete or negligent nurses are an ongoing source of medical errors e. More punitive measures must be taken to decrease provider errors f. Universities are not making any effort to expand educational programs for health care providers

A. Long work hours and provider fatigue are a major factor in medical errors B. Full-time employees may not have health insurance as a benefit C. The United States spends more on health care than any other country in the world

How did health care and its delivery change during the 1980s? Select all that apply. a. Public health programs suffered reduced political supports, financing, and effectiveness. b. Use of health maintenance organizations was encouraged c. Nurse practitioners were increasingly used to provide care d. Laws began to be passed that discouraged the use of alcohol, drugs, and tobacco e. Funding to public health increased as funding for acute hospital care decreased f. The National Center for Nursing Research (NCNR) was established

A. Public health programs suffered reduced political supports, financing, and effectiveness B. Use of health maintenance organizations was encouraged C. Nurse practitioners were increasingly used to provide care D. Laws began to be passed that discouraged the use of alcohol, drugs, and tobacco F. The National Center for Nursing Research (NCNR) was established

The nurse working with a client who immigrated from Mexico would consider during care which cultural charasterics that are typically associated with Mexican-American culture? Select all that apply. a. Respect authority b. Value independence and autonomy c. Oppose the statue quo d. Value extended family e. Have patriarchal outlook

A. Respect authority D. Value extended family E. Have a patriarchal outlook

Six students order meals at the local mom-and-pop restaurant. Which students are at high risk for illness? Select all that apply a. The fifth student asks for the recipe of the week. Carpaccio (raw beef tenderloin) b. The fourth student orders a breakfast meal with two very soft-poached eggs and toast c. The sixth student orders two tomato-and cheese pizza slices d. The first student asks for a salad with chicken strips and dressing on the side e. The third student orders a tuna salad with extra mayonnaise f. The second asks for a hamburger-very rare

A. The fifth student asks for the recipe of the week. Carpaccio (raw beef tenderloin) B. The fourth student orders a breakfast meal with two very soft-poached eggs and toast F. The second asks for a hamburger-very rare

8. The community health nurse explains to a group at a senior citizen center that older adults may be predisposed to fluid imbalances for which reasons? Select all that apply. a. They may not pay attention to thirst or may experience less thirst. b. They may not drink fluids if it is difficult to the bathroom. c. They tend to dislike the taste of water. d. They eat only canned and prepackaged food e. They may fear too much fluid if they have a tendency for ankles to swell.

A. They may not pay attention to thirst or may experience less thirst B. They may not drink fluids if it is difficult to go to the bathroom E. They may fear too much fluid if they have a tendency for ankles to swell

The community health clinic nurse is conducting screenings. Which client assessment finding indicate the client teaching is needed about the risk for stroke? Select all that apply. a. Weight 205 lbs and height 5 feet 4 inches b. Eats bran for breakfast daily c. Serum cholesterol level is 172 mg/dL d. Blood pressure 164/92 mmHg e. Smokes 1/2 pack cigarettes per day

A. Weight 205 lbs and health 5 feet 4 inches D. Blood pressure 164/92 mmHg E. Smokes 1/2 pack cigarettes per day

The nurse who wishes to establish a program to decrease the death rate in children will have the greatest likelihood of success by targeting which health problem?

Accidents and injuries

For a bedridden Muslim patient, the nurse rearranges the room and moves the bed so that it faces toward Mecca for the patient's daily prayers. This is an example of which of the following?

Accommodation

The emergency department nurse receives a telephone call and is informed that a tornado has hit a local residential area and that numerous casualties have occurred. The victims will be brought to the emergency department. The nurse should take which initial action?

Activate the emergency response plan

The nurse on the agency's quality improvement team has been asked to evaluate nursing care in the nurses assigned area. After deciding to ask the nursing staff for assistance in this effort, what would be most appropriate for the nurse to initially ask the staff to do?

Administer a client and family satisfaction survey

Following the administration of a diphtheria/pertussis/tetanus (DPT) immunization the nurse notes that the infant has inspiratory stridor. The nurse should take which action?

Administer epinephrine as per protocol orders

A group of teenagers with diabetes is arguing over whether to have meetings during summer vacation. Which response, by the nurse, represents an understanding of group dynamics?

Admit that it is difficult for everyone to agree on everything; then ask whether the group can try to decide how to agree on the issue and ask whether group members think there are other issues involved

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

Adolescent suicides

The nurse working in a sexually transmitted infection (STI) clinic of the city health department gives a tour to a group of student nurses. A student notes that the clinic population consists largely of teenagers. The nurse explains that adolescents are a greater risk for contracting STIs because of which factor?

Adolescents are risk-takers and believe they are invincible

A mother brings her infant to the immunization clinic for the final hepatitis B vaccines. After picking up the vial of vaccine to draw up the dose, the nurse notes that it is cloudy. What action should the nurse take?

Agitate the vial gently and draw up the vaccine

A client with suspected severe acute respiratory syndrome (SARS) arrives at the emergency department. Which physician order should the nurse implement first?

Airborne and contact precautions

At a local hospital, postpartum care policy requires that nurses observe the mother during infant care to assess the mother's ability to care for the new baby and to promote bonding. A new immigrant mother expresses concern that in her country, all infant care is provided by other family members so that the mother can rest and recover. Otherwise, it is believed that the mother will be unable to care for the child because she will not have healed sufficiently. What will the culturally competent nurse do?

Allow family members to provide the baby's care and assess the mother's knowledge of child care through discussion.

The community health nurse is leading a support group for adult children of aging parents who have come to live in their home because of deteriorating health. Which principle does the nurse encourage the group members to follow to promote quality of life for all concerned?

Allow independence in those things that are safe or minimal risk of harm

A 16-year old is admitted to the hospital for acute appendicitis and an appendectomy is performed. Which nursing intervention is most appropriate to facilitate normal growth and development post-operatively.

Allow the child to interact with others in his or her same age group

Anthrax is a/an:

An acute bacterial disease that can occur in three forms: pulmonary, cutaneous, or gastrointestinal

What should a nurse caring for clients of another culture be sure to do?

Alter personal nonverbal behaviors to reflect the cultural norms of the client

Which of the following clients is most at risk for skin cancer?

An 80-year old farmer who wears a cap when working

What is an aggregate?

An aggregate is a collection of people who share one or more personal or environmental characteristics

What would be the best approach for a home health nurse to help a client who has right-sided paresis secondary to a stroke?

Grasp the retention sutures and spread the opening

The nurse learns that a family has decided not to accept medical intervention for a health care problem because paying for the care would drastically reduce the family's resources and ability to meet the needs of other family members. Ethically, what should the nurse in such a situation do?

Appreciate that the family has made the decision that it feels is best and take no further action if it is clear the family has made an informed choice

When conducting an initial assessment on an infant, a home health nurse notices that the infant is wearing a soiled piece of braided yarn around the neck. Which action by the nurse is most appropriate?

Ask about its significance and suggest that it be placed more safely on the bodt

A major portion of a construction project has collapsed. The emergency department (ED) has been notified that numerous victims are being transported to the ED. What should be the first action of the ED nurse?

Assess department for resources-staff, beds, equipment

A male client is saying he is "wired", feels like he is on "pins and needles", and is irritable. He says he stopped using alcohol abruptly. What is the nurse's next intervention in caring for this client?

Assess for all current substance abuse patterns, including time of last use, and begin to assess for withdrawal

The community health nurse has an order to give an infant a dose of inactivated poliovirus vaccine (IPV) The nurse would take which action before administering the medication to ensure the dose is safe and effective?

