Test 3 Flashcards
study
When describing the global framework, which of the following would the community health nurse be least likely to include?
A) Population
B) Provider
C) Procedure
D) Physician
Ans: D
Feedback:
The global framework is bounded by a context and includes three parts, the three Ps. These are the population, the provider, and the procedure. A physician would be included as a provider.
When applying the Universal Imperatives of Care, which of the following would be the priority?
A) Mortality
B) Daily functioning
C) Decision-making
D) Cost
Ans: A
Feedback:
The Universal Imperatives of Care include mortality, morbidity, daily functioning, decision-making, and cost. This paradigm underscores the notion of first things first. That is, one must be alive and well before interventions focus on functioning or decision-making.
A nursing student is considering a career in international community health nursing.
Which of the following statements is accurate regarding the context of international community health nursing? Select all that apply.
A) Global community health care is complex and is affected by multiple factors relating to geography, history, politics, culture, religion,
and economy.
B) The types of services that can be provided include a range from providing clinical services to policy making at an international
level.
C) People’s conceptions of health, wellness, and illness are static from culture to culture.
D) By looking through a computer window, the student is able to see almost anywhere, connect to about any person, and access
information about almost any concept.
E) The ways in which people view nurses and other health care providers are affected by
their attitudes toward women, their culture,
and belief systems.
Ans: A, B, D, E
Feedback:
The following statements are true: Global community health care is complex and is
affected by multiple factors relating to geography, history, politics, culture, religion, and economy; The types of services that can be provided range from providing clinical services to policy making at an international level. By looking through a computer window, the student is able to see almost anywhere, connect to about any person, and access information about almost any concept. The ways in which people view nurses and other health care providers are affected by their attitudes toward women, their culture, and their belief systems. The statement that people’s conceptions of health are static from culture to culture is false. Indeed, people’s conceptions of health, wellness, and illness vary from culture to culture.
A community health nurse is preparing a presentation for a community group about
tuberculosis (TB) and its current epidemic status. Which of the following would the nurse
include in the presentation about this
disease?
A) TB kills about 1.7 million people each year.
B) All persons who are infected by the causative organism become ill and can spread the causative organism to others throughout the remainder of their lifetime.
C) Three-fourths of the world’s population is thought to be currently infected by the
causative organism.
D) The highest number of deaths is in Eastern
Europe.
Ans: A
Feedback:
TB kills approximately 1.7 million people each year. Only 5 to 10 of those infected become ill or can spread the causative organism to others within their lifetime. One-third of the world’s population is thought to be currently infected by the causative organism (Tubercle bacillus). The highest number of deaths occur in Africa.
A community health nurse has identified noise as an environmental hazard. Using the
Blumenthal classification, the nurse would
identify this as which of the following classes?
A) Infectious agents
B) Asphyxiates
C) Poison
D) Physical agents
Ans: D
Feedback:
The Blumenthal classification lists classes of environmental hazards. They include infectious agents (e.g., bacteria and viruses), respiratory fibrotic agents (e.g., coal dust), asphyxiates (e.g., carbon monoxide), poison (e.g., pesticides), physical agents (e.g., noise),
psychological agents (stressful synergisms such as crowding combined with noise), mutagens (e.g., dioxin), teratogens (e.g., cadmium), and carcinogens (e.g., cigarette
smoke).
Which one of the following factors has resulted in the Era of Chronic Long-Term Health Conditions?
A) Decreased usage of tobacco by young populations
B) Despite programs of control, many infectious diseases persist, with many people surviving to experience chronic, long-term conditions secondary to the infectious disease.
C) Shorter life expectancies due to chronic
diseases
D) Death from infectious diseases results in a
decrease in degenerative diseases.
Ans: B
Feedback:
Despite the programs of control, many infectious diseases persist. However, populations now survive and also experience chronic, long-term conditions. These conditions affect mortality and morbidity, daily functioning, decision-making, and cost. Thus, the longevity that has resulted from meeting the challenges of the Era of Infectious Diseases compounds the more recent emergence of chronic diseases in many countries. The emergence of multidrug-resistant diseases, continued persistence of infectious disease, and urbanization with deforestation have resulted in new and emerging infectious diseases and conditions.
When reviewing statistics about illnesses worldwide, which of the following would the
nurse identified as the most common and a leading cause of mortality?
A) Tuberculosis
B) Smallpox
C) Acute respiratory tract infection
D) Infectious diarrheal disease
Ans: C
Feedback:
The most common illness in the world and a leading cause of mortality is acute respiratory tract infection (ARI). Three million deaths annually are attributed to ARI among
children younger than 5 years of age, usually from pneumonia. Tuberculosis is considered
epidemic today. Smallpox has been eradicated. Infectious diarrheal disease has been reduced due to oral rehydration therapy and improvements in water and sanitation.
help achieve a reduction in the number of measles deaths worldwide?
A) Integrated Management of Childhood Illness (MCI)
B) Global Alliance for Vaccine and Immunization
C) Oral rehydration therapy
D) Geographical information systems
Ans: A
Feedback:
The MCI is the intervention considered to have the greatest impact on reducing measles.
It provides wide immunization coverage, rapid referral of serious cases, prompt recognition of secondary conditions, and improved nutrition and vitamin A supplementation. The Global Alliance for Vaccine and Immunization is an interagency initiative that seeks to protect every child against vaccine-preventable diseases. This initiative addresses all of these types of diseases. Oral rehydration therapy has been used to reduce mortality associated with diarrheal diseases. Geographical information systems is not a program but a means to monitor diseases.
Which one of the following statements about
Is poliomyelitis the most accurate?
A) Polio is not endemic in any countries at
present.
B) Polio has been eliminated worldwide.
C) Rotary International has contributed no funds but many hours of manpower to eradicate polio.
D) Polio has been eliminated from the Western hemisphere.
Ans: D
Feedback:Polio has been eliminated from the Western Hemisphere. It is now almost eliminated worldwide. Polio is endemic in Afghanistan, India, Pakistan, and Nigeria. Rotary International has contributed over $900
million dollars to help eradicate this disease.
A community health nurse is reading a journal article about global health and communicable diseases. The article states that elimination is the goal. The nurse interprets this to mean which of the following?
A) There are no further cases of the disease
anywhere.
B) No further preventive efforts are necessary.
C) The disease is no longer a public health threat.
D) The disease has been interrupted in a
geographic area.
Ans: D
Feedback:
The term elimination is used when a disease has been interrupted in a defined geographic
area. In 1991, WHO defined elimination as a reduction of prevalence to less than one case per 1 million population in a given area.
Eradication means interruption of person-to-person transmission and limitation of the reservoir of infection so that no further preventive efforts are required; it indicates a status whereby no further cases of a disease occur anywhere. The term control indicates that a specific disease has ceased to be a
public health threat.
A community health nurse instructs a local community group on how to prepare homemade oral rehydration solution. Which of the following ingredients would the nurse include?
A) Sea water
B) Table salt
C) Baking soda
D) Crushed bananas
Ans: B
Feedback:
Oral rehydration solution consists of 1 L of safe water, to which is added half a teaspoon of salt and four large spoons of sugar. In addition, bananas or green coconut water are encouraged to compensate for the
loss of potassium.
Communicable disease is a global health concern with the primary goal of eradicating communicable diseases worldwide.
Achievement of this goal would involve
A) interrupting disease in a limited, defined
geographic area.
B) reducing the incidence and/or prevalence of communicable diseases.
C) establishing primary health care services for all people on the globe.
D) interrupting transmission and reservoir of
infection to prevent further cases.
