Exam 4 Flashcards
What is the cause of teen pregnancy?
a. Changing moral attitudes
b. Sexual code
c. Economic circumstances
d. No uniform reason
ANS: D
There is no uniform cause of teen pregnancy. The causes of teen pregnancy are diverse and affected by changing moral attitudes, sexual codes, and economic circumstances.
According to the 2013 Youth Risk Behavior Surveillance System, fewer teens reported engaging in which behavior?
a. Riding in a car with a driver who had been drinking
b. Current alcohol usage
c. Trying marijuana
d. Episodic heavy drinking
ANS: A
Fewer teens reported binge drinking or riding in a car with a driver who had been drinking. However, these and other significant risk behaviors continued at high rates. Current alcohol use, trying marijuana, and episodic heavy drinking still continue at high rates in teens.
Which statement best illustrates that the main causes of teen mortality are high-risk behaviors?
a. Teenagers generally leave home before they are mature enough.
b. Teenagers often engage in activities that put them at risk for life-threatening diseases.
c. Teenagers are prone to developing chronic diseases that lead to disability early in life.
d. Teenagers want to get pregnant at an early age to be able to enjoy life later on.
ANS: B
Teenagers are often engaged in activities that put them at risk for life-threatening diseases. For example, the human immunodeficiency virus (HIV) infection and newly identified sexually transmitted diseases are prevalent in teenagers.
A high school-aged teen tells the school nurse that she wants to become pregnant. Which of the following would be the appropriate action for the nurse to take?
a. Ignore the comment
b. Tell the teen that she should not engage in sexual activity or get pregnant
c. Call the teen’s parents
d. Provide preconceptual counseling and emphasize the need to achieve good health
ANS: D
Providing preconceptual counseling and emphasizing the need to achieve good health demonstrates that the nurse has heard what the teen is saying. This provides useful information that may encourage the teen to examine her plans carefully, seriously, and maturely.
Many teenagers who give birth:
a. are from middle-class families.
b. are honor students.
c. planned to get pregnant.
d. see few advantages in delaying pregnancy.
ANS: D
Many teenagers who give birth see few advantages in delaying pregnancy. Many times these teenagers are poor and have limited educational achievements; they do not expect that their circumstances will improve at a later time. Most teens report that their pregnancy was unplanned.
Which factor has been linked to the decrease in pregnancies among teens?
a. Fewer are becoming sexually active
b. More are using complementary alternative methods of birth control
c. More have tighter parental control at home
d. Fewer are engaging in risky behaviors
ANS: A
The decrease in pregnancies among teens has been attributed to stabilization of the numbers of teens becoming sexually active, increased condom use, and increased use of more effective and long-acting hormonal methods of birth control.
A parent has requested access to his child’s medical records at a school-based health clinic. Which of the following statements about access and release of a minor’s medical record is correct?
a. Reproductive information is protected by the Health Insurance Portability and Accounting Act (HIPAA).
b. A minor cannot get birth control without parental consent.
c. Medical records are available to anyone who wishes to access them.
d. Parents can legally access all medical records of a minor child.
ANS: D
In many states, parents can legally access all medical records of their minor children, which limits the confidentiality assurances offered to a teen seeking reproductive health care. The HIPAA Privacy Rule established that if a minor consented to care, then only that individual could access and release those medical records. However, the Privacy Rule also deferred to existing state law.
A teenage mother discusses with the school nurse the possibility of having a second child. Which of the following risk factors would place this client at risk for having a second pregnancy?
a. Remaining in school
b. Reporting an unplanned first pregnancy
c. Being from a small family
d. Having a disadvantaged background
ANS: D
Having a disadvantaged background is a risk factor for a second teen pregnancy. Other risk factors include lower educational and cognitive ability, mental health issues, physical trauma, losses (such as death of a loved one), and substance use.
A nurse is providing information about parental consent to an adolescent client who is seeking an abortion. Which of the following information would be accurate?
a. Parental consent must be given to the abortion provider.
b. Parents must be notified by the abortion provider before the abortion is performed.
c. The adolescent’s right to privacy and ability to give consent varies by state.
d. Federal protection of the adolescent’s right to privacy makes consent unnecessary.
ANS: C
For an adolescent female seeking abortion, her right to privacy and ability to give consent vary by state. No federal protection is extended to adolescents requesting abortion services
Which factor increases a young woman’s risk for early sexual experiences and pregnancy?
a. History of sexual abuse
b. Parents who have high demands for their children to act maturely
c. Parents who communicate openly with their teens about birth control and sexuality
d. Male partner of the same age
ANS: A
Having a history of sexual abuse increases a young woman’s risk for early sexual experiences and pregnancy. Parental higher education, family communication, and good family health practices have been associated with decreased sexual risk behaviors. Parents who are extremely demanding and controlling or neglectful and who have low expectations are least successful in instilling parental values in their children. Parents who have high demands for their children to act maturely and who offer warmth and understanding with parental rules have children more likely to exhibit appropriate social behavior and to delay early sexual experiences and pregnancy.
