Exam #2 Community

Question 1

A nurse reviewed some handouts before meeting the community residents attending a program on healthful living. What is this nurse’s behavior called?

Answer 1

b. Health promotion

Question 2

What is it called when a 50-year-old woman comes to the clinic for her first screening mammogram?

Answer 2

c. Health protection

Question 3

Which is the best definition of health?

Answer 3

a. A goal and a resource for living

Question 4

A nurse was becoming frustrated. She had given her client extensive information on his health problem, but the client continued to be noncompliant in making needed changes. What had the nurse forgotten?

Answer 4

b. Information, while necessary, will not motivate people to change.

Question 5

The nurse working with a client to change behavior to maximize health asked the client to bring his family to the next visit. Why would the nurse want the family to come with the client?

Answer 5

d. To evaluate whether the family members approve of the proposed changes

Question 6

Under the Theory of Reasoned Action, what is the easiest way to determine whether a person will change his or her behavior?

Answer 6

a. One’s intention to perform a behavior

Question 7

In addition to working with a client to change behavior to improve health, what else must be kept in mind according to the Theory of Planned Behavior?

Answer 7

c. The client’s belief about factors that may facilitate or impede the behavior

Question 8

Why would some people believe the air within a particular building carries a risk and makes them ill?

Answer 8

a. They consistently feel worse on workdays and weeks without holidays.

Question 9

Individual responsibility can be assumed for modifiable risk factors, but what risk factors are least subject to modification?

Answer 9

b. Environmental exposure

Question 10

Individual responsibility can be assumed for modifiable risk factors, but what risk factors are least subject to modification?

Answer 10

b. Environmental exposure

Question 11

What is the primary reason risk reduction is of such importance in the United States today?

Answer 11

c. The leading causes of death are all related to lifestyle choices

Question 12

What is the cause of most preventable deaths in the United States?

Answer 12

d. Tobacco

Question 13

Which question is the most important to be included in each client’s health history?

Answer 13

d. What kinds of tobacco do you use daily?

Question 14

During a health history, the client looked confused and said, “But everybody drinks, like at parties and such. How much drinking do you think is too much?” How should the nurse respond?

Answer 14

c. Per day, no more than one drink for women and two drinks for men.

Question 15

What is the primary reason that so many Americans are obese?

Answer 15

b. For many people, caloric intake is more than needed for their physical activity.

Question 16

Based on statistics, which group is probably more physically active?

Answer 16

d. A group of highly paid college graduates

Question 17

Which neighborhood would probably be best for someone interested in retaining his or her health?

Answer 17

c. One with high walkability

Question 18

Which factors have a profound, if sometimes unrecognized, impact on one’s health? Select all that apply.

a. Adequate resources to allow easy access to health services
b. Interpersonal relationships with family and friends
c. Local, state, and national policies
e. Physical neighborhood where one works and lives

Answer 18

A, B, C, E

Question 19

Which factors are included in Pender’s model explaining what influences individuals to pursue health promotion activities? Select all that apply.

a. A belief that one can change one’s behaviors
b. Environmental choices possible
d. The rewards one believes will result if action is taken
f. What one’s family and peers believe should be done

Answer 19

A, B, D, F

Question 20

What interventions might a nurse choose based on the Health Belief Model to help a client improve his or her lifestyle choices? Select all that apply.

c. Examine the individual’s perceptions of his or her health in relation to current lifestyle behavior choices
d. Review how lifestyle changes can reduce risk and improve the client’s life
e. Share statistics regarding the probability of health problems and their seriousness if action is not taken
f. Use communication channels to send reminders of action currently needed

Answer 20

C, D, E, F

Question 21

A nurse was becoming frustrated. It had been 2 weeks, and although the client had verbalized that the best time of day to take a 15-minute walk was early in the morning, the client had not begun to exercise. What had the nurse forgotten? Select all that apply.

a. A decision to act always occurs before action begins.
b. Behavior change is difficult and takes time.

