Download Comprehensive Assessment Tina Jones Shadow Health Transcript, Subjective, Objective & and more Exams Nursing in PDF only on Docsity! Exam 1 Chapter 1: Health: A Community View 1. Which of the following best describes the primary reason that Americans are concerned about health care? A. Politicians are discussing how to improve health care. B. The media has provided mixed messages about the health care system. C. Our national health care costs keep increasing. D.The new health care system offers free services to Americans. Answer:C 2. A nurse has begun to lobby with politicians for changes to the health care system. Why is this involvement important? A. Nurses, as central characters in several popular TV series, are currently very visible in American media. B. Nurses are primarily responsible for managing the various units in our health care system. C. Nurses are the largest group of health care providers. D. Nurses are the only group that is employed both inside and outside of hospitals. Answer: C 3. What conclusion can be drawn from examining where nurses are employed? A. There is a trend toward consolidation of health care into large central medical centers. B. There is an increased emphasis on community-based health care. C. There is an obvious need to decrease health care costs by cutting positions. D. Managed care organizations (MCOs) are employing nurses to improve customer relations. Answer:B 4. Which ethical belief would be most helpful in the current health care crisis? A. Emphasis should be on individual and corporation freedom in the marketplace. B. Emphasis should be on individual autonomy and freedom of choice. C. Emphasis should be on social justice and collective responsibility. D. Emphasis should be on the effectiveness of technology in resolving problems. Answer:C 5. What is the primary problem seen in Healthy People 2020's emphasis on choosing healthy lifestyle behaviors, such as daily exercise or healthy food choices? A. Emphasis on other lifestyle choices, such as not smoking and minimal use of alcohol or drugs, is also needed. B. All of us must work together to make unhealthy behaviors socially unacceptable. C. It costs more to make healthy choices, such as buying and eating fresh fruits and vegetables as opposed to quick and cheap fast-food choices. D. Public policy emphasizes personal responsibility but ignores social and environmental changes needed for well-being. Answer:D 6. What responsibility does the American Nurses Association (ANA) Code of Ethics require of the nurse beyond giving excellent care to patients? 17. Which action would probably result in the largest change in health care outcomes for Americans? A. Establish large numbers of scholarships for education of nurses, physicians, and other health care providers B. Fund a one-time extremely large stimulus to allow all health care providers and agencies to create and integrate computer network systems for client health care records C. Increase funding for hospitals and medical centers to expand their neighborhood clinics D. Redirect a large portion of federal funding from acute care to health promotion activities Answer:D 18. Which task will be most helpful in meeting the public health agency's goals? A. Complete staff evaluations in preparation for individual meetings to plan their agency and individual goals for the next year B. Actively participate in community agencies' collaborative action plan to meet the community's health goals for the year C. Meet with the college of nursing faculty to finalize student objectives and schedules for the next semester D. Teach a free course in healthful living for community residents Answer:B 19. A community health nurse is overwhelmed with all that needs to be done in one day. Which task could most easily be postponed? A. Reviewing the most recent hospital patient data collected by the local college of nursing B. Deciding which of several possible new clinic options would be most effective in better meeting the needs of the local community C. Evaluating the results of the most recent community-wide screening program before planning for the next community health program D. Giving testimony to the state legislature on a new health and safety bill Answer:A 20. A nurse who works on the surgical unit at the local hospital was asked by the home health unit to make a home visit to a patient who had been discharged the previous day and to give follow- up care (for overload pay). What kind of nursing would this nurse be doing? A. Acute care hospital nursing B. Community-based nursing C. Community health nursing D. Public health nursing Answer: B 21.Which task is most crucial for the community health nurse to do well? A. Review the most recent morbidity and mortality data B. Create a new clinic to better meet local health needs C. Evaluate the results of the recent screening program D. Give testimony regarding proposed state health legislation Answer:D 22.A new public health nurse carefully assessed all the local mortality and morbidity data in preparation for making appropriate planning suggestions at a meeting next week. What other action is crucial before the nurse can feel prepared? A. Ask other nursing staff their perceptions of the community's needs B. Assess the nurse's own assets, strengths, and ability to contribute C. Meet members of the community to determine their culture and values D. Review discussions and decisions from previous meetings Answer:C 23.Why are high-risk and vulnerable subpopulations identified by public health nurses before deciding on appropriate interventions? A. It is easiest to make improvements among these groups. B. Populations are not homogeneous, and resources are limited. C. Such groups are most vocal about their needs and wants. D. These groups are often recipients of special funding. Answer:B 24.A nurse works hard to develop alliances among various community organizations toward improving health in the community. What are actions such as this called? A. Building coalitions B. Collaboration C. Communication D. Community cooperation Answer: A 25.After completing a master's degree, a nurse took a course in marketing. Should the agency reimburse the nurse's tuition costs? A. No, courses taken for personal enjoyment are not eligible. B. No, courses taken outside the professional's responsibilities are not eligible. C. Yes, the nurse is demonstrating professional commitment by continuing education. D. Yes, the nurse could use such information in social marketing for the agency. E. Answer: D 26.Which factor is most responsible for differences in an individual's health? A. Culture of the majority of the community's citizens B. Individual's education and income C. Number of physicians and other health care providers in the community D. Quality of the community health agency and hospital in the community Answer: B 27.What are the leading health indicators found in Healthy People 2020? (Select all that apply.) A. Financial issues B. Health system issues C. Individual behaviors D. Issues related to legal and illegal immigration E. Legislative issues Epidemic Pandemic Answer: B 4. Which of the following best describes an innovation introduced by the Romans? Citizenship duties Daily street cleaning Hospitals and nursing homes Daily exercise Answer: C 5. Which of the following best describes a modern public health practice that was originally developed as a means of self-protection from the Black Death (bubonic plague)? Care in a hospital Chemical intervention Isolation and quarantine Herbal remedies Answer: C 6. Which of the following diseases provided immunity to smallpox? Cowpox Measles Mumps Scarlet fever Answer: A 7. A scholar during the Sanitary Revolution created medical topography. What was the advantage of these surveys? Citizens knew which wells were safe to use for drinking water. People knew what housing areas to avoid. Results demonstrated environmental factors related to regional disease. The king could isolate areas of disease from safe areas. Answer: C 8. How did Edwin Chadwick's ideas help decrease disease in the nineteenth century? The minimum wage was increased leading to improved quality of life. Parish workhouses where poverty-level children labored for their room and board were closed. Social reform legislation resulted in changes such as sidewalks. The new emphasis on individual responsibility encouraged people to act to protect their own health. Answer: C 9. Which of the following best describes how John Snow was able to decrease deaths from cholera? Removed a source of contaminated water Created the world's first antibiotic Encouraged the new process of vaccination Helped pass laws that required home quarantine Answer: A 10. Which of the following best describes the achievement that Lemuel Shattuck is well known for in the United States? Publishing the census of Boston, which demonstrated the effect of sanitary reforms Demonstrating the usefulness of vital statistics by analyzing environmental data Developing