Public Health Science And Nursing Practice By Christine Savage,Joan Kub -Test Bank

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Public Health Science And Nursing Practice By Christine Savage,Joan Kub -Test Bank

Chapter 2: Optimizing Population Health

 

MULTIPLE CHOICE

 

  1. In 2011, the National Prevention Strategy released a plan to increase the number of Americans who are healthy at every stage of life. The National Prevention Strategy was authorized by the:
A. Department of Health and Human Services
B. Centers for Disease Control and Prevention
C. Affordable Care Act
D. American Medical Association

 

 

ANS:  C

Objective: 1. Describe the National Prevention Strategy.

  1. 27-28

Heading: Introduction

Integrated Processes: N/A

Client Need: Health Promotion and Maintenance

Cognitive Level: Knowledge [Remembering]

Concept: Promoting Health; Legal

Difficulty: Easy

  Feedback
A The Department of Health and Human Services is the U.S. government’s main agency for the protection of health of all Americans, but it did not authorize the National Prevention Strategy.
B The Centers for Disease Control and Prevention is a research facility that aids the development of better public health, but it is not a legislative body and did not authorize the National Prevention Strategy.
C The National Prevention Strategy was part authorized by the legislation of the Affordable Care Act.
D The American Medical Association is the professional association of medical doctors. It does not enact governmental mandates and did not authorize the National Prevention Strategy.

 

 

PTS:   1                    CON:  Promoting Health | Legal

 

  1. A nursing student is studying the National Prevention Council Action Plan. The student correctly identifies which one of the following interventions as not reflecting the strategic directions in this plan?
A. Conducting bi-weekly visits to new mothers and newborn babies
B. Paying for insurance for low-income families
C. Providing nutrition classes which offer weekly fill-in guides for grocery shopping
D. Building a health and exercise center in a hospital near the physical and occupational therapy areas

 

 

ANS:  B

Objective: 1. Describe the National Prevention Strategy.

  1. 27-28

Heading: Introduction

Integrated Processes: Teaching/Learning

Client Need: Health Promotion and Maintenance

Cognitive Level: Application [Applying]

Concept: Promoting Health; Nursing Roles; Legal

Difficulty: Moderate

  Feedback
A One goal of the National Prevention Council Action Plan is to build healthy and safe community efforts to create a supportive healthy ecology.
B Providing financial health-care assistance for lower income families is not one of the strategic directions of the National Prevention Council Action Plan.
C Empowering people to make healthy choices by educating them through health promotion and risk reduction is one of the goals of the National Prevention Council Action Plan.
D Expanding quality preventive services in both clinical and community settings is one of the goals of the National Prevention Council Action Plan.

 

 

PTS:   1                    CON:  Promoting Health | Nursing Roles | Legal

 

  1. Based on the ecological model of health, a nurse would evaluate which of the following to understand why a community is having a large incidence of recurring respiratory infections?
A. Local health-care facilities
B. Community health-care programs
C. Medical tests results
D. Living and employment situations

 

 

ANS:  D

Objective: 2. Describe public health in terms of current frameworks guiding prevention efforts from a local to a global perspective.

  1. 29

Heading:  Population Health Promotion, Health Protection, and Risk Reduction > Health Protection and Risk Reduction

Integrated Processes: Nursing Process

Client Need: Health Promotion and Maintenance

Cognitive Level: Application [Applying]

Concept: Assessment; Promoting Health; Evidence-Based Practice

Difficulty: Easy

  Feedback
A The local health-care facilities would not be a part of the patient’s environment so the nurse would not evaluate them based on the ecological model.
B The community health-care program could assist in health promotion and risk reduction activities, but it is not a place the nurse would evaluate to understand the increasing rate of infection according to the ecological model.
C Medical tests could diagnose the underlying problems, but they would not illuminate the causes of the problems according to the ecological model.
D Based on the ecological model, the public health nurse would evaluate how, where, and with whom the patients spent most of their time.

 

 

PTS:   1                    CON:  Assessment | Promoting Health | Evidence-Based Practice

 

  1. If a nurse is focusing on prevention and establishing a public health intervention for an illness by following the natural history of a disease, he or she is:
A. Making sure that everyone in a certain area receives treatment
B. Studying the biological components of the disease
C. Looking at medical trends of clients who have had the disease
D. Going to the autopsies of the patients who have died

 

 

ANS:  C

Objective: 2. Describe public health in terms of current frameworks guiding prevention efforts from a local to a global perspective.

  1. 30-32

Heading: Prevention Frameworks > Natural History of Disease

Integrated Processes: Nursing Process

Client Need: Health Promotion and Maintenance

Cognitive Level: Application [Applying]

Concept: Promoting Health; Health-Care System

Difficulty: Easy

  Feedback
A Following a disease does not involve treating everyone in an area.
B Studying the biological components of the disease may help in some aspects, such as prescribing antibiotics, but this is not part of following the natural history of a disease.
C Following the natural history of a disease allows the nurse to identify who is at the greatest risk by looking at the groups who have had it.
D Following the natural history of a disease allows the nurse to identify who is at the greatest risk for developing the disease by looking at groups who have had it. This does not include attending autopsies.

 

 

PTS:   1                    CON:  Promoting Health | Health-Care System

 

  1. When a health-care provider offers nutritional health teaching on portions, patterns, and choices, he or she is using which type of approach?
A. Ecological
B. Downstream
C. Upstream
D. Health promotion

 

 

ANS:  B

Objective: 2. Describe public health in terms of current frameworks guiding prevention efforts from a local to a global perspective.

