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Community health at fdu > kaplan study card > Flashcards

kaplan study card Flashcards

1
Q

The community nurse provides care for a client who has experienced blindness as a result of diabetes mellitus. In the natural history of diabetes mellitus, the nurse identifies the onset of blindness as reflective of which stage?

  1. susceptibility
  2. Exposure
  3. Clinical
  4. Early pathogenesis
A

3 (clinical) is correct –> In stage 4, also known as the culmination stage, the disease or health condition causes sufficient anatomic or functional changes to produce recognizable signs and symptoms
rationale:
1- susceptibility is stage 1 where the disease is not present and individuals have not been exposed
2- Stage 2 occurs when individuals have been exposed to a disease but are asymptomatic
4- in stage 3, signs and symptoms actually begin to develop

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2
Q

4 stages of a disease progression are and how many phases are there?

A

Stage 1: susceptibility–> primary prevention occurs here
Stage 2: adaptation–> primary prevention occurs here
Stage 3: onset –> secondary prevention occurs here
Stage 4: the culmination –>tertiary prevention occurs here

Phase 1:

  • pre-pathogenesis
  • the 1st two stages

Phase 2:

  • pathogenesis
  • stages 3 and 4
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3
Q

What is the primary goal for the community health nurse to accomplish by acting as a client advocate?

  1. Efficient referral system
  2. Coordination of team members
  3. Effective discharge planning
  4. Client independence
A
  1. client independence (correct)
    * client advocacy consists of nursing actions that inform, support, and affirm clients in their goal of self-determination

rationale:
1- providing referrals is an appropriate goal; however, the primary goal of the community health nurse, acting as a client advocate, is maintaining the client’s independence
2- coordination of team members reflects the role of the consultant or case manager
3- Discharge planning may be part of the primary goal; however, the primary goal of the community health nurse, acting as a client advocate, is maintaining the client’s independence

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4
Q

Community health nursing

A
  • population-based nursing practiced in various community settings
  • promotes and protects the health of the community
  • collaborative model of health care delivery
  • for individuals and families within the community
  • Addresses primary health needs for acute and chronic conditions in a variety of settings:
    - community, nursing centers, and institution-based facilities
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5
Q

Community-based nursing

assessment consists of:

A
  • the current health status of the client: (acute and chronic health conditions, and effectiveness of prescribed treatments and strategies of management)
  • capacity and level of client participation in self-care
  • access to services
  • need for referrals
  • safety concerns of the client and family members
  • client strengths
  • available resources
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6
Q

Community-based nursing

planning consists of:

A
  • identify the client and family needs
  • advocate for the client
  • collaborate with members of health care
  • manage and coordinate needed resources and services
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7
Q

Community-based nursing

The implementation consists of:

A
  • establish and maintain a therapeutic relationship with the client and family
  • enable client and family to view nurse as an advocate in health care system
  • address the needs that may impair access to health services:
    • cultural
    • social
    • financial
    • legal
    • make referrals as needed
  • Provide direct care and teaching
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8
Q

Community-based nursing

The evaluation consists of:

A
  • nurse will determine the effectiveness of interdisciplinary interventions
  • nurse will give attention to changing health needs
  • nurse will identify new health issues
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9
Q

The nurse receives a large grant for the purpose of educating a state about the leading cause of death due to infectious disease in the United States. The nurse develops a television-based public service announcement focused on which disease?

  1. HIV
  2. Tuberculosis
  3. Hepatitis
  4. Pneumonia
A
  1. pneumonia (correct)
    * the lower respiratory infection is the leading cause of death due to infectious disease in the United States

rationale:
1- HIV is not the leading cause of death
2- Tuberculosis is not the leading cause of death
3- Hepatitis is not the leading cause of death

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10
Q

Vital Statistics

A

Information from registrations

  • births
  • deaths
  • divorces
  • marriages
  • used as a source of information for epidemiologic studies
  • information found on state websites
  • part of existing data is used as a source of data for epidemiologic study
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11
Q

Which action or intervention represents a form of secondary prevention?

