Community Exam 3 Flashcards

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Healthy People 2020is a guidepost for nurses and interdisciplinary teams in community

and public health. Which new focal areas will the nurse discover has been added to the

2020 goals? (Select all that apply.)

  • Adolescent health
  • Blood disorders and safety
  • Dementia
  • Early and middle childhood
  • Genomics
  • Global health
  • Health care associated infections
  • Health related quality of life
  • LGBTQQA health
  • Older adults
  • Preparedness
  • Sleep health
  • Social determinants of health


The nurse has determined the specific indicators and focal areas that are needed to

establish immunization and well-child clinics in a low-income neighborhood. What actions

should the nurse prioritize to meet the health outcomes of the project?

  • Develop a plan to meet costs and promote benefits of the project


Absenteeism due to illness has increased recently in the local middle school. The increase is noted to be related to exacerbation of asthma symptoms in the student population.

Which would be the most effective approach in decreasing absenteeism among this


  • Develop asthma education and surveillance programs that address students, family, and faculty


The local clinic is dedicated to the well adult and child. It has evening hours and offers

varied programs for the community. The programs include immunizations and classes on

fire safety, health education, and car safety, to name a few. How would the nurse best

explain the level of prevention used in this setting to your colleagues?

  • Primary


The nurse works in a facility that provides hospice care for clients with cancer diagnoses.

The nurse recognizes that the care provided in this facility is tertiary in nature. When developing the care plan for these individuals, which functions should the nurse prioritize? (Select all that apply.

  • Palliative care
  • Pain control
  • Support and emotional comfort of family and client
  • Decreasing isolation
  • Organize help from community


The nurse decided to use a learning model based on Skinner with a client with diabetes to improve compliance with dietary and blood glucose assessment requirements. Which

would be the bestway to implement this program?

Positive reinforcement- give rewards for low blood sugars and eating healthy


The nurse decides to use the health belief model for a wellness walking program for older adults. The walk is to begin each day at 8 PM. Each day a different participant is to start a chain of phone calls to other participants to remind all to attend. The nurse informs the

clients in the clinic that walking will improve their overall health and well-being. Two older

adults show up the first night and none the second. Which information should the nurse

gather to explain the failure of the program? (Select all that apply.)

  • Severity of potential illness
  • Populations level of susceptibility
  • Benefits of action
  • Challenges and factors discouraging participation
  • Presence or absence of cues (exposure to factors that prompt action)


A 47-year-old client and three members of his neighborhood have had their homes robbed and belongings scattered. The client contacts the police and, with their assistance, develops a neighborhood watch. The watch is organized, and 24 families have been recruited to participate. The watch will be active throughout vacation months and as needed. Which

model will this organization be mostutilizing in this process?

  • Relapse prevention model


1The nurse is analyzing an epidemiologic study conducted on the occurrence of Zika virus

cases in his state. While evaluating the information, which option is the best interpretation

of “rate”?

  • Primary measure used to describe either the occurrence or existence of a specific state of health or illness
  • Number of cases within a specific time/ population at risk during that specific time


In researching cases of West Nile virus in the community, the nurse explores how the

interactions among people infected with this virus, mosquitoes, and the environment they

share contribute to outbreaks of this disease. Which epidemiologic model is the nurse

prioritizing in this case?

  • Epidemiologic triad


3The nurse explores all of the possible factors that contribute to coronary artery disease in

the community as links in multiple interrelated chains. Which epidemiologic models is the

nurse utilizing in this case?

  • Web of causation


The nurse is appraising new epidemiologic research concerning the reported cases of

measles over the past 5 years. Which is the best explanation for the nurse to apply to

“risk factor” when analyzing this research?

  • Characteristic or event that has been shown to increase probability of a disease to develop


The nurse has been requested to investigate the outbreak of H1N1 in the community. In

documenting the outbreak, which should the nurse prioritize in its description? Select all

that apply.

  • Person (name of infected)
  • Place (geographical area of outbreak)
  • Time (onset, duration, resolution)


In researching an outbreak of malaria in the developing nation where the nurse currently

works, the nurse decides not to focus on the role of mosquitoes in transmitting the disease

but on how the physical environment of the community, biologic aspects of the

community, and social customs interact to affect the prevalence of this disease. Which

epidemiologic model is the nurse utilizing?

  • Wheel of causation


A public health nurse is curious if there has been an increase in the need for hospitalization among reported influenza cases. Which factor should the nurse prioritize for researching to answer this query?

