Exam 1

The factors, exposures, characteristics, and behaviors that determine patterns of disease are described using: a. Descriptive epidemiology b. Analytic epidemiology c. Distribution d. Determinants

ANS: D Determinants may be individual, relational, social, communal, or environmental.

A study that uses information on current health status, personal characteristics, and potential risk factors or exposures all at once is called: a. Cross-sectional b. Ecological c. Case-control d. Cohort

ANS: A A cross-sectional study collects information on current health status, personal characteristics, and potential risk factors or exposures all at once.

A nurse is providing education to a mother about the importance of having her infant immunized for measles, mumps, and rubella. This immunization will provide what type of immunity? a. Active b. Passive c. Natural d. Acquired

ANS: A Active immunity refers to the immunization of an individual by administration of an antigen (infectious agent or vaccine) and is usually characterized by the presence of an antibody produced by the individual host.

A nurse is teaching a postpartum mother how to breastfeed her infant. The nurse notes that the mother is alert and agrees that breastfeeding is important to her and beneficial to her baby. The nurse outlines the expectations of breastfeeding for the mother and the baby. Considering the events of instruction, which of the following should the nurse do next? a. Ask the mother about her previous experience with breastfeeding b. Demonstrate how to position the baby for breastfeeding c. Show the mother a video about breastfeeding d. Have the mother demonstrate breastfeeding

ANS: A Asking the mother about her previous experience with breastfeeding identifies her educational needs. Using the TEACH mnemonic, the first thing the nurse should do is "Tune in": listen before starting to teach; the client's needs should direct the content. Thus, this should be done before the nurse does any demonstration, showing of audiovisual resources, or return demonstration. DIF: Cognitive level: Applying REF: p. 360 TOP: Nursing process: Implementation MSC: NCLEX: Health Promotion and Maintenance

One effect of the use of block grants was a: a. Reduction of federal expenditures b. Decreased ability of states to spend money on programming c. Guaranteed continuation of programs with demonstrated effectiveness d. Shift from hospital-based to community-based nursing care

ANS: A Block grants enabled financial responsibility to shift from the federal level to the state level, thereby reducing expenditures.

The state orders a person newly diagnosed with tuberculosis to be quarantined. What type of law allows the state to do this? a. Constitutional b. Common c. Judicial d. State

ANS: A Constitutional law provides overall guidance for selected practice situations.

A nurse is teaching a group of clients newly diagnosed with diabetes how to give themselves injections. Which of the following formats would be most appropriate for the nurse to use? a. Demonstration b. Health fair c. Lecture d. Non-native language session

ANS: A Demonstration also includes return demonstration. Giving injections can best be learned by seeing the behavior being done. Health fairs target specific populations and are held in a variety of locations. Non-native language sessions are a way to adapt the health fair to a population that does not speak English. Lecture is a non-interactive method of teaching. DIF: Cognitive level: Applying REF: p. 362 (Box 16-2) TOP: Nursing process: Planning MSC: NCLEX: Health Promotion and Maintenance

When a local health department provides a hypertension screening to all individuals, which general category of health care functions is being used? a. Direct services b. Financing c. Information d. Policy setting

ANS: A Direct services are actions that provide health care directly to individuals.

A public health nurse collaborates with a physicians clinic to increase the number of infants and toddlers who receive lead screening. According to the integrative model, what client system and focus of care are being addressed? a. Aggregate level health promotion b. Aggregate level illness prevention c. Family level illness care d. Individual level health promotion

ANS: A Each succeeding level of the client system is more complex. In this situation, the public health nurse is working with an aggregate of infants and toddlers. The focus of care being addressed is health promotion, focusing on positive measures such as education for healthy living and promotion of favorable environmental conditions as well as periodic examinations, including well-child developmental assessment and health education.

A nurse examining a child in the early stages of HIV infection would expect to see: a. Failure to thrive and developmental delays b. Kaposis sarcoma and developmental delays c. Toxoplasmosis and oral candidiasis d. Fatigue and shortness of breath

ANS: A Early symptoms of pediatric HIV infection include failure to thrive and developmental delays.

Which statement about education is true? a. It emphasizes the provider of knowledge and skills. b. It emphasizes the recipient of knowledge and skills. c. It is a process of gaining knowledge and expertise. d. It results in behavioral change.

ANS: A Education is the establishment and arrangement of events to facilitate learning. Education emphasizes the provider's role in providing knowledge and skills. Learning emphasizes the recipient of knowledge and skills. Education does not necessarily result in change, as change is typically not easy for most people. Education is designed to effect changes in the knowledge, skills, and attitudes, not necessarily expertise. DIF: Cognitive level: Understanding REF: p. 357 TOP: Nursing process: Evaluation MSC: NCLEX: Safe and Effective Care Environment: Management of Care

HIV transmission can occur through: a. Exposure to blood b. Insect bites c. Sharing of school supplies d. Toilets

ANS: A HIV can be transmitted through exposure to blood.

What is the best method for preventing hospital-acquired infections? a. Perform good hand washing before and after approaching every patient. b. Prevention is almost impossible due to the high infection rates in hospitals. c. Isolate every patient having surgery. d. Use contact isolation for every patient at risk.

ANS: A Hand washing is the best way to prevent infection.

What is the purpose of providing education across the three levels of prevention? Education: a. enables clients to attain optimal health. b. identifies and treats health problems early to eliminate disability. c. enables populations to break into individuals. d. teaches people about Healthy People 2020.

ANS: A Health education enables clients to attain optimal health, prevent health problems, and identify and treat health problems early to minimize disability. Elimination of disability may not be possible. Health education does not teach about the Healthy People 2020 document or break populations into individuals. DIF: Cognitive level: Understanding REF: p. 356 TOP: Nursing process: Evaluation MSC: NCLEX: Safe and Effective Care Environment: Management of Care

Which type of hepatitis would likely be found where sanitation is inadequate? a. A b. B c. C d. D

ANS: A Hepatitis A would likely be found where sanitation is inadequate.

A public health nurse collaborates with local community leaders to develop a local campaign educating about the importance of wearing a seat belt. What client system of the integrative model does this describe? a. Community b. Aggregate c. Family d. Individual

ANS: A Interventions to initiate or maintain healthy lifestyles must be multifocal. At the broadest level of care (community), nurses work with community leaders, other community residents, and health professionals to plan programs to promote optimal health for the community and its people.

A nurse is uncomfortable discussing such topics as sexual behavior and sexual orientation when counseling clients. By avoiding this topic with clients: a. Potential risks and risky behaviors will not be identified. b. Transmission of sexually transmitted diseases will decrease. c. Clients will be reluctant to return to care providers. d. The nurse will be violating the laws in most states.

ANS: A It is important that nurses be able to discuss these topics to help prevent and control STDs. Without discussion of these topics, it is possible that clients will not be aware that they have an STD and may transmit it to others.

John Snow is called the father of epidemiology because of his work with: a. Cholera b. Malaria c. Polio d. Germ theory

ANS: A John Snow investigated the spread of cholera in the mid-nineteenth century.

Which statement is true about mortality rates? Mortality rates: a. Are informative only for fatal diseases b. Provide information about existing disease in the population c. Are calculated using a population estimate at year-end d. Reveal the risk of getting a particular disease

ANS: A Mortality rates are informative only for fatal diseases and do not provide direct information about the level of existing disease or the risk of getting a particular disease.

As a result of an outbreak of influenza in a community, a nurse encourages members of the community to receive the influenza vaccine. Which level of prevention is being used? a. Primary prevention b. Secondary prevention c. Tertiary prevention d. Multifactorial prevention

ANS: A Nurses are involved in epidemiologic surveillance by monitoring the potential for disease outbreaks. Primary prevention refers to interventions aimed at preventing the occurrence of disease, injury, or disability.

A nurse is assisting an employer who has hired an individual who has been recently diagnosed with HIV. Which intervention would be most appropriate for the nurse to implement? a. Educate about how to reduce the risk of breaching the employees confidentiality. b. Explain how to inform co-workers about avoiding HIV transmission. c. Facilitate obtaining medical insurance coverage for the HIV-infected employee. d. Describe the early signs and symptoms of HIV infection.

ANS: A Nurses frequently work in the education role, and employers may need assistance in dealing with HIV-infected employees.

It is important that nurses are involved in health policy because: a. Government and policy have a large impact on nursing and health. b. Policy affects nursing values as set forth by Florence Nightingale. c. Political science is a course of study that parallels nursing. d. Nurses must interpret laws to fit their practice.

ANS: A Nurses should be advocates for the health of the population. In order to do this, nurse professionals must have a working knowledge of government, health care law, the policy process, and the political forces that are shaping the future of health care.

An occupational health nurse maintains a log of injuries from contaminated sharps because of the: a. Bloodborne Pathogen Standard b. Occupational Safety and Health Administration (OSHA) c. Department of Labor (DOL) d. Department of Defense (DOD)

ANS: A OSHA is part of the Department of Labor. The Bloodborne Pathogen Standard became effective in 2002.

A community health nurse is writing an objective. Which of the following would be most appropriate for the nurse to write? a. Each member of the family will give an insulin injection to the client with accurate dosage 100% of the time for 10 consecutive trials. b. The client will perform a blood sugar test on herself with an accurate blood sugar reading. c. The community will take their children to receive immunizations within 1 month of the immunization due date. d. Fifty percent of the eligible women seen in the clinic will return for their scheduled mammogram appointment.

