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Community And Public Health Nursing With Clinical)

NUR450 Exam 1

1. According to the Herpes Simplex Virus Case Study, which education topic is most important for a comprehension sex education program?
   • Side-effects of contraceptives
   • Services available for counseling
   • Ways to prevent sexually transmitted infections
   • Methods for pregnancy testing
2. In the “Gonorrhea Case Study”, why did the patient in the case study require IV antibiotic therapy, when the usual treatment for gonorrhea is oral antibiotics?
   • She had an advanced form of the disease that had affected her heart valves
   • She had too many contacts to treat
   • She couldn’t tolerate the oral antibiotics
   • She was non-compliant with the oral antibiotics
3. Which of the following best describes community-based nursing?
   • Providing care with a focus on the group’s needs
   • Giving care with a focus on the needs of the community
   • A value system in which all patients receive optimal care
   • A practice in which care is provided for acute and chronically ill individuals and families
4. Which of the following is the primary focus of public health nursing?
   • Individuals and families
   • Individuals within the family unit
   • Health care of communities and populations
   • Illness-oriented care
5. A nurse advises a patient with osteoporosis to have three servings of milk or dairy products daily. Which of the following levels of prevention is being used by the nurse?
   • Secondary prevention
   • None of the above
   • Primary prevention
   • Tertiary prevention Interventions that prevent worsening of a condition are tertiary prevention activities. In this instance, the client already has a health problem (osteoporosis). By advising adequate dairy intake, the nurse aims to ensure that enough calcium is available to limit worsening of the osteoporosis.
6. An occupational health nurse at a local factory is using primary prevention strategies to reduce the environmental health risks among employees. Which of the following activities would the nurse most likely implement?
   • Teaching new employees who will work outdoors about the signs and symptoms of heat-related illness
   • Using spirometry to rule out obstructive or restrictive lung disease for workers who are wearing mask respirators
   • Checking radiation detectors to monitor for unsafe levels of radiation exposure
   • Irrigating the eyes of an employee who has had a chemical splash to the face Education is a primary preventive strategy. When examining the sources of environmental health risks in communities and planning intervention strategies, it is important to apply the basic principles of disease prevention.
7. SELECT ALL of the following which are primary prevention activities
   • Helping install baby car seats for a group of new parents
   • Provide fluoride in a community water supply
   • Teaching teenagers who are morbidly obese about health eating
   • Working with local law enforcement to promote use of helmets for bicycle safety week
   • Giving flu vaccine to seniors at a community health center
8. What topics should the nurse include when planning a secondary prevention project for the local

• Medicare
• The ACA or Obamacare
• Medicaid

20. A nurse is caring for a 44 year-old patient in the outpatient clinic who has insurance that is paid for by funding from both the federal and state governments and is administered by the state for patients who fall below predesignated income levels. The nurse knows this patient is on which of the following.

• Medicare
• Medicaid
• SCHIP
• Aetna Insurance

21. African American families have a higher mortality rate from breast cancer than white females. This is an example of which one of the following.

• Racism
• Prejudice
• Disparity
• Projection Disparities are racial or ethnic differences in the quality of health care, not based on access or clinical needs, preferences, or appropriateness of an intervention.

22. Which of the following best describes how care can be appropriately given in the community?

• Provide individualized care to unique individuals as much as resources will allow
• Prioritize care for the healthiest population first
• Consider the community itself as the client
• Administer care according to the priorities published by the state health department As it is clearly impossible and impractical to give service to each person in a community, the best approach considers the community itself to be the unit of service.

23. Which behavior of a health care provider exemplifies culturally competent care?

• Knowledgeable of the patient’s culture background
• Speaking the patient’s language
• Delivering care that demonstrates understanding and accommodation of the patient’s unique cultural preferences
• Understanding some health traditions of the patient When delivering culturally competent care, the provider demonstrates understanding and attends to the total context of the patient's situation

24. A nurse is making a home visit for a patient of another culture. Which of the following is appropriate for culturally competent care for this patient?

• Use hand signals, gestures, and pictures to communicate
• Tell the patient he is in the US now and should do things according to this culture
• Quickly google the patient’s country of origin
• Ask about his customs and beliefs and what he prefers

25. The nurse manager of the Rehabilitation Unit realizes the benefits of providing culturally competent care include which of the following? SELECT ALL THAT APPLY

• Helps healthcare facilities meet legislative and regulatory accreditation mandates
• Improves quality of services and health outcomes
• Increases reimbursement for clients
• Helps eliminate disparities

27. Which of the following are considered social determinates of health? SELECT ALL THAT APPLY

• Having a high school diploma
• Living in a neighborhood with large farmhouses
• Living in a dangerous neighborhood that has high crime levels

• Having an insurance policy with Blue Cross/Blue Shield
• Having a genetic predisposition to colon cancer