A nurse is providing education to teenagers about prevention of unintended pregnancy. Which of the following principles should the nurse understand as to why some of these teenagers may get pregnant?
a. They often feel invincible and do not recognize risks related to their behaviors.
b. They enjoy engaging in sexual activity and want children.
c. They influence each other and succumb to peer pressure.
d. They have realistic attitudes about school, work, parenting, and socializing.
ANS: A
Teens often feel invincible, and they do not think about the negative outcomes they are advised could come true. Many teens believe that they are unique and different and that everything will work out fine. Teenagers often express the unrealistic attitude that they can do it all. Most pregnancies are unintended.
A young man has just learned that his partner is pregnant. Which of the following statements regarding his reaction to the pregnancy is true?
a. His reaction often depends on the nature of the relationship before the pregnancy.
b. Most young men believe that fathering a child can make them feel manly.
c. Most young men are not interested in their partner’s pregnancy.
d. His reaction often includes blaming the partner.
ANS: A
Young men’s reaction to their partner being pregnant often depends on the nature of the relationship before the pregnancy. A large percentage of young men will continue to accompany the young woman to some prenatal visits and may even attend the delivery. It is not usual for a young man to be excluded or even rejected by the young woman’s family (usually her mother).
A nurse is providing adoption counseling to pregnant teenagers. Which of the following is an important concept for the nurse to keep in mind?
a. Have the father present as well during the counseling session.
b. When speaking of adoption, use the words “giving the child away.”
c. Describe the details of raising a child in order to influence adoption decisions.
d. Do not impose opinions on the decision-making process of teen mothers.
ANS: D
Nurses must keep in mind that they should avoid imposing opinions on the decision- making process of teen mothers. The nurse should also assess the relationship between the pregnant teen and her partner and what role she expects him to play. Sensitive language should be used—avoid saying “giving away a child” or “putting up for adoption.”
A nurse is counseling a pregnant adolescent about her nutritional needs during pregnancy. Which of the following should the nurse use as the basis for providing the client information about nutritional needs?
a. Chronologic age
b. Gynecologic age
c. Age at menarche
d. Blood protein levels
ANS: B
Nutritional needs are based upon gynecologic age, the number of years between chronologic age, and age at menarche.
A nurse is assessing a pregnant teen’s weight gain. Which of the following would be the appropriate nursing intervention to implement?
a. Advise the teen to pay close attention to weight gain
b. Encourage the teen to gain as much weight as possible
c. Recommend weight gain based on prepregnancy weight
d. Instruct about the benefits to the fetus by gaining 2 pounds per week
ANS: C
The weight gain recommendations for the pregnant adolescent are based on the teen’s prepregnancy weight. Teenagers who begin the pregnancy at a normal weight should be counseled to begin weight gain in the first trimester and to average gains of 1 pound per week for the second and third trimesters.
A nurse is counseling an adolescent female about prevention of iron deficiency anemia. Which of the following would be the most appropriate nursing intervention?
a. Provide information about appropriate weight gain during puberty
b. Educate about consuming foods containing vitamin C
c. Instruct on drinking at least eight glasses of water each day
d. Emphasize the need to follow up with a dietician
ANS: B
Iron deficiency anemia is the most common nutritional problem among both pregnant and nonpregnant adolescent females. The nurse should educate about iron-rich foods and foods that promote iron absorption, such as those containing vitamin C. Proper hydration and weight gain do not help prevent iron deficiency anemia. Following up with a dietician is not necessary as the nurse discusses prevention of anemia.
The nurse plans a home visit to a pregnant teen to discuss proper prenatal nutrition. Which of the following best describes a demonstrated outcome of this nursing intervention?
a. Increase in birth weight and utilization of prenatal care and support services
b. Increase in family coping skills to prevent crisis
c. Coordinated and comprehensive teen pregnancy approach
d. Family approach to health care
ANS: A
An increase in birth weight and utilization of prenatal care and support services is a demonstrated outcome of a nurse planning a home visit to a pregnant teen. Home visits may not lead to an increase in family coping skills to prevent crisis, a coordinated and comprehensive approach, or a family approach to health care.
A nurse is teaching a pregnant teenager about the risks of contracting a sexually transmitted infection. Which of the following statements would the nurse most likely make?
a. Transmission of sexually transmitted infections is unlikely when you are pregnant.
b. Contracting a sexually transmitted infection may cause your infant to require assistance immediately after birth.
c. Sexually transmitted infections can cause premature labor.
d. The father of the baby is at high risk to contract a sexually transmitted infection.
ANS: C
When a young woman is pregnant, sexually transmitted infections can cause premature rupture of membranes, premature labor, and postpartum infection. Periodic screening during pregnancy should be done. Transmission of sexually transmitted infections can occur during pregnancy. There is no indication that transmission will cause a need for the infant to require immediate assistance following birth. Transmission of a sexually transmitted infection to the father is dependent on the father’s sexual activity.
