NUR 412 - MID TERM,

Which of the following factors has influenced the implementation of evidence-based practice in health care? a. Increased expectations of consumers b. Advances in technology c. Nursing shortages d. Increases in lawsuits e. Implementation of electronic health records

. Increased expectations of consumers b. Advances in technology d. Increases in lawsuits

Which activity by the community nurse is an illness prevention strategy?! Encouraging the client to exercise daily Arranging an immunization program for chickenpox Teaching the community about stress management Teaching the client about maintaining a nutritious diet

Arranging an immunization program for chickenpox

The nurse is teaching a parenting class. Which suggestion would the nurse make about managing the behavior of a young school-age child! Avoid answering questions. Give the child a list of expectations. Be consistent about established rules. Allow the child to plan the day's activities.

Be consistent about established rules.

Nurses come to home health from a variety of educational and practice settings. Based on educational level, nurses are prepared to practice at various levels. To ensure the public of competence and quality in a highly competitive health care environment, it may become necessary for nurses to seek which of the following? a. Accreditation b. Advanced degrees c. Certification d. Specialization

Certification

Which preventive and primary care service provided by a community health center is most expensive?! Running errands Health education Disease management Routine physical examinations

Disease management

Which services do community health centers provide in preventive and primary care services? Select all that apply. One, some, or all responses may be correct.! Daycare Health screenings Physical assessments Disease management Acute and chronic care management

Health screenings Physical assessments Disease management

The nurse is instructing a community group regarding risk factors for coronary artery disease. Which risk factor cannot be modified?! Heredity Hypertension Cigarette smoking Diabetes mellitus

Heredity

The nurse is teaching campfire safety to a group of community members and includes information about what to do if a person catches on fire. The nurse teaches the most effective method for putting out the flames. Which information from the group members indicates successful learning?! Wrap hand with towel and slap at the flames. Instruct the victim to roll on the ground. Pour cold liquid over the flames. Remove the victim's burning clothes.

Instruct the victim to roll on the ground.

Which characteristic is most common to those living in poverty?! Open expression of anger Long-term feeling of powerlessness Willingness to postpone gratification Compliance with health recommendations

Long-term feeling of powerlessness

A senior high school student asks the school nurse which immunizations will be included in the precollege physical. Which vaccine would the nurse tell the student to expect to receive?! Hepatitis C (HepC) Influenza type B (HIB) Measles, mumps, rubella (MMR) Diphtheria, tetanus, pertussis (DTaP)

Measles, mumps, rubella (MMR)

Which services do block and parish nursing provide for preventive and primary care services? Select all that apply. One, some, or all responses may be correct.! Respite care Running errands Homemaker aides Routine physical examination Communicable disease control

Respite care Running errands Homemaker aides

The son of migrant farm workers has no history of immunizations and is brought to the county health clinic. After measles is diagnosed, the public health nurse goes to the migrant camp to search for people with a greater-than-average chance of contracting the disease. Which terminology is the name of this variable?! Risk factor Frequency rate Probability rate Causative factor

Risk factor

Which risk of adolescent pregnancy would the community nurse teach?! Risk for premature birth Risk for having a large baby Risk for chromosomal defects Risk for increased weight gain

Risk for premature birth

Which activities would the nurse include when teaching adults about activities that increase the risk of developing bladder cancer? Select all that apply. One, some, or all responses may be correct.! Jogging 3 miles (4.8 km) a day Drinking three cans of cola a day Smoking two packs of cigarettes a day Working with dyes used in rubber every day Using a jackhammer and chainsaw every day

Smoking two packs of cigarettes a day Working with dyes used in rubber every day

Which topic is most important for the nurse to teach in a community health promotion class for middle-aged adults?! Tobacco cessation Infection prevention Alcohol abstinence Pain management

Tobacco cessation

Migrant workers and their families who reside in a specific mobile home park during the summer months would best be classified as a: a. Community b. Group c. Setting of practice d. Target population

a. Community

When applying evidence-based practice (EBP), community-oriented nurses are primarily obligated to ensure that evidence applied to practice is: a. acceptable to the community. b. Contains cost and reduces legal liability c. Applied as a universal remedy d. Limited to research funding

a. acceptable to the community.