ANS: A Objectives are specific, short-term criteria that need to be met as steps toward achieving the long-term goal. They are written as statements of an intended outcome or expected change in behaviors and should be defined in measurable terms. The objective "each member of the family will give an insulin injection to the client with accurate dosage 100% of the time for 10 consecutive trials" contains the components of a written objective. "The client will perform a blood sugar test on herself with an accurate blood sugar reading" does not provide any measureable terms. "The community will take their children to receive immunizations within 1 month of the immunization due date" does not provide a measurable percentage of the members of the community. "Fifty percent of the eligible women seen in the clinic will return for their scheduled mammogram appointment" focuses on a long-term goal, rather than a short-term objective and does not provide a time frame for when this would be measured. DIF: Cognitive level: Analyzing REF: p. 359 TOP: Nursing process: Planning MSC: NCLEX: Health Promotion and Maintenance

A public health nurse is reviewing Healthy People 2020 to determine where to prioritize programming for the county health department. Based on Healthy People 2020, the nurse decides to implement programming to: a. Reduce the rate of HIV transmission among adults and adolescents. b. Eliminate STDs from developed countries. c. Reduce deaths from gonorrhea. d. Increase awareness about HIV in lesbian females.

ANS: A One of the Healthy People 2020 objectives is reducing the number of cases of HIV infection among adults and adolescents.

A client diagnosed with diabetes reports to the nurse that she has been learning more about controlling her blood sugars by reading information found on the Internet. Which of the following statements by the nurse would be appropriate? a. "Looking at the date the content was posted on the website is important." b. "The Internet is an unreliable source of information and should not be used." c. "The best sources of information are found on pharmaceutical websites." d. "Your physician will provide you better information than the Internet."

ANS: A One of the ways to assess the reliability and validity of Internet sources is to look at its currency, including the dates when the content was posted and updated. The Internet has reliable information, but the quality of the information must be assessed. Pharmaceutical websites may have biased information. Physicians are another source of information, but this may or may not be better than what is found on the Internet. DIF: Cognitive level: Analyzing REF: p. 364 TOP: Nursing process: Implementation MSC: NCLEX: Health Promotion and Maintenance

Pelvic inflammatory disease (PID) is a common complication of: a. Gonorrhea b. Syphilis c. Chancroid d. Herpes

ANS: A PID is a common complication of gonorrhea.

An example of a point source of air pollution is: a. A smoke stack b. The number of cars and trucks c. How much fossil fuel is consumed in a community d. Ground ozone levels

ANS: A Point sources of pollution are identifiable sources of air pollution, such as a smoke stack.

A nurse discusses with legislators the importance of passing legislation to ban smoking in all public places. This demonstrates the nurses involvement in: a. Policy b. Politics c. Law d. Health policy

ANS: A Politics is the art of influencing others to accept a specific course of action. Therefore political activities are used to arrive at a course of action (the policy).

Why is it important for nurses to understand the premises of environmental health? a. Nurses should be able to assess risks and advocate for policies that support healthy environments. b. Toxicologists often consult nurses about environmental pollutants. c. Pollutant exposures such as lead are reported by nurses to the Environmental Protection Agency. d. Many Americans live in areas that do not meet current national air quality standards.

ANS: A Potential risks to health are concerns for professional nurses. It is the responsibility of the nurse to understand as much as possible about these risks: how to assess them, how to eliminate/reduce them, how to communicate and educate about them, and how to advocate for policies that support healthy environments.

A nurse is completing an exposure history using the mnemonic I PREPARE. What data would a nurse collect when asking questions about the first P? a. Present work b. Potential exposures c. Personal protective equipment use d. Problems with health

ANS: A Present work is the first P.

A screening for diabetes revealed 20 previously diagnosed diabetics and 10 probable new cases, which were later confirmed, for a total of 30 cases. This is called: a. Prevalence b. Incidence c. Attack d. Morbidity

ANS: A Prevalence is the measure of existing disease in a population at a particular time.

Adoption of universal precautions by health care workers is an example of: a. Primary prevention b. Secondary prevention c. Tertiary prevention d. Specific protection

ANS: A Primary prevention refers to those interventions aimed at preventing the occurrence of disease, injury, or disability.

Immunization for measles is an example of: a. Primary prevention b. Secondary prevention c. Tertiary prevention d. Health promotion

ANS: A Primary prevention refers to those interventions aimed at preventing the occurrence of disease, injury, or disability.

Screening blood products and donor organs and tissue for hepatitis C infection is: a. Primary prevention b. Secondary prevention c. Tertiary prevention d. Health promotion

ANS: A Primary prevention refers to those interventions aimed at preventing the occurrence of disease, injury, or disability.

A nurse uses the leadership behavior of reflecting when providing education to community members about how to lead healthy lifestyles. Which of the following actions is most likely being taken by the nurse? a. Providing feedback on how behavior appears to others b. Introducing new topics to the group c. Verifying information through questions and restatement d. Highlighting important points from the discussion

ANS: A Reflecting involves giving feedback on how behavior appears to others. Advising introduces new topics. Clarifying verifies new information. Summarizing highlights the important points. DIF: Cognitive level: Applying REF: p. 371 (Box 16-7) TOP: Nursing process: Implementation MSC: NCLEX: Safe and Effective Care Environment: Management of Care

Which Core Competency of communication is used by nurses engaged in group work? a. Soliciting input from individuals and organizations b. Using simple language when presenting information c. Asking the group to develop the program of interest d. Presenting material to lay audiences

ANS: A Soliciting input from individuals and organizations is a communication competency. Various strategies should be used to present the information. The group should assist in determining the topic, but not developing the program. The material should be presented to professional and lay audiences. DIF: Cognitive level: Understanding REF: p. 373 (Box 16-8) TOP: Nursing process: Assessment MSC: NCLEX: Health Promotion and Maintenance

A nurse is presenting information to the county health department about potential bioterrorism threats. Which of the agents would the nurse discuss in this presentation? a. Smallpox b. West Nile Virus c. Severe acute respiratory syndrome (SARS) d. Novel influenza A H1N1

ANS: A Susceptibility to smallpox is 100% in the unvaccinated and fatality rate is estimated at 20% to 40% or higher. The agents of highest concern are anthrax, plague, smallpox, botulism, tularemia, and selected hemorrhagic viruses.

An example of tertiary prevention is: a. Rehabilitative job training b. Parenting education c. Testicular self-examination d. Family counseling

ANS: A Tertiary prevention includes those interventions aimed at disability limitation and rehabilitation from disease, injury, or disability.

The agency most heavily involved with the health and welfare concerns of United States citizens is the: a. Unites States Department of Health and Human Services (DHHS) b. Public Health Service c. Health Resources and Services Administration d. World Health Organization

ANS: A The DHHS is the agency most heavily involved with the health and welfare of United States citizens. It touches more lives than any other federal agency.

A member of the military receives health care services through which department? a. Defense b. Labor c. Agriculture d. Justice

ANS: A The Department of Defense delivers health care to members of the military, including their dependents and survivors, and to retired members and their families.

The nurse counsels a client to have the enzyme-linked immunosorbent assay (EIA) test in order to: a. Indicate the presence of the antibody to HIV. b. Reveal whether or not the client has AIDS. c. Isolate the HIV virus. d. Confirm HIV after having a positive Western blot.

ANS: A The EIA is used to indicate the presence of the antibody to HIV.

The Guide to Clinical Preventive Services provides: a. The most recent recommendations for preventive interventions b. Assistance in interpreting Healthy People 2020 c. A basis for public health nursing practice d. Health risk appraisal instruments

ANS: A The Guide to Clinical Preventive Services provides recommendations for preventive interventions including screening tests, counseling, immunizations, and chemoprophylaxis.

A nurse is working with a group of clients diagnosed with diabetes and is teaching a class about avoiding the long-term effects of diabetes. The nurse begins the class by reviewing the basic physiology of diabetes, which was taught the week before. Which of the following principles of effective education is the nurse using? a. Stimulating recall of prior learning b. Gaining attention c. Presenting the material d. Providing learning guidance

ANS: A The educator should have the learners recall previous knowledge related to the topic of interest. The principle of gaining attention should have been applied as the program started the week before. Recall should be done before new material is presented and before learning guidance is provided. DIF: Cognitive level: Applying REF: p. 361 TOP: Nursing process: Implementation MSC: NCLEX: Health Promotion and Maintenance

When a school nurse reports suspected child abuse, there is a breach of confidentiality. This breach is allowed because of: a. Civil immunity b. Sovereign immunity c. Nurse practice act d. Respondeat superior

ANS: A The law mandates that a health professional breach patient confidentiality norms to protect someone who may be in a helpless or vulnerable position.

Examples of modifiable behaviors include: a. Smoking, poor diet, and alcohol consumption b. Cancer, emphysema, and cardiovascular disease c. Walking, running, and aerobic exercise d. Genetic abnormalities

ANS: A The leading causes of death in 2000 were tobacco use, poor diet, physical inactivity, and alcohol consumption. These are modifiable behaviors.

