Community Health Nursing Practices and Strategies, Exams of Nursing

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ATI Community Health 2019 Version 1

1. A nurse working in an infectious disease clinic is caring for a client who has a new diagnosis of Lyme disease. Which of the following agencies is responsible for voluntarily reporting cases of this disease to the Centers for Disease Control and Prevention? b. Office of the Surgeon General c. Local Red Cross chapter d. Hospital infection control department
2. A case manager is completing discharge planning for a client who has alcohol use disorder and cirrhosis of the liver. Which of the following actions should the case manager take first? a. Contact a social worker to assist the client with managing finances. b. Provide the client with information on self-help groups for alcohol use disorder. c. Arrange for a home health nurse to visit the client following discharge.
3. A nurse is providing teaching to a client about directives regarding end-of-life care. Which of the following information should the nurse include in the teaching? a. The client can verbally choose a health care proxy if two nurses witness the designation. b. The client’s family has the authority to revoke the do-not- resuscitate order at any time. d. The client can choose a non-family member as the designated power of attorney.
4. A nurse in an antepartum clinic is reviewing the medical records of four clients. Which of the following infectious conditions should the nurse report to the Centers for Disease Control and Prevention? a. Human papillomavirus b. Bacterial vaginosis c. Gonorrhea d. Genital herpes simplex virus
5. A home health nurse is performing an eye assessment for an older adult client. Which of the following findings is the priority for the nurse to report to the provider? a. Decreased near vision b. Conjunctivitis c. Hemianopsia d. Increased sensitivity to glare
6. A home health nurse is caring for a client who has Clostridium difficile infection. Which of the following actions should the nurse take? a. Obtain a surgical mask for the client to wear when away from home. b. Instruct the client to avoid the use of probiotics. c. Use an alcohol-based hand sanitizer following care.
7. A nurse in a mobile health clinic is caring for a client who requires a tetanus immunization and is accompanied by his daughter. The client does not speak the same language as the nurse. Which of the following actions should the nurse take? a. Arrange for a member of the client’s community to interpret the teaching. b. Have the client's daughter communicate information about the procedure. d. Use professional terminology when providing education prior to the procedure.
8. A parish nurse is counseling a family following a client's recent diagnosis of heart disease. Which of the following actions should the nurse take first? a. Assist the client and the client’s partner with finding an affordable exercise program. b. Discuss the benefits of eating a well-balanced diet with the client’s family. d. Offer to accompany the client and the client’s partner during health care provider visits.
9. A school nurse is planning primary prevention activities for the school year. Which of the following actions should the nurse plan to take? b. Schedule hearing screenings for each grade level. c. Provide referrals for students who have asthma. d. Provide first aid for injured students.
10. A home health nurse is planning the initial home visit for a client who has dementia and lives with his adult son’s family. Which of the following actions should the nurse take first during the visit? b. Provide the family with information about respite care. c. Educate the family regarding the progression of dementia. d. Encourage the family to join a support group. a. Engage the family in informal conversation. a. Monitor the immunizations status of students. relationships within the family. c. Ask family members about the impact of the disease on interpreter. c. Identify the client’s spoken dialect prior to contacting an d. Clean the client’s bathroom with a diluted bleach solution. client and the provider. c. The living will is a legally binding contract between the implement. d. Determine which home safety measures the client needs to a. State health department

