Pop Final

Health People 2020 (HP 2020) is a guidepost for nurses and interdisciplinary teams in community and public health. New focal areas for HP 2020 include: (Select all that apply.)

Adolescent health Genomics Social determinants of health

What is a nongovernmental organization?

Agency that acquires resources to help others from private versus public sources

A teenager reveals during the assessment of a 2-year history of inhalant use. Using your knowledge that fumes may be inhaled through the mouth, this will achieve a state of intoxication similar to what substance?

Alcohol

What is a philanthropic organization?

An organization that uses endowed funds or private fundraising to address the needs of individuals, families, and populations

Using your knowledge about the uses of comparisons between groups to determine the role of various risk factors in causing the problem, what type of study should be considered?

Analytic

Response to a disaster is in its final phase. Although still in the recovery phase of the response, an evaluation meeting is arranged. The purpose of the evaluation meeting is to

Analyze the strengths and weaknesses of the response and submit a plan to improve response in the future.

The nurse is called to make an unscheduled visit to a new client in her home. The purpose of the visit is to admit the client and treat an abdominal wound. The nurse discovers that the client is from a culture unfamiliar to her. In this situation, the nurse should demonstrate cultural competence and awareness by: (Select all that apply.)

Being open to the client's ideas and way of life Exhibiting respect and patience Being aware of your own culture

During an ice storm, people in one neighborhood banded together and shared the home of a neighbor who still had power and heat. Other neighbors provided food, water, and bedding. In another neighborhood the neighbors did not know one another and weathered the storm alone. Both neighborhoods are part of the same community. What characteristic did the people in the first neighborhood share that made them a subculture that those in the second neighborhood lacked?

Belief in the value of cooperation

Following a work-related illness or injury, an initial physical assessment including documentation and medical case record initiation is required. Using your knowledge of root cause analysis, defining the characteristics of the case occurs during which step of the root cause analysis?

Define the problem

What type of study could lead to hypotheses for the future research on the effects of tight insulin control for diabetes?

Descriptive epidemiologic

As a community health nurse, you are responsible for the general health of the community on multiple levels. The local school nurse identifies that there are an increased number of sick days for children ages 7 to 12 at the local school. On the basis of your research, you note that there is a disparity in the education of the families of the asthmatic children as well as other factors that influence noncompliance with current treatment plans. The next step in your plan of care is to

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

A student is considering becoming a home health nurse. In researching this type of nursing, the student finds that several key factors have played a part in the development of home healthcare as it is today? These include: (Select all that apply.)

Development of health insurance Rising costs in healthcare Increase in medical and nursing specialization

Environmental justice is an important consideration when working with tribal communities. Many tribal communities still continue to try and practice traditional tribal life ways. In what aspect are traditional practices often directly affected by contaminated land and water?

Dietary practices

The nurse researches whether the community would benefit from monthly blood pressure clinics. Which system level would such an intervention address?

Downstream

There are 12 students in grades 5 to 7 at the local school with confirmed cases of H1N1 flu. The caregivers of the ill children are advised to keep the children home for a minimum of 5 to 7 days. The next step is

Education in the school setting regarding respiratory and hand hygiene

Using your knowledge about research validity, a threat to internal validity of research is testing. What has to be considered about testing?

Effect of multiple measurements of participants' responses that could influence the participants' responses, thereby altering the outcome of the study

Although the potential for serious adverse health effects from exposure to dangerous substances or less than optimal conditions is associated with every occupation, the majority of workers do not experience hazards in the workplace. The specialty of occupational health focuses on the identification and control of risks to health that occur as a result of physical, chemical, and other workplace hazards. Using your knowledge of common workplace hazards and exposures, what is an example of a physical hazard?