Assess prior to dose for allergy to neomycin, streptomycin, or polymixin B

For nurses who are familiar with evidence-based practice (EBP), and want to implement EBP into their care of clients, what might be the biggest challenge?

Assessing one's current and accessing evidence-based resources

A group of nurses has attended a symposium on evidence-based practice (EBP) and want to implement EBP into their care of clients, what might be their biggest personal challenge?

Assessing one's current practice and accessing evidence-based resources

Which action best represents public health nursing?

Assessing the effectiveness of the large high school health clinic

Which nursing intervention would be most appropriate to meet the safety needs when caring for an older adult with sensory changes.

Assist in preparing a bath because the client may be less able to feel intensity of heat.

In a predominantly poor community, where eating clay (pica) is a common practice, the nurse in community health can intervene at the tertiary prevention level by which of the following?

Assisting those who eat large amounts of clay to obtain food stamps after explaining that clay, although filling, does not provide necessary nutrients

Nursing students have been assigned to set up a health fair for the homeless population in a large urban setting. Without any funds to pay for space, where should the health fair be located, assuming that all of the following sites are available at no cost?

At the city's homeless shelter, which is, by policy, vacant during the day

A homeless family brought their father to the public health clinic after he reported bleeding when he went to the bathroom. Which nursing action is most appropriate?

Begin tests to determine the cause of the bleeding while asking about other family concerns from nutrition to shelter for the night.

Which represents an example of infectious disease spreading via a vector?

Being bitten by an infected mosquito

The community nurse has just finished teaching a group of boy scouts about transmission of hantaviral pulmonary syndrome. The nurse suspects they need additional teaching when she hears one of the older boys make which statement(s). Select all that apply a. "When fresh rodent urine, droppings, or nesting materials are stirred up, tiny droplets containing the virus get into the air and the virus can be transmitted by airborne transmission." b. "As long as we are vaccinated before we go into the woods we cannot contract hantaviral pulmonary syndroms." c. "In the United States, deer mice, cotton rats, rice rats, and the white footed mouse are the reservoir of the virus." d. "Hantavirus can also be contracted from rodent infestations in and around my house and is a primary risk factor for exposure." e. "Hantaviral Pulmonary Syndrome is spread by breathing the infected droppings from bats and birds."

B. "As long as we are vaccinated before we go into the woods we cannot contract hantavirus pulmonary syndromes." E. "Hantaviral Pulmonary Syndrome is spread by breathing the infected droppings from bats and birds."

Which statements by a nurse demonstrate understanding of the unique needs of vulnerable groups? Select all that apply. a. "I make sure to do a complete assessment, since we often don't know when the person will return to the clinic." b. "I always address the problem that the client believes is the most important." c. "When a client needs to see a financial advisor but can't afford one, I give the best advice I can." d. "I try to observe the client's cultural traditions as I probe for signs of abuse." e. "I sometimes bend the rules a bit to adapt my care to the needs of my clients." f. "I avoid asking clients for income or financial information, because this is an invasion of privacy."

B. "I always address the problem that the client believes is the most important." D. "I try to observe the client's cultural traditions as I probe for signs of abuse."

The nurse examining the skin of a client notes a pruritic rash characterized by burrows, vesicles, and nodules located in the webs of the fingers, intra-gluteal folds, axilla, palms, wrists, and other creased areas. The client describes it as very itchy, especially at night. Based on these findings the nurse will: Select all that apply a. Conclude the client has been bitten by bed bugs and advise that all bed linen, stuffed animals, and clothing be washed and dried in very hot water and dried in a very hot dryer b. Conclude the client has scabies and advise that all bed linen, stuffed animals, and clothing be washed and dried in very hot water and dried in a very hot dryer c. Recommend a shampoo such as Quell after mechanically removing nits with a close-toothed comb d. Conclude the client has pediculosis and advise that all bed linen, stuffed animals, and clothing be washed and dried in very hot water and dried in a very hot dryer e. Recommend a scabicide lotion/cream be applied to the entire body (avoiding eyes and mucous membranes) using a toothbrush to get under fingernails and toenails, showering it off after 8-12 hours

B. Conclude the client has scabies and advise that all bed linen, stuffed animals, and clothing be washed and dried in very hot water and dried in a very hot dryer E. Recommend a scabicide lotion/cream be applied to the entire body (avoiding eyes and mucous membranes) using a toothbrush to get under fingernails and toenails, showering it off after 8-12 hours

The nurse is restarting the IV line on a client known to have hepatitis B. Which precaution should the nurse use to protect against exposure? Select all that apply a. Mask b. Handwashing c. Face shield d. Gown e. Gloves

B. Handwashing E. Gloves

A 20-year old female sees a health care provider for her first adult physical examination. The nurse anticipates that which screening measure will be done at this visit as a baseline for further reference? Select all that apply a. Mammography b. Serum cholesterol level c. Blood glucose d. Clinical breast exam (CBE) e. Body mass index measurement (BMI)

B. Serum cholesterol level D. Clinical breast exam (CBE) E. Body mass index measurement (BMI)

A mother is appalled because her daughter came home drunk. She says to the nurse, "What did I do wrong?" Which of the following explanations of why the daughter may have been drinking would be helpful for the nurse to give to the mother? Select all that apply a. The daughter was probably hungry, and alcohol was the only thing she could obtain. b. The daughter may be challenging her parents' authority over her. c. The daughter was probably trying to impress her peers or to fit in with a group of them. d. Drinking may have made the daughter feel better. e. The daughter was probably trying to reduce her inhibitions so that she would feel more comfortable engaging in other risky behaviors. f. Pressure from school, friends, and parents may have been factors.

B. The daughter may be challenging her parents' authority over her C. The daughter was probably trying to impress her peers or to fit in with a group of them D. Drinking may have made the daughter feel better F. Pressure from school, friends, and parents may have been factors

A newly adopted 8-year old child is brought to the pediatric immunization clinic to being the hepatitis B immunization series. Before providing the immunization, the nurse inquires about any known history of allergy to which item?

Baker's yeast

The mother of a three-year old with measles calls the nurse at the clinic asks what she can do to help decrease the redness and itching. The nurse responds that which action is likely to help?

Bathe the child in an oatmeal (Aveeno) bath

What do demographic figures suggest about the ways in which the population of the United States is changing? Select all that apply a. Households consisting primarily of intact families continue to grow b. Mortality for both genders in all age-groups declined c. Overall the population of the United States is declining d. Approximately 12% of the U. S. population was born in a different country e. Hispanics are the largest minority group population f. Of the foreign born, most are from Asia

B.Mortality for both genders in all age-groups declined D. Approximately 12% of the U. S. population was born in a different country E.Hispanics are the largest minority group population

When does disaster management begin?

Before the disaster occurs

A nurse states, "The best way to treat a client from another country is to care for them the same way we would want to be cared for. After all, we are all humans with the same wants and needs." What does this statement reflect in relation to culture?

Blindness

Of the following educational objectives, which example best meets all necessary criteria for a well-written objective?

By the end of the class, 80% of children in the course will correctly identify two vegetables on a page of food pictures

A nurse is planning a program to teach cardiac health at the senior citizens center. Which of the following is an effective written objective for the program?

By the end of the program each participant will report walking at least 30-minutes a day at least 5 days out of 7

Which statements indicate to the nurse that a male client understands how to correctly apply a condom? Select all that apply. a. "I can use oil-based lubricants if needed." b. "I need to put it on before the penis is erect." c. "I can use water-based lubricants if needed." d. "I should unroll the condom, then place it on the penis." e. "When putting on the condom, I need to leave some space at the tip to collect the sperm."