ideas about public health care reform, which were eventually adopted Establishing a state board of health to deal with the problems he had noted Answer: C 11. Which of the following nursing interventions would have most likely been used by Florence Nightingale when treating wounded soldiers? Establishing private visits with spouses Improving food, clothing, and cleanliness Administering intravenous medications Completing a community assessment of the army hospital Answer: B 12. Which of the following best describes how Nightingale responded to challenges about her suggestions for reform of health care? She influenced male friends as political leaders to publicize her ideas. She conveyed her statistical data in more detail and depth, and shared it with political leaders. She encouraged those who challenged her to come up with more acceptable approaches to lowering the death rate. She understood their concerns and tried to word her suggestions in a more politically acceptable way. Answer: B 13. When comparing a surgeon today with a surgeon of Nightingale's time, which of the following best describes the primary difference in how they would operate on a patient? Current physicians have better surgical equipment (tools). Current physicians have nursing support staff in the operating room. Current physicians would carefully scrub between cases. Current physicians would prescribe antibiotics in the operating room to avoid possible infections. Answer: C 14. Which of the following scientific beliefs or ideas eventually changed medical practice and decreased morbidity and mortality? Bad fluids cause disease, which can be cured by their removal. Specific contagious organisms cause disease. Spontaneous generation theory—disease grows naturally. The miasmic theory—environmental conditions cause disease. Answer: B 15. Why did local and state governments start to become more involved in controlling disease? Hospitals were becoming overcrowded. Businesses were unable to make a profit when employees were ill. Physicians demanded government support in their individual efforts. Citizens were becoming upset with local conditions. Answer: D 16. Which of the following interventions was the first step in controlling the incidence of tuberculosis (TB)? Institutions were required to report TB cases. Federal funding was devoted to seeking TB causes and cures. Physicians began surveillance of TB cases. States built large public hospitals to treat patients with TB. Answer: A 17. Which of the following best describes the overall result of Abraham Flexner's report? All medical schools reorganized into the German model. Citizens were encouraged to become more involved in medical education. Folk healers again became more widely used than physicians. Funding was withdrawn from weak medical schools. Answer: D 18. Which of the following groups was primarily responsible for the establishment of the first school of public health? The American Medical Association The Association of State Departments of Public Health The federal government The Rockefeller Foundation Answer: D 19. A family living in England in 1860 was part of the community where district nursing was implemented. Who would most likely have seen this family? A social worker and a nurse A health teacher and a nurse A nurse A physician and a nurse Answer: A 20. Which of the following interventions was most helpful in assisting people become educated on healthy living in nineteenth-century England? Brochures were distributed without charge in public places. Health visitors joined nurses in providing care in the homes. Nurses spend the majority of their time teaching families. Schools set up health programs for neighborhood adults. Answer: B 21. Which of the following best describes the district nursing service created in the United States by Lillian Wald and Mary Brewster? House on Henry Street Visiting Nurses Association New York City District Nursing Service Wald and Brewster Nursing Service Answer: A 22. Which of the following statements best summarizes Wald and Brewster's approach to home nursing? "All services all the time" 29. Which of the following statements best describes the increase in life expectancy among Americans during the twentieth century? Life expectancy increased by 30 years; the majority can be attributed to advances in medical technology. Life expectancy increased by 30 years; the majority can be attributed to public health efforts. Life expectancy increased by 30 years; the majority can be attributed to improved physician education. Life expectancy increased by 30 years; the majority can be attributed to increased access to care. Answer: B 30. Which of the following is a major challenge for health care provider education today? Ensuring that research findings related to families and groups are included in the curriculum Expanding the curriculum to allow additional experiences in community health settings outside the hospital Increasing course emphasis on environmental influences on health Refocusing the curriculum from care of the individual to needs of aggregates Answer: D 31. Which of the following tool(s) were used by Florence Nightingale to create change? (Select all that apply.) Her incredible beauty and personality Influence of all the nurses Nightingale trained Political advocacy Publication of treated soldiers' death rate changed from 42% to 2% Use of statistics to demonstrate the effectiveness of her interventions Wealth of her family and relatives Answer: C, D, E 32. Which of the following of Nightingale's ideas were forgotten until recently? (Select all that apply.) The need for education for women The influence of environment on health The importance of clinical practice for expertise to develop The need to recognize gender role limitations The problem-solving (nursing) process The use of statistics and a sound research base Answer: B, F 33. Which of the following best describes why folk healers are used by many people? (Select all that apply.) Folk healers are often effective. Folk healers do not charge for their efforts. Folk healers integrate religion and medicine. Folk healers use media very effectively. Folk healers may involve the whole family. Many physicians recommend folk healers. Answer: A, C, E 34. What current emphases are focusing attention on public health? (Select all that apply.) Cost containment and managed care models Focus on disease prevention and health promotion Increased funding for care of chronic diseases Liberal politicians encouraging public health as part of a national health reform Movies showing national disasters and government lack of preparedness Shortage of the H1N1 flu vaccine Answer: A, B 35. Which of the following were the chief factors that led to the creation and growth of Blue Cross hospital insurance? (Select all that apply.) Hospitals banded together, and their leaders encouraged such plans. Hospitals thought such a plan would allow them to expand further and faster. It was an employer alternative to increasing employee pay compensation. Nurses fought for the right of all citizens to purchase insurance as desired. Physicians were concerned with nonpayment of their office fees. Politicians encouraged this alternative to government-supported health care. Answer: A, C Chapter 5: Epidemiology 1. An epidemiologist has written a summary of a food poisoning outbreak, including its cause and ways to prevent it from occurring in the future. Which of the following best describes what has been done? Analytic epidemiology Descriptive epidemiology Prospective cohort study Retrospective cross-sectional survey Answer: B 2. Two brothers played with their cousin. One brother later became quite ill, whereas the other did not. Which of the following provides the best explanation for this occurrence? Difference in length of time exposed Difference in how actively the children played Difference in genetic inheritance between the two brothers Difference in lifestyle between the two brothers Answer: C 3. In which of the following circumstances would it be more helpful to use the wheel model of epidemiology than the epidemiological triangle model? When factors outside the triangle model are involved When there are multiple causes for a chronic disease When research has not yet determined the exact cause When trying to explain the situation to a lay person Answer: B 4. Which of the following best describes the importance of discovering all of the variables that may be involved in creating a disease state in some persons? People want an explanation of why they are ill. Knowing causes helps obtain funds for research to try to create a cure. Finding variables that are susceptible to prevention or early intervention is important. It is important to educate communities on how to avoid any risk factors. Answer: C 5. Which of the following best describes the advantage of the web of causation model in comparison with the epidemiological triangle model? 