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NUR425 Final Exam Questions With
Complete Answers
-week 3 epidemiology (3 questions) -week 4 US pub health system (3 questions) -week 5 disaster preparedness (5 questions)
- week 7 planning for comm change (3 questions)
- week 8 infect and communicable diseases and pharm (6 questions)
- week 9 describing health conditions (3 questions)
- week 12 violence, abuse, and community health and pharm (4 questions)
- week 13 TB 101 and pharm (2 questions)
- week 14 school and faith (3 questions)
- week 15 environmental, occupation, and correctional (3 questions) - ANSWER The cornerstones of public health nursing are: a. Concepts from public health and nursing practice. b. Interventions public health nurses perform. c. Described in the nurse practice act. d. Assessment, policy development, and assurance. - ANSWER A As you think about your role as a public health nurse you are reminded of the nurse who coined the term "public health nurse" when working in a New York settlement. She was: a. Madeline Leininger b. Lillian Wald c. Clara Barton d. Florence Nightingale - ANSWER b As your text described, Lillian Wald is considered to be the founder of public health nursing. Her work with the Henry Street Settlement is where the name for the Henry Street New Graduate competencies came from! Teaching infant care and development to an immigrant family is: a. primary prevention b. risk reduction c. secondary prevention d. tertiary prevention - ANSWER a A public health nursing student needs to demonstrate the competency "utilizes collaboration to achieve public health goals." Which would be the most appropriate activity to meet this competency:
a. Take blood pressures at a health fair b. Write an article for a healthy communities news letter on stress prevention c. Meet with pastors and lay leaders in a church to help develop a pandemic flu response plan for their congregation d. Make a home visit to a new mother and baby - ANSWER c A public health nurse meets with a group of community health officials to develop a law which defines a public health nuisance. This is an example of the core function of: a. Assessment b. Policy development c. Assurance d. Research - ANSWER b A school nurse reviews student immunization records. The nurse knows that up to date immunizations are an important means of: Select one: a. Primary prevention b. Secondary prevention c. Tertiary prevention d. Disease treatment - ANSWER a A school nurse conducts a blood pressure screening for the school staff. Blood pressure screening is considered: a. Primary level prevention b. health promotion c. tertiary level prevention d. secondary level prevention - ANSWER d A school nurse carries out many activities to find new cases of health problems within the school. Case Finding is the individual level for which of the public health interventions? a. Surveillance, disease and health investigation, outreach, and screening b. Consultation, counseling, and health teaching c. Community organizing, coalition building, and collaboration d. Advocacy, social marketing, policy development, and enforcement - ANSWER a What level of intervention is a public health nurse performing when creating a billboard about the hazards of lead paint? Select one: a. Individual/family level b. Community level c. Multiple levels d. Systems level - ANSWER b
d. Community-based care - ANSWER d what diseases/infections should be reported? - ANSWER - AIDS
- anthrax
- botulism
- candidiasis
- chickenpox
- chlamydia
- diphtheria
- ebola
- gonorrhea
- hepatitis A, B, C, D, E
- HIV
- influenza
- malaria
- measles
- meningitis
- meningococcal disease
- mumps
- pertussis
- plague
- poliomyelitis
- rabies
- respiratory syncytial virus (RSV)
- rubella
- staphylococcus aureus
- syphilis
- tetanus
- tuberculosis
- west nile virus
- yellow fever
- zoster (shingles) In a pregnant woman, which area of the triangle would each item fit in when looking to prevent birth defects in the fetus?
- maternal age
- older low income housing
- folic acid intake - ANSWER - maternal age --> host
- older low income housing --> environment
- folic acid intake --> agent what is active naturally induced immunity? - ANSWER acquired from exposure to the disease organism through infection with the actual disease
- child who has chickenpox
what is passive immunity? - ANSWER short term immunity using antibodies produced outside the body
- newborn's mom had chickenpox as a child what is active vaccine induced immunity? - ANSWER immunity from antibodies in a vaccination
- child who receives vaccine for chickenpox what is herd immunity? - ANSWER When a majority of a population are vaccinated against a disease. This means that even people who have not been vaccinated are less likely to get it because there are fewer people to catch it from.
