RELIAS RN PHARMACOLOGY TESTBANK ACTUAL EXAM QUESTIONS AND ANSWERS 2025, Exams of Nursing

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P a g e 1 | 171 A provider orders one liter of NS to be infused over four hours. At what rate would you set the IV pump? - ans250ml/hr Normal Saline (NS) is the solution of choice over D5W when preparing to administer a blood transfusion because: - ansNormal Saline is an isotonic solution and prevents cell hemolysis Acetylsalicylic acid (Aspirin) has which of the following pharmacological effects? - ansAnt

RELIAS RN PHARMACOLOGY TESTBANK ACTUAL EXAM 2025

. "Red Man" Syndrome may occur during the administration of vancomycin (Vancocin), primarily due to - ansAn increase in histamine production WRONG Which medication is used to treat iron toxicity? - ansA) digoxin immune fab (Digibind) B) Naloxone (Narcan) C) Mephyton (Vitamin K) D) WRONG deferoxamine (Digibind) WRONG Which of the following anticoagulant is MOST commonly administered for DVT prophylaxis in a patient who has undergone a hip replacement? - ansA)WRONG heparin B) enoxaparin C) aspirin D) warfarin A nurse is caring for a patient with hyperparathyroidism and notes that the patient's serum calcium level is 13mg/dl. Which medication should the nurse prepare to administer as prescribed to the patient? - anscalcintonin (Miacalcin) A patient has a prescription to take Guaifenesin (Mucinex) every 4 hours, as needed. The nurse determines that the patient understands the MOST effective use of the medication if the patient states that he or she will: - anstake the medication with a full glass of water A patient's capillary blood glucose reading is 33mg/dl. Which of the following medications will the nurse administer if the patient is unable to tolerate PO? - ansDextrose 50% IV push Convert 1.2 milligrams to micrograms - ans1200 mcg

P a g e 2 | 171 Patient is to receive 5mg/kg of medication. Patient weighs 80kg. How much would you administer? - ans400mg

Sildenafil (Viagra) is prescribed to treat a patient with erectile dysfunction. A nurse reviews the patient's medical record and would question the prescription if which of the following is noted in the history? - ansUse of nitroglycerin Sildenaphil(viagra) is prescribed to treat a patient with erectile dysfuction. A nurse reviews the patient's medical record and would question the prescription of which of the following is noted in the history? - ansUse of Nitroglycerin The dosage of which drug must be tapered off slowly to prevent acute adrenal insufficiency? - ansprednisone (Deltasone) The patient is diagnosed with multiple myeloma. The physician has ordered cyclophosphamide (Cytoxan). Which instruction should be given to the patient? - ansIncrease daily water intake The patient is diagnosed with multiple Myeloma. The physician has ordered cyclophosphamide (Cytoxan). Which instruction should be given to the patient? - ansIncrease daily water intake When a patient has pernicious anemia, the nurse would expect to give them: - ansVitamin B When caring for a patient with a central line who is receiving TPN, what is the MOST important action on the part of the nurse to prevent CLABSI? - ansPerform correct sterile technique for dressing change at the CVC site When teaching a new nurse on how to administer IV push furosemide (Lasix), you emphasize that it should be given over two minutes to avoid: - anstinnitus Which of the following is considered an antiplatelet medication? - ansclopidogrel (Plavix) Which of the following medications is known to cause orange- colored urine? - ansphenazopyridine (Pyridium) Which of the following medications should be held today considering that your patient received IV contract two hours ago fir a CT scan? - ansMetformin (Glucophage) Which of the following medications should be questioned by the nurse, if

ordered by the provider to treat a patient's complaint of nausea and vomiting? - ansfamotidine (Pepcid) Which of the following medications will crystalize when mixed with D5NS? - ansphenytoin (Dilantin)