A nurse is implementing an intervention at the primary level of prevention related to teen pregnancy. Which of the following would be most appropriate for the nurse to implement?
a. Teach well-baby classes to new mothers
b. Teach young people about sexual practices that will prevent untimely pregnancy
c. Provide services for pregnancy detection
d. Counsel a young couple about abortion and adoption
ANS: B
Education often occurs at the primary level of prevention. The primary level of prevention focuses on preventing a problem before it occurs. Teaching well-baby classes to new mothers focuses on tertiary prevention as the teen pregnancy has already occurred. Providing services for pregnancy detection is secondary prevention. Counseling a young couple about abortion and adoption is tertiary prevention.
What are reasons that adolescents may not seek care for health problems? (Select all that apply.)
a. Access to care may be hindered because there are not enough professionals with expertise in dealing with the teen population.
b. Cost of care or availability of insurance may limit services.
c. Teenagers do not care about their health.
d. Health care professionals may not be able to discuss sensitive topics in a non-judgmental way.
e. Parents are unaware of the services available for adolescents.
ANS: A, B, D
Adolescents may not seek care because their access to care is hindered by either lack of professionals or costs of the care; they may fear that health care professionals will not be able to discuss sensitive topics with them in a non-judgmental way. Although health may not be a top priority, it shouldn’t be assumed that teenagers do not care about it. Most likely, parents are aware of the services available for adolescents but may not be able to access these services for a variety of reasons.
A nurse is working with adolescent clients. Which of the following describes therapeutic approaches that would be appropriate for the nurse to use when working with this population? (Select all that apply.)
a. Creating a caring and understanding atmosphere
b. Using neutral words in eliciting symptoms
c. Insisting that teens use appropriate terminology when expressing their concerns
d. Paying attention to what the teen verbalizes and fails to verbalize
e. Encouraging the teen to talk to the school guidance counselor about problems
ANS: A, B, D
Creating a caring and understanding atmosphere, using neutral words to elicit symptoms, and paying attention to what the teen verbalizes and fails to verbalize are appropriate therapeutic approaches. The nurse can offer more appropriate terms for the client to use once trust is established. The nurse should listen to the teen first before referring the client to someone else.
Which objective related to adolescent health is discussed in Healthy People 2020? (Select all that apply.)
a. Increasing the age of legal consumption of alcohol to 25
b. Increasing the number of planned pregnancies
c. Increasing the proportion of teens who receive formal instruction on reproductive health issues
d. Increasing the proportion of teens who consistently use some form of birth control
e. Increasing the number of teens who are employed
ANS: C, D
Healthy People 2020 goals are to increase the proportion of 15 to 19 year olds who use condoms and hormonal contraceptives and increase the proportion of teens who receive reproductive health information through formal instruction as well as from their parents or guardians.
Why must nurses examine their attitudes about alcohol, tobacco, and other drug (ATOD) abuse and addiction before working with individuals with this health problem?
a. Working with clients who have addiction problems often puts the nurse at risk for violence.
b. The population of persons with drug and alcohol addiction is found in low-income neighborhoods.
c. To be therapeutic, a nurse must develop a trusting nonjudgmental relationship with clients.
d. Nurses are the primary persons who treat addiction problems.
ANS: C
To be therapeutic, the nurse must develop a trusting, nonjudgmental relationship with clients. Therefore, nurses must examine their own attitudes ahead of time. Working with clients who have addiction problems does not put the nurse at risk for violence. People with drug and alcohol addiction can be found in any neighborhood. Nurses do not treat addiction problems.
Which health problem causes more deaths, illnesses, and disabilities than any other in the United States?
a. Tobacco addiction
b. Alcohol abuse
c. Substance abuse
d. Caffeine addiction
ANS: C
Substance abuse is the number one national health problem, causing more deaths, illnesses, and disabilities than any other health condition. Tobacco addiction, caffeine addiction, and alcohol abuse are part of substance abuse.
The use of any substance that threatens a person’s health or impairs his or her social or economic functioning is:
a. drug dependence.
b. substance abuse.
c. drug addiction.
d. illegal.
ANS: B
Substance abuse is the use of any substance that threatens a person’s health or impairs his or her social or economic functioning. Drug dependence is a state of neuroadaptation caused by the chronic, regular administration of a drug. Drug addiction is a pattern of abuse characterized by an overwhelming preoccupation with the use of a drug, securing its supply, and a high tendency to relapse if the drug is removed. Illegal means that it is against the law, not all substances are illegal.
Dependence is a term that refers to the:
a. presence and severity of withdrawal symptoms.
b. necessary use of drugs to prevent withdrawal symptoms.
c. level of intoxication associated with addiction.
d. amount of substance needed to satisfy cravings.
ANS: B
Dependence refers to the necessary use of drugs to prevent withdrawal symptoms. This occurs because of a state of neuroadaptation (a physiological change in the central nervous system).
What happened in the United States as a result of prohibition?
a. Substance abuse declined
b. Violent crime and corruption increased
c. The need for community health nurses declined
d. Facilities to treat substance abuse improved
ANS: B
Prohibition led to increased crime and corruption among law officials related to the illicit market. Because of the problems that were caused, prohibition was eventually recognized as a failure and repealed.