Electric and magnetic fields

The nurse conducts a class on the basics of nutrition to a group of obese adults. The nurse counsels the audience, telling them that they need to change their behaviors. By the end of the class, the nurse has lost the audience. To enhance audience participation and learning in the next class, the nurse should:

Encourage the group to participate in the decision making

Chloroquine-resistant malaria occurs in most of Africa, the Middle East, and Asia and all of the South Pacific islands. This type of disease occurrence is known as:

Endemic

In researching cases of West Nile virus in the community, the nurse explores how the interactions among people infected with this virus, mosquitoes, and the environment they share contribute to outbreaks of this disease. Which epidemiologic model is used in this case?

Epidemiological triad

You have heard rumors in the hospital where you work of an Ebola outbreak in your community and you would like to investigate it further. Which of the following should be your first step in the investigation?

Establish the existence of the outbreak

An occupational and environmental health nurse provides leadership in developing occupational safety and health policy within the organization, functions in upper executive or management roles; serves as a consultant to business and government; and designs and conducts significant research. Using your knowledge of AAOHN competency levels in occupational and environmental health nursing, at what level is this nurse functioning?

Expert

A community health nurse visits a village in Chad. The nurse has just finished assessing a 10-year-old girl who reports always being hungry. She lives in a home with her mother and father, who both work. She says she's never been to a healthcare provider before. Which level of poverty should the nurse most suspect in this girl and her family?

Extreme

The physician approaches the client with a treatment plan for his cancer. The client states that his life is in God's hands and refuses conventional treatment. This is an example of:

Fatalistic behavior

What is an example of a family inventory of life events related to illness and family care strains?

Filial responsibility for oldest girl sibling to care for chronically ill parents

The nurse prepares to enter the room of a client with suspected Ebola virus disease (EVD). Which pieces of personal protective equipment (PPE) should the nurse wear? (Select all that apply.)

Fluid resistant gowns Gloves Mask Goggles

As a public health nurse, you may participate in individual, family, or community assessments. An organized approach to assessment in the form of an evaluation that is commonly used is

Functional health pattern

The nurse works to identify epidemiologic transitions in the community. Which is an example of a demographic transition?

High fertility and high mortality, resulting in slow population growth

Which type of agency can be either profit or nonprofit?

Hospital based

The nurse wishes to calculate the probability of persons in your county developing chronic obstructive pulmonary disease over the course of a year. Which measure should the nurse use?

Incidence rate

Using your knowledge about research validity and reliability, what is a threat to internal validity that needs to be considered?

Instrumentation

The nurse provides care covered by Medicare for a client over 2 hours during the day, 3 days during the week, for 60 days. Which type of care is the nurse providing?

Intermittent

Secondary HIV prevention or positive prevention is used when caring for African-American women living with HIV by addressing which behavioral risks? (Select all that apply.)

Interpersonal mistrust Poor adherence to treatment Compromised self-advocacy in sexual relationships

The nurse is present when a mother begins cupping her child. She states that it will help to heal the child's respiratory tract infection. The nurse understands that the cultural belief that cupping will aid in the healing process is a:

Learned behavior

The home health nurse has to ensure that a safety plan is in place to address falls. Using knowledge that 55% of fall-related injuries occur with falls inside the home, a total of more than 60% of these falls occur in which two rooms?

Living room and bedroom

What are the groups with the most experience with congregational health ministers?

Mainline protestant and Roman catholic

The nurse works at a clinic in Arizona that provides bilingual (English and Spanish) care to low-income immigrant workers from Mexico. Which designation most accurately describes the area or the population this nurse serves?

Medically underserved population

Which most accurately describes how disease patterns have changed from 1900 to the present?

Morbidity and mortality from noninfectious diseases have increased

A patient wants to know more about effective treatment options for substance use. Using your knowledge that the most effective treatment involves a multimodal approach, which intervention would be helpful to include for effective treatment?

Motivational interviewing

The nurse has recently been appointed to a community-based advisory board of an agency that is interested in providing fiscally sound, high-quality care for clients they decide will be their service population. Any profit margin that is acquired is reinvested in the operations of the home healthcare service. Which type of agency is this?