While delivering the lunch tray of a patient who is taking warfarin (Coumadin), the nurse notices diversity of food items. Which of the following foods would be a concern? - ansSpinach You are caring for a patient with diabetes. Humalog insulin is ordered via sliding scale AC and HS. When is the best time to administer Humalog insulin? - ans15 minutes before meal arrives You are ordered to give digoxin. Your patient's vital signs are as follows: Blood Pressure 130/75, Temp 97.9 oral, HR 52, O2 Sat 100% room air. What should you do next? - ansHold digoxin and call the provider Your patient has an epidural infusing hydromorphone with bupivacaine at 6ml/hr continuously. The patient's blood pressure at the beginning of your shift was 92/58 with a heart rate of 68. You noticed the patient's blood pressures have been around 130/70. What should you do FIRST? - ansCheck infusion rate to confirm 6ml/hr, then notify anesthesia provider Your patient has been diagnosed with. chronic CHF and will be taking Lasix 80mg PO twice a day. When teaching about high Potassium foods in the diet, which group of foods would you recommend to the patient? - ansBananas, spinach, raisins Your patient is on a Morphine PCA after a recent exploratory surgery. While doing your rounds, you notice that your patient is slumped over, unresponsive, with delayed and slow respirations. You suspect narcotic overdose. Which reversal medication would you administer? - ansnaloxone (Narcan) Your patient is receiving vancomycin (Vancocin) 500mg IV every 12 hours. As a nurse, you understand that the PRIMARY rationale for monitoring serum levels of vancomycin is that: - ansIt can cause nephrotoxicity Your patient is to receive 2 G vancomycin over 2 hours. The medication comes in from the pharmacy as 2 G Vancomycin in 250ml normal saline. At what rate will the IV medication run? - ans125ml/hr Your patient presents with CHF and has a Potassium level of 5.8. Which diuretic do you anticipate being ordered by the provider? - ansbumetanide (Bumex) Your patient taking digoxin (Lanoxin) has an AM Potassium level of 3.0. This level may:

• ansIncrease risk of digoxin toxicity

Case management involves assessment—in this case, screening—and arrangement for delivery of services. Primary prevention includes case management to identify at-risk clients and arrange for services to prevent disease. Through nurse management activities, general community deficiencies in the quality or quantity of health services are often Your patient, a Type 1 diabetic with a history of schizophrenia is exhibiting signs and sym When implementing interventions at the systems-level of practice, the public health nurse Involve the entire community in solving the health problem. Identify health problems in the community. Change laws, policies, and practices that influence population-based issues. Provide outreach services to populations at risk. - ANSANS: C Systems-level practice consists of changing laws, policies, and practices that influence po

. Which statement regarding mutations is true? 1. A home health case manager is charged with identifying opportunities for health prom a. Mutations in the DNA sequence occur on a regular basis. b. Mutagens are a result of a mutation. c. Environmental factors can be linked to many mutations. d. Spontaneous mutations occur because of environmental exposure. - ANSANS: C A large number of agents are known to cause mutations. These mutations are attributed to known environmental causes. DNA replication is very accurate, thus, mutations do not occur on a regular basis. Mutagens are the factors that cause mutations. Spontaneous mutations occur naturally during DNA replication. a. collaborates with a local chaplain to ensure that the spiritual needs of cancer clients are addressed. b. refers a new diabetic client to a nutrition counselor for dietary teaching. c. teaches a school nurse how to care for a client who will be returning to school and will require new asthma treatments. d. tracks the immunization status of clients and facilitates access to immunization when needed. - ANSANS: D

The approach of relief activities needs to shift from short-term aid to long- term support. Promoting individual, family, and community preparedness increases safety in the event of disaster and can help children and adults feel empowered. This builds on the resilience of the individual, family, and/or community. Individuals and families still need to be assessed for indications of mental distress (case finding) and referred to a mental health professional if the need exists. Open discussions of the family's response to the slow process of recovery or long-term results of living under adverse conditions can uncover lingering mental distress or exacerbations of chronic conditions that require attention. During the initial stages of c. consideration that the family will have worked through the emotional aftermath by now assessment of the family's home environment to rule out safety issues. avoidance of discussion of the disaster of 3 years ago. The nursing process function of assessment is complementary to the case management process function of case finding and includes such activities as applying screening tools d. support of the family in preparing a personal disaster response plan. - ANSANS: D a. Community cost concerns b. Community conflict resolution skills c. Community satisfaction d. Community weaknesses in quality of services e. Community weaknesses in quantity of services - ANSANS: D, E reveal the broader picture of health services in and health status of the community. Community assessment, policy development, and assurance activities that frame the core functions of public health actions are often the logical next step in the nurse case manager's practice to intervene at the community level to make changes. Therefore, the core components of case according to program goals and objectives.