Which factor has contributed to the problem of substance abuse?
a. Increased knowledge about the use of drugs
b. Social acceptability of certain drugs
c. Recognition of substance abuse as a health problem
d. Control of the content and strength of illegal drugs
ANS: B
Social acceptance of certain drugs, such as caffeine, alcohol, and tobacco, contributes to the substance abuse problem. Not all substances that are abused are illegal.
A nurse is providing care for a family in which a nonaddict is experiencing a stress-induced preoccupation with an addict’s life, leading to extreme dependence on the addict. Which of the following best describes what is happening?
a. Obsession
b. Codependency
c. Enabling
d. Addiction
ANS: B
Codependency occurs when a person in a close relationship with an addict develops unhealthy coping mechanisms to continue the relationship. Obsession is a thought that continually preoccupies ones’ thoughts. Enabling is the act of shielding or preventing the addict from experiencing the consequences of addiction. Drug addiction is a pattern of abuse characterized by an overwhelming preoccupation with the use of a drug, securing its supply, and a high tendency to relapse if the drug is removed.
A client has not yet made a commitment to take action to change his health behaviors. Which stage of change is the client experiencing?
a. Precontemplation
b. Contemplation
c. Preparation
d. Action
ANS: B
During contemplation, the individual is aware that a problem exists and is seriously thinking about overcoming it but has not yet made a commitment to take action. The nurse can encourage the individual to weigh the pros and cons of the problem and the solution to the problem. In precontemplation, the person does not intend to change in the foreseeable future. In the preparation phase, the individual is prepared for action and may reduce the problem behavior but has not yet taken effective action. In the action stage, the individual modifies the behavior, experiences, or environment to overcome the problem.
A nurse is working with a client during a smoking cessation program. The client has developed an action plan for smoking cessation, but has not yet implemented it. Which stage of change is the client experiencing?
a. Precontemplation
b. Contemplation
c. Preparation
d. Action
ANS: C
During preparation, the individual is prepared for action and may reduce the problem behavior but has not taken effective action yet. During contemplation, the individual is aware that a problem exists and is seriously thinking about overcoming it but has not yet made a commitment to take action. The nurse can encourage the individual to weigh the pros and cons of the problem and the solution to the problem. In precontemplation, the person does not intend to change in the foreseeable future. In the action stage, the individual modifies the behavior, experiences, or environment to overcome the problem.
A school nurse is coordinating the implementation of a drug education program in the school. Which of the following levels of prevention is being implemented?
a. Primary level of prevention
b. Secondary level of prevention
c. Tertiary level of prevention
d. Primary health care prevention
ANS: A
Primary prevention includes education about drugs and guidelines for their use, preventing the problem before it occurs. Secondary prevention aims for early detection and screening. Tertiary prevention addresses treatment and rehabilitation. Primary health care prevention is not a level of prevention.
A nurse is assessing a client for addiction. Which of the following primary symptoms of addiction should the nurse recognize?
a. Anger
b. Apathy
c. Denial
d. Violence
ANS: C
In assessing for addiction, the nurse should be aware that a primary symptom of addiction is denial. Anger, apathy, and violence are not considered the primary symptoms of addiction.
A nurse is giving advice using the acronym FRAMES. Which of the following actions would most likely be taken by the nurse?
a. Offer a suggestion as to how the behavior should change
b. Provide clear guidance to change risky behavior
c. Refer the client to a local support group
d. Emphasize the need for others to support the client’s change
ANS: B
Providing clear advice to change risky behavior is one of the elements of the FRAMES method of intervention, “A”—advice. The other FRAMES are feedback, responsibility, menu, empathy, and self-efficacy.
A nurse is caring for adolescents who have experienced substance abuse. Which of the following should the nurse recognize as a major influence in this population?
a. Family-related factors
b. Positive media messages
c. Socioeconomic level
d. Peer pressure
ANS: A
Substance abuse among adolescents is influenced most by family-related factors, such as genetics, family stress, and parenting styles. Research suggests that successful social influence-based prevention programs may be driven by their ability to foster social norms that reduce an adolescent’s social motivation to begin using ATODs. Peer pressure and socioeconomic level may play a role in the abuse of substances, but this has not been the major factor identified. Media messages promoting the use of substances may influence this population, but is not the major factor that has been identified.
A nurse is implementing the harm reduction model. Which of the following will be the focus of nurse when using this approach?
a. Education
b. Law enforcement
c. Scare tactics
d. Rehabilitation
ANS: A
The harm reduction model accepts the reality that psychoactive drug use is endemic, and it focuses on pragmatic interventions, especially education, to reduce the adverse consequences of drug abuse and get treatment for addicts. The harm reduction model encourages nurses to seek the underlying roots of various health problems and plan action that is realistic, nonjudgmental, holistic, and positive. Law enforcement, scare tactics, and rehabilitation are not part of the harm reduction model
A nurse recommends to a school board that other methods besides the “just say no” approach be considered when providing drug use prevention education to the elementary students. Which of the following best describes the rationale for this recommendation?
a. Children do not like to hear the word “no,” and the approach is too negative.
b. Project DARE is more effective and has decreased drug use.
c. Children are naturally curious and may experiment with drugs.
d. “Just say no” to drugs does not include smoking and alcohol abuse.