Private/voluntary

What is biomonitoring?

Process of using medical tests to determine whether a person has been exposed to a contaminant

What is a risk assessment?

Process to determine the likelihood or probability that adverse effects will occur in a group of people because of an exposure to an environmental contaminant.

An occupational and environmental health nurse quickly obtains the information needed for accurate assessment and moves quickly to the critical aspects of a problem within priority setting and structural goals in response to a the client situation. The nurse usually possesses sophisticated clinical or managerial skills in the work and or community environment. Using your knowledge of AAOHN competency levels in occupational and environmental health nursing, at what level is this nurse functioning?

Proficient

After successfully implementing and managing a smoking cessation program in an inner-city neighborhood for 5 years, the group expands the efforts to include a nearby rural community. After a challenging first year, the nurse finds that with a few modifications the program is proving successful in the rural setting, as well. Which essential component of program design has been established by success in the rural community?

Program replication

The nurse recently took a position in a national chain of home healthcare agencies directed at caring for clients who are on home hemodialysis. The services provided are often paid for privately by families, and any profit margin is used to benefit the owner of the agency. Which type of agency is this?

Proprietary

Preventing intimate partner violence (IPV) and recurrence of violence requires targeting efforts at all three levels of prevention: primary, secondary, and tertiary. Which is a tertiary prevention strategy?

Providing a woman who is being abused by her husband the number to an abuse hotline so that she can get help leaving him

Which of the following represents a nursing intervention at the secondary level of prevention?

Providing support in the emergency room to a rape victim

What type of design examines causality?

Quasi-experimental Experimental

The environment and its effect on human health are often considered in two ways. What is an example of how to focus on contaminants in the environment?

Radon influence on human health

What is the gold standard for a research design that should be considered?

Randomized, control group

Incidence rates for groups exposed to a secondhand smoke are compared with the incidence rates for people who are not exposed to secondhand smoke. This will measure the:

Relative risk ratio

The school nurse notifies you that there have been six confirmed cases of pertussis in the sixth-grade classes. In addition to responding to the cluster of cases you would

Research the vaccine compliance in the school

A client reluctantly came to the clinic only after his daughter insisted that he do so. The nurse finds that he has type 2 diabetes. When the nurse explains that he has a serious condition, the client brushes it off and says, "I can still work and provide for my family. I'm not sick." Which model of health has this client adopted?

Role performance model

Preventing intimate partner violence (IPV) and recurrence of violence requires targeting efforts at all three levels of prevention: primary, secondary, and tertiary. Which is a secondary prevention strategy?

Screening a woman for evidence of abuse who has several risk factors for IPV

The case manager for two families with children who have type 2 diabetes is struck by the differences between the families. In one family, the parents are intentional about providing fruits and vegetables for their child to eat, regularly remind him to check his blood glucose level, and make sure that he engages in some sort of outdoor activity every afternoon. In the other family, the kitchen is stocked primarily with potato chips and processed snack foods, the child does not monitor her glucose level consistently, and she spends her afternoons texting or watching videos on the sofa. By this comparison, the case manager realizes how critical the family is in forming the attitude the child has toward caring for his or her own health. Which grand nursing theory does this experience best illustrate?

Self-care agency

Which theory views the family as the foundation for self-care and a setting for care?

Self-care agency

Which of the following represents a nursing intervention at the tertiary level of prevention?

Serving as case manager for a mentally ill homeless client

The nurse meets with a group of fellow nurses. They discuss the number of children who have died in hot cars and how likely they are to gain support from their state legislators to address the problem. The nurses are currently in which step of the policy-making process?

Setting an agenda

What are examples of primary prevention activities?

Smoking cessation program Heart-healthy eating program

The nurse wishes to compare the number of persons aged 40 to 49 years who die each year with the midyear population of persons in this age range, per 100,000 population. Which type of rate is the nurse attempting to calculate?

