NURS 439 Exam 3

Question 1

The nurse has been asked to join the team which will be conducting a community assessment. How will becoming involved with this group potentially affect the future of the community?

A) Identify the need for a community commission
B) Identify a method to improve the health of at-risk clients
C) Provide a means of grant funding for clinics
D) Provide a client base for at-risk neighborhoods

Answer 1

B

Question 2

The nurse conducts a community assessment in a town once supported by multiple paper factories. The factories closed 2 years ago and most of the population is now out of work. The school nurse notes that 68% of the students are behind schedule in their physicals and immunizations. Which recommendation should the nurse prioritize based
on this community assessment?

A) Initiation of neighborhood clinics at low or no cost to the community
B) Creation of a task force to assess the impact of low income on immunization
compliance
C) A formal petition to the local government to mandate immunizations by imposing
monetary fines on parents whose children are not immunized
D) A tax relief program for new companies wishing to settle in the community

Answer 2

A

Question 3

3. While completing a community assessment, the nurse notes that the computer companies in the community hire a disproportionate number of their employees from local suburban communities rather than the community in which the company is housed. Which individuals should the nurse choose to create an accurate community assessment?
   A) All of the company’s employees but count those living outside the community
   separately, as outliers
   B) Only the employees that live in the community, disregarding the others as
   statistically irrelevant
   C) All of the company’s employees and include those living outside the community as
   part of the aggregate
   D) Only the employees that live in the community in your initial assessment; then
   collect data on others as part of a separate assessment for the community in which they live

Answer 3

C

Question 4

Many in the community have developed cancer. The EPA has discovered a leak of biohazardous waste from a local factory that has leached into the water table. The area is decontaminated and cleaned. The community identifies the need for a local hospice for those with cancer who are dying. Area communities participate in the fund drive. Which type of community effort was employed to reach their goal?

A) Geopolitical community
B) Epidemiologic model
C) Community of solution
D) Developmental model

Answer 4

C

Question 5

At an international nurses’ conference, nurses from all around the world make contact. Which components of the various communities will most likely be represented at this conference? (Select all that apply.)
A) Vary significantly in composition
B) Have no shared interests and goals related to health and safety
C) Are challenged in their attempts to identify its members
D) Thought of as members of a global community
E) Do not need to assess their communities’ needs because they are obvious

Answer 5

ACD

Question 6

The nurse conducts a community assessment. The community is large and the members range from affluent executives to poor migrant workers. Which approach will provide the most accurate assessment for this nurse?
A) Use a questionnaire written on a fifth-grade reading level
B) Use multiple methods or perspectives
C) Interview a subpopulation of each group represented
D) Analyze census data

Answer 6

B

Question 7

The community health nurse assesses the neighborhood in which the clients live. When observing the physical environment, the nurse notes that most of the homes in the neighborhood are well kept and the children playing in the yards are wearing clean clothing. The children appear well nourished. The nurse determines that the neighborhood has little need for a well-child clinic. Which assessment is the nurse basing this decision on?
A) Subjective data
B) Objective data
C) Cognitive analysis
D) Valid data

Answer 7

A

Question 8

The community health nurse is responsible for the general health of the community on multiple levels. The nurse discovers an increase in the number of sick days used by children aged 7 to 11 years at the local elementary school in recent weeks. Research indicates that the families of asthmatic children tend to be less educated and less likely to comply with current treatment plans. Which step should the nurse employ to continue following the care plan using an epidemiologic approach?
A) Conduct a broad-based survey of all families with asthmatic children within several communities
B) Determine trends that interfere with family problem-solving techniques
C) Develop school-based education programs for both the children and their
caregivers
D) Submit a proposal to the town for neighborhood asthma clinics

Answer 8

C

Question 9

The school nurse notifies the community nurse that there have been five confirmed cases of pertussis in the sixth-grade classes. Which action should the community nurse prioritize at this time?
A) Recommend that the school be closed
B) Research the vaccine compliance in the school
C) Recommend that notes be sent home to the parents regarding a pertussis epidemic
D) Consult with the infection control healthcare provider at the local hospital

Answer 9

B

Question 10

There are 12 students with confirmed cases of the H1N1 flu in grades 6 to 8 at the local middle school in the community. The community nurse advises the caregivers of the ill children to keep the children home for a minimum of 5 to 7 days. Which should be the nurse’s next step?
A) Recommend closing the school for 6 weeks
B) Implement education in the school setting regarding respiratory and hand hygiene
C) Require each child in the school to undergo a physical evaluation by the school
nurse
D) Initiate a system of discipline in the school setting for improper hand washing

Answer 10

B

Question 11

The new community health nurse introduces herself to the local minister and attends various neighborhood meetings. The nurse learns about the ethics, values, and culture of the neighborhood. The community is vocal about the need for public safety and the care of the homeless, especially in the winter. Which is the best rationale for considering all of the influences in the neighborhood affecting their health and well-being?
A) The information can be used to obtain funds to create shelters for the homeless
B) A neighborhood watch may be created with police support
C) The information will help to effectively assess the community
D) It will help the nurse create a controlled clinical environment