17. A student athlete receives a screening examination before being active in school sports. Which of the following levels of prevention is being used? Health prevention Primary prevention Secondary prevention Tertiary prevention Answer: C 18. For which of the following would a screening test be most appropriate? Disease A, which must be caught early because society punishes those known to have the disease Disease B, which can be controlled if caught early in the disease process Disease C, which people need to know whether they have contracted, even though there is no treatment for the disease Disease D, because people may want to use that information in family planning Answer: B 19. One hundred women received notification that their screening tests suggested that they might have a serious health problem. Which of the following actions should the nurse take to ensure that they will complete follow-up testing? Compliment them on their willingness to be tested and suggest an immediate appointment before they have too much time to think about the issue. Imply that the test could be wrong; the testing materials may not be effective, but the only way to be sure is to be tested further. Point out that screening is only suggestive and that not all positive screenings mean they actually have the health problem. Reassurance is not therapeutic; reality must be faced. Emphasize the need for immediate treatment. Answer: C 20. Which of the following would be the best method to increase the positive predictive value of a screening test? Test a large population at once Test a group at high risk for the health problem Use a very sensitive screening test Use a very specific screening test Answer: B 21. Which of the following is the most effective way to determine if Healthy People 2020 is improving the health of Americans? Availability of relatable data on total population's health problems Comprehensive and systematically collected surveillance data on the health status of various population groups Increased financing to allow ongoing collation of information Willingness of individuals to share health information with the federal government Answer: B 22. A researcher is examining potential risk factors in comparison with disease at a specific time through collecting data regarding current exercise, sleep patterns, and current health status among 12-year-olds. Which of the following research studies would be most appropriate? Cross-sectional study Prospective study Retrospective study True experiment Answer: A 23. A researcher, interested in the onset of early menses, compared the life experiences and history of 1000 14-year-old girls, half of whom had monthly periods and half of whom did not, to determine what variables might be observed. Which of the following would be the most appropriate categorization of this study? Cross-sectional study Prospective study Retrospective study True experiment Answer: C 24. One famous study followed a cohort of nurses over their lives, collecting data and health histories as they aged. Which of the following would be the most appropriate categorization of this study? Cross-sectional study Prospective study Retrospective study True experiment Answer: B 25. A researcher wanted to engage in the best possible research design to obtain reliable information about the possible cause(s) of a disease. Which of the following designs would the researcher choose? Cross-sectional study Descriptive study Prospective study Retrospective study Answer: C 26. A researcher has limited time and funds. Which of the following research designs would be most appropriate? Cohort study Incidence study Longitudinal study Retrospective study Answer: D 27. On the basis of findings related to elevated blood levels of cholesterol, a researcher wanted to determine whether a new drug would notably lower the blood levels of cholesterol in otherwise healthy persons. Which of the following studies would the researcher most likely use? Cross-sectional study Experimental study Prospective study Retrospective study Answer: B 28. A client has developed pellagra because of a lack of certain B vitamins. Which of the following best describes the classification of the nutritional deficiency? Relative risk factor Agent factor Environment factor Host factor Answer: B 29. Which of the following best describes the Tuskegee Syphilis Study? It provided excellence in research design. It used an extensive subject base leading to confirmed conclusions. It developed information about the causes and treatment of syphilis. It implemented unethical and racist treatment of uninformed subjects. Answer: D 30. An epidemiologist is gathering data to determine which factors may lead to disease. Which of the following data will be gathered? (Select all that apply.) Demographic characteristics Disease characteristics Geographic data Health protection measures taken Length of the disease process When disease struck the area Answer: A, C, F 31. Which of the following information must be analyzed to derive an adequate explanation of disease? (Select all that apply.) Description of commonalities among those who became ill Depiction of the possible pathogen Explanation of the health care system in the community Portrayal of the geographic area where people became ill Review of the methods by which disease can be spread Substances that are effective in sanitizing the area described Answer: A, B, D 32. Which of the following best describes the advantage of the ecosocial epidemiology model over both the web of causation model and the epidemiological triangle model? (Select all that apply.) It decreases the focus on the individual person. It demonstrates the usefulness of molecular epidemiology in disease prevention. It emphasizes the role of complex political and economic context. It is more useful in public policy campaigns in explaining what people need to do to protect themselves. It reflects the current emphasis on ecology and the environment. Its use suggests possible public policy interventions. Answer: A, C, F 33. Which of the following factors are necessary to assume there might be a cause-effect relationship between a particular variable A and a specific illness? (Select all that apply.) It is easy to understand how the variable A could lead to the illness. Anyone who has time to be available Environmental proximity Same employment responsibilities Similar religious faith Answer: B 5. Which of the following best describes how people typically respond when asked of what community are they a member? Geographic community (neighborhood or city) House of worship participants or members Occupational or professional group Those who are devoted to a particular craft or hobby Answer: A 6. Which of the following best describes what community members receive from each other? Safe environment to live and work Entertainment and recreational opportunities Socialization and role fulfillment Useful services such as physicians and medical centers Answer: C 7. An individual lives in a healthy community. Which of the following characteristics would this community most likely display? Ability to adapt and respond to changes Lack of environmental pollution Low unemployment rate Ongoing growth in population Answer: A 8. A nurse is helping a community develop its capacity to address future problems. Which of the following activities is the nurse most likely implementing? Addressing problems in priority order Promoting collaboration and team building Developing community competence Providing education about health issues Answer: C 9. Which of the following best describes shoe leather epidemiology? Implementing the wheel model of epidemiology Engaging in extensive truth seeking like a detective in the community Traveling throughout the community to absorb an overall impression of it Facilitating sharing of the community's history by community leaders Answer: C 10.A community health nurse wants to obtain an overview of the community, but has limited time and resources. Which of the following methods would the nurse most likely use to obtain this information? Engage in a windshield survey Establish a health department committee of community leaders willing to fill out periodic surveys related to various health issues in the community Live in the community for several years 16.The nurse is interviewing community members as part of a community assessment. Which of the following groups of people would the community health nurse most likely want to interview? Bankers who could share economic data on the community Long-time residents who were informal leaders in the community Pastors and other religious leaders who share the faith of the community Realtors who could share housing and living conditions in the community Answer: B 17.A nurse was debating about which approach to use to both obtain data about community needs and encourage community participation in their resolution. Which of the following approaches would be most effective in meeting both goals? A community forum, open to all interested residents