Ans: D
Feedback:
Eradication is an ambitious and expensive goal and has occurred with smallpox in 1977
and is under way with other diseases such as poliomyelitis, guinea worm, leprosy, and measles so that many diseases can be eradicated early in the 21st century. One major means of eradicating communicable diseases is to interrupt the transmission and reservoir, thereby preventing the development of new cases. Interrupting disease in a limited area may be a starting point, but more widespread involvement is needed. Reducing the incidence or prevalence would provide indications about the effects of attempting to eradicate the disease. Establishing primary health care services is the goal of Alma-Ata Health for All.
Is immunization true?
A) The World Health Organization estimates that a billion more lives could be saved each year with immunizations.
B) Vaccines are one of the most cost-effective
interventions found in public health.
C) Half of the world’s children are being reached with essential vaccines.
D) In the United States, toddlers are thoroughly vaccinated.
Ans: B
Feedback:
Vaccines are one of the most cost-effective interventions found in public health. The World Health Organization estimates that 3 million more lives could be saved each year with immunizations. Three-fourths of the world’s children are being reached with essential vaccines. In the United States, only 10% of toddlers are protected against measles, mumps, and rubella via vaccinations.
A community health nurse is working with an international agency in Australia. The nurse would most likely encounter which type of health care system?
A) Entrepreneurial
B) Welfare-oriented
C) Comprehensive
D) Socialist
Ans: B
Feedback:
Australia subscribes to a welfare-oriented health care system in which statutory programs drive these systems to support the cost of health care for all, or almost all, of the population through their <national health insurance. An Entrepreneurial Health Care System, found in the United States, is one in which the country’s health care system is based, in part, on its political economy. A Comprehensive Health Care System is a step away from the welfare-oriented type
in that substantial modifications exist in delivery and financing that result in universal
entitlements. These systems are found in Scandinavian countries, Great Britain, and New Zealand. Socialist health care systems came about through social revolutions that abolished free-market economies and replaced them with socialism, where the health care system is also socialized. They are found in countries such as Russia, Eastern Europe, Albania, Bulgaria, Czechoslovakia, East Germany, Hungary, Poland, Romania, Yugoslavia, and China.
Which of the following are factors that influence populations’ perceptions of health and health status and their receptivity to community health nursing programs? Select all that apply.
A) Their perceptions of healthy food
B) Their attitudes toward women
C) Their culture
D) Their belief systems
E) Their geographic location
Ans: B, C, and D
Feedback:
The factors that influence populations’ perceptions of health and health status and their receptivity to community health nursing programs include their attitudes toward women, their culture, and their belief systems. Their perceptions of healthy food or their geographic location would not have a direct bearing on their perception of health, health status or receptivity to community
health nursing programs.
A community health nurse is preparing to work in a country in which women are viewed
as weak and ineffectual. Which of the following would the nurse need to do first?
A) Determine his or her own position and beliefs about this view
B) Develop a basic plan to change the view of
women
C) Become aware of possible areas that might
impact care
D) Avoid situations involving the care of women
Ans: A
Feedback:
Community health nurses first need to determine their own position on this issue and
come to terms with it, realizing that it may impact their care. Once aware, the nurses can then prepare appropriately for situations in which their care may be affected. It would be
inappropriate and probably impossible to attempt to change the view or avoid situations
involving the care of women.
Which of the following statements about the personal and professional perceptions that nurses have of providing community health nursing interventions within an international context is most accurate?
A) Community health nurses are not susceptible to preconceived perceptions and biases.
B) It is not necessary for community health
nurses to face their own beliefs.
C) Community health nurses are universally opposed to female circumcision, the use of
non-licensed personnel to carry out medical treatments, and the use of Western interventions used simultaneously with other methods of treatment.
D) It is critical for community health nurses to face their own beliefs when confronting
female circumcision, the use of non-licensed personnel to carry out medical treatments, and the use of Western interventions used simultaneously with other methods of
treatment.
Ans: D
Feedback:
It is critical for community health nurses to face their own beliefs when confronting
female circumcision, the use of non-licensed personnel to carry out medical treatments, and the use of Western interventions used simultaneously with other methods of treatment. Community health nurses are as susceptible as any other group of people to preconceived perceptions and
biases. Community health nurses may not be universally opposed to female circumcision, the use of non licensed personnel to carry out medical treatments, and the use of Western interventions used simultaneously with other
methods of treatment.
Community health nurses need to be knowledgeable about the World Health Organization.
Organization because its mission reflects which of the following?
A) Collaboration in health development to free
the world from poverty
B) Service as an independent agency providing economic and humanitarian assistance overseas
C) Representation of global interests and
concerns of the nursing profession
D) Global health promotion by supporting development efforts of governments,
organizations, and universities throughout the
world
Ans: D
Feedback:
WHO’s mission reflects global health promotion by supporting the development efforts of governments, organizations, and universities throughout the world. Collaboration to free the world from poverty reflects the mission of the World Bank. Service as an independent agency for economic and humanitarian assistance describes the
mission of the United States Agency for International Development (USAID). Representation of global interests and concerns of nurses describes the mission
of the International Council of Nurses (ICN).
An instructor in community health nursing teaches a group of students about the role of
the World Health Organization and global health, reviewing the importance of the Declaration of Alma-Ata. The instructor determines that the students have grasped its importance when they describe it as which of the following?
A) The beginning of the Carter Center’s work in disease prevention and agriculture
B) A formal document written by 134 nations in 1978 to achieve health for all
C) Participatory development activities, working in partnership with voluntary organizations
D) Alliance building and communicating best
practices for global health development
Ans: B
Feedback:
The declaration represents the work of 134 nations during a WHO/UNICEF conference
in 1978 to achieve primary health care for all. The Carter Center was founded in 1986 and is not related to the work at Alma-Ata.
Participatory development activities describe the work of the United States Agency for
International Development (USAID). Alliance building and communicating best practices
describe the Global Health Council, which is a leading private, voluntary, American nongovernmental organization.
Which of the following statements about the International Council of Nurses (ICN) are
accurate? Select all that apply.
A) ICN represents the global interests and
concerns of the nursing profession.
B) The mission of ICN is to maintain the role of
nursing in health care through its global voice.
C) ICN has, as members, nursing organizations from 130 countries representing 13 million
nurses.
D) ICN is a governmental organization.
E) ICN employs regional nursing advisors.
Ans: A, B, C
Feedback:
The following statements about ICN are accurate: ICN represents the global interests and concerns of the nursing profession; the mission of ICN is to maintain the role of nursing in health care through its global voice; and ICN has, as members, nursing organizations from 130 countries representing 13 million nurses. ICN is a nongovernmental organization. Regional nursing advisors are employed at the international level of the World Health Organization.
After teaching a class of community health nursing students about the World Health Organization, the instructor determines that the teaching was successful when the class identifies which of the following as the highest governing body?
A) World Health Assembly
B) WHO Collaborating Centers
C) The European Union
D) U.S. Agency for International Development
Ans: A
Feedback:
The World Health Assembly is the highest governing body within the WHO. WHO Collaborating Centers are networks of centers focusing on specific areas of expertise and carrying out the work of the member countries in these areas. The European Union is an organization that provides funding for many projects, including health. The U.S. Agency for International Development is an independent bilateral agency of the executive branch that works to enhance long-term and equitable economic growth.
A group of students are reviewing for an examination on nongovernmental organizations that provide global interventions. The students demonstrate the need for additional study when they identify which of the following as an example?
