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
- Early and middle childhood
- Global health
- Health care associated infections
- Health related quality of life
- LGBTQQA health
- Older adults
- 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?
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
- 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
- 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
- 3D reconstruction of the environment
- 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
- 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?
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)
- Small pox
- 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
- Respiratory tract
- 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
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.)
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)
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
- 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
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
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
- Homeless and poverty
- Mental health
- Substance use
- Foster children
- Frail elders
- 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
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
- Assist with transition, community referrals, partnerships, advocate
What are the common health problems for Refugees?
- Forced to leave home because of war or disaster
- 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
- 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
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
Symptoms- headache, fever, chills, muscle aches, chest discomfort, dyspnea, shock
Early 20th century leading cause of death
Respiratory diseases (TB)
Leading cause of death in children and second leading cause of death overall