of the community A community survey mailed to all residents Establishing focus groups with selected participants Conducting in-depth interviews with select community residents Answer: C 18.A community health nurse has completed a community assessment and is now writing a community diagnosis for the problem. Which component of the diagnosis will be used to summarize the assessment data of the problem? Identification of the health risk Evidence supporting the choice of priority The aggregate that needs the intervention The cause of the identified health problem Answer: A 19.A community health nurse is trying to determine the success of a planned intervention. Which of the following would the community health nurse most likely examine? Changes in funding made available to the agency to continue their efforts An increase or decrease in the number of persons asking for assistance Current problem data to compare with original baseline data Feedback from community residents Answer: C 20.A community health nurse found a very small number of families in the community who were desperately in need of basic preventive health services. Which of the following ethical approaches supports expending agency resources on these few, but needy, families? Beneficence suggests focusing on the most needy, so resources should be expended on these families. Deontological ethics suggest that the nurse must give priority to the intervention that would have the broadest impact. Utilitarianism (the most good for the largest number) would suggest continuing to focus on broader community needs. Virtue ethics would suggest focusing on these families to support the nurse's own character development. Answer: A 21.Which of the following best describes the aspects central to the definition of community? (Select all that apply.) Geographic boundaries at a point in time Whatever is most convenient for the nurse Patterns of disease found Persons who share common goals and interests Persons who band together to address a shared problem The name the people have given themselves Answer: A, E, F 22.Which of the following is a central function unique to community health nursing? (Select all that apply.) Being willing to travel to give care in an appropriate setting Collaborating and cooperating with other health care team members Gathering appropriate comprehensive assessment data on the community Incorporating epidemiological approaches throughout the nursing process Keeping accurate and detailed medical records on care given Being willing to contribute to health policy development Answer: C, D, F 23.Which of the following are considered the most important determinants of a healthy community? (Select all that apply.) Child-friendly neighborhoods Several different choices of houses of worship Employment opportunities Low crime rate Safe food and water supplies Varied housing choices Answer: A, D 24.Which of the following from vital statistics records is useful to community health nurses? (Select all that apply.) Relatively early age of death may suggest a new pathogen in the community Divorce rate, suggesting whether children will need additional services Documentation of the mortality and morbidity of the local community Indication of whether the total population is growing or declining Records of occurrence of congenital malformations Stability of marriages, making family structure become obvious Answer: C, D, E Chapter 7: Community Health Planning, Implementation, and Evaluation 1. Which of the following best describes how care can be appropriately given in a Ability to adapt and respond to changes Lack of environmental pollution Low unemployment rate Ongoing growth in population Answer: A 8. A nurse is helping a community develop its capacity to address future problems. Which of the following activities is the nurse most likely implementing? Addressing problems in priority order Promoting collaboration and team building Developing community competence Providing education about health issues Answer: C 9. Which of the following best describes shoe leather epidemiology? Implementing the wheel model of epidemiology Engaging in extensive truth seeking like a detective in the community Traveling throughout the community to absorb an overall impression of it Facilitating sharing of the community's history by community leaders Answer:C 10.A community health nurse wants to obtain an overview of the community, but has limited time and resources. Which of the following methods would the nurse most likely use to obtain this information? Engage in a windshield survey Establish a health department committee of community leaders willing to fill out periodic surveys related to various health issues in the community Live in the community for several years Review public health department records from up to 5 years ago Answer:A 11.Which of the following best describes how the U.S. Census Bureau surveys are helpful to a community health nurse? They provide the distribution of age, sex, race, and ethnicity in the community. They document the mortality and morbidity of the community. They ensure that all community residents are involved. They temporarily give employment opportunities to residents. Answer:A 12. A public health nurse wanted statistics on the disability, illness, and other health- related variables for the state. Which of the following would be the best resource for the nurse to obtain the most extensive data? State health department records State department of vital statistics The Centers for Disease Control and Prevention The National Center for Health Statistics Answer:D 13.Which of the following best describes when a community health nurse would try to collect data on a health issue? When available data exists When data must be purchased from the agency that collects it Exam 1 Chapter 1: Health: A Community View 1. Which of the following best describes the primary reason that Americans are concerned about health care? A. Politicians are discussing how to improve health care. B. The media has provided mixed messages about the health care system. C. Our national health care costs keep increasing. D.The new health care system offers free services to Americans. Answer:C 2. A nurse has begun to lobby with politicians for changes to the health care system. Why is this involvement important? A. Nurses, as central characters in several popular TV series, are currently very visible in American media. B. Nurses are primarily responsible for managing the various units in our health care system. C. Nurses are the largest group of health care providers. D. Nurses are the only group that is employed both inside and outside of hospitals. Answer: C 3. What conclusion can be drawn from examining where nurses are employed? A. There is a trend toward consolidation of health care into large central medical centers. B. There is an increased emphasis on community-based health care. C. There is an obvious need to decrease health care costs by cutting positions. D. Managed care organizations (MCOs) are employing nurses to improve customer relations. Answer:B 4. Which ethical belief would be most helpful in the current health care crisis? A. Emphasis should be on individual and corporation freedom in the marketplace. B. Emphasis should be on individual autonomy and freedom of choice. C. Emphasis should be on social justice and collective responsibility. D. Emphasis should be on the effectiveness of technology in resolving problems. Answer:C 5. What is the primary problem seen in Healthy People 2020's emphasis on choosing healthy lifestyle behaviors, such as daily exercise or healthy food choices? A. Emphasis on other lifestyle choices, such as not smoking and minimal use of alcohol or drugs, is also needed. B. All of us must work together to make unhealthy behaviors socially unacceptable. C. It costs more to make healthy choices, such as buying and eating fresh fruits and vegetables as opposed to quick and cheap fast-food choices. D. Public policy emphasizes personal responsibility but ignores social and environmental changes needed for well-being. Answer:D 6. What responsibility does the American Nurses Association (ANA) Code of Ethics require of the nurse beyond giving excellent care to patients? 