During a class on newborn care given at a local health department, a nursing student asks the participants to practice with baby dolls. Which of the following steps of promoting effective education is the student using? a. Eliciting performance b. Assessing performance c. Enhancing retention and transfer of knowledge d. Gaining attention

ANS: A The step of eliciting performance includes encouraging the learners to demonstrate what they have learned. Gaining attention occurs at the beginning of the program. Assessing performance occurs at the end of the program. Enhancing retention and transfer of knowledge occurs as the learners are asked to apply the information to their lives and situations (not to the care of the dolls). DIF: Cognitive level: Applying REF: p. 361 TOP: Nursing process: Implementation MSC: NCLEX: Health Promotion and Maintenance

A 5-feet, 6-inch, 25-year-old woman who weighs 120 pounds runs 5 miles a day because it improves her mood and energy level. Which term best describes this example? a. Health promotion b. Illness prevention c. Health maintenance d. Health protection

ANS: A The woman is exercising to improve and promote her health. Health promotion is directed toward achieving a greater level of health.

When a nurse examines birth and death certificates during an epidemiologic investigation, what data category is being used? a. Routinely collected data b. Data collected for other purposes but useful for epidemiologic research c. Original data collected for specific epidemiologic studies d. Surveillance data

ANS: A These are examples of data collected routinely.

Nurses are available to provide health services for women and children due to the provisions of the: a. Sheppard-Towner Act b. Public Protection of Maternity and Infancy program c. Early Periodic Screening and Developmental Testing (EPSDT) program d. Women, Infants, and Children (WIC) program

ANS: A This act also offered well-child and child-development services, provided adequate hospital services and facilities for women and children, and provided grants-in-aid for establishing maternal and child welfare programs.

The basic science applied to understanding the health effects associated with chemical exposures is: a. Toxicology b. Pharmacology c. Chemistry d. Environmental epidemiology

ANS: A Toxicology is the study of the health effects associated with chemical exposures.

An example of a vertical transmission of a disease is through: a. Breast milk b. Sexual transmission c. Mosquitoes d. Contaminated food

ANS: A Vertical transmission is the passing of infection from parent to offspring via sperm, placenta, milk, or contact in the vaginal canal at birth.

Which intervention is being performed on the individual level? Select all that apply. a. Teaching well-balanced nutrition to a mother with a malnourished child b. Providing a parent age-specific information for immunizations c. Assessing the community for other cases of malnutrition d. Assessing other families on the same street for similar problems

ANS: A, B Teaching well-balanced nutrition and age-specific information about immunizations are the only interventions that focus on individuals. The other examples relate to families and the community.

A public health nurse working with a family living in poverty recognizes that they are more likely to be exposed to environmental hazards because they have (select all that apply): a. Limited funds to pay for health care b. Poor nutrition c. Homes located closer to hazardous waste sites d. Less education

ANS: A, B, C Families living in poverty are more likely to experience environmental justice issues such as disproportionate environmental exposures. Sub-standard housing, living closer to hazardous waste sites, working in more hazardous jobs, poorer nutrition, and less access to quality health care all contribute to this issue. Although limited education is related to poverty, it is not discussed as causing an increase in environmental exposure.

Congress's legal base for actions in health care include (select all that apply): a. Providing for the general welfare b. Raising funds to support research c. Regulating commerce among the states d. Providing spending power

ANS: A, B, C, D The legal base for actions in health care includes providing for the general welfare, regulating commerce among the states, providing spending power, and raising funds to support the military.

Which elements of surveillance does a nurse use? Select all that apply. a. Mortality registration b. Epidemic field investigation c. Laboratory reporting d. Individual case investigation

ANS: A, B, C, D There are 10 basic elements of surveillance. Mortality registration, epidemic field investigation, laboratory reporting, and individual case investigation are among them

The Centers for Disease Control and Prevention accomplishes its mission by (select all that apply): a. Implementing prevention strategies b. Detecting and investigating health problems c. Dictating world health policy d. Fostering safe and healthful environments

ANS: A, B, D The Centers for Disease Control and Prevention implements prevention strategies, detects and investigates health problems, and fosters safe and healthful environments.

A nurse is using basic educational principles when conducting an effective educational program. Which of the following principles would the nurse most likely be using? (Select all that apply.) a. Use a clear, succinct style b. Use an active voice c. Refer to Internet sources d. Use aids to highlight key points e. Repeat information several times

ANS: A, B, D Using a clear, succinct style, active voice, and using aids to highlight key points are all basic educational principles that should be used by the nurse. Reliable sources must be used, and information found on the Internet is not always reliable. Repeating information is not an education principle. DIF: Cognitive level: Applying REF: pp. 359-360 TOP: Nursing process: Implementation MSC: NCLEX: Health Promotion and Maintenance

The nurse is counseling a female who has recently tested positive for HIV. The nurse educates her that she is responsible to (select all that apply): a. Have regular medical evaluations and follow-ups. b. Donate blood, plasma, body organs, or sperm. c. Inform health care providers about the HIV infection. d. Consider the risk of perinatal transmission.

ANS: A, C, D A person who is infected with HIV should have regular medical evaluations and follow-up appointments; not donate blood, plasma, body organs, or sperm; inform health care providers about the HIV infection; and consider the risk of perinatal transmission and follow-up with contraceptive use.

When using Anderson and McFarlanes model to complete a community health assessment, a nurse would collect information about the _____ the community. a. Resources available to promote health in b. Interactions among subsystems in c. Physical environment of d. Demographics of

ANS: B A community health assessment must include information about the subsystems and interactions of the total community with the systems external to it.

Which is an example of an agent in the epidemiologic triangle? a. Human population distribution b. Salmonella c. Genetic susceptibility d. Climate

ANS: B An agent includes infectious organisms.

An example of an agent is: a. Host resistance b. Virus c. Infectiousness d. Bug bite

ANS: B An agent is described by its ability to cause disease and the nature and the severity of the disease.

An epidemiologist wanting to know what caused severe diarrhea and vomiting in several people at a local banquet would be using: a. Descriptive epidemiology b. Analytic epidemiology c. Distribution d. Determinants

ANS: B Analytic epidemiology is directed toward understanding the etiology of the disease.

Environmental health is important to nurses because chemical, biological, and radiological materials are: a. A major cause of global warming b. Often found in the air, water, and products we use c. Frequently linked to the development of chronic illnesses d. Products that nurses work with on a daily basis

ANS: B Chemical, biological, and radiological pollutants are often found in the air we breathe, the water we drink, and the products we use.

A public health nurse is working with a migrant farm worker who has experienced an exposure to a pesticide. When researching pesticides, the nurse looks at the family of the chemical. What similarities are found among chemicals that have been placed in the same family? a. Route of entry into the body b. Actions and associated risks c. Effects that they have on the body d. Potency and toxicity

ANS: B Chemicals are grouped so its possible to understand the actions and risks associated with each group.

Food intoxication is caused by: a. Toxins produced by bacterial growth and chemical contaminants b. Bacterial, viral, or parasitic invasion of food c. Overcooking of meat and produce d. Adding too many spices or ingredients to food

ANS: B Food intoxication is caused by bacterial, viral, or parasitic invasion of food.

A nurse is developing a goal for a client who is learning how to care for an ostomy. Which of the following would be most appropriate to develop? a. The client will look at his stoma without disgust each time his ostomy bag comes off. b. The client will be able to independently take care of his ostomy bag within three months. c. The client will gather all ostomy supplies correctly each time his ostomy bag needs to be changed. d. The client will successfully describe to the nurse how to care for his ostomy when he is asked.

ANS: B Goals are broad, long-term expected outcomes. The correct answer describes something that will happen over a long period of time. The other choices describe objectives. DIF: Cognitive level: Analyzing REF: p. 359 TOP: Nursing process: Planning MSC: NCLEX: Health Promotion and Maintenance

An example of HIV transmission is: a. Having contact with a HIV-positive individual who is coughing b. An infant receiving breast milk from a HIV-positive mother c. Receiving a mosquito bite while in Africa d. Being near a HIV-positive individual who is sneezing

ANS: B HIV can be transmitted through breast milk.

In comparison with HIV infection in adults, HIV infection in infants and children: a. Has the same signs and symptoms b. Has a shorter incubation period c. Has a longer survival period d. Is detected by using the same tests

ANS: B HIV infection in infants and children has a shorter incubation period.

Needle stick legislation clarified the role of employers to: a. Use Universal Precautions when dealing with all patients. b. Select safer needle devices as they became available. c. Provide needle disposal boxes. d. Incinerate all infectious waste including needles.

ANS: B Health care facilities by law have to select safer needle devices and involve employees in identifying and choosing the devices.

A nurse uses Healthy People 2020 as a guide when planning health education in the community. Which of the following actions would be taken by the nurse? a. Focus on avoiding cigarette smoking and using alcohol in moderation b. Educate clients using primary and secondary levels of prevention c. Use Bloom's taxonomy when planning educational objectives d. Design health fairs aimed at individuals

ANS: B Healthy People 2020 focuses on implementing health promotion in priority areas using primary and secondary prevention. Understanding the three learning domains is crucial in providing effective health care. Health fairs targeted at specific populations can provide a venue for providing primary and secondary prevention. DIF: Cognitive level: Applying REF: p. 356 TOP: Nursing process: Implementation MSC: NCLEX: Health Promotion and Maintenance

Immunity is a characteristic of the: a. Agent factor b. Host factor c. Environmental factor d. Epidemiologic triad

ANS: B Immunity refers to species-determined resistance to an infectious agent.