  • Outbreak investigation


A nurse is concerned there has been an increase in the number of influenza cases in the

county over the past year when compared with last year. Which rate will best provide the

answer to this nurse?

  • Prevalence rate


A nursing student is examining an epidemiologic report for a class project. Which

explanation should the student conclude will best define sensitivity?

Ability of a test to correctly identify people who have a health problem or probability of the test being positive and the person having the disease


The nurse wishes to calculate the probability of persons in the county developing chronic obstructive pulmonary disease over the course of a year. Which measure will be best for

the nurse to utilize?

  • Incidence rate


The nurse is maintaining a graph which depicts the distribution of influenza cases by the

time of onset of influenza

  • Epidemiologic curve


Spatial map

  • 3D reconstruction of the environment


Incidence rate

  • Number of new cases in a specific time/ total population X1000



  • True positive results/ true positive+ false positive X100



  • Number of existing cases in a specific time/ total population X1000


Attack rate

  • Number of people exposed to a specific agent and develop the disease/ total number of people exposed


The nurse works with a female client who recently developed an infection of

Staphylococcus aureuswhile in the hospital. The nurse would determine that S. aureusis

which component in the chain of infection?



A student nurse asks if an infectious disease is the same thing as a communicable disease. The nurse explains that an infectious disease is not necessarily a communicable disease.

Which factor could the nurse point out that a communicable disease must have that an

infectious disease would not have to have? (Select all that apply.)

  • Portal of exit
  • Portal of entry
  • Mode of transmission


The school nurse is concerned when a student presents to the office with chickenpox. The nurse determines that some of this student's classmates are most likely in which part of

the infectious cycle?

Incubation period


The nurse notes a client arrives for an appointment who appears to have a severe upper

respiratory infection. Which mechanism of transmission is the nurse most likely

attempting to prevent by requesting this client to wear a mask while sitting in the waiting


  • Airborne transmission


Several levels of public health surveillance are necessary to protect the nation's health. At what level are healthcare providers and health facilities required to report certain infectious




Chain of infection

  • Agent-host-environment-portal of exit-portal of entry-mode of transmission


Defense mechanisms (kinds of immunity) Active

live or dead exposure to a pathogen, takes longer to build but last


Defense mechanisms (kinds of immunity) Passive

  • given immunity, fast acting but doesn’t last


Defense mechanisms (kinds of immunity)Acquired

- defense built with exposure


Defense mechanisms (kinds of immunity) Natural

develops on own


Defense mechanisms (kinds of immunity) Herd

  • exposure unlikely


SC reportable diseases (immediate list)

  • Anthrax
  • Measles
  • Plague
  • Rabies
  • Small pox
  • Ebola



  • A characteristic of a particular population, environment or region



  • An outbreak that occurs when there is an increase incidence of disease beyond the normal amount found within a population



  • Epidemic usually limited to a localized increase in the incidence of the illness



  • The prevalence of disease over a whole country or world


Modes of transmission- Airborne

  • travel through air in small droplets


Modes of transmission- Droplet

  • travel < 3 feet through air in small particles


Modes of transmission- direct contact

  • direct body surfaces touching


Modes of transmission- indirect contact

involves an inanimate object or vector



transmission occurs through carrier


Portal of entry and exit

  • Skin
  • Respiratory tract
  • Conjunctiva
  • Genital tract


A man who lives in a homeless shelter is diagnosed with active tuberculosis (TB). The

shelter keeps a list of those who are assigned beds, and the majority of those sleeping there

are regulars. Which finding would indicate a positive tuberculin skin test result using a

two-step process?

6mm induration


A 16-year-old client visits the community health clinic with concerns that she may have a STI. She asks whether STIs are treatable. Which STIs should the nurse point out are easily treated and curable? (Select all that apply.)

  • Gonorrhea
  • Syphilis
  • Chlamydia
  • Trichomonas


The school nurse is preparing for a health class discussion covering the basics of sexually transmitted infections (STIs). Which factors should the nurse point out will place an

individual at high risk for acquiring a STI? (Select all that apply.)

  • Multiple sex partners
  • Not using condoms
  • Presence of other STIs
  • Partner with an STI
  • 15-24 years-old


What are the clinical manifestations of TB?

  • Long lasting cough, coughing blood, chest pain, weight loss, fatigue, fever, night sweats, chills


What are the clinical manifestations of Syphilis?