  1. 28-29

Heading: Population Health Promotion, Health Protection, and Risk Reduction > Health Promotion

Integrated Processes: Teaching/Learning

Client Need: Health Promotion and Maintenance

Cognitive Level: Application [Applying]

Concept: Nutrition; Promoting Health; Nursing Roles

Difficulty: Moderate

 

  Feedback
A This refers to a larger model that includes a more upstream approach. The health promotion strategy in this question is considered a downstream approach.
B This approach to health promotion is considered downstream since it does include environmental factors such as a lack of supermarkets in its focus.
C The upstream approach looks more at the environmental factors that prevent or allow healthy choices, such as urban zoning for gardening or a lack of supermarkets in a community.
D Health promotion is the broad term used to classify all incentives and interventions to encourage healthy lifestyles.

 

 

PTS:   1                    CON:  Nutrition | Promoting Health | Nursing Roles

 

  1. A school cafeteria is planning menus for the school year. They must follow the 2012 national law that calls for school lunch programs to:
A. Have larger portions of fruits and vegetables, less sodium, and no trans fats
B. Have more protein and fewer carbohydrates
C. Offer 2% milk and low fat dairy products
D. Places a cap on lunch calories at 900, for all grades

 

 

ANS:  A

Objective: 2. Describe public health in terms of current frameworks guiding prevention efforts from a local to a global perspective.

  1. 28-29

Heading: Population Health Promotion, Health Protection, and Risk Reduction > Health Promotion

Integrated Processes: Nursing Process

Client Need: Health Promotion and Maintenance

Cognitive Level: Application [Applying]

Concept: Nutrition; Promoting Health; Legal

Difficulty: Easy

  Feedback
A The new law mandates larger portions of fruits and vegetables, less sodium, and no trans fats.
B The law does not mention proteins and carbohydrates; it mandates larger portions of fruits and vegetables, less sodium, and no trans fats.
C The law states that milk can be, at the most, 1% fat, and flavored milk must be fat-free.
D The calories for each grade group must be 650 for grades K-5, 700 for grades 6-8, and 850 for grades 9-12.

 

 

PTS:   1                    CON:  Nutrition | Promoting Health | Legal

 

  1. A nurse could encourage prevention for a patient with diabetes by
A. Having the patient try an experimental treatment
B. Asking them to share their experiences with other people
C. Having them take doses of the prescribed medicine on a PRN, or as needed, basis.
D. Helping him or her to slow the progression of the disease and prevent secondary illnesses related to the disease, such as blindness

 

 

ANS:  D

Objective: 4. Compare and contrast different levels of health promotion, protection, and risk reduction interventions.

  1. 29

Heading: Population Health Promotion, Health Protection, and Risk Reduction > Health Protection and Risk Reduction

Integrated Processes: Nursing Process

Client Need: Physiological Integrity: Reduction of Risk Potential

Cognitive Level: Application [Applying]

Concept: Metabolism; Promoting Health

Difficulty: Moderate

  Feedback
A The experimental medication might or might not work, so prevention might not occur.
B Sharing experiences with other people might help the patient’s morale and guide other people to better health, but it will not prevent the progression of the disease.
C Taking the prescribed medicine as needed might lessen side effects, but it might not be the most therapeutic and beneficial path for the patient.
D The most beneficial function the nurse could perform is to help the patient avoid additional illnesses by encouraging good health care through programs and practices.

 

 

PTS:   1                    CON:  Metabolism | Promoting Health

 

  1. In order to assess the predominance of a disease in a population, a public health nurse (PHN) looks at a prevalence pot, which is
A. A way of estimating the amount of vaccine that needs to be produced
B. A way of estimating the past number of cases of a specific disease in a given area
C. A way of assessing the total number of cases of a disease that takes into account all of the stages of the disease
D. A method of calculating the potential number of various diseases in a given area

 

 

ANS:  C

Objective: 2. Describe public health in terms of current frameworks guiding prevention efforts from a local to a global perspective.

  1. 29

Heading: Population Health Promotion, Health Protection, and Risk Reduction > Health Protection and Risk Reduction

Integrated Processes: Nursing Process

Client Need: Health Promotion and Maintenance

Cognitive Level: Application [Applying]

Concept: Promoting Health

Difficulty: Moderate

  Feedback
A A prevalence pot is used for more epidemiological use than pharmaceutical use.
B A prevalence pot estimates current data, not past cases.
C A prevalence pot is a way of depicting the total number of cases of a disease in a population that takes into account issues related to duration of the disease and the incidence of the disease.
D A prevalence pot depicts the number of cases of one disease for a given population.

 

 

PTS:   1                    CON:  Promoting Health

 

  1. A PHN notices the rising incidence of H1N1 (swine flu) in a geographic area. The nurse considers possible interventions, knowing that the preclinical phase of H1N1 lasts:
A. One to two days
B. Two to four days
C. Three to four days
D. Five to seven days

 

 

ANS:  A

Objective: 3. Apply public health prevention frameworks to specific diseases.

  1. 29

Heading: Population Health Promotion, Health Protection, and Risk Reduction > Health Protection and Risk Reduction

Integrated Processes: Nursing Process

Client Need: Safe and Effective Care Environment: Safety and Infection Control

Cognitive Level: Application [Applying]

Concept: Infection; Clinical Thinking

Difficulty: Difficult

  Feedback
A The preclinical phase of H1N1 lasts one to two days, and people that are infected can infect others on the first day. Symptoms develop rapidly, and intervention cannot prevent progression to the clinical phase.
B This is past the preclinical phase of H1N1. The preclinical phase lasts only one to two days.
C This is past the preclinical phase of H1N1. The preclinical phase lasts only one to two days.
D This is past the preclinical phase of H1N1. The preclinical phase lasts only one to two days.

 

 

PTS:   1                    CON:  Infection | Clinical Thinking

 

  1. In the traditional public health prevention framework, the level of prevention that includes early detection and initiation of treatment for disease, or screening, is referred to as the:
A. Clinical level
B. Primary level
C. Tertiary level
D. Secondary level

 

 

ANS:  D

Objective: 2. Describe public health in terms of current frameworks guiding prevention efforts from a local to a global perspective.