A nurse is working with an individual who has a low literacy level. Which of the following barriers to learning should the nurse anticipate? a. Asking for additional clarification of materials b. Requesting to read the information later c. Having a high level of anxiety d. Being overly dependent on others

ANS: B Individuals with a limited literacy may have a limited vocabulary and general knowledge and do not ask for clarification. They may focus on details and deal in literal or concrete concepts versus abstract concepts. They may select responses on a survey without necessarily understanding them and may be unable to understand math. They may have a low motivation to engage in learning or may drop subtle clues that they cannot read by stating they will look at information later or take it home. The level of anxiety may vary among these individuals; it is more common for these individuals to request to read it later. DIF: Cognitive level: Applying REF: p. 365 TOP: Nursing process: Planning MSC: NCLEX: Health Promotion and Maintenance

A nurse has evaluated the learning needs of a community support group. Which of following steps should the nurse take when developing an educational program for them? a. Consider any potential barriers to learning b. Establish goals and objectives for the program c. Select appropriate materials for the program d. Assess the dynamics of the group

ANS: B Instructional objectives need to be evaluated before a teaching program is designed. The five steps of the educational process are: (1) identifying educational needs, (2) establishing educational goals and objectives, (3) selecting appropriate educational methods, (4) implementing the educational plan, and (5) evaluating the educational process. DIF: Cognitive level: Applying REF: p. 359 TOP: Nursing process: Planning MSC: NCLEX: Health Promotion and Maintenance

Which is an example of an epidemic? a. Bird flu in China b. Adult obesity in the United States c. An isolated case of smallpox in Africa d. The nursing shortage in the United States

ANS: B It is estimated that 30% of the adults in the United States are obese. According to the CDC, this is an epidemic.

According to Leavell and Clark, primary prevention consists of: a. Health promotion and rehabilitation b. Health promotion and specific protection c. Early diagnosis and prompt treatment d. Health maintenance and early diagnosis

ANS: B Leavell and Clark stated that primary prevention includes health promotion and specific protection from disease.

States have certain continuing education requirements for persons to renew a nursing license. This type of law is called: a. Constitutional law b. Legislation and regulation c. Judicial and common law d. Police power

ANS: B Licensing is regulated by each states nurse practice act as a function of the board of nursing.

A nurse is working in a health department when a patient arrives who has been traveling to South America and has been diagnosed with malaria. The nurse knows: a. The Morbidity and Mortality Weekly Report should be consulted to investigate the rate of malaria in the United States. b. This is a disease that must be reported to the state health department. c. The nurse should take precautions to wear a mask and gown to avoid exposure. d. The patient is very ill and should be sent to the hospital immediately.

ANS: B Malaria is on the list of infectious diseases notifiable at the national level.

A doctoral prepared nurse (PhD) at a university wants to submit a grant to study the impact of a nursing activity on patient outcomes. From which federal agency could this nurse potentially seek funding? a. Centers for Disease Control and Prevention (CDC) b. National Institute of Nursing Research (NINR) c. Department of Health and Human Services (DHHS) d. World Health Organization (WHO)

ANS: B NINR funds the development of the knowledge base of nursing and promotion of nursing services in health care.

Which situation describes the role of a nurse being involved in surveillance? a. Educating clients about influenza immunizations b. Collecting information about occurrence of measles c. Evaluating the effectiveness of a HIV/AIDS prevention program d. Advocating for changes in the national disease reporting requirements

ANS: B Nurses are frequently involved in surveillance by collecting data, making diagnoses, investigating and reporting cases, and providing information to the general public.

One of the main purposes of the Patient Protection and Affordable Care Act was to: a. Create a government-funded insurance program for all Americans. b. Make health insurance affordable for the middle class and small businesses. c. Decrease the rates of chronic disease in the United States. d. Increase the funding for public health agencies.

ANS: B One of the main purposes of this legislation was to make health insurance affordable for middle class families and small businesses with one of the largest tax cuts for health care in history: reducing premiums and out-of-pocket costs. This act does not create a government-funded insurance program nor does it increase funding for public health agencies.

An outbreak of a gastrointestinal illness from a food-borne pathogen is an example of a(n): a. Attack rate b. Point epidemic c. Secular trend d. Event-related cluster

ANS: B One temporal and spatial pattern of disease distribution is the point epidemic. A point epidemic is most clearly seen when the frequency of cases is plotted against time. The sharp peak characteristic of such graphs indicates a concentration of cases in some short interval of time.

A leader controls members through rewards and often keeps members in the dark about the goals and rationale behind prescribed actions. What type of leadership does this describe? a. Democratic b. Patriarchal c. Socialist d. Paternal

ANS: B Patriarchal is authoritative, whereas one may control members through rewards and threats. Paternal leaders win respect and dependence through parent-like devotion. Democratic leadership is cooperative in nature and promotes and supports members' involvement in all aspects of decision making and planning. Socialist leadership supports community ownership and involvement of the community. DIF: Cognitive level: Applying REF: p. 371 TOP: Nursing process: Implementation MSC: NCLEX: Safe and Effective Care Environment: Management of Care

Which is considered a nonpoint source of pollution? a. Hazardous waste site b. Animal waste from wildlife c. Chlorine poured down a well d. Stagnant water

ANS: B Point source means a single place from which the pollutant is released into the environment, whereas nonpoint source implies a more diffuse source of pollution.

A nurse is planning to evaluate an individual's progress toward a health goal. Which of the following components should be included in the evaluative process? a. Type of teaching strategy used b. Recognition of accomplishments in the group c. Conflict that occurred in the group d. The type of leadership in the group

ANS: B Recognition of accomplishments in the group and of the group is built into the evaluative process. The type of teaching strategies used, types of leadership, and conflict are not part of the evaluative process of the group. DIF: Cognitive level: Applying REF: p. 374 TOP: Nursing process: Evaluation MSC: NCLEX: Health Promotion and Maintenance

The probability an event will occur within a specified period of time is called: a. Rate b. Risk c. Epidemiology d. Epidemic

ANS: B Risk is the probability an event will occur within a specified period of time.

Rabies post-exposure immunization is an example of which of the following levels of prevention with regard to infectious disease interventions? a. Primary prevention b. Secondary prevention c. Tertiary prevention d. Assessment

ANS: B Secondary prevention focuses on early detection and prompt treatment of disease, injury, or disability.

Screening for hearing defects is an example of: a. Primary prevention b. Secondary prevention c. Tertiary prevention d. Health promotion

ANS: B Secondary prevention focuses on early detection and prompt treatment of disease, injury, or disability.

Screening school-age children for hearing deficits is an example of: a. Primary prevention b. Secondary prevention c. Tertiary prevention d. Health promotion

ANS: B Secondary prevention focuses on early detection and prompt treatment of disease, injury, or disability.

Teaching a client with gonorrhea how to prevent reinfection and further spread is an example of _____ prevention. a. Primary b. Secondary c. Tertiary d. Primary health care

ANS: B Secondary prevention focuses on early detection and prompt treatment of disease, injury, or disability.

In which situation does the nurse need to be aware of the potential for selection bias? a. Determining the population to be studied b. Considering how the participants will enter the study c. Studying cause and effect relationships d. Documenting results of the study

ANS: B Selection bias is attributable to the way subjects enter a study. It has to do with selection procedures and the population from which subjects are drawn.

If a nurse wanted more information on indoor air quality, which website would be most helpful? a. The National Institutes of Health (NIH) b. The American Lung Association c. Right to Know d. The Occupational Safety and Health Administration (OSHA)

ANS: B Sources of information about air quality include the Environmental Protection Agency (EPA) and the American Lung Association.

If a nurse researcher wants to get information on the occurrence of an internationally important disease, where would be a good place to seek this information? a. The United Nations website b. The World Health Organization (WHO) website c. The World Bank website d. The World Health Assembly website

ANS: B The WHO publishes day-to-day information about international occurrence of disease, injury, and death.

A health educator is trying to change a client's attitudes about smoking. Which of the following domains would be used? a. Cognitive b. Affective c. Psychomotor d. Developmental

ANS: B The affective domain is used to attempt to influence what individuals, families, communities, and populations feel, think, and value. The cognitive domain includes memory, recognition, understanding, reasoning, and problem solving. The psychomotor domain includes the performance of skills that require some degree of neuromuscular coordination and emphasizes motor skills. Developmental domain is not one of the domains of learning. DIF: Cognitive level: Applying REF: p. 358 TOP: Nursing process: Implementation MSC: NCLEX: Health Promotion and Maintenance

The biomedical model defines health as the: a. Avoidance of illness b. Absence of disease c. Promotion of healthy behaviors d. Protection from illness and disease states

ANS: B The biomedical model defines health as the absence of disease. It does not explain why populations remain healthy or how health is enhanced.

Which part of the immunological system suffers the greatest damage as a result of HIV infection? a. Dendrite cells b. CD4+ T-lymphocytes c. Macrophages d. Monocytes

ANS: B The count drops when the virus is most plentiful in the body.

The United States Department of Health and Human Services (DHHS) is part of which branch of the government? a. Judicial b. Executive c. Legislative d. Health

ANS: B The executive branch includes regulatory departments, one of which is the United States DHHS.

The time interval between invasion by an infectious agent and the first appearance of signs and symptoms of the disease is called: a. Communicable period b. Incubation period c. Infectiousness d. Pathologic reaction

ANS: B The incubation period is the time interval between invasion by an infectious agent and the first appearance of signs and symptoms.