The most common causes of preventable disease, disability, and death among children are: a. injuries and accidents. b. maintaining a healthful diet. c. physical activity.

a. injuries and accidents.

Each client in the Medicare home care program must be under the care of a doctor (medicine, podiatry, or osteopathy). The home health nurse must involve the doctor in developing a plan of care. The role of the doctor in the home health interdisciplinary team is to do which of the following? a. Achieve the optimal level of functioning by teaching. b. Certify/recertify the medical necessity and plan of care. c. Deal with the social, emotional, and environmental factors that affect well-being d. Provide maintenance, preventive, and restorative treatment for clients. Each client in Medicare-funded home care programs must be under the current care of a doctor of medicine, podiatry, or osteopathy to certify that the client has a medical problem. The physician must certify a plan of treatment before care is provided to the client.

b. Certify/recertify the medical necessity and plan of care.

Jennifer is a nurse in a family medicine clinic. Today she is assessing Jose, a 4-year-old who is being seen for an earache. The type of nursing Jennifer practices is: a. Community oriented nursing b. Community based nursing c. Public health nursing d. Tertiary health nursing

b. Community based nursing

Nonprofit home health agencies can be reimbursed for home health services through Medicare, Medicaid, and private insurance companies. A major difference between an official agency and a voluntary or private agency is that official agencies receive additional: a. Client payment b. Charity support c. Public funding d. Third party payments

c. Public funding

The gold standard of evidence gathering in evidence-based practice is: a. Clinical knowledge and judgment b. Expert opinions c. Randomized clinical trials d. Theories of practice

c. Randomized clinical trials

The nurse in community health reviews the monthly and year-to-date health service use report for the local community to monitor trends as correlates of the community's health. The nurse is viewing community health through the dimension of: a. Partnership b. Process c. Status d. Structure

d. Structure

Two nurses in community health schedule a day to ride through a low-income community to better understand the community and what factors affect the health of that community. This direct data collection method is often referred to as: a. Composite database b. Participation observation c. Secondary analysis d. Windshield survey

d. Windshield survey

Which suggestion by the nurse is an example of primary prevention?! "Engage in daily physical exercise." "Get yearly physical examinations." "Attend hypertension screening programs." "Read about how to prevent diabetes complications."

"Engage in daily physical exercise."

The nurse administers a pneumococcal vaccine to a 70-year-old client. The client asks, "Will I have to get this every year like I do with the flu shot?" How would the nurse respond?! "You need to receive the pneumococcal vaccine every other year." "The pneumococcal vaccine should be received in early autumn every year." "You should get the flu and pneumococcal vaccines at your annual physical examination." "It is unnecessary to have any follow-up injections of the pneumococcal vaccine after this dose."

"It is unnecessary to have any follow-up injections of the pneumococcal vaccine after this dose."

A home health nurse checks the client's vital signs and obtains a blood sample for an international normalized ratio (INR). After these tasks are completed, the client asks the nurse to straighten the blankets on the bed. Which response by the nurse is correct?! "I would, but my back hurts today." "Okay. It will be my good deed for the day." "Of course. I want to do whatever I can for you." "I would like to, but it is not in my job description.

"Of course. I want to do whatever I can for you."

How does the nurse play the role of a "change agent" in a community-based nursing practice?! By helping clients identify and clarify health problems By establishing relationships with community service organizations By establishing an appropriate plan of care, based on assessment of clients By identifying and implementing new and more effective approaches to problems

By identifying and implementing new and more effective approaches to problems

Which avoidance instruction would the public health clinic nurse use to teach prevention of toxoplasmosis?! Contact with cat feces Exposure to heavy metals Ingestion of freshwater fish Excessive radiation exposure

Contact with cat feces

​​The nurse is analyzing and explaining the demographics of a population under research. Which phase of the nursing process is the nurse exercising when analyzing and explaining the demographics of a population under research?! Diagnosis phase Evaluation phase Assessment phase implementation phase