28. Which one of the following patients would be of least concern for disenfranchisement?

• A 39 year old homeless female
• A 39 year old transgender person who receives weekly chemotherapy treatments for cancer
• A 39 year old undocumented farm worker
• A 39 year old in prison for manslaughter

29. Which statements by a nurse show understanding of the unique needs of vulnerable populations? SELECT ALL THAT APPLY

• I assume they are uneducated and don’t provide written materials
• I avoid asking clients for financial information because it often doesn’t pertain to the care that I provide
• I always address the problem that the client believes to be the most important
• I try to observe the client’s cultural tradition as I complete my assessment

30. Which of the following terms is used to describe aggregates (populations) who are at high risk for having poor health outcomes because of limited resources?

• Resilient populations
• Disadvantaged families
• Multi-problem families
• Vulnerable populations Vulnerable populations are groups (aggregates) with an increased risk to develop adverse health outcomes. Families are a subgroup of populations.

31. A homeless family brought their father to the public health clinic after he reported bleeding when he went to the bathroom. Which of the following nursing actions would be most appropriate?

• Suggest that the family take him to an urgent care center immediately
• Begin tests to determine the cause of the bleeding while asking the family about other family concerns from nutrition to shelter for the night
• Refer the man to a urologist
• Treat the urinary infection and give the man medication to take to prevent the return of the infection

32. A nurse is assessing a young mother of one child, who lost her job. She has no way to support her family and has found herself living on the streets because she doesn’t have any other family in the area. which of the following should she do first?

• Help her find shelter at the community shelter for women and children
• Look at the broader picture and see if there are any opportunities for policy change
• Ask her to come back in six months for re-evaluation
• Provide her with information on resources to help with financial support while she seeks a new job

33. During a lecture on health disparities, a student asks the instructor how communities with great access to health care can still have poor outcomes. How should the instructor respond?

• The student is incorrect. Communities with good access to care have good health outcomes
• Members of these communities only have access to primary-care providers, which reduces the quality of care they receive
• This only occurs in communities where the quality of health care is poor
• Social determinants of health determine how people respond to health threats and how they access preventative care

34. A nurse is working with a group of refugees who recently arrived in the United States after suffering conflict-related violence in their country. The nurse knows that they should be assessed for:

• All of the above
• Mental illness such as post-traumatic stress disorder (PTSD)
• Communicable diseases
• Injuries related to torture or sexual assault

35. A nurse epidemiologist is studying a community where disease X has an increasing prevalence over

completes this sentence?

• Be zero
• Decease
• Increase
• Stay the same

43. A nurse is employed as a nurse epidemiologist. Which of the following activities would most likely be completed by the nurse?

• Providing treatment and health education to a client with a disease
• Obtaining the health history of a client presenting with an illness
• Performing a physical examination of an ill-client
• Evaluating the number of clients presenting with similar infectious diseases Epidemiology differs from clinical medicine, which focuses on the diagnosis and treatment of disease in individuals. Epidemiology monitors the health of the population.

44. In the assessment phase, the nurse gathers and interprets data and determines the community’s strengths and weaknesses. Why does the nurse conduct interview with key informants and stakeholders?

• To generate nonstatistical data such as values, beliefs, and perceived needs
• To find sources for fund raising for the community
• To ensure that others agree with the nurse’s plans for interventions
• To personally get to know people in the community

46. Which of the following would be considered to be key informants or stakeholders in a community? SELECT ALL THAT APPLY

• A parent who is active and vocal about school safety and the school’s interaction with the greater community
• A person who has recently moved in the community who expresses an interest in becoming active in local politics
• A church leader who is very vocal about helping the underserved and improving the community
• A member of a minority group who has respect of his community and has knowledge of community interactions among various groups

47. Two community health nurses are assessing potential health risks in a suburban area. Which of the following should they do first as part of their assessment?

• Perform a windshield survey
• Conduct health risk assessments of selected individuals
• Survey community members
• Review facility permits and consumer confidence reports

48. A nurse is overwhelmed with the needs of the community. Which of the following should be the first priority of the nurse?

• A problem in an area where the nurse has great deal of expertise
• A problem that affects the disadvantage residents in the community
• A problem that is very easy and inexpensive to address
• A problem that is of high concern to the community

49. A community health nurse has been recently hired to work in an unfamiliar community. Which of the following persons would be effective key informants for the nurse? SELECT ALL THAT APPLY

• Local politicians such as the town mayor
• Community’s immigrant group activist
• Federal senators and representatives
• State health board members

50. A public health nurse was asked to come to a town that was having some noticeable health problems. Driving through town, the nurse noted there were many for sale signs, as well as very little green space and some trash in the street. This assessment is called:

• Health status survey
• Community strengths assessment