Specific

What type of injuries has the highest incidence rate resulting in days away from work?

Sprains Strain and tears Cuts

Which correctly defines an adjusted rate?

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

You are a community health nurse assessing the neighborhood in which your clients live. When observing the physical environment, you note that most of the homes in the neighborhood are well kept and the children playing in the yards are wearing clean clothing. The children appear well nourished. You place the neighborhood on the list as a low priority for a neighborhood well-child clinic. Your assessment is based on

Subjective data

One of the most difficult but essential parts of nursing is providing postmortem care. What position is the body to be placed after the death pronouncement?

Supine

A challenge in identifying people at risk for substance abuse is that many health care practitioners in primary care do not directly, or routinely, ask about alcohol or drug use when collecting information about a person's health history. Reliable and valid screening instruments that are easy to administer are important tools to aid community health nurses in evaluating populations and individual people at risk for substance abuse. Using your knowledge of women who are pregnant, which screening instrument for alcohol use has been validated for assessment in this group?

T-ACE

Which of the following represents a nursing intervention at the primary level of prevention?

Teaching a class in parent effectiveness training

Using knowledge of the parish or faith community nurse, which interventions are likely to perform on the basis of the key roles of this type of nurse? (Select all that apply.)

Teaching a class to faith community members on managing high blood pressure Providing counsel on preventing upper respiratory illness to member Referring a faith community member to a nutritionist for dietary counsel

Using the tenets of secondary prevention, the committee seeks to establish an HIV/AIDS clinic. The nurse states that it is important for the location of the clinic to be associated with the local hospital. The committee states that the cost of the clinic associated with the hospital is higher than one that is free standing. Which presents the best rationale for the nurse's suggestion?

The hospital can more easily implement programs of care for the clients

You are conducting a community assessment in a town once supported by multiple paper factories. The factories closed 2 years ago and the majority of the population is now out of work. The school nurse notes that 68% of the students are behind in their physicals and immunizations. On the basis of your community assessment, you will recommend

The initiation of neighborhood clinics at low or no cost to the community.

The patient has come to the clinic complaining of symptoms of withdrawal. Using your knowledge of physical and psychological symptoms of withdrawal, what assessment would describe what this patient is experiencing?

The lack of euphoria, with no changes in perception or cognition as well as physical effects related to the physiological and psychological effects of substances.

Which federal agency is directly involved w/health and health care of US citizens or refugees/asylees?

United States Department of Health and Human Services

o As an advocate for leukemia research, the nurse along with many others succeeded in urging the U.S. Congress to debate and vote on a bill that significantly increases federal funding for this research. Which system level would such an intervention address?

Upstream

Contaminants that stay in the environment longer may influence health over a greater period of time. What is an example of a radiological contaminant?

Uranium

What is a multilateral agency?

Uses both governmental and nongovernmental resources

A nurse, new to the community health agency, works in a culturally diverse area of the community. The nurse is responsible for providing holistic care to clients and to be culturally competent. The health agency requires the nurse to demonstrate which competency to exhibit cultural competence? (Select all that apply.)

Value diversity Acquire cultural knowledge Adapt to diversity

The student-nurse discusses transmission that involves contact of a susceptible host with a vehicle. Based on the chain of infection links, which exemplifies a vehicle?

Water

The nurse explores all of the possible factors that contribute to coronary artery disease in the community as links in multiple interrelated chains. Which epidemiologic models is the nurse using?

Web of causation

Who in the history of epidemiology developed mortality surveillance systems, addressed basic epidemiologic concepts, and is considered the founder of modern statistics?

William Farr

In a healthcare facility, a client is regarded as being healthy if he or she has no diagnosed diseases and is free of any symptoms. Which model of health is in place at this facility?

