Community As Partner Theory And Practice in Nursing 7th edition by Anderson – Test Bank

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Community As Partner Theory And Practice in Nursing 7th edition by Anderson – Test Bank

Chapter 2

1. Select the best term for professional nurses who have been educated in the processes of population-based nursing and whose principal client is the aggregate community.
A) Community health nursing
B) Community-based practice nursing
C) Community psychology nursing
D) Home care nursing
Ans: A
Feedback:
Community health nursing is the practice of nursing by professional nurses who have been educated in the processes of population-based nursing and whose principal client is the aggregate community. Community-based practice is the provision of skilled therapy services within a client’s own home or community. Community psychology is the application of psychology to community programs. Home health nursing provides intravenous therapy and wound care.

 

 

2. Based on Lillian Wald’s work living among the residents of the Henry Street Settlement House in New York City, community health nurses can effect change in a community’s health by:
A) advocating for better housing
B) working to change labor practices, wages
C) analyzing risks and benefits of care decisions
D) teaching preventive practices
E) accessing and using emerging research evidence
Ans: A, B, D
Feedback:
Lillian Wald’s contributions include establishing nursing schools, advocating for better housing, working to change child labor laws, teaching preventive practices, advocating occupational health nursing, and improving the education of public health nurses. Today’s nurses can continue this work. Analyzing risks and benefits of care decisions as well as accessing and using emerging research evidence are important nursing actions for individual clients.

 

 

3. Select the number that according to the Centers for Disease Control and Prevention (CDC) best represents the number of years added to the life expectancy because of public health.
A) 15
B) 20
C) 25
D) 30
Ans: C
Feedback:
According to the Centers for Disease Control and Prevention (CDC), public health is credited with adding 25 years to the life expectancy of people in the United States.

 

 

4. As communicable disease declined in the 1960s, which key public health issue became more prominent?
A) Immunizations
B) Workplace safety
C) Cigarette smoking
D) Family planning
Ans: C
Feedback:
Beginning in the 1960s, as communicable diseases declined, attention turned to prevention of chronic diseases and related risk factors, such as cigarette smoking and dietary fat.

 

 

5. Following the decline of communicable diseases and the prevention of chronic diseases related to such things as cigarette smoking and obesity, the World Health Organization began to focus on health promotion in which decade?
A) 1960s
B) 1970s
C) 1980s
D) 1990s
Ans: C
Feedback:
In the 1980s the focus of health shifted somewhat to health promotion, prompted by the Health for All era established by the World Health Organization (WHO, 1978).

 

 

6. In the 1990s, which was the major concern of policy makers in the United States?
A) High cost of health care
B) Treatment of communicable diseases
C) High-tech medicine to increase life span
D) Fluoridation of drinking water
Ans: A
Feedback:
The 1990s can be characterized as the era in which the high cost of health care in the United States became a major concern of policy makers.

 

 

7. Explain the focus of community health nursing.
A) Direct clinical care
B) Prevention rather than one-on-one care
C) Family-focused roles
D) Community-focused roles and functions
Ans: B
Feedback:
Community health practice is changing its focus to prevention of illness, health promotion, and assurance that care is provided, rather than one-on-one care. Official agencies are more involved in direct clinical care, assigning less importance to family- and community-focused roles and functions.

 

 

8. Which of the following represent nursing activities for the essential public health service?
A) Participate in community assessment and identify potential environmental hazards.
B) Manage chronic conditions in daily life to maximize function.
C) Understand and identify determinants of health and disease.
D) Develop and implement community-based health education.
E) Participate in continuing education and preparation to ensure competence.
Ans: A, C, D, E
Feedback:
Nurses can work toward public health by participating in community assessment and identifying potential environmental hazards; understanding and identifying determinants of health and disease; developing and implementing community-based health education; and participating in continuing education and preparation to ensure competence. Although important, managing chronic conditions in daily life to maximize function is a one-on-one nursing action.

 

 

9. To enforce laws and regulations that protect health and ensure safety, the nurse can implement which action?
A) Develop programs and services to meet the needs of high-risk populations as well as members of the broader community.
B) Regulate and support safe care and treatment for dependent populations such as children and the frail elderly.
C) Participate in continuing education and preparation to ensure competence.
D) Participate in early identification of factors detrimental to the community’s health.
Ans: B
Feedback:
Nurses can enforce laws and regulations that protect health and ensure safety by regulating and supporting safe care and treatment for dependent populations such as children and the frail elderly. Nurses can develop policies and plans that support individual and community health efforts by developing programs and services to meet the needs of high-risk populations as well as members of the broader community. Nurses can ensure a competent public health and personal health care workforce by participating in continuing education and preparation to ensure competence. Nurses can research new insights and innovative solutions to health problems by participating in early identification of factors detrimental to the community’s health.