Answer 21

A, B

Question 22

Why do nurses often ask clients how they are sleeping? Select all that apply.

c. Many adults report sleep problems or occasional lack of sleep.
d. Many important functions occur during sleep.

Answer 22

C, D

Question 23

What is it called when an epidemiologist writes a summary of a food poisoning outbreak, from cause to plans, for prevention in the future?

b. Descriptive epidemiology

Answer 23

B

Question 24

Two brothers played with their cousin. One brother later became quite ill, whereas the other did not. How can this be explained?

c. Difference in genetic inheritance between the two brothers

Answer 24

C

Question 25

When would the wheel model of epidemiology be more helpful than the epidemiological triangle model? b. When there are multiple causes for a chronic disease

Answer 25

B

Question 26

Why is it so important to discover all the variables that may be involved in creating a disease state in some persons? c. To find variables susceptible to prevention or early intervention.

Answer 26

C

Question 27

What is the advantage of the web of causation model in comparison with the epidemiological triangle model? d. The web of causation model shows the relationships among variables.

Answer 27

D

Question 28

The textbook summarizes a research study of sexually transmitted infections among young adults. What was determined to be a major variable in exposure to infection? c. The environment in which the young adults lived

Answer 28

C

Question 29

A community health nurse determined exactly how many cases of a particular disease were current in the community. What should the nurse do before determining what interventions should be planned? b. Compare the current rate with the previous rate of disease

Answer 29

B

Question 30

People were very concerned about another outbreak of swine flu. All care providers were asked to report, without individual names, any new cases to the public health department for tracking. What would be most helpful for local media to report to keep citizens informed? a. The ongoing incidence rate

Answer 30

A

Question 31

In trying to determine whether the swine flu outbreak was getting worse, what rate should be carefully observed? c. The swine flu incidence rate

Answer 31

c

Question 32

A newspaper published an article about the athletic banquet at the local high school that had approximately 1000 family members in attendance. Exactly 650 persons became ill within 24 hours, complaining of severe diarrhea, vomiting, and cramping. What is the attack rate? c. 650:1000

Answer 32

c

Question 33

In a particular community, the rate of new cases of diabetes and the rate of new cases of flu during the month of January were precisely the same. Which disease would have the higher prevalence rate? b. As a chronic condition, diabetes would have the higher prevalence rate.

Answer 33

b

Question 34

Why do we not know the incidence or prevalence of gonorrhea? a. Gonorrhea is not a reportable condition.

Answer 34

a

Question 35

Which group should be used for determining the community’s pregnancy rate? d. Women between 15 and 45 years old in the community

Answer 35

d

Question 36

Which research study would determine the attributable risk of a sedentary lifestyle in cardiac disease? c. Subtracting the rate of cardiac disease among athletes from the rate of cardiac disease among nonathletes

Answer 36

c

Question 37

A nurse did a study of two skin lotions: an inexpensive one and an expensive one. The nurse found that there was a risk factor of 0.7 for skin sores using the inexpensive one and a risk factor of 1.2 using the expensive one. Which one should the nurse use?

Answer 37

d. The inexpensive lotion

Question 38

What is the name for the model that demonstrates the progression of disease from prepathogenesis through disease outcome?

Answer 38

c. Natural history model

Question 39

What level of prevention does a screening examination, required for each school athlete before being active in school sports, represent?

Answer 39

c. Secondary prevention

Question 40

What disease would be the best choice for screening if any of the following were possible?

Answer 40

b. Disease B, which can be controlled if caught early in the disease process

Question 41

One hundred women received notification that their screening tests suggested that they might have a serious health problem. How can you reassure these scared women so they will come in for follow-up testing and treatment?

Answer 41

c. Point out that screening is only suggestive and that not all positive screenings mean they actually have the health problem.

Question 42

What is the best way to increase the positive predictive value of a screening test?

Answer 42

b. Test a group at high risk for the health problem

Question 43

Healthy People 2020 establishes goals for improving the health of all Americans. What is most necessary to determine whether Americans’ health is improving?