- community vaccination rate of 90% for chicken pox and the unvaccinated child has this immunity The school nurse is working to stop an outbreak of head lice in a kindergarten class. The nurse finds that when students forget to bring a hat to wear for recess they use one from a box of spare hats. The shared hats would be what part of the epidemiologic triangle? a. host b. reservoir c. vector d. vehicle - ANSWER d In the natural history of disease model, what type of prevention strategies are used in the pre-exposure stage? Select one: a. Quantary b. Primary c. Tertiary d. Secondary - ANSWER b In the pre-exposure stage the focus is on preventing disease before it occurs, which is primary prevention. A nurse is investigating an outbreak of pertussis in a school. The nurse explores interactions among vaccine rates, the school environment, and patterns of cases. Which epidemiologic model would the nurse be most likely to use? a. Wheel of causaton b. Epidemiologic Triangle c. Natural history d. Web of causation - ANSWER b for a communicable disease the best model to use is the epi triangle. agent is vaccine rates. host is vaccine rates and patters of cases. environment is the school environment.
what does the Department of Health and Human services do? - ANSWER they're responsible for health and welfare of citizens what does health resources and services administration (HRSA) do? - ANSWER agency responsible for improving access to health care services for people who are uninsured, isolated or medically vulnerable what is healthy people 2020? - ANSWER a set of goals and objectives with 10-year targets designed to guide national health promotion and disease prevention efforts to improve the health of all people in the US
- highlights the importance of addressing social determinants of healthy by including "create social and physical environments that promote good health for all" as one of the four overarching goals for the decade what is an example of health policy at the local level? - ANSWER hospital and clinical promote immunizations with every patent encounter what is an example of health policy at state level? - ANSWER state laws require immunizations before attending school what is an example of health policy at national level? - ANSWER funding provided to help promote and pay for immunizations in communities what is an example of health policy at the International level? - ANSWER surveillance of disease preventable with vaccinations what are the three Ps of health policy? - ANSWER - power: ability to influence others in a n effort to achieve goals
- politics: the process of influencing decision making and the allocation of resources when there is an uncertainty of choices
- policy: a definite course or method of action selected from alternatives in light of given conditions to guide and determine present and future decisions The nurse describes a nongovernmental organization as an organization that a. Is based in only one country but provides services to many other countries. b. Acquires resources to help others from private rather than public sources. c. Uses only governmental funding to address the needs of individuals, groups, and communities. d. Collects data related to healthcare use across a variety of professional and service parameters. - ANSWER b The nurse identifies that which statement best exemplifies a public health goal in the United States? a. To lobby for legislation that ensures the accessibility to health insurance on the basis of one's health.