 

 

10. Which of the following factors is shaping 21st-century health?
A) Communicable diseases
B) Tertiary health care
C) Family planning clinics
D) Health care reform
Ans: D
Feedback:
The factors that are shaping 21st-century health are health care reform, demographics, globalization, poverty and growing disparities, violence, injuries, and social disintegration.

 

 

11. How can the community health nurse mobilize community partnerships to identify and solve health problems?
A) Develop programs and services to meet the needs of high-risk populations as well as members of the broader community.
B) Explain the significance of health issues to the public and participate in developing plans of action.
C) Establish programs and services to meet special needs.
D) Participate in early identification of factors detrimental to the community’s health.
Ans: B
Feedback:
Nurses can mobilize community partnerships to identify and solve health problems by explaining the significance of health issues to the public and participate in developing plans of action. Nurses can develop policies and plans that support individual and community health efforts by developing programs and services to meet the needs of high-risk populations as well as members of the broader community. Nurses can link people to needed personal health services and ensure the provision of health care when otherwise unavailable by establishing programs and services to meet special needs. Nurses can research new insights and innovations solutions to health problems by participating in early identification of factors detrimental to the community’s health.

 

 

12. When doing a presentation on public health nursing, the nurse should include which of the following as a great public health achievement of the 20th century?
A) Environmental sanitation
B) Abolishment of child labor
C) Control of infectious diseases
D) Decline in deaths from pulmonary disease
Ans: C
Feedback:
The 10 great public health achievements in the 20th century are immunizations; improvements in motor vehicle safety; workplace safety; control of infectious diseases; decline in deaths from heart disease and stroke; safer and healthier foods; healthier mothers and babies; family planning; fluoridation of drinking water; and recognition of tobacco as a health hazard.

 

 

13. Which statement best defines health disparities?
A) Gaps between rich and poor, including poverty and health insurance, plus geographic, racial, ethnic disparities
B) Social, economic, and political issues where inequality, poverty, exploitation, violence, and injustice are at the root of ill health and the death of the poor and marginalized people
C) The increased economic, political, social, technological, and intellectual interconnectedness of the world
D) The health issues that transcend national boundaries and may best be addressed by cooperative actions
Ans: A
Feedback:
Health disparities are differences in the incidence, prevalence, mortality, and burden of diseases and other adverse health conditions that exist among specific population groups in the United States. Globalization is a term used to refer to the increasing economic, political, social, technological, and intellectual interconnectedness of the world. Health is a social, economic, and political issue where inequality, poverty, exploitation, violence, and injustice are at the root of ill health and the death of poor and marginalized people. Global health is health issues that transcend national boundaries and may best be addressed by cooperative actions.

 

 

14. Although it is true that many of us have improved our standard of living, globally how many people will still live in extreme poverty by 2015?
A) 750 thousand
B) 1 million
C) 1 billion
D) 4 billion
Ans: C
Feedback:
Although it is true that many of us have improved our standard of living, it is estimated that 1 billion people worldwide will still live in extreme poverty by 2015.

 

 

15. Which statement is most relevant to population?
A) World population
B) Clients living in Chicago with diabetes
C) Immunization clinics held annually in California
D) Poverty in four continents
Ans: B
Feedback:
The American Nurses Association defines a population as those living in a specific geographic area (e.g., neighborhood, community, city, or county) or those in a particular group (e.g., racial, ethnic, age, disease) who experience a disproportionate burden of poor health outcomes. Using this definition, clients living in Chicago with diabetes represent a population. Diabetes is an example of a particular group in a particular geographic area. The world is not a specific geographic area. Neither immunization clinics in California nor poverty in four continents reflects a specific set of clients.