ANS: C
The “just say no“ approach does not help young people because children are naturally curious and drug experimentation is often a part of normal development, children from dysfunctional homes often use drugs to get attention and escape intolerable environments, and it does not address the powerful component of peer pressure. Most recent studies have found that the DARE program is less effective than other interactive prevention programs and may even result in increased drug use.
A nurse is providing comprehensive education about HIV transmission for an injection drug user (IDU). Which of the following would be the most important information to include?
a. How and where to acquire needles
b. Proper needle usage and possible injection sites
c. Spreading of the virus via homosexual activities
d. Using bleach between needle uses
ANS: D
IDUs represent the most rapidly growing source of new cases of AIDS, and they are the greatest risk for spread of the virus in the heterosexual community. Emphasis is being placed on reduction of the transmission of this disease through contaminated needles. Nurses should provide education on cleaning needles with bleach between uses to decrease the spread of the virus. Education on needle exchange programs is also appropriate; however, this population is not as likely to use these programs even when they are available.
A nurse has collected a urine specimen from a client for drug testing. Which of the following best describes the purpose of a urinalysis?
a. To assess whether a certain drug has been used in the recent past
b. To determine the degree of intoxication
c. To assess the extent of performance impairment
d. To determine how much alcohol was consumed
ANS: A
The nurse collects a urine specimen with the rationale that urinalysis for drug testing can be used to determine whether a certain drug has been used in the recent past. Urine testing indicates only past use of certain drugs, not intoxication. The extent of performance impairment cannot be determined with urine testing. Alcohol is not always included in a urine drug screen.
A nurse is assessing the community for potential settings of drug experiences. Which of the following describes what the nurse would most likely identify?
a. A back alley or abandoned building where people are using crack
b. An area at the local high school where students are known to smoke cigarettes
c. The individuals using the drug, including that individual’s expectations
d. The physical, social, and cultural environment within which the use occurs
ANS: D
Setting is the influence of the physical, social, and cultural environmental within which the use occurs. All of these environments influence the use of drugs. A back alley, an area at the local high school, and individuals using the drug do not address all of the aspects of setting.
A nurse is assessing the drug use patterns of a client. Which of the following questions would be most appropriate for the nurse to ask?
a. Where was the drug acquired?
b. Who gave the drug to you?
c. Why do you use the drug?
d. How often do you use the drug?
ANS: D
During an assessment, all relevant drug-use history is collected and aids in the assessment of drug-use patterns. The nurse should note any changes in drug-use patterns over time. Thus, the most appropriate question is the nurse asking how often a client uses drugs.
A nurse refers a client to alcoholics anonymous (AA). Who will play the most important role in the treatment of alcoholism at this support group?
a. Self
b. Spouses
c. Children
d. Peers
ANS: D
AA began a strong movement of peer support to treat a chronic illness. The fellowship, support, and encouragement among AA members provide a vital social network for the person recovering from an addiction.
A nurse partners with multiple agencies in the community to create a support group for those diagnosed with addiction in the community. Which of the following levels of prevention is being implemented?
a. Primary
b. Secondary
c. Tertiary
d. Health promotion
ANS: C
When using tertiary prevention, the nurse focuses on treatment and rehabilitation. The support group for those with addiction is helping the addict and the addict’s family, who already “have a problem.” Primary prevention focuses on health promotion and disease prevention. Secondary prevention focuses on early detection and screening. Health promotion is not a level of prevention.
A nurse lobbies with legislators for the passage of legislation to prohibit smoking of tobacco products in public places. Which of the following levels of prevention is being implemented?
a. Primary
b. Secondary
c. Tertiary
d. Health promotion
ANS: A
When using primary prevention, the focus is on health promotion and disease prevention. When using tertiary prevention, the nurse focuses on treatment and rehabilitation. Secondary prevention focuses on early detection and screening. Health promotion is not a level of prevention.
A nurse is caring for a client who has a history of chronic alcohol abuse. Which of the following medical problems should the nurse anticipate? (Select all that apply.)
a. Gastrointestinal disturbances
b. Cardiac dysrhythmias
c. Depression
d. Organic brain syndrome
e. Hepatitis B
ANS: A, B, C, D
Gastrointestinal disturbances, cardiac dysrhythmias, depression, and organic brain syndrome are some effects of chronic alcohol abuse
Which group has the highest rate of violence?
a. Older, Caucasian men
b. Young, minority men
c. Young, Caucasian women
d. Older, minority women
ANS: B
Young, minority men have the highest rate of unemployment in the United States, ranging upward to 50% even in times of prosperity. Unemployment may precipitate aggressive outbursts. Most analyses conclude that the differential rates of violence between African Americans and Caucasians in the United States have more to do with socioeconomic disparities, such as poverty, unemployment, and overcrowding, than with race.