A) Global Health Council
B) CARE
C) Carter Center
D) World Bank
Ans: D
Feedback:
The World Bank is an agency that focuses on economic development. It partners with countries, WHO, and other organizations. It is not a non-governmental organization. Examples of nongovernmental organizations include Global Health Council, The Center for
International Health and Cooperation,
CARE, and the Carter Center.
Which organization would be most appropriate for the community health nurse to contact for assistance when dealing with countries shattered by war and ethnic
violence?
A) Center for International Humanitarian
Cooperation
B) CARE
C) Global Health Council
D) International Council of Nurses
Ans: A
Feedback:
The Center for International Humanitarian Cooperation (CIHC), founded in 1992,
promotes healing and peace in countries shattered by war, regional conflicts, and ethnic violence. CARE intervenes by responding to famines and disasters worldwide with emergency food, supplies, and rehabilitative efforts. The GHC advocates for needed policies and resources, builds networks and alliances among those working to improve health, and shares innovative ideas, knowledge, and best practices in health. The ICN represents the global interests and concerns of the nursing profession.
Which of the following statements about the
Is the World Health Organization accurate?
A) The World Health Organization does not provide technical support for interventions or
provide assistance in developing nursing
knowledge and skills.
B) The World Health Organization can help a member state determine the drugs that are
essential and will assist in developing health
policy, project plans, and programs.
C) The World Health Organization provides medicines and other tangible resources to its
member states.
D) The World Health Organization focuses on professional issues to support the
development of particular health-related
practitioners, such as nurses.
Ans: B
Feedback:
The World Health Organization can help a member state determine the drugs that are
essential and will assist in developing health policy, project plans, and programs. The World Health Organization does focus on providing technical support related to the interventions and provides assistance in developing nursing knowledge and skills. The World Health Organization does not provide medicines and other tangible resources to its member states but does help member states determine the drugs that are essential and assist in developing health policy, project
plans, and programs.
Which of the following statements regarding WHO Collaborating Centers is most accurate?
A) One or two Regional Nursing Advisors carry
out the work of a region that might be home to thousands of nursing personnel.
B) The World Health Organization Collaborating Centers in Nursing and other fields focus on specific areas of expertise and carry out the work of the member countries in these areas.
C) It is referred to as a philosophy, a movement, a way of thinking, a setting for health services, or a set of principles.
D) It focuses on professional issues to support
the development of particular health-related practitioners.
Ans: B
Feedback:
The World Health Organization Collaborating Centers in Nursing and other fields focus
on specific areas of expertise and carry out the work of the member countries in these areas.
Regional Nursing Advisors work in collaboration with WHO Collaborating Centers to accomplish the work within each region. Primary Health Care refers to a philosophy, a movement, a way of thinking, a setting for health services, or a set of
principles.
A community health nurse is working with people who experienced a tornado and have
been forced to leave their homes to escape the effects of a disaster. The nurse would identify these people as which of the following?
A) Indirect victims
B) Refugees
C) Displaced persons
D) Casualties
Ans: C
Feedback:
Displaced people are those who have been forced to leave their homes to escape the effects of a disaster. Indirect victims are the relatives and friends of direct victims. Refugees are direct victims who are forced to leave their homeland, usually due to war, religious persecution, or political turmoil. A casualty is a human being who is injured or killed by or as a direct result of an accident.
A community health nurse working as a part of a disaster response team is told that the disaster is classified as a multiple-casualty incident. The nurse would interpret this to
mean which of the following?
A) There is more than 1 but less than 10
casualties.
B) The number of casualties is between 2 and
100.
C) Casualties number over 100.
D) There are too many casualties to count.
Ans: B
Feedback:
If casualties number more than two people but fewer than 100, the disaster is characterized as a multiple-casualty incident. A mass- casualty incident involves100 or more casualties.
A community health nurse is part of a disaster response team that is first to respond to an
earthquake. The team evaluates the level of destruction and devastation, identifying
as which of the following?
A) Intensity
B) Scope
C) Casualty
D) Range of effect
Ans: A
Feedback:
The intensity of a disaster is determined by the level of destruction and devastation it causes. The scope of a disaster is the range of its effect, either geographically or in terms of the number of victims. Casualty refers to the human being(s) injured or killed by or as a
direct result of an accident.
Which of the following examples of disasters
are natural disasters? Select all that apply.
A) The Earthquake and tsunami in Japan in 2011
B) The 2008 shootings at Virginia Tech
C) The terrorist attacks on the United States on September 11, 2001
D) Wildfires that affected California in October
2007
E) The oil spill in the gulf coast in 2010 that
threatened hundreds of species of wildlife
Ans: A, D
Feedback:
Examples of natural disasters include the earthquake and tsunami in Japan in 2011 and
wildfires that affected California in October 2007. The following disasters are man-made: the 2008 shootings at Virginia Tech; the terrorist attacks on the United States on September 11, 2001; and the oil spill in the gulf coast in 2010 that threatened hundreds of
species of wildlife.
After teaching a class about the factors that contribute to disasters, the instructor determines that the teaching was successful when the students identify which of the
following as the agent?
A) Population’s age
B) Radiation
C) Level of preparedness
D) Flood-prone location
Ans: B
Feedback:
The agent is the natural or technological element that causes the disaster. For example, the high winds of a hurricane and the lava of an erupting volcano are agents, as are radiation, industrial chemicals, biologic agents, and bombs. The population’s age is an example of a host factor. The level of preparedness and flood-prone location are
examples of environmental factors.
Which of the following federal agencies would a community health nurse expect to be
contacted to assist with a disaster in the
United States?
A) American Red Cross
B) Federal Emergency Management Agency
(FEMA)
C) WHO’s Emergency Relief Operations
D) Pan American Health Organization
Ans: B
Feedback:
The Federal Emergency Management Agency (FEMA) is the federal agency responsible for assessing and responding to disaster events in the United States. The American Red Cross is
authorized to provide disaster assistance free of charge across the country through its more than 1 million volunteers. It is not supported by the federal government. The World Health Organization’s Emergency Relief Operations provide disaster assistance internationally, and the Pan American Health Organization works to coordinate relief efforts in Latin America
and the Caribbean.
The nurse is using the epidemiological triad to explain the factors contributing the
disaster. Which one of the following statements about the environmental factors that contribute to disasters is most accurate?
A) The environment is the natural or technological element that causes the disaster.
B) The environment is the human being who
experience the disaster.
C) Factors that could potentially contribute to or mitigate a disaster are environmental.
D) Examples of environmental factors that cause a disaster are the high winds of a hurricane and the lava of an erupting volcano.
Ans: C
Feedback:
Factors that could potentially contribute to or mitigate a disaster are environmental. The agent factor is the natural or technological element that causes the disaster, for example, the high winds of a hurricane and the lava of an erupting volcano. The host is a human
being who experiences the disaster.
A community health nurse is working with a community that is involved with identifying risk factors for program development in case of a disaster. This community is in which phase of disaster management?
A) Prevention
B) Preparedness
C) Response
D) Recovery
Ans: A
Feedback:
During the prevention phase, no disaster is expected or anticipated. The task during this
phase is to identify community risk factors and develop and implement programs to prevent disasters from occurring. Disaster preparedness involves improving community and individual reactions and responses so that the effects of a disaster are minimized. The response phase begins immediately after the onset of the disastrous event. During the recovery phase, the community takes actions to repair, rebuild, or relocate damaged homes and businesses and restore health and economic vitality to the community.
A community health nurse is working with a community that is involved with improving community and individual reactions and responses so that the effects of a disaster are minimized. This community is in which phase of disaster management?