 

 

16. Community health nurses are tasked with identifying unserved and underserved populations in communities. Which factors should the nurse look for? Select all that apply.
A) Sexual violence, stalking, and intimate partner violence against women, men, and children
B) Increase in number of Asian, Pacific Islander, and Hispanic Americans
C) Increase in number of Americans older than 65 years
D) Effects of free trade on government programs
E) Lack of continuing education programs for health care community
Ans: A, B, C, D
Feedback:
Nurses can identify unserved and underserved populations in communities by looking for those factors shaping 21st-century health care. These include the effects of sexual violence, stalking, and intimate partner violence against women, men, and children; the growing number of Asian, Pacific Islander, and Hispanic Americans as well as those Americans older than 65 years; and the effects of free trade on government programs, especially in resource-poor areas. Although it is important for community health nurses to ensure a competent public health and personal health care workforce, a lack of continuing education programs would not affect the identification of unserved and underserved populations.

 

 

17. Choose the demographic factor that is helping to shaping the future of community health nursing.
A) Decline in smoking
B) Social integration
C) Shift in medical care from chronic to acute illness
D) Increasing ethnic diversity
Ans: D
Feedback:
Two significant demographic factors shaping the future of community health nursing are the increasing age and ethnic diversity of the American population.

 

 

Chapter 10

1. Which objective meets Healthy People 2020 disaster preparedness goals of addressing preparation, prevention, response, and recovery?
A) Develop and maintain a workforce for national health campaigns.
B) Ensure timely and effective communications.
C) Evaluate quality improvement.
D) Ensure national security.
Ans: B
Feedback:
Healthy People 2020 has identified a national preparedness goal: “Improve the Nation’s ability to prevent, prepare for, respond to, and recover from a major health incident.” To address this goal, Healthy People 2020 created related objectives to address preparation, prevention, response, and recovery: develop and maintain the workforce needed for national health security; ensure timely and effective communications; ensure prevention or mitigation of environmental and other emerging threats to health. These objectives were derived from National Health Security Strategy of the United States of America (NHSS), which stresses the importance of cross-border and global partnerships.

 

 

2. As in other areas of community health practice, disaster management has its own terminology and classification schemes. Which describes vulnerabilities?
A) Normal conditions of existence are disrupted, and the level of suffering exceeds the capacity of the hazard-affected community to respond to it.
B) Social, economic, physical, or environmental factors that increase individual or community susceptibility to the effects of hazards or that inhibit ability to expect, manage, or recover from a disaster
C) The potential exists to cause disruption or damage to the community (e.g., earthquake, flood, typhoon, or cyclone).
D) A vast ecological breakdown in the relation between humans and their environment: a serious or sudden event on such a scale that the stricken community needs extraordinary efforts to cope, often with outside or international aid
Ans: B
Feedback:
Vulnerabilities are social, economic, physical, or environmental factors that increase individual or community susceptibility to the effects of hazards or that inhibit ability to expect, manage, or recover from a disaster. Disaster occurs as a result of an event where normal conditions of existence are disrupted, and the level of suffering exceeds the capacity of the hazard-affected community to respond to it. A vast ecological breakdown occurs when, in the relation between humans and their environment, a serious or sudden event happens on such a scale that the stricken community needs extraordinary efforts to cope with it, often with outside or international aid. A hazard occurs when an event has the potential to cause disruption or damage to the community (e.g., earthquake, flood, typhoon, or cyclone).

 

 

3. Which describes a man-made disaster?
A) Chemical spill
B) Droughts
C) Earthquakes
D) Wildfires
Ans: A
Feedback:
A chemical spill is an example of a man-made disaster. Droughts, earthquakes, and wildfires are examples of natural disasters.

 

 

4. Disaster epidemiology focuses on the range of short-term and long-term negative effects of community disasters. A study of the people of Fukushima, Japan, after the earthquake in 2011 showed what negative effect?
A) Higher risk of cancer in general Japanese population
B) Lower levels of cesium in the elderly
C) Overpopulation
D) Environmental contamination
Ans: D
Feedback:
The Fukushima disaster in 2011 produced environmental contamination and increased radioactivity. There is no higher rate of cancer in the general Japanese population, higher levels of cesium in the elderly, and no evidence of overpopulation due to the Fukushima disaster.

 

 

5. Which is the first priority in the Disaster Paradigm?
A) Assess hazards.
B) Detect.
C) Evacuate and transport victims and casualties.
D) Incident command
Ans: B
Feedback:
The Disaster Paradigm (AMA, 2004a, 2005) is a useful model for recognizing and managing a disaster scene. This paradigm establishes the eight priorities following the acronym DISASTER: detect, incident command, scene security and safety, assess hazards, support, triage and treatment, evacuation and transport of victims and casualties, and recovery.