  1. Meals on wheels for people who are unable to leave their homes
  2. Breast self-exam
  3. Use of seat belts
  4. Flu vaccine
A
  1. Breast self-exam (correct)
    * this is screening which is early identification that can lead to positive client outcomes

rationale:
1- meals on wheels–> tertiary prevention, implemented after a disease or injury is established. The client’s health status (housebound) warrants assistance with nutrition
3- Using seatbelts —> primary prevention, the intent is to reduce or eliminate causative risk factors (risk reduction)
4- vaccines–> primary prevention, provides an intervention before there is evidence of disease or injury

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12
Q

What is the purpose of prevention?

A

prevent the disease from developing

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13
Q

Primary prevention

A

-precedes the development of disease
-education about health promotion activities
-immunizations
-wear protective devices to prevent injury
-activities that promote health and prevent illness
-emotional support for parents with a child with autism
(support groups, counseling, social services)

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14
Q

Secondary prevention

A
  • screening (colon cancer, breast cancer, testicular, pap smear, etc)
  • early detection and treatment of disease
  • contact investigation
  • case-finding
  • identify health issues at the earliest opportunity
  • prevent complications
  • providing appropriate first aid
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15
Q

tertiary prevention

A

-after the disease has resulted in damage
-limiting disability
-rehabilitating clients to the highest level of functioning
-restore individuals, families, or communities to the highest level of functioning
(providing rehab, pt, OT, etc)

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16
Q

Before educating and health-promoting what do you want to do?

A
  • assess the level of readiness for enhanced learning
  • health needs
  • client goals
  • personal preferences
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17
Q

The nurse applies for a staff position to provide hospice care. What is the primary objective of hospice care?

  1. offer reassurance to the client’s family
  2. Keep the client clean, dry, and nourished
  3. help maintain client integrity and comfort
  4. make referrals for a client with spiritual distress
A
  1. help maintain client integrity and comfort (correct)
    *client-centered care is the focus of care, dying peacefully while maintaining integrity and dignity is the focus of hospice care
    rationale:
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18
Q

Hospice

A

The interdisciplinary (involves many people- doctor, nurses, home health aide, hospice workers, bereavement counselors, etc) program of palliative care and supportive services

  • addresses the needs of terminally ill clients and their families:
    • physical
    • spiritual
    • economic
    • social
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19
Q

The community health nurse meets with the residents of a small town. To best assess the goals of the community, the nurse obtains an answer to which question?

  1. “what are the most important features of your community?”
  2. “What is the purpose of the community?”
  3. “What are some activities in your community?”
  4. “What things help the community meet the needs of its members?”
A
  1. “What is the purpose of the community?”
    * goals of the community are focused on maximizing the well-being of members, promoting survival, and meeting the needs of the community members. Inquiring about the purpose of the community would be the first step in the community assessment
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20
Q

What are some types of community assessments? (select all that apply)

  1. amount of trees
  2. windshield survey
  3. problem-oriented assessment
  4. community subsystem assessment
  5. comprehensive assessment
A

2, 3, 4, 5

*community assessment is the act of becoming knowledgeable about the community

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21
Q

Which activity best addresses population-focused practice by the community nurse?

  1. assessing a family of victims involved in an apartment fire
  2. examining sixth graders for the presence of scoliosis
  3. counseling young couple regarding parenting skills
    4 addressing a town council regarding a flu vaccination program
A
  1. Addressing a town council regarding a flu vaccination program
    * the primary mission of the population-focused practice is working with groups within the community
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22
Q

The population is described as:

A
  • a group of people sharing at least one characteristic such as:
    • age
    • gender
    • race
    • risk factor
    • disease
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23
Q

What are some interventions for population-focused practice:

A

a. community organizations
b. health teaching
c. case management
d. advocacy
e. screening
f. disease and health event investigations

24
Q

In order to understand the rate of growth of a community, the nurse requires which piece of data?