11. A nurse is working with a case manager for a client who participates in a health maintenance organization. The nurse should identify that HMO provides which of the following payment structures? a. The client pays the insurer a percentage of the total costs for each service rendered by the provider. c. The provider bills the client directly for a predetermined percentage of the cost of services. d. The client is participating in a fee-for-service health care insurance program.
12. A nurse manager at a clinic is reviewing the preventative services offered to clients. Which of the following activities should the nurse identify as a secondary prevention activity? a. Advocate for laws that prohibit texting while driving. b. Refer a client who is recovering from a substance use disorder to a social service program. c. Provide a smoking cessation class.
13. A school nurse is planning safety education for a group of adolescents. The nurse should give priority to which of the following topics as the leading cause of death for this age group? a. Substance abuse prevention b. Sports injury prevention c. Gun safety
14. A home health nurse is caring for a client who has chemotherapy- induced nausea that has been resistant to relief from pharmacological measures. Which of the following interventions should the nurse initiate? (SATA) a. Use seasonings to enhance the flavor of foods. e. Offer 120 mL (4oz) of cold 2% milk as a meal replacement.
15. A nurse is working with a community health care team to devise strategies for preventing violence in the community. Which of the following interventions is an example of tertiary prevention? a. Urging community leaders to make nonviolence a priority b. Presenting community education programs about stress management c. Assessing for risk factors of intimate partner abuse during health examinations
16. A nurse is developing health promotion strategies for older adult clients at an assisted living facility. Which of the following strategies is the priority for the nurse to include? a. Scheduling annual dental examinations for the clients c. Encouraging the clients to exercise regularly d. Providing the clients with a low-fat diet
17. A nurse is triaging clients who were involved in a commuter train crash. Which of the following clients should the nurse choose for transport to the emergency departments first? a. A client who has a fracture of the humerus with a 2+ radial pulse in the affected arm b. A client who is exhibiting agonal respirations with fixed and dilated pupils d. An ambulatory client who has a nosebleed and reports feeling dizzy
18. A nurse is assessing an outbreak of mumps among school-age children. Using the epidemiological triangle, the nurse should recognize which of the following is the host? b. The virus c. The vaccine d. The school
19. A home health nurse is discussing electrical hazards with a client. Which of the following statements should the nurse include? a. “You should cover electrical cords with an area rug.” c. “You should secure extension cords with clear packing tape.” d. “You should pull on the cord when unplugging items.”
20. A nurse in a clinic is reviewing home safety precautions with a client who is to begin radioactive iodine therapy. Which of the following statements by the client indicates an understanding of the teaching? a. “I will wait 1 week after treatment to use a laxative.” b. “I will allow my granddaughter to visit for 4 hours daily.” c. “I will use cloth handkerchiefs instead of tissues.” d. “I will use a toilet that is not used by others in my family.”
21. A community health nurse is teaching a group of parents about manifestations of alcohol withdrawal. Which of the following manifestations should the nurse include in the teaching? a. Somnolence c. Hypotension d. Hyperglycemia b. Seizures a. The children total body surface area c. A client who has full-thickness burn injuries over 30% of his b. Immunizing the clients against influenza d. Developing resources for victims of abuse after eating. d. Maintain the head of the client’s bed in an elevated position meals. c. Provide sips of room-temperature ginger ale between b. Assist the client in using guided imagery. d. Motor vehicle safety d. Encourage a pregnant client to participate in prenatal care. or yearly basis. b. The provider is paid a fixed sum for the client on a monthly b. “You should limit your use of extension cords.”

22. A nurse is reviewing levels of prevention with a newly licensed nurse. Which of the following is an example of tertiary prevention? a. Providing STI testing for students on a college campus c. Educating adults about breast cancer screening guidelines d. Promoting the use of helmets with children who ride bicycles
23. A nurse is serving on a state task force for disaster planning. The nurse is engaging in disaster preparedness efforts when performing which of the following actions? a. Functioning as a manager at a temporary shelter b. Assisting with the identification of a biological agent c. Implementing a disaster triage plan with a local medical facility
24. A parish nurse is planning activities for a faith-based community. Which of the following activities should the nurse include? b. Offer primary care to uninsured members c. Provide case management d. Change a negative pressure wound therapy dressing
25. A nurse in a community health clinic is assessing a client who has two preschoolers, was recently divorced, and is seeking help for managing depression. Which of the following questions should the nurse ask first? b. “Could you describe how you are feeling today?” c. “Is there anything that makes you feel less depressed?” d. “Who is available to help you?”
26. A community health nurse encounters a client who has a suspected bioterrorism-related illness. Which of the following actions should the nurse take? a. Report the client’s condition to the Federal Bureau of Investigation. b. Move the client to a quarantine area. d. Disinfect contaminated areas of skin with isopropyl alcohol.
27. A nurse is teaching a group of clients about ways to prevent skin cancer. Which of the following statements by the nurse demonstrates a primary prevention strategy? a. “Avoid direct sunlight between 10 am and 4 pm.” b. “Apply cool tap water soaks for 20 minutes to relieve sunburn.” c. “Use acetaminophen as needed for sunburn.” d. “Ensure you have a yearly skin examination with your provider.”
28. A home health nurse is caring for a client who has terminal cancer and no longer wants to receive enteral tube feedings. Which of the following actions should the nurse take? a. Complete an against medical advice form. b. Request the facility chaplain to visit the client. c. Ask the client to sign an informed consent form.
29. 7. A nurse working in an assisted care facility is developing a disaster plan. Which of the following is the first action the nurse should take? a. Verify dates of the annual community-wide mass casualty drill. c. Identify materials needed for staff and resident education. d. Develop response strategies specific to older adults.
30. A nurse is providing teaching to a 50 - year-old female client. Which of the following statements should the nurse include in the teaching? b. “You should have your fasting blood glucose level checked every 6 years.” c. “You should have your stool tested for blood every other year until the age of 74.” d. “You should have your hearing screened every 5 years.”
31. A nurse is providing teaching to a newly licensed nurse about case management. The nurse should include which of the following tasks is the responsibility of a case manager? a. Perform employee risk assessment. b. Enforce OSHA standards in the workplace. c. Teach a smoking cessation support group.
32. A community health nurse is working with a task force to decrease community violence. Which of the following planned interventions should the nurse identify as a primary prevention strategy? a. Providing sexual assault nurse examiner training for nurses in the local clinic b. Developing a protocol for managing victims of violence d. Arranging for a local clinic to provide methadone treatment
33. A nurse educator is teaching a group of newly licensed nurses about maintaining client confidentiality according to HIPAA d. Evaluate the cost-effectiveness of client treatments. years until the age of 64.” a. “You should have a complete eye examination every 2 b. Determine potential environmental health hazards. d. Explain the process for completing a living will. a. “Are you having any thoughts about hurting yourself?” a. Teach stress management strategies d. Organizing a mass casualty drill for community members b. Teaching about inhaler use to a client who has asthma c. Providing parenting classes for local parents c. Don personal protective equipment.