Answer 11

C

Question 12

The community health nurse learns that there are statistically high levels of obesity and elevated cholesterol in the community. In addition, the community has a disproportionately high number of fast food restaurants, compared with surrounding communities. Which would be the most appropriate next step, based on these data?
A) Gather support in the community to ban fast foods
B) Gather further information regarding trans fats
C) Target education and support programs
D) Create local exercise programs

Answer 12

C

Question 13

The community health nurse explores pedestrian access to all healthcare facilities in the community. Which tool would be most helpful in performing this task?
A) Geographic information systems
B) Functional health pattern
C) Epidemiologic model
D) Developmental model

Answer 13

A

Question 14

The community nurse has been involved with the local community for several years. Which type of assessment is this nurse utilizing as she keeps data which outlines the basic behaviors of the entire community during this time period?
A) Asset-based assessment
B) Epidemiologic model
C) Collaborative model
D) Functional health pattern

Answer 14

D

Question 15

The nurse assesses a community undergoing change. Five years ago, a series of setbacks caused the local foundry to close. Through interviews, the nurse discovers that generations of families worked at the foundry. Research indicates that no other businesses have been able to provide work for those who no longer work at the foundry. Which actions will the nurse be able to complete after gathering this developmental data concerning the community’s history? (Select all that apply.)
A) Determine what resources were available before the foundry closed
B) Determine what variables may have enhanced or detracted from community
development
C) Develop an understanding of the community’s strengths and resources today
D) Understand cultural changes within the community over time
E) Identify where in the community health clinics are most needed

Answer 15

ABD

Question 16

The community is concerned about public safety and the care of their elders living at home. When the nurse assesses the community, the nurse finds there is potential to solve their problems within the community setting without outside resources. The plans to meet the community needs are accepted by the members of the community. Which action has been most successfully exhibited in this nurse’s assessment of this community?
A) Make the assessment process empowering to the community
B) Assess the community through interview and share findings in a timely manner
C) Involve the community when there is difficulty with the assessment
D) Create an environment of change within the community

Answer 16

A

Question 17

The local community has collaborated in a plan to create services and education to enhance their health and well-being. Which goal will most likely be achieved by this plan?
A) Create an environment that fosters change
B) Have an increased rate of success
C) Empower the community but diminish the rate of success
D) Shift the focus from dependency to empowerment

Answer 17

D

Question 18

The community health nurse works in a community recently devastated by a tornado. Many of the survivors are cared for in their homes. Care is needed for those who are ill, recovering, or in hospice. Which action should the nurse prioritize to provide the most holistic and effective care to the community?
A) Refer the clients to an outreach center
B) Consult with the hospice nurse and the social worker
C) Provide care according to the healthcare provider’s orders
D) Collaborate with other healthcare workers and the clients

Answer 18

D

Question 19

Following a hurricane, the disaster team chooses to use a collaborative model to assess the needs of the community. Each team member is given a community analysis and assigned the task to create a tentative plan of action. Why would the use of a collaborative model hamper the progress of the assessment and plan in a disaster? (Select all that apply.)
A) Individual decision-making creates bias
B) Assessment is time-consuming
C) Approach to problem solving is linear
D) Approaches must be pre-established
E) Collaboration is limited

Answer 19

BD

Question 20

The nurse is approached by the health department to investigate and assess the rise in developmental disabilities in an isolated section in the community. To begin the assessment, the nurse should gather objective data from which source?
A) Client interview—aggregate data
B) Internet—aggregate data
C) Internet—Wikipedia
D) Direct observation of the area

Answer 20

B

Question 21

The school nurse has reached out to the public health nurse for assistance in performing a community assessment. Which rationales are appropriate for performing community assessments in the school setting? (Select all that apply.)
A) To learn about an outbreak of lice
B) To assess effectiveness of children with type I diabetes managing insulin shots at school
C) To stage a student’s brain tumor
D) To assess students for food allergies
E) To provide education on preventing the spread of influenza

Answer 21

ABE

Question 22

The nurse discusses home care options with an 85-year-old client who recently fractured her humerus in a fall in her house. The client is recovering well now but says the experience has made her see that it is time for her to change her living arrangements. The client can still bathe herself and cook meals on occasion but says she would like to live where nursing care is available onsite and where communal dining and recreation options are offered. Which living arrangements should the nurse point out will best fit the situation?
A) Assisted living facility
B) Independent living in a senior living facility
C) Nursing home
D) Apartment located near a hospital

Answer 22

A

Question 23

A community care nurse at a healthcare agency assists in coordinating a plan for providing health services in the most cost-effective way possible to a large number of members living in the region. Which type of work is this nurse exhibiting?
A) Case management
B) Home healthcare
C) Interdisciplinary collaboration
D) Care management

Answer 23

D

Question 24

The case manager works with a client who has type 2 diabetes and heart disease. In this role, which actions would be most appropriate for the nurse to take in assisting the client to manage diseases? (Select all that apply.)
A) Provide weekly coaching sessions by telephone for blood glucose management
B) Supervise cardiac stress tests in the exercise room of the local hospital
C) Administer emergency insulin when the client arrives at the hospital in a diabetic
coma
D) Demonstrate use of a glucose meter to the client
E) Review heart-healthy and diabetic-friendly food options with the client and his
family.