17. Which action would probably result in the largest change in health care outcomes for Americans? A. Establish large numbers of scholarships for education of nurses, physicians, and other health care providers B. Fund a one-time extremely large stimulus to allow all health care providers and agencies to create and integrate computer network systems for client health care records C. Increase funding for hospitals and medical centers to expand their neighborhood clinics D. Redirect a large portion of federal funding from acute care to health promotion activities Answer:D 18. Which task will be most helpful in meeting the public health agency's goals? A. Complete staff evaluations in preparation for individual meetings to plan their agency and individual goals for the next year B. Actively participate in community agencies' collaborative action plan to meet the community's health goals for the year C. Meet with the college of nursing faculty to finalize student objectives and schedules for the next semester D. Teach a free course in healthful living for community residents Answer:B 19. A community health nurse is overwhelmed with all that needs to be done in one day. Which task could most easily be postponed? A. Reviewing the most recent hospital patient data collected by the local college of nursing B. Deciding which of several possible new clinic options would be most effective in better meeting the needs of the local community C. Evaluating the results of the most recent community-wide screening program before planning for the next community health program D. Giving testimony to the state legislature on a new health and safety bill Answer:A 20. A nurse who works on the surgical unit at the local hospital was asked by the home health unit to make a home visit to a patient who had been discharged the previous day and to give follow- up care (for overload pay). What kind of nursing would this nurse be doing? A. Acute care hospital nursing B. Community-based nursing C. Community health nursing D. Public health nursing Answer: B 21.Which task is most crucial for the community health nurse to do well? A. Review the most recent morbidity and mortality data B. Create a new clinic to better meet local health needs C. Evaluate the results of the recent screening program D. Give testimony regarding proposed state health legislation Answer:D 22.A new public health nurse carefully assessed all the local mortality and morbidity data in preparation for making appropriate planning suggestions at a meeting next week. What other action is crucial before the nurse can feel prepared? A. Ask other nursing staff their perceptions of the community's needs B. Assess the nurse's own assets, strengths, and ability to contribute C. Meet members of the community to determine their culture and values D. Review discussions and decisions from previous meetings Answer:C 23.Why are high-risk and vulnerable subpopulations identified by public health nurses before deciding on appropriate interventions? A. It is easiest to make improvements among these groups. B. Populations are not homogeneous, and resources are limited. C. Such groups are most vocal about their needs and wants. D. These groups are often recipients of special funding. Answer:B 24.A nurse works hard to develop alliances among various community organizations toward improving health in the community. What are actions such as this called? A. Building coalitions B. Collaboration C. Communication D. Community cooperation Answer: A 25.After completing a master's degree, a nurse took a course in marketing. Should the agency reimburse the nurse's tuition costs? A. No, courses taken for personal enjoyment are not eligible. B. No, courses taken outside the professional's responsibilities are not eligible. C. Yes, the nurse is demonstrating professional commitment by continuing education. D. Yes, the nurse could use such information in social marketing for the agency. E. Answer: D 26.Which factor is most responsible for differences in an individual's health? A. Culture of the majority of the community's citizens B. Individual's education and income C. Number of physicians and other health care providers in the community D. Quality of the community health agency and hospital in the community Answer: B 27.What are the leading health indicators found in Healthy People 2020? (Select all that apply.) A. Financial issues B. Health system issues C. Individual behaviors D. Issues related to legal and illegal immigration E. Legislative issues Epidemic Pandemic Answer: B 4. Which of the following best describes an innovation introduced by the Romans? Citizenship duties Daily street cleaning Hospitals and nursing homes Daily exercise Answer: C 5. Which of the following best describes a modern public health practice that was originally developed as a means of self-protection from the Black Death (bubonic plague)? Care in a hospital Chemical intervention Isolation and quarantine Herbal remedies Answer: C 6. Which of the following diseases provided immunity to smallpox? Cowpox Measles Mumps Scarlet fever Answer: A 7. A scholar during the Sanitary Revolution created medical topography. What was the advantage of these surveys? Citizens knew which wells were safe to use for drinking water. People knew what housing areas to avoid. Results demonstrated environmental factors related to regional disease. The king could isolate areas of disease from safe areas. Answer: C 8. How did Edwin Chadwick's ideas help decrease disease in the nineteenth century? The minimum wage was increased leading to improved quality of life. Parish workhouses where poverty-level children labored for their room and board were closed. Social reform legislation resulted in changes such as sidewalks. The new emphasis on individual responsibility encouraged people to act to protect their own health. Answer: C 9. Which of the following best describes how John Snow was able to decrease deaths from cholera? Removed a source of contaminated water Created the world's first antibiotic Encouraged the new process of vaccination Helped pass laws that required home quarantine Answer: A 10. Which of the following best describes the achievement that Lemuel Shattuck is well known for in the United States? Publishing the census of Boston, which demonstrated the effect of sanitary reforms Demonstrating the usefulness of vital statistics by analyzing environmental data Developing ideas about public health care reform, which were eventually adopted Establishing a state board of health to deal with the problems he had noted Answer: C 11. Which of the following nursing interventions would have most likely been used by Florence Nightingale when treating wounded soldiers? Establishing private visits with spouses Improving food, clothing, and cleanliness Administering intravenous medications Completing a community assessment of the army hospital Answer: B 12. Which of the following best describes how Nightingale responded to challenges about her suggestions for reform of health care? She influenced male friends as political leaders to publicize her ideas. She conveyed her statistical data in more detail and depth, and shared it with political leaders. She encouraged those who challenged her to come up with more acceptable approaches to lowering the death rate. She understood their concerns and tried to word her suggestions in a more politically acceptable way. Answer: B 13. When comparing a surgeon today with a surgeon of Nightingale's time, which of the following best describes the primary difference in how they would operate on a patient? Current physicians have better surgical equipment (tools). Current physicians have nursing support staff in the operating room. Current physicians would carefully scrub between cases. Current physicians would prescribe antibiotics in the operating room to avoid possible infections. Answer: C 14. Which of the following scientific beliefs or ideas eventually changed medical practice and decreased morbidity and mortality? Bad fluids cause disease, which can be cured by their removal. Specific contagious organisms cause disease. Spontaneous generation theory—disease grows naturally. The miasmic theory—environmental conditions cause disease. Answer: B 15. Why did local and state governments start to become more involved in controlling disease? Hospitals were becoming overcrowded. Businesses were unable to make a profit when employees were ill. Physicians demanded government support in their individual efforts. Citizens were becoming upset with local conditions. Answer: D 16. Which of the following interventions was the first step in controlling the incidence of tuberculosis (TB)? Institutions were required to report TB cases. Federal funding was devoted to seeking TB causes and cures. Physicians began surveillance of TB cases. States built large public hospitals to treat patients with TB. Answer: A 17. Which of the following best describes the overall result of Abraham Flexner's report? All medical schools reorganized into the German model. Citizens were encouraged to become more involved in medical education. Folk healers again became more widely used than physicians. Funding was withdrawn from weak medical schools. Answer: D 18. Which of the following groups was primarily responsible for the establishment of the first school of public health? The American Medical Association The Association of State Departments of Public Health The federal government The Rockefeller Foundation Answer: D 19. A family living in England in 1860 was part of the community where district nursing was implemented. Who would most likely have seen this family? A social worker and a nurse A health teacher and a nurse A nurse A physician and a nurse Answer: A 20. Which