question

What is community-based nursing?

answer

Provision of acute care and care for chronic health problems to individuals and families in the community; direct care, previously diagnosed.

question

What is community-oriented nursing?

answer

Nursing that has as its primary focus the health care of either the community or a population of individuals, families, and groups; indirect care, people are well/not previously diagnosed.

question

You are working as a school nurse. You have discovered that 3 6th grade students have asthma and are not well-managed. You meet with the students 3 times a week for 2 weeks to teach them how to use their inhalers in order to reduce the incidence of bronchial spasms. This is an example of ________________ _______. Why?

answer

Community-based nursing. The children are already diagnosed with asthma.

question

The nurse who is working in a clinic that provides direct care services to clients with TB would be classified as practicing _______________ _______. Why?

answer

Community-based nursing. The children are already diagnosed with TB and they are providing direct care.

question

The nurse working at a large manufacturing company is planning a smoking cessation clinic for workers who have expressed a desire to quit smoking. This nurse is providing __________________ ____. Why?

answer

Community-oriented care. The workers are not previously diagnosed with anything and she is educating and giving health promotion information.

question

The nurse who works in a family medicine clinic is assessing a 3 year old who presents with a sore throat. The type of nursing being practiced in this scenario is _______________ _______. Why?

answer

Community-based nursing. The nurse is managing an acute/chronic condition, 1:1 care, the child is seeing a doctor for symptoms, working in a clinic, patient is already sick.

question

What are the 3 public health core functions?

answer

Assessment, Policy development, assurance

question

Your clinical group is focused on providing community-oriented care and you have identified obesity as a problem in the elementary school. your next step in population-focused practice is to make this info available to the school personnel and parents. Which of these core functions of public health does this address?

answer

Assessment.

question

The Michigan Department of Community Health has received multiple complaints that there are not enough transportation services to one of the state funded senior centers in Macomb County. As a public health nurse, you are assigned to work with the community to evaluate its program for elder transportation services to publicly sponsored elder care programs. Which public health core function does this address?

answer

Assurance.

question

A community -oriented nurse has identified smoking as a problem in the high school. The next step the nurse should take in population-focused practice is to make that information available about the health of the high school students to administrators, parents and students. Which core function of public health does this describe?

answer

Assesment

question

The County health department has issued information bulletins in print and over social media that flu immunizations are available at various locations in the county. This would be an example of which of the core public health functions?

answer

Assurance

question

What is a public health nurse?

answer

Specialty of nursing that synthesizes nursing, social, and public health sciences to provide care to populations. "The practice of promoting and protecting the health of populations using knowledge from nursing, social, and public health sciences

question

What is the difference between formal and informal power? (ch.12-community assessment and evaluation)

answer

Formal power- elected or recognized by everyone as having power (president) Informal power- person with leadership qualities (church leaders, assistants)

question

What are the social determinants of health?

answer

Environment Education Economy Culture

question

What three dimensions do nurses use to define the community?

answer

People Place Function

question

In the current US health care system, Cost is ____, Access is _______, and Quality is ________.

answer

high, limited, mediocre

question

What is Primary Health Care?

answer

Essential services the country says we should have

question

What did the declaration of Alma Alta decide should be available to everyone?

answer

Antibiotics, insulin, HTN meds, Immunizations, preventative screenings, family planning, safe water, nutrition.

question

What is Primary Care?

answer

The first contact into the health care system.

question

Which federal system is responsible for WIC?

answer

The dept. of agriculture

question

What is epidemiology?

answer

Study of a group of people looking at causes and distribution of disease

question

What is descriptive epidemiology?

answer

describes disease in terms of person place and time; what, who, what, when, where

question

What is analytic Epidemiology?

answer

looks at origin and causes; why and how

question

Which type of epidemiology (descriptive/analytic) would a nurse use when determining factors that contribute to childhood obesity?

answer

Analytic

question

What are proportions in terms of epidemiology?

answer

What fraction of the population is affected; numerator is included in the denominator. Ex: males/total births

question

What is rate in terms of epidemiology?