Answer 24

ADE

Question 25

The case manager works with a 10-year-old girl who has asthma. Because the client's family has trouble affording inhalers, the case manager researches client assistance programs through which they could receive free medications. Which aspect of case management is this nurse portraying with this action? A) Care management B) Advocacy C) Disease management D) Interdisciplinary collaboration

Answer 25

B

Question 26

The case manager for a 12-year-old boy who is obese and prediabetic. To help the client develop a diet that will promote weight loss and control of his glucose level, the case manager decides to consult with a dietitian, who provides several current journal articles that present findings on various diets. Which aspect of case management is employed with this action? A) Care management B) Advocacy C) Disease management D) Interdisciplinary collaboration

Answer 26

D

Question 27

A student is considering becoming a home health nurse. In researching this type of nursing, the student finds that several key factors have played a part in the development of home healthcare as it is today. Which key factors has this student most likely discovered? (Select all that apply.) A) Increase in the number of hospitals nationwide B) Reduction in the incidence of chronic diseases C) Development of health insurance D) Rising costs in healthcare E) Increase in medical and nursing specialization

Answer 27

CDE

Question 28

The nurse has recently been appointed to a community-based advisory board of an agency that is interested in providing fiscally sound, high-quality care for clients they decide will be their service population. Any profit margin that is acquired is reinvested in the operations of the home healthcare service. Which type of agency is this? A) Private/voluntary B) Hospital based C) Proprietary D) Official

Answer 28

A

Question 29

The nurse recently took a position in a national chain of home healthcare agencies directed at caring for clients who are on home hemodialysis. The services provided are often paid for privately by families, and any profit margin is used to benefit the owner of the agency. Which type of agency is this? A) Private/voluntary B) Hospital based C) Proprietary D) Official

Answer 29

C

Question 30

A nurse is relocating to a new community and is trying to decide where to seek employment. The nurse has learned that there are several similar agencies providing care, some of which are nonprofit and others are for-profit. Which type of agency is the nurse considering for employment? A) Private/voluntary B) Hospital based C) Proprietary D) Official

Answer 30

B

Question 31

he nurse takes care of a dependent family member whose husband is in the military. Which government funding is most likely going to be used for home healthcare services for this client? A) Medicare B) Medicaid C) TRICARE D) Veterans Administration

Answer 31

C

Question 32

The nurse is researching the latest provisions governing home healthcare. Who should the nurse check with to discover if any new regulations have been passed to regulate the provisions of home healthcare? (Select all that apply.) A) Insurance companies B) Local government C) State government D) Federal government E) Veterans Administration

Answer 32

CD

Question 33

The nurse is assisting a client to apply for home healthcare. Which criteria must an individual meet to receive Medicare for home health services? (Select all that apply.) A) Home bound B) Specific plan of care C) Skilled healthcare needs D) Intermittent care needs E) Continuous 24-hour necessity for care

Answer 33

ABCD

Question 34

The nurse provides care covered by Medicare for a client over 2 hours during the day, 3 days during the week, for 60 days. Which type of care is the nurse providing? A) Interdisciplinary B) Skilled C) Intermittent D) Part time

Answer 34

C

Question 35

The client wants to know how long Medicare will pay for skilled needs. How long can the nurse continue to provide this care before she must seek a renewal if skilled needs continue to exist? A) 30 days B) 45 days C) 60 days D) 90 days

Answer 35

C

Question 36

The nurse reviews the official document called the Scope and Standards of Home Health Nursing Practice. Which factors will the nurse anticipate being included in the standards of care? (Select all that apply.) A) Assessment by collecting data about home care clients B) Implementation of nurse-centered actions in collaboration with healthcare providers C) Diagnosis through the analysis of data D) Outcome identification that helps identify nurse-sensitive measures E) Planning nurse-sensitive interventions directed at the identified outcomes

Answer 36

ACDE

Question 37

The clinic is preparing a program which will provide telehealth to the clinics. What services will most likely be available after telehealth is implemented? (Select all that apply.) A) Chronic care B) Home telenursing C) Electronic referrals to specialists in expert health facilities D) Transmission of healthcare information to people in the same geographical area E) Specialty consultations