  1. 32-37

Heading: Prevention Frameworks > Public Health Prevention Frameworks

Integrated Processes: N/A

Client Need: Health Promotion and Maintenance

Cognitive Level: Comprehension [Understanding]

Concept: Promoting Health

Difficulty: Easy

  Feedback
A The clinical level is not a level of prevention in the traditional public health framework.
B The primary level of prevention includes intervention, not screening.
C The tertiary level includes prevention of disability and premature death, not screening.
D The secondary level includes screening.

 

 

PTS:   1                    CON:  Promoting Health

 

  1. Attributable risk is the proportion of cases or injuries that would be eliminated if a risk factor did not occur, but preventable fraction is:
A. The number of cases that actually occur
B. What could be achieved with a program implemented in a community setting within the at-risk population when community members actually participate in the program?
C. The number of cases that require intervention
D. What the estimated number of cases with high-risk factors are

 

 

ANS:  B

Objective: 4. Compare and contrast different levels of health promotion, protection, and risk reduction interventions.

  1. 32-37

Heading: Prevention Frameworks > Public Health Prevention Frameworks

Integrated Processes: N/A

Client Need: Health Promotion and Maintenance

Cognitive Level: Application [Applying]

Concept: Promoting Health

Difficulty: Moderate

 

  Feedback
A Preventable fraction is not the number of cases that actually occur.
B Preventable fraction includes the portion of the population at risk that actually participates in a program and the number of cases prevented.
C The preventable fraction includes the number of cases that have been prevented from happening, not the cases that now require intervention.
D The estimated number of cases with high-risk factors is included in attributable risk.

 

 

PTS:   1                    CON:  Promoting Health

 

  1. Population attributable risk (PAR) is based on the assumption that the risk factor is removed from the entire population being targeted. It also can be used to calculate the cost benefit and the ____ of a prevention program.
A. Cost effectiveness
B. Necessity
C. Population ecology
D. Percent of repeat participants

 

 

ANS:  A

Objective: 4. Compare and contrast different levels of health promotion, protection, and risk reduction interventions.

  1. 32-37

Heading: Prevention Frameworks > Public Health Prevention Frameworks

Integrated Processes: N/A

Client Need: Health Promotion and Maintenance

Cognitive Level: Application [Applying]

Concept: Promoting Health; Economics

Difficulty: Moderate

  Feedback
A PAR can be used as a measurement of the cost benefit and cost effectiveness of a prevention program, which is based on the strength of the risk factor and the prevalence of the risk factor in a population.
B PAR can be used to estimate the cost effectiveness of a prevention program. The estimation of the cost effectiveness of a program is a separate issue from whether a program is necessary or not.
C PAR can be used to estimate the cost effectiveness of a prevention program. There is no measurement of the population ecology, only of the strength and prevalence of the risk factor.
D PAR can be used to estimate the cost effectiveness of a prevention program. The percent of repeat participants is not a measure of the cost effectiveness of the program when the risk factor has been removed from the targeted population.

 

 

PTS:   1                    CON:  Promoting Health | Economics

 

  1. The nursing student is studying learning theories. He learns that television commercials are an example of which learning theory?
A. Constructivism
B. Cognitivist
C. Bandura’s theory of social learning
D. Behaviorism

 

 

ANS:  C

Objective: 5. Identify health education strategies and chronic disease self-management within the context of prevention frameworks.

  1. 38

Heading: A Primary Prevention Approach: Health Education

Integrated Processes: Teaching/Learning

Client Need: Health Promotion and Maintenance

Cognitive Level: Application [Applying]

Concept: Evidence-Based Practice; Promoting Health; Nursing Roles

Difficulty: Easy

  Feedback
A Constructivism is a learning theory that includes reflecting on our own experiences and knowledge.
B Cognitivist focuses on inner mental activity and knowledge that has changed thought patterns through rationally responding to an external stimulus.
C Bandura’s theory of learning specifically connects understanding, behavior, and environment. Whereas the other theories listed are based in behavior and cognitive frameworks, Bandura’s theory stresses imitation and reinforcement in learning. In this example, the audience is encouraged to mimic the behavior seen on the commercial.
D Behaviorism includes the theory of classical conditioning, which emphasizes that change comes with an environmental stimulus resulting in a response.

 

 

PTS:   1                    CON:  Evidence-Based Practice | Promoting Health | Nursing Roles

 

  1. A patient diagnosed with diabetes buys books, reads articles, talks with knowledgeable people, informs himself about what he can do to improve his health, and takes action. The PHN recognizes this method of adult learning as
A. Pedagogy
B. Andragogy
C. Constructivism
D. Humanism

 

 

ANS:  D

Objective: 5. Identify health education strategies and chronic disease self-management within the context of prevention frameworks.

  1. 38-40

Heading: A Primary Prevention Approach: Health Education > Theories of Education

Integrated Processes: Nursing Process

Client Need: Health Promotion and Maintenance

Cognitive Level: Application [Applying]

Concept: Evidence-Based Practice; Promoting Health

Difficulty: Easy

  Feedback
A Pedagogy is the correct use of teaching strategies to provide the best learning.
B Andragogy is the art and science of helping adults learn.
C Constructivism is a learning theory that includes reflecting on our own experiences and knowledge.
D Humanism is defined as self-directed learning through examining personal motivation and goals. It also includes the development of personal actions to fulfill one’s personal motivation and goals.

 

 

PTS:   1                    CON:  Evidence-Based Practice | Promoting Health

 

  1. A nursing student is listening to a lecture on poor health outcomes. Based on research by the Institute of Medicine (IOM), the instructor says that less knowledge of chronic disease management, performance of fewer health promotion activities, low usage of the health-care system, and less use of preventative services are due to:
A. Low health literacy
B. Poor insurance
C. Limited access to medical services
D. Few prevention programs

 

 

ANS:  A

Objective: 5. Identify health education strategies and chronic disease self-management within the context of prevention frameworks.