The most important predictor of overall mortality is: a. Race b. Age c. Gender d. Income

ANS: B The mortality curve by age drops sharply during and after the first year of life to a low point in childhood, then begins to increase through adolescence and young adulthood and then increases sharply through middle and older ages.

When one case of smallpox occurs in a population in which it was considered to be previously eliminated, it is called: a. Endemic b. An epidemic c. Pandemic d. Infectivity

ANS: B The occurrence of one case of smallpox in a population in which it was considered to be previously eliminated is an epidemic.

When planning, delivering, and financing responsibility for programs is shifted from the federal level to the state level, it is called: a. Evolution b. Devolution c. Block granting d. State administration

ANS: B The process of shifting the responsibility for planning, delivering, and financing programs from the federal level to the states is called devolution. This was a major effort during the Reagan administration.

A nurse provides counseling to an obese client about the importance of good nutrition and regular exercise with the intention of helping the client avoid future chronic diseases associated with obesity. What client system and focus of care are being applied in this situation? a. Family level health promotion b. Individual level illness prevention c. Aggregate level illness prevention d. Individual level health promotion

ANS: B The simplest level of the client system is the individual. The focus of care is illness prevention, directed at disease or disability prevention.

When would it be appropriate for a nurse to use a Geographic Information System (GIS)? a. Recording client data collected at a foot clinic b. Determining neighborhoods that have an increased incidence of lead poisoning c. Evaluating effectiveness of a farm safety program d. Scheduling health promotion programs in the community

ANS: B The use of a Geographic Information System (GIS) allows the public health nurse to apply the principles of epidemiology into practice. GIS allows nurses to code data so that it is related spatially to a place on earth and is helpful in determining concentrated areas for incidence of disease and illness.

A 5-feet, 6-inch, 25-year-old female who weighs 120 pounds walks 5 miles a day because she has a long family history of early death from heart attacks and is refraining from a sedentary lifestyle. Which term best describes this example? a. Health promotion b. Illness prevention c. Health maintenance d. Health protection

ANS: B The woman is exercising to prevent an illness that runs in her family. Illness prevention is a behavior directed toward reducing the threat of illness.

When would a nurse use The Guide to Clinical Preventive Services? a. Conducting group risk appraisal and risk reduction b. Providing recommendations for preventive interventions c. Completing a community wellness inventory d. Improving environmental living conditions and sanitation

ANS: B These include screening tests, counseling, immunizations, and chemoprophylaxis regimens for more than 80 conditions.

A nurse utilizes the provisions created by the Ryan White Comprehensive AIDS Resource Emergency Act when performing which intervention? a. Increasing AIDS awareness in the community b. Determining available health care services for HIV-infected individuals c. Preventing the transmission of AIDS to children from their mothers d. Allowing persons in the final stages of HIV to die with dignity

ANS: B This act provides services including emergency services, services for early intervention and care, and drug reimbursement programs for HIV-infected individuals.

A public health nurse understands that the emergence of new infectious diseases is influenced by the: a. Increased availability of immunizations b. Globalization of food supplies c. Decreased use of child care facilities d. Creation of sanitation systems in third world countries

ANS: B This is one of the many factors that can influence the emergence of infectious diseases.

What information would be appropriate for a nurse to share when educating IV drug users about sharing equipment? a. Tell the clients to throw away their equipment after one use. b. Educate the clients on using full-strength bleach on their drug paraphernalia for 30 seconds. c. Report illegal activities to the authorities and confiscate the needles and syringes. d. Give out needles and syringes to whoever wants them.

ANS: B Using bleach on the needles and syringes is a way to decrease cross contamination.

An example of a vector is: a. Contaminated water b. A tick c. A dirty needle d. An infected person

ANS: B Vectors transmit the infectious agent by biting or depositing the infective material near the host.

West Nile Virus is an example of which of the following types of illness? a. Foodborne b. Vectorborne c. Waterborne d. Zoonoses

ANS: B West Nile virus is carried by a mosquito, which is a vector.

Nurses incorporate epidemiology into their practice and function in epidemiologic roles through (select all that apply): a. Policy making and enforcement b. Collection, reporting, analysis, and interpretation of data c. Environmental risk communication d. Documentation on patient charts and records

ANS: B, C, D The 2nd, 3rd, and 4th options are examples of the use of epidemiology in practice. The first option does not apply to epidemiology.

Which approach(s) can a nurse use when assessing environmental health risks? Select all that apply. a. Ask legislators to provide a list of environmental pollutants in the area. b. Develop a list of exposures associated with urban, rural, or suburban settings. c. Assess the risk by medium such as air, water, soil, or food. d. Divide the environment into functional locations: home, school, workplace, and community.

ANS: B, C, D The 2nd, 3rd, and 4th options are ways a nurse can assess the environment.

Epidemiologic studies of diseases conducted by nurses during the twentieth century were influenced by the (select all that apply): a. Increasing rate of poverty b. Declining child mortality rates c. Overcrowding in major cities d. Development of new vaccinations

ANS: B, D Factors contributing to the development and application of epidemiologic methods in the twentieth century were: improved nutrition, new vaccines, better sanitation, the advent of antibiotics and chemotherapies, and declining infant and child mortality and birth rates. A rise in the standard of living occurred for many following the Great Depression and World War II.

When writing to a legislator to advocate for funds to support advanced practice nursing education, a nurse should remember to (select all that apply): a. Limit the letter to one page in length. b. Identify oneself as a nurse. c. Provide only factual information. d. Share personal knowledge about the issue.

ANS: B, D When writing to a legislator, the letter should be a maximum of two pages in length and opinions should be expressed. Additionally, the nurse should identify oneself as a nurse and share knowledge about the issue.

. The type of epidemiologic study that is used to describe a group of persons enrolled in a study who share some characteristic of interest and who are followed over a period of time to observe some health outcome is a(n): a. Case control study b. Cross-sectional study c. Cohort study d. Experimental study

ANS: C A cohort study is the type of epidemiologic study that is used to describe a group of persons enrolled in a study who share some characteristic of interest and who are followed over a period of time to observe some health outcome.

A person has syphilis with signs and symptoms of rash, sore throat, and muscle and joint pain. This person is experiencing which stage of syphilis? a. Congenital b. Primary c. Secondary d. Tertiary

ANS: C A person with signs and symptoms of a rash, sore throat, and muscle/joint pain is experiencing the secondary stage of syphilis.

Nurses working in hospice and home care settings need to be knowledgeable of health policy to: a. Provide safe nursing care. b. Prevent elder abuse. c. Receive payment for the services provided. d. Influence future legislation.

ANS: C Although nurses should be involved in influencing future legislation by contacting their legislators, the best response is that nurses need to be knowledgeable of the current health policies needed so that payment can be received for services that are providing.

A nurse fulfills the environmental health competency of assessment and referral when: a. Advocating for public policy changes b. Understanding policy framework and major pieces of legislation c. Completing an environmental health history d. Describing the scientific principles about environmental health

ANS: C Assessment is always an important element of the nursing process. The third option is an example of the assessment phase of the nursing process.

What action can a nurse take on an individual level to reduce pollution in the environment? a. Provide a tax incentive to factories that do not pollute. b. Make laws related to allowed levels of pollution in the area. c. Choose a less-polluting car. d. Move to an area with less pollution.

ANS: C Citizens can reduce air pollution by doing their part, which can include choosing less-polluting cars.

A nurse tells a coworker that she has been working on a regular basis with a group that demonstrates cohesion. Which of the following groups is the nurse most likely to describe? a. A group with several leaders b. A group with diverse attitudes and values c. A group with a common goal d. A group with efficient members

ANS: C Cohesion is the attraction between individual members and between each member and the group. Group effectiveness improves as members work together toward group goals while still satisfying the needs of individual members. A group with several leaders may have difficulty obtaining cohesion if each of the leaders has a different idea. Common attitudes and values among the group members will be important for the group to obtain cohesion. Efficiency does not play a role in developing cohesion. DIF: Cognitive level: Applying REF: p. 369 TOP: Nursing process: Implementation MSC: NCLEX: Health Promotion and Maintenance

Epidemiology: a. Is a science that studies the poisonous effects of chemicals b. Explains the association between learning disabilities and exposure to lead-based paint at the cellular level c. Helps nurses understand the strength of the association between exposure and health effects d. Is a method for tracking the prevalence of a disease

ANS: C Epidemiology studies the incidence and prevalence of disease, helping nurses understand the strength of the association between exposure and health effects.

A nurse is implementing an educational program about the importance of being physically active. Which of the following steps would the nurse complete first? a. Provide learning guidance b. Present the stimulus c. Gain the learner's attention d. Ask learners to recall prior learning

ANS: C Gaining the learner's attention must happen first before learning can take place. The following steps of implementation include telling the learners the objectives of the instruction, asking learners to recall previous knowledge, presenting the essential materials, helping the learners apply the information, encouraging learning to demonstrate what they have learned, and providing feedback to help learners improve their knowledge and skills. DIF: Cognitive level: Applying REF: p. 361 TOP: Nursing process: Implementation MSC: NCLEX: Health Promotion and Maintenance

While researching various health care services that are provided in prisons, a nursing student learns that these services: a. Are funded by the Department of Defense b. Focus on health promotion interventions c. Must be provided at an adequate level d. Are available to those diagnosed with a chronic illness

ANS: C Health care services for prisoners are required at an adequate level for all incarcerated individuals. This is administered by the Department of Justice. Prisoners will receive health care services when diagnosed with chronic illnesses as well as acute illnesses.