1. A nurse is assigned to provide community outreach to a small town that was partially destroyed by a tornado 3 years earlier and has been rebuilt. The first client is a family who lost their home and their best friend in the tornado. The best intervention would include:
2. A nurse performing home hospice case management notes the increasing number of hospice clients who lack caregivers in the home environment. The nurse identifies the potential need for a hospice house facility to meet the needs of these clients. The case management process frequently reveals larger picture issues such as which of the following?

Case management activities with individual clients and families very often reveal the larger picture of health services and health status of a community. General community weaknesses in the quality and quantity of services often are discovered. The nurse can then intervene at the community level to initiate changes. In this case, the nurse identified a deficiency in the quality of hospice services to individuals who did not have a caregiver in the home environment and the parallel concern of the lack of hospice- related facilities to meet the needs of these clients to achieve a quality dying process.

1. A nurse volunteering at a local homeless shelter notes that many of the clients have acute and chronic illnesses and are in need of primary health care services. The most effective strategy to consider when networking with homeless individuals, families, or populations is to: a. form a community partnership to establish a clinic for homeless persons. b. create a trusting environment and establish a therapeutic relationship. c. collaborate with the local United Way to obtain funding for primary care services. d. dialogue with local clergy to address the unmet primary care need for homeless persons. - ANSANS: B Nurses need to be able to work with poor and homeless clients to promote, maintain, and restore health. Nurses must be prepared to look at the whole picture: the person, the family, and the community interacting with the environment. In working with the homeless, it is important to create a trusting environment. Trust is essential to the development of a therapeutic relationship with poor or homeless persons. Many clients and families have been disappointed by interactions with health care and social systems. They are now mistrustful and see little hope for change. Establishing a trusting relationship lays the foundation for a more comprehensive assessment of clients' perception of their health care needs and a determination of factors that may contribute to their current health status issues.
2. A school nurse is teaching a class of sophomores about the relationship between the risk of sexually transmitted disease (STD) and risk-taking behaviors. A key point to include is: a. all STDs are easily preventable with consistent condom use. b. once a young woman is pregnant, she is no longer at risk for most STDs. c. STDs are most likely to be transmitted during a student's initial sexual encounter. d. use of alcohol and drugs makes a student more likely to make decisions that result in exposure to and infection with STDs. - ANSANS: D Drug use is linked to STD transmission because drugs such as alcohol lower inhibitions and impair judgment about engaging in risky behaviors. Addictions to drugs may cause individuals to acquire the drug or money to

purchase the drug by performing sexual favors. This increases both the frequency of sexual contacts and the chances of contracting STDs. Adolescents are particularly at risk. Not all STDs are preventable through condom use. The challenge of preventing human papillomavirus (HPV)

Community health program planning is population focused and puts the well-being of the public above private interests. Systematic planning for meeting the needs of populations in a community has benefits for clients, nurses, employing agencies, and the community. It ensures that available resources are used to address the actual needs of people in the community, focuses attention on what the organization and health provider are attempting to do for clients, identifies resources and activities that are needed to meet the objectives of client services, reduces role ambiguity by giving responsibility to specific providers to meet program objectives, reduces uncertainty within the program environment, increases the ability of the provider and agency to cope with the external environment and anticipate events, allows for quality decision making, and provides better control over the actual program Homelessness is correlated with poor health outcomes. The incidence of acute and chronic illness, acquired immune deficiency syndrome (AIDS), and trauma is significantly higher among homeless persons. Although homeless persons are at higher risk for physiological problems, they have greater difficulty accessing health care services. Health care is usually crisis oriented and sought in emergency departments, and those who access health care have a hard time following prescribed regimens. Health problems of homeless clients are often directly related to poor preventive health care services. In addition to facing challenges related to

1. Effects of homelessness on health care outcomes can be devastating and may include infection (genital warts) is that condoms do not necessarily prevent infection because warts may grow in areas that barriers such as condoms do not cover and skin-to-skin contact may occur
2. Advantages of community health program planning include ensuring that available resources are used to meet the needs of the population and: a. applying for grants. b. identifying clients and soliciting board members' support. c. identifying resources, activities, and needs. d. increasing the visibility of the program. - ANSANS: C c. Crisis-oriented health care, usually in emergency departments d. Reduced eligibility for entitlement/assistance programs e. Lack of awareness of care options - ANSANS: A, B, C, E a. Higher incidence of acute and chronic disease