Homicide is the second leading cause of death among which population?
a. Individuals between 15 and 24 years of age
b. Native American infants
c. Caucasian women between 25 and 34 years of age
d. African American children between 15 and 19 years of age
ANS: A
Homicide is the second leading cause of death for individuals between 15 and 24 years of age. Rates of homicide for children under the age of 1 were highest in Non-Hispanic blacks and American Indian/Alaska Native infants.
What factor associated with crime and violence is particularly important to community health nursing practice?
a. Violence is a universal problem.
b. Violence impacts everyone in the United States.
c. Nurses must spend a great deal of time on the results of violence.
d. Significant mortality and morbidity result from violence.
ANS: D
Communities across the United States are concerned about crime and violence rates because of significant mortality and morbidity that often result. These issues are closely related to community health nursing. While it is true that violence is universal, and so to some degree affects all citizens, resulting in the need for nursing care, these issues relate to nursing in general and especially those involved in direct care of the patient’s physical and emotional needs.
Which statement about rape is true?
a. Rural areas are high-risk areas for rape to occur.
b. Most rapes occur in the winter.
c. Male victims suffer more emotional trauma than females.
d. College women are at high risk for experiencing rape.
ANS: D
College women are at particularly high risk for sexual victimization in the United States, with research estimating that approximately 25% of female college students will experience an attempted or completed rape at some point during their college experience.
It appears that the emotional trauma for a male rape victim is at least as serious as that for a woman.
Homicides are least likely to be perpetrated by a(n):
a. friend.
b. acquaintance.
c. family member.
d. stranger.
ANS: D
Homicides are least likely to be committed by a stranger. When strangers are involved, many of these are related to the illegal substance abuse network. Homicides are usually perpetrated by friends, acquaintances, or family members during an argument.
The greatest risk factor for suicide in adult women is:
a. divorce.
b. unemployment.
c. intimate partner violence.
d. terminal illness.
ANS: C
The greatest risk factor for actual and attempted suicide in adult women is intimate partner violence.
A public health nurse (PHN) is working in a community where there have been multiple closures of large factories, leaving many individuals without employment. Which of the following is this population most at risk for?
a. Becoming an abuser at home
b. Committing violence in and outside the home
c. Developing addictive behaviors
d. Neglecting the needs of their children
ANS: B
Unemployment is associated with violence within and outside the home. Abuse may increase both in and outside of the home due to unemployment. Applying for unemployment benefits is not a risk for this population. Neglecting the needs of their children only addresses what could happen inside of the home and not outside of the home.
A nurse is developing a community program to prevent violence. Which of the following should be the first action taken by the nurse?
a. Talk to people who are victims of violence for their opinion
b. Identify factors that lead to violence
c. Develop a plan of action to combat violence
d. Evaluate current community programs
ANS: B
A community’s population can influence the potential for violence. The starting point is the identification of factors that lead to violence, such as poverty, urban crowding, and racial inequality. In addition, one’s perceptions of the safety in a community can be influenced by racism and perceptions of criminality.
A nurse is counseling a client who has been abusive toward a spouse. Which of the following experiences has the client most likely had in the past?
a. Perceived or actual crisis
b. History of social isolation
c. Previous exposure to violence
d. Long-term marital strain
ANS: C
Perpetrators of intimate partner violence often believe that violence within an interpersonal relationship is a normal behavior pattern, based on their upbringing, living conditions, and increased stress.
A nurse is working with children who may be at risk for experiencing abuse. In which situation is child abuse most likely to occur?
a. When the parents have high expectations for their children
b. When the parents’ sense of control is threatened
c. When the parents are sensitive to their children’s needs
d. When the parents lack a social support network
ANS: D
Parents with a lack of social support, history of abuse as a child, or who have minimum education, a tendency toward depression, or multiple stress factors may be at risk for abusing their children. Parents who have high expectations for their children or are sensitive to their children’s needs do not have a tendency toward abuse. Parents who have their sense of control threatened do not have a tendency toward abuse.
What type of abuse is occurring when a child does not receive the basic nurturing and caring needed for healthy development?
a. Sexual abuse
b. Emotional neglect
c. Physical neglect
d. Child abuse
ANS: B
Emotional neglect is the omission of basic nurturing, acceptance, and caring of a child. Physical neglect is failure to provide adequate food, proper clothing, shelter, hygiene, or necessary medical care and is most often associated with extreme poverty. Child abuse ranges from violent physical attacks to passive neglect. Sexual abuse is a form of child abuse when a child has had nonconsensual sexual contact of any kind.
A nurse is caring for a child who lives in extreme poverty. Which of the following types of abuse is this child at greatest risk for?
a. Sexual abuse
b. Emotional neglect
c. Physical neglect
d. Child abuse
ANS: C
Physical neglect is failure to provide adequate food, proper clothing, shelter, hygiene, or necessary medical care. Emotional neglect is the omission of basic nurturing, acceptance, and caring of a child. Child abuse ranges from violent physical attacks to passive neglect. Sexual abuse is a form of child abuse when a child has had nonconsensual sexual contact of any kind.