answer

proportion with time; how fast the disease is occurring

question

What is morbidity?

answer

sickness

question

What is mortality?

answer

death

question

One of the basic concepts in epidemiology is the concept of risk. Risk refers to the:

answer

Probability that an event will occur within a specified time period.

question

What is the incidence rate?

answer

new events in time period/ population X1000

question

What is prevalence?

answer

# of events new and old/population at risk X1000

question

What are the components of the epi-triad?

answer

Agent, Host, and environment

question

A worker gets sick from a chemical at work. Put this information into an epi-triad

answer

Agent- Chemical Host- Worker Environment- Work

question

A nurse is investigating an episode of illness caused by bacteria in the drinking water. All residents in the community were exposed but only some became ill. What best explains why only some people became ill and others did not?

answer

Host factors

question

What is primary prevention?

answer

Interventions that seek to promote health and prevent the occurrence of disease, injury, or disability; education, immunizations, health promotions, lifestyle changes

question

What is secondary prevention?

answer

Interventions that seek to detect disease EARLY in its progression, before clinical signs and symptoms become apparent, in order to make an early diagnosis and begin treatment; screenings, early diagnosis and early treatment. (broken arm, chemical eye splash, first aid, self breast exam)

question

What is tertiary prevention?

answer

Interventions aimed at disability limitation and rehabilitation from disease, injury, or disability.

question

At ABC high school several students were diagnosed with diabetes mellitus Type 2 during the annual health fair. The school nurse then developed and implemented an educational program that focused on the risk factors for diabetes mellitus Type 2 as well as the proper nutrition required. How would the nurse know if there has been a positive impact?

answer

The incidence of diabetes is slowly decreasing during screening events.

question

What is the job of a nurse who is employed as a nurse epidemiologist?

answer

Evaluating the number of clients presenting with similar diseases.

question

This year 600 of 8000 young women ages 17 to 20 years tested positive for a sexually transmitted infection (STI) at a university health center. Which of the following terms would you use to describe the data?

answer

Prevalence

question

The nursing staff at CXY high school screened the entire student body for diabetes. How would the nurses know if the screenings were successful?

answer

The incidence of diabetes will increase

question

A nurse advises a client with osteoporosis to have three servings of milk or dairy products daily. Which level of prevention is the nurse using?

answer

Tertiary

question

In developing and implementing an exercise program of walking to help community residents to improve health behaviors, which level of prevention is the nurse addressing?

answer

Primary

question

A school nurse wants to decrease the incidence of obesity in elementary school children. What is a secondary intervention that the nurse could implement?

answer

Weighing students to determine if they are overweight

question

Nurses in community health often use epidemiology. What is an example of how the CHN uses epidemiology to monitoring disease trends?

answer

The CHN investigates an outbreak of measles in a second grade at a local elementary school.

question

You are at a health fair and you have only a regular adult blood pressure cuff. What are you worried about?

answer

Validity

question

What is an intervention is probably the most effective and least expensive in decreasing the number of premature deaths due to cardiovascular disease?

answer

Promoting a healthy lifestyle and behavior choices.

question

What are some social determinants of health?

answer

Economic status, education, environment, nutrition, stress, and prejudice

question

What did the Social Security Act of 1935 do?

answer

It created largest federal support program for elderly and poor Americans

question

What is HIPAA?

answer

The Health Insurance Portability and Accountability Act was intended to help people keep their health insurance when moving from one place to another. Confidentiality of health records

question

What are wrap-around services in terms of vulnerable populations?

answer

Available comprehensive health services, and social and economic services provided either directly or through referrals. In this way, social and economic services are "wrapped around" health services.

question

What are Comprehensive services in terms of vulnerable populations?

answer

Health services that focus on more than one health problem or concern

question

Mr. Schmidt is treating a 52-year-old male or a possible eye infection. While the patient is at the clinic, Mr. Schmidt also requests a dental evaluation and educates the patient about diet and exercise, smoking and alcohol cessation counseling, and the importance of a follow-up for a flu immunization at a future clinic. What type of nursing approach is being used?