In 1988, the IOM's report stated that public health is "what we, as a society, do collectively to assure the conditions in which people can be healthy." Consequently, the mission of public health is "to generate organized community effort to address the public's interest in health by applying scientific and technical knowledge to prevent disease and promote health." This clearly places the emphasis on the desire of the population and community to ensure access to services that foster the health status of the overall community through the equitable distribution of a. what public-private partnerships do to treat vulnerable populations. b. what the government does to ensure that vital programs are in place. c. what the U.S. Public Health Service does to prevent disease, promote health, and deliver services. d. what society does collectively to ensure the conditions in which people can be healthy. - ANSANS: D food and shelter. They spend most of their time trying to survive. Just getting money to buy food is a major challenge. Although some homeless persons are eligible for entitlement programs such as Temporary Assistance for Needy Families (TANF), Women, Infants, and Children (WIC), or Social Security, others must beg for money, sell plasma or blood products, steal, sell drugs, or engage in prostitution. Barriers to treatment include lack of awareness of treatment options, lack of available space in treatment facilities, inability to pay for treatment, lack of transportation,

1. In 1988, the Institute of Medicine (IOM) published a report on the future of public health and its mission that defined public health as:
2. In caring for migrant workers and their families, the nurse should first assess the migrant workers' lifestyle, especially their current: a. communicable diseases. b. educational level. c. housing arrangements. d. pesticide exposure. - ANSANS: C The way of life of migrant farmworkers and their families is stressful. They often have trouble finding decent and affordable housing. Available housing is often overcrowded and lacking in individual sanitation, bathing or laundry facilities, window screens, and fans or heaters. Housing may be located in hazardous areas next to fields or farm machinery. Housing may be rundown or structurally deficient. Some families may be living in cars or tents when housing is unavailable. All of these factors impact the health status of migrant families and need to be understood by the nurse to direct

Nurses can serve as social and political advocates for migrant populations. Educating communities regarding these individuals, collecting necessary data on their lives and health, and communicating with legislators and other policymakers at local, state, and national levels are necessary A vulnerable population group is a subgroup of the population that is more likely to develop health problems as a result of exposure to risk and to have worse outcomes from these health problems than the rest of the population. That is, the interaction among many variables creates a more powerful combination of factors that predispose the person to illness. Vulnerable populations often experience multiple cumulative risks, and they are particularly sensitive to the effects of those risks. Examples of vulnerable populations of concern to nurses are persons who are poor and homeless, people with special needs, pregnant teens, migrant workers and b. Evaluation of an outreach program for at-risk pregnant teenagers c. Community subpopulations with high rates of type 2 diabetes d. New technologies to monitor diabetes e. Prevalence of hypertension among various age, race, and gender groups - ANSANS: B, C, E Public health specialists often define problems at the population or aggregate level as opposed to the individual level. At the population level, public health specialists are usually concerned with more than one subpopulation and frequently with the health of the entire community.

1. The community health nurse can serve as an advocate for the vulnerable migrant population by engaging in which of the following actions? (Select all that apply.) a. Becoming culturally and linguistically competent b. Collecting necessary data on migrant workers' lifestyle and health status c. Educating communities about the migrant workers in their areas d. Educating policymakers about successful programs for migrant workers e. Using lay health workers to provide health education in migrant camps - ANSANS: B, C, D
2. The population group that is likely to be the MOST vulnerable is: a. children with a family history of sickle cell disease and hypertension. b. homeless pregnant teens in a substance abuse program. c. nNative Americans at risk for diabetes. d. overweight children. - ANSANS: B
   1. Public health nursing specialists are interested in which of the following topic(s)? (Select all that apply.) a. Educational materials for individuals with HIV/AIDS

incarcerated, persons with communicable diseases and those who are risk, and persons who are human immunodeficiency virus (HIV) positive or have hepatitis B virus or sexually transmitted diseases (STDs).