A nurse is making a home visit to a low-income, frail, older person’s home. Which of the following would most likely cause the nurse to suspect adult maltreatment?
a. The older person reports giving money to family members on a regular basis.
b. The windows of the house are in need of repair.
c. The older person spends a great deal of time watching television.
d. There are dogs running loose in the yard of the home.
ANS: A
Older adults are at risk for financial abuse through fraud, coercion to relinquish property rights, and money mismanagement. A low-income, frail, older person would most likely not be giving money to family members on a regular basis, because the client would need the money to meet basic needs.
A nurse is working with a recent rape survivor. Which of the following actions would be most appropriate for the nurse to implement?
a. Provide continuous care once the victim enters the health care system
b. Examine evidence for its authenticity
c. Work with the criminal justice system to find the rapist
d. Provide long-term therapy for psychological trauma
ANS: A
Not only do nurses often provide continuous care, in some states nurses are trained as sexual assault examiners who gather forensic evidence. Nurses provide victims with privacy, respect, and assurance of confidentiality. The nurse would not be providing long-term therapy for the survivor or have the responsibility to find the rapist.
A nurse is completing a community assessment. Which of the following community characteristics would be identified as a factor for violence?
a. Lack of family cohesion
b. High crime rate
c. Social isolation
d. Substance abuse
ANS: B
High crime rate is the only “community characteristic.” Lack of family cohesion is a familial factor. Social isolation and substance abuse are individual factors.
A nurse helps the community to take a stand against violence and advocates for elected officials and local media to make nonviolence a priority. Which of the following levels of prevention is being implemented?
a. Primary
b. Secondary
c. Tertiary
d. Primary care
ANS: A
Primary prevention refers to those interventions aimed at preventing the occurrence of disease, injury, or disability. Being an advocate for nonviolence demonstrates primary prevention. Secondary prevention refers to interventions aimed at early detection and screening. Tertiary prevention refers to interventions aimed at treatment and rehabilitation. Primary care is not a level of prevention.
A nurse assists an injured victim in finding a safe location to live after being abused. Which of the following levels of prevention is being implemented?
a. Primary
b. Secondary
c. Tertiary
d. Primary care
ANS: B
Secondary prevention focuses on early detection and prompt treatment of disease, injury, or disability. Finding shelter for a victim of abuse demonstrates secondary prevention. Primary prevention refers to those interventions aimed at preventing the occurrence of disease, injury, or disability. Tertiary prevention refers to interventions aimed at treatment and rehabilitation. Primary care is not a level of prevention.
A nurse is providing tertiary prevention. Which of the following interventions should be included?
a. Education
b. Prevention
c. Referral
d. Detection
ANS: C
Tertiary prevention refers to interventions aimed at treatment and rehabilitation. Nurses should know about available community resources for abuse victims and perpetrators. Education and prevention primarily deal with primary prevention strategies. Detection is part of secondary prevention.
A nurse is assessing an individual who has been the victim of domestic violence. Which part of the body should the nurse assess first?
a. Front of the body
b. Back of the body
c. Proximal parts of the body
d. Distal parts of the body
ANS: C
Attacks are often inflicted on proximal parts of the body that can easily be disguised by clothing, so the nurse should assess this area first.
A nurse is caring for a woman who has been battered for a number of years. Which of the following has the client most likely seen an increase in over the years?
a. Self-blame
b. Remorse by the man
c. Severity of the abuse
d. Emotional strength
ANS: C
Severity of abuse and its frequency is most likely to increase over time. Both the man and the woman tend to blame the incident on something external. The man’s remorse tends to lessen over time.
A nurse working at a battered woman’s shelter is counseling a pregnant woman who has just entered the shelter. When assessing the client’s history, which information would the client most likely report?
a. A history of abuse before pregnancy
b. A history of child abuse
c. A history of multiple pregnancies
d. A history of substance abuse
ANS: A
Abuse before pregnancy is the most important risk factor for physical battery during pregnancy. A history of child abuse, multiple pregnancies, and substance abuse are not as closely associated with the risk of physical battery during pregnancy.
A child has reported to the school nurse that he is being bullied. Which of the following is most likely happening to this child?
a. Difficulty talking to the guidance counselor
b. Inclusion in group activities
c. Intimidation by a peer
d. Discipline from parents at home
ANS: C
Bullying has become a major problem in schools. Bullying can be physical and/or psychological abuse, intimidation, or verbal abuse; the exclusion of some children in group activities is another form of bullying.
A community health nurse visits a home and notices multiple bruises on a 4-year-old child. The mother reports that her husband is an alcoholic and is currently sleeping. What is the most appropriate action for the nurse to take?
a. Question the mother about sexual abuse
b. Initiate interventions directed at family violence
c. Report the case of suspected child abuse to authorities
d. Refer the mother to a social worker or Al-Anon group
ANS: C
It is required by law that nurses report all cases of suspected child abuse. The mandatory reporting laws protect reporters from legal action on cases that are never substantiated. It is essential that this is the first action to be taken by the nurse. After this action is taken, it may be appropriate to initiate interventions related to decreasing family violence or asking specifically about abuse. Referral of the mother to a social worker would not assist in decreasing the potential abuse that may be occurring.