Evaluation phase

A nurse in community health integrates new slides into a presentation that will be given to a local elementary school group regarding the techniques of proper hand washing. The new slides will repeat essential points during the presentation. This demonstrates the nurse's understanding of what principle? a. Repetition b. Integration c. Participation d. Sequencing

Repetition

Which goal is the main focus of community health nursing?! To meet the acute care needs of a population To improve the quality of health in a population To influence political processes affecting public policies To assess the health care needs of an individual or family

To improve the quality of health in a population

A nurse in community health is planning to begin a class to help mothers returning to work better cope with the stresses of multiple roles. The nurse would most likely use: a. An andragogical approach b. A behavioral approach c. A operational approach d. A pedagogical approach

a. An andragogical approach

The nurse in community health identifies an elder abuse problem related to caregiver stress among families. The nurse further identifies a lack of caregiver support services in the local community. The next step in the community-oriented nursing process would be to: a. Analyze the community problem b. Establish priorities c. Establish goals and objectives d. Identity intervention activities

a. Analyze the community problem

A neighborhood association group has asked the local nurse in community health for a class on environmental hazards. The nurse in community health has seen good information in the community health text and thinks about getting permission to copy some of the information. The most important thing the nurse should do before using copies of this material is to: a. Assess The literacy level of the group b. See how many plan to attend c. See weather the group is ready to learn d. Secure a good space for a group meeting

a. Assess The literacy level of the group

A state agency has received multiple complaints regarding the availability of elder transportation services to a specific county senior center. The state agency assigns a public health nurse to work with the community to evaluate its program for elder transportation services to publicly sponsored elder care programs. The public health core function applied is: a. Assurance b. Policy development c. Primary prevention d. Public transportation

a. Assurance

A school nurse teaches three middle school students with asthma conditions techniques to minimize their incidence of bronchial spasms. This is an application of: a. Community based nursing b. Community oriented nursing c. Institutional nursing d. Public health nursing

a. Community based nursing

The nurse in community health uses information about family structure, household composition, marriage, divorce, birth, death, adoption, and other family life events to forecast and predict stresses and developmental changes experienced by families and identify possible solutions to family challenges. This best describes the study of: a. Family demographics b. Family functions c. Family health d. Family resilience

a. Family demographics

Which educational method has been shown to be most effective in fostering treatment adherence? a. Internet-based education b. In-person counseling c. Telephone counseling d. Self-directed learning

a. Internet-based education

Which of the following domains are used in evaluating the strength of evidence? a. Quality b. Quantity c. Cost effectiveness d. Consistency e. Usefulness

a. Quality b. Quantity d. Consistency

In a federally funded preschool program such as Head Start, nursing services that include conducting developmental-level screening for cognitive and psychomotor development of individual children would most likely be considered community- oriented nursing care when: a. individual results are compared with established standards for children of the same age group b. program characteristics are assessed for their effectiveness in making the school population healthier c. referral is provided for a child identified with delayed psychomotor development. d. treatment is initiated for a child with an identified learning disability.

a. individual results are compared with established standards for children of the same age group

A nurse in community health is invited to work with a coalition of churches to address safety concerns for children in the local community. The nurse provides training in problem-solving skills, manages conflict, facilitates the process, and provides expertise in interpreting data. This nurse has chosen the implementation role of: a. Change agent b. Change partner c. Group leader d. Data collector

b. Change partner

A nursing student prepares a treatment plan for a client that draws upon the student's understanding of pathophysiology and nursing practice theory learned in the student's coursework. This application of new information used in a different way demonstrates the educational principle of: a. Affective domain b. Cognitive domain c. Events of instruction d. Principles of effective education

b. Cognitive domain

A nurse in community health contacts three individuals who have had sexual encounters with an individual recently diagnosed with syphilis. The concept basic to community-oriented nursing practice that is best described by this intervention is: a. Community b. Community as client c. Individual as client d. Partnership