answer

Comprehensive services

question

In partnering with vulnerable clients, what techniques will create a more successful interaction with the individual?

answer

Demonstrate trustworthiness, Develop programs and policies for populations of vulnerable persons, and create a partnership with the client through careful assessment.

question

The nurse informs the patient that her doctor has ordered daily blood pressure monitoring and that she should obtain a portable monitor. What approach should the nurse use to assess the patient's ability to obtain the machine?

answer

"The doctor would like for you to monitor your blood pressure. Are you able lot purchase a machine?"

question

When assessing patient from a vulnerable population what should you keep in mind?

answer

Socioeconomic resources Preventive health needs Congenital and genetic predisposition to illness Amount of stress Living environment/neighborhood surroundings

question

What is the educational process when referring to health promotion?

answer

Identify education needs Establish educational goals and objectives Select appropriate educational models Implement educational plan Evaluate the educational process. ~Similar to the nursing process~

question

What are the 3 domains of learning?

answer

Cognitive Affective Psychomotor

question

What are examples of cognitive learning?

answer

Discussion, lecture, Q&A

question

What are examples of affective learning?

answer

Story telling, discussion group

question

What are examples of Psychomotor learning?

answer

Demonstration, practice, return demonstration

question

What are the 5 I's of chronic conditions?

answer

Intellectual impairment Immobility Instability Incontinence Iatrogenic drug reactions

question

The mother of a 13 year old boy approaches the school nurse because she is concerned about her son's weight. She states that she approached his pediatrician about the issue and felt dismissed. The nurse assesses the height and weight of the boy and determines that he is above the 9th percentile for his age. What are the next steps for the school nurse?

answer

Educate about healthy diet and physical activity and instruct the mother that her son should remain his current weight while increasing his height.

question

The school nurse provides education to the students about injury prevention measures. What educational topic is shared with the middle school age?

answer

Bicycle safety

question

A student presents to the nurse's office with a severe allergic reaction to a bee sting. What is the first thing the nurse should do?

answer

Provide emergency care then notify parents

question

What is the role of the federal public health agency?

answer

policy development; Department of health and human services; set standards; survey nation's health status and needs

question

What is the role of the state public health agency?

answer

Distributes funds to local public health agencies to implements programs at the community level

question

What is the role of the local public health agency?

answer

Implement and enforce local, state, and federal public health codes and ordinances and provides essential public health programs to community; reporting mortality and morbidity rates

question

What is an Endemic?

answer

expected disease

question

What is an epidemic?

answer

High incidence in a specific area

question

What is a pandemic?

answer

high incidence across multiple countries

question

A rural public health nurse is spending time reviewing death certificates. Why is she doing this?

answer

To obtain mortality data for the local area

question

Several children were hospitalized for severe vomiting and diarrhea. Why would the nurse continue to purpose the cause of the illness even after discharge?

answer

So that action could be taken to avoid any future episodes

question

A nurse noted that of 18 children in a day care, 5 became ill. What host factor may be associated with the illness?

answer

Some of the children were from very low socioeconomic families

question

A public health nurse traces sexual contacts of clients with STDs for screening and treatment. What level of prevention is this?

answer

Secondary

question

Providing case management services to link clients with co-dependency diagnoses to community support groups is an example of what level of prevention?

answer

Tertiary

question

What is a vector?

answer

means of infectious disease travel.

question

What is vertical transmission?

answer

parent to offspring

question

What is horizontal transmission?

answer

person to person

question

What are the 3 things that likelihood of infection is dependent on?

answer

1. how large the infection is 2. degree of infectivity 3. how immunocompromised the person is

question

What level of prevention is Quarantine/isolation?

answer

secondary

question

What are the 3 factors for communicable disease prevention?

answer

1. Removal of cause 2. disrupt chain of disease transmission 3. protection of susceptible population

question

What is the #1 type of diseases to look out for?

answer

food and waterborne diseases

question

What is the most common type of Hepatitis and how is it transmitted?