Answer 37

BC

Question 38

A nurse graduate is seeking a position of a faith community nurse. Which interventions will this nurse most likely be performing in this position? (Select all that apply.) A) Teaching a class to faith community members on managing high blood pressure B) Providing counsel on preventing upper respiratory illness to member C) Referring a faith community member to a nutritionist for dietary counsel D) Assisting an obstetrician in the birth of a faith community member's child E) Administering vaccinations at a local health clinic

Answer 38

ABC

Question 39

The home care agency has just received a client referral from a healthcare provider and assigned the case. How soon should the client expect to be contacted by the nurse for the initial visit? A) 12 hours B) 24 hours C) 36 hours D) 48 hours

Answer 39

B

Question 40

The community health nurse can receive a referral to a home health agency at any time. Which phases will this nurse most likely utilize in this process? (Select all that apply.) A) Plan personal safety of visit B) Initiating a visit C) Preparation D) Actual visit E) Termination of the visit

Answer 40

BCDE

Question 41

The home health nurse has to ensure that a safety plan is in place to address falls. Based on statistics that 55% of fall-related injuries occur inside the home, which areas should the nurse prioritize for safety concerns? A) Living room and hallway B) Kitchen and bathroom C) Hallway and bedroom D) Living room and bedroom

Answer 41

D

Question 42

The nurse works with 68-year-old client who is having great difficulty managing his blood glucose level. The nurse finds that the client is not following the diet that he had agreed to follow and is eating portions that are far too large. He apologizes and explains that he is grieving the loss of his wife, who died 2 weeks ago. The nurse shares condolences with him on his loss and explains that it is perfectly understandable to have trouble following a new diet while grieving. In this scenario, the nurse is utilizing which principal approach in motivational interviewing? A) Expressing empathy B) Supporting self-efficacy C) Rolling with resistance D) Finding a discrepancy

Answer 42

A

Question 43

The nurse is meeting with a parent who is learning how to manage the care of the 8-year-old child who has been diagnosed with muscular dystrophy. Which action by the nurse will best portray the parent's ability to provide the best care for this family? A) Follow the same guidelines which have been appropriate in the past B) Encourage the parent to continue the appropriate care C) Ensure the parent is aware of what mistakes he or she is making D) Conference with the supervisor after each visit

Answer 43

B

Question 44

The community health nurse meets with families of all types. With each family, the nurse takes the time to discover each member's place and function within the family structure. Which concept is the nurse utilizing with this action? A) Determining how well the family functions B) Predicting the type of family structure C) Evaluating how the family has progressed through the various stages D) Exploring how the family is influenced by the community

Answer 44

B

Question 45

The community health nurse has noted an increase in delay of developmental tasks within younger children in the community. Which factor would the nurse most likely anticipate to be contributing to this delay? A) Lack of parenting skills B) Increase in divorces among the families C) More children being born outside marriage D) Lack of adequate preschools and daycare facilities

Answer 45

B

Question 46

The community health nurse has limited time for family assessments because of demanding caseloads or staffing shortages. Which activity should the nurse prioritize that will acknowledge the family's strengths? A) Ask family members if they see an area that could be changed B) Allow everyone present to voice observations, insights, or concerns before offering how they could change the situation C) Share any genograms and ecomaps that illustrate relationships with family members D) Collaborate with the family to set priorities, plan care, and evaluate goals

Answer 46

C

Question 47

The community health nurse is reviewing guidelines for the 15-minute assessment to keep the interview focused and family centered. Which questions and considerations for the family assessment can be asked for the question “Who is part of the family?” (Select all that apply.) A) “What is the nature of individuals' connections to one another?” B) ”Does the individual live alone or have no living family members?” C) “What influences from the family of origin are present in daily life?” D) “Do members speak independently or is an interpreter present?” E) “What observations can be made about the interpersonal dynamics between members?”

Answer 47

ABC

Question 48

The community health nurse is responsible for meeting with several young mothers and their infants to ensure they are remaining healthy. Which goal of the Nurse-Family Partnership Program is the nurse fulfilling with this action? A) Provide education for the parent which can be used to find employment B) Ensure there is not a substance or alcohol use disorder by the parents C) Improve child health and development by helping parents D) Ensure the child will be ready for preschool

Answer 48

C

Question 49

The nurse has been provided with information concerning a new family and notes they consist of a nuclear family. Which family structure will the nurse anticipate finding when arriving for the first visit? A) First-degree relatives who live together B) First- and second-degree relatives who live together C) First- and second-degree relatives who live in the same neighborhood D) Individuals who are not blood relatives but share a common locale of origin or culture

Answer 49

A

Question 50

The nurse has noted an increase in the number of blended families in the community. Which reasons might the nurse attribute to this increase? (Select all that apply.) A) People who remarry following a divorce B) People who remain single after being widowed C) Recognized gay and lesbian relationships D) Married couples having children E) Couples cohabiting with children from prior relationships