C. "I can use water-based lubricants if needed." E. "When putting on the condom, I need to leave some space at the tip to collect the sperm."

After conducting a client teaching to a group of travelers about Malaria, the community health nurse determines the group needs further instruction when he hears one of them make which statement (s)? Select all that apply. a. "It could take up to one year after exposure for symptoms of malaria to occur." b. "If I use insect repellent I can reduce my chance of contracting malaria." c. "Malaria is caused by being bitten by a rat." d. "There is no cure for malaria." e. "If I travel to a place where malaria is endemic, I may not be able to donate blood upon returning to the United States."

C. "Malaria is caused by being bitten by a rat." D. "There is no cure for malaria."

5. The public health nurse discusses swimming pool safety with the parents of 4-year old twins. Which statement identifies that more instruction is needed? Select all that apply. a. "Our children are enrolled in swimming classes." b. "We remove all toys from the pool area when not in use." c. "The twins wear floatation devices when they are in the pool by themselves." d. "We always tell the twins not to run by the pool." e. "We never go in the house for more than a minute when the twins are in the pool."

C. "The twins wear floatation devices when they are in the pool by themselves." E. "We never go in the house for more than a minute when the twins are in the pool."

A community citizen reports to the public health department nurse that the city water in one neighborhood has had an unusual taste for the past few months. What action should the nurse take first?

Check the most recent consumer confidence report

When teaching an inservice on culturally competent care, the nurse explains that which cultural values tend to be associated with Anglo-American culture? Select all that apply. a. Harmony b. Interdependence c. Competition d. Youth e. Materialism

C. Competition D. Youth E. Materialism

The pediatric community health nurse is seeing a 2-month old infant in the clinic for routine immunizations. The nurse should select which immunization teaching sheets to give to the mother before preparing the immunizations appropriate for this visit? Select all that apply a. Measles, mumps, and rubella (MMR) b. Varicella c. Haemopilus influenza type b (Hib) d. Diphtheria, tetanus, and acellular pertussis (DTaP) e. Inactivated polio (IPV)

C. Haemopilus influenza type B (Hib) D. Diptheria, tetanus, and acellular pertussis (DTaP) E. Inactivated polio (IPV)

Which of the following are accurate concerns about the use of marijuana? Select all that apply .a. Marijuana has painful withdrawal symptoms b. Marijuana can often reduce pain but physicians refuse to prescribe it c. Marijuana is illegal in Louisiana d. Marijuana is extremely toxic e. Marijuana very quickly leads to psychological and physiological dependence f. Marijuana may damage the respiratory tract

C. Marijana is illegal in Louisiana F. Marijuana may damage the respiratory tract

The home health nurse is assessing a client's coping behaviors during a psychological assessment and wished to address factors that can contribute to depression. The nurse would ask the client about which priority item)s). Select all that apply. a. Number of siblings. b. Occupation. c. Substance abuse. d. Recent losses. e. Level of income.

C. Substance abuse D. Recent losses

A male IV drug abuser admits to the nurse that he has no desire to stop using drugs, so rather than lecture him on the dangers of drug addiction, the nurse counsels him on how to sterilize his needles. What is the nurse attempting to achieve? Select all that apply. a. Primary prevention through education on safe injections b. Primary prevention through avoiding future legal complications c. Tertiary prevention to reduce the risk for infection or other complications d. Secondary prevention to minimize future drug use e. Tertiary prevention to minimize future drug use f. Reduction in the transmission of blood-borne diseases

C. Tertiary prevention to reduce the risk for infection or other complications F. Reduction in the transmission of blood-borne diseases

A migrant farmworker brings his daughter into the clinic with severe heat stroke from being out in the sun. The nurse explains the danger signs and stresses staying cool and drinking lots of water. The man seems to know this already. So what is the most likely reason this happened?

Children may work on small farms because the family may need the additional income

A 2-year old child is in the hospital for a fractured femur breaks out with chickenpox. Which nursing intervention will best prevent secondary skin infections?

Caladryl lotion to lesions

The nurse is assessing an adolescent who presents to the clinic with history of bloody diarrhea, cramping, abdominal pain and fever. The client reports having recently visited a farm and drinking unpasteurized (raw) milk. Based on the history and symptoms the nurse suspects the adolescent has contracted:

Camplybacter enteritis

A client with a diagnosis of human papilloma virus (HPV) is at risk for which of the following?

Cervical cancer

When assessing the client for meningitis, the nurse looks for which manifestation as a frequent first sign of increased intracranial pressure?

Change in mood or attention level

Based on research, what is the best way to increase the number of persons who come to their screening test appointments?

Client reminders via telephone, e-mail, or mail

The home care nurse has asked the client to demonstrate self-injection technique. In doing so, the nurse is primarily attempting to determine which of the following?

Client's ability to perform the skill

During the home health assessment the nurse observes a client and family interaction. Observed behaviors include anger, rigidity, and lack of support for one another. The nurse should consider this interaction as an assessment of which family characteristic?

Communication patterns

Several small communities requested help from the state department of health for improving their teen pregnancy rates. Which community should the nurse suggest get funds first?

Community D - with 90 single teenage pregnancies in a city of 1500

Several small communities requested help from the state department of health for improving their teenage pregnancy rate. Which community should the nurse suggest get the funds first?

Community D - with 90 single teenage pregnancies in a city of 1500

A school health nurse plans to use evidence-based practice (EBP) to guide the development of health education programs most likely to increase retention of learning in elementary school children. What may be the best way to use EBP in this situation?

Compare and contrast randomized clinical trials related to learning in elementary school children

A nurse wishes to develop cultural competence. What should the nurse attempt to do first?

Consider how the nurse's own personal beliefs and decisions are reflective of his or her culture

The nurse working in a sexually transmitted infection (STI) clinic uses communication skill to assess clients and to provide health education. When developing rapport with a new adolscent client, it is important for the nurse to use which approach?

Consistently give honest information

The nurse working in a sexually transmitted infection (STI) clinic uses communication skills to assess clients and to provide health education. When developing rapport with a new adolescent client, it is important for the nurse to use which approach?

Consistently give honest information

A Native American client who has a low-grade fever tells the nurse on the reservation that he will only use a sweat ledge to treat his illness. Which approach by the nurse would be most appropriate?

Continue to monitor the client's status

The nurse is providing discharge instructions to a Chinese American client regarding prescribed dietary modifications. During the teaching session, the client continuously turns away from the nurse. The nurse should implement which best action?

Continue with the instructions, verifying client understanding

The school health nurse is legally responsible for emergency care but may not always be present in a particular school. With this in mind, the best way for the school nurse to fulfill his or her responsibilities in an emergency would be to:

Create and share an emergency plan with all teachers and staff

A health care provider is concerned about the high number of clients with type 2 diabetes mellitus who have poor glucose control. What would be the best reference for the provider to implement evidence-based practice (EBP) in the management of this problem?