answer

Hep C;blood/bodily fluids

question

The community health nurse is aware that African-American adults are more likely to be admitted to the hospital for what?

answer

Diabetic patient with lower leg wound

question

What is most closely related to poor health outcomes?

answer

Low socio-economic status

question

What should the CHN should know about in order to identify vulnerable clients?

answer

One of every five children in America lives in poverty

question

How should the nurse who has just taught a newly diagnosed diabetic client how to administer sliding-scale insulin evaluate how effective the teaching was?

answer

Ask for a return demonstration

question

A nurse is planning a program to teach cardiac health at the local Senior Center. What is the best objective for the program?

answer

By the end of the program each participant will report walking at least 30 minutes a day at least 5 days of each week.

question

Which finding in a young single pregnant woman would cause you, the nurse, the most concern?

answer

Persistent homelessness

question

As a nursing student you prepare a teaching plan for a client with CHF. You use your patho and nursing practice texts to develop the teaching plan explaining the structure and function of the respiratory system. What educational principle are you focusing on?

answer

Cognitive domain

question

A Public Health Nurse working in the Children with Special Needs program is concerned about a recent referral for a 15-month-old child with spina bifida. The infant lives in a very poor neighborhood. The nurse knows that this child may be at higher risk for the most harmful effects of poverty including:

answer

Developmental delays

question

What program would be most successful in decreasing the death rate in school-age children?

answer

Accidents and injuries

question

After giving a very informative and engaging presentation on Domestic Violence against males, the nurse gave each participant a handout outlining the presentation. Later, the nurse discovered that most of the handouts were left in the room or thrown in the wastebasket. What might be the reason for this?

answer

Many Americans do not have a high reading level.

question

The CHN develops a Testicular Self-Examination education session. Which of the following is the best learning objective for teaching testicular self- examination (TSE)?

answer

90% of the men will correctly demonstrate testicular self-examination.

question

Which of the four main factors that affect health is the least important?

answer

Health care system

question

A young man, age 25 years old works at a local CVS. He was abused by his parents and has recently been diagnosed with a stress-related illness. The young man works for $9.00/hrs. but does not receive health benefits. This individual is predisposed to the development of:

answer

Vulnerability

question

Barriers to the referral process can be individual client barriers or resource barriers. These barriers include:

answer

Attitudes of health care providers Client motivation Physical accessibility of resources

question

A nurse offers homeless clients yearly tuberculosis screening and free treatment for those who test positive for TB. Which is the level of prevention is being used?

answer

secondary

question

A useful way to distinguish between Medicare Part A and Medicare Part B is to recognize that

answer

- Part A is hospital insurance - Part B is outpatient care insurance - Part B is a voluntary supplemental program

question

Referral is an important part of community health nursing practice. What should the nurse NOT do?

answer

The nurse should not select the resource most appropriate for the client.

question

A school nurse is working with the Parent Teacher Organization to improve the health status of 7-10 year old students who are mostly African American and Hispanic. Given the demographics of the community, what health issue is this population of students at greatest risk for:

answer

Childhood obesity

question

Mr. J. Williams, a home care nurse, is visiting Mrs. C, a diabetic, twice a week for dressing changes on a lower leg ulcer. Mrs. C. has not been taking her antiglycemic medication regularly and refuses to change her own dressings. Mr. Williams has to make an ethical decision as to whether he should continue or stop his visits. What is the first and most crucial step in his ethical decision-making process?

answer

Identify the ethical concerns

question

A CHN working at a free clinic in the community informs a mother who has come in for treatment of hypertension that her children may qualify for enrollment in the State Children's Health Insurance Program (SCHIP), the goal of which is to reduce health disparities. What does SCHIP provide?

answer

Funds to insure currently uninsured children

question

When health care providers in the community refuse to accept Medicare clients, this implies reduced access to care, potential decreases in acceptable quality of services, and a form of health care rationing. This becomes a public health and nursing issue because:

answer

Public health systems and nurse must ensure that essential clinical services are available

question

Which statements by a nurse demonstrate an understanding of the unique needs of vulnerable groups? - "I always address the problem that the client believes is the most important." - "I avoid asking clients for income or financial information because this is an invasion of privacy." - "I try to observe the client's cultural traditions as I probe for signs of abuse." - "I make sure to do a complete assessment so I have as much information as I can get."