Answer 43

b. Comprehensive and systematically collected surveillance data on the health status of various population groups

Question 44

Which kind of study would be most helpful in examining potential risk factors in comparison with disease at a specific time through collecting data regarding current exercise, sleep patterns, and current health status among 12-year-olds?

Answer 44

a. Cross-sectional study

Question 45

A researcher, interested in the onset of early menses, compared the life experiences and history of 1000 14-year-old girls, half of whom had monthly periods and half of whom did not, to determine what variables might be observed. How would this study be categorized?

Answer 45

c. Retrospective study

Question 46

One famous study followed a cohort of nurses over their lives, collecting data and health histories as they aged. What kind of study is this?

Answer 46

b. Prospective study

Question 47

A researcher wanted to engage in the best possible research design to obtain reliable information about the possible cause(s) of a disease. Which design would the researcher choose?

Answer 47

c. Prospective study

Question 48

Which research design would a researcher with limited time and funds probably choose?

Answer 48

d. Retrospective study

Question 49

On the basis of findings related to elevated blood levels of cholesterol, a researcher wanted to determine whether a new drug would notably lower the blood levels of cholesterol in otherwise healthy persons. What kind of study would the researcher probably choose?

Answer 49

b. Experimental study

Question 50

The lack of certain B vitamins can result in pellagra. Where would a nutritional deficiency fit in the agent-host-environment model?

Answer 50

b. Agent factor

Question 51

What is the Tuskegee Syphilis Study best known for today?

Answer 51

d. Unethical and racist treatment of uninformed subjects

Question 52

What types of data do epidemiologists gather to try to determine which factors may lead to disease? Select all that apply.

Answer 52

a. Demographic characteristics c. Geographic data f. When disease struck the area

Question 53

What is the advantage of the ecosocial epidemiology model over both the web of causation model and the epidemiological triangle model? Select all that apply.

Answer 53

a. It decreases the focus on the individual person. c. It emphasizes the role of complex political and economic context. f. Its use suggests possible public policy interventions.

Question 54

Which factors are necessary to assume there might be a cause-effect relationship between a particular variable A and a specific illness? Select all that apply.

Answer 54

a. It is easy to understand how the variable A could lead to the illness. b. Research studies consistently demonstrate a relationship between variable A and the illness. d. The more of variable A present, the sicker the person becomes.

Question 55

A nurse wanted a screening test that was very sensitive in determining who might have a particular illness. What might be a problem with using such a sensitive test? Select all that apply.

Answer 55

c. Persons who do not have the illness are told that they might, which leads to anxiety, as well as time and cost of follow-up diagnostic tests. d. Such a test may have lower specificity, so some persons with the disease are told they are disease free and hence do not receive care.

Question 56

Why would a patient not do what the nurse instructs after being told several times what needs to be done to get better?

Answer 56

A. Barriers prevent action.

Question 57

What did Florence Nightingale suggest is one of the most fundamental nursing principles?

Answer 57

B.Constantly engage in health teaching.

Question 58

Why might health education in the community be more effective than health education in a professional setting such as a hospital or clinic?

Answer 58

C. The setting is familiar and comfortable to participants.

Question 59

What must the nurse do before implementing a comprehensive and entertaining educational program?

Answer 59

B.Develop an open and trusting relationship with participants.

Question 60

Why is there such a community health emphasis on heath education programs?

Answer 60

A. Behavioral change must be voluntary.

Question 61

What is the chief determinant of whether a health education program will create change?

Answer 61

A. Amount of input and participation by learners

Question 62

What is the best way to choose the goals for a particular educational program?

Answer 62

D. The target audience must determine their needs and priorities.

Question 63

What factor is crucial to plan an effective health education program?

Answer 63

C. The sociopolitical cultural context of the community’s environment

Question 64

How does one know if learning has occurred?

Answer 64

D. There is a long-term change in knowledge and behavior.

Question 65

What led to the creation of the Health Belief Model (HBM)?