  1. 40-42

Heading: A Primary Prevention Approach: Health Education > Health Literacy

Integrated Processes: Teaching/Learning

Client Need: Health Promotion and Maintenance

Cognitive Level: Application [Applying]

Concept: Promoting Health; Nursing Roles; Evidence-Based Practice

Difficulty: Easy

  Feedback
A The lack of health-care literacy is the problem, particularly in older Americans with limited education. There is a causal relationship between low health literacy and poor health outcomes due to the lack of understanding of one’s health problems.
B Poor insurance produces problems such as a lack of access to health services and inability to receive proper care. However, this is not the cause cited by the IOM research of the trends mentioned above.
C Limited access to medical services due to transportation or financial issues means poorer outcomes, but this is not the cause cited by the IOM research.
D Few prevention programs means more intervention programs are needed, but this is not related to the trends mentioned above.

 

 

PTS:   1                    CON:  Promoting Health | Nursing Roles | Evidence-Based Practice

 

  1. The PHN recognizes that which of these tests is not an indicator of health literacy?
A. The Test of Functional Health Literacy in Adults (TOFHLA)
B. Rapid Estimate of Adult Literacy in Medicine (REALM)
C. National Quality Forum (NQF)
D. Suitability Assessment of Material (SAM)

 

 

ANS:  C

Objective: 5. Identify health education strategies and chronic disease self-management within the context of prevention frameworks.

  1. 40-42

Heading: A Primary Prevention Approach: Health Education > Health Literacy

Integrated Processes: Nursing Process

Client Need: Health Promotion and Maintenance

Cognitive Level: Comprehension [Understanding]

Concept: Assessment; Promoting Health; Quality Improvement

Difficulty: Easy

 

  Feedback
A The TOFHLA is a 50-item reading comprehension and numerical test available in English and Spanish that tests the ability of the patient to understand health-related materials.
B REALM is used to assess the reading skills of patients.
C The NQF is an agency for health-care quality, safety, and infection control, but not a test.
D SAM assesses health information for content and cultural appropriateness.

 

 

PTS:   1                    CON:  Assessment | Promoting Health | Quality Improvement

 

COMPLETION

 

  1. If the total number of cases of a disease is 100, and the total number of persons in a population is 1,000, what would the prevalence be? ____________________

 

ANS:

0.1

Feedback: The prevalence of a disease is calculated by dividing the total number of disease cases (100) by the total number of persons in a population (1,000) to equal the total number of cases of disease in a population. 100 ÷ 1,000 = 0.1.

 

Objective: 2. Describe public health in terms of current frameworks guiding prevention efforts from a local to a global perspective.

  1. 30-32

Heading: Prevention Frameworks > Natural History of Disease

Integrated Processes: Nursing Process

Client Need: Health Promotion and Maintenance

Cognitive Level: Application [Applying]

Concept: Promoting Health

Difficulty: Easy

 

PTS:   1

 

  1. In a hypertensive study, nurses took the blood pressure readings of 250 participants. In order to determine the accuracy of their readings, they wanted to test the sensitivity of their instruments. If the number of true positives is 40, and the total number of participants with disease (true positives plus false negatives) is 55, the sensitivity of the instrument is ____________________.

 

ANS:

72.7%

Feedback: The number of true positives (40) is divided by the total number of people with the disease (true positives plus false negatives = 55) and multiplied by 100 to equal the sensitivity of the instrument. (40/55) ´ 100 » 72.7%.

 

Objective: 2. Describe public health in terms of current frameworks guiding prevention efforts from a local to a global perspective.

  1. 46-50

Heading: Screening and Early Identification > Sensitivity and Specificity

Integrated Processes: Nursing Process

Client Need: Health Promotion and Maintenance

Cognitive Level: Application [Applying]

Concept: Assessment; Perfusion; Promoting Health

Difficulty: Easy

 

PTS:   1

 

MULTIPLE RESPONSE

 

  1. A nursing student is studying preventable causes of death. In 2004, what were the three leading causes of preventable death?

Select all that apply.

A. Tobacco use
B. Drowning
C. Alcohol use
D. Falls
E. Improper diet and physical inactivity

 

 

ANS:  A, C, E

Objective: 2. Describe public health in terms of current frameworks guiding prevention efforts from a local to a global perspective.

  1. 32-37

Heading: Prevention Frameworks > Public Health Prevention Frameworks

Integrated Processes: Teaching/Learning

Client Need: Health Promotion and Maintenance

Cognitive Level: Application [Applying]

Concept: Addiction; Sleep, Rest, and Activity; Nutrition; Promoting Health; Nursing Roles

Difficulty: Easy

 

  Feedback
1. The three leading causes of preventable death in 2004 were tobacco use, alcohol use, and improper diet and physical activity.
2. The three leading causes of preventable death in 2004 were tobacco use, alcohol use, and improper diet and physical activity.
3. The three leading causes of preventable death in 2004 were tobacco use, alcohol use, and improper diet and physical activity.
4. The three leading causes of preventable death in 2004 were tobacco use, alcohol use, and improper diet and physical activity.
5. The three leading causes of preventable death in 2004 were tobacco use, alcohol use, and improper diet and physical activity.

 

 

PTS:   1

CON:  Addiction | Sleep, Rest, and Activity | Nutrition | Promoting Health | Nursing Roles

 

  1. When screening for, monitoring, and diagnosing disease, a health-care provider always evaluates a measurement tool for which of the following attributes?

Select all that apply.

A. Reliability
B. Validity
C. Functionality
D. Sensitivity
E. Specificity

 

 

ANS:  A, B, D, E

Objective: 6. Describe components of screening from a population and individual perspective.

