Ati Community Health

Ati Community Health

A nurse who is facilitating a support group in a community center notices that one member of the group expresses anger repeatedly. Which of the following strategies should the nurse use to facilitate the group process with this member.
Remind the group that everyone should have a chance to participate.
Divide the group into pairs and give each pair a topic for discussion.
Give the member extra time to compose her thought before expressing them.
Focus more on the group members who have a positive outlook.

Focus more on the group members who have a positive outlook.

This is a strategy that is often effective with group members who demonstrate angry, hostel, or negative behavior. The nurse should also speak to the group member in private to try to uncover the source of her ongoing anger.

Which of the following activities done by a nurse is considered public health nursing?
Reviewing morbidity and mortality data for the community.
Caring for new mothers and infants.
Reviewing the medications prescribed for an older adult couple.

Reviewing morbidity and mortality data for the community.

Reviewing morbidity and mortality data for the community is a key component of public health nursing, which focuses on the health care of populations and communities.

A nurse working for a non-profit organization with limited resources is asked to develop an education program that will benefit a supporting agency’s employees. The nurse was planning another program to benefit more people in the community. Which of the following is an ethical tenet the nurse should follow in deciding which program to implement.
Allow members of the community to vice their shared ideas.
Develop public policy in concert with the interest and needs of the community.
Give precedence to community support provided by public servants over entrepreneurs.
Place the needs of the community above those of special interest groups.

Place the needs of the community above those of special interest groups.

This statement upholds the ethical tenet for policy development: to serve citizens, not customers. While the nurse may feel pressure to comply with the agency’s request due to its financial or material support, the nurse must use available resources to meet the needs of the greatest number of citizens first.

A community health nurse is providing care to a client who has stopped taking his prescribed blood pressure medication. Which of the following actions should the nurse take first to promote adherence to treatment.
Inform the provider of the client’s decision.
Determine the client’s reason for discontinuing the medication.
Discuss the consequences of discontinuing the medication with the client.

Determine the client’s reason for discontinuing the medication.

Using the nursing process, the first step the nurse should take is to assess the client. By determining the client’s reason for discontinuing the medication, the nurse can promote adherence to treatment.

A clinic nurse is caring for a client who reports taking ginkgo biloba for several weeks since seeing a naturapathic healer. The nurse should instruct the client that ginkgo biloba may alter the effects of which of the following medications?

Warfarin
Metoprolol
Digoxin

Warfarin

Ginkgo biloba can hinder coagulation; therefore, the nurse should instruct the client that ginkgo biloba may alter the effects of warfarin.

A community health nurse is preparing a community presentation about the epidemiological triangle. Which of the following elements is a host.?
Salmonella on a wood cutting board.
A raccoon with rabies
A farm containing pesticides.
a factory with high noise levels.

A raccoon with rabies.

The epidemiological triangle is a model of the agent-host environment interaction that causes disease. The host is a living species, either human or animal, that is capable of being infected ore affected by an agent.

A community health nurse is providing anticipatory guidance to a group of adolescents. To reduce premature deaths in this age group, which of the following topics would be most important to discuss.

Underage smoking
Safe sex practices
Safety belt use.

Safety belt use.

Automobile crashes are currently the leading cause of death among adolescents; therefore, this topic is important to discuss when providing anticipatory guidance to reduce premature deaths in the age group.

A newly licensed nurse in a public health agency is assigned to assist with the task force that is responsible for the core function of assessment. Which of the following is a task that the nurse could be assigned that would be consistent with the focus of the task force?

Investigating local health hazards.
updating local policies to support community health efforts.
Collaborating with community agencies to improve availability of services.

Investigating local health hazards

Investigating health hazards of the local community is a component of the public health core function of assessment.

A community health nurse is visiting a family that has newborn twins and two school-age children. The parents tell the nurse they are emotionally and financially overwhelmed. Which of the following referrals are appropriate? (Select all that apply).
Postpartum support group
Women, Infant, and Children (WIC) program
Child Protective Service (CPS)
Medicare Part B
Free school lunch program.
Postpartum support group
Women, Infant, and Children (WIC) program
Free school lunch program.
A public health nurse is working in a community that has a population of 24.096. There are 2.096 existing cases of heart disease within the population. The nurse can determine which of the following from this information.
Mortality rate
Attack rate
Prevalence proportion
Incidence proportion.

Prevalence proportion

The prevalence proportion can be calculated given how many people were affected at a given time and the total population.

A newly licensed nurse is performing a community assessment. While collecting secondary data at the library, the nurse is approached by a community member who is concerned about air pollution. Which of the following statements by the nurse indicates a need for further education regarding confidentiality?