Clinical model

A significant number of the members of your community have developed cancer. The EPA has discovered a leak of biohazardous waste from a local factory that has leached into the water table. The area is decontaminated and cleaned. The community identifies the need for a local hospice for those with cancer who are dying. Area communities participate in the fund drive. This type of community effort may be considered (a)

Community of solution

The nurse conducts a well-child clinic in your community. The client population is culturally diverse, and, although the clinic is busy, it runs smoothly because it has an interpreter. In addition to the interpreter, it is important that the nurses treat each client that reflects his or her individual cultural needs. This is cultural:

Competence

An occupational and environmental health nurse recognizes a range of practice issues and functions comfortably in roles as clinician, coordinator, and case manager following company procedures, utilizing assessment checklist and clinical protocols to provide treatment. Using your knowledge of AAOHN competency levels in occupational and environmental health nursing, at what level is this nurse functioning?

Competent

You are a community health nurse working in a receiving station after a radiological disaster. You are wearing the requisite PPEs and note that the majority of the victims have blast injuries. A volunteer worker reports that many of the victims have dust on their clothes. Your response to the dust is to

Consider it radioactively contaminated and notify HAZMAT.

What are examples of biological hazards?

Contaminated body fluids Poisonous plants Venomous snakes

A client is receiving adjuvant medications to increase the effectiveness to treat the pain associated with end-stage prostate cancer. What is an example of an adjuvant medication?

Corticosteroids

You are appointed to be a member of the risk communication team during a disaster response situation. During an evacuation, you are informed that an increasing number of individuals are reluctant to leave their homes. In order to complete an orderly evacuation, it is necessary to

Create an environment of trust and credibility

The nurse is measuring the occurrence of chronic obstructive pulmonary disease being investigated in the entire population. Which rate does this represent?

Crude

The nurse is caring for a client who refuses the food as served. He states that the food is foreign to him and will make him ill. All food must be blessed. The personal care attendant is upset by this behavior and states that the client should eat the food anyway. The client's behavior is most likely a result of:

Cultural belief

Which represents the correct order of events in the policy-making process?

1) Setting an agenda 2) Policy formation 3) Policy adoption 4) Policy implementation 5) Policy assessment 6) Policy modification

The nurse is conducting research on the relative risk of acquiring lung cancer as a result of being exposed to secondhand smoke. The nurse is studying two different groups. Group A includes 400 adults who do not smoke but are exposed to secondhand smoke in their home on a daily basis. Group B includes 400 adults who do not smoke and are not exposed to secondhand smoke in their home. Over the course of 10 years, 20 subjects in Group A are diagnosed with lung cancer, whereas only 2 subjects in Group B are diagnosed with lung cancer. Which is the relative risk ratio that would result from this study?

10

The patient states a history of substance abuse. Using your knowledge of abstinence, this patient would be considered abstinent when there had been no use of illicit substances or alcohol in the preceding how many months?

12

City A has a population of people who are exposed to HIV, whereas City B has a population of people who are considered nonexposed to HIV. There were 3,267 new HIV cases in a given year for City A, with a population (exposed) of 10,000,000. There were only 5 new HIV cases in the same year for City B, with a population (nonexposed) of 150,000. Which is the attributable risk of HIV occurring in City A in terms of cases per 100,000 population?

29.34

A man who lives in a homeless shelter is diagnosed with active tuberculosis (TB). The shelter keeps a list of those who are assigned beds, and the majority of those sleeping there are regulars. Which finding would indicate a positive tuberculin skin test result using a two-step process?

6

What is the incidence rate for hearing loss if 65 workers of 1000 employees have more difficulty hearing at certain frequencies this year than last.

6.5%

The client wants to know how long Medicare will pay for skilled needs. How long can the nurse continue to provide this care before she must seek a renewal if skilled needs continue to exist?