  1. 46-50

Heading: Screening and Early Identification > Sensitivity and Specificity

Integrated Processes: Nursing Process

Client Need: Health Promotion and Maintenance

Cognitive Level: Application [Applying]

Concept: Assessment; Promoting Health

Difficulty: Easy

 

  Feedback
1. Reliability is the ability of the instrument to give consistent results on repeated trials.
2. Validity is the degree to which the instrument measures what it is supposed to measure.
3. Functionality is the quality of being suited to serve a purpose well. This not one of the attributes by which a measurement tool is always evaluated.
4. Sensitivity is the ability of the screening test to a positive finding when the person truly has the disease or is a true positive.
5. Specificity is the ability of the screening test to give a negative finding when the person does not have the disease or is a true negative

 

 

PTS:   1                    CON:  Assessment | Promoting Health

 

Chapter 12: Injury and Violence

 

MULTIPLE CHOICE

 

  1. A nurse is educating new staff in the emergency department about the types of injuries and illness they might be treating. The nurse mentions that which population is at greatest risk for unintentional injuries?
A. Women under the age of 45
B. Women over the age of 45
C. Men under the age of 45
D. Men over the age of 45

 

 

ANS:  C

Objective: 1. Describe the impact of injury and violence on the health of a population.

  1. 266-267

Heading: Introduction > Types of Injuries

Integrated Processes: Teaching/Learning

Client Need: Safe and Effective Care Environment: Safety and Infection Control

Cognitive Level: Application [Applying]

Concept: Trauma; Nursing Roles; Safety

Difficulty: Moderate

  Feedback
A This is incorrect. Young men, under the age of 45 are at highest risk for unintentional injuries. In addition, children under the age of 19 are also at high risk for unintentional injuries and in fact, it is the fifth leading cause of death in this population.
B This is incorrect. Young men, under the age of 45 are at highest risk for unintentional injuries. In addition, children under the age of 19 are also at high risk for unintentional injuries and in fact, it is the fifth leading cause of death in this population.
C This is correct. Young men, under the age of 45 are at highest risk for unintentional injuries. In addition, children under the age of 19 are also at high risk for unintentional injuries and in fact, it is the fifth leading cause of death in this population.
D This is incorrect. Young men, under the age of 45 are at highest risk for unintentional injuries. In addition, children under the age of 19 are also at high risk for unintentional injuries and in fact, it is the fifth leading cause of death in this population.

 

 

PTS:   1                    CON:  Trauma | Nursing Roles | Safety

 

  1. A nurse has volunteered with an organization treating women who were the victims of rape as a weapon of war in the Congo. This violence is considered:
A. Community violence
B. Collective violence
C. Stranger violence
D. Interpersonal violence

 

 

ANS:  B

Objective: 1. Describe the impact of injury and violence on the health of a population.

  1. 267-268

Heading: Introduction > Types of Violence

Integrated Processes: Nursing Process

Client Need: Safe and Effective Care Environment: Safety and Infection Control

Cognitive Level: Application [Applying]

Concept: Violence; Safety

Difficulty: Moderate

  Feedback
A This is incorrect. Community violence occurs within the community and includes stranger and acquaintance violence. The correct answer is collective violence, which describes violence that occurs when a large group of people engages in violence, such as with war crimes.
B This is correct. Collective violence occurs when a large group of people engages in violence, such as with war crimes.
C This is incorrect. Stranger violence occurs between strangers within the context of the community. The correct answer is collective violence, which describes violence that occurs when a large group of people engages in violence, such as with war crimes.
D This is incorrect. Interpersonal violence occurs between two individuals within the context of the family or the community. The correct answer is collective violence, which describes violence that occurs when a large group of people engages in violence, such as with war crimes.

 

 

PTS:   1                    CON:  Violence | Safety

 

  1. A nurse is reviewing car accident data to see how a city’s statistics compare with state and national data. Which of the following would provide the most comprehensive database of information?
A. National Violent Death Reporting System
B. Vital Statistics
C. Department of Motor Vehicles
D. Department of Transportation

 

 

ANS:  A

Objective: 2. Define the burden of disease related to injury and violence using current epidemiological frameworks.

  1. 268

Heading: Surveillance of Injury and Violence

Integrated Processes: Nursing Process

Client Need: Safe and Effective Care Environment: Safety and Infection Control

Cognitive Level: Application [Applying]

Concept: Safety; Violence; Evidence-Based Practice

Difficulty: Moderate

  Feedback
A This is correct. While Vital Statistics, The Department of Motor Vehicles, and the Department of Transportation all track motor vehicle accidents, the National Violent Death Reporting System is a centralized system that compiles the data from all of these sources. This database is especially helpful to look at injury and violence at the state and population level.
B This is incorrect. While Vital Statistics tracks motor vehicle accidents, the National Violent Death Reporting System is a centralized system that compiles the data from this and other sources. This database is especially helpful to look at injury and violence at the state and population level.
C This is incorrect. While the Department of Motor Vehicles tracks motor vehicle accidents, the National Violent Death Reporting System is a centralized system that compiles the data from this and other sources. This database is especially helpful to look at injury and violence at the state and population level.
D This is incorrect. While the Department of Transportation tracks motor vehicle accidents, the National Violent Death Reporting System is a centralized system that compiles the data from this and other sources. This database is especially helpful to look at injury and violence at the state and population level.

 

 

PTS:   1                    CON:  Safety | Violence | Evidence-Based Practice

 

  1. A nurse has seen an increase in infant injuries during motor vehicle accidents due to poor car seat installation. The nurse wants to consider upstream policies at the population level to address this issue but doesn’t have the time to take on the project. How should the nurse proceed?
A. Reconsider the project at a different time when the workload at his or her primary job lightens.
B. Delegate some of the project tasks to an unlicensed assistive personnel (UAP).
C. Quit the job to dedicate all of his or her time to the project.
D. Consider a collaborative relationship with the public health department and fire and police departments.

 

 

ANS:  D

Objective: 4. Understand the role of policy in injury and violence prevention.