b. To restore the ability of a patient to perform activities of daily living after a stroke. c. To develop treatments to address symptoms related the chemotherapy treatment. d. To establish a free exercise program at a community center to promote fitness in a neighborhood with high obesity rates. - ANSWER d The nurse recognizes which example as the best illustration of the World Health Organization's definition of health? a. 20-year-old man with no significant history of disease who smokes, works a stressful job, and is sedentary. b. 50 year-old-woman with no health complaints, who drinks 2-3 alcohol beverages a day, and lives alone with little social contact. c. 98-year-old man with memory loss, participates in few activities, and lives in an assisted living facility. d. 72-year-old woman with well-managed diabetes who walks 2 miles every day and takes classes at the local community college. - ANSWER d Which of the following represent ways nurses can actively engage in policy making? (Select all that apply.) a. Testify at congressional hearings b. Document on symptoms following a physical examination c. Disseminate information on health issues in the media d. Serve as members on governing boards - ANSWER a, c, d what are examples of a macro system? - ANSWER - educational systems
- legal systems
- cultural systems
- geographic location what are examples of a meso system? - ANSWER - interactions among elements of individual microsystem: parent's relationship w/ teachers, relationship b/w church and family, sibling and friend's relationship what are examples of a microsystem? - ANSWER - family
- neighborhood
- religious community
- school
- peers A public health nurse (PHN) is responsible for field triage of a radiologic disaster. Using the START triage system, triage each patient 40 year old woman, painful itching rash on exposed skin 15 year old boy, vomiting blood
These symptoms are characteristic of small pox. This disease has been eradicated, therefore just one confirmed case would be considered an outbreak. A public health nurse is responding to a community disaster related to flooding. One section of town has experienced loss of water and electricity for four days. What action would you take to meet the immediate needs of the community at this time? Select one: a. Develop a system to distribute safe water and food b. Set up an immunization clinic c. Make home visits to your regular case load d. Refer community members to counseling support resources - ANSWER a Distribution of safe water and food is an immediate need. The nurse is appointed to be a member of the risk communication team during a disaster response situation. During an evacuation, the nurse is informed that an increasing number of individuals are reluctant to leave their homes. What is the first action the nurse should perform to complete an orderly evacuation? Select one: a. Disseminate information regarding the necessity of the evacuation b. Create an environment of trust and credibility c. Request the state governor to activate the National Guard d. Request local police remove residents from homes - ANSWER b First develop an environment of trust with the community. Then disseminate information. Police would not be requested to remove residents from homes. People have a right to stay in their own homes, even if it creates a risk to themselves. In a state of emergency the Governor may activate the National Guard. The public health nurse is a member of a disaster team responding to a confirmed outbreak of pneumonic plague. What is the best method to respond to the needs of the public on a wide scale? Select one: a. Administration of antivirals at point-of-distribution sites (PODs) b. Door-to-door visits to administer preventative medication c. Administration of antibiotics at point-of-distribution sites (PODs) d. Isolating designated hospitals to prevent spread of the plague - ANSWER c treatment of plague is with antibiotics. PODs provide a fast an efficient means of providing care to a large number of people. What type disaster incident is most likely to cause illness and/or death shortly after exposure and requires decontamination? (Select all that apply.) Select one or more: a. Chemical
b. Radiologic c. Biological d. Natural disaster - ANSWER a, b Chemical and radiological exposures can quickly cause illness or death. Both require decontamination procedures. what is the disaster management continuum? - ANSWER Preparedness Mitigation Response Recovery Evaluation what is the scope of a disaster? - ANSWER the range of its effect, either geographically or in terms of the number of people affects. what is the intensity of a disaster? - ANSWER level of destruction and devastation it causes. what is NIMS? - ANSWER national incident management system
- developed to allow responders from different jurisdictions and disciplines to work more cohesively in response to natural disasters, emergencies, terrorist acts what does the command staff do? - ANSWER - public information officer
- safety officer
- liaison officer what does the planning section do? - ANSWER - prepares status reports
- manages the planning process
- produces incident action plans what does the operations section do? - ANSWER - assists in developing strategy
- assigns and supervises resources including personnel
- location where public health and medical personal report what does the logistics section do? - ANSWER - orders resources
- develops the transportation, communication, and medical plans what does the finances and administration section do? - ANSWER - develops cost analyses
- ensures that the proposed plans are within budget
- pays for the resources What is cultural competence? - ANSWER an attitude of openness to, respect for, and curiosity about different cultural values and traditions, and ideally
- Changing