“Records indicate that several pesticides have been entering the local streams causing significant water pollution.”
According to the latest research, there is an infant mortality ratio of 6.7 per 1,000 live births in this community.
The circulation supervisor at the library is concerned about the amount of air pollution coming from the town’s industrial corridor.
Residents near Cherry Street Substation have a mortality rate of 29.6% from brain tumors compared to the citywide rate of 9.2%.

The circulation supervisor at the library is concerned about the amount of air pollution coming from the town’s industrial corridor.

The nurse has a responsibility to protect community members who share concerns or provide controversial information.

A nurse is planning to teach a community group abut the menigococcal vaccine. For which of the following individuals is this vaccination recommended.
An individual traveling to northern Europe.
An infant who has bronchitis.
An infant who is 4 weeks old.
An individual moving into a dormitory setting.

An individual moving into a dormitory setting.

Individuals living in crowded areas such as dormitories should receive the menigococcal vaccine.

A community health nurse is caring for a client who has a new diagnosis of Lyme disease. The requirements for a reporting Lyme disease are mandated by which of the following?
Local county health departments
Individual state law
federal law
Center for disease control and prevention.

Individual state law.

While Lyme disease is on the list of national diseases, the requirements and methods of reporting individual diseases are determined by state laws.

A community health nurse is conducting an educational program for parents abut the effects of pollution on preschool-age children. Which of the following statements by a parent indicates an understanding of the teaching?
Children drink fewer fluids for their body weight than adults, so they take in fewer toxins.
The kidneys filter toxins at a greater rate in children than in adults.
Children breathe more rapidly than adults, which increases their exposure to air pollutants.
Outdoor air pollutants are more likely to trigger asthma attacks than indoor pollutants.

Children breathe more rapidly than adults, which increases their exposure to air pollutants.

Children breathe faster than adults, which increases their exposure to toxins in the air

A school nurse sees four students in 1 week who have a return-to-school release after being diagnosed with methicillin-resistant Staphylococcus aureus(MRSA). Which of the following actions should the nurse take
Coordinate an immunization clinic at the school.
Recommend prophylactic treatment for classmates.
Report the cases of MRSA to child protective services.
Provide education about MRSA throughout the school system.

Provide education about MRSA throughout the school system.

Appropriate hand hygiene will prevent the spread of MRSA.

A nurse in a rural community is planning education for a young-adult client who is a migrant farm worker. Which of the following should the nurse include in the plan of care (select all that apply).
Provide environmental health information.
Conduct tuberculosis screening
Provide skin cancer information
Conduct dental health screening.
Provide forms to apply for medicare.
Provide environmental health information.
Conduct tuberculosis screening
Provide skin cancer information
Conduct dental health screening.
An occupational health nurse is assessing a client who reports taking ibuprofen daily for several years. The nurse should counsel the client on the risk for which of the following conditions?
Gastric ulceration
Orthostatic hypotension
Hyperglycemia
Urinary retention.

Gastric ulceration

Long term use of NSAIDs such as ibuprofen increases the risk of gastric ulceration, perforation and hemorrhage.

A school health nurse is caring for an adolescent newly diagnosed with type 1 diabetes mellitus. Which of the following actions is appropriate to include in the client’s plan of care?
Consult with a dietitian to determine an appropriate school lunch for the client.
Encourage the client to have a snack 3 hours prior to physical activities.
Provide weekly updates on the clients condition to the insurance provider.
Obtain specimen to test for ketonuria daily.

Consult with a dietitian to determine an appropriate school lunch for the client.

This action assists the client in obtaining appropriate nutrition for the disease process.

A school nurse is helping a student schedule speech therapy and physical therapy appointments that do not interfere with the student’s academic schedule. This is an example of which of the following roles of the school nurse?
Health educator
Case manager
Counselor
Consultant

Case manager

The nurse is coordinating the members of the interdisciplinary team to provide the health care required by the student.

A nurse in a community health center is talking with the parent of an adolescent who is concerned that her sons seems depressed and is giving away his favorite belongings. Which of the following actions should the nurse take?
Tell the parent that it is common for adolescents to lose interest in their belongings.
Explain that what might seem like depression is probably typical teenage boredom.
Talk with the adolescent abut trying to be more cooperative and appreciative.
Determine if the adolescent has considered harming himself.

Determine if the adolescent has considered harming himself.

Clues that should alert the nurse to suicidal intent include giving away possessions. Depression is another risk factor for suicide.

A nurse is collecting demographic data as a part of a community assessment. Which of the following should be included?
Racial distribution
Family genograms
Number of open water sources
Presence of condemned buildings.