  1. 270-271

Heading: Prevention of Injury and Violence > Nursing Role in Prevention

Integrated Processes: Nursing Process

Client Need: Safe and Effective Care Environment: Safety and Infection Control

Cognitive Level: Application [Applying]

Concept: Safety; Critical Thinking; Promoting Health; Collaboration

Difficulty: Moderate

  Feedback
A This is incorrect. This is an important community issue that needs to be addressed, especially if children are being injured at an increasing rate. The nurse should consider a collaborative relationship with the public health department and fire and police departments.
B This is incorrect. These are not appropriate tasks to delegate to a UAP, especially tasks related to assessment. The nurse should consider a collaborative relationship with the public health department and fire and police departments.
C This is incorrect. It is not appropriate to quit a job to work on this project. The nurse should consider a collaborative relationship with the public health department and fire and police departments.
D This is correct. The nurse should consider a collaborative relationship with the public health department and fire and police departments. This still addresses the needs of the community, but also helps distribute the workload and responsibilities among different departments.

 

 

PTS:   1                    CON:  Safety | Critical Thinking | Promoting Health | Collaboration

 

  1. A nurse is providing fire prevention education to families in the community. Which of the following groups in the United States is not at a higher risk for suffering burns from a fire at home?
A. Men
B. Women
C. Children
D. Older adults

 

 

ANS:  A

Objective: 3. Utilize appropriate frameworks in the assessment of injury and violence.

  1. 272-273

Heading: Epidemiology of Unintentional Injury: Fire-Related Injuries

Integrated Processes: Teaching/Learning

Client Need: Safe and Effective Care Environment: Safety and Infection Control

Cognitive Level: Application [Applying]

Concept: Promoting Health; Safety; Skin Integrity; Nursing Roles

Difficulty: Moderate

  Feedback
A This is correct. In the United States, women, children, and older adults are at higher risk for suffering burns from a fire at home. In most situations, children suffer from burns when they are not being supervised by an adult.
B This is incorrect. In the United States, women, children, and older adults are at higher risk for suffering burns from a fire at home. In most situations, children suffer from burns when they are not supervised by an adult.
C This is incorrect. In the United States, women, children, and older adults are at higher risk for suffering burns from a fire at home. In most situations, children suffer from burns when they are not supervised by an adult.
D This is incorrect. In the United States, women, children, and older adults are at higher risk for suffering burns from a fire at home. In most situations, children suffer from burns when they are not supervised by an adult.

 

 

PTS:   1                    CON:  Promoting Health | Safety | Skin Integrity | Nursing Roles

 

  1. A nurse is teaching water safety at the local community pool and mentions that which of the following is the most significant risk factor for drowning?
A. Gender
B. Income
C. Education
D. Age

 

 

ANS:  D

Objective: 5. Apply current evidence based population interventions to the prevention of injury and violence.

  1. 275-276

Heading: Epidemiology of Unintentional Injury: Drowning > Risk factors for Drowning

Integrated Processes: Teaching/Learning

Client Need: Safe and Effective Care Environment: Safety and Infection Control

Cognitive Level: Application [Applying]

Concept: Safety; Nursing Roles

Difficulty: Moderate

  Feedback
A This is incorrect. Age is the most significant risk factor for drowning. Young children are more susceptible to falling into water (including toilets, bathtubs, and buckets), and are more likely to be curious around water. In older adults, swimming ability declines with age.
B This is incorrect. Age is the most significant risk factor for drowning. Young children are more susceptible to falling into water (including toilets, bathtubs, and buckets), and are more likely to be curious around water. In older adults, swimming ability declines with age.
C This is incorrect. Age is the most significant risk factor for drowning. Young children are more susceptible to falling into water (including toilets, bathtubs, and buckets), and are more likely to be curious around water. In older adults, swimming ability declines with age.
D This is correct. Age is the most significant risk factor for drowning. Young children are more susceptible to falling into water (including toilets, bathtubs, and buckets), and are more likely to be curious around water. In older adults, swimming ability declines with age.

 

 

PTS:   1                    CON:  Safety | Nursing Roles

 

  1. A nurse is performing a home visit for a young mother that lives in the projects in Brooklyn, New York. There is a young child who is three years old living in the apartment as well. The nurse notices that the window guards on the bedroom window are hanging off the building. How does the nurse proceed?
A. Encourage the woman to call the landlord after the nurse leaves.
B. Call Child Protective Services to report an unsafe living situation.
C. Call the landlord directly to ensure the timely repair of the window guards and encourage the woman to keep the windows closed in the meantime.
D. Call the city to report a bad landlord.

 

 

ANS:  C

Objective: 4. Understand the role of policy in injury and violence prevention.

  1. 277

Heading: Epidemiology of Unintentional Injury: Falls in Children > Prevention of Falls in Children

Integrated Processes: Nursing Process

Client Need: Safe and Effective Care Environment: Safety and Infection Control

Cognitive Level: Application [Applying]

Concept: Safety; Assessment; Critical Thinking

Difficulty: Moderate

  Feedback
A This is incorrect. The nurse has no way of knowing whether the woman is following up with the landlord appropriately. The nurse can call the landlord directly and use the opportunity to provide education about fall prevention.
B This is incorrect. The woman may not realize the importance of the window guards, or she may have reported them to the landlord several times without response.
C This is correct. It is better for the nurse to call the landlord directly, since it conveys the importance of the situation and also ensures that the landlord is called. In addition to keeping the windows closed, the nurse should remove from the room items that the child could climb on to access the window, and also encourage constant supervision until the window guards are repaired.
D This is incorrect. The nurse should give the landlord a chance to repair the window guards, since it is possible that the landlord was unaware of the needed repair.

 

 

PTS:   1                    CON:  Safety | Assessment | Critical Thinking

 

  1. A nurse is working at a high school when a young woman comes down to the nursing office concerned about her boyfriend whom she states is making suicidal comments. How does the nurse proceed?
A. Counsel the young woman about relationship issues.
B. Call the young woman’s parents about her concerns.
C. Inform the school psychologist immediately and notify the boyfriend’s parents.
D. Call the young man down to the nurse’s office for a mental health evaluation.