  1. number of migrant workers present in the summer months
  2. age, gender, marital status, and occupation of the residents
  3. estimate the number of full-time residents over a period of time
  4. number of residents in the physical space of land available
A
  1. estimate the number of full-time residents over a period of time
    * the rate of growth is based on the number of full-time residents over a specified time frame

rationale:
1- this number represents mobility (represents the people moving in and out of a community on a seasonal basis)
2. these specific characteristics represent a composition
4- this data is associated with density

25
Q

In an effort to develop an education program to lower the incidence of Lyme disease in a New England town, the nurse begins by studying the prevalence. Which information reflects this concept?

  1. the percentage of persons who died due to Lyme Disease
  2. How the disease was spread from person to person
  3. the number of reported cases over the past three years
  4. the factors which contributed to contracting Lyme disease
A
  1. the number of reported cases over the past three years
    * the prevalence is the number of cases of a specific disease at a given point in time, in a given population

rationale:
1. is an example of case fatality rate
2. represents the transmission
4. represents a person’s susceptibility

26
Q

Prevalence rate

A

all people with a particular health condition existing in a given population at a given point in time
-calculated by dividing the number of persons with the characteristic by the total number in the population

27
Q

Which represents a qualitative assessment for the community nurse to use for children’s health needs?

  1. attend a meeting with other health care workers to discuss improving the school lunch program
  2. use the internet to determine the number of daycare facilities located in the area
  3. assist at an immunization clinic whose goal is to triple the number of vaccines administered from last year
  4. determine what organized sports teams are available for children under the age of ten
A
  1. (correct) attend a meeting with other health care workers to discuss improving the school lunch program
    * qualitative assessment requires discussion, listening, and gathering insights and opinions

rationale:
2. quantitative assessments are investigations in which numbers are used to measure variables such as characteristics, concepts, or things. Counting the facilities represents a quantitative method
3. assessing the numbers represents a quantitative method
4. reviewing the numbers represents a quantitative method

28
Q

When applying the epidemiological triangle to a disaster event, the nurse recognizes which as the host?

  1. efforts utilized to prevent, predict, and control the victims’ needs
  2. the physical item actually causing the destruction in the disaster
  3. human characteristics that influence the severity of the disaster effects
  4. factors that directly affect the outcome of disaster
A
  1. (correct) human characteristics that influence the severity of the disaster effects
    * the host is represented by the human aspect
    examples:
    - genetic susceptibility
    - immutable characteristics–> family history, age, and sex
    - acquired characteristics–> immunologic status, heart disease, and obesity
    - lifestyle factors–> diet, exercise, drug use, intake of caffeine, and use of tobacco products
29
Q

HOST-AGENT-ENVIRONMENT MODEL

Agent

A 
are factors that causes or contributes to illness or conditions 
INFECTIOUS example: 
-bacteria 
-virus
-fungi
-parasites

CHEMICAL examples

  • heavy metals
  • toxic chemicals
  • pesticides

PHYSICAL examples:

  • radiation
  • heat
  • cold
  • machinery
  • power tools
30
Q

HOST-AGENT-ENVIRONMENT MODEL

Environment

A 
external factors that contribute to the host's susceptibility or resistance 
A. CLIMATE example: 
-temperature 
-rainfall
-number of days in the sun 
B. Plant and animal examples: 
-agents
-reservoirs or habits for agents 
-types and numbers 
C. Human population distribution examples: 
-crowding 
-social support
-apartments versus subdivisions 
-number of people per acre/block of land 
D. Socioeconomic factors examples: 
-education 
-sources
-access to care 
-income 
E. Working condition examples: 
-levels of stress 
-noise
-satisfaction 
-factory inside air pollution
31
Q

The community nurse calculates the rate of H1N1 influenza diagnosed in a local high school senior class on a particular day. There are six known cases out of a population of 300 students. The nurse determines which prevalence rate is correct?

  1. 2%
  2. 5%
  3. 10%
  4. 12%
A
  1. 2%
    * the prevalence rate is calculated by the number of persons with a characteristic divided by the total number in a population (300)

rationale:
2,3,4–> the percentage is too high

32
Q

The community nurse leads a discussion about primary prevention. Which example BEST reflects this level of prevention?