A) Prevention
B) Preparedness
C) Response
D) Recovery
Ans: B
Feedback:
Disaster preparedness involves improving community and individual reaction and
responses so that the effects of a disaster are minimized. During the prevention phase, no disaster is expected or anticipated. The task during this phase is to identify community risk factors and to develop and implement programs to prevent disasters from occurring. The response phase begins immediately after the onset of the disastrous event. During the recovery phase, the community takes actions to repair, rebuild, or relocate damaged homes and businesses and restore health and
economic vitality to the community.
When would the nurse expect the response phase of a disaster to occur?
A) When no disaster is expected or anticipated
B) Immediately after the onset of the disastrous event
C) Long-term phase occurring after the disastrous event
D) Prior to the disastrous event
Ans: B
Feedback:
The response phase of a disaster occurs immediately after the onset of the disastrous event. During the prevention phase no disaster is expected or anticipated. The long-term phase occurring after the disastrous event is the recovery phase. Prior to the disastrous event is the preparedness phase.
Which of the following statements about disaster planning is most accurate?
A) Disaster planning is essential for a
community, business, or hospital.
B) A disaster plan must be lengthy and detailed.
C) A disaster plan should be created by the person responsible for the emergency
management of the community.
D) It is assumed that all professionals have
addressed their personal preparation.
Ans: A
Feedback:
Disaster planning is essential for a community, business, or hospital. A disaster plan need not be lengthy. A disaster plan should be created by all involved, including community leaders, health and safety professionals, and laypeople. All nurses should address their own personal preparedness to respond in a disaster, but this may not be assumed.
Which of the following are necessary components of a nurse’s personal
preparedness? Select all that apply.
A) Workplace and community disaster plans have been reviewed by the nurse.
B) An individual disaster plan for the nurse’s
own family has been developed.
C) The nurse participated in disaster drills at the workplace and had a family disaster drill to practice what actions to take in the event of a disaster.
D) It is not necessary for the nurse to bring
copies of their nursing license and driver’s license.
E) In the case of an actual disaster, the nurse will be able to use equipment made available to
them.
Ans: A, B, C
Feedback:
To be personally prepared, a nurse should have read and understood workplace and
community disaster plans, should have developed a disaster plan for his or her own family, and should have participated in disaster drills. Nurses preparing to work in disaster areas should bring copies of their nursing license and driver’s license and bring
basic equipment.
As part of secondary prevention, the community health nurse engages in crisis intervention to achieve which of the
following?
A) Reestablish equilibrium to the lives of those
involved
B) Prevent the crisis altogether
C) Involve as many people as possible in the
resolution
D) Triage clients during the recovery phase of
the crisis
Ans: A
Feedback:
The stated goal of crisis intervention is to reestablish equilibrium. Prevention is the best
approach, but some crises, such as natural disasters, cannot be prevented. They can, however, be prepared to decrease the negative effects of the crisis as much as possible. It is important to have an adequate number of people to come to a resolution. However, too many people involved in the resolution may cause additional confusion, chaos, and unnecessary delays. Triage decisions need to be made during the response phase of the disaster or crisis, not deferred until the recovery phase. Triage is an ongoing process throughout the response phase.
A community health nurse is engaged in primary prevention activities related to disasters. Which of the following would be examples of appropriate activities? Select all
that apply.
A) Providing anticipatory guidance
B) Practicing an escape plan
C) Providing emergency assistance
D) Planning disaster drills
E) Providing immediate response
F) Reducing the degree of disability
Ans: A, B, D
Feedback:
Anticipatory guidance, practicing escape plans, and planning disaster drills all constitute
primary prevention activities. Providing emergency assistance and immediate response reflect secondary prevention activities. Reducing the degree of disability or damage resulting from the disaster reflects tertiary-level prevention activities.
When describing primary prevention activities that would occur in the preparedness
phase of a terrorist attack involving biologic weapons like smallpox or anthrax to a local
community group, which of the following
would the nurse include?
A) Investigating outbreaks to determine source
B) Administering vaccines
C) Screening suspected cases
D) Treating people who have been infected
Ans: B
Feedback:
Primary prevention activities that would occur in the preparedness phase of a terrorist
attack involving biologic weapons like smallpox or anthrax would include administering
vaccines. Investigating outbreaks to determine the source, screening suspected cases, and treating people who have been infected
would be secondary prevention activities.
A community health nurse is assisting the local community in preparing a disaster plan.
Which of the following would the nurse
expect to be addressed? Select all that apply.
A) Chain of command
B) Routes for transportation
C) Triage
D) Basic equipment
E) Copies of licenses
Ans: A, B, C
Feedback:
A disaster plan should address the chain of command, routes and modes of transportation, and triage methods. Basic equipment and licenses are items that a nurse should bring along when preparing to work in a disaster area.
A community health nurse is responding to a disaster. Which of the following would
most likely be the least appropriate area for the nurse to be located?
A) The disaster site
B) Triage
C) Victim treatment area
D) Local hospitals
Ans: A
Feedback:
Usually, the immediate disaster site is not the best place for the disaster nurse, who can
be far more effective in the triage and treatment of victims. One of the lessons of the World Trade Center bombing was that the greatest need for medical professionals was at the local hospitals, not at the disaster site.
When performing triage during a disaster, which color would indicate that the victim is
in urgent need of care?
A) Red
B) Yellow
C) Green
D) Black
Ans: A
Feedback:
During triage, red indicates that the victim has injuries or medical problems that will
likely lead to death if not treated immediately.
Yellow indicates that the person has injuries that require medical attention, but time for treatment is not yet critical. Green indicates that the victim has minor injuries or is presenting with minimal signs of illness.
Black indicates that the victim is dead or has
suffered mortal wounds.
A community health nurse responding to a disaster is involved with caring for the bodies
of the casualties who have died. Which of the following would be an appropriate method for
documentation?
A) Making a note on the triage tag
B) Using a toe tag for identification
C) Placing the name on a casualty list
D) Recording the name on the victim’s body
Ans: B
Feedback:
Toe tags make documentation visible and accessible and are the most appropriate means for documentation. Making a note on the triage tag, placing the name on a casualty list and recording the name on the victim’s body are inappropriate.
Which time after the disaster would be the
ideal time for this to occur?
A) Within 18 hours
B) 1 to 3 days
C) 4 to 6 days
D) 7 to 10 days
Ans: B
Feedback:
The ideal time for CISD is between 24 and 72
hours after the disaster event.
When providing secondary prevention activities for individuals experiencing psychological consequences of a disaster, which of the following would the nurse do as
a generic approach?
A) Providing situational support for stress relief
B) Conveying warmth and concern for the client
C) Teaching about expected emotional reactions
D) reunifying family members who were separated.
Ans: C
Feedback:
The generic approach is designed to reach high-risk individuals and large groups who
have experienced the same disaster, teaching them about the expected emotional reactions to the type of disaster they have experienced and promoting adaptive responses. Environmental manipulation results in a change in a person’s physical or interpersonal situation, providing situational support to relieve stress. An example of environmental manipulation is when a community health nurse coordinates the reunification of family members separated by the disaster. General support is defined as the caring, warmth, and concern the community health nurse conveys
to the client as she or he delivers services.
A community health nurse suspects that a client who was a victim of a disaster three months ago is experiencing post-traumatic stress disorder. Which of the following would the nurse expect to find? Select all that apply.
A) Diminished startle response
B) Hypervigilance
C) Feelings of detachment
D) Flashbacks
E) Full range of affect
Ans: B, C, D
Feedback:
Signs and symptoms of post-traumatic stress disorder include increased startle response,
hypervigilance, feelings of detachment,
flashbacks, and restricted affect.