b. Community as client

While conducting a community health assessment, a nurse in community health meets with local religious leaders to understand the values, norms, perceived needs, and influence structures within the community. This process of data collection can best be described as: a. Data gathering b. Data generation c. Data interpretation d. Problem identification

b. Data generation

A community-oriented nurse convenes a support group for teenage mothers. The nurse understands that this strategy fosters cohesiveness among members and allows the members to learn from one another. What other benefit specific to group teaching will be achieved? a. Cultural sensitivity b. Efficiency in client service c. Learning of new skills d. distraction free surroundings

b. Efficiency in client service

Home health care can be defined as a broad spectrum of health and social services offered in the home environment to recovering, disabled, or chronically ill persons. Participation in providing the needed maintenance care for the home care client is essential by which of the following? a. Chaplain b. Family caregivers c. Home health aids d. Physicans

b. Family caregivers

The model of care delivered in the home setting which focuses on symptom management at the end of life is known as: a. Hospice care b. Palliative care c. Personal care d. Transitional care

b. Palliative care

Public health nursing is a specialty with a distinct focus and scope of practice and requires a special knowledge base different from other specialty areas of nursing. A public health nurse would first be interested in: a. Drug treatments for diabetes b. Populations with the highest rate of diabetes c. Educational material for individual with diabetes d. New technology for diabetic care

b. Populations with the highest rate of diabetes

A school nurse is working with the Parent Teacher Organization (PTO) to improve the health status of preschool students in a lower socioeconomic urban community. Given the demographics of the community, the nurse is aware that this population is at greatest risk for: a. Asthma b. Attention deficit disordered (ADDO c. Childhood obesity d. Poisoning

c. Childhood obesity

The nurse who works in the community setting must ensure that the application of the best available evidence to improve practice is also: a. Accessible and diverse b. Competence and complaint c. Culturally and financially appropriate d. Reasonable and deliverable in a timely fashion

c. Culturally and financially appropriate

A Hispanic outreach program works with the nurse in community health to train Hispanic health care workers in providing basic services and education within the local Hispanic community. The concept basic to community-oriented nursing practice that is best described by this intervention is: a. Community b. Community client c. Community health d. Community partnership

d. Community partnership

Since 2000, home health agencies have been paid by the federal government based on which type of reimbursement? a. Diagnosis-related groups b. Distributive care c. Episodic care d. Prospective payment system

d. Prospective payment system

Which point about community health nursing made by the student nurse needs correction?! "The focus is on preserving, protecting, promoting, or maintaining health." "The emphasis is to improve the quality of health and life within that community." "Community health nursing does not provide direct or indirect care services to subpopulations in a community."

"Community health nursing does not provide direct or indirect care services to subpopulations in a community."

The nurse is teaching first aid to a group of community members. A participant asks which first aid should be administered, after calling 911, to a person who suffers extensive burns. Which response by the nurse is appropriate?! "Apply ice to burned areas because this decreases pain." "Cover the burned areas with a bed sheet because this provides protection." "Do nothing because attempting to treat the burned areas may cause further damage." "Use first aid cream to burned areas because this prevents infection and decreases pain."

"Cover the burned areas with a bed sheet because this provides protection."

Which instruction is beneficial for an aging Black client with hypertension?! "Check the pulse daily." "Have an annual urinalysis." "Record blood pressure weekly." "Visit an ophthalmologist monthly."

"Have an annual urinalysis."

A community-oriented nurse has identified obesity as a problem in the middle school. The next step in a population-focused practice is to make information available about the health of the middle school students. This describes the public health core function of: a. Assessment b. Assurance c. Policy development d. Research

Assessment

Which nursing activities are examples of primary prevention? Select all that apply. One, some, or all responses may be correct.!! Preventing disabilities Correcting dietary deficiencies Establishing goals for rehabilitation Assisting with immunization programs Facilitating a program about the dangers of smoking

Assisting with immunization programs Facilitating a program about the dangers of smoking

Which action does a community-based nurse do as a change agent? Select all that apply. One, some, or all responses may be correct.! Helps clients gain the skills and knowledge needed to provide self-care. Empowers clients to become instrumental in creating change within a health care agency. Does not make decisions but helps clients reach decisions that are best for them Empowers clients and their families to creatively solve problems. Works with clients to solve problems and helps clients identify an alternative care facility.