Answer 50

ACE

Question 51

The community health nurse is using a genogram to aid in the family assessment. What aspect of family connections and relationships should the nurse include in the genogram? A) Influence of other systems on families B) Influence of groups on families C) Family relationships and their vital connections D) Relationships across two or more generations

Answer 51

D

Question 52

The community health nurse is meeting with a client and caregiver, the eldest son. The nurse notes the son is spending approximately 15 hours a week at the parent's home to take care of various tasks. The son lives about 12 blocks away and has two older adolescent children. Which action should the nurse prioritize in this situation? A) Assist the client with locating a home health aide B) Monitor the son for signs of stress and frustration C) Suggest the mother move to an assisted-living care facility D) Ensure the client remains safe in the home

Answer 52

B

Question 53

The nurse is conducting a 15-minute interview with a family. Which actions should the nurse prioritize during this interview? (Select all that apply.) A) Have family members share their family history going back several generations B) Listen actively as the family members speak C) Construct an ecomap of the family D) Ask family members to prioritize their needs and to express their expectations regarding nursing care E) Point out the strong relationships they enjoy in their family and explaining how they will help them cope with the health issue of concern

Answer 53

BCDE

Question 54

In a 15-minute family interview, after asking a question, the nurse pauses and remains silent while the grandmother, whose English is limited, replies to the question. The nurse makes eye contact with her and nods while she talks. When she is finished, the nurse asks a few follow-up questions. Which principle is the nurse utilizing in this session? A) Appropriate manners B) Therapeutic conversation C) Therapeutic questions D) Acknowledgment of family strengths

Answer 54

B

Question 55

The nurse conducts a functional assessment on a family. Which actions by the family would exemplify health routines? (Select all that apply.) A) Siblings all brushing their teeth together before bed every night B) Parents taking their 9-month-old child to the health clinic when he has a fever C) Entering a 5K run/walk charity event each year as a family D) Taking a walk together around the neighborhood after dinner each evening E) The mother having a mammogram performed every year

Answer 55

AD

Question 56

The nurse provides care to several clients who live in a low-income apartment complex. When utilizing the family structural-functional theory, which factors would the nurse most likely anticipate witnessing in these family units? (Select all that apply) A) Children growing and developing into responsible adults B) The individual members constantly interacting with a suprasystem C) Individuals representing each of the stages of development D) Adding new family members by adoption E) Families attempting to provide the basic needs

Answer 56

AE

Question 57

The community health nurse spends time appraising each case to determine if perhaps there may be a better or different method to use with each family to ensure top quality care. Which action is the nurse prioritizing? A) Ensuring the nursing actions are based on the company's approved policies B) Practicing self-reflection to ensure his or her actions are most appropriate C) Ensuring documentation is up-to-date D) Reporting any concerns to the family's healthcare provider

Answer 57

B

Question 58

A group of public health nurses are providing maternal care to various members of the community. Which actions by the nurses have a positive effect on the families and should improve the outcomes of these visits? (Select all that apply.) A) Remain friendly and approachable B) Encourage mother to lead the visit C) Dictate what the mother should be doing D) Ensure each visit follows the prescribed standards E) Remain flexible and let the families' needs dictate the visit

Answer 58

ABE

Question 59

The home health nurse is working with an older adult client and the family caregiver. Which resources can the nurse point out, which are available to assist this family in the care of this client? (Select all that apply.) A) Adult day care program B) Grocery delivery services C) Caregiver support group D) Support animal E) Companions

Answer 59

ABCE

Question 60

The community health nurse is meeting with an older adult client whose adult grandchild has recently moved in to help provide daily care. Which actions should the nurse prioritize with this grandchild to help adjust to providing care? (Select all that apply.) A) Suggest ways to improve the safety in the home B) Congratulate the grandchild when a new skill is learned C) Demonstrate better methods for completing basic care as needed D) Employ therapeutic communication with the grandchild E) Offer to teach the grandchild the skills needed for becoming a certified nursing assistant

Answer 60

ABCD

Question 61

The community health nurse strives to respect all family structures when providing care and interacting with family members. Which concept should the nurse conclude will be a constant factor in the family structure? (Select all that apply.) A) It is always changing in structure B) There will be five basic stages all families progress through C) Economic factors can affect the structure of the family D) Developing intergenerational relationships is a focus of a later stage E) The basic stages are predictable within the family structure

Answer 61

ACD

Question 62

The public health nurse works closely with the school nurse to locate at-risk pregnant adolescents to include them in the Nurse–Family Partnership Program. The nurse points out that which benefit can result from being included in the program? A) Better prepared for the next pregnancy B) Monitor intrafamily conflict which can occur C) Improve relationship with father of infant D) Improved pregnancy outcomes

Answer 62

D

Question 63

The nurse assesses a 77-year-old woman who has been caring for her husband who has Alzheimer's disease in their home for the past 8 years. The client complains of exhaustion and depression. Which stressors should the nurse most suspect as the cause of this client's symptoms? A) Marital strain B) Caregiver burden C) Spillover D) Interfamily strain