A group of ten people from the commune in the hills come into town dressed in robes and
have their faces covered. They have weapons hidden in their clothing and begin entering the
three banks in town to rob them. These actions can be classified as either of the
following?
A) Natural disaster
B) Terrorism
C) Casualty
D) Adventitious crisis
Ans: B
Feedback:
The actions resemble terrorism, the unlawful use of force and violence against persons or
property to intimidate or coerce a government, the civilian population, or any segment thereof in furtherance of political or social objectives. The actions are not a natural disaster. Casualty refers to the person who is injured or killed by or as a direct result of an accident. An adventitious crisis is an event that is out of the ordinary in magnitude and personal experience.
After teaching a group of students about agents associated with chemical warfare, the
instructor determines that additional teaching is needed when the students identify which as
an example?
A) Explosives
B) Nerve agents
C) Anthrax
D) Jet fuel
Ans: C
Feedback:
Anthrax is considered a bioweapon. Explosives, nerve agents, and jet fuel are considered agents of chemical warfare.
Which of the following would be most appropriate for community health nurses to
encourage when helping communities cope
with the anxiety associated with terrorism?
A) Maintaining high levels of alertness and fear
B) Spending time with children and young
people
C) Spending more time indoors
D) Keeping a fear journal
Ans: B
Feedback:
Most young people carry a charge of positive energy that is infectious. Maintaining high levels of alertness and fear is not healthy. Instead, individuals should be a little afraid, because a certain level of fear is healthy if the person learns to use it as positive energy. Spending more time outdoors is a helpful remedy. Individuals should keep a courage journal; fear immobilizes and courage takes
action.
A community health nurse is preparing a presentation for a community group about
possible agents of terrorism. Which of the following would the nurse include as an example of a bioweapon? Select all that
apply.
A) Mustard gas
B) Sarin
C) VX gas
D) Nerve agents
E) Bombs
Ans: A, B, C
Feedback:
Bioweapons include mustard gas, sarin, VX gas, and anthrax. Nerve agents and bombs are
examples of chemical warfare agents.
A community health nurse is reviewing the medical records of several families in the
community who have experienced varying crises. The nurse identifies which of the following as developmental crises? Select all
that apply.
A) A windstorm that damaged 20 homes in a
community
B) Grandpa Jones dying at age 82
C) A couple getting engaged
D) The Smiths getting a divorce
E) The Jones experiencing a home invasion
F) Seven people died in an automobile crash
Ans: B, C, and D
Feedback:
Developmental crises are periods of disruption that occur at transition points during normal growth and development. Developmental crises, as a rule, do not occur suddenly. They
are more evolutionary than revolutionary. Even the advancing age, illness, or death of a
A grandparent or parent is a developmental expectation. However, the actual event may occur suddenly. Experiencing damage from a windstorm, a home invasion, or an automobile crash is a situational crisis.
A community health nurse is preparing a presentation for a community center group
about crisis. Which of the following concepts about situational crises should be included in
the presentation? Select all that apply.
A situational crisis is a stressful, disrupting event arising from external circumstances that
occur suddenly to a person, group, aggregate, or community.
B) Situational crises can be predicted, expected, and planned.
C) Situational crises are never positive.
D) Situational crises often occur without
warning.
E) Situational crises occur to people because of where they are in time and space.
Ans: A, D, E
Feedback:
A situational crisis is a stressful, disrupting event arising from external circumstances that
occur suddenly to a person, group, aggregate, or community. Situational crises often occur
without warning. Situational crises occur for people because of where they are in time and space. Situational crises cannot be predicted, expected, or planned. Some situational crises arise from positive events such as significant job promotion or sudden acquisition of great wealth because the change makes increased demands on individuals who must make
major life adjustments.
Which one of the following statements about
Which primary prevention method for family violence is most accurate?
A) The cycle of violence within the family
cannot be interrupted.
B) Persons who have been victims of family
violence will repeat the behavior with others.
C) Primary prevention includes planned
activities undertaken by the nurse to prevent an unwanted event from occurring.
D) It is not possible for the community health
nurse to foster healthful practices that will counteract unhealthful influences.
Ans: C
Feedback:
Primary prevention includes planned activities undertaken by the nurse to prevent an
unwanted event from occurring. The cycle of violence within the family can be interrupted, and people who have been victims of family violence can learn to use more appropriate coping strategies. It is possible for the community health nurse to foster healthy practices that will counteract unhealthful influences.
The nursing student reads the textbook in preparation for a class meeting about primary, secondary, and tertiary prevention related to families in crisis. The student determines which one of the following statements is most
accurate regarding the levels of prevention?
A) Often, people in crisis are temporarily helpless and unable to cope on their own but are receptive to outside influence.
B) Secondary prevention interventions include taking action to prevent the unwanted event
from occurring.
C) Tertiary prevention focuses on moving past
the crisis and returning to the precrisis state.
D) Primary prevention is the least effective level of intervention in terms of promoting the client’s health and containing costs.
Ans: A
Feedback:
Often, people in crisis are temporarily helpless and unable to cope on their own, but
understand the need for outside help and are receptive to other people’s suggestions.
Primary prevention, not secondary prevention, involves actions that help to prevent an unwanted event from occurring. Tertiary prevention focuses on moving past the crisis, although returning to the precrisis state may not be possible. Primary prevention is the most effective level of intervention in terms of promoting client’s health and containing costs.
After teaching a class about family and domestic violence directed toward children as a community health problem, which of the following, if stated by the class, indicates to the instructor that the teaching was effective?
A) Family violence is new and occurs as a result of our fast-paced technological society.
B) Family violence has occurred in most countries for centuries, as children have been
thought of as the property of their parents.
C) Family violence occurs mostly in the urbanized areas of the United States, where exposure to crime is more prevalent.
D) Family violence is decreasing in industrialized countries in the world as a
result of more public awareness.
Ans: B
Feedback:
The history of family and domestic violence is long. For centuries, children were thought
of as the property of their parents, and any treatment doled out by the parents was their
prerogative. It is only fairly recently in history (early 1900s) that groups have become concerned and begun to do something about family violence. Family violence is brought to the attention of officials more frequently today than in yesteryear, especially in urban areas where more people live, but it occurs throughout the world in urban, rural, and remote areas with no signs of decreasing. Family violence in the United States occurs mostly in urbanized areas, where exposure to crime is more prevalent. Family violence is decreasing in industrialized countries around the world as a result of increased public awareness.
After teaching a group of students about abuse and families, the instructor determines that
the students have an understanding of this
issue when they state which of the following?
A) Less than 10% of women worldwide reported being physically abused by an intimate
partner at some point in their lives.
B) A woman’s risk of intimate partner violence decreases during pregnancy but increases
once the baby is born.
C) Intimate partner violence is a leading cause of
morbidity and mortality in women worldwide.
D) Intimate partner violence is a private matter
and not a public health issue
Ans: C
Feedback:
Intimate partner violence is a leading cause of morbidity and mortality in women
worldwide and is a public health issue. It is estimated that between 10% and 52% of women report being physically abused by an intimate partner at some point in their lives worldwide. A woman’s risk of intimate partner violence increases during pregnancy, with 44% to 48% of all women being abused at least once during the pregnancy.
In preparation for an examination on the history of family violence, a group of students reviews the various laws enacted for protection. The students demonstrate understanding when they identify which of the following was one of the earliest laws enacted?