1. Vulnerable population groups are those that, in comparison with the population as a whole, have which of the following characteristics? (Select all that apply.) a. Better access to health care services but poor health outcomes b. Greater likelihood of exposure to risk factors c. Multiple risk factors but equal health outcomes d. Worse health outcomes - ANSANS: B, D Vulnerable populations are defined as those at greater risk for poor health status and health care access. In health care, risk is an epidemiologic term indicating that some people have a higher probability of illness than others. The natural history of disease model explains how certain aspects of physiology and the environment make it more likely that a certain individual will develop a particular health problem. However, not everyone who is at risk develops health problems. Some individuals are more likely to develop the health problems for which they are at risk. A vulnerable population group is a subgroup of the population that is more likely to develop health problems as a result of exposure to risk or to have worse outcomes from these health problems than the rest of the population.
2. A client newly diagnosed with HPV infection, herpes simplex virus 2 (HSV-

infection, and syphilis asks, "Okay, so how do I get rid of all this stuff?" In developing a plan of care, the nurse recognizes that it is essential to address: a. correct use of condoms to prevent transmission of all STDs. b. cures for each of the STDs identified. c. risk of skin-to-skin contact in transmitting the identified STDs. d. safety of sexual contact in the absence of lesions. - ANSANS: C The client needs to understand which STDs are transmitted by skin-to-skin contact and which are transmitted by body fluids. The client also needs to understand which infections are curable with antibiotics (syphilis) and which are virus infections that are treatable but not curable (HPV, HSV- infections). In HSV-2 infection, although the ability to pass the infection is higher when active lesions are present, some individuals can spread the infection even when they are asymptomatic. HPV transmission occurs through direct contact with the warts that result from HPV, but the virus has also been detected in semen, and exposure to the virus through body fluids is also possible. In addition, the challenge of HPV prevention is that condoms do not necessarily prevent

infection because warts can grow in areas that are not covered by barriers such as condoms and skin-to-skin contact may occur.

There are several types of needs assessment tools, including community forums, focus groups, key informants, indicators approach, survey of existing agencies, and general surveys. Both community forums and focus groups are low-cost tools. The focus group provides clients with the opportunity to participate in identification of needs and can help increase community support for a program. The focus group method has several disadvantages, such as being time consuming to carry out and tending to focus on irrelevant or political "hot button" issues. Leading focus groups The scope of practice of public health nurses is population focused and community oriented, with a primary emphasis on population-level interventions that target strategies for health promotion and disease prevention. In addition, public health nursing is concerned with the health of all members of a population or community, particularly vulnerable

2. A community health nurse is conducting a community assessment as part of a program Community forum Focus group c. Indicators approach d. Survey - ANSANS: B
3. A registered nurse is seeking a position as a public health nurse. In reviewing the job description, the nurse would expect to find a description of a position that focused on functions such as: a. monitoring pregnant teenagers for symptoms of complications of pregnancy. b. offering free hypertension screening and treatment referral at local health fairs to low- income, uninsured, community members. c. partnering with local seasonal farmworkers to design a program aimed at preventing illness and injury, and advocating for this population with local political and community leaders. d. preventing injury among a population of elderly residents in an assisted living facility and treating residents' chronic illnesses. - ANSANS: C
4. During a home visit, a case manager for a community health center notes marked pitting edema, shortness of breath, and increased fatigue in a 52-year-old male client who lives alone. The client is admitted to the hospital, where he is diagnosed with congestive heart failure. The case manager works with the hospital's utilization manager to devise a discharge

a. assess the client; obtain information on the scope of services covered by the benefit plan for the client; if needed services are not covered, seek to identify and arrange for the resources to provide these services. b. call the client, reintroduce himself or herself, and explain his or her role as a case manager for homebound clients. c. discuss with the family their schedule of availability to offer care in the client's home; ensure that the client has daily visits by family members. d. investi - ANSANS: A Case management has been described as a set of logical steps and process of interaction within a service network that ensures that a client receives needed services in a supportive, effective, efficient, and cost-effective manner. The National Case Management Task Force defines case management as a collaborative process that assesses, plans, implements, coordinates, monitors, and evaluates the options and services to meet an individual's needs, using communication and available resources to promote quality cost-effective outcomes. Case management has been defined in the public health nursing literature as the establishment of an appropriate plan of care based on assessment of the client/family and coordination of the necessary resources and services for the client's benefit. Therefore, a critical role of the case manager is to help clients obtain the care they need to achieve a maximum level of health. The nurse needs to understand what the client's insurance covers (broker). If necessary services or equipment is not covered by insurance, the nurse may act as an advocate (facilitator) and connect the client with other resources in the community (coordinator) if available.