 

 

6. Treatment for disaster victims depends on the type of emergency or disaster, scene safety, and resources needed and available. The client has a triage classification of yellow. What is the client’s care priority?
A) Comfort care
B) Delayed care
C) Immediate care
D) Urgent care
Ans: D
Feedback:
Triage classification for care by color is as follows: green, delayed care; yellow, urgent care; red, immediate care; and black, no care and comfort care.

 

 

7. When treating a disaster victim, which is the last step of the START triage system?
A) Rescuers instruct persons at the scene of the incident to move to a designated area away from the scene.
B) For those unable to move, rescuers assess and designate patients to a general category.
C) Rescuers locate patients in the immediate care priority and address airway or severe bleeding issues.
D) For those with potential or suspected injuries, rescuers recheck as often as resources and time permit.
Ans: D
Feedback:
The Simple Triage and Rapid Treatment (START) system uses a systematic approach based on three observations (Respiration, Perfusion, and Mental status [RPM]) to triage multiple victims into four categories of care: minor, delayed, immediate, and dead. The steps of assessment are as follows: (1) rescuers instruct persons at the scene of the incident to move to a designated area away from the scene; (2) for those unable to move, rescuers assess and designate patients to a general category; (3) rescuers locate patients in the immediate care priority and address airway or severe bleeding issues; and (4) for those with potential or suspected injuries, rescuers recheck as often as resources and time permit.

 

 

8. Many nursing skills needed in emergency or disaster situations are familiar to nurses. What is an example of a routine nursing activity that needs to be completed during stage 2 of preparedness?
A) Develop/implement prevention strategies for worksites, community sites, and home.
B) Participate in agency or community vulnerability assessments and strategies for improvement.
C) Locate/be able to respond to institutional emergency plans.
D) Organize and participate in community immunization activities.
Ans: C
Feedback:
“Locate/be able to respond to institutional emergency plans” is an example of nursing activity to be completed during the preparedness stage of disaster response. Develop/implement prevention strategies for worksites, community sites, and home; participate in agency or community vulnerability assessments and strategies for improvement; and organize and participate in community immunization activities are examples of nursing activities to be completed during the prevention stage of disaster response.

 

 

9. Which is an example of primary prevention activity for control of infectious diseases at the individual level?
A) Teach barrier precautions to all health care workers.
B) Screen and treat all sexually transmitted diseases.
C) Mandate that health care workers are immunized for hepatitis A and B.
D) Provide an adequate supply of gloves and sharps containers in client care areas.
Ans: A
Feedback:
An example of primary prevention activity for control of infectious diseases at the individual level is to teach barrier precautions to all health care workers. An example of secondary prevention activity for control of infectious diseases at the individual level is to screen and treat all sexually transmitted diseases. Two examples of primary prevention activity for control of infectious diseases at the population level are to mandate that health care workers are immunized for hepatitis A and B and provide an adequate supply of gloves and sharps containers in client care areas.

 

 

10. An infectious agent that has invaded its host and found conditions hospitable will replicate until it can be shed. Which indicates that an infection is in the incubation period?
A) Shed pathogens without any disease symptoms
B) Before shed of pathogens
C) Shed of the pathogen agent
D) Disease symptoms first appear.
Ans: D
Feedback:
The incubation period refers to the time of invasion to the time when disease symptoms first appear. A carrier is an individual who sheds pathogens without any disease symptoms. The period of replication before shedding of pathogens is called the latent period. The communicable period begins with the shedding of the pathogen agent.

 

 

11. Which would the nurse consider an outbreak of infectious disease?
A) Identification of the occurrence of new cases in a population
B) Unexpected occurrence of an infectious disease in a limited geographic area during a limited period of time
C) Steady occurrence of disease over a large geographic area or worldwide
D) Unexpected increase of an infectious disease in a geographic area over an extended period of time
Ans: B
Feedback:
Outbreak refers to the unexpected occurrence of an infectious disease in a limited geographic area during a limited period of time. Identification of the occurrence of new cases in a population is referred to as incidence. Pandemic defines the steady occurrence of disease over a large geographic area or worldwide. Epidemic refers to the unexpected increase of an infectious disease in a geographic area over an extended period of time.