Current research findings

The nurse anticipates that which client newly diagnosed with a terminal illness is least likely to have difficulty facing his or her mortality? a. A 68-year old female who is an atheist b. A 71-year old female whose grandson, sister, and best friend died over the past 6 months c. A 59-year old male who never married, is an only child, and whose parents are both health D. A 70-year old male who has planned his funeral and enjoys riding his motorcycle at high speeds in rural areas

D. A 70-year old male who has planned his funeral and enjoys riding his motorcycle at high speeds in rural areas

The home health nurse concludes that more teaching might be necessary after making which observation during the first home visit to a client discharged after a stroke? Select all that apply. a. Hand weights are next to the couch b. A commode is observed at the bedside c. Metamucil is on the kitchen counter d. There is a small scatter rug at the side of the bed e. A fluid restriction chart on the refrigerator

D. There is a small scatter rug at the side of the bed E.A fluid restriction chart on the refrigerator

A mother brings her daughter to the emergency department. The daughter was at a party and danced for the last few hours, but now she is sweating and does not look well. Assessment revels temperature of 103* F, weight loss, and that the client is grinding her teeth. What should the nurse be most concerned about?

Dehydration and electrolyte imbalance

Persons with immune deficiencies may have a negative tuberculosis (TB) skin test even though they are infected. Knowing this, what would the nurse expect to see in the test results when a TB skin test is given to persons with AIDS?

Decreased sensitivity

The client has been diagnosed with trichomonas vaginitis. The community health nurse explains during client teaching that this infection can affect fertility by which means?

Decreasing pH of vaginal secretions, thus destroying most spermatozoa

A parent brings a 3-year old child to the immunization clinic for DTaP vaccine. During the interview, the mother indicates the child is just finishing a tapered-dose of prednisone for a chronic respiratory problem. Which action should the nurse take at this time?

Delay the vaccine administration for 1 month after the medication is completed

A 12-year old boy is diagnosed with early human immunodeficiency virus (HIV) secondary to factor transfusions for hemophilia. The family is very concerned about their ability to manage his care, risk of infection to family members, and whether the child should remain at home. Which action by the nurse will best promote family coping at this time?

Demonstrate positive acceptance of the child with each contact

Some of the nurses are debating about the appropriate action to take in relation to a particular family. The father is ill and the other family members have chosen to continue working rather than take time off to care for the ill family member. One nurse states, "It is a wife's responsibility to care for an ill husband." What ethical approach is this nurse using?

Deontological ethics

What is the most crucial aspect in minimizing the damage from a bio-terrorism attack?

Detecting an increase in people with similar signs and symptoms

What action by the nurse can best ensure long-term positive health outcomes of poor pregnant teens and their children?

Developing programs that allow teen mothers to complete their education

The nurse is assessing a child in the outpatient clinic who has a low grade fever, sore throat, malaise, and anorexia. Upon examination the nurse notes the child also has a foul mucopurulent nasal discharge and a smooth, thick, adherent white/gray membrane on the tonsils and pharynx that make it difficult for the child to breathe. The nurse suspects which childhood communicable disese?

Diptheria

What is the most helpful intervention a nurse in community health can initiate to increase lasting resilience among new immigrants?

Direct clients to English as a second language courses

A nurse preparing to draw up a dose of vaccine notices that a vial of DTaP vaccine on the countertop does not have a date recorded for when it was opened. What action should the nurse take?

Discard the vaccine according to agency's policy

The nurse prepares to teach a class about normal aging to a group of nursing assistants. The nurse should select which teaching technique as most appropriate?

Discuss a case study in which an older adult with an infection had a temperature of 98 degrees F

What actions would a nurse take to reduce the high incidence of coronary artery disease (CAD) in the community?

Distribution of handouts, including age-appropriate games, self-assessments, and education on heart-healthy lifestyles; availability of community screenings for hyperlipidemia in persons age 35 and older; and walking programs for those affected with CAD

Which clinical manifestation would be most significant and require further investigation when assessing the skin of an 85-year old client?

Ecchymosis on both forearms

The staff cannot reach an agreement on what is the right thing to do in relation to a specific patient. What approach should the nurse use in personally deciding what is right?

Do whatever the nurse would recommend to anyone in a similar position

Of the options listed, what is the best advice a nurse can give a pregnant teen to improve the long term health outcomes for both the teen and her unborn child?

Don't drop out of school

Research demonstrates that exercise is important for general wellness and weight control. How might the school nurse use this information to implement primary prevention?

Drafting policy for increases in noncompetitive physical activity programs

A community health nurse drives through her assigned community before visiting the community groups scheduled for the day. She then drives through the community again that evening before going home. From a community nursing perspective, what might be the nurse's reason for driving through the community twice in the same day?

Driving through twice allows the nurse to see the community when many residents are at work or at school and then again when most are at home

A nurse who works for a hospital in employee health notes that several nurses from one unit have missed work after contracting a communicable disease from a patient. In this scenario, the host is which of the following?

Each sick nurse

Which suggestion would the nurse give to a client with human immunodeficiency virus (HIV) infection to best alleviate nausea?

Eat small, frequent meals

A nurse explained to a family exactly how to care for their family member, who had just been discharged home from the hospital. When the nurse visited the family 3 days later, it was apparent that neither the patient nor the family had completed certain activities since the previous visit. What is the most probable explanation?

Emotional stress limited the information the family could absorb

The nurse would take which action to protect the client from infection at the portal of entry

Empty Jackson-pratt drain using sterile technique

A nurse reports that in comparison to all the children in a particular school, the children who are members of the Cub Scouts have 0.3 risk for obesity before entering the sixth grade. What would you recommend to the new parents of two boys who had just moved into this school's neighborhood?

Encourage the parents to enroll their sons in Cub Scouts

The occupational health nurse is preparing to administer a purified protein derivative (PPD) tuberculin skin test to an employee. Before administration, the nurse should take which actions?

Ensure that the employee has not had a positive test result in the past

After hearing of plans to build a city dump near a community of poor and predominantly African-American citizens, what principle might cause a nurse to want to help block the proposed site for consideration?

Environmental justice

Which model would be helpful to the nurse in examining all the various factors that can lead to the disease?

Epidemiological triangle

What is the underlying science or area of study on which public health nursing is based?

Epidemiology

A nurse working in a community health immunization clinic ensures at the beginning of each workday that which of the priority medications is available and within the expiration date?

Epinephrine (adrenaline)

What is the relationship between ethics and a community health nursing practice?

Ethics is constantly involved in nurses' clinical decisions

A nurse says, "I'm not going to change the way I practice nursing based on where the client is from, because research shows that Western health care technology and research is best." What is such a belief called?

Ethnocentrism

A busy school health nurse concerned over the rising incidence of obesity wants to implement evidence-based practice but faces barriers because of time constraints. Her manager has offered to help her, which response by the manager is most helpful at this stage?

Evaluating best practices to determine those that have the highest success rates for weight control in children.

In which of the following activities is the nurse acting in the role of a nurse epidemiologist

Evaluating the number of clients presenting with similar diseases

A member of a community weight-loss group has maintained a healthy weight for 2 years through healthy eating and daily exercise. At which step of the affective domain is this participant?

Evaluation

The nurse is examining blood lead levels in school-age children 1 year after a community-wide education intervention. What phase of the nursing process does such testing represent?

Evaluation

How can nurses know whether they have been effective in assessing the community and planning and implementing appropriate interventions?

Examine the morbidity and mortality rate of the community

The 5-year old is being tested for enterobiasis (pinworms). To collect a specimen for assessment of pinworms, the nurse should teach the mother to:

Examine the perineal area with a flashlight 2-3 hours after the child is asleep

On the second day after a disaster, a male colleague tells the nurse he has a splitting headache. The nurse notes the colleague seems irritable and he admits he is having difficulty focusing. What is the nurses best response in this situation?

Explain that he is experiencing signs and symptoms of psychological stress and recommend that he take some time off for a break

The nurse has completed a summative evaluation of a program designed to decrease obesity in school-aged children, of the following statements, which best represents summative evaluation?