A) Child Abuse Prevention and Treatment Act
B) Family Violence Prevention and Services Act
C) Keeping Children and Families Safe Act
D) Child Abuse Prevention and Treatment and
Adoption Reform Act
Ans: D
Feedback:
In 1974, the Child Abuse Prevention and Treatment Act was passed, becoming Public Law 93-247 (PL 93-247). The Child Abuse Prevention and Treatment and Adoption Reform Act of 1978 was followed by the Family Violence Prevention and Services Act of 1984. Later, all three acts were consolidated into the Child Abuse Prevention, Adoption, and Family Services
Act of 1988 (Public Law 100-294), and most recently, the Act was amended and reauthorized as
the Keeping Children and Families Safe Act.
A community health nurse suspects
Munchausen syndrome by proxy when a child
A) experiences seizures only when a parent is
present, not if a third party is present.
B) has stunted growth and shortened limbs that
have been noticeable since birth.
C) has a noticeable limp when wearing shoes but
not in bare feet.
D) has periods of acting out and misbehaving,
especially when there is company.
Ans: A
Feedback:
Experiencing seizures only when a parent is present would be a red flag for this syndrome if it were occurring in a child. Stunted growth, limping, or acting out are not associated with Munchausen syndrome by proxy.
Which of the following would lead to
community health nurse to suspect possible child neglect? Select all that apply.
A) 15-year-old Lucy misses school once a week
to watch her baby sister while Mom works.
B) 6-year-old Sam plays in the yard with a
sweater on when it is 60 degrees outside.
C) Twins, Bobby and Billy, arrive at school in
dirty and smelly clothing most school days.
D) 11-year-old Samantha comes to school
without lunch or lunch money each day.
E) 9-year-old Tommy misses school two or three
times a month due to asthma attacks.
F) 14-year-old Jennifer watches her neighbor’s 2
year-old every Saturday.
Ans: A, C, and D
Feedback:
Educational neglect involves Lucy missing school to watch her baby sister, and general neglect is evident for the twins and Samantha. Sam may be appropriately dressed based on how hard and long he is playing he may be comfortable. Although Tommy is missing a number of days of school, he has a legitimate excuse. Fourteen is an appropriate and legal age to babysit.
Which of the following would the community health nurse identify as an act of sexual exploitation of a child?
A) Child pornography
B) Child molestation
C) Fondling of child’s genitals
D) Vaginal penetration with an object
Ans: A
Feedback:
Sexual exploitation of children includes conduct or activities related to pornography that depict minors in sexually explicit situations and the promotion of prostitution by minors. Sexual assault includes rape, gang rape, incest, sodomy, lewd, or lascivious acts with a child younger than 14 years of age (in most states), oral copulation, fondling of the child’s genitals, penetration of the genital or anal opening by a foreign object, and child molestation.
A community health nurse assesses a child during a home visit. Which of the following
would lead the nurse to suspect that the child
is a victim of sexual abuse?
A) Bruising of the arms and back
B) Evidence of numerous dental caries
C) Complaints of pain on urination
D) Burns on the hands and feet
Ans: C
Feedback:
A sign of sexual abuse would be complaints of pain on urination or defecation. Bruising on the arms and back and burns on the hands and feet would suggest physical abuse. Numerous dental caries may suggest neglect.
A group of families are attending a local community group for a class on Internet safety
and children. Which of the following statements by the group indicates effective teaching?
A) It’s not so much the time they spend but the
sites they use.
B) We’ll move the computer to the family room so we can easily observe the child’s internet use.
C) We’ll set the Internet browser feature to
medium.
D) The firewall program that we have from 2
years ago should still be good.
Ans: B
Feedback:
To promote Internet safety with children, the computer should be placed in a high-traffic area.
area in the home so that others can easily observe what is going on. Parents need to monitor the
time as well as the sites that the child uses. The Internet security browser should be set to high.
With the advances in technology, a firewall program that is 2 years old may not be adequate to protect the child. However, it would be better than no firewall program at all.
While visiting a family in their home, a community health nurse hears a parent screaming
who says, Everything you do is wrong. Can’t you do anything right ever? The nurse suspects which of the following?
A) Neglect
B) Emotional abuse
C) Sexual abuse
D) Physical abuse
Ans: B
Feedback:
Emotional abuse involves psychological mistreatment or neglect and may involve verbal abuse, such as statements like Everything you do is wrong. Can’t you do anything right? Neglect occurs when physical, emotional, medical, and educational resources necessary for healthy growth and development are withheld or unavailable. Sexual abuse involves acts of sexual assault or sexual exploitation of a minor. Physical abuse is intentional harm that results in pain, physical injury, or death.
When describing the cycle of violence to a group of students, the instructor includes which of the following as occurring as the cycle continues?
A) Frequency of the cycle slows
B) Tension-building occurs less often
C) Loving reconciliation lasts longer
D) Acute battering occurs more often
Ans: D
Feedback:
As the cycle of violence continues, the frequency of the cycle increases, with the tension-building phase and the acute battering incident occurring more often and the loving reconciliation phase eliminated. Without intervention, this shorter, more violent cycle becomes increasingly risk-filled, for outcomes that may lead to injury or maiming of a partner, incarceration, or death of a partner.
Which of the following would a community health nurse expect to assess in a perpetrator of intimate partner violence?
A) Occasional marijuana use
B) High academic achievement
C) Belief in male dominance
D) Desire for complacency
Ans: C
Feedback:
Characteristics of perpetrators of intimate partner violence include a belief in strict gender roles, such as male dominance, heavy alcohol and drug use, low academic achievement, and desire for power and control in relationships.
When discussing elder abuse with a senior
citizen group, which of the following would community health include?
A) Older men experienced abuse at a higher rate
than elderly women.
B) Types of elder abuse include physical abuse,
emotional abuse, neglect, and exploitation.
C) The majority of cases of elder abuse are
perpetrated by persons unknown to the victim.
D) Elders with dementia are less likely to be abused since they have less social
interactions.
Ans: B
Feedback:
Types of elder abuse include physical abuse, emotional abuse, neglect, and exploitation.
Older women experienced abuse at a higher rate than elderly men. The perpetrators of elder abuse may be either known or unknown to the elder. Some elders are especially vulnerable to elder abuse.
A community health nurse is designated as a
mandated reporter. Which of the following best describes this designation?
A) The nurse must witness abuse and neglect
before being mandated to report.
B) The nurse commands that battered women
report the abuse.
C) The supervising community health nurse is responsible for reporting only known cases of
elder abuse.
D) The nurse must report any case of known or
suspected abuse and neglect in children or elders.
Ans: D
Feedback:
The abuse or neglect simply needs to be suspected in order for the nurse to report. In most states, the nurse can receive a jail sentence and a fine for not reporting suspected abuse. Reporters may never witness the actual abusive event, but they can often see the resulting damage. Each nurse follows through with reporting abuse and neglect cases she or he suspects according to the community’s laws.
A community health nurse is providing a community education program about suicide. Which of the following would the nurse include as a common method used by women?
A) Hanging
B) Firearms
C) Vehicle crash
D) Overdose
Ans: D
Feedback:
Women usually choose less violent methods, such as overdosing on medications. Men
choose more violent forms of suicide, such as
hanging, use of firearms, or vehicle crashes.
Which of the following would be least appropriate for a community health nurse to
include in a plan of care at the secondary prevention level for families who may need to
respond in a case of crisis in the future?
A) Teaching social problem-solving skills
B) Helping women develop assertiveness skills
C) Providing parenting classes
D) Helping to reestablish a sense of safety
Ans: D
Feedback:
Helping to reestablish a sense of safety would be appropriate at the secondary level of
prevention. Teaching social problem-solving skills, helping women develop assertiveness skills, and providing parenting classes are appropriate primary prevention level
activities.