A client eats a nutritious, balanced diet on a daily basis to keep the current state of health. This is described as _____ behavior. a. Illness prevention b. Health promotion c. Health maintenance d. Health protective

ANS: C Health maintenance behavior is directed toward keeping a current state of health.

One advantage of health-risk appraisal instruments is that they: a. Are suitable for all age-groups b. Accurately reflect an individuals ability to initiate changes in lifestyle c. Provide support to nurses in counseling individuals about self-care behaviors d. Emphasize environmental factors

ANS: C Health-risk appraisal instruments provide support to nurses in counseling and educating individuals in self-care behaviors.

When a nurse is sued for malpractice and goes to court, which type of law is being used? a. Constitutional b. Common c. Judicial d. Institutional

ANS: C Judicial law is based on court or jury decisions.

A nurse is working with a group focused on improving the health of the community. Which of the following interventions should be used by the nurse? a. Make decisions for the group to move the process along b. Invite business leaders to participate in the group process c. Maintain members through recognition and encouragement d. Teach topics that are of national importance

ANS: C Maintaining members is an important intervention to facilitate group process. The topics that are taught should be of importance to the group. The group should be part of the decision-making process. The membership of the group should be maintained, inviting new members to the group may hinder the processes of the group. DIF: Cognitive level: Applying REF: p. 372 TOP: Nursing process: Implementation MSC: NCLEX: Health Promotion and Maintenance

When studying chronic disease, the multifactorial etiology of illness is considered. What does this imply? a. Genetics and molecular structure of disease is paramount. b. Single organisms that cause a disease, such as cholera, must be studied in more detail. c. Focus should be on the factors or combinations and levels of factors contributing to disease. d. The recent rise in infectious disease is the main focus.

ANS: C Multifactorial etiology implies a focus on combinations and levels of factors.

When working with a client who is HIV positive, the nurse serves as an educator, teaching about the modes of transmission, and serves as a(n): a. Advocate, lobbying for AIDS research b. Counselor, discussing implications of future sexual activity c. Role model, providing supportive care d. Policy maker, addressing laws governing privacy rights of HIV-positive persons

ANS: C Nurses must be role models because many HIV-positive patients are stigmatized.

Which information is important for the nurse to know about preventing and controlling parasitic infections? a. The medication to prescribe to treat these infections b. The nature and symptoms of all parasitic illnesses c. What specimens to collect and how and when to collect them d. Public policy about parasitic infections

ANS: C Nurses need to be cognizant about what specimens to collect, how and when to collect, and what laboratory techniques to use.

When using the integrative model for community health promotion, the nurse would apply the dimension of client system by: a. Concentrating on individual health behaviors b. Studying client-centered initiatives c. Providing multidimensional nursing care among various levels of clients d. Focusing on health promotion, illness prevention, and illness care

ANS: C Nursing care is targeted toward several levels of clients in the client system.

The most common vector-borne disease in the United States is: a. Malaria b. Yellow fever c. Lyme disease d. Rocky Mountain spotted fever

ANS: C Over 15,000 cases of Lyme disease are reported per year. Malaria is most common worldwide.

A nurse is addressing the problem of air pollution in the community. The first step in the process of controlling the pollution would be: a. Setting standards b. Monitoring c. Permitting d. Compliance

ANS: C Permitting is a process by which the government places limits on the amount of pollution emitted into the air or water.

A community health nurse visits a homeless shelter that has several clients with tuberculosis who are taking antimicrobial drugs. Supervised drug administration may be done on a daily basis with persons with poor adherence because: a. This type of client does not care about his or her health. b. Homeless people have no access to medications. c. Poor adherence can result in drug resistance. d. The antimicrobials are so powerful, clients must be observed for reactions.

ANS: C Poor adherence has lead to antibiotic resistant strains.

The proportion of persons with positive test results who actually have a disease, interpreted as the probability that an individual with a positive test result has the disease, is the: a. Sensitivity b. Specificity c. Positive predictive value d. Negative predictive value

ANS: C Positive predictive value refers to the proportion of persons with positive test results who actually have the disease, interpreted as the probability that an individual with a positive test result has the disease.

An example of primary prevention is: a. Pap smear b. Blood pressure screening c. Diet and exercise d. Physical therapy

ANS: C Primary prevention refers to those interventions aimed at preventing the occurrence of disease, injury, or disability.

When a nurse is evaluating the components of an educational program. Which of the following best describes the action that is being taken by the nurse? a. Short-term evaluation b. Educational product c. Process evaluation d. Long-term evaluation

ANS: C Process evaluation means looking at the components of an educational program. The educational product is the outcome of the educational process. Short-term evaluation evaluates the immediate effects of a health program. Long-term evaluation is geared toward following and assessing the status of an individual, family, community, or population over time. DIF: Cognitive level: Applying REF: p. 367 TOP: Nursing process: Evaluation MSC: NCLEX: Health Promotion and Maintenance

Requirements for disease reporting in the United States are mandated by: a. The Centers for Disease Control and Prevention (CDC) b. Federal laws c. State laws and regulations d. The World Health Organization (WHO)

ANS: C Requirements for disease reporting in the United States are mandated by state laws and regulations.

The practices of physicians, nurses, and other health care providers are differentiated by the: a. Health Resource and Services Administration (HRSA) b. State board of nursing c. Scope of practice d. United States Department of Health and Human Services

ANS: C Scope of practice involves defining nursing, setting its credentials, and then distinguishing between the practices of nurses, physicians, and other health care providers.

A nurse is told that a screening test has high specificity. This means that the test: a. Provides precise and consistent readings b. Accurately identifies those with the condition or trait c. Accurately identifies those without the trait d. Has a high level of false positives

ANS: C Specificity refers to the test accurately identifying those without the trait.

The nurse teaches food handlers to wash utensils after contact with raw meat. This prevention focuses on the: a. Agent b. Host c. Environment d. Food handler

ANS: C Teaching food handlers to wash utensils after contact with raw meat is a prevention that focuses on the environment.

The nurse teaches the family of an AIDS client about managing symptomatic illness by preventing deteriorating conditions, such as diarrhea, skin breakdown, and inadequate nutrition. This nursing intervention is an example of _____ prevention. a. Primary b. Secondary c. Tertiary d. Primary health care

ANS: C Tertiary prevention includes those interventions aimed at disability limitation and rehabilitation from disease, injury, or disability.

Vocational rehabilitation of a person with a neuromuscular disease is an example of: a. Primary prevention b. Secondary prevention c. Tertiary prevention d. Health promotion

ANS: C Tertiary prevention includes those interventions aimed at disability limitation and rehabilitation from disease, injury, or disability.

The nurse provides footwear and gloves to leprosy clients to prevent trauma to their insensitive and deformed hands and feet. This is an example of ____ prevention. a. A primary level of b. A secondary level of c. A tertiary level of d. Primary health care

ANS: C Tertiary prevention reduces complications through treatment and rehabilitation.

Which environmental law sets basic structure for regulating pollutants to United States waters? a. Safe Drinking Water Act b. Toxic Substance Control Act c. Clean Water Act d. Pollution Prevention Act

ANS: C The Clean Water Act sets basic structure for regulating pollutants to United States waters.

A nurse is interested in census data. Which federal departments website would be a good place to start? a. Department of Labor b. United States Immunization Survey c. Commerce Department d. World Health Organization

ANS: C The Commerce Department handles the United States Census and population estimates and projections.

The Office of Homeland Security has a mission to rebuild the crumbling public health infrastructures of each state and provide: a. Vaccines for smallpox, anthrax, and plague b. Regulation of nuclear weapons c. Surveillance of bioterrorism threats d. Regulation of foreign nurses entering the United States

ANS: C The DHHS and the new federal agency, the Office of Homeland Security, have provided funds to address serious bioterrorism threats to the people of the United States.

The Framingham Heart Study was successful in: a. Providing information on the effectiveness of risk-reduction interventions b. Documenting the relationship between social variables and heart disease c. Identifying factors contributing to the development of coronary heart disease d. Demonstrating the effects of mass media in modifying high-risk behavior

ANS: C The Framingham Heart Study identified factors contributing to the development of coronary heart disease and high blood pressure.

The first major federal government action relating to health was the: a. Passage of the Social Security Act b. Creation of the National Institutes of Health (NIH) c. Creation of the Public Health Service (PHS) d. Creation of Medicare and Medicaid

ANS: C The PHS was created in 1798.

The cognitive domain includes: a. changes in attitudes and the development of values. b. the performance of skills. c. memory, recognition, understanding, reasoning, and problem solving. d. memorization of one set of skills before moving on to the next.

ANS: C The cognitive domain includes memory, recognition, understanding, reasoning, and problem solving. The affective domain includes changes in attitudes and the development of values. The psychomotor domain includes the performance of skills that require some degree of neuromuscular coordination and emphasizes motor skills. Memorization of skills is only one part of the cognitive domain. DIF: Cognitive level: Understanding REF: p. 358 TOP: Nursing process: Assessment MSC: NCLEX: Health Promotion and Maintenance

A nurse is found to be negligent. Because of the doctrine of respondeat superior, the one responsible for that negligence is the: a. Administrator b. Nurses immediate supervisor c. Nurses employer d. Nurse

ANS: C The doctrine of respondeat superior says that when a nurse is employed and functioning within the scope of that job, the one responsible for that negligence is the nurses employer.