 

 

12. Which of the following describes the reservoir in the chain of transmission?
A) The organism capable of producing infection or infectious disease
B) The environment in which a pathogen lives and multiplies
C) The means by which an infectious agent is transported from the host
D) The method whereby the infectious agent is transmitted from one host to another host
Ans: B
Feedback:
The reservoir is the environment in which a pathogen lives and multiplies. The infectious agent is an organism capable of producing infection or infectious disease. The portal of exit is the means by which an infectious agent is transported from the host. The mode of transmission is the method whereby the infectious agent is transmitted from one host to another host.

 

 

13. Which describes the direct mode of transmission for infectious agents?
A) Fomite
B) Person to person
C) Vector
D) Vehicle
Ans: B
Feedback:
Direct transmission is person-to-person transmission. Indirect transmission implies a vehicle of transmission, such as a biologic or mechanical vector, which can be an animal, insect or arthropod, common vehicle or fomite, which can be any inanimate object, material, or substance that acts as a transport agent for the microbe.

 

 

14. Which indicates virulence of an infectious agent?
A) Immune response in the host
B) Ability to produce serious disease in the host
C) Power to invade and infect large numbers of people
D) Ability to produce disease in those infected with the agent
Ans: B
Feedback:
Virulence is the ability to produce serious disease in the host. Antigenicity is an immune response in the host. Infectivity is the power to invade and infect large numbers of people. Pathogenicity is the ability to produce disease in those infected with the agent.

 

 

15. Spraying for mosquitoes is designed to:
A) Control the agent
B) Eradicate the nonhuman reservoir
C) Control the human reservoir
D) Improve host resistance and immunity
Ans: B
Feedback:
Treating nonhuman reservoirs or eliminating them (e.g., by spraying for mosquitoes) are effective methods of preventing replication of pathogens and thus preventing transmission. Controlling the agent is an area in which technology and medical science have been effective. Inactivating the agent is the principle behind disinfection, sterilization, and radiation of fomites that may harbor pathogens. Treating infected persons, whether they are symptomatic or not, is effective in preventing transmission of pathogens that can be transmitted directly to others. This is a way of controlling the human reservoir. Many factors, such as age, general health status, nutrition, and health behaviors, contribute to host resistance. Immunity, however, is an indispensable defense against infection.

 

 

16. There are several different kinds of immunity, each providing resistance in different ways to different pathogens. Which indicates there is a natural immunity?
A) Innate resistance to a specific antigen or toxin
B) Derived from actual exposure to the specific infectious agent
C) When the body produces its own antibodies against an antigen as a result of infection with the pathogen or through a vaccine
D) Temporary resistance that has been donated to the host through transfusions of plasma, proteins, immunoglobulin, or antitoxins
Ans: A
Feedback:
Natural immunity is an innate resistance to a specific antigen or toxin. Acquired immunity is derived from actual exposure to the specific infectious agent. Active acquired immunity is when the body produces its own antibodies against an antigen as a result of infection with the pathogen or through a vaccine. Passive acquired immunity is temporary resistance that has been donated to the host through transfusions of plasma, proteins, immunoglobulin, or antitoxins.

 

 

17. Which indicates there is secondary vaccine failure?
A) The failure of a vaccine to stimulate any immune response
B) The waning of immunity following an initial immune response
C) Vaccine failure caused by improper storage or improper administration route
D) State in which those not immune will be safe if a certain proportion of the population has been vaccinated
Ans: B
Feedback:
Secondary vaccine failure is the waning of immunity following an initial immune response. Primary vaccine failure is the failure of a vaccine to stimulate any immune response. It can be caused by improper storage or improper administration route. Herd immunity refers to a state in which those not immune to an infectious agent will be safe if a certain proportion of the population has been vaccinated or is otherwise immune.

 

 

18. Infectious diseases require organized, public efforts for their prevention and control because of their potential to spread and cause communitywide or worldwide emergencies. What laws prevail over federal laws related to health?
A) Local
B) Public health
C) State
D) International
Ans: C
Feedback:
An important concept to remember is that, in areas of health within a state, state laws usually prevail over federal law. The U.S. Constitution does not address health, and the Tenth Amendment reserves power to the states over all issues not addressed in the Constitution.

 

 

19. What is missing from this documentation? “1/13/10: John Brown received on 1/13/10 ABC vaccine by Great manufacturer, lot number # 12345 by Flo First. The client received 12/2009 Vaccine Information Statement.
A) The documentation is complete.
B) Title and address of the individual administering the vaccine
C) Client name and date of immunization
D) Vaccine manufacturer and vaccine lot number
Ans: B
Feedback:
Legal documentation of vaccinations is important for future administration and follow-up of hypersensitivity reactions. The health care provider, often the nurse, is responsible for maintaining accurate records, including client name, date(s) immunized, vaccine type, vaccine manufacturer, vaccine lot number, date of the Vaccine Information Statement (VIS); and the name, title, and address of the person administering the vaccine.