2. In an effort to decrease health disparities and improve life expectancy, the Social Security Act was amended in 1998 to provide federal funding to: a. assure access to health care for elderly Americans. b. build hospitals to care for the medically indigent. c. insure children without health insurance. d. provide supplementary income for citizens with disabilities. - ANSANS: C Title XXI of the Social Security Act, passed in 1998, established the State Children's Health Insurance Program to provide funds to insure currently uninsured children. Legislation enacted subsequently provided for new outreach and case- finding efforts to enroll eligible children in Medicaid.
3. The highest priority for a nurse who is among the first responders to a disaster is: a. arranging for shelter for disaster providers. b. beginning community assessment as soon as possible to ensure a rapid

recovery. c. beginning surveillance and planning needed health education for disaster survivors. d. immediately developing plans for effective triage and client management.

• ANSANS: D

Annually agricultural work ranks in the top four most dangerous occupations in the United States. Migrant farmworkers are exposed to weather because they work outside in the elements, very often for long hours, and typically live in inadequate housing. Exposure to both naturally occurring plant substances and applied chemicals such as pesticides places farmworkers at risk of immediate health problems (contact dermatitis, allergies, and conjunctivitis) and long- term health effects (lung diseases and cancer). Workers may not receive adequate training regarding the use of mechanical equipment, and the equipment may not be properly maintained. The workers' low educational level may impede their ability to comprehend essential training or warnings. In most states, migrant farmworkers are not protected by the same occupational health regulations Crisis poverty is a conception of homelessness that views the homeless as people whose lives are generally marked by hardship and struggle. For this group, homelessness is often transient or episodic. Their homelessness may result from lack of employment opportunities, lack of education, obsolete job skills, and/or domestic violence.

2. Which of the following best represents the concept of homelessness as crisis poverty?
3. The nurse case manager in a migrant farmworker clinic assesses this vulnerable population from the perspective of occupational and environmental risks related to: a. contaminated water, applied chemicals, and unfamiliar farm equipment. b. naturally occurring plant substances, pesticides, and fear of injury reporting. c. traffic accidents, weather, lack of worker supervision, and inadequate sewage. d. weather, pesticides, and strict enforcement of occupational regulations. - ANSANS: B a. Man with chronic alcoholism and drug abuse living in a halfway house b. Recently unemployed man evicted from his apartment c. Teenager living on the streets and abusing drugs d. Woman with schizophrenia who is living in a shelter - ANSANS: B The first priority when responding to a disaster is to immediately plan for, coordinate, and carry out effective triage. Disaster response includes community assessment, surveillance, health education, and coordination of shelter arrangements. However, the first task is to provide care for life-
4. A community health nurse is serving as a case manager for premature infants receiving home health care. The case manager arranges for an in- home apnea monitor and daily home visits by a registered nurse who specializes in high-risk pediatrics. The case manager is demonstrating which of the following case manager roles?

The case manager is responsible for fulfilling a variety of roles. The nurse is acting as a consultant when working with suppliers to arrange for the apnea monitor. The nurse is acting as a coordinator when arranging for needed heath care services such as daily home visits by a specially trained Cost studies are essential to show the value of nursing in the marketplace now and in the future. All cost studies involve three major tasks: financial, research, and statistical. The financial tasks include identifying total program costs. The statistical tasks include identifying appropriate, quantifiable measures for analyzing data. The research tasks include setting up an appropriate study design to answer questions about benefit, efficiency, or effectiveness. Types of cost studies include cost-accounting, b. Mentor and liaison c. Monitor and reporter d. Standardization monitor and negotiator - ANSANS: A a. cost studies. b. Mobilizing for Action through Planning and Partnerships (MAPP) model. c. Planning Approach to Community Health (PATCH) method. d. Tracer method. - ANSANS: A