  1. teaching parenting classes to parents in their second trimester of pregnancy
  2. instructing older adult clients with osteoporosis about the benefits of walking
  3. counseling clients with emphysema about pollution indexes
  4. helping cardiac surgery clients to find access to exercise equipment
A
  1. teaching parenting classes to parents in their second trimester of pregnancy
    * Planning for the future to avoid physical and or psychological problems is an example of primary prevention

rationale:
2. tertiary prevention in the form of rehabilitation
3. example of secondary prevention in reaction to a confirmed diagnosis
4. this is an example of tertiary prevention in the form of rehabilitation

33
Q

In the host-agent-environment model of epidemiology, the nurse identifies which factor as the environment?

  1. a herd of infected cattle
  2. waste products dumped in a nearby lake
  3. individuals living in a crack house
  4. water contaminated with e.coli
A
  1. water contaminated with e.coli
    * contaminated water is an environmental factor and the environment refers to all the external factors surrounding the host that may influence vulnerability or resistance

rationale:
1. (host)
2. the agent is the factor that causes/contributes to a health problem or condition
3. (host) susceptible humans and animals that harbor and nourish a disease-causing agent such as hepatitis/HIV

34
Q

A predominately rural town of 25,000 residents has an influx of 5,000 migrant workers from May to September. The nurse identifies which aspect of the population perspective is represented by the incidence?

  1. mobility
  2. composition
  3. rate of growth
  4. density
A
  1. mobility
    * people moving in and out of a community on a seasonal basis is an example of mobility

rationale:
2. composition reflects demographic information of residents, including age, sex, marital status, and occupation
3. the number of full-time residents over a period of time is the rate of growth
4. density is the number of residents in the physical space of land available

35
Q

Which statement best reflects the best description of an incubation period?

  1. the students do not have the disease, nor have they been exposed
  2. exposure to the virus has occurred and the organism is multiplying
  3. students may have a cough and low-grade fever during this time
  4. hospitalization may be necessary at this point
A
  1. exposure to the virus has occurred and the organism is multiplying
    * when the organism multiplies to sufficient numbers to produce a host reaction it is referred to as the incubation period

rationale:
1. this describes the susceptibility stage. it is the pre-exposure period in which the individual is vulnerable or at risk to acquire the infection
3. the clinical stage is the period of time at the onset of signs and symptom s, to moderate symptoms, or to the severe expression of illness
4. referred to as the clinical disease or culmination stage

36
Q

A mass screening for hyperlipidemia is being planned by a community nurse. Which represents the BEST target group for this project?

  1. women with a BMI of 40 or greater
  2. adults who consume fast food daily
  3. employees at a local manufacturing plant
  4. Males who consume three or more servings of alcohol daily
A
  1. employees at a local manufacturing plant
    * this group is accessible and easily identifiable through the contained place of employment

rationale:
1. this group would not be readily accessible due to the potential for body image disturbance
2. this group would not be easily accessible as it would be very difficult to identify and assimilate the group
4. this group would not be easily accessible or identifiable

37
Q

Which scenario does BEST to reflect a biophysical factor contributing to a family’s state of homelessness?

  1. following a kidney transplant, 40% of the families income was required for anti-rejection medication
  2. both parents of 4 siblings experience post-traumatic stress syndrome following a fire that destroyed their home
  3. due to urban redevelopment, a family-owned grocery store was closed down permanently
  4. a counseling center 2 blocks from a families home was closed due to funding shortages
A
  1. following a kidney transplant, 40% of the families income was required for anti-rejection medication
    * a biophysical factor is one affecting health. Economic factors that impact this family’s income were directly related to the disease process or medical care required by a family member

rationale;

  1. this represents a psychosocial factor affecting mental health
  2. this is a sociocultural factor
  3. this is a health system factor
38
Q

The nurse designs a project to investigate the use of smokeless tobacco of male graduates from a local high school and the incidence of oral cancer ten years later. This represents which type of study?