Empowers clients to become instrumental in creating change within a health care agency. Empowers clients and their families to creatively solve problems. Works with clients to solve problems and helps clients identify an alternative care facility.

Which activities reflect secondary prevention interventions in relation to health promotion? Select all that apply. One, some, or all responses may be correct.! Encouraging regular dental checkups Facilitating smoking cessation programs Administering influenza vaccines to older adults Teaching the procedure for breast self-examination Referring clients with a chronic illness to a support group

Encouraging regular dental checkups Teaching the procedure for breast self-examination

A community health care nurse is conducting a survey about homeless children in the community. Which finding helps the nurse distinguish absolute homelessness from relative homelessness?! The children are underimmunized and at risk for childhood illnesses. The children are more likely to drop out of school. The children have access to health care only through the emergency department. The children do not have a physical shelter and may sleep outdoors or in vehicles

The children do not have a physical shelter and may sleep outdoors or in vehicles

A current challenge for home health care is the issue of family responsibility for the role of caregiver. Which of the following statements reflect underlying factors that contribute to this home health care challenge? a. Able family members with multiple obligations b. Debilitation of family members c. Number of women working outside the home d. Reimbursement to family e. Social support systems for caregivers

a. Able family members with multiple obligations c. Number of women working outside the home e. Social support systems for caregivers

When applying evidence-based practice (EBP), community-oriented nurses are primarily obligated to ensure that evidence applied to practice is: a. Acceptable to the community b. Contains cost and reduce legal liability c. Applied as a universal remedy d. Limited to research funding

a. Acceptable to the community

Which of the following would demonstrate a creative strategy to implementing EBP? a. Adopting quality indicators for evaluating websites claiming to contain EBP b. Avoiding the issue of community politics c. Creating the role of a knowledge manager d. Making decisions on behalf of the community

a. Adopting quality indicators for evaluating websites claiming to contain EBP

In applying the developmental theory, a family nurse determines the developmental stage of the family based on: a. Age of the eldest child b. Family strengths c. Individual growth patterns d. Overall tasks of the family

a. Age of the eldest child

A nurse planning a smoking cessation clinic for adolescents in the local middle schools and high schools is providing: a. Community oriented care b. Community based care c. Secondary care d. Tertiary care

a. Community oriented care

A nurse in a clinic that provides direct care services to clients with tuberculosis would be classified as practicing: a. Community-based nursing b. community -oriented nursing c. institutional nursing d. Public health nursing

a. Community-based nursing

Home health agency types, whether official, private and voluntary, combination, hospital based, or proprietary, are similar in terms of which of the following? a. Conditions of participation (COP) for Medicare and Medicaid b. Federal income tax exemption status or accreditation status c. Governance models and administrative structures d. Homemaker services or service contracting practices

a. Conditions of participation (COP) for Medicare and Medicaid

The home health nurse completes an initial assessment on a recently admitted home health client. The nurse should now analyze the assessment data and complete what step in the nursing process that is consistent with the standards of home health practice? a. Diagnosis b. Implementation c. Outcome identification d. Planning

a. Diagnosis

Which of the following best support the concept of community-oriented nursing practice? a. Direct nursing care of individuals with tuberculosis (TB) b. Hospice home care for a terminally ill individual and family c. Nursing interventions to stop elder abuse d. Nutrition education programs for teenagers and their families e. Wound care for a homebound individual

a. Direct nursing care of individuals with tuberculosis (TB) c. Nursing interventions to stop elder abuse d. Nutrition education programs for teenagers and their families

The nurse in community health defines goals and measurable objectives during the planning phase of a community health intervention. This also marks the beginning of the: a. Evaluation phase b. Implementation phase c. Needs assessment d. Problem analysis

a. Evaluation phase

What terms are used to describe healthy families? a. Families with strength b. Dysfunctional c. Functional families d. Resilient families e. Resistant families

a. Families with strength c. Functional families d. Resilient families

Evidence-based public health utilizes which of the following guidelines? a. Decision making for the community served b. Application of program planning frameworks c. Judicious use of the Internet for use of evidence d. Conducting evaluations e. Disseminating what has been learned

b. Application of program planning frameworks d. Conducting evaluations e. Disseminating what has been learned