 

 

20. Which principle for effective risk communication is probably the most difficult to achieve?
A) Early announcement
B) Trust
C) Transparency
D) Listening
Ans: C
Feedback:
Transparent communication is truthful and easy to understand. It reinforces trust. This principle is probably the most difficult to achieve. Health officials and professionals may withhold information because of worry that they will be blamed or held accountable for the emergency.

 

 

Chapter 20

1. Which statement represents the priority for the older adults, their families, and the health care system?
A) A focus on disease prevention for institutionalized elders is critical.
B) Wellness programs are necessary for the expanded elder communities to thrive.
C) Health promotion and disease prevention are of increasing importance.
D) Noninstitutionalized elders require health promotion to improve health status.
Ans: C
Feedback:
Health promotion and disease prevention activities are an increasing priority for older adults, their families, and the health care system. No support data are presented that support the other answers regarding noninstitutionalized, institutionalized, or elder community wellness programs.

 

 

2. When considering what age group would be a priority for health promotion planning, the nurse considers the older adult. What statement would confirm that this is a priority group?
A) The number of older Americans has doubled in the past 100 years.
B) The percentage of older Americans has more than tripled since 1900.
C) Older Americans are more prevalent in the South but less prevalent in the North.
D) California has twice the number of older Americans than any other state.
Ans: B
Feedback:
The percentage of older Americans has more than tripled from that of 1900 (4.1%), and the number has increased more than 13 times (from 3.1 million to 40.2 million).

 

 

3. A child born in 2010 could expect to live 77.9 years compared with about 29 years in 1900. What is the main reason for this phenomenal growth?
A) Decreased mortality of adults
B) Decreased morbidity of children
C) Decreased mortality of children and young adults
D) Decreased morbidity of adults and older adults
Ans: C
Feedback:
This phenomenal growth has occurred as a result of reduced mortality rates of children and young adults.

 

 

4. The majority of older persons have at least one chronic condition and many have multiple conditions. From 2009 to 2011, what was the most frequently occurring condition of the elderly?
A) Arthritis
B) Cancer
C) Diabetes
D) Hypertension
Ans: D
Feedback:
From 2009 to 2011, the most frequently occurring conditions of the elderly included hypertension (72.0%); diagnosed arthritis (51.0%); all types of heart disease (31.0%); any cancer (24.0%); and diabetes (20.0%).

 

 

5. When looking at disabilities in the older population, which statement, as of 2011, is true and would direct the nurse in planning interventions to assist with optimizing independence in this age group?
A) Older men report more disabilities than do older women.
B) 38% of older men report at least one disability.
C) Over one third of older adults reported at least one severe disability.
D) Women are more likely to have at least one severe disability.
Ans: C
Feedback:
In 2011, 35% of older men and 38% of older women reported having at least one disability, and over one third reported at least one severe disability.

 

 

6. Accessibility and affordability of health care are challenges for the elderly, particularly for rural and poor elders. What type of service that is often limited for the elderly needs to be increased to address these challenges?
A) Preventive
B) Secondary
C) Tertiary
D) Chronic disease
Ans: A
Feedback:
Access to preventive services is often limited for the elderly. Medicare, the primary health insurance for older adults, offers very little coverage for health promotion and preventive services. Preventive services for the elderly are often neglected because many providers do not see any point in prevention during the last years on the age continuum.

 

 

7. As functional status and sensory acuity begin to decline, the elderly become vulnerable to an assortment of abusive and neglectful situations. A survey in 2004 showed a significant increase in substantiated cases of elder abuse. What definition would have been used when looking at what constituted elder abuse?
A) Maltreatment of an older person residing in his or her own home
B) Maltreatment of an older person residing in a residential facility
C) Neglect inflicted when the safety or health of older people is threatened by their living alone
D) Knowing, intentional, or negligent act by a caregiver or any other person that causes harm or a serious risk of harm to a vulnerable population
Ans: D
Feedback:
Elder abuse is an umbrella term referring to any knowing, intentional, or negligent act by a caregiver or any other person that causes harm or a serious risk of harm to a vulnerable population. According to the National Aging Information Center, there are three basic categories of abuse: domestic, institutional, and self-neglect. Domestic elder abuse refers to maltreatment of an older person residing in his or her own home or the home of a caregiver. Institutional abuse occurs in residential facilities. Self-neglect refers to neglect inflicted when the safety or health of older people is threatened by their living alone.