of the following interventions was most helpful in assisting people become educated on healthy living in nineteenth-century England? Brochures were distributed without charge in public places. Health visitors joined nurses in providing care in the homes. Nurses spend the majority of their time teaching families. Schools set up health programs for neighborhood adults. Answer: B 21. Which of the following best describes the district nursing service created in the United States by Lillian Wald and Mary Brewster? House on Henry Street Visiting Nurses Association New York City District Nursing Service Wald and Brewster Nursing Service Answer: A 22. Which of the following statements best summarizes Wald and Brewster's approach to home nursing? "All services all the time" 29. Which of the following statements best describes the increase in life expectancy among Americans during the twentieth century? Life expectancy increased by 30 years; the majority can be attributed to advances in medical technology. Life expectancy increased by 30 years; the majority can be attributed to public health efforts. Life expectancy increased by 30 years; the majority can be attributed to improved physician education. Life expectancy increased by 30 years; the majority can be attributed to increased access to care. Answer: B 30. Which of the following is a major challenge for health care provider education today? Ensuring that research findings related to families and groups are included in the curriculum Expanding the curriculum to allow additional experiences in community health settings outside the hospital Increasing course emphasis on environmental influences on health Refocusing the curriculum from care of the individual to needs of aggregates Answer: D 31. Which of the following tool(s) were used by Florence Nightingale to create change? (Select all that apply.) Her incredible beauty and personality Influence of all the nurses Nightingale trained Political advocacy Publication of treated soldiers' death rate changed from 42% to 2% Use of statistics to demonstrate the effectiveness of her interventions Wealth of her family and relatives Answer: C, D, E 32. Which of the following of Nightingale's ideas were forgotten until recently? (Select all that apply.) The need for education for women The influence of environment on health The importance of clinical practice for expertise to develop The need to recognize gender role limitations The problem-solving (nursing) process The use of statistics and a sound research base Answer: B, F 33. Which of the following best describes why folk healers are used by many people? (Select all that apply.) Folk healers are often effective. Folk healers do not charge for their efforts. Folk healers integrate religion and medicine. Folk healers use media very effectively. Folk healers may involve the whole family. Many physicians recommend folk healers. Answer: A, C, E 34. What current emphases are focusing attention on public health? (Select all that apply.) Cost containment and managed care models Focus on disease prevention and health promotion Increased funding for care of chronic diseases Liberal politicians encouraging public health as part of a national health reform Movies showing national disasters and government lack of preparedness Shortage of the H1N1 flu vaccine Answer: A, B 35. Which of the following were the chief factors that led to the creation and growth of Blue Cross hospital insurance? (Select all that apply.) Hospitals banded together, and their leaders encouraged such plans. Hospitals thought such a plan would allow them to expand further and faster. It was an employer alternative to increasing employee pay compensation. Nurses fought for the right of all citizens to purchase insurance as desired. Physicians were concerned with nonpayment of their office fees. Politicians encouraged this alternative to government-supported health care. Answer: A, C Chapter 5: Epidemiology 1. An epidemiologist has written a summary of a food poisoning outbreak, including its cause and ways to prevent it from occurring in the future. Which of the following best describes what has been done? Analytic epidemiology Descriptive epidemiology Prospective cohort study Retrospective cross-sectional survey Answer: B 2. Two brothers played with their cousin. One brother later became quite ill, whereas the other did not. Which of the following provides the best explanation for this occurrence? Difference in length of time exposed Difference in how actively the children played Difference in genetic inheritance between the two brothers Difference in lifestyle between the two brothers Answer: C 3. In which of the following circumstances would it be more helpful to use the wheel model of epidemiology than the epidemiological triangle model? When factors outside the triangle model are involved When there are multiple causes for a chronic disease When research has not yet determined the exact cause When trying to explain the situation to a lay person Answer: B 4. Which of the following best describes the importance of discovering all of the variables that may be involved in creating a disease state in some persons? People want an explanation of why they are ill. Knowing causes helps obtain funds for research to try to create a cure. Finding variables that are susceptible to prevention or early intervention is important. It is important to educate communities on how to avoid any risk factors. Answer: C 5. Which of the following best describes the advantage of the web of causation model in comparison with the epidemiological triangle model? 17. A student athlete receives a screening examination before being active in school sports. Which of the following levels of prevention is being used? Health prevention Primary prevention Secondary prevention Tertiary prevention Answer: C 18. For which of the following would a screening test be most appropriate? Disease A, which must be caught early because society punishes those known to have the disease Disease B, which can be controlled if caught early in the disease process Disease C, which people need to know whether they have contracted, even though there is no treatment for the disease Disease D, because people may want to use that information in family planning Answer: B 19. One hundred women received notification that their screening tests suggested that they might have a serious health problem. Which of the following actions should the nurse take to ensure that they will complete follow-up testing? Compliment them on their willingness to be tested and suggest an immediate appointment before they have too much time to think about the issue. Imply that the test could be wrong; the testing materials may not be effective, but the only way to be sure is to be tested further. Point out that screening is only suggestive and that not all positive screenings mean they actually have the health problem. Reassurance is not therapeutic; reality must be faced. Emphasize the need for immediate treatment. Answer: C 20. Which of the following would be the best method to increase the positive predictive value of a screening test? Test a large population at once Test a group at high risk for the health problem Use a very sensitive screening test Use a very specific screening test Answer: B 21. Which of the following is the most effective way to determine if Healthy People 2020 is improving the health of Americans? Availability of relatable data on total population's health problems Comprehensive and systematically collected surveillance data on the health status of various population groups Increased financing to allow ongoing collation of information Willingness of individuals to share health information with the federal government Answer: B 22. A researcher is examining potential risk factors in comparison with disease at a specific time through collecting data regarding current exercise, sleep patterns, and current health status among 12-year-olds. Which of the following research studies would be most appropriate? Cross-sectional study Prospective study Retrospective study True experiment Answer: A 23. A researcher, interested in the onset of early menses, compared the life experiences and history of 1000 14-year-old girls, half of whom had monthly periods and half of whom did not, to determine what variables might be observed. Which of the following would be the most appropriate categorization of this study? Cross-sectional study Prospective study Retrospective study True experiment Answer: C 24. One famous study followed a cohort of nurses over their lives, collecting data and health histories as they aged. Which of the following would be the most appropriate categorization of this study? Cross-sectional study Prospective study Retrospective study True experiment Answer: B 25. A researcher wanted to engage in the best possible research design to obtain reliable information about the possible cause(s) of a disease. Which of the following designs would