A nurse doing a family assessment asks the client, "Have any of your blood relatives had mental illness?" The nurse is asking this question to: a. determine whether the family is stable. b. assess for biological risk factors. c. decide whether this family member needs medication d. demonstrate open-mindedness about mental illness

b. assess for biological risk factors.

A nurse in community health is conducting an assessment on a family of four. During the course of the assessment, the nurse collects information about previous generations of the family and siblings. The results are used to create a diagram for the family that displays the family unit across generations. Further discussions occur regarding the patterns of health and illness that relate to biological health risks. The diagram is called a. An ecomap b. A family plan c. A genogram d. A risk plot

c. A genogram

The nurse has just taught a client newly diagnosed with diabetes how to administer sliding-scale insulin. The most effective way to evaluate learning is to: a. Provide an online test module b. Ask whether there are any concern s c. Ask for a return demonstration d. Give a short paper and pencil quiz

c. Ask for a return demonstration

The public health nurse deals with the examination of a community setting to determine the community's health status. Which of the following activities should be considered in the assessment phase? a. Assisting communities to implement and evaluate plans and projects b. Building constituencies to work with the community c. Collecting, analyzing, and disseminating information d. Evaluating the social, economic, and environmental characteristics of the population e. Questioning the availability of health services to the community

c. Collecting, analyzing, and disseminating information d. Evaluating the social, economic, and environmental characteristics of the population e. Questioning the availability of health services to the community

The current-day definition of family refers to two or more individuals who depend on one another for emotional, physical, and/or financial support. Which of the following is the most important principle to support this broader definition? a. Families are defined by genetic ties. b. Family names are needed to confer status c. Members of a family are self-defined. d. Traditional family functions have been redefined.

c. Members of a family are self-defined.

The family systems theory encourages nurses to view both the individual clients as participating members of a whole family. What is the major weakness of the systems framework? a. Views families from both a subsystem and a suprasystem approach. b. Defines the direction of interactions. c. Views the family as an agent of change. d. Focuses on the interaction of the family with other systems.

d. Focuses on the interaction of the family with other systems.

A home health nurse receives a referral to educate an older adult client with diabetes in proper foot care. The nurse's assessment of the client determines that the client has poor eyesight that may affect the client's ability to learn and perform certain skills. Which educational principle is being examined? a. Cognitive domain b. Events of instruction c. principles of effective instruction d. Psychomotor domain

d. Psychomotor domain

A home health nurse is working with a client who requires a catheter insertion and wound care. The nurse is also helping the client and family to develop positive coping skills and identify resources that will help the client to attain a state of optimal functioning. It is important for the nurse to specifically document nursing services provided because of which of the following? a. The agency is required to practice within the guidelines set up by regulatory agencies. b. Each criterion has minimum standards to which the program must adhere. c. Nurses are required to provide supervision of services. d. Reimbursement is dependent on the provision of skilled care.

d. Reimbursement is dependent on the provision of skilled care.

One reason that nursing may be slow in developing evidence-based practice (EBP) in the community setting may be the lack of understanding about the links between EBP and: a. Evidence gathering b. Research designs c. Research funding d. Research use

d. Research use

In a community clinic that screens and treats individuals for cardiovascular disorders, the nurse practicing public health/population-focused nursing would most likely ascertain: a. A holistic treatment plan b. A specific clinical diagnosis c. Individual dietary interventions for cardiovascular disorders d. The prevalence rate of cardiovascular disorders among various groups

d. The prevalence rate of cardiovascular disorders among various groups

Which of the following social science theories is used by public health nursing to describe how environments and systems outside of the family influence the development of a child over time? a. Life cycle theory b. Family developmental theory c. Family systems theory d. bioecological system theory

d. bioecological system theory