When assessing a family in crisis, which of the following would the community health nurse need to do first?
A) Assess the nature of the crisis
B) Determine client’s perception
C) Define available supports
D) Assess coping abilities
Ans: A
Feedback:
Initially, the nurse must assess the nature of the crisis and the client’s response to it. Next, the nurse focuses on the clients’ perceptions of the event. Then the nurse determines who is
available for support for the individual or family. Finally, the nurse assesses the client’s
coping abilities.
A community health nurse is developing a plan of care for families in crisis. Which of the
following would be most appropriate for
the nurse to include?
A) Encourage clients to suppress feelings to
minimize pain
B) Avoid correcting distorted facts to reduce
stress
C) Allow clients to blame others for the crisis
D) Help clients confront crisis
Ans: D
Feedback:
In a crisis, the community health nurse encourages clients to accept help by
acknowledging the problem. The nurse should encourage clients to express their feelings openly, assist them in finding facts (distortions create additional tension that may lead to maladaptive responses), and avoid blaming others to promote responsibility for
problem solving.
Critical population health indicators that affect childbearing women, infants, toddlers, and
Preschool populations globally and in the United States include which of the following?
Select all that apply.
A) Maternal mortality rate
B) Infant mortality rate
C) HIV/AIDS
D) Crude mortality rate
E) Fetal alcohol syndrome
Ans: A, B, C, E
Feedback:
Critical population health indicators that affect childbearing women, infants, toddlers, and
Preschool populations globally and in the United States include the maternal mortality rate, infant mortality rate, HIV/AIDS, and fetal alcohol syndrome. The crude mortality rate does not apply specifically to childbearing women infant, toddler, and preschool populations.
Which one of the following statements about low-birth-weight and very-low-birth-weight
babies is most accurate?
A) Low birth weight is more common in Whites and Hispanics than in African Americans.
B) Birth weight is one of the most important
predictors of infant mortality.
C) The incidence of low-birth-weight in the United States is decreasing in relation to the
increase in multiple births.
D) Recent trends in very-low-birth-weight babies show that they continue to have morbidity with significant increases in survival.
Ans: B
Feedback:
Birth weight is one of the most important predictors of infant mortality. Low birth weight
is more common in African Americans than in whites and Hispanics. The overall incidence of low birth weight is increasing slightly, which can be explained by increased multiple births.
Recent trends in very-low-birth-weight babies show that they continue to have morbidity with no significant increases in survival.
A community health nurse is developing a program that would encourage mothers to use breast-feeding exclusively for their babies’ nutrition for the first 6 months. The nurse bases this program on the understanding
about which of the following?
A) Exclusive breast-feeding promotes better
growth and development.
B) Its lower cost provides more money for other needed items.
C) Infant mortality would significantly decrease.
D) It would aid in decreasing maternal mortality rates.
Ans: C
Feedback:
Approximately 1.3 million infants would survive annually if mothers were able to
exclusively breast-feed their infants for 6 months. The lack of breast-feeding is related to
decreased survival and increased morbidity from infections, lower intelligence test scores,
increased cardiac risk factors, and inadequate nutrition. The superiority of breast milk and lower costs would not be factors in developing a community health program for breast-feeding. Exclusive breast-feeding is not associated with decreasing maternal mortality
rates.
A community health nurse is integrating the Healthy People 2010 goals into suggested
programs for a local community. Which of the following goals would the nurse identify as
having been met?
A) Reduction in low-birth-weight infants
B) Reduction in total preterm births
C) Increase in the number of infants put to sleep on their backs
D) Increased proportion of mothers breast-
feeding at 6 months
Ans: C
Feedback:
After years of working toward improving maternal and child health, the United States has made limited progress. One objective, however, has been met: 70% of infants are now being put to sleep on their backs (up from 35% baseline), largely due to public health educational efforts and reminders. Objectives for LBW, VLBW, and preterm births all moved away from their Healthy People 2010 targets. Breast-feeding is beneficial to both mother and infant, and in 2005, almost 73% of infants were breast-fed for some period of time. However, the goal has not been met.
Which Healthy People 2020 goal has
been established has been met?
A) The number of infants being put to sleep on their backs and the rate for sudden infant
death syndrome
B) Improving the proportion of infants who are breast-fed
C) Reduce the rate of fetal and infant deaths
D) Reduce the occurrence of fetal alcohol syndrome
Ans: A
Feedback:
After years of working toward improving maternal and child health, the United States has made limited progress. One objective, however, has been met: 70% of infants are now being put to sleep on their backs, up from a 35% baseline. The rate of sudden infant death syndrome (SIDS) has dropped by over 50% since 1994. The proportion of infants who are breast-fed is reducing the rate of fetal and infant deaths and occurrences of fetal alcohol syndrome have not been met.
A community health nurse is providing a class for pregnant women about the dangers of alcohol consumption during pregnancy. Which of the following would the nurse include as an effect on the newborn? Select all that apply.
A) Intellectual impairment
B) Low-birth-weight
C) Leukemia
D) Respiratory distress
E) Altered growth and development
F) Childhood cancers
Ans: A, B, E
Feedback:
The health of infants can be dramatically affected by maternal consumption of alcohol.
The pregnancy itself can be threatened.
However, the most devastating consequence of alcohol consumption during pregnancy are fetal alcohol spectrum disorders (FASD) and fetal alcohol syndrome (FAS), both of which
compromise the intellectual functioning, birth weight, and altered growth and development of the infant or child. Respiratory distress, leukemia, and other childhood cancers are not associated with maternal alcohol
consumption.
A community health nurse is working with a group of pregnant women in the community
to reduce lifestyle risk factors associated with low-birth-weight newborns and infant mortality. Which of the following would the
nurse address?
A) Multiparity
B) College-level education
C) Environmental toxins
D) Single-gestational pregnancy
Ans: C
Feedback:
Environmental toxins are lifestyle risk factors associated with low-birth-weight newborns
and infant mortality. Other risk factors include primiparity, low educational level, and
multiple gestations, among others.
A community health nurse visits a local women’s health center to provide education about the effects of smoking during pregnancy. After teaching the class, the nurse determines that the women have understood the teaching when they identify which of the following as a possible maternal or infant effect:?
A) Low-birth-weight newborns
B) Newborn feeding problems
C) Genetic malformations
D) Developmental delays
Ans: A
Feedback:
One of the strongest predictors of both LBW and preterm birth is maternal smoking.
Other studies have shown that there is a greater incidence of stillbirths, spontaneous abortions, and perinatal mortality in pregnancies in which women smoke. Smoking during pregnancy is not associated with genetic malformations, developmental delays, or feeding problems.
A local community health center is providing classes to childbearing families about the
effects of alcohol use during pregnancy.
During one of the classes, a community health nurse describes fetal alcohol spectrum disorder (FASD). Which of the following would the nurse include as a common finding in the newborn?
A) Large for gestational age
B) Facial abnormalities
C) Hypoactive behavior
D) Enhanced intellectual development
Ans: B
Feedback:
A newborn with FASD typically exhibits facial abnormalities and is small for gestational age.
age, demonstrates hyperactivity and
intellectual impairment.
While providing preconception counseling to a group of women, the community health
nurse emphasizes the need for adequate weight gain during pregnancy based on the
understanding of which of the following?
A) Maternal nutritional habits do not affect later life.
B) Inadequate weight gain increases the woman’s risk for cesarean birth.
C) Prolonged labor can occur with too little or
too much weight gain.
D) Adequate weight gain is positively correlated with normal birth weight.