Answer 65

D. Attempting to understand why people did not flock to free health care

Question 66

Which factor is the main determinant of behavior within the Health Belief Model?

Answer 66

B. Perceived benefits of engaging in healthy behaviors

Question 67

What is a factor found in the Health Belief Model (HBM) that is not a factor in Pender’s Health Promotion Model (HPM)?

Answer 67

C. Personal threat as motivator

Question 68

What is the primary purpose of both the HBM and HPM models? c. To help explain why individuals do or do not engage in health actions d. To help professionals know how to intervene in client decisions

Answer 68

C. To help explain why individuals do or do not engage in health actions

Question 69

Which method is most consistent with Freire’s approach to empowerment?

Answer 69

A. Encouraging active participation and dialogue in critical reflection

Question 70

What is the most crucial skill for a nurse teaching diabetic self-care in a small group?

Answer 70

D. Listening carefully to understand participants’ issues

Question 71

What is the most likely reason that a nurse responsible for teaching spends more time being quiet than giving information?

Answer 71

D. The nurse is listening to the group’s dialogue to identify problems.

Question 72

What is the goal of participatory action research? Social change resulting from stakeholders’ strategies

Answer 72

D. Social change resulting from stakeholders’ strategies

Question 73

What would be an appropriate response if a nurse were asked, “Why are you so rarely in the department office?”

Answer 73

A. “I have to be where the people are.”

Question 74

A very busy day was planned at a community health fair. Why would a nurse spend time greeting and meeting each new person who walked in?

Answer 74

B. To immediately establish a friendly relationship and a level of trust

Question 75

What nurse behavior would be most effective at creating a base for providing culturally effective care?

Answer 75

C. Exhibiting sensitivity to individual differences resulting from culture and experiences

Question 76

What is the first and most crucial step according to the Framework for Developing Health Communications?

Answer 76

D.Target the program to meet the audience’s learning needs as they perceive them

Question 77

What is the best way for the nurse to be sure that the teaching material and communication channels will be effective?

Answer 77

D. Pretest the materials with members of the target group to obtain feedback about their acceptability and understandability

Question 78

How is “health literacy” operationally defined in the United States?

Answer 78

C. Knowing how to access and use information to make health decisions

Question 79

When handed the consent form to sign before treatment could be given, a patient looked at the nurse and said, “I’m sorry; I forgot my glasses today.” What should the nurse do?

Answer 79

D, Wonder if the patient might have difficulty with reading and therefore summarize the content of the form for the client

Question 80

How can a nurse determine a patient’s reading level?

Answer 80

A. Ask, “Do you find it useful to have someone help when you receive written material from your doctor or pharmacy?”

Question 81

Why would the nurse continue to ask questions and encourage attendees to contribute examples from their own lives relevant to the discussion?

Answer 81

C. Because persons learn by doing through active participation

Question 82

What may help the nurse be effective in helping clients change their behavior?

Answer 82

A. Counseling through the Ask, Advise, Assess, Assist, and Arrange approach

Question 83

What does Knowles say is especially typical of adult learners? Select all that apply. c. Learning draws on the learner’s previous life experiences. e. Sharing experiences with others enriches and motivates learning. f. They want information related to current developmental tasks.