3. A nurse is assigned to teach clients STD prevention information. The nurse updates her teaching plan to incorporate new guidelines from the Centers for Disease Control and Prevention. She includes which of the following as updated information during her next teaching session? a. Always use spermicides with condoms to reduce the risk of contracting chlamydia or gonorrhea. b. Condoms can be effective in preventing infections transmitted by fluids from mucosal surfaces but are not always effective in preventing infections transmitted by skin-to-skin contact. c. Condoms should not be used during oral sex, because they are not effective in preventing transmission of infection. d. When genital ulcers are present, condoms should be used to prevent the spread of infection. - ANSANS: B The lesions of HSV-2 and HPV infection as well as other lesions capable of transmitting STDs can occur on all parts of the male and female genitalia and rectum. Condoms are effective in reducing transmission via body fluids from the penis and vagina. However,
   3. A community-oriented nurse is writing a grant application for funding for a nurse-run clinic serving clients with chronic illnesses. The grant application asks for information regarding program benefits, effectiveness, and efficiency. The most effective tool to obtain this

lesions not covered by a male or female condom can still transmit infection even with proper condom use

3. A public health nurse leader is encountering barriers when trying to shift the public health agency's efforts to a population-focused practice. The reasons peers are not supportive of the proposed shift to a population focus are most likely related to: a. agency colleagues' push for nurses to focus on population initiatives. b. costs associated with staff training and revision of documents. c. lack of support from the agency's funding sources. d. opinions that nursing should focus on the provision of direct client care and services.

• ANSANS: D Barriers to implementing population-focused care include lack of understanding of the public health nurse role and its relationship to other roles in nursing, such as direct care and services; workplace role socialization that determines what roles are appropriate and inappropriate or accessible and inaccessible for nurses; and lack of comprehensive training at the graduate level in the disciplines basic to public health such as epidemiology, biostatistics, community development, service administration, and policy formation.

3. Deinstitutionalization of chronically ill individuals from publicly funded psychiatric hospitals had the unintended consequence of: a. moving clients to readily available community- based care. b. shortening hospital stays in mental health facilities. c. increasing the funding for community-based services. d. increasing the number of homeless persons. - ANSANS: D Deinstitutionalization of chronically mentally ill individuals from public psychiatric hospitals increased the number of homeless persons. The intent was to move clients from public psychiatric hospitals to community-based treatment centers. However, adequate community-based services were not funded. Few of the intended community mental health centers were ever built.
4. The definition of a migrant farmworker includes which of the following? a. Farmer who helps his neighbors on their farms after his own crop fails b. High school student who works part time at his uncle's rose farm c. Teenager who moved with his family ten times in 2 years to work different crops

According to the Department of Labor, a migrant farmworker is a seasonal farmworker who had to travel to do the farm work and was unable to return to a permanent residence within the same day. A seasonal d. Woman who works in the crop fields in the summer and at a grocery store in thewinter - ANSANS: C

Resource limitations are strongly related to health. Lack of adequate social, educational, and economic resources make people more vulnerable and more likely to experience health disparities, and poverty is a primary cause of vulnerability. A correlation has been found between individual indicators of socioeconomic status (e.g., income, education, and occupational status) a. authority to step in and take control of state, local, and voluntary organizations during disasters. b. command and control for American Red Cross and Disaster Medical Assistance teams. c. oversight of federal and state response operations, with minimal interaction with other organizations. d. written approach, protocol, and common language for responders from federal agencies and other voluntary organizations. - ANSANS: D The first level of disaster response is carried out by the locality (office of emergency management). Through mutual aid agreements, localities can arrange for additional support from surrounding communities (emergency operations center). When the response needs exceed the capability of the localities and state-level resources or capabilities, then the governor may request assistance under a presidential declaration of disaster or emergency. The way the federal government offers assistance is through the NRF. The NRF was written to approach a domestic incident in a unified, well- coordinated manner that enables all responding entities to work together more effectively and efficiently. All member organizations of the responding teams, including all relevant branches of the federal government, are assigned functions that are listed in the plan as emergency support functions. When large disasters require the services of a variety of emergency responding units with personnel coming from different parts of the country, the challenge of working together in unison may require the use of the NIMS, which provides all responders with a protocol and common language for working together. The importance of interoperable communication equipment is stressed by the NIMS.