A nurse is implementing a community health education program at a local church. Which of the following educational principles should the nurse implement when providing this education? a. Refer to trustworthy sources b. Use an active voice c. Create the best learning environment d. Accentuate the positive health behaviors of the participants

ANS: C The environment must be conducive to learning for educational programs to be effective. The environment should be free of distractions and consistent with the message. The other strategies may assist with the educational program, but are not one of the major educational principles discussed in the textbook. DIF: Cognitive level: Applying REF: p. 362 TOP: Nursing process: Planning MSC: NCLEX: Health Promotion and Maintenance

Which example contains the components necessary to form an epidemiologic triangle? a. Pesticides, water, food b. Lead, mercury, soil c. Trichloroethylene, water, infants d. Children under 12, elderly, temperature

ANS: C The epidemiologic triangle consists of an agent (chemical), host (community consisting of several variants), and environment (air, water, soil,

Which question would a nurse ask during the first phase of a risk assessment? a. Has the chemical been released into the environment? b. How much and by which route of entry can the chemical enter the body? c. Is the chemical known to be associated with a negative health effect? d. What is the prediction for potential harm?

ANS: C The first phase is determining if a chemical is known to be associated with negative health effects (in animals or humans).

A nurse would like to propose legislation requiring all schools to employ a registered nurse. The first step taken in the legislative process would be: a. Introducing the bill to the legislature b. Moving the bill to the other house c. Developing the policy option into a bill d. Hearings, testimony, and lobbying

ANS: C The first step in the legislative process is developing the policy option into a bill. This is then followed by introducing the bill to the legislature; hearings, testimony, and lobbying; and the bill moving to the other house.

A group member has taken on the role of the "gatekeeper." Which of the following actions would most likely be taken by this member? a. Seek and accept the authority or direction of others b. Guide and direct the group activity c. Control outsiders' access to the group d. Focus the movement toward the main work of the group

ANS: C The gatekeeper controls outsiders' access to the group. The follower seeks and accepts the authority or direction of others. The leader guides and directs group activity. The task specialist focuses or directs movement toward the main work of the group. DIF: Cognitive level: Applying REF: p. 371 (Box 16-6) TOP: Nursing process: Implementation MSC: NCLEX: Health Promotion and Maintenance

According to Laffrey, Loveland-Cherry, and Winkler, the health perspective views: a. Health as the absence of disease b. Human lifestyle based on ones prescribed regime c. Humans as complex and interconnected with the environment d. Community education as the role of the registered nurse

ANS: C The health paradigm includes the view that humans are complex and interconnected with the environment.

Which branch of the government interprets the states rights to grant abortions? a. Executive branch b. Legislative branch c. Judicial branch d. Federal branch

ANS: C The judicial branch interprets laws and their meaning, as in its ongoing interpretation of states rights to define access to reproductive health services for citizens of the states.

The most chronic bloodborne infection in the United States is: a. Hepatitis A b. Hepatitis B c. Hepatitis C d. HIV

ANS: C The most chronic bloodborne infection in the United States is hepatitis C.

Public health professionals refer to three levels of prevention as tied to specific stages in the: a. Epidemiologic triangle b. Web of causation c. Natural history of disease d. Surveillance process

ANS: C The natural history of disease is the course of the disease process from onset to resolution. The three levels of prevention provide a framework commonly used in public health practice to depict this process.

A nurse is providing information to a local newspaper about the presence of infectious diseases in the United States. Which statement by the nurse is accurate? a. It is the goal of the World Health Organization to prevent the transmission of the plague by avoiding direct contact with inflicted individuals. b. Rabies is easily spread by contact with animals. c. Polio has been eliminated in the United States since 1994. d. The onset of tularemia is characterized by a distinct skin lesion often called a bulls-eye lesion.

ANS: C The plague is a vector-borne disease and cannot be spread by direct contact with inflicted individuals. Rabies is a rare event because of the widespread vaccination of dogs in the 1950s. The Americas were certified as polio free in 1994. The onset of Lymes disease is characterized by a bulls-eye lesion.

A woman has attended a weight reduction program for a year and lost 75 pounds. She now attends weekly meetings to keep the weight off. Which term best describes this example? a. Health promotion b. Illness prevention c. Health maintenance d. Health protection

ANS: C The womans weight is being maintained through attending the weight reduction program. Health maintenance focuses on keeping a current state of health.

Which strategy would be the most appropriate for a public health nurse to use to increase the immunization coverage of infants and toddlers? a. Read the Mortality and Morbidity Weekly Report to learn about vaccinations. b. Require that children have all their immunizations before going to public school. c. Track children known to be at risk for underimmunization. d. Lead teams of health care workers to enforce laws related to immunizations.

ANS: C This is a function of public health nurses who work in health departments where immunizations are given and tracked.

Voters have recently decided to have fluoride added to the city water system. Epidemiologists wanting to study the effect of fluoride on dental caries would be conducting a(n): a. Ecological study b. Double-blind study c. Community trial d. Screening

ANS: C This is similar to clinical trials, but the issue is often health promotion and disease prevention rather than treatment of existing disease.

Employees working with hazardous chemicals have the right to know about the chemicals they are working with through the creation of the: a. Material Safety Data Sheet b. Consumer Confidence Report c. Hazard Communication Standard d. Environmental Protection Agency

ANS: C This standard requires employers to maintain a list of all hazardous chemicals that are used on site.

A community health nurse investigates an outbreak of pinworm at a local day care center. What suggestions would the nurse give to the day care workers? a. Close the day care until all surfaces are cleaned. b. No action is necessary because it is easily treated with oral vermicides. c. Using good hand washing is important to prevent the transmission. d. Every child in the day care should be treated because they all are probably infected.

ANS: C Transmission is through the fecal-oral route, so good hand washing after toileting is essential.

An example of a bacterial STD is: a. Trichomonas b. HIV c. Syphilis d. Genital warts

ANS: C Trichomonas, HIV, and genital warts are caused by viruses.

The greatest single source of air pollution in the United States is from: a. Waste incineration b. Power plants c. Motor vehicles d. Molds

ANS: C Waste incineration and power plants are major contributors after motor vehicles. Molds contribute to poor indoor air quality.

An acceptable level of emissions or a maximum contaminant level allowed is an example of which environmental protection strategy? a. Controlling pollution b. Waste minimization c. Land use planning d. Environmental standard

ANS: D An example of an environmental standard is an acceptable level of emissions or a maximum contaminant level allowed.

A nurse prepares for a presentation to a group of adults using strategies appropriate for adult learning. Which of the following concepts is being applied? a. Authoritarianism b. Learning style c. Pedagogy d. Andragogy

ANS: D Andragogy is a term and model developed by Malcolm Knowles to describe learning strategies for adult learners. In pedagogy the teacher assumes full responsibility for making decisions about what will be learned, and how and when it will be learned. In authoritarianism the leader controls group movement and progress through interpersonal power. Learning style refers to how someone learns best. DIF: Cognitive level: Applying REF: p. 363 TOP: Nursing process: Planning MSC: NCLEX: Health Promotion and Maintenance

A nurse is using the educational process of selecting appropriate educational methods when planning a community health program. Which of the following steps of the nursing process does this action most resemble? a. Assessment b. Evaluation c. Implementation d. Planning

ANS: D Assessment would be identifying educational needs, evaluation would be evaluating educational process, and implementation would be implementing the educational plan. Planning is similar to selecting appropriate educational methods. DIF: Cognitive level: Analyzing REF: pp. 359-360 TOP: Nursing process: Planning MSC: NCLEX: Health Promotion and Maintenance

An example of an attack rate is the: a. Number of cases of cancer recorded at a medical center b. Number of people who died of cholera in India in a given year c. Number of beef cattle inoculated against mad-cow disease on a farm d. Proportion of people becoming ill after eating at a fast-food restaurant

ANS: D Attack rates are often specific to exposures, such as food-specific attack rates.

A nurse is teaching a client about how to complete a wound dressing change. Which of the following conditions must be met before learning will occur? a. Must be able to memorize the instructions, relay this information to a partner, and demonstrate the dressing change b. Must master the dressing change at the time it is taught, repeat the demonstration for the nurse, and teach another person c. Must be able to speak the language of the nurse, have time to practice the dressing change, and master the dressing change in a short time d. Must have the necessary ability, a sensory image of how to carry out the dressing change, and an opportunity to practice the dressing change

ANS: D Before psychomotor learning occurs, the learner must have the necessary ability, a sensory image of how to carry out the skill, and an opportunity to practice the skill. This is the only option that contains all of the necessary requirements of the learner. DIF: Cognitive level: Applying REF: pp. 358-359 TOP: Nursing process: Implementation MSC: NCLEX: Health Promotion and Maintenance

A nurse utilizing a disease-oriented approach would: a. Promote a greater level of positive health. b. Teach about common disease processes. c. Provide acute care management of chronic disease. d. Direct care toward disease prevention.

ANS: D Disease prevention, risk appraisal, and disease management are all elements of the disease-oriented approach.