  • Small painless sores or genitals, mouth, or rectum that heals in 3-6 weeks, enlarged lymph nodes


What are the clinical manifestations of Chlamydia?

Intermenstrual bleeding, cervical discharge, rectal discharge, cervical tenderness, dysuria


What are the clinical manifestations of Gonorrhea?

  • Anal itching, discharge from rectum, bright red blood during bowel movements, pain and sensitive to light


What are the clinical manifestations of HPV?



What are the clinical manifestations of HSV?

  • Fever, headache, malaise, pain, itching, discharge, sores


Identify the kinds of abuse (select all that apply)

  • Emotional
  • Physical
  • Sexual
  • Financial
  • Neglect


What are the strategies to reduce societal violence: primary, secondary, tertiary (select all that apply)

  • Primary- teaching coping mechanisms, risk reduction, public understanding of aging process, educate about services
  • Secondary- screening, assessment of bruises, screen all pregnant women, emergency response to rape, counsel, help offenders deal with struggles, advocate
  • Tertiary- long term follow-up, resources in community, court, support groups


The nurse is evaluating a young mother who believes she may be pregnant again. Which relationship factor discovered by the nurse should raise suspicions that this family is at

risk for intimate partner violence?

  • Inability for a member to cope
  • Resentment to baby
  • Doubts of paternity
  • Insecurity and jealousy
  • Financial burden or other stressor
  • Isolation
  • Physical and emotional changes to women


Preventing intimate partner violence (IPV) and recurrence of violence requires targeting efforts at all three levels of prevention:

  • Primary-reduce stress, teach coping skills, educate
  • Secondary- identify and screen those at risk, assist and counsel, support, advocate
  • Tertiary- long term follow-up, resources, court help, referrals, support groups


Pediatric providers face special issues in screening for intimate partner violence (IPV) in a caregiver who is accompanying a child. Which strategies should the healthcare providers

prioritize for addressing this screening issue? (Select all that apply.)

  • Asking the mother indirectly with a written survey
  • Screening the safety and dangerousness of the situation before asking the mother


Preventing intimate partner violence (IPV) and recurrence of violence requires targeting efforts at all three levels of prevention: primary, secondary, and tertiary. Which is an

appropriate tertiary prevention strategy?

  • Providing the number to an abuse hotline


The public health nurse is conducting a routine well-child visit. Which statements should raise concern with the nurse in regards for the safety of children? (Select all that apply.)

  • Threats to kill care taker, child or self
  • Physical injury
  • Child was forced to witness or participate abuse
  • Weapons were used or threats were made about a weapon


The nurse is completing a screening of a suspected case of child abuse. Which instance would the nurse considered child abuse and neglect and report? Select all that apply

  • Reasonable belief that a child’s well-being has been or is in danger
  • Information is received during their professional job


1 The nurse works with a 16-year-old client who has an alcohol use disorder. Which mental disorder, highly correlated to substance use disorder, should the nurse also assess for in

this client? (Select all that apply.)

  • Major depression
  • OCD
  • Anxiety
  • Bipolar


A client arrives at the clinic shaky and requesting a refill on a prescription for alprazolam. The nurse suspects that the client might be experiencing substance withdrawal. Which comment by the client would mosttend to confirm the nurse's suspicion?

  • I ran out of pills a week ago and have felt sweaty and agitated ever since


The community health nurse is concerned with the prevalence of new HIV infections in

the community and understands the strong correlation between substance use disorders

and HIV. Which interventions should the nurse promote in the community health clinic to

bestaddress this problem? (Select all that apply.)

  • Opioid solution treatment
  • Syringe exchange program


The nurse works in the ER when a client arrives with respiratory depression associated

with a heroin overdose. Which medication should the nurse predict to be ordered for this


  • Naloxone


The public health nurse is evaluating the community in the effort to determine the

underserved members with the goal of decreasing their risk for health problems. Which

factors should the nurse evaluate to determine who belongs to this group? (Select all that


  • Rural residency
  • Migrant employment and undocumented
  • Veterans
  • Disabilities
  • Homeless and poverty
  • Mental health
  • Substance use
  • Foster children
  • Frail elders
  • Violence
  • Correctional and prison population
  • Human trafficking



  • A pattern of pathological, compulsive use of substances and involves physiological and psychological dependence
  • Cardinal indicator of dependence includes manifestations of withdraw and tolerance



  • a primary indication of dependence and can include lying, defensiveness, minimizing use, blaming, going with the flow