- Refreezing what are the elements of triple aim? - ANSWER population health experience of care per capita cost looks at better care for individuals, better health for populations, and lower per capita costs A nurse is collecting data to identify health needs in the local community. Which of the following examples should the nurse identify as secondary data? (Select all that apply). a. previous healthy survey results b. health records c. community forum d. birth statistics e. windshield survey - ANSWER a, b, d data doesn't directly come from data nurse collected, data from someone else, another source The nurse recognizes a core function of the role of government in health care is to: a. Provide affordable health insurance b. Assess health care problems c. Improve access to primary care d. Lower costs - ANSWER b True or False: Health disparities are social conditions in which people live and work - ANSWER false All of the following are elements of the Triple Aim EXCEPT: a. Experience of Care b. Hospital admission rates c. Population health d. Per Capita Cost - ANSWER b Community assessment begins with a. Determining evaluation criteria b. Defining the community to be studied c. Collecting community data d. Deciding which community problems to assess - ANSWER b All of the following are Principles of Ethical Practice of Public Health EXCEPT: a. Public health institutions should ensure the professional competence of their employees
b. Public health programs and policies should incorporate a variety of approaches that anticipate and respect diverse values, beliefs, and cultures in the community c. Public health policies, programs, and priorities should be developed and evaluated with input primarily from governmental leaders d. Public health should achieve community health in a way that respects the rights of individuals in the community - ANSWER c Ways a public health nurse can advocate for healthy change in communities include (select all that apply): a. Remain silent when asked about controversial health issues b. Testify at a congressional hearing c. Write a letter to a member of Congress d. Serve on a local health board - ANSWER b, c, d According to the American Public Health Association, the 2022 advocacy priorities include: a. Repealing the Affordable Care Act b. Addressing gun violence c. Changing public health laws d. Reducing racial and health equity - ANSWER b correctly match the definitions for misinformation, disinformation, and fake news. a. false information which is intended to mislead, especially propaganda issues by a government organization to a rival power of the media b. purposefully crafted, sensational, emotionally charged, misleading or totally fabricated information that mimics the form of mainstream news c. false or inaccurate information that is spread, regardless of intent to mislead - ANSWER a: disinformation b. fake news c. misinformation morbidity vs mortality rate - ANSWER morbidity: describes the relative incidence of a specific disease in a population, for example, the number of individuals diagnosed w/ pancreatic cancer of the total population mortality: the probability of death from any cause among the entire population within a given time frame. for example maternal mortality rate, the number of moms dying related to childbirth in a year what is incidence rate? - ANSWER measure of the probability that people without a certain condition will develop that condition over a period of time what is prevalence rate? - ANSWER measures the number of people in a given population who have an existing condition at a given point in time
If a disease is R0=4 what can you expect to see in terms of disease spread? a. Only spread of disease to previously infected people b. Stable disease in a population over time c. Decrease in the number of cases of disease over time d. Increase in the number of cases over time - ANSWER d R0 greater than 1 indicates the disease is spreading and there will be an increase in cases over time The public health nurse epidemiologist is studying a group of children whose mothers participate in a home visiting program. The children's growth is measured from birth through first grade. What type of a study design is the nurse using? a. Cohort b. Prevalence c. Clinical trial d. Case control - ANSWER a Cohort studies look at data from a group or cohort and look prospectively through time going forward. Which is the primary method used to measure the existence of states of health or illness in a population during a given time period? Select one: a. Sensitivity b. Ratio c. Relative risk ratio d. Rate - ANSWER d The rate is the primary measurement used to describe the occurence of a state of health in a specific group over a period of time. The nurse is reading an article reporting on an epidemiologic prospective study. Which best describes a prospective study? Select one: a. Analytic study in which participants are enrolled after the health outcome of interest has occurred b. Descriptive study in which participants are enrolled after the health outcome of interest has occurred c. Analytic study in which participants are enrolled before the health outcome of interest has occurred d. Descriptive study in which participants are enrolled before the health outcome of interest has occurred - ANSWER c The public health nurse wants to report the prevalence of hypertension in Hendersonville. Which measure represents the concept of prevalence? Select one:
a. Twenty-five people were diagnosed as having hypertension last month in Hendersonville. b. Five percent of older adults in Hendersonville developed hypertension last year c. There were 73 new cases of hypertension identified in Hendersonville last year d. Five hundred people in Hendersonville have hypertension - ANSWER d This represents the number of cases in this community at one point in time. A public health nurse needs to report the rate of death due to diabetes in a community. What type of rate would the nurse use? Select one: a. Morbidity b. Crude rate c. Mortality d. Specific rate - ANSWER c Mortality is the rate of death. Incidence rates of lung cancer for groups exposed to a secondhand smoke are compared with the incidence rates of lung cancer for people who are not exposed to secondhand smoke. What is this measurement? Select one: a. Relative risk ratio b. Specific rate c. Incidence density d. Prevalence rate - ANSWER a The relative risk ratio is the ratio of the incidence rate in the exposed group and the incidence rate in the nonexposed group. The nurse reviews a published analytical research study that compares one group of clients who developed diabetes mellitus before the start of the study with a group of clients without diabetes mellitus. Which type of study design was used in this study? Select one: a. Cohort b. Clinical trial c. Case control d. Cross sectional - ANSWER c The public health nurse wants so measure how measure how many cases of pertussis are in the community at one point in time. What measure will be used?