Which statement best describes health risk appraisals? a. Data about health practices are collected from families. b. Primary prevention strategies are implemented by using the collected data. c. Identified risks can be easily modified. d. Individual health practices are compared with data from epidemiologic studies.

ANS: D During a health risk appraisal, individuals supply information about their health practices, demographic characteristics, and personal and family medical history for comparison with data from epidemiologic studies. These comparisons are used to predict individuals risk of morbidity and mortality and to suggest areas in which disease risks may be reduced. Health risks appraisals use secondary prevention by screening to prevent or detect disease in its earliest stages.

A nurse is working for a public health department as the community health educator. Which of the following is a potential barrier that a nurse may experience? a. Working with clients with a low literacy level b. Memorizing the information that is to be taught c. Having a limited vocabulary d. Lacking knowledge about how to gain participation

ANS: D Educators may lack knowledge about how to gain participation. Participation can be fostered by asking open-ended questions, inviting participation, and planning small-group activities whereby a person responds based on the group rather than presenting his own information. Clients with low literacy levels and limited vocabularies are considered to be a learner-related barrier, not a barrier of the educator. Memorizing the information to teach may cause problems with the presentation but would not be a barrier for the educator. DIF: Cognitive level: Applying REF: pp. 364-365 TOP: Nursing process: Implementation MSC: NCLEX: Health Promotion and Maintenance

An inspection of a facility after a permit is obtained for the purpose of observing whether the plans submitted in the permit application are being implemented as approved is an example of which environmental protection strategy? a. Controlling pollution b. Waste minimization c. Land use planning d. Environmental monitoring

ANS: D Environmental monitoring would be an inspection of a facility after a permit is obtained to observe whether the plans submitted in the permit application are being implemented as approved.

To understand the causes of health and disease, epidemiology studies: a. Individuals b. Families c. Groups d. Populations

ANS: D Epidemiology monitors health of populations, understands determinants of health and disease in communities, and investigates and evaluates interventions to prevent disease and maintain health.

A nurse believes additional funding is necessary to support a home-delivered meal program for the elderly. The best way to share these ideas with a legislator is to: a. Send an e-mail. b. Write a formal letter. c. Attend a town hall meeting. d. Schedule a face-to-face visit.

ANS: D Face-to-face visits with legislators are viewed as the most effective means of communication.

A nurse recognizes the importance of group norms when planning community health education. Which of the following provides the best explanation for why this is important? a. Allow for creativity and variety among group members b. Influence members' perception of community c. Are helpful in evaluating the effectiveness of the group d. Maintain the group through various supports to members

ANS: D Group norms serve to maintain the group through various supports to members. They are the standards that guide, control, and regulate individuals and communities. They suggest what a group believes is important, what it finds acceptable or objectionable, or what it perceives as of no consequence. Group norms may limit the creativity and variety among the group members. Members' perception of the community could be influenced by group norms, but this is not why this consideration should be made when planning community health education. Group norms are not used to evaluate the effectiveness of the group. DIF: Cognitive level: Applying REF: p. 370 TOP: Nursing process: Implementation MSC: NCLEX: Health Promotion and Maintenance

A nurse is working in a public health center. A patient who has been newly diagnosed as HIV positive comes for counseling. By law, what must the nurse do? a. Give antiviral medications to the patient. b. Ask the person to name all of his or her sexual contacts. c. Refer the patient to the social worker as someone possibly needing case management. d. Report the HIV-infected person to the state health department.

ANS: D It is mandatory to report HIV cases in all states. The information is then sent to the Centers for Disease Control and Prevention (CDC). Some states report HIV infections either by name or by code.

When caring for a client with methicillin-resistant S. aureus (MRSA), the community health nurse should know: a. Persons with MRSA usually have a chronic illness. b. MRSA is a hospital-acquired infection and not often seen in the community. c. VRE (vancomycin-resistant Staphylococcus aureus) follows MRSA. d. MRSA is becoming more common in the community.

ANS: D MRSA is being seen more and more in the community with outbreaks frequently associated with school athletic programs and prison populations.

How have nurses historically learned to identify a possible relationship between environmental chemical exposures and their potential harm? a. Extrapolation by toxicologists b. Biomonitoring c. Completing chemistry courses d. Observing signs and symptoms in clients

ANS: D Nurses have historically made discoveries related to chemical exposure when people presented with signs and symptoms related to known chemical toxicity. The first two options are modern methods.

An established group requests a teaching and learning session on hypertension. Which of the following should the nurse expect with this type of group? a. The group membership will change from week to week. b. The members all have the same interests. c. They prefer lectures rather than demonstrations. d. The group already has operating methods that have been successful.

ANS: D Nurses working with established groups should know that this type of group has membership ties and an existing structure that has proven to be successful. An established group would have a stable group membership. Learning occurs better in all groups with demonstrations instead of lectures. In an established group, they may be together because of a common interest, but may not share all of the same interests. DIF: Cognitive level: Applying REF: p. 372 TOP: Nursing process: Implementation MSC: NCLEX: Health Promotion and Maintenance

Which would be considered a serious epidemic of influenza? a. 50 cases b. 100 cases c. 500 cases d. Unable to determine

ANS: D One cannot tell the degree of seriousness without a denominator, which represents the total population.

A goal of the Division of Nursing is to: a. Enhance nursing competence in providing high-tech skills b. Apply disease prevention, environmental health, and health promotion concepts c. Provide scholarships for advanced nursing education d. Enhance racial and ethnic diversity in the nursing workforce

ANS: D One of the Division of Nursing goals is to enhance racial and ethnic diversity and cultural competency in the nursing workforce. The other statements apply to other agencies or are false.

Action taken to protect the health, safety, and welfare of citizens, such as requiring immunizations of children before admission to school, is called what kind of power? a. Executive b. Legislative c. Judicial d. Police

ANS: D Police power is state power concerning health care. This power allows states to act to protect the health, safety, and welfare of their citizens.

A public health nurse is organizing a multidisciplinary team to address the issue of water pollution in the community. The most likely members that would be invited to address this issue would be: a. Physicians, water sanitation workers, and occupational therapists b. Pharmacologists, radiologists, and epidemiologists c. Nurse practitioners, pharmacologists, and environmentalists d. Geologists, meteorologists, and chemists

ANS: D Scientists who study how pollutants travel in air, water, and soil are geologists, meteorologists, and chemists.

An example of secondary prevention is: a. Rehabilitation b. Avoidance of high-risk behaviors c. Immunization d. Mammogram

ANS: D Secondary prevention focuses on early detection and prompt treatment of disease, injury, or disability.

The case rate of tuberculosis (TB) is highest among which ethnicity in the United States? a. African American b. Native American c. Hispanic d. Asian

ANS: D TB is most often found in Asian Americans, at 25.6 new TB cases per 100,000 people.

Which community-based risk-reduction intervention resulted in equally favorable health risk changes for both control and treatment groups? a. Framingham Heart Study b. Stanford Heart Disease Prevention Program c. North Karelia Study d. Minnesota Heart Health Program

ANS: D The Minnesota Heart Health Program resulted in equally favorable health risk changes for both control and treatment groups.

The federal government provides for the protection of the publics health by: a. Interpreting decisions related to womens right to privacy b. Setting up immunization clinics for smallpox vaccine c. Regulating nursing at the state level d. Monitoring the influx of disease at the borders

ANS: D The United States Constitution gives the federal government the authority to provide for the protection of the publics health. By monitoring the influx of disease at the borders the publics health is being protected.

The ability of an agent to produce a severe pathologic reaction is known as: a. Antigenicity b. Invasiveness c. Toxicity d. Virulence

ANS: D The ability of an agent to produce a severe pathologic reaction is known as virulence.

When applying the integrative model for community health promotion, a nurse assesses a neighborhood for accessibility and adequacy of care to provide treatment for medical conditions. What client system does this describe? a. Individual b. Family c. Aggregate d. Community

ANS: D The community focus includes the nurse assessing the community for accessibility and adequacy of care to provide treatment for medical conditions.

The interaction between an agent, a host, and the environment is called: a. Natural history of disease b. Risk c. Web of causality d. The epidemiologic triangle

ANS: D The epidemiologic triangle consists of the interaction between an agent, a host, and the environment.

The most common reportable infectious disease in the United States is: a. Gonorrhea b. Syphilis c. Herpes d. Chlamydia

ANS: D The most common reportable infectious disease in the United States is Chlamydia.

The nurse is teaching a new diabetic client how to give himself an insulin injection. Which of the following domains would be used? a. Developmental b. Cognitive c. Affective d. Psychomotor

ANS: D The psychomotor domain includes the performance of tasks that require some degree of neuromuscular coordination and emphasizes motor skills. Developmental domain is not one of the domains of learning. The cognitive domain includes memory, recognition, understanding, reasoning, and problem solving. The affective domain is used to attempt to influence what individuals, families, communities, and populations feel, think, and value. DIF: Cognitive level: Applying REF: p. 358 TOP: Nursing process: Implementation MSC: NCLEX: Health Promotion and Maintenance

Which group should receive an injection of prophylactic immune globulin for possible exposure to hepatitis A? a. Persons who have had direct contact with blood b. Those who ate at the same restaurant as the person with hepatitis A c. All health care workers d. All those who had household or sexual contact with persons with hepatitis A

ANS: D Those who have been in close contact with persons who develop hepatitis A should receive immune globulin.