Comorbidities and associated or coexisting health problems

  • Anxiety- GAD, panic disorders, PTSD
  • Mental disorders- depression, bipolar, ADHD, borderline personality, and antisocial personality disorder
  • Schizophrenia


General physical appearance of substance use

  • Alcohol- hypotension, CNS depression, coma, slurred speech, ataxia
  • Heroine- constricted pupils, slurred speech, euphoria, CNS depression, coma
  • Amphetamines/ cocaine- dilated pupils, insomnia, tachycardia, paranoia, hallucinations, elevated BP, stroke
  • LSD- dilated pupils, elevated vitals, tremor, psychosis, death
  • Cannabis- red eyes, dry mouth, increased pulse, panic


Strategies to reduce substance disorders

  • Primary- increase public awareness (young people) by school or public education programs
  • Secondary-identify at risk population and connect them with proper resources and screen
  • Tertiary- life style changes, decrease risk and stress, referral to groups (AA), provide emotional support and reinforcement to individuals and family


A nurse is assessing a client who was recently released from prison. Which crime would the nurse mostsuspect that the client may have committed?

  • Drug possession and trafficking


The nurse works at a clinic in Arizona that provides bilingual (English and Spanish) care to low-income immigrant workers from Mexico. Which designation mostaccurately describes the area or the population this nurse serves?

  • Medically underserved population


Medically underserved area

  • shortage of health care services amongst people in a geographical are


Medically underserved population

  • shortage of health care services amongst sub-groups of people living in an area



  • lacking ability to advance health and wellness with greater need for others to help



  • not served equality due to stigma


What are the common health problems for migrant workers?

  • Dental disease, TB, chronic conditions, mental disorders (stress and anxiety), leukemia, iron deficiency anemia, stomach cancers, lack of prenatal care, higher infant mortality rates, STIs and HIV


Migrant workers- prevention

  • Primary- educate and reduce exposure to pesticides, teach accident prevention, prenatal care, mobilize preventative services
  • Secondary- create testing programs (TB), implement screenings
  • Tertiary- treat pesticide exposure, mobilize emergency services, promote rehabilitation, educate chronic conditions


What are the common health problems for veterans?

  • Mental health issues (PTSD, depression, anxiety), substance use, suicide, infectious diseases, exposure to hazards (chemicals), brain injuries, sexual trauma, hearing impairments, visual impairments


Veteran prevention

  • Assist with transition, community referrals, partnerships, advocate


What are the common health problems for Refugees?

  • Forced to leave home because of war or disaster


Refugee prevention

  • TANF, Medicaid, SSI, assess crisis, help with assistant programs


What are the common health problems for pregnant adolescents?

  • Limited education and job opportunities, risk for poverty and homelessness, school problems, increased violence, malnutrition, low birth weight and premature births


Pregnant adolescence prevention

  • Secondary- early detection, counseling and action plans, encouragement, prenatal care
  • Tertiary- peer groups, assistant programs


What are the common health problems for prison population?

  • Mental health disorders, rape and assault, chronic diseases


Prison population prevention

  • Health promotion and counseling, programs to reintegrate into society, follow up, reduce future violence


What are the common health problems for LGBTQQA?

  • Psychological distress, substance use, problems with adequate care, discrimination and stigma, increased risk for disability


LGBTQQA prevention

  • Surveys and monitoring, reduce bullying, increase health insurance coverage, reduce tobacco and drug use, increase primary health



Symptoms- hemorrhage, NVD, shock, fever, headache, muscle ache

PPE- contact and droplet isolation


Biological agents-plague

Symptoms- fever, chills, weakness, tender lymphnodes

PPE- droplet and contact



Symptoms- sudden fever, chills, headache, diarrhea, muscle aches, progressive weakness, septic infection and pneumonia



Symptoms- high fever, fatigue, rash begins on face and tongue but quickly speads to trunk, arms, legs, hands and feet, then turn to pus filled lescions

Onset- rash appears 2-4 days after fever

PPE- contact and airborne



Symptoms- double blurred vision, slurred speech, difficulty swallowing, progressive muscle weakness, difficulty breathing


inhalation anthrax

Symptoms- headache, fever, chills, muscle aches, chest discomfort, dyspnea, shock

PPE- airborne


Early 20th century leading cause of death

Respiratory diseases (TB)


Leading cause of death in children and second leading cause of death overall

Infectious diseases