60

You are notified that a possible anthrax exposure occurred at the local military base. Civilian workers are routed to the local hospital's emergency department. Your responsibility is to set up PODs in the community. The function of the PODs in response to the anthrax exposure is to

Administer prophylactic medications

The nurse enters a client's home to provide care to a wound and teach the client's wife how to care for the wound. The nurse is comfortable with the client's culture and the fact that it is matriarchal in nature. As teaching begins, the husband interrupts and states that the woman does not change bandages according to his culture. He asks if the nurse is familiar with his culture and then says that all members of his neighborhood follow its principles. The nurse should suspect that the client is a member of:

A subculture

To demonstrate true cultural sensitivity and awareness, the nurse must:

Be competent in his or her own cultural heritage

An older woman in a rural health clinic tells the nurse that this is the first time she's been in a medical facility for more than 10 years. She shows signs of advanced diabetes, including significant necrosis in her feet. When asked why she didn't come in sooner, she says, "I don't drive, myself, and I hate asking my son to bring me—I feel like such a burden." This situation exemplifies which of the seven A's of challenges to elders in rural areas?

Acceptability

While visiting the home of an 89-year-old woman out in the country, the nurse learns that her primary care provider's office is one hour's drive away. The client states, "I've just stopped going in for appointments in the past few years. It's just too far for me to drive by myself." This situation exemplifies which of the seven A's of challenges to elders in rural areas?

Accessibility

The local clinic is dedicated to the well adult and child. It has evening hours and offers varied programs for the community. The programs include immunizations and classes on fire safety, health education, and car safety, to name a few. How would the nurse explain the level of prevention used in this setting to your colleagues?

Primary

Which best defines program replication?

Ability to reproduce a successful program w/i a different community

A client wants to know the best way to avoid sexually transmitted infections (STIs). The nurse should mention:

Abstinence

The nurse collects specific data related to risk factors, health indicators, and health outcomes that determine the burden of disease. Which data would the measure known as HALE yield about health indicators and outcomes?

Average number of years that a person can expect to live in "full health" by taking into account years lived in less than full health due to disease and/or injury

When speaking with an older man in a rural community about his lifelong smoking habit, the nurse is alarmed to learn that he has never heard that cigarette smoking is the major cause of lung cancer. This situation exemplifies which of the seven A's of challenges to elders in rural areas?

Awareness

A community care nurse at a healthcare agency assists in coordinating a plan for providing health services in the most cost-effective way possible to a large number of members living in the region. This work is known as:

Care management

What type of research study would entail an in-depth analysis of one group of developmentally disabled individuals and the effects of music therapy?

Case

Using your knowledge about observational analytic studies that enroll one group of persons with a certain health problem and a group of persons without the health problem, what type of study was used in this published research study?

Case control

The nurse wishes to determine how many people in the city die from heart attacks each year per 100,000 population. Which type of rate is the nurse attempting to calculate?

Cause-specific mortality rate

Which rate measures the number of people in a given population who have influenza at a given point in time?

Prevalence

The nurse educator is responsible for conducting educational seminars for the staff. After the education component of the program, the group engages in discussion. It is important that nurses routinely attend educational programs related to cultural competence because:

Nurses can facilitate social change

The nurse works in a facility that provides hospice care for clients with cancer diagnoses. The nurse recognizes that the care provided in this facility is tertiary in nature. The nurse develops a plan for the clients that would include the tenets of tertiary prevention. The plan would include: (Select all that apply.)

Palliative care Pain control Supportive spiritual development

The hospital board is in the process of developing a policy regarding the use of cell phones within the hospital. At the current meeting, the board has decided to allow use of cell phones only within certain waiting areas within the hospital, and nowhere else. Which stage of policy-making does this action represent?

Policy adoption

The hospital board is in the process of developing a policy regarding the use of cell phones within the hospital. After 6 months of a policy being in place and weeks of ongoing evaluation of the policy by individual board members, the board decided to expand the areas where cell phone use is permitted to include all waiting rooms and some client rooms. Which stage of policy-making does this action represent?

Policy modification

The nurse is passionate about research for a cure for pediatric leukemia and has written the state representatives in Congress to urge them to expand federal funding for this research. This behavior is an example of involvement in:

Politics