Answer 63

B

Question 64

The nurse works with a female client who recently developed an infection of Staphylococcus aureus while in the hospital. The nurse would determine that S. aureus is which component in the chain of infection? A) Host B) Environmental reservoir C) Agent D) Portal

Answer 64

C

Question 65

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.) A) Pathogenic microorganism B) Portal of exit from the infected person C) Means of transmission D) Portal of entry to a susceptible host E) Organism that harbors the infectious agent

Answer 65

BCD

Question 66

The student nurses have completed a session exploring infections and biologic agents. The instructor would determine the session is successful when the student nurses correctly choose which as a biologic agent in the infectious process? (Select all that apply.) A) Fungi B) Fomites C) Bacteria D) Viruses E) Helminths

Answer 66

ACDE

Question 67

In infectious disease epidemiology, just the presence of an infectious agent is not sufficient to produce an infectious disease. Which host factors determine whether a person is at risk for an infection or an infectious disease? (Select all that apply.) A) Age B) Sex C) Occupation D) Physical and emotional health E) Immune status

Answer 67

ABDE

Question 68

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? A) Carrier time B) Colonization C) Incubation period D) Latent period

Answer 68

C

Question 69

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? A) Airborne B) Droplet C) Direct contact D) Indirect contact

Answer 69

A

Question 70

The student nurse is creating a poster for a class project which will illustrate the chain of infection. Which item should the student nurse point out as a vehicle in this chain? A) Animals B) Insects C) Reptiles D) Water

Answer 70

D

Question 71

A nurse is preparing to travel to Asia to assist with care of clients suffering from chloroquine-resistant malaria. Which type of disease occurrence is this nurse becoming involved with if this disease also occurs in most of Africa, the Middle East, and the South Pacific islands? A) Endemic B) Epidemic C) Pandemic D) Outbreak

Answer 71

A

Question 72

9. A nurse is preparing a description of an epidemiologic problem. Which factor should the nurse be prepared to point out will occur with a propagated outbreak? A) Same person or vehicle as the reservoir or means of transmission B) Infection transmitted from person to person over a short period of time C) Generation of a secondary infection with the usual incubation period for the infection D) Generation of a tertiary infection following exposure to a primary case

Answer 72

C

Question 73

10. 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? A) Local B) State C) Federal D) International

Answer 73

B

Question 74

11. The community health clinic is noting a rise in the number of individuals with H1N1 virus and is concerned that an epidemic is occurring. Which agency would be most appropriate to become involved with this situation? A) Department of Health and Human Services B) Centers for Disease Control and Prevention C) World Health Organization D) Department of Defense

Answer 74

D

Question 75

12. A client arrives on the unit, diagnosed with norovirus infection from eating shellfish. The client has been vomiting repeatedly and is now severely dehydrated. Which interventions are likely to be performed for this client? (Select all that apply.) A) Starting an intravenous line for fluid and electrolyte replacement B) Encouraging the client and the client's family to practice good handwashing C) Immediately disinfecting all potentially contaminated objects and surfaces D) Isolating the client until 12 hours after the client has been symptom free E) Administering a vaccination

Answer 75

ABC

Question 76

13. A client presents with severe diarrhea. The client tells the nurse that she went to a chicken roast at church the previous weekend. The nurse suspects a foodborne illness. Which cause of bacterial foodborne illness should the nurse most suspect in this case? A) Campylobacter B) Listeria monocytogenes C) Salmonella D) Escherichia coli O157:H7

Answer 76

A

Question 77

14. A client arrives at the clinic reporting diarrhea and flu-like symptoms. On questioning, the client tells the nurse about a family gathering she attended recently where she had some smoked seafood. Which foodborne illness should the nurse most suspect in this client? A) Campylobacter B) Listeria monocytogenes C) Salmonella D) Escherichia coli O157:H7

Answer 77

B

Question 78

15. The client reports diarrhea, fever, and abdominal cramps 24 hours following exposure to raw eggs while cooking. Which recipe should the nurse recommend for the client to prepare at home to help with rehydration that is efficient and effective? A) One level teaspoon of salt and eight level teaspoons of sugar into one quart or liter of clean drinking water B) Eight level teaspoons of salt and one level teaspoon of sugar into one quart or liter of clean drinking water C) One level teaspoon of salt and one level teaspoon of sugar into one quart or liter of clean drinking water D) Eight level teaspoons of salt and eight level teaspoons of sugar into one quart or liter of clean drinking water

Answer 78

A

Question 79

16. A client reports symptoms of severe abdominal cramps, bloody diarrhea, and vomiting after eating commercially packaged salad. The nurse suspects Escherichia coli O157:H7. The client asks about the average time of resolution of these symptoms. What time frame should the nurse point out? A) 3 to 5 days B) 5 to 7 days C) 7 to 10 days D) 12 to 14 days