Has obesity in school-aged children decreased

Mexican immigrants who take metamizole ("Mexican aspirin") for pain may experience life-threatening agranulocytosis. What will a nurse who employs cultural repatterning do?

Explain the harmful effects of metamizole and recommend an alternative medication for pain.

After a house fire, a five-year old begins sucking his thumb and wetting the bed. What is the nurse's best intervention strategy?

Explain to the family that this behavior is a normal reaction to disaster

Based on previous research, of the options listed below, which is the most effective approach to increase enrollment in SCHIP (State Children's Health Insurance Program)?

Handing out SCHIP applications to uninsured children seen in local hospital emergency departments

A public health agency is planning to implement the electronic health record. Which of the following is a benefit of this choice?

Facilitation of interprofessional care

A nurse in community health has implemented an education program that incorporates computer games to reinforce learning in a community of older adults. Although the research demonstrates evidence of improved retention of information, the nurse experiences exactly the opposite for this group of clients. What is the most likely cause of such poor outcomes?

Failure to consider client and setting differences

The community health nurse is participating in a health promotion fair. When discussing aerobic exercise, the nurse should include which point?

Fast walking is a good form of aerobic exercise

When beginning to present information about heart disease to a client newly diagnosed with heart disease, what is most important for the community health nurse to do first?

Find out what the client knows or has heard about the disorder

The community health nurse knows that the bacterium Yersinia pestis is the cause of bubonic plague. She is preparing to teach a class on disease prevention to students who plan to travel overseas to an area where this disease is endemic. To be sure the students understand the transmission cycle of the disease she should include which information?

Fleas transmit the disease to humans and other mammals after they have become infected by feeding on infected rodents and subsequently feeding on the humans or mammals

A client visiting a family planning clinic is suspected of having a sexually transmitted infection (STI). The best diagnostic test for tremonema pallidum is?

Florescent treponemal antibody (FTA)

The nurse is taking the history from a student at the college infirmary who report attending the end of summer picnic earlier today where he ate turkey, potato salad, bread, butter, milk, and dessert. He is now presenting with the following symptoms: severe stomach ache, diarrhea, and vomiting. He also reports that several of his friends who also attended the picnic are sick as well. The nurse suspects the student has:

Food poisoning

Societies have several choices on how to approach drug addiction. Which approach has research suggested is the most effective?

Harm reductions with pragmatic interventions

The nurse is taking the history from a college student who recently returned form a hiking/camping trip that involved surviving by 'living off the land'. The student has been back for a about a week and reports developing the following symptoms: bloating, nausea with or without vomiting, malaise, and fatigue. Based on the history and symptoms the nurse suspects which disease?

Giardiasis

Contact precautions are initiated for a client with health care associated (nosocomial) infection caused by methicillin-resistant staphylococcus aureus. The nurse prepares to provide colostomy care and should obtain which protective items to perform this procedure?

Gloves, gown, goggles, face shield

The nurse is leaving the room of a patient who has methicillin-resistant Staphylococcus aureus (MRSA) microorganism in a wound and the urine. Place the following personal protective equipment in order of removal.

Gloves, mask, gown, eye protection

The community health nurse is taking the history from a college student who reports a history of: A burning sensation when urinating; A white, yellow, or green discharge from the penis; Painful or swollen testicles. Based on the assessment and history the nurse concludes that he has which communicable disease?

Gonorrhea

Nurses at a homeless clinic are concerned that homeless clients rarely return to have the nurses assess the findings of their tuberculosis (TB) skin tests. What should the clinic's policy be regarding the screening test findings?

Have homeless individuals read their TB skin test, if necessary, and mail in results on a postage-paid card coded to protect privacy

Of the four main factors that affect health, which is the least important?

Health care system

When an RN talked to the women at the senior citizens' center, the nurse reminded them that the only way the center would be able to afford a driver and van service for those who could no longer drive themselves would be to continue to write letters to their local city council representatives requesting funding for such a service. What was the nurse trying to accomplish?

Helping the women engage in political action

The community health nurse is taking the history from a client who reports a 2-week history of anorexia, nausea, vomiting, malaise, fever, and jaundice followed by dark-colored urine, and clay-colored stools. The nurse suspects which communicable disease?

Hepatitis B

The reservoir for Anthrax is:

Herbivores, and the spores may be redistributed passively in the soil and adjacent vegetation through the action of wind, water, and other environmental forces

During the initial interview, the client reports that she has a lesion on the perineum. Further investigation reveals a small blister on the vulva that is painful to touch. The nurse is aware that the most likely source of the lesion is:

Herpes

A committee of health care professionals would like to establish a countywide program to improve Hispanic immigrant access to culturally competent health care services. Which person might be most helpful as a key informant?

Hispanic community leader

A pediatric client is scheduled to receive a dose of MMR (measles, mumps and rubella) vaccine. The nurse would question the order to give the dose at this time if which data was obtained during the short intake history?

History of allergy to neomycin or gelatin

A 90-yearl old client expresses a wish to die at home after being told that an esophageal stricture prevents swallowing. The client refuses a feeding tube. The family fully supports this decision. What would be the most appropriate resource for the nurse to call?

Hospice care

A nurse is investigating bacteria that have caused a health problem in the community. Only some of the people exposed to the bacteria have become ill. What could account for this?

Host factors

Evaluation is underway for a statewide program to decrease teen injury and death associated with teens that drive while under the influence of alcohol. Which question would best assess a summative evaluation of the program?

How do statistics for injuries and deaths associated with drunk driving compare for teens in the year following the program

Which question is least useful in the assessment of a client with AIDS?

How old were you when you became sexually active?

The nurse would assess for which electrolyte imbalance as a common finding in a client with AIDS?

Hyponatremia

What is the first and most crucial step in the ethical decision-making process?

Identify the ethical concern

A home health nurse asks a client with arthritis to attend a demonstration in which an assistive device is used to put on shoes. Which phase of the nursing process is the nurse's current focus?

Implementation

Which action would be most helpful for the nurse executive to implement evidence-based practice at a community nursing center that serves a large Cuban immigrant population?

Include Cuban immigrants from the community on the center's advisory board

What statistic do countries use to compare the success of their health care systems?

Infant mortality rate

A young college student came to the clinic after contracting genital herpes. Which of the following interventions would be most important?

Instruct him yo avoid sexual contact during acute phase of illness

A female client arrives at the health unit and tells the nurse that she was just bitten by a tick and would like to be tested for Lyme Disease. The client tells the nurse that she removed the tick and flushed it down the toilet. Which of the following nursing actions is most appropriate?

Instruct the client to return in 4-6 weeks to be tested because testing before this time is not reliable

From an ethical standpoint, what is the problem with the belief that everyone should receive his or her fair share, that life should always be fair, and that everyone should make his or her own decisions?

Insufficient resources to give everyone a fair share

What is the chief group pressuring clinicians to use evidence-based practice (EBP)?

Insurance companies and other third-party payers

A nurse practitioner has established a mobile clinic to vaccinate noninstitutionalized adults against influenza. What part of the nursing process does this represent?

Intervention

In what way is nursing in the community more challenging than nursing in an acute care setting?

It is more challenging to control the environment in the community

A new mother who bottle-feeds her infant comes in to the community health clinic for a 6-week postpartum visit and discusses being depressed and is prescribed an antidepressant. The nurse providing medication instructions assesses the client's alcohol-use patterns, and learns the client has 1-2 drinks once or twice a week. What explanation should the nurse provide for not using alcohol or drugs in this situation?