Global burden of disease includes health risks and health outcomes in various demographic populations and social settings related to a set of diseases and injuries. True or False: An Influenza pandemic can start any time and any place in the world - ANSWER true The nurse is assessing a client who is seeking a fourth refill on a prescription for an opioid. The nurse is concerned that the client may be developing a tolerance for the drug. Which comment by the client would most confirm this concern a. "Lately, I've had to double up on my dose just for it to be effective." b. "I feel like I just can't function without the medicine." c. "I ran out of pills a week ago and have felt sweaty and agitated ever since" d. "The medicine had been wonderful. I think one more refill should do it for me." - ANSWER a The nurse assesses a 19-year old client for alcohol abuse. Which would be the most significant risk factor for alcohol abuse for this client a. History of type I diabetes b. African-American race c. Enrollment in college d. Female gender - ANSWER c The nurse assesses a client who arrives at the clinic shaky and requesting a refill on a prescription for oxydocone. Which comment by the client would most confirm the nurse's suspicion of substance withdrawal? a. "I ran out of pills a week ago and have felt sweaty and agitated ever since." b. "Then medicine has been wonderful. I think one more refill should do it for me." c. "Lately I've had to double up on my dose just for it to be effective." d. "I feel like I Just can't function without the medicine." - ANSWER a The nurse performs motivational interviewing to assess the client's history. The interview should begin with a. Being supportive of the client's life goals b. Eliciting feelings about how the drinking behavior is affecting the client's life c. Listening empathetically to establish trust d. Noting discrepancies between attitudes toward alcohol and alcohol- associated harms - ANSWER c The nurse teaches a client about pharmacologic treatments for alcohol- dependent disorders. The client correctly understands the teaching when she
tells the nurse that a medication that induces aversive effects if alcohol is consumed is a. Buprenorphine b. Disulfiram c. Acamprosate d. Naltrexone - ANSWER b The nurse works in the Emergency Department when a client arrives with respiratory depression associated with heroin overdose. Which medication should the nurse expect to be ordered for this client? a. Disulfiram b. Acamprosate c. Naloxone d. Naltrexone - ANSWER c what is a medically underserved area? - ANSWER An area with a lack of medical care services as determined by the number of primary medical care physicians per 1,000 population, infant mortality rate, percentage of the population with incomes below the poverty level, and percentage of the population 65 years or older Harm Reduction with Opioid Use Disorder includes: (select all that apply) a. Forcibly limiting use b. Arresting someone to help sober them up c. Addressing conditions of use d. Abstinence e. Safer Use f. Meeting people where they are at g. Addressing use h. Managed use - ANSWER c, d, e, f, g, h what is substance abuse? - ANSWER any unnecessary or improper use of chemical substances for non-medical purposes what is methadone? - ANSWER - binds to opioid receptors (Mu)
- Used in the treatment of narcotic dependence & withdrawal
- blocks the euphoric and sedating effects and relieves cravings
- opioid free at least 5 days or heroin free at least 7 days or will trigger withdrawal symptoms what is buprenorphine? - ANSWER - Opioid "partial" agonist
- enables opioid-dependent people to continue opioids without experiencing withdrawal symptoms
- 12-24 Horus after last use of opioid
- SE: hepatic failure, CNS depression when taken with benzos or alcohol