the researcher choose? Cross-sectional study Descriptive study Prospective study Retrospective study Answer: C 26. A researcher has limited time and funds. Which of the following research designs would be most appropriate? Cohort study Incidence study Longitudinal study Retrospective study Answer: D 27. On the basis of findings related to elevated blood levels of cholesterol, a researcher wanted to determine whether a new drug would notably lower the blood levels of cholesterol in otherwise healthy persons. Which of the following studies would the researcher most likely use? Cross-sectional study Experimental study Prospective study Retrospective study Answer: B 28. A client has developed pellagra because of a lack of certain B vitamins. Which of the following best describes the classification of the nutritional deficiency? Relative risk factor Agent factor Environment factor Host factor Answer: B 29. Which of the following best describes the Tuskegee Syphilis Study? It provided excellence in research design. It used an extensive subject base leading to confirmed conclusions. It developed information about the causes and treatment of syphilis. It implemented unethical and racist treatment of uninformed subjects. Answer: D 30. An epidemiologist is gathering data to determine which factors may lead to disease. Which of the following data will be gathered? (Select all that apply.) Demographic characteristics Disease characteristics Geographic data Health protection measures taken Length of the disease process When disease struck the area Answer: A, C, F 31. Which of the following information must be analyzed to derive an adequate explanation of disease? (Select all that apply.) Description of commonalities among those who became ill Depiction of the possible pathogen Explanation of the health care system in the community Portrayal of the geographic area where people became ill Review of the methods by which disease can be spread Substances that are effective in sanitizing the area described Answer: A, B, D 32. Which of the following best describes the advantage of the ecosocial epidemiology model over both the web of causation model and the epidemiological triangle model? (Select all that apply.) It decreases the focus on the individual person. It demonstrates the usefulness of molecular epidemiology in disease prevention. It emphasizes the role of complex political and economic context. It is more useful in public policy campaigns in explaining what people need to do to protect themselves. It reflects the current emphasis on ecology and the environment. Its use suggests possible public policy interventions. Answer: A, C, F 33. Which of the following factors are necessary to assume there might be a cause-effect relationship between a particular variable A and a specific illness? (Select all that apply.) It is easy to understand how the variable A could lead to the illness. Anyone who has time to be available Environmental proximity Same employment responsibilities Similar religious faith Answer: B 5. Which of the following best describes how people typically respond when asked of what community are they a member? Geographic community (neighborhood or city) House of worship participants or members Occupational or professional group Those who are devoted to a particular craft or hobby Answer: A 6. Which of the following best describes what community members receive from each other? Safe environment to live and work Entertainment and recreational opportunities Socialization and role fulfillment Useful services such as physicians and medical centers Answer: C 7. An individual lives in a healthy community. Which of the following characteristics would this community most likely display? Ability to adapt and respond to changes Lack of environmental pollution Low unemployment rate Ongoing growth in population Answer: A 8. A nurse is helping a community develop its capacity to address future problems. Which of the following activities is the nurse most likely implementing? Addressing problems in priority order Promoting collaboration and team building Developing community competence Providing education about health issues Answer: C 9. Which of the following best describes shoe leather epidemiology? Implementing the wheel model of epidemiology Engaging in extensive truth seeking like a detective in the community Traveling throughout the community to absorb an overall impression of it Facilitating sharing of the community's history by community leaders Answer: C 10.A community health nurse wants to obtain an overview of the community, but has limited time and resources. Which of the following methods would the nurse most likely use to obtain this information? Engage in a windshield survey Establish a health department committee of community leaders willing to fill out periodic surveys related to various health issues in the community Live in the community for several years 16.The nurse is interviewing community members as part of a community assessment. Which of the following groups of people would the community health nurse most likely want to interview? Bankers who could share economic data on the community Long-time residents who were informal leaders in the community Pastors and other religious leaders who share the faith of the community Realtors who could share housing and living conditions in the community Answer: B 17.A nurse was debating about which approach to use to both obtain data about community needs and encourage community participation in their resolution. Which of the following approaches would be most effective in meeting both goals? A community forum, open to all interested residents of the community A community survey mailed to all residents Establishing focus groups with selected participants Conducting in-depth interviews with select community residents Answer: C 18.A community health nurse has completed a community assessment and is now writing a community diagnosis for the problem. Which component of the diagnosis will be used to summarize the assessment data of the problem? Identification of the health risk Evidence supporting the choice of priority The aggregate that needs the intervention The cause of the identified health problem Answer: A 19.A community health nurse is trying to determine the success of a planned intervention. Which of the following would the community health nurse most likely examine? Changes in funding made available to the agency to continue their efforts An increase or decrease in the number of persons asking for assistance Current problem data to compare with original baseline data Feedback from community residents Answer: C 20.A community health nurse found a very small number of families in the community who were desperately in need of basic preventive health services. Which of the following ethical approaches supports expending agency resources on these few, but needy, families? Beneficence suggests focusing on the most needy, so resources should be expended on these families. Deontological ethics suggest that the nurse must give priority to the intervention that would have the broadest impact. Utilitarianism (the most good for the largest number) would suggest continuing to focus on broader community needs. Virtue ethics would suggest focusing on these families to support the nurse's own character development. Answer: A 21.Which of the following best describes the aspects central to the definition of community? (Select all that apply.) Geographic boundaries at a point in time Whatever is most convenient for the nurse Patterns of disease found Persons who share common goals and interests Persons who band together to address a shared problem The name the people have given themselves Answer: A, E, F 22.Which of the following is a central function unique to community health nursing? (Select all that apply.) Being willing to travel to give care in an appropriate setting Collaborating and cooperating with other health care team members Gathering appropriate comprehensive assessment data on the community Incorporating epidemiological approaches throughout the nursing process Keeping accurate and detailed medical records on care given Being willing to contribute to health policy development Answer: C, D, F 23.Which of the following are considered the most important determinants of a healthy community? (Select all that apply.) Child-friendly neighborhoods Several different choices of houses of worship Employment opportunities Low crime rate Safe food and water supplies Varied housing choices Answer: A, D 24.Which of the following from vital statistics records is useful to community health nurses? (Select all that apply.) Relatively early age of death may suggest a new pathogen in the community Divorce rate, suggesting whether children will need additional services Documentation of the mortality and morbidity of the local community Indication of whether the total population is growing or declining Records of occurrence of congenital malformations