It will decrease the effectiveness of the antidepressant

A man says, "I just can't get myself to leave the house and go for a 30-minute walk each day. I wish I could think of some way to motivate myself." An effective measure by the nurse would be to suggest that the man:

Join a group that walks early each morning

Which assessment finding in an older adult client should alert the community health nurse to an increased risk of falls?

Kyphotic posture

How does the government inadvertently encourage low-income persons to use emergency departments as their primary care provider?

Legally, emergency departments must see clients even if clients can't pay

The nurse is completing and admission history on a client who reports recently returning from a conference. During the history-taking the client repeatedly complained about the mustiness and poor ventilation in the hotel and stated that she spent a good deal of time in the hot tub. Since returning she has developed the following symptoms: cough, shortness of breath, high fever, muscle aches, headaches. Based on this history and symptoms the nurse suspects the client has contracted:

Legionellosis

A nurse meets with a senator to lobby for passage of a bill to increase funding for interpreter services. Through which branch of government is the nurse interacting?

Legislative branch of government

What single factor is most closely correlated with poor health?

Low socioeconomic status

The state board of nursing can write regulations to clarify in a more concrete manner what the nurse practice act allows and requires. What type of effect do these regulations have on the individual nurse?

Major, since these rules and regulations have the effect of law and must be obeyed

The nurse would include which statement when discussing nutritional status with a client who is infected with HIV and is progressing toward AIDS?

Malnutrition is seen as a consequence of the immune disease

The nurse gives a very informative and engaging presentation and then gives everyone in the audience a handout that outlines the presentation. Later, the nurse discovers that many of the handouts were thrown away before the audience left the building. What might the nurse have forgotten?

Many Americans do not have a high reading level

A nurse is checking health department records to compare the number of new teen clients presenting for birth control counseling and management in the 2 months before and after an education intervention program to decrease teen pregnancy. Which step of the evaluation process is the nurse's action?

Measuring the goal effect

For children whose parents do not receive health insurance as an employment benefit and who do not have the financial resources to pay for health care out of pocket, what referral, of those listed below, should the nurse make?

Medicaid

Public health nurses have been activated to open a shelter due to an approaching hurricane. What most important items should families be encouraged to take to the emergency shelter?

Medication and viral records

When engaging in a family assessment, the nurse would recognize which behavior as suggestive of a family with problems?

Most of the conversation was between the father and the eldest daughter

The nurse is concerned that which viral infection, if experienced by an adult male, may cause infertility?

Mumps

The nurse is assisting a client who has methicillin-resistant staphylococcus aureus in collecting a clean-catch urine specimen. Which protective equipment is unnecessary?

N95 particulate respirator

A home health nurse is assigned to an Asian American client who refuses to take the blood pressure medication prescribed by the physician. The client is using acupuncture treatments and does not believe in taking pills. How can the nurse best help this client?

Notify the physician of the client's health practices, and monitor the condition for an impending crisis

What is the primary reason that meeting the needs of a dying child and his or her family is more challenging for most nurses than meeting the needs of a dying adult?

Nurses themselves are often parents

A quarterly audit is now due to evaluate implementation of an electronic medical record system at the home health agency. As the representative who supervised the adaptation of this documentation system, how can the nurse best determine if nursing staff have accepted this change?

Nursing staff uses the electronic medical record daily in routine documentation

A hospice nurse in a small Appalachian community is caring for a client at home who is an active member of the community church. As death nears, the minister, and several members of the congregation come together in the home for a "death watch.". Which action by the nurse is most therapeutic?

Observe client's religious beliefs and allow family and minister unlimited access to the client.

Which objective is most appropriate for the development of a community-oriented nursing care plan?

Of mothers receiving nutrition counseling, 80% will identify five sources of calcium by the end of class

A man entered the emergency department bleeding profusely and screaming, "I've got to see a doctor right now! I've got a right to see a doctor! I'm hurt. You have to take care of me!" What premise would ethically justify such a demand for immediate attention?

Our society believes that all persons should be treated equally and that basic needs, such as not dying if death can be avoided, should be met.

If the nurse teaches solely by lecturing to clients, what part of the education process is missing?

Participation

During an outbreak of hepatitis A, nurses are giving injections of hepatitis A immunoglobulin to selected susceptible persons. What sort of immunity will follow?

Passive immunity

What type of surveillance is occurring when case reports are routinely sent to local health departments by health care providers and laboratories where the data is then summarized and forwarded to those responsible for monitoring such reports?

Passive surveillance

Which antibiotic-resistant microorganisms requires transmission-based droplet precautions?

Penicillin-resistant Streptococcus pneumonia

What is a useful first step in assessing potential environmental health risks in a community?

Performing a windshield survey

This year 600 of 8000 young women ages 17 to 20 years at a university health center tested positive for a sexually transmitted infection (STI). What does this finding represent?

Prevalence

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

Primary

When teaching a nutrition class to a student group with a large Hispanic population, the student health nurse incorporates foods such as salsa and other healthy dishes familiar to Hispanic students into the presentation. What type of action does the nurse's approach represent?

Primary prevention

A physician refuses to order pain medication for a drug addict who has been severely injured in a car accident. When reminded by nurses that pain medication has not been ordered, the physician merely replies that the patient's suffering from the pain of his injuries will build character and that the addicted patient needs to get off drugs. What ethical theory is the physician using (or misusing)?

Priniciplism

The nurse is caring for a client with meningitis and implements which transmission precautions for this client?

Private room or cohort client

What is the unique primary focus of public health nursing?

Promotion of quality of life

Which program exemplifies an emphasis on tertiary prevention?

Providing a diabetes management program for persons with diabetes mellitus

The public health nurse wants to create a program that addresses secondary health prevention? Which response best represents secondary health prevention?

Providing an influenza vaccination program in a community retirement village

Which public health service represents secondary health prevention?

Providing an influenza vaccination program in a community retirement village

To enhance meeting the psychosocial needs of a client on transmission-based precautions, the nurse should place highest priority on which of the following?

Providing the client with divisional activities to enhance sensory input

The client with acquired immune deficiency syndrome is diagnosed with cutaneous Kaposi's sarcoma. Based on the diagnosis, the nurse understands that this has been confirmed by which of following?

Punch biopsy of cutaneous lesions

A 9-year old client is brought to the pediatrician's office for a varicella virus vaccine. before preparing the does of the vaccine, the nurse would determine the child's status regarding what health history item?

Recent blood product transfusion

A nurse wants to help keep the community environment safe. What is the best action he can take?

Reduce, reuse, and recycle

The ambulatory care nurse is discussing preoperative procedures with a Japanese American client who is scheduled for surgery the following week. During the discussion, the client continually smiles and nods the head. How should the nurse interpret this nonverbal behavior?

Reflecting a cultural value

A father confides to the parish nurse that his wife has been really hurting their 3-year-old daughter. The nurse examines the daughter and finds evidence of physical abuse. In the parish nurse role, what will the nurse do first?

Report the findings to child protective services

A two-year old child with Rubeola (Measles) is brought to the hospital with a rash covering the entire body, photophobia, and stuffy nose that interferes with breathing. The nurse uses which nursing diagnosis as a priority in caring for this child?

Risk for impaired gas exchange

A nurse is assessing a child in the clinic who has reportedly been experiencing low grade fever, headache, malaise, anorexia, mild conjunctivitis, coryza, sore throat, and lymphadenopathy. The child has also developed a discrete pinkish red maculopapular rash on the face that is spreading downward. The nurse suspects which childhood communicable disease?