3. Vulnerability is multidimensional, and one of the primary contributors to vulnerability is: a. gender. b. race and ethnicity. c. resource limitations. d. urban or rural residency. - ANSANS: C residence, worked in agriculture for at least 25 days or parts of days and did not work year round only in agriculture.
   3. The emergency support functions of the National Response Framework (NRF) and the National Incident Management System (NIMS) provide:

resulting from various health problems). Not only do individual-level socioeconomic characteristics seem to matter, but population-level characteristics such as income inequality also make a difference. Resource limitations affect the individual's ability to show resilience in the face of problems and crises. Resource limitations may also place individuals and families at risk because of substandard housing, impoverished neighborhoods, and hazardous environments. Although race has been correlated with poor health outcomes, poverty seems to be a key contributing factor for minority populations. Poverty is more likely to affect women and children than other groups.

4. A community health nurse is the case manager for a homebound client recovering from a hip replacement. The nurse works with the client and his family to prioritize needs and services, and to address these care needs. These activities represent which step in the nursing process? a. Assessment and planning/outcome b. Diagnosis and planning c. Implementation d. Planning/outcome - ANSANS: D The case management process function of problem prioritizing and planning to address care needs is complementary to the planning/outcome step of the nursing process.
5. A nurse is working with a disaster medical assistance team as it responds to a disaster. A new team member excitedly insists that its personnel can exceed their 12- hour shifts and do not need breaks. The best intervention on the part of the nurse is to: a. arrange for the team member to be transferred to another unit. b. arrange for the team member to leave duty, return home, and talk with his or her pastor. c. educate the rescuer about necessary stress-management techniques and offer to pair up with the individual so that each can monitor the other's stress level. d. help the team member to call home to speak with his or her family. - ANSANS: C The nurse needs to be aware that rescue workers are repeatedly exposed to stress and, despite their training in managing such situations, have a higher than normal risk of developing post-traumatic stress syndromes. The nurse can assist the new team member by educating the rescuer about the importance of stress- management and self- management techniques. The nurse could pair up with the new team member so that they could monitor each other's stress responses and could provide guidance in adhering to stress management

4. A nurse providing a tertiary prevention intervention to a population of women who are HIV positive will most likely: a. educate about self-care and the women's rights as employees.

Helping clients understand their rights to protect from on-the-job discrimination is part of the nurse-advocate role. Tertiary prevention includes educating women with a chronic disease such as HIV about self- care strategies and health-promotion activities to minimize risky behaviors and poor health outcomes. Enhancing levels of self-esteem and empowerment can prevent feelings of powerlessness and hopelessness, Nursing assessment should always include taking a comprehensive sexual history to determine an individual's potential risk for STDs. Each sexual partner is potentially exposed to all the STDs of all the persons with whom their partner has been sexually active. PID is a serious infection involving the fallopian tubes and is the most common complication of gonorrhea, but it may also result from chlamydial infections. Symptoms include fever, abnormal menses, and lower abdominal pain. Symptoms can vary among women. PID can cause ectopic pregnancy, and this should be ruled out in d. teach how to lobby state legislators. - ANSANS: A

4. A woman comes to the community health center complaining of increasing lower abdominal pain, fever, and abnormal menses for several months. During the assessment, the client indicates that she is aware that her husband has had multiple sex partners in the past 2 years. Appropriate intervention by the nurse would be to: a. arrange to have the client referred for medical evaluation for pelvic inflammatory disease (PID) and appropriate intervention and treatment. b. contact the health department to confirm the spouse's diagnosis of Chlamydia infection to determine the client's exposure, give the client antibiotics, and have her return to the clinic if symptoms worsen. c. provide STD prevention and treatment education and refer the client to the health department for STD screening for gonorrhea and/or Chlamydia infection. d. supply the client with nonsteroidal anti-inflammatory drugs and caution her to call the after- - ANSANS: A
5. The migrant clinic's mobile van program provides health education through lay health workers; screening for pesticide illness, tuberculosis (TB), and diabetes; pregnancy testing; and treatment for some acute and chronic illnesses typically seen in this vulnerable population. In dealing with this population's beliefs about disease causality, this program demonstrates the application of the health promotion and disease prevention principle of: a. advocacy. b. cultural competency. c. outreach. d. primary prevention. - ANSANS: C b. establish a partnership with a community to initiate a community health center.