Answer 83

CEF

Question 84

``` Which of these can be found in both the Health Belief Model and Pender’s Health Promotion Model? Select all that apply. a. Cues to action b. Demographics c. Perceived barriers d. Perceived benefits ```

Answer 84

ABCD

Question 85

What variables are missing from both the HBM and HPM models? Select all that apply. a. Ignoring the impact of being socially and politically disenfranchised b. Inaccessibility of health services d. Omitting the influence of social, structural, and physical environmental factors

Answer 85

ABD

Question 86

A nurse involved with a community group told peers that the group was learning networking, negotiating, lobbying, and information seeking. Why isn’t the nurse working toward a noticeable improvement in health status for the group? Select all that apply. b. Networking, negotiating, lobbying, and information seeking will continue to be useful throughout the participants’ life span. d. There are no immediate solutions to the current health problems in most communities.

Answer 86

BD

Question 87

Which suggestions would be helpful for effective teaching? Select all that apply. a. Be encouraging and give positive feedback for helpful comments d. Review and summarize the key points at periodic intervals e. Incorporate demonstrations, illustrations, and real-life examples

Answer 87

ADE

Question 88

What might be the result if a health care provider charged more than the managed care organization typically paid for a procedure?

Answer 88

C. Provider would get the typical payment instead of what was charged.

Question 89

What would be the easiest way to explain case management to a client? d. “With your input we will coordinate your care for the best outcome.”

Answer 89

D. “With your input we will coordinate your care for the best outcome.”

Question 90

A hospital was going to start a care management program. Which group of clients may be selected to first receive such services?

Answer 90

c. Clients with potentially better outcomes if their care was more carefully coordinated

Question 91

Who first created the idea of a continuum of care, which later evolved into the term “case management”?

Answer 91

d. Those who coordinated services for discharged psychiatric patients after World War II (WWII).

Question 92

What was the aftermath of the deinstitutionalization of mentally ill patients into the community during the 1970s? d. Without follow-up care, many clients were readmitted to care.

Answer 92

d. Without follow-up care, many clients were readmitted to care.

Question 93

Which elderly persons are often the targets of case management?

Answer 93

b. Those who live alone without close relatives

Question 94

What is the purpose of case management from the client’s perspective?

Answer 94

a. To help clients navigate a complex, fragmented, confusing health care system to obtain appropriate care

Question 95

For hospitalized patients, when is case management implemented?

Answer 95

A. Immediately on admission

Question 96

Why are utilization review departments becoming case management units?

Answer 96

b. Monitoring service use alone does not improve patient outcomes.

Question 97

Why are health care institutions unhappy beyond the fact that they are not receiving the previous high reimbursement for procedures from Medicaid or Medicare?

Answer 97

b. Because insurance companies and other third-party payers copy Medicaid’s approach to holding down costs

Question 98

Why are nurses increasingly becoming case managers when social workers have historically been so successful in the role? a. Because of the need for ongoing patient assessment.

Answer 98

a. Because of the need for ongoing patient assessment.

Question 99

A very skilled baccalaureate-prepared clinical nurse was asked to assume a case manager role. What will initially be the most difficult for the new case manager?

Answer 99

c. Gaining knowledge of reimbursement structures and financial strategies

Question 100

What is the biggest influence on the case manager’s role?

Answer 100

d. The specific program that employs the case manager

Question 101

How may a client continue to receive care management services after the existing program services expire?

Answer 101

b. Pay for such services via contract

Question 102

The case manager gave the client a list of eight possible sources for the equipment needed for care after discharge. Why did the nurse not just tell the client the best source for the equipment?

Answer 102

a. The client has a right to select providers of needed resources.

Question 103

What are the goals of nursing case management regardless of setting? Select all that apply. b. Contain costs and control use of services c. Decrease duplication and fragmentation d. Enhance client’s quality of life

Answer 103

BCD

Question 104

Which clients may be eligible for hospital-based, disease-specific case management support? Select all that apply. a. A large group of patients who have high-cost conditions c. Those who may be maintained in a stable condition in their home environment

Answer 104

AC

Question 105

What are considered core functions of a case manager? Select all that apply. a. Assessment and diagnosis of needs b. Coordination and collaboration with others d. Monitoring and evaluating patient status

Answer 105

ABD

Question 106

How does the case manager identify people who would benefit from case management services? Select all that apply. a. Evidence-based criteria d. Referrals from health care providers or agencies e. Risk identification from data management f. Use of health risk screening tools

Answer 106

ADEF

Question 107

Under the New England model of case management, how does the nurse determine the appropriate financial cost of care? Select all that apply. b. Discharge of the patient within the allotted number of allowed hospital days f. Use of a diagnosis-appropriate critical pathway

Answer 107

BF