Answer 79

C

Question 80

17. The public health department nurses are concerned the community is experiencing an outbreak of Cryptosporidium. Which criteria must be met to define this outbreak as a water-associated disease outbreak? A) Two or more people with laboratory-confirmed primary amebic meningoencephalitis B) Two or more cases of chemical poisoning if water quality data indicate contamination by the chemical C) Two or more people having experienced a similar illness after exposure to water D) Epidemiologic evidence implicating drinking water as the probable source of the illness

Answer 80

C

Question 81

18. 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.) A) Human papillomavirus B) Herpes simplex C) Chlamydia D) Gonorrhea E) Syphilis

Answer 81

CDE

Question 82

19. 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.) A) Having multiple sexual partners B) Using a condom during sex C) Having no other STIs D) Having a sexual partner who has had an STI E) Receiving a blood transfusion

Answer 82

AD

Question 83

20. A client wants to know the best way to avoid STIs. Which actions should the nurse point out will help decrease the risk of becoming infected with a STI? A) Abstinence B) Monogamous relationship with an infected partner C) Washing the genitals after sex D) Use of latex condoms

Answer 83

A

Question 84

21. A client presents with several ulcerative sores on his penis that are firm, round, and painless. He also has rough, reddish brown spots on his palms and the bottoms of his feet. He acknowledges that he is sexually active with multiple partners and is inconsistent in his use of a condom. Which sexually transmitted infection should the nurse most suspect in this client? A) Gonorrhea B) Chlamydia C) Syphilis D) Human papillomavirus

Answer 84

C

Question 85

1. The clinic clients respond negatively to the need for a yearly flu shot. They ask why the medical communities don't just create one shot that will last for several years. Which is the best response from the nurse? A) Genetic changes in the bacteria that cause the flu require a rotating course of antibiotics B) Genetic changes make the flu virus resistant to the flu shot from year to year C) There is more than one strain of the flu virus and you must be protected from all of them D) The shots last only for 3 to 6 months and must be renewed on a yearly basis

Answer 85

B

Question 86

2. Nursing students in an enclosed classroom begin to become ill with a gastrointestinal illness. The public health department identifies this occurrence as an emerging epidemic and isolates the population that is ill. Which factor will become apparent among those who survive this disease? A) Recover with adaptive organism reintroduction into the environment B) Develop improved defenses against reinfection C) Become hosts to the organism, which is symbiotic in nature D) Become carriers of the infection, ultimately leading to an epidemic

Answer 86

B

Question 87

3. Three years after exposure to a virulent form of the flu, a population faces the same flu strain. The public health department determines that there are members of the population who have not been exposed to the flu strain. Which will the public health department predict will occur next? A) The unexposed population will contract the illness B) The unexposed population is not likely to contract the illness C) The unexposed population will contract the illness and reinfect others D) The flu will reach epidemic proportions and both populations will become ill

Answer 87

B

Question 88

4. The public health department is conducting research in an area where medical resources are limited. Which environmental factors should the department most consider when evaluating the likelihood of a disease outbreak? (Select all that apply.) A) Temperature B) Geology C) Precipitation D) Humidity E) Amount of daylight

Answer 88

ACD

Question 89

5. Tent communities are constructed in a rural community by the American Red Cross after a disaster. Because of overcrowding, surrounding states create accommodations for the displaced and homeless. The survivors are accommodated in the cities of four Southern states. Which factors will most likely increase the possibility of disease emergence in these cities? (Select all that apply.) A) Poor hygiene B) Decreased socialization C) Poor sanitation D) Decreased viral load E) Increased violence

Answer 89

AC

Question 90

6. An 80-year-old client is being treated for chronic urinary tract infections with multiple antibiotics in the past 6 months. The healthcare provider orders a urine culture. The results of the urine culture reveals Staphylococcus aureus >100,000 colonies and demonstrated resistance to sulfamethoxazole and trimethoprim, penicillin, methicillin, and erythromycin. The client is diagnosed with methicillin-resistant S. aureus (MRSA) on the basis of the findings of her urine test. The nurse would predict this is the result of which microbial action? A) Rejection B) Assimilation C) Adaptation D) Stagnation

Answer 90

C

Question 91

7. The community health nurse works in a region where severe acute respiratory syndrome (SARS) has just been reintroduced into the environment. Which measure is imperative for the nurse to take to prevent spread of the disease? A) Prophylactic antibiotics B) Enhanced infection control measures C) Use of alcohol cleansers D) Report of clusters to the CDC

Answer 91

B

Question 92

8. There is an outbreak of Middle East respiratory syndrome coronavirus (MERS-CoV) in the community. The nurse is responsible for the dissemination of the education plan adopted by the public health department. Which key components of the plan should the nurse include? (Select all that apply.) A) Quarantining infected families in their homes B) Respiratory hygiene C) Hand hygiene D) Droplet precautions for visitors in contact with affected clients E) Contact precautions for all cases