Rubella (German measles)

Based on the highest risk during this period of life, what would be the focus of the nurse who is setting up a health promotion booth for adults in their thirties

Safety education for accident prevention

The nurse is examining a male patient in the clinic for a routine pre-employment physical. During the exam the nurse notes that the client has a rash that is rough, with reddish-brown spots on the palms of his ands and the bottoms of his feet. He also has a slight fever and swollen lymph glands. The nurse suspects the client has which stage of syphilis?

Secondary

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

Secondary

After conducting a physical assessment, the nurse would conclude that a 75-year old client's ability to maintain personal safety would be most adversely affected by declining function in which body system?

Sensory

A school nurse has finished conducting a teaching session with high school freshman about breast self-examination (BSE). The nurse concludes that the information was learned correctly when one of the girls states to do the exam at which time?

Seven days after menstruation begins

In what way could Florence Nightingale be considered an epidemiologist?

She demonstrated that a safer environment resulted in decreased mortality rate.

Which factor predisposes many migrant farmworkers to disenfranchisement?

Short length of time in the community

A nurse working inthe perinatal clinic concludes that genetic counseling would be most important for the cient who has a family history of which disorder?

Sickle Cell Anemia

A nurse didn't know what to do when faced with a particular ethical dilemma because an option that would have a good outcome didn't seem possible. The nurse finally decided to talk to the agency supervisor and let the supervisor decide what action to take. In terms of ethics, this approach would be considered.

Simply an opportunity to discuss the issue because the nurse is still responsible for his or her own personal choices.

The nurse is teaching a new group of volunteers about the chain of infection. Which item would the nurse include as an example of how an infection would spread through droplets?

Sneezing and coughing

Several children were hospitalized for severe vomiting and diarrhea. The public health nurse must continue to pursue the cause of the illness even after the children are discharged from the hospital for what reason?

So that action could be taken to avoid any such future episodes

Persons often point out that smokers choose to light their cigarettes, alcoholics life the glass to their mouth, and drug addicts inject or ingest their drugs. Why, then, don't nurses simply focus on helping persons who engage in poor health behaviors to behave appropriately?

Society must offer healthy choices, offer support, and practice helpful policies

A nurse noted that of 18 children in a day care center room, 5 became ill. What might be a host factor for some becoming ill?

Some of the children were from very low socioeconomic families

Who is responsible for determining the scope of practice for registered nurses?

State legislators

The school nurse is assessing a school-aged child. Which finding by the nurse may indicate physical neglect?

Stealing or hoarding food

A health care worker tells a nurse, "It does no good to try to teach those Medicaid clients about nutrition because they will just eat what they want to no matter how much we teach them." What is such a global statement called?

Stereotyping

A client has been referred for dietary teaching regarding the management of hepatitis. The nurse would base development of nutritional goals on which data?

That the diet should be high in calories and high in protein

A nurse is asked to meet with a family who recently emigrated from Botswana (Africa). After the clinical doctor tells the husband the wife's diagnosis of breast cancer, the family thanks the physician and starts to leave. Ethically, what is the nurse's most important action?

Stressing the seriousness of the diagnosis and the need to act immediately

What is the law in relation to clinical practice by nursing students?

Students are expected to meet the same standard of care as the professional nurse

A client with hypertension has been told to maintain a diet low in sodium. The community health nurse who is teaching this client about foods that are allowed should include which food item in a list provided to the client?

Summer squash

During ahealth fair at a public recreational park, the nurse providing cancer health risk information answers several questions for clients who use ultraviolet light tanning salons. Which piece of information is most important to include?

Sun damage from ultra violent lights is more likely than from indirect sunlight

What are some of the best ways in which nurse managers can facilitate incorporation of evidence-based practice in the clinical setting?

Supporting nurses using practice-oriented research findings in decision making

The mother of a 2-month old receiving immunizations for the first time will also be a beginning nursing student when the next semester begins. When the mother asks the nurse to relate the immunizations to what she learned in microbiology class, the nurse states that administering childhood immunizations interrupts the chain of infection at what link?

Susceptible host

What occurrence would confirm that the nurse's advocacy has been truly successful or effective?

Systematic social changes are made to improve quality of life

The nurse looks for results of which laboratory measurement that provides a reliable indicator of lymphocyte status in a client with HIV infection?

T-helper cells (CD4)

The nurse is instructing a client who has been hospitalized with bacterial meningitis and will be going home soon. Which of the following will be of the highest priority?

Take all of the antibiotics as directed until completely gone

A community health nurse teaches an older adult client about misuse of medications. Which subsequent behavior by the client indicates that the instruction was effective?

Taking medications on time and, if a dose is missed, taking the next one on time

A nurse is meeting to discuss problems and solutions with a group of teenagers who have been newly diagnosed with diabetes. One teenager states "My mom found this particular brand of popcorn that has only 15 carbohydrates in the whole giant bag." What group purpose is being served by the teenager's statement?

Task function of sharing information and resources

What would be the best approach for a home health nurse to help a client who has right-sided paresis secondary to a stroke?

Teach the client to participate in self-care activities

Which nursing action is most likely to result in maximizing quality of life while reducing health care costs?

Teaching high school boys about sexually transmitted infections and proper condom application.

A child is being treated at home for chicken pox. The home health nurse is visiting and notes an elevated temperature. To prevent a common complication of fever the nurse recommends which of the following?

Tepid sponge baths

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

Tertiary

What kind of prevention is a nurse implementing when advising a client with osteoporosis to have three servings of milk or dairy products daily?

Tertiary prevention

A child steps on a rusty nail and is brought to the emergency department. The child's electronic health record indicates the child has not been adequately immunized against Tetanus according to the immunization schedule. What would the emergency department nurse expect to be ordered for the child.

Tetanus immune globulin

The community health nurse is facilitating a group meeting of teenagers with diabetes. In the beginning stages the nurse was very directive in arranging the meetings, including location, snacks and steering the discussion. After about three months of meeting together the nurse noted that the group members began making decisions themselves rather than doing everything she suggested. Of the responses what is the most likely reason for this shift?

That the group became cohesive enough to share leadership tasks

The pharmacist sent up the wrong medication for the patient. The nurse filled out an incident report when the error was discovered. What will be the likely outcome when the quality improvement team reviews the incident report?

The CQI team will try to determine how the error occurred

What demographic factor is expected to have the greatest influence on national health care spending

The aging population

A college student is preparing for a mission trip to a country in which Smallpox is endemic. After receiving a smallpox vaccination from the public health nurse, the nurse instructs that student to observe for the following signs that are common following a smallpox vaccination;

The appearance of a red and itch bump develops at the vaccination site in three or four days, followed by a large pus-filled blister that drains, eventually scabs, and then disappears leaving a scar

A school nurse was caring for an 8-year-old child who had been hurt on the school playground. During the nurse's assessment, the child admitted that her mother was working but didn't make much money so the girl and her mother were living in their car. Based on this information, what might the nurse suspect?

The child may be a member of the 5H club

The mother of a child who has been exposed to chicken pox telephones the pediatric clinic for advice. The triage nurse asks about which of the following before responding to the mother's request for information.

The child's exposure and immune status

The nurse is explaining to a woman considering pregnancy how rubella is transmitted. The nurse determines that the teaching session has had the desired outcome if the client states that rubella is transmitted by which route?

The droplet route

The nurse is caring for a 6-year old client in the home care setting who has a diagnosis of conjunctivitis. Before administering eye drops, the nurse should recognize that it is essential to consider which of the following?