  1. experimental
  2. prospective
  3. cross-sectional
  4. retrospective
A
  1. prospective
    * the study looks FORWARD in time to find a causal relationship

rationale:
1. experimental –> involves the investigator/researcher controlling or changing factors suspected of causing the condition and observing the results
3. a cross-sectional–> explores the relationship of a health condition to other variables in a specified population at a specific point in time
4. retrospective study–> look backward in time to find a causal relationship

39
Q

Quantitative research design types

(mentions descriptive, correlational, quasi-experimental, clinical trials) see next card for more

A
  1. Descriptive and correlational –> no researcher intervention

Descriptive–> describes characteristic of topic (individuals, groups, situations, frequency or occurrence of certain phenomena)
Correlational–> examine relationships between variables or subjects, look for strength and direction of relationship)

  1. Quasi-experimental and experimental–> researcher intervention, examine causality)

Quasi-experimental–> no random assignment or control group
Experimental–> random assignment of subject, have an experimental and control group

  1. Clinical trials–>
    Experimental design that assesses effects of new or revised clinical interventions (clinical treatments, medications, medical equipment), safety and efficacy of intervention studied
    A. RCT–> gold standard or evidence-based practice decisions , very tightly controlled experimental decisions
    -uses random sampling (probability sampling)
    -allows for generalizability of findings
    -selection process is highly controlled
    -focuses on objectivity, elimination of bias
40
Q

Cross sectional studies

A 
look at phenomenon at one point in time
-across multiple separate populations that differ in characteristics: age, developmental  status, time periods, positions in educational system)
-no follow-up
ADVANTAGES
-compared with longitudinal 
-relatively economical 
-easy to design and implement 
-quick to conduct, obtain results
41
Q

Double-blind experiment

A

Neither subjects nor researchers know who is in either the control or experimental group
-Purpose-> decrease researcher bias, decrease Hawthorne effect, gold standard for experimental research

Control group–> group of subjects in experimental research study comparable to the experimental group

  • does not receive experimentally intervention or treatment is given (given placebo)
  • differences in outcomes between groups is measured
  • decrease threats to external validity
  • increases confidence that study findings can be generalized to other people and settings
42
Q

Longitudinal Prospective Cohort studies

A

follows subjects over a period of time in the future

-collects data at two or more different points in time

43
Q

Cohort study

A

is a type of longitudinal study

-subjects have all been born in a particular time period or have similar backgrounds

44
Q

Pilot study

A

small scale version or largely planned study

  • designed to identify and prevent problems from occurring in a larger study
  • tests all methods and procedures for feasibility and accuracy
  • tests instrumentation
  • sample has similar characteristics to the sample planned for the study
45
Q

Retrospective studies

A

focus on the past

  • Uses data–> that is already collected about events having already occurred-secondary data
  • identifying present conditions(looks to past to determine the cause)
  • record review is a possible data source
  • good beginning for exploratory research and is never experimental
46
Q

What factors influence a community’s potential for violence?

  1. large populations of children, elderly, and developmentally disabled people
  2. implementing group norms to promote civility
  3. previous exposure to and participation in violent acts
  4. social conditions and multiple demands on the population’s economic conditions
A
  1. social conditions and multiple demands on the population’s economic conditions
    * Factors such as unemployment, social isolation, media influence, rigid religious beliefs, and population density contribute to potential violence in a community
47
Q

The public health nurse visits an undergraduate nursing program as a guest speaker. Which statement made by a student indicates further learning is necessary on the topic of epidemiology?

  1. “epidemiology tracks the incidence of communicable diseases”
  2. “epidemiology involves health care reform to lower medical cost”
  3. “epidemiology searches for causal relationship in health and illness”
  4. “epidemiology reduces debilitating injuries in the workplace”
A
  1. “epidemiology involves health care reform to lower medical cost”
    * health care reform is not a focus of the field of epidemiology

rationale:
1. this is a component to track the incidence of communicable disease
3. this is the overall definition of epidemiology
4. a component of epidemiology is to reduce debilitating injuries in the workplace

48
Q

Which is the nurse’s primary focus when developing health promotion programs for clients in the workplace?