answer

1 and 3

question

Many of those who are homeless seek care in emergency departments because they don't have other options. The most difficult challenge for nurses treating this vulnerable population is to recognize the client's:

answer

Limitation in following treatment protocols

question

Four major factors that affect health care are: personal lifestyle, environmental factors, human biology and the health care system. Medical services are said to have the least effect on health care, yet the U.S. spends more on costly technology and sickness care. This statement supports the need for increased investment in:

answer

Primary prevention

question

The CHN has been asked to talk to the Future Nurses' Club at the local high school about Occupational Health Nursing. Which of the following statements describe what an occupational health nurse might do?

answer

Conduct ongoing assessment of the workplace. Conduct risk appraisal screening for employees. Conduct hearing and vision screening.

question

The CHN has just completed the presentation on self-breast examination to a group of women at a local church. During the session, the CHN distributed literature and used culturally appropriate visual aids. However, the evaluations indicated that the session was not as effective as it could have been. Which of the following is most likely what was missing from the presentation?

answer

The opportunity for the women to practice what they learned

question

Home health care can be defined as a broad spectrum of health and social services offered in the home environment to recovering, disabled, or chronically ill persons. Participation in providing the needed maintenance care for the home care client is essential by whom?

answer

Family Caregivers

question

Nonprofit home health agencies can be reimbursed for home health services through Medicare, Medicaid, and private insurance companies. A major difference between an official agency and a voluntary or private agency is that official agencies receive additional:

answer

public funding

question

Home health agency types, whether official, private and voluntary, combination, hospital based, or proprietary, are similar in terms of what?

answer

Conditions of participation (COP) for Medicare and Medicaid

question

Nurses come to home health from a variety of educational and practice settings. Based on educational level, nurses are prepared to practice at various levels. To ensure the public of competence and quality in a highly competitive health care environment, it may become necessary for nurses to seek what?

answer

certification

question

The home health nurse completes an initial assessment on a recently admitted home health client. The nurse should now analyze the assessment data and complete what step in the nursing process that is consistent with the standards of home health practice?

answer

diagnosis

question

Each client in the Medicare home care program must be under the care of a doctor (medicine, podiatry, or osteopathy). The home health nurse must involve the doctor in developing a plan of care. The role of the doctor in the home health interdisciplinary team is to do which of the following?

answer

Certify/recertify the medical necessity and plan of care

question

A home health nurse is working with a client who requires a catheter insertion and wound care. The nurse is also helping the client and family to develop positive coping skills and identify resources that will help the client to attain a state of optimal functioning. It is important for the nurse to specifically document nursing services provided because of which of the following?

answer

Reimbursement is dependent on the provision of skilled care.

question

Since 2000, home health agencies have been paid by the federal government based on which type of reimbursement?

answer

Prospective payment system

question

The model of care delivered in the home setting which focuses on symptom management at the end of life is known as:

answer

Palliative care

question

A current challenge for home health care is the issue of family responsibility for the role of caregiver. What reflects underlying factors that contribute to this home health care challenge?

answer

Able family members with multiple obligations Number of women working outside the home Social support systems for caregivers

question

What is a unique characteristic of the standards of practice for school nurses?

answer

Alignment with the American Academy of Pediatrics (AAP) guidelines for providing health care to students

question

A second-grade child with cerebral palsy receives services from a physical therapist and occupational therapist during the child's academic day. The school nurse sets up the schedule to ensure that the therapists' visits do not unnecessarily affect the child's academic day negatively. This role of the school nurse is best described as what?

answer

Case manager

question

A middle school student approaches the school nurse and asks, "Can I speak with you about something important?" The school nurse responds affirmatively but should also state what?

answer

If anything you tell me indicates that someone is in danger, the parents and school officials must be told."