 

 

8. As functional status and sensory acuity begin to decline, the elderly become vulnerable to an assortment of abusive and neglectful situations. What assessment of the elderly would support self-neglect?
A) Maltreatment of an older person residing in his/her own home
B) Maltreatment of an older person residing in a residential facility
C) Neglect inflicted when the safety or health of older people is threatened by their living alone
D) Knowing, intentional, or negligent act by a caregiver or any other person that causes harm or a serious risk of harm to a vulnerable population
Ans: C
Feedback:
Elder abuse is an umbrella term referring to any knowing, intentional, or negligent act by a caregiver or any other person that causes harm or a serious risk of harm to a vulnerable population. According to the National Aging Information Center, there are three basic categories of abuse: domestic, institutional, and self-neglect. Domestic elder abuse refers to maltreatment of an older person residing in his or her own home or the home of a caregiver. Institutional abuse occurs in residential facilities. Self-neglect refers to neglect inflicted when the safety or health of older people is threatened by their living alone.

 

 

9. Community nurses need to be familiar with state abuse reporting laws and how to work with state adult protective services agencies. In a 2004 survey of State Adult Protective Services agencies, the National Center on Elder Abuse noted an increase in substantiated elder abuse cases from 2000 to 2004. What statement would help direct the need for change in identifying this type of abuse?
A) The National Center on Elder Abuse found a 10.5% increase in substantiated cases.
B) The National Center on Elder Abuse found a 13.4% increase in substantiated cases.
C) The National Center on Elder Abuse found a 15.6% increase in substantiated cases.
D) The National Center on Elder Abuse found a 16.5% increase in substantiated cases.
Ans: C
Feedback:
In a 2004 survey of State Adult Protective Services agencies, the National Center on Elder Abuse found a 15.6% increase in substantiated elder abuse cases from 2000 to 2004.

 

 

10. Many community-dwelling elders are virtually prisoners in their homes. Why are people older than 65 years more likely to be victims of crime in or near their own homes?
A) Lack of access to transportation
B) Victims of frequent scams
C) Live in high-crime neighborhoods
D) Fear being mugged or robbed
Ans: A
Feedback:
People older than 65 years are more likely to be victims of crime in or near their own homes because elderly people often lack access to transportation and do not travel great distances.

 

 

11. Mental health issues faced by the elderly include social isolation and loneliness, depression, suicide, and alcohol addiction. What individuals are at highest risk for social isolation?
A) People aged 65 years or older
B) Elderly people living in a nursing home
C) Individuals who are in frail health
D) Individuals retired from career work
Ans: C
Feedback:
Social isolation is associated with the very old (aged 85 years and older), those in frail health, and the elderly living alone.

 

 

12. Which statement made by an older adult client, regarding the client’s adjustment to the aging process, poses the greatest concern for the nurse conducting an assessment?
A) “I used to enjoy dancing and jogging so much, but now I have arthritis in my knees, so it’s hard to even walk.”
B) “I’ve given my grandchildren money for college so they can live a better life than I had.”
C) “Growing old certainly presents all sorts of challenges. I wish I knew then what I know now.”
D) “As I age I’ve found it is harder to do the things I love doing, but I guess it will all be over soon enough.”
Ans: D
Feedback:
Stating “I guess it will all be over soon enough” is suggestive of depression. Estimates of depression in older adults living in the community range from less than 1% to 5%, but the estimates rise to 13% for those receiving home health care and 11.5% for elderly hospital clients. The other responses show that the client is coping with the challenges of older age.

 

 

13. Falls are the most common accidents experienced by people older than 70 years. It is estimated that about two thirds of falls among the elderly are preventable. What risk factor is most common and would alert the nurse to place the client on fall risk precautions?
A) Osteoporosis
B) Hypertension
C) Poor vision
D) Middle ear disturbance
Ans: C
Feedback:
Common risk factors for falls include use of medications or alcohol, poor physical condition, changes in visual acuity, inner ear disturbance, foot problems, gait and balance disorders, and hazards in the home and community. The presence of osteoporosis increases the likelihood of a broken bone when a fall occurs, particularly in women.