Racial distribution

Racial distribution is part of demographic data.

A nurse is a clinic is planning teaching for a client who is newly diagnosed with hepatitis C. Which of the following instructions should the nurse include in the teaching?
Consume a low carbohydrate diet until symptoms resolve.
Schedule an appointment for an immunoglobulin injection.
Abstain from sexual intercourse until antibody tests are negative.
Wear a mask in public places while receiving treatment.

Abstain from sexual intercourse until antibody tests are negative.

Hepatitis C is transmitted through sexual intercourse; therefore, the nurse should instruct the client to abstain from sexual intercourse until antibody tests are negative.

A home health nurse is caring for an older adult client who has diabetes mellitus complicated by severe peripheral neuropathy. Which of the following instructions should the nurse provide the client to avoid injury to the feet and lower legs? (select all that apply)
Test bath water with a thermometer before entering.
Wear shoes that extend 0.64 cm past the longest toe.
Use a dry heating pad to enhance circulation in feet.
Inspect feet for areas of redness daily.
Monitor temperature of feet and lower extremities for changes.
Test bath water with a thermometer before entering.
Wear shoes that extend 0.64 cm past the longest toe.
Inspect feet for areas of redness daily.
Monitor temperature of feet and lower extremities for changes.
A community health nurse is planning an in-service about sexually transmitted infections to a group of adolescents. Which of the following clinical findings should the nurse include as a manifestation of primary syphilis?
Malaise
Maculopapular rash on palms
Chancre
Lyomphadenopathy.

Chancre

Chancre is a clinical manifestation of primary syphilis.

A hospice nurse is caring for a client who is at the end of life and has developed dyspnea and noisy breathing. Which of the following actions should the nurse take?
Suction the client’s oropharynx.
Encourage the client to take sips of water frequently.
Use a fan in the client’s room.
Offer small portions of the clients favorite foods.

Use a fan in the client’s room.

A fan moves the air, which stimulates the client’s trigeminal nerve and can minimize the sensation of dyspnea.

A nurse at a rehabilitation facility is providing discharge teaching for a client who is recovering from a stroke. Which of the following statements should the nurse include.
Your family should provide the majority of your care to ensure that your needs are met.
You should contact outpatient therapy to schedule an admission assessment within two weeks.
You should use a hand-held mirror to improve your ability to see objects around you.
You should focus on dressing and caring for the unaffected side of your body first.

You should use a hand-held mirror to improve your ability to see objects around you.

Clients who experience a stroke may experience altered visual perception and decreased visual fields; therefore, the nurse should recommend that clients use a hand-held mirror to improve the ability see objects in the surrounding environment.

A nurse manger is providing orientation to a nurse who is new to hospice care. Which of the following statements indicates that the new nurse needs additional orientation.
I will link clients with services that assist them to continue living at home.
I will modify client’s treatment plan as needed to maximize his independence level.
I will provide care and education to clients in order to promote recovery.
I will work as team to alleviate symptoms and meet the client’s special needs.

I will provide care and education to clients in order to promote recovery.

The goal of hospice is to deliver palliative care and emotional support to clients who are no longer seeking curative treatment for an illness.

A nurse in a community health center is talking with a client who is receiving treatment for an opioid addiction. Which of the following statements by the nurse is appropriate for encouraging the client to attend his 12-step meeting?
You’ll find the Narcotics Anonymous will help you regain power over your addictions.
Narcotics Anonymous will help you take responsibility for the symptoms of you disease.
At Narcotics Anonymous you willingness to change will be crucial for your sobriety.
At Narcotic Anonymous you’ll learn to maintain control by never admitting to defeat.

At Narcotics Anonymous you willingness to change will be crucial for your sobriety.

Basic tenets of all 12-step programs, including Narcotics Anonymous, have a willingness to change and to make amends, as well as the incorporation of the 12-step process into daily life.

A community health nurse is asked to give a health education program to a group of African-American men age 40 to 75. Considering the health concerns of this group, which of the following topics is most important to include in the program?
Prostate cancer screening.
Diabetes screening.
Depression screening.
Skin cancer screening.

Prostate cancer screening.

Cancer is the second leading cause of death for men and prostate cancer is the second leading cause of cancer deaths in men. The incidence rate of prostate cancer is 51% higher among African-American men than white men.