regulations. Which of the following statements by a licensed nurse indicates an understanding of the teaching? b. “We should share our computer passwords with our manager.” c. “HIPAA rules vary from state to state.” d. “A client's diagnosis can be posted on the communication board inside the client's room.”

34. A nurse is working for a hospice organization. The nurse should identify which of the following criteria must be met for a client to qualify for hospice care? a. The client has documentation stating he has less than 12 months live. b. The client’s insurance provides coverage for palliative care. d. The client requires inpatient care due to lack of a caregiver.
35. A nurse is conducting home visits to postpartum adolescents who participated in prenatal parenting classes. Which of the following statements indicates an understanding of the teaching? a. “I use baby talk when talking to my baby.” b. “I limit the time her grandparents cuddle my baby to prevent spoiling her.” c. “I warm my baby’s bottle in the microwave for 30 seconds at a time.”
36. A community health nurse is working with a migrant population. The nurse should recognize which of the following interventions is necessary to provide care to this population? a. Treating clients on a fee-for-service basis b. Offering health screenings at a community center d. Requiring clients to show a work visa before they receive care
37. A nurse at a rural clinic is interviewing a family who has different cultural beliefs than the nurse. The family reports seeing a folk healer. Which of the following statements should the nurse make? a. “Many folk medicine treatments work by providing a placebo effect.” b. “I can refer you to a medical practitioner for your health care needs.” c. “Alternative medicine practices can be dangerous and should be avoided.”
38. A nurse in a community clinic is assessing a client who reports injecting heroin 1 hr ago. Which of the following findings should the nurse expect? b. Dilated pupils c. Tachypnea d. Nystagmus
39. A nurse case manager is providing discharge planning for a client. The nurse is functioning in which of the following roles when arranging for the delivery of medical equipment to the client’s home? b. Systems allocator c. Advocate d. Consultant
40. A mental health nurse is scheduling a home health appointment with a client who has recently lost his partner in a motor-vehicle crash. Which of the following statements by the client indicates the need for immediate nursing intervention? a. “I just feel so angry right now.” b. “Everything is going to be fine soon.” c. “I’m not going to talk to you about my problems.” d. “There’s no need for anyone to come see me, including you.”
41. A nurse is providing teaching to a newly licensed nurse about secondary prevention strategies related to violence and abuse. Which of the following strategies should the nurse include in the teaching? a. Coordinate a personal defense program at a local agency. b. Refer clients to the appropriate community agency if signs of abuse are evident. c. Teach a parenting skills class at a child development center.
42. A nurse is planning primary prevention activities for the new school year. Which of the following should the nurse include? (SATA) a. Recommending a seating arrangement for a child in a body cast b. Teaching a class about the risks of cigarette smoking c. Lobbying for funding for health promotion efforts d. Creating a plan of care for children who have a diagnosis of diabetes mellitus e. Organizing a program to promote skateboard safety
43. A nurse at a community clinic is preparing an education guide about cultural variances in expression of pain. Which of the following information should the nurse include? health visits. d. Assess clients for withdrawal and passivity during home a. Coordinator a. Euphoria health.” d. “Describe how you hope the treatments will affect your d. “I carry my baby with me as I move around the house.” treatments. c. The client has declined additional life-prolonging records.” a. “HIPAA rules allow clients to receive a copy of their medical c. Provider health services at work sites

a. Middle Eastern cultural practices include hiding pain from close family members b. Puerto Rican cultural practices include the view that outspoken expressions of pain are shameful c. Native American cultural practices include being outspoken about pain