question

At the end of each school term, the school nurse schedules an equipment safety assessment of each school playground in the district. The school nurse uses the guidelines of the U.S. Consumer Protection Safety Commission and prepares a report of the findings for the school board for planning purposes. This intervention by the school nurse is an example of what?

answer

Primary prevention

question

A child with severe macular degeneration and some hearing loss will be attending the third grade in a local school. A tertiary prevention intervention the school nurse should perform would be what?

answer

Meet with the assigned teachers to discuss classroom seating to enhance the child's learning experience.

question

The future of school nursing is very strong and will be further enhanced by the future trend in what?

answer

Telehealth and telecounseling

question

A school district in the Midwest has included health education, physical education, health services, nutrition services, and counseling, psychological, and social services as components of the student health services. Additionally, the district has integrated family/community involvement, staff health promotion, and a commitment to a healthy school environment in its program design. This school district has adopted the school health service program scope of what?

answer

CDC's Federal School Health Program

question

An urban school-based clinic is located in a school district where many of the children lack health insurance. The school nurse continues to provide screening, assessment, first aid, and record keeping but can refer students who require additional services to the nurse practitioners that staff the school-based health center (SBHC) on the school grounds. The SBHC is federally funded under what?

answer

The Affordable Care Act

question

The school nurse at the intermediate level arranges for a presentation by the trauma educator at the local regional medical center. Bicycle and helmet safety will be the primary topic at the school's open house. This is an example of what school nurse roles?

answer

Community outreach

question

Secondary prevention activities are the largest responsibility of the school nurse and may include what?

answer

-Establishing an emergency plan when a child or staff member needs immediate care, -Giving medications to children during the school day, -Screening for vision, hearing, height and weight, oral health, TB, and scoliosis, -Teaching standard precautions to all staff

question

What is a unique characteristic of the role of the occupational health nurse?

answer

Adapts to the needs of the agency and specific groups of workers

question

During a recent heat advisory, baggage handlers at the local airport were placed on a 1-hour shift rotation. This work-health interaction demonstrates the theoretical application of what?

answer

Epidemiologic model

question

A recent news article reported the death of a 60-year-old road construction worker on a day with a posted heat advisory. An occupational health nurse would recognize the additional host factors that contributed to this fatality as what?

answer

Age and work practices

question

The greatest risk for experiencing work-related accidents with subsequent injuries is to what?

answer

New workers with less than 1 year of experience on the current job

question

In health care facilities and clinical laboratories, the occupational health nurse needs to be aware of the worker groups that are at risk for exposure to biological agents. Besides the health care workers, worker groups at risk for exposure to biological infectious agents may include who?

answer

Maintenance personnel

question

A widely recognized chemical health hazard in health care environments is what?

answer

Latex allergy

question

The occupational health nurse is aware that several employees from the accounting/finance departments are complaining about exhaustion, anxiety, and heartburn and notes an increase in absenteeism for these departments. On further exploration, the nurse learns that a new chief financial officer (CFO) has been in place for 1 month. The new CFO is demanding higher productivity and turnaround with expectations of working overtime and weekends to "get the job done" ahead of deadlines. The occupational health nurse, using the epidemiologic model, recognizes this as a psychological agent that can best be described as what?

answer

organizational culture

question

The difference between the Occupational Safety and Health Administration (OSHA) and the National Institute for Occupational Safety and Health (NIOSH) can best be described as what?

answer

OSHA sets the workplace safety standards, and NIOSH examines potential hazards of new work technologies and practices

question

An effective industrial disaster plan is a written plan that is shared with all who will be involved, such as the internal first responders, external community-based emergency personnel (transportation, fire, EMS, hospitals), and other key resources in the community. Another factor that influences the effectiveness of an industrial disaster plan is what?

answer

Conducting a response agency worksite walk-through

question

Changes in the workforce will pose new challenges to protecting worker health and safety. What trends will influence business strategies to increase health status, employment longevity, and satisfaction of workers?

answer

Female workforce increasing Increase in minority workers More racially diverse workforce

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