Stability of marriages, making family structure become obvious Answer: C, D, E Chapter 7: Community Health Planning, Implementation, and Evaluation 1. Which of the following best describes how care can be appropriately given in a Ability to adapt and respond to changes Lack of environmental pollution Low unemployment rate Ongoing growth in population Answer: A 8. A nurse is helping a community develop its capacity to address future problems. Which of the following activities is the nurse most likely implementing? Addressing problems in priority order Promoting collaboration and team building Developing community competence Providing education about health issues Answer: C 9. Which of the following best describes shoe leather epidemiology? Implementing the wheel model of epidemiology Engaging in extensive truth seeking like a detective in the community Traveling throughout the community to absorb an overall impression of it Facilitating sharing of the community's history by community leaders Answer:C 10.A community health nurse wants to obtain an overview of the community, but has limited time and resources. Which of the following methods would the nurse most likely use to obtain this information? Engage in a windshield survey Establish a health department committee of community leaders willing to fill out periodic surveys related to various health issues in the community Live in the community for several years Review public health department records from up to 5 years ago Answer:A 11.Which of the following best describes how the U.S. Census Bureau surveys are helpful to a community health nurse? They provide the distribution of age, sex, race, and ethnicity in the community. They document the mortality and morbidity of the community. They ensure that all community residents are involved. They temporarily give employment opportunities to residents. Answer:A 12. A public health nurse wanted statistics on the disability, illness, and other health- related variables for the state. Which of the following would be the best resource for the nurse to obtain the most extensive data? State health department records State department of vital statistics The Centers for Disease Control and Prevention The National Center for Health Statistics Answer:D 13.Which of the following best describes when a community health nurse would try to collect data on a health issue? When available data exists When data must be purchased from the agency that collects it 19.A community health nurse is trying to determine the success of a planned intervention. Which of the following would the community health nurse most likely examine? Changes in funding made available to the agency to continue their efforts An increase or decrease in the number of persons asking for assistance Current problem data to compare with original baseline data Feedback from community residents Answer: C 20.A community health nurse found a very small number of families in the community who were desperately in need of basic preventive health services. Which of the following ethical approaches supports expending agency resources on these few, but needy, families? Beneficence suggests focusing on the most needy, so resources should be expended on these families. Deontological ethics suggest that the nurse must give priority to the intervention that would have the broadest impact. Utilitarianism (the most good for the largest number) would suggest continuing to focus on broader community needs. Virtue ethics would suggest focusing on these families to support the nurse's own character development. Answer:A 21.Which of the following best describes the aspects central to the definition of community? (Select all that apply.) Geographic boundaries at a point in time Whatever is most convenient for the nurse Patterns of disease found Persons who share common goals and interests Persons who band together to address a shared problem The name the people have given themselves Answer: A, E, F 22.Which of the following is a central function unique to community health nursing? (Select all that apply.) Being willing to travel to give care in an appropriate setting Collaborating and cooperating with other health care team members Gathering appropriate comprehensive assessment data on the community Incorporating epidemiological approaches throughout the nursing process Keeping accurate and detailed medical records on care given Being willing to contribute to health policy development Answer: C, D, F 23.Which of the following are considered the most important determinants of a healthy community? (Select all that apply.) Child-friendly neighborhoods Several different choices of houses of worship Employment opportunities Low crime rate Safe food and water supplies Varied housing choices Answer: A, D 24.Which of the following from vital statistics records is useful to community health nurses? (Select all that apply.) Relatively early age of death may suggest a new pathogen in the community Divorce rate, suggesting whether children will need additional services Documentation of the mortality and morbidity of the local community Indication of whether the total population is growing or declining Records of occurrence of congenital malformations Stability of marriages, making family structure become obvious Answer: C, D, E Chapter 25: Communicable Disease 1.Which of the following infections continues to increase in the United States? Measles Pertussis Hepatitis A, B, and C Sexually transmitted diseases (STDs) Answer: D 2. Which of the following best describes what is happening with infectious diseases in the United States? There is a continuing decrease in vector-borne infections. There is a continuing increase in food-borne and waterborne infections. Many airborne diseases are being spread by bioterrorists. The rate of infection varies extensively by income and ethnic groups. Answer: D 3. Which of the following is a fairly recent surprise regarding infectious diseases in the United States? Cervical cancer and coronary artery disease may be caused by infectious agents. Epidemics such as the H1N1 flu continue to occur. Mortality caused by infectious diseases continues to rise. Some infectious diseases remain endemic in our society. Answer:A 4. A female client develops a fungal vaginal infection after being treated with antibiotics for strep throat. Which of the following components of the epidemiological triangle is primarily responsible? Agent Environme nt Host Answer:D 10.Which of the following best describes why clinical areas are so careful to ensure sanitization of surfaces and equipment between each patient? To avoid direct patient-to-patient transmission of infection To provide a clean environment for clients and staff To decrease transmission by fomites To decrease transmission by vectors Answer:C 11.Which of the following is the first step in preventing further spread of a particular sexually transmitted disease (STD)? Have a citywide free screening program in all high schools and colleges Provide public education about safe sex from abstinence to monogamous relationships Require all public facilities to sanitize all restrooms with a stronger, more effective agent Treat each infected person with the appropriate pharmaceutical agent Answer:D 12.A case of severe acute respiratory syndrome (SARS) was diagnosed immediately on signs of illness at a tourist site in China. Which of the following actions should be taken to protect the badly needed income from tourist dollars? Close the airports and refuse to let the tourists in the area leave Begin to immunize everyone in the immediate area with protective vaccine as soon as possible Quarantine the ill person and use isolation techniques when providing care Screen everyone in the area by requiring a blood and urine sample Answer:C 13.A patient walks into a community clinic complaining of severe intestinal cramps and diarrhea. Which of the following actions can be taken to protect the staff at the clinic? Refuse to see anyone that sick as clinics have a different mission than secondary and tertiary care of the obviously ill Send the patient immediately to the closest hospital emergency department Treat the patient with broad-spectrum antibiotics and lots of fluids Use universal precautions with all patients regardless of the situation Answer: D 14.During an outbreak in the hospital, all staff members were given immunoglobulin if they were not already immune to the disease. Which of the following types of immunity will the staff who received the immunoglobulin have? Active immunity Long-lasting immunity Natural immunity Passive immunity Answer: D 15.The nurse could not find a vaccine in the refrigerator. The unopened vaccine vial had been put in a storage cabinet with the other medications. The nurse drew up the appropriate dose in the syringe and then put the vial of vaccine in the refrigerator. Which of the following would be the most likely result? The client will have immunity to the disease after the vaccination