 

 

ANS:  C

Objective: 3. Utilize appropriate frameworks in the assessment of injury and violence.

  1. 278-280

Heading: Epidemiology of Self-Directed Violence: Suicide

Integrated Processes: Communication and Documentation

Client Need: Psychosocial Integrity

Cognitive Level: Application [Applying]

Concept: Violence; Communication; Ethics; Safety

Difficulty: Difficult

  Feedback
A This is incorrect. This does not validate the young woman’s concerns about her boyfriend. Every suicide threat needs to be taken seriously, and so it is appropriate for the nurse to refer the young man to the school psychologist.
B This is incorrect. This does not address the potential mental health issues of the young man who is making the suicidal threats. It also potentially alienates the trust of the young woman.
C This is correct. The nurse should make the appropriate referral and notify his parents about her concerns. Every threat of suicide must be taken seriously, and it is appropriate for the nurse to intervene.
D This is incorrect. It is not appropriate for the nurse to perform the mental health evaluation. It is better that the nurse refer the student to a mental health professional and inform his parents about her concerns.

 

 

PTS:   1                    CON:  Violence | Communication | Ethics | Safety

 

  1. A nurse is working at a suicide prevention hotline and is training new staff members. He or she informs the new nurses that the most important questions to ask callers include:
A. Whether they have a means or a plan to commit suicide, including whether they have access to a weapon, such as a gun
B. If they have been diagnosed with a mental illness
C. If they suffer from addiction
D. None of the above

 

 

ANS:  A

Objective: 3. Utilize appropriate frameworks in the assessment of injury and violence.

  1. 280

Heading: Epidemiology of Self-Directed Violence: Suicide > Risk Factors for Suicide

Integrated Processes: Teaching/Learning

Client Need: Psychosocial Integrity

Cognitive Level: Application [Applying]

Concept: Violence; Safety; Nursing Roles; Assessment

Difficulty: Moderate

  Feedback
A This is correct. Having a plan and access to a weapon is one of the biggest risk factors for committing suicide.
B This is incorrect. Having a plan and access to a weapon is one of the biggest risk factors for committing suicide.
C This is incorrect. Having a plan and access to a weapon is one of the biggest risk factors for committing suicide.
D The correct answer is whether they have a plan and mean to commit suicide. Having a plan and access to a weapon is one of the biggest risk factors for committing suicide.

 

 

PTS:   1                    CON:  Violence | Safety | Nursing Roles | Assessment

 

  1. A group of nurses is looking to design a home visitation program for parents who are at high risk for child maltreatment. What factors should the nurses focus on?
A. Parenting skills and access to educational support
B. Promoting family relationships and increasing child monitoring
C. Increasing access to nutrition and wellness programs
D. Assisting with parental education and financial assistance programs as needed

 

 

ANS:  B

Objective: 5. Apply current evidence based population interventions to the prevention of injury and violence.

  1. 281

Heading: Epidemiology of Family Violence > Risk Factors for Child Maltreatment

Integrated Processes: Nursing Process

Client Need: Psychosocial Integrity

Cognitive Level: Analysis [Analyzing]

Concept: Safety; Violence; Promoting Health; Critical Thinking

Difficulty: Difficult

  Feedback
A This is incorrect. Home visitation programs seeking to lower child maltreatment rates are most effective when they not only nurture parenting skills, but also promote family relationships, support the development of household rules, and increase child monitoring.
B This is correct. Home visitation programs seeking to lower child maltreatment rates are most effective when they nurture parenting skills, promote family relationships, support development of household rules, and increase child monitoring.
C This is incorrect. Home visitation programs seeking to lower child maltreatment rates are most effective when they nurture parenting skills, promote family relationships, support development of household rules, and increase child monitoring.
D This is incorrect. Home visitation programs seeking to lower child maltreatment rates are most effective when they nurture parenting skills, promote family relationships, support development of household rules, and increase child monitoring.

 

 

PTS:   1                    CON:  Safety | Violence | Promoting Health | Critical Thinking

 

  1. A nurse is caring for a young woman in a same sex relationship. The woman frequently presents to the ER with vague injuries and the nurse is beginning to suspect that the woman is being physically abused by her partner. How should the nurse proceed?
A. Inform the physician.
B. Give her a pamphlet about escaping domestic violence.
C. Notify the police.
D. Refer her to a social worker and engage her in discussion about creating a safety plan.

 

 

ANS:  D

Objective: 3. Utilize appropriate frameworks in the assessment of injury and violence.

  1. 283

Heading: Epidemiology of Intimate Partner Violence > Prevention of Intimate Partner Violence

Integrated Processes: Communication and Documentation

Client Need: Psychosocial Integrity

Cognitive Level: Analysis [Analyzing]

Concept: Communication; Safety; Violence; Legal

Difficulty: Moderate

  Feedback
A This is incorrect. While the physician should be aware of what is going on with the patient, the nurse can make the referral to the social worker independently. The nurse can also start the conversation about available resources and creating a safety plan.
B This is incorrect. It may be dangerous for the woman to bring home written information about escaping domestic violence, especially if her partner finds it. The nurse can make the referral to the social worker independently and can also start the conversation about available resources and creating a safety plan.
C This is incorrect. If the woman isn’t ready to press charges against her partner, it is more important to make the referral to the social worker. The nurse can also start the conversation about available resources and creating a safety plan.
D This is correct. The nurse can make the referral to the social worker independently. The nurse can also start the conversation about available resources and creating a safety plan.