The eyes should be cleansed with warm water, removing any exudate, before instilling the eye drops

Students at first-day orientation at the local community college are discussing alcohol and drug abuse with their freshmen advisor. During a break, some students go outside for soft drinks and snacks. Soon after, the advisor walks by and notices several of these students smoking cigarettes. Based on this, what topic of the drug and alcohol orientation would be most important for the advisor to reemphasize after the break?

The fact that tobacco smoking causes more deaths than any other behavior in the United States

The following people enter the health clinic together: an unmarried man and his year-old son, an unmarried woman with a year-old daughter, and the man's married brother, who is separated from his wife. During the assessment it is determined that both men work and contribute to the household, where all of them live. Who is considered to be the "family" in this group?

The family includes whoever the adults state are family members

What is a basic assumption of public health?

The health of individuals cannot be separated from the health of the community

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

The housekeeping staff

In a particular community, high school students were starting to be diagnosed with diabetes during annual high school health fairs. Over the next few years, a nursing staff worked very hard to establish and maintain educational programs on diabetes risk factors and proper nutrition. How will the nurses know if they are having any impact?

The incidence of diabetes is slowly decreasing during screening events

The nursing staff has worked very hard this year in trying to screen essentially the entire African-American population in the community for diabetes. How can the success of the nursing staff's efforts be immediately verified?

The incidence of diabetes will increase in the community

A nurse who is explaining to a client why it is important to take medication, states, "The medication takes a couple of weeks to be effective, but then you should feel better." When the client is next seen, no medication has been purchased. What is the most likely explanation?

The nurse emphasized that eventually the client would feel better, but the client needed to feel better immediately so didn't bother with the drug.

Which public health nurse is most clearly fulfilling responsibilities?

The nurse who spent the day attending meetings of various health agencies

Which action would be most typical of a public health nurse?

The nurse works with community groups to create policies to improve the community's environment

A nurse is about to despair. Earlier in the week, she carefully taught a patient from a different culture exactly how much medication to take and emphasized the importance of taking the correct amount. However, the patient is back in the hospital today with symptoms of an overdose, although the patient denies taking more than the label indicated. What is the most likely explanation?

The patient was also taking folk medicines that had many of the same effects and perhaps some of the same ingredients as the prescribed medication.

A patient known to be Buddhist enters the hospital for some diagnostic tests just before lunch time. The nurse tells the aide passing out lunch trays to give a meal tray to the new patient, since no tests will be done until later that evening. The aide gives the patient a meal of Salisbury steak, bread, green beans, and potatoes with brown gravy. The patient eats nothing but a slice of bread and the green beans. What did the nurse forget?

The patient's Buddhist faith probably requires a vegetarian diet

Between 2010 and 2014, 1000 of 10,000 young women ages 17-20 years at a local university tested positive for a sexually transmitted infection (STI). Of the 1000 diagnosed STIs, 300 were gonorrhea and 500 were chlamydia. How could this STI problem be summarized?

The proportion of STIs to the total population was 100:1000

A nurse just finished teaching breast self examination to a large group of professional women. During the session culturally appropriate literature and visual aid were used. The nurse encouraged questions but ran out of time before the participants had time to use the breast models. Of the following, what is the most likely reason the session was not as effective as the nurse had hoped?

The women needed an opportunity to practice what they had learned

The mother of an adolescent with diabetes mellitus tells the nurse that her son likes to eat cheeseburgers and French fries when go goes out with his friends. The son is aware he is exceeding the allowable carbohydrate exchanges on the diabetic diet. How could the nurse best explain why adolescents sometimes make choices that place their health at risk?

They want to be like their peers

What is the purpose of local health departments making unannounced inspections of local restaurants?

To ensure compliance

A nurse, client, family, and other care providers meet to discuss what will be the best approach to use to continue care. Why would the nurse suggest changing the goal from obtaining appropriate long-term care placement to ensuring that the clients convalescence is beneficial and safe?

To expand the goal so that different solutions can be generated and considered

During the assessment phase, the nurse compiles and interprets available data and draws conclusions as to the community's strengths and concerns. Why might the nurse go on to continue t o observe and interview key informants?

To generate non statistical data such as values, beliefs, and perceived needs

What is the purpose of disaster management?

To manage response to disasters

What is the goal of the nurse in advocacy?

To promote the client's rights and self determination

It is very clear to the public health nurse what needs to be done and where to begin to improve the health of a certain community. So why does this nurse spend time meeting with community groups to discuss what is the most important task to be addressed first?

To work with the groups, not for the groups

A nurse wants to have a greater understanding of the physiological effects of selected chemicals. From whom would the nurse be most likely to find useful information?

Toxicologist

The community health nurse is taking the history from a female client who reports a history of vaginal itching, burning, redness or soreness of the genitals, discomfort with urination, or a thin discharge with an unusual smell that is yellow-to-greenish. Based on the history the nurse suspects what type of communicable disease?

Trichomoniasis

Which suggestion by the nurse would be most helpful to a human immunodeficiency virus (HIV) positive client who has altered taste perception?

Try zinc supplementation to improve taste perception

What is the dominant issue in ethical debate around an issue such as continuing or withdrawing treatment in acute health care?

Upholding ethical principles

Which item should the nurse discuss when teaching home care measures to the parents of a child who has bilateral bacterial conjunctivitis

Use of warm, moist, disposable, compresses to remove crusting

A nurse is conducting a screening at the local high school, and all community residents have been invited. A large group of people have gathered to have various screening tests done. The nurse has only a regular blood pressure (BP) cuff. Since it will be used on individuals who are extremely obese as well as some students who look anorexic, what might the BP results lack?

Validity

Jessie, a young man with new diagnosis of acquired immune deficiency syndrome (AIDS) is being discharged from the hospital. The nurse knows that the teaching regarding prevention of AIDS transmission has been effective when the client:

Verbalizes the role of sexual activity in spread of the disease

The nurse places highest priority on taking which action to reduce the spread of microorganisms when caring for a client at risk for infection?

Wash hands before and after care

Which action would the nurse institute that is specific to the care of an assigned client who has tuberculosis?

Wearing a particulate respirator mask when taking vital signs

Which model would be helpful to the nurse in examining the various factors that can lead to disease and suggesting several areas where the nurse could possibly intervene to reduce future incidence of disease?

Web of causality

A nurse wishes to see a bill passed to support funding for the use of interpreters for clients with limited English proficiency. When is the best time for the nurse to request support from the local senator who serves on the Veterans Affairs Committee but not on the HELP (Health, Education, Labor and Pensions) committee?

When the bill moves out of the HELP committee to be heard by the entire Senate

The nurse is caring for a pediatric client with acquired immunodeficiency syndrome (AIDS). Which activity by the nurse should be reported to the employee health department as an exposure for the nurse?

While flushing out the bedpan, fluid splashes in the nurse's eyes

The community health nurse is providing a teaching session about terrorism to members of the community and is discussing information regarding anthrax. The nurse tells those attending that anthrax can be transmitted by which route(s)? Select all that apply a. Through a cut or abrasion in the skin b. Bites from ticks or deer flies c. Ingestion of contaminated undercooked meat d. Inhalation of bacterial spores e. Sexual contact with an infected individual

a. Through a cut or abrasion in the skin c. Ingestion of contaminated undercooked meat d. Inhalation of bacterial spores

The nurse is preparing to enter the room of a client with pneumonia caused by penicillin- resistant Streptococcus pneumonia (PRSP). The client has a tracheostomy and requires suctioning. In what order would the nurse put on the following personal protective equipment?

gown, mask, eye protection, gloves