 

 

14. Health promotion and health protection are two elements of primary prevention. What definition would the nurse use when explaining health promotion?
A) Emphasis on helping people change their lifestyles
B) Protecting people from disease and injury
C) Providing annual immunizations
D) Eliminating exposure to environmental health hazards
Ans: A
Feedback:
Health promotion and health protection are two elements of primary prevention. Health promotion denotes emphasis on helping people change their lifestyles and move toward a state of optimal health, whereas health protection focuses on protecting people from disease and injury by providing immunizations and reducing exposure to carcinogens, toxins, and environmental health hazards.

 

 

15. What is the goal of individual- or family-focused health promotion and health protection interventions?
A) Design interventions to increase the individual’s or family’s knowledge, skills, and competence to make health decisions
B) Involvement in activities that maximize health promotion and health protection behaviors
C) Empowerment of the elderly and their families to make rational health decisions
D) Activities and programs that are directed toward community elders
Ans: C
Feedback:
Individual- or family-focused health promotion/health protection interventions are designed to increase the individual’s or family’s knowledge, skills, and competence to make health decisions that maximize health-promoting and health-protecting behaviors. The goal is empowerment of the elderly and their families to make rational health decisions. Community-focused interventions are activities and programs that are directed toward community elders as a whole or various elderly subgroups in a community.

 

 

16. What is a category of health promotion and health protection intervention that targets the individual or family?
A) Health screenings
B) Crime prevention activities
C) Health fairs in the community
D) Collaboration with organizations to provide comprehensive services to elderly
Ans: A
Feedback:
A category of health promotion and health protection intervention that targets the individual or family is health screenings. Examples of community-focused interventions include collaboration with universities, churches, senior centers, senior housing projects, and other established community organizations to provide comprehensive services to subgroups of elders; crime prevention activities; and participation in community-based health fairs.

 

 

17. Elderly populations, in general, are open to new health practices and respond to a variety of approaches that have the potential to improve their health. To plan effective health programs, community health nurses should validate proposed goals and strategies with the targeted elderly group. What is an action step for working with older adults in the community?
A) Try to incorporate outreach activities into the program.
B) Anticipate needs of those with poor hearing.
C) Maintain a fast pace for activities to maintain relatively short sessions.
D) Allow plenty of time for elders to share life experiences.
Ans: D
Feedback:
Action steps for working with older adults in the community include incorporating outreach activities into all programs; anticipating the needs of those with poor vision; maintaining a slow pace for activities and allowing adequate time for responses; allowing plenty of time for elders to share life experiences; and keeping teaching sessions relatively short.

 

 

18. People older than 65 years need regular primary health care services to maintain health and prevent disabling chronic illness and life-threatening conditions. What is a health promotion service that can form the basis for a community nursing intervention?
A) Referral to existing national pharmacy assistance programs
B) Continuous source of tertiary care
C) Connection to acute illness support groups
D) One-stop shopping for health care
Ans: D
Feedback:
Health promotion services that can form the basis for a community nursing intervention include referral to existing state pharmacy assistance programs; continuous source of primary care; connection to chronic illness support groups; and one-stop shopping for health care.

 

 

19. Adequate nutrition is important for older adults to maintain health, prevent disease, and slow progression of existing chronic illnesses. What makes nutrition classes more effective?
A) Limit recipe sharing of nondiabetic diets.
B) Eliminate existing negative habits.
C) Include ethnic food preferences.
D) Use colorful single-page, small-print pamphlets.
Ans: C
Feedback:
Nutrition classes are more effective if they are highly interactive—incorporate recipe tasting and recipe sharing, build on existing positive habits, and include ethnic food preferences. Use of colorful, large-print posters and videos is appropriate. Reinforcing handouts are also helpful.

 

 

20. The benefits of exercise are well established across the life span. Exercise activity for elders must be suitable to health and functional status. What is the best approach to exercise in the elderly?
A) Staying active throughout the day
B) Participate in 20 minutes of high-intensity exercise three times a week.
C) Participate in 20 to 30 minutes of moderate-intensity exercise most days of the week.
D) Low-impact activity schedules 3 times a day for 20 minutes at each session
Ans: C
Feedback:
Older adults who participate in 20 to 30 minutes of moderate-intensity exercise on most days of the week have better physical function than do older persons who are active throughout the day or who are inactive.

 

 

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