A clinical nurse manager is developing an education program on tuberculin skin testing. The nurse should include that which of the following can cause a false negative result? (Select all that apply).
Advanced HIV or AIDS.
Bacilli Calmette-Gue’rin (BCG) vaccination.
Time between exposure and screening.
Age of the client.
Recent abuse of IV-substance.
Advanced HIV or AIDS.
Time between exposure and screening.
Age of the client.
A nurse is planning health promotion activities for the local community. Which of the following is an example of primary prevention.
Teaching foot care to adults who have diabetes mellitus.
Testing school-age children for lead exposure.
Providing tuberculosis screening for day care providers.
Teaching meal planning classes to older adults.

Teaching meal planning classes to older adults.

This is an example of primary prevention.

A nurse is caring for a client who has AIDS and is experiencing rapid weight loss. Which of the following action should the nurse take first.
Examine the client’s oral mucous membranes.
Encourage the client to consume 1.2 to 2.0 g/kg of protein daily.
Recommend the client increase daily calorie intake by 25%.
Teach the client about findings that should be reported to the provider.

Examine the client’s oral mucous membranes.

The first action the nurse should take using the nursing process is to assess the client. The nurse should examine the oral mucous membranes for painful lesions, such as candidiasis, that result from HIV or HIV therapy.

A nurse is caring for a 50 year old client who has diabetes mellitus, recently lost his job,and has no health insurance. The nurse should advise the client to do which of the following?
Contact Medicare to determine eligibility.
Contact Medicaid to determine eligibility.
Go to the emergency department when services are needed.
Go to the public health department when services are needed.

Contact Medicaid to determine eligibility.

Medicaid is available to individuals with low income and no insurance. Eligibility and resources vary by state, so the client should contact the local office to determine his status.

A home health nurse is assessing a client who has a prescription for captopril to treat heart failure. Which of the following findings is an adverse effect of this medication.
Weight gain
Ataxia
Photophobia
Dry cough

Dry cough

Captopril prevents the conversion of angiotensin 1 to angiotensin 2 which causes bradykinin to accumulate. The client may experience cough as a result of bradykinin accumulation.

A community health nurse is providing education to a group of children who have asthma. Which of the following statements indicates an understanding of the teaching.
I shouldn’t play sports because it will make me too tired.
I will stay indoors during cold weather.
I will use my rescue medication every day.
I shouldn’t get the flu shot because it might make me sick.

I will stay indoors during cold weather.

Cold air can be trigger for asthma. This response indicates the student recognizes the risk.

A client asks a home health infusion nurse the difference between a peripheral IV line and Peripherally inserted central catheter (PICC) for long-term venous access. Which of the following responses is appropriate?
Blockages do not form in central catheters like they do in peripheral catheters.
There won’t be any infections in your arm from the central catheter.
The central catheter does not require flushing like the peripheral catheter.
The central catheter does not require replacement as often as a peripheral IV

The central catheter does not require replacement as often as a peripheral IV

Nurses must replace peripheral IV catheters every 72 to 96 hours, while a PICC may remain in place for a year or more, as long as there are no complications with the insertion site or the catheter.

The daughter of a client who is terminally ill and at the end of life approaches the hospice nurse and asks what she can do to help relieve her father’s anxiety. Which of the following interventions should the nurse suggest?
Give the client brief hand massages.
Increase the illumination in the room.
Place a warm cloth on the clients forehead.
Administer citalopram when the client is agitated.

Give the client brief hand massages.

Soft massage and brief hand massage can reduce stress in palliative care settings.

A community health nurse is teaching a group of older adults about environmental health hazards. A need for additional teaching is indicated when a group member lists which of the following as a possible source of carbon monoxide exposure.
Motor vehicles
Gas ranges
Vented gas heaters
Electric space heaters.

Electric space heaters.

Electric space heaters are not a source of carbon monoxide poisoning.

A community health nurse is planning a presentation to aging adults who have a family history of Alzheimer’s disease. The nurse should include that which of the following behaviors is an early manifestation of the disease.
Withdrawal form social activities
Difficulty learning new things
Loss of language skills
Neglecting personal hygiene.

Difficulty learning new things.

Difficulty learning new things is generally an early indication of Alzheimer’s disease. Other early indicators include short-term memory loss and subtle changes in personality.

A home health nurse is planning care for the day. Which of the following clients should the nurse visit first.?
An older adult client who was treated in the emergency department last night with a stage 3 pressure ulcer.
A school-age child who was treated in the emergency department last night with status asthmaticus.
An older adult client on a newly prescribed antihypertensive who needs a blood pressure check.
A school-age child whose percutaneous endoscopic gastrostomy (PEG) tube needs changing.
A school-age child who was treated in the emergency department last night with status asthmaticus.
A nurse is providing safety information to the parents of an infant. Which of the following statement by a parent indicates the need for further teaching.
It important to keep our bathroom doors closed.
The slats on our child’s crib are 2 inches apart.
I will make sure the water heater setting is no higher than 140 degrees F.
I will clip a pacifier onto my child’s clothing during naps.