A nurse is assessing a school-age child whose parents have reported recent violent activity from the child that is atypical from this child. Which of the following may have contributed to the child’s change in behavior?
a. Getting a new pet
b. Watching too much television
c. Playing violent video games
d. Having a new sibling at home
ANS: C
Research on violent television and films, video games, and music demonstrates that media violence increases the likelihood of aggressive and violent behavior, both immediately and long-term. Parents and caregivers are critical in monitoring what reaches their children
A nurse is assisting with community planning. Which of the following facilities should the nurse encourage be developed to reduce the potential for crime and violence in the community? (Select all that apply.)
a. Playgrounds
b. Movie theaters
c. Swimming pools
d. Shopping malls
e. Restaurants
ANS: A, B, C
Recreational facilities including playgrounds, movie theaters, and swimming pools all provide socially acceptable outlets for a variety of feelings, including aggression. Shopping malls and restaurants would not be considered recreational facilities.
A nurse is providing care to a child who has been abused. Which characteristics are most likely present in this child’s family? (Select all that apply.)
a. The parents are unemployed.
b. There is no support network willing to offer assistance.
c. The parents are not knowledgeable about child development.
d. The mother seems frightened of her partner.
e. There is no primary caregiver in the home.
ANS: A, B, C, D
Risk factors for child abuse include unemployed parents, no support network, parents not knowledgeable about child development, and a mother who is scared of her partner.
Which statement about advanced public health nurses (APHNs) and nurse practitioners (NPs) is correct?
a. They often work in similar settings.
b. They have identical educational preparation.
c. Their practices have become more similar during the past decade.
d. The clinical nurse specialist role always involves prescriptive practice.
ANS: A
APHNs and NPs often work in similar settings. APHNs and NPs have differing educational preparation depending on the specialty focus. The practices have continued to differ during the past decade. The clinical nurse specialist role typically does not involve prescriptive practice.
The NP movement began at the University of Colorado with nurses providing _____ care.
a. maternity
b. well-child
c. nursing home
d. diabetes
ANS: B
It was determined that educating community-oriented nurses could decrease morbidity among medically deprived children. Nursing practice for pediatric NPs included the identification, assessment, and management of common acute and chronic health problems, with appropriate referral of more complex problems to physicians.
An advanced practice nurse uses knowledge and physical, psychosocial, and environmental assessment skills to respond to common health and illness problems. Which of the following best describes this individual?
a. Advanced practice nurse
b. APHN
c. NP
d. Clinical nurse specialist
ANS: C
An NP applies nursing knowledge with physical, psychosocial, and environmental assessment skills. An advanced practice nurse is a licensed professional nurse prepared at the master’s level or doctoral level to take leadership roles in applying the nursing process and public health sciences to achieve specific health outcomes for the community. An APHN has a minimum of a master’s degree and has specialized courses related to public health. Clinical nurse specialists influence care outcomes by providing expert consultation for nursing staffs and by implementing improvements in health care delivery systems.
An NP is employed in a primary health care setting. Which services are most likely provided in this setting?
a. Primary health services and prison medicine services
b. Public health and primary care services
c. Family practice and geriatrics care
d. Home health and school health services
ANS: B
Primary health care includes public health and primary care services by definition
Which statement accurately describes how NP programs began?
a. Started as a physician’s assistant program
b. Were an offshoot of midwifery
c. Have not always required a master’s degree
d. Began in Europe and didn’t reach the United States until 1970
ANS: C
The early NP degree programs were often continuing education programs and certificate programs that did not require a master’s degree or even a baccalaureate degree. NP programs began with a focus on well children. The NP movement began in 1965 at the University of Colorado.
A student is pursuing a graduate nursing education with preparation as a generalist, functioning at the micro-systems level, and assuming accountability for health care outcomes for a specific group of clients. Which educational preparation is this student receiving?
a. Clinical nurse leader
b. APHN
c. NP
d. Doctor of Nursing Practice (DNP)
ANS: A
A clinical nurse leader is defined as a nurse who is a master’s prepared generalist who functions at the micro-system level and assumes accountability for health care outcomes for a specific group of clients within a unit or area. An NP applies nursing knowledge with physical, psychosocial, and environmental assessment skills. An APHN has a minimum of a master’s degree and has specialized courses related to public health. A DNP is the preferred educational preparation for specialty advanced practice nurses.
A registered nurse (RN) would like to become an NP. Which level of education is required?
a. Bachelor of science in nursing degree
b. Master’s or higher degree in nursing and NP education
c. Bachelor of science in nursing degree and completion of a formal NP program
d. Master’s degree with a specialty in public health nursing
ANS: B
As of 1992, the American Nursing Credentialing Center (ANCC) required a master’s degree or higher for NP certification. The practice doctorate is encouraged for NP certification, but is not required.
