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Community Exam 3

front 1

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.)

back 1

  • 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

front 2

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?

back 2

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

front 3

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

population?

back 3

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

front 4

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?

back 4

  • Primary

front 5

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.

back 5

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

front 6

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?

back 6

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

front 7

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.)

back 7

  • 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)

front 8

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?

back 8

  • Relapse prevention model

front 9

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”?

back 9

  • 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

front 10

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?

back 10

  • Epidemiologic triad

front 11

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?

back 11

  • Web of causation

front 12

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?

back 12

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

front 13

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.

back 13

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

front 14

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?

back 14

  • Wheel of causation

front 15

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?

back 15

  • Outbreak investigation

front 16

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?

back 16

  • Prevalence rate

front 17

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

explanation should the student conclude will best define sensitivity?

back 17

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

front 18

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?

back 18

  • Incidence rate

front 19

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

time of onset of influenza

back 19

  • Epidemiologic curve

front 20

Spatial map

back 20

  • 3D reconstruction of the environment

front 21

Incidence rate

back 21

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

front 22

Sensitivity

back 22

  • True positive results/ true positive+ false positive X100

front 23

Prevalence

back 23

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

front 24

Attack rate

back 24

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

front 25

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?

back 25

Agent

front 26

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.)

back 26

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

front 27

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?

back 27

Incubation period

front 28

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

room?

back 28

  • Airborne transmission

front 29

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

diseases?

back 29

State

front 30

Chain of infection

back 30

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

front 31

Defense mechanisms (kinds of immunity) Active

back 31

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

front 32

Defense mechanisms (kinds of immunity) Passive

back 32

  • given immunity, fast acting but doesn’t last

front 33

Defense mechanisms (kinds of immunity)Acquired

back 33

- defense built with exposure

front 34

Defense mechanisms (kinds of immunity) Natural

back 34

develops on own

front 35

Defense mechanisms (kinds of immunity) Herd

back 35

  • exposure unlikely

front 36

SC reportable diseases (immediate list)

back 36

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

front 37

Endemic

back 37

  • A characteristic of a particular population, environment or region

front 38

Epidemic

back 38

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

front 39

Outbreak

back 39

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

front 40

Pandemic

back 40

  • The prevalence of disease over a whole country or world

front 41

Modes of transmission- Airborne

back 41

  • travel through air in small droplets

front 42

Modes of transmission- Droplet

back 42

  • travel < 3 feet through air in small particles

front 43

Modes of transmission- direct contact

back 43

  • direct body surfaces touching

front 44

Modes of transmission- indirect contact

back 44

involves an inanimate object or vector

front 45

Vector

back 45

transmission occurs through carrier

front 46

Portal of entry and exit

back 46

  • Skin
  • Respiratory tract
  • Conjunctiva
  • Genital tract

front 47

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?

back 47

6mm induration

front 48

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.)

back 48

  • Gonorrhea
  • Syphilis
  • Chlamydia
  • Trichomonas

front 49

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.)

back 49

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

front 50

What are the clinical manifestations of TB?

back 50

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

front 51

What are the clinical manifestations of Syphilis?

back 51

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

front 52

What are the clinical manifestations of Chlamydia?

back 52

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

front 53

What are the clinical manifestations of Gonorrhea?

back 53

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

front 54

What are the clinical manifestations of HPV?

back 54

warts

front 55

What are the clinical manifestations of HSV?

back 55

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

front 56

Identify the kinds of abuse (select all that apply)

back 56

  • Emotional
  • Physical
  • Sexual
  • Financial
  • Neglect

front 57

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

back 57

  • 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

front 58

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?

back 58

  • 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

front 59

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

back 59

  • 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

front 60

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.)

back 60

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

front 61

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?

back 61

  • Providing the number to an abuse hotline

front 62

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.)

back 62

  • 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

front 63

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

back 63

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

front 64

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.)

back 64

  • Major depression
  • OCD
  • Anxiety
  • Bipolar

front 65

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?

back 65

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

front 66

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.)

back 66

  • Opioid solution treatment
  • Syringe exchange program

front 67

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

client?

back 67

  • Naloxone

front 68

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

apply.)

back 68

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

front 69

Dependence

back 69

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

front 70

Denial

back 70

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

front 71

Comorbidities and associated or coexisting health problems

back 71

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

front 72

General physical appearance of substance use

back 72

  • 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

front 73

Strategies to reduce substance disorders

back 73

  • 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

front 74

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

back 74

  • Drug possession and trafficking

front 75

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?

back 75

  • Medically underserved population

front 76

Medically underserved area

back 76

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

front 77

Medically underserved population

back 77

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

front 78

Vulnerability-

back 78

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

front 79

Underserved-

back 79

  • not served equality due to stigma

front 80

What are the common health problems for migrant workers?

back 80

  • 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

front 81

Migrant workers- prevention

back 81

  • 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

front 82

What are the common health problems for veterans?

back 82

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

front 83

Veteran prevention

back 83

  • Assist with transition, community referrals, partnerships, advocate

front 84

What are the common health problems for Refugees?

back 84

  • Forced to leave home because of war or disaster

front 85

Refugee prevention

back 85

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

front 86

What are the common health problems for pregnant adolescents?

back 86

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

front 87

Pregnant adolescence prevention

back 87

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

front 88

What are the common health problems for prison population?

back 88

  • Mental health disorders, rape and assault, chronic diseases

front 89

Prison population prevention

back 89

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

front 90

What are the common health problems for LGBTQQA?

back 90

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

front 91

LGBTQQA prevention

back 91

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

front 92

Ebola

back 92

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

PPE- contact and droplet isolation

front 93

Biological agents-plague

back 93

Symptoms- fever, chills, weakness, tender lymphnodes

PPE- droplet and contact

front 94

Tularemia

back 94

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

front 95

Smallpox

back 95

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

front 96

Botulism

back 96

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

front 97

inhalation anthrax

back 97

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

PPE- airborne

front 98

Early 20th century leading cause of death

back 98

Respiratory diseases (TB)

front 99

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

back 99

Infectious diseases