I will make sure the water heater setting is no higher than 140 degrees F.

The water heater should be at a setting no higher than 120 degrees F to prevent accidental burns.

A school nurse is notified that an elementary school child is newly diagnosed with pertussis. Which of the following actions should the school nurse take? (select all that apply).
Instruct the parent to keep the child home until the coughing stage has passed.
Encourage family members to obtain prophylactic treatment.
Quarantine the children in the child’s class.
Recommend the child receive a pneumococcal vaccine in 28 days.
Check the immunization status of child’s classmates.
Instruct the parent to keep the child home until the coughing stage has passed.
Encourage family members to obtain prophylactic treatment.
Check the immunization status of child’s classmates.
Community leaders have requested a meeting with a community health nurse to discuss creating a mobile meals program. Which of the following should the community health nurse assess first?
The need for the program.
The accessibility of residences.
The availability of volunteers.
The leadership of the community.

The need for the program.

Using the urgent vs. non-urgent approach to client care, the nurse should first assess the need for the mobile meals program. This action allows the nurse to collect data on the client, which is the community, and meets the first step of program planning. The needs of the community will determine all other steps of the planning process.

A public health nurse is providing an educational program about inhalation anthrax to a group of first responders in the community. Which of the following statements by a member of the group indicates an understanding of the teaching?
Inhalation anthrax is highly contagious.
A person exposed to inhalation anthrax may develop a dry cough.
The drug of choice to treat inhalation anthrax is ciprofloxacin.
The fatality rate for untreated inhalation anthrax is about 65%.

A person exposed to inhalation anthrax may develop a dry cough.

Early clinical manifestation of inhalation anthrax include fever, fatigue, mild chest pain, and a dry cough.

A nurse is providing education regarding lead exposure to a group of clients who live in a subsidized housing development built in 1968. Which of the following silent statements indicates an understanding of the teaching?
I will use a dry sanding technique when preparing to repaint my front door.
I will vacuum our wood floors every week.
I will increase the amount of red meat and milk in my child’s diet.
I will use hot tap water when preparing my baby’s formula.

I will increase the amount of red meat and milk in my child’s diet.

Children should get adequate amounts of iron and calcium in their diets in order to prevent lead absorption from their environment.

A nurse is preparing a community education program about health care needs during pregnancy. The nurse should include that which of the following vaccines is safe to administer to a client who is pregnant?
Herpes zoster
Tetanus, diphtheria, pertussis.
Varicella
Measles, mumps, rebells

Tetanus, diphtheria, pertussis.

The center for disease control and prevention recommends this vaccine during pregnancy.

A nurse is developing a community education program about risk factors for family violence. The nurse should include which of the following circumstances as a risk factor for becoming a victim of intimate partner abuse.
Attempting to end the relationship with their partner.
Lacking supportive friends outside the relationship.
Having health issues that limit independence.
Taking anti-anxiety or sedative medication.

Attempting to end the relationship with their partner.

Those in a relationship with a potential or actual abuser heighten their risk for abuse when they attempt to leave the relationship.

A community health nurse has conducted a teaching session abut breast self-examination. Which of the following best indicates whether or not the teaching was effective?
Completion of a written quiz.
Verbalization of the steps in the process.
Demonstration on a breast model.
Self-evaluation of the teaching session.

Demonstration on a breast model.

A return demonstration is the best indicator of teaching effectiveness when teaching a psychomotor skill.

A home health nurse is talking with a client whose partner died 3 months ago. The client states ” I still can’t believe my partner is gone sometimes.” Which of the following is an appropriate nursing response.
Many people experience these feelings while grieving for a lost loved one.
Just give yourself some more time, and you’ll feel better
Tell me more about how you’re feeling.
I will schedule an appointment for you with the leader of your church.

Tell me more about how you’re feeling.

The nurse should encourage the client to share her feelings about her life without her partner.

A home health nurse is orienting a newly licensed nurse who is drawing blood from a client for laboratory testing and gets stuck by used needle. Which of the following statements by the newly licensed nurse indicates a need for further teaching.
The client will be tested for HIV.
The client will be tested for hepatitis B virus.
The client will be tested for hepatitis C virus.
The client will be tested for hepatitis A virus.

The client will be tested for hepatitis A virus.

The client would not be tested for hepatitis A because it is primarily transmitted by the oral-fecal route.