  1. safe work habits
  2. healthy lifestyle choices
  3. treatment of injuries
  4. provide protective equipment
A
  1. healthy lifestyle choices
    * health promotion programs in the workplace often include smoking cessation, weight reduction, and stress management

rationale:
1. this is more of OSHA (occupational safety and health administration)
3. the treatment of injuries is a secondary focus within the workplace. Primary prevention will be the nurse’s focus
4. providing protective equipment is an employer’s responsibility

49
Q

The community nurse is aware that health promotion programs are PRIMARILY designed to accomplish which goal?

  1. enable individuals to respond positively to environmental stressors
  2. expand the potential for health and personal development
  3. reduce the risks to health from a global perspective
  4. detect an early incidence of the disease
A
  1. expand the potential for health and personal development
    * health promotion focuses on changing patterns of behavior for individuals and populations

rationale:
1. goals for health promotion also include aggregates of population
3. reducing the risk to health represents illness prevention
4. early detection of disease represents illness prevention

50
Q

The nurse provides teaching to clients about first-time medication prescriptions. Which represents primary prevention?

  1. use a soft toothbrush while on warfarin for A-fib
  2. placement of the etonogestrel/Ethinyl vaginal ring for contraception
  3. having a yearly physical and bloodwork done
  4. correct procedure for drawing up two different insulins in one syringe
A
  1. placement of the etonogestrel/Ethinyl vaginal ring for contraception
    * primary prevention is an intervention that is implemented before there is evidence of disease and injury. Family planning/pregnancy prevention is a form of primary prevention

rationale:
1. this example represents tertiary prevention (intervention is implemented after a disease or injury)
3. this is secondary prevention (after a disease has begun but before it is symptomatic)
4. secondary prevention

51
Q

The nurse identifies which characteristic BEST serves as an indicator of a community social index?

  1. suicide rate
  2. ratio of firefighters to residents
  3. location of mental health services
  4. prematurity birth rates
A
  1. ratio of firefighters to residents
    * a community social index uses numerical measures that describe the well-being of communities. Indicators are made up of one or several components combined into an index. They are used to describe and evaluate community well-being in terms of social, economic, and psychological welfare. The number of protective services to the number of residents is an example of social indexes

rationale:
1. this serves as a measure of the community health status
3. the number of mental health services, versus the locations, would serve as a measure of the community’s health status
4. this serves as a measure of the community health status

52
Q

Emergency response systems in a community are:

A

services such as emergency response, police protection, and civil defense enhance feelings of safety and security to the community and are part of the psychological environment

53
Q

What are the major types of interventions typically planned by community health nurses (select all that apply)?

  1. policy setting and implementation
  2. screening programs
  3. increasing community self-help
  4. health education programs
  5. designing public green spaces
  6. establishment of services
A
  1. policy setting and implementation
  2. screening programs
  3. increasing community self-help
  4. health education programs
  5. establishment of services
54
Q

The nurse is aware the concept of causality is likely to present in which event?

  1. an executive gets a job promotion and suffers a myocardial infarction
  2. two of four siblings are born with cleft lip palates
  3. a student with a history of childhood asthma performs poorly on a college entrance exam
  4. following the use of marijuana, a construction worker falls
A
  1. following the use of marijuana, a construction worker falls
    * research supports illicit drug use affects cognitive and physical functioning

rationale:
1. long-standing cardiovascular disease was likely to cause rather than new position
2. cleft lip palate has a genetic origin
3. it is uncertain whether the asthma history played a role in the student’s performance

55
Q

Causality

A

relationship between cause and effect which allows community health nurse to understand why conditions/illness develop

56
Q

Epidemiology rates (4)

A

the rates are a statistical measure expressing the proportion of people with a defined health problem among a population
THEY ARE:
prevalence
incidence
morbidity
mortality rates (crude mortality rates, cause-specific mortality rate, case fatality rate, proportional mortality ratio, age-specific mortality rate)

Community health at fdu (4 decks)

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