Ans: D
Feedback:
Research has demonstrated a positive correlation between weight gain during pregnancy and normal birth weight in babies. Inadequate weight gain is related to LBW, premature births, and perinatal mortality.
Gaining large amounts of weight can also cause problems at birth, including increased numbers of cesarean deliveries and large-for-gestational-age babies, along with the mother’s retention of excessive weight.
Maternal nutritional habits set gene switches
that affect later life.
After teaching a group of pregnant women about the need for proper oral health during
pregnancy, which of the following statements by the group indicates the need for additional
teaching?
A) We should continue seeing the dentist, like
We always do.
B) Chewing sugar-free gum is okay, even with
the pregnancy.
C) If we need dental work, we can postpone it
until after the birth.
D) Flossing and brushing are just as important
now as before.
Ans: C
Feedback:
Postponing dental work is inappropriate. Dental health procedures have generally been found to be effective and safe for pregnant women, especially during the second trimester. Statements about the importance of regular dental health checkups and proper dental hygiene, along with referrals for dental treatment when needed, indicate effective teaching. Sugar-free gums that contain xylitol and chlorhexidine may be helpful in reducing the maternal-child
transmission of caries-causing bacteria.
What are the roles that public and community health nurses need to enact in order to maximize the outcome for pregnant adolescents? Select all that apply.
A) Clinician
B) Educator
C) Counselor
D) Provider of referrals
E) Friend
Ans: A, B, C, D
Feedback:
Roles that public and community health nurses need to enact in order to maximize the outcome for pregnant adolescents include clinician, educator, counselor, and provider of referrals. It is not appropriate for the nurse to enact the role of friend with pregnant adolescent clients or any other client.
follow up. Which of the following would be appropriate to include when teaching the woman about controlling her blood pressure at this time?
A) Ensuring rest periods with legs elevated
B) Limiting her daily intake of fluid
C) Restricting intake of fresh fruits
D) Encouraging additional weight gain
Ans: A
Feedback:
Various methods are employed to attempt to prevent and control hypertension during pregnancy, namely, a diet rich in fresh fruits and vegetables, adequate fluid intake, weight gain limitations, rest, and regular exercise. These remain the most common preventive suggestions that community health nurses, in
collaboration with the clients’ primary health care providers can give to their pregnant clients. A
calm environment, along with periods of rest with the pregnant woman either elevating her feet
or reclining in a left-side-lying position is also recommended.
During a home postpartum visit, a community health nurse suspects that the woman is experiencing depression. Which of the following responses would be most appropriate?
A) You should try drinking more caffeine to
help you be less tired.
B) Don’t worry. Good mothers don’t hurt their babies.
C) Try napping when the baby is napping.
D) You should be able to achieve perfection with housekeeping tasks while you are still on
maternity leave.=
Ans: C
Feedback:
Getting adequate sleep is important, because sleep deprivation exacerbates psychiatric symptoms. Napping when the baby naps, resting when possible throughout the day, and going to bed early (albeit with the knowledge that sleep may be interrupted two or more times to feed the infant) will provide more hours of rest and sleep. Caffeine can lead to sleep disturbance, and alcohol is a depressant that has been implicated in depression. The elimination of both is a simple yet helpful suggestion. The statement about telling the woman not worry discounts her
feelings. In addition, it also may increase her anxiety because she may be worried about hurting
the baby. The statement about ability to achieve perfection with housekeeping tasks while on
maternity leave is counterproductive as it has been recently identified perfectionism increases the
risk for postpartum depression.
After teaching a group of students about various community nutritional programs, the
instructor determines that the teaching has been successful when the students identify which of
the following as a result of the WIC
program?
A) Increased expenditures for health care
B) Decreased rates of large for gestational age
babies
C) Reduced rates of infant iron deficiency
anemia
D) Drop in breast-feeding rates
Ans: C
Feedback:
In addition to supporting women and young children with nutritious foods and achieving the initial goals of decreasing the rates of preterm and LBW babies, increasing the length of pregnancy, and reducing the incidence of infant and child iron deficiency anemia, WIC also increases breast-feeding rates and improves pregnant women’s
nutritional status.
A group of nursing students are studying for a test on child health statistics. The students demonstrate that they are prepared for the test when they identify which of the following is a major cause of death in the 1- to 4-year-old population.
A) Pneumonia
B) Poverty
C) Unintentional injuries and homicide
D) Heart disease
Ans: C
Feedback:
Unintentional injuries and homicide cause most of the deaths in the 1- to 4-year-old population: motor vehicle crashes, falls, drowning, fires, and burns. Pneumonia is not a major cause of death among children. Poverty contributes to morbidity and mortality but is not a cause of death in and of itself. Heart disease is the fourth leading
cause of death among young children.
A community health nurse is developing a plan to address the nutritional needs of infants.
toddlers, and preschoolers. Which of the following would the nurse need to incorporate as a
major issue associated with
nutritional problems?
A) Life in the culture of poverty
B) Overfeeding of an infant
C) Cultural food preferences
D) Rapid growth spurts
Ans: B
Feedback:
Overfeeding an infant can lead to childhood obesity and become a risk factor for heart disease.
disease, hypertension, and diabetes. Many parents overfeed infants and toddlers and allow
preschool-aged children to make inappropriate food choices, which can lead to a lifetime of
nutritional problems. Poverty may limit food choices and selection of inappropriate foods.
However, poverty itself does not cause nutritional problems. Although there are major differences,
in food preferences and eating practices among different cultural groups, they do not account for
A community health nurse implements a teaching program for new parents about ways to
reduce infant mortality. Which suggestion
would the nurse include as most important?
A) Never leave the infant alone on a dressing
table or couch.
B) Check the temperature of the bath water
before bathing.
C) Stay within an arm’s length when the baby is
in the tub.
D) Put the infant to sleep on his or her back.
Ans: D
Feedback:
Suffocation is the leading cause of death in infants. Therefore, the suggestion to put the baby to sleep on the back is a major preventive measure and the most important. Never leaving the infant alone would reduce the risk of falls, a leading case of nonfatal injuries for infants. Checking bath water temperature is appropriate to prevent burns. Staying within an arm’s length while bathing is a suggestion to prevent drowning.
A community health nurse is involved in a screening program for lead exposure. The nurse would target this program primarily at which age group?
A) Birth to 1-year-olds
B) 18- to 3-year-olds
C) 3- to 5-year-olds
D) 5- to 7-year-olds
Ans: B
Feedback:
The critical age of lead exposure (or peak level) is thought to be between 18 and 36
months. Levels generally begin to decline
after age 3.
Which of the following issues motivated the increased doses of certain vaccines and reformulated vaccines?
at the start of the 21st century? Select all that apply.
A) Increased virulence of the vaccine-preventable disease-causative organisms
B) Pertussis immunity was found to wane with age, so the vaccine was reformulated for cocoon infants by immunizing the adults around them to prevent infant exposure.
C) Varicella vaccine given in two doses has been
found to increase immunity.
D) Measles outbreaks were identified in populations where parents had refused MMR vaccination for their children and received personal belief exemptions.
Ans: B, C, and D
Feedback:
The following issues motivated the increased doses of certain vaccines and reformulated vaccines at the start of the 21st century:. Pertussis immunity was found to wane with age so the vaccine was reformulated to cocoon infants by immunizing the adults around them to prevent exposure of infants; varicella vaccine given in two doses has been found to increase immunity; and measles outbreaks were identified in populations where parents had refused MMR vaccination for their children and received
personal belief exemptions. There is no evidence that the vaccine prevents disease; organisms have increased virulence.