Answer 92

BCD

Question 93

9. International health experts have determined that the avian flu is the virus most likely to cause the next pandemic. Which factor will most likely improve its transmissibility to the public? A) Increase in consumption of chicken B) Increase in autoimmune disease incidence C) Shift to zoonotic transmission D) Antigenic shift

Answer 93

D

Question 94

10. The nurse is responsible for the construction of an isolation unit during an H5N1 outbreak. The unit is designated for only those clients with a confirmed diagnosis of H5N1. Which unit should the nurse prioritize to fulfill this need? A) 12-room unit with negative air pressure units B) 15-room unit with a portable supply of PPEs C) 8-room unit with four code carts D) 12-room unit with four to six air changes per hour

Answer 94

A

Question 95

11. Ten documented cases of West Nile virus (WNV) have occurred recently in the community. Which points should the nurse prioritize when educating the community about this outbreak? (Select all that apply.) A) Avoid contact with birds B) Avoid contact with mosquitoes C) Avoid those with a confirmed diagnosis D) Eliminate standing water E) Avoid exposure to the environment during the daylight hours

Answer 95

BD

Question 96

12. The client is diagnosed with Lyme disease. He states that he is not a hiker and does not remember being bitten by a tick. Which is the best response from the nurse? A) “You must have been bitten by a tick and didn't recognize it as such.” B) “Did you spend time in a brushy or grassy area in the last 90 days?” C) “Conduct a full-body tick check once a week during the summer.” D) “A history of a tick bite is not required.”

Answer 96

D

Question 97

13. The nurse admits a client to the hospital with the diagnosis of Escherichia coli O157:H7. The client is dehydrated and febrile. During the history phase of the admission, the client states that he doesn't know how he could have gotten sick at the local county fair---the hamburger he bought was well done. Which factor would the nurse predict was most responsible for the transmission of the bacteria? A) Use of a gas barbecue B) Improper cleaning of the cooking tools C) Use of wood instead of charcoal to cook the meat D) Animals roaming in the fair grounds

Answer 97

D

Question 98

14. Four employees at a local restaurant have positive purified protein derivative (PPD) tuberculin skin tests and have been diagnosed with latent tuberculosis (TB) infection. Which employee would the nurse predict to be at the greatest risk for contracting active TB disease? A) Works two jobs B) Vacations in South America C) Cooks the food D) Takes immunosuppressants

Answer 98

D

Question 99

15. The nurse assesses a client in the local neighborhood clinic. He exhibits signs and symptoms of tuberculosis (TB) yet has a negative tuberculin skin test result. Which factor will lead the nurse to predict the healthcare provider will order additional tests? A) Visited Central America recently B) Is recovering from jet lag C) Is HIV positive D) Works in a factory setting

Answer 99

C

Question 100

16. The nurse is responsible for the directly observed therapy (DOT) program in the community. Which represent the best methods to ensure compliance with clients' drug regimens? (Select all that apply.) A) Social service support B) Housing assistance C) Hospitalization D) Isolation until treatment is complete E) Treatment enablers

Answer 100

ABE

Question 101

As the occupational health nurse in factory that finds that five employees out of 30 have positive tuberculin skin test results. One employee on the 3-to-11 shift has been diagnosed with active tuberculosis (TB). She asks if this means that the whole factory has been exposed. Which factor would the nurse point out would most likely increase the possibility of infecting others? (Select all that apply.) A) Concentration of infectious droplet nuclei in the air B) Duration of exposure to the infected person C) Proximity to the infected person D) The use of safety gloves by employees E) Physical exertion required in the job

Answer 101

ABC

Question 102

18. 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? A) 4-mm induration B) 2-mm induration C) 6-mm induration D) 3-mm induration

Answer 102

C

Question 103

19. Each employee in a small community hospital is informed that he or she needs a tuberculin skin test and of the date that the test is due. The kitchen employees tell the nurse that they don't need the test and never had to have it before. Which is the best response by the nurse? A) The test does not need to be given if you do not have client contact. B) Tuberculosis guidelines require testing of an entire healthcare setting. C) The test will not hurt; we won't fire you if you test positive. D) The tuberculosis guidelines state kitchen workers are at risk.

Answer 103

B

Question 104

20. A nurse is studying the Institute of Medicine's convergence model to learn how four types of interrelated and overlapping microbe--human interactions can lead to emerging/reemerging infectious diseases. Which four types of interactions will the nurse be to point out as essential after learning about this model? (Select all that apply.) A) Genetic and biologic B) Physical/environmental C) Spiritual and psychological D) Ecologic E) Social, political, and economic

Answer 104

ABDE

Question 105

21. The nurse prepares to enter the room of a client with suspected Ebola virus disease (EVD). Which PPE items should the nurse ensure is in place before entering the room? (Select all that apply.) A) Fluid-resistant gown B) Gloves C) Respirator D) Mask E) Goggles

Answer 105

ABDE