44. A home health nurse is providing teaching to the guardian of a child who has leukemia about methods to prevent complications. Which of the following statements by the guardian indicates an understanding of the teaching? a. “I’m sure my child will feel better now that he can ride his bicycle.” b. “I will make sure my child gets a measles, mumps, and rubella vaccine this week.” d. “I should take my child's rectal temperature daily.”
45. A public health nurse is developing protocols to use in emergency shelters following a disaster. Which of the following interventions should the nurse include as a secondary prevention strategy for clients who survive a disaster? a. Providing age-appropriate activities for shelter residents b. Publishing a listing of shelter locations in a local media sources d. Compiling resources available to transition individuals from shelters to a home
46. A nurse is caring for a client who asks, “Can I decide not to continue with chemotherapy?” The nurse responds, “This is your choice, and I’ll support whatever decision you make.” The nurse’s response is an example of which of the following ethical principles? a. Beneficence c. Veracity d. Nonmaleficence
47. A school nurse is caring for a child who has muscular dystrophy and is having difficulty swallowing at lunch. Which of the following referrals should the nurse initiate? a. Respiratory therapist b. Occupational therapist c. Dietitian
48. A nurse is planning a primary prevention strategy for reducing obesity in a community. Which of the following strategies should the nurse use? a. Encourage enrollment and attendance at weight-reduction programs. c. Measure the BMI of older adults at a community senior center. d. Distribute health-risk appraisal questionnaires at community functions.
49. A nurse is caring for a client who has hepatitis A virus. Which of the following reservoirs should the nurse identify for this infection? a. Skin b. Genitourinary tract c. Blood
50. A nurse in an extended care facility enters the room of a client and notices a fire in the trash can. Which of the following actions is the nurse's priority? a. Activate the alarm. c. Attempt to extinguish the fire. d. Shut the doors and windows of the room.
51. A case manager in a rehabilitation facility is discussing discharge plans with a client who has a pressure injury and requires a special bed at home. Which of the following statements should the nurse make first? a. “Eat a balanced diet with high-protein snacks.” b. “A social worker can help you with the cost of supplies.” c. “Apply moisture barrier ointment three times a day.”
52. An occupational health nurse is assessing agricultural workers for acute effects of pesticide exposure. Which of the following findings should the nurse expect? a. Hypoglycemia b. Diplopia d. Oliguria
53. A home health nurse is assessing a client who has AIDS. Which of the following responses by the client indicates a risk for suicide? a. “I am afraid of experiencing pain near the end.” c. “I don't want to lose control of my ability to make decisions.” d. “I am relying more and more on my partner for support.”
54. A faith-based organization asks a community health nurse to develop a mobile meal program for older adults who are no longer b. “I know that everything will be better soon.” d. “Describe the place where you are currently living.” b. Move the client to another location. d. Feces exercise. b. Educate children at a daycare center about nutrition and d. Speech-language therapist b. Autonomy effectiveness of coping behaviors c. Interviewing shelter residents to determine the family dishonor d. Chinese cultural practices include enduring pain to prevent c. Dizziness c. “I should inspect my child's mouth for sores.”

driving. Which of the following actions should the nurse plan to take first? a. Identify alternative solutions to address concerns. c. Inquire about the availability of volunteers. d. Determine potential funding resources for the program.

55. An occupational health nurse is completing a walk-through of a factory to identify workers at risk for injury. Which of the following workers should the nurse identify as being at risk? a. A worker who is standing in place for extending periods and rests one foot on a box c. Develop teaching using a variety of strategies.
56. A first-response team is working at the location of a bombing incident. A nurse triaging a group of clients should give treatment priority to which of the following clients? b. A client who has superficial partial-thickness burn injuries over 5% of his body c. A client who has a femur fracture with a 2+ pedal pulse d. A client who is ambulatory and exhibits manic behavior c. A working who is wearing a back brace and bends at the waist when picking up a pallet d. A worker who is 7-weeks postoperative following rotator cuff surgery and is labeling boxes
57. A nurse is teaching a client who has a terminal illness about hospice care. Which of the following statements by the client indicates an understanding of the teaching? ( SATA) a. “I will need to have private insurance because Medicare does not cover hospice services.” c. “My provider will recommend that I enter hospice care when I have 1 year left to live.”
58. A nurse is participating in a quality improvement committee for home health clients. Which of the following topics should the nurse recommend for the committee to review? a. An increase in clients receiving annual flu vaccines b. An increase in client admissions for home health care d. An increase in levels of local air pollution
59. A nurse is planning an in-service about isolation precautions for her coworkers. For which of the following infections should the nurse identify the need for contact precautions? a. Pertussis b. Diphtheria d. Pulmonary tuberculosis
60. A nurse is caring for a client who is homeless. Which of the following actions should the nurse take first? a. Assist the client to develop goals for obtaining shelter. b. Discuss the risks of being homeless with the client. e. “I can discontinue hospice care whenever I want.” members.” d. “I will receive care from a variety of interprofessional team b. “I can receive care in the hospital or at home.” shock a. A client who has a rigid abdomen with manifestations of d. Determine the client's understanding of her living situation. b. Perform a needs assessment. a cart toward himself b. A worker standing with a wide base of support when pulling c. Herpes simplex c. An increase in client falls at home