 

 

PTS:   1                    CON:  Communication | Safety | Violence | Legal

 

  1. A young woman presents to a community clinic. She states that she is having severe anxiety and insomnia after suffering an acquaintance rape at school last year. She is unable to go back to college and her grades are suffering as a result. What does the nurse suspect that this young woman is suffering from?
A. Post-traumatic stress disorder
B. Generalized anxiety disorder
C. Major depression
D. Personality Disorder

 

 

ANS:  A

Objective: 1. Describe the impact of injury and violence on the health of a population.

  1. 284-285

Heading: Epidemiology of Community Violence

Integrated Processes: Nursing Process

Client Need: Psychosocial Integrity

Cognitive Level: Application [Applying]

Concept: Assessment; Stress; Sleep, Rest, and Activity; Violence

Difficulty: Easy

  Feedback
A This is correct. This young woman is probably suffering from post-traumatic stress disorder, a type of anxiety disorder that occurs after a traumatic event.
B This is incorrect. This young woman is probably suffering from post-traumatic stress disorder, a type of anxiety disorder that occurs after a traumatic event.
C This is incorrect. This young woman is probably suffering from post-traumatic stress disorder, a type of anxiety disorder that occurs after a traumatic event.
D This is incorrect. This young woman is probably suffering from post-traumatic stress disorder, a type of anxiety disorder that occurs after a traumatic event.

 

 

PTS:   1                    CON:  Assessment | Stress | Sleep, Rest, and Activity | Violence

 

  1. A nurse is performing a community assessment of an inner city neighborhood. The nurse is looking for physical risk factors in the community to determine if they might be contributing to the high level of violence and drug abuse in the neighborhood. Which of the following factors should be evaluated?
A. Youth activity
B. Dwelling types
C. Physical layout of the community
D. All of the above

 

 

ANS:  D

Objective: 4. Understand the role of policy in injury and violence prevention.

  1. 285

Heading: Epidemiology of Community Violence > Risk Factors for Community Violence

Integrated Processes: Nursing Process

Client Need: Safe and Effective Care Environment: Safety and Infection Control

Cognitive Level: Application [Applying]

Concept: Addiction; Violence; Safety; Critical Thinking; Assessment

Difficulty: Moderate

  Feedback
A The correct answer is all of the above. A recent study developed a tool that looks at the physical characteristics of a community to determine the risk of violence and drug and alcohol addiction. The characteristics that the tool looks at include layout of the community, housing types and the other buildings or structures within the community, adult and youth daily activities, and the physical and social order and disorder within the community.
B The correct answer is all of the above. A recent study developed a tool that looks at the physical characteristics of a community to determine the risk of violence and drug and alcohol addiction. The characteristics that the tool looks at include layout of the community, housing types and the other buildings or structures within the community, adult and youth daily activities, and the physical and social order and disorder within the community.
C The correct answer is all of the above. A recent study developed a tool that looks at the physical characteristics of a community to determine the risk of violence and drug and alcohol addiction. The characteristics that the tool looks at include layout of the community, housing types and the other buildings or structures within the community, adult and youth daily activities, and the physical and social order and disorder within the community.
D The correct answer is all of the above. A recent study developed a tool that looks at the physical characteristics of a community to determine the risk of violence and drug and alcohol addiction. The characteristics that the tool looks at include layout of the community, housing types and the other buildings or structures within the community, adult and youth daily activities, and the physical and social order and disorder within the community.

 

 

PTS:   1                    CON:  Addiction | Violence | Safety | Critical Thinking | Assessment

 

  1. A nurse is presenting a lecture about providing nursing and medical care during wars and in conflict areas. The nurse is discussing how war has changed in the last few decades. Which of the following statements is correct?
A. There are more wars currently than in the past.
B. War-related deaths have increased in the past decade.
C. Fewer countries have weapons of mass destruction due to increased world condemnation of such weapons.
D. Reporting of wars and war crimes has increased.

 

 

ANS:  D

Objective: 2. Define the burden of disease related to injury and violence using current epidemiological frameworks.

  1. 286-287

Heading: Epidemiology of War: An Example of Collective Violence

Integrated Processes: Teaching/Learning

Client Need: Safe and Effective Care Environment: Safety and Infection Control

Cognitive Level: Application [Applying]

Concept: Violence; Nursing Roles

Difficulty: Moderate

  Feedback
A This is incorrect. In fact, there were fewer wars at the beginning of this previous decade then at the beginning of the last.
B This is incorrect. War-related deaths have actually decreased during the last decade. Increased reporting of war atrocities have made it seem like there are increased deaths, when in fact, the number of deaths has declined.
C This is incorrect. More countries have developed weapons of mass destruction, including nuclear, biological, and chemical weapons.
D This is correct. There has been an increased reporting of wars and war atrocities. Even in situations where formally trained journalists are not present in an area, the use of social media has allowed citizens to still cover these events.

 

 

PTS:   1                    CON:  Violence | Nursing Roles

 

  1. A nurse is reviewing the safety procedures and protections in place at the community center where he or she works. Which of the following should he or she be most concerned about?
A. Presence of two regular doors next to the revolving door in the front of the center
B. Brightly lit exit signs
C. Absence of decorations on the walls
D. None of the above

 

 

ANS:  D

Objective: 4. Understand the role of policy in injury and violence prevention.

  1. 273-275

Heading: Epidemiology of Unintentional Injury: Fire-Related Injuries > Prevention of Burn Injuries

Integrated Processes: Nursing Process

Client Need: Safe and Effective Care Environment: Safety and Infection Control

Cognitive Level: Analysis [Analyzing]

Concept: Assessment; Safety; Legal

Difficulty: Moderate

  Feedback
A The correct answer is none of the above. Fire code regulations are very strict and aim to help prevent the spread of a fire and to help people escape from a fire. The presence of two regular doors next to a revolving door prevents the revolving door from being jammed if a lot of people are trying to exit the building. Brightly lit exit signs guide people through the dark smoke toward the exit. Finally, the absence of decorations on the walls keeps a fire from spreading along flammable materials.
B The correct answer is none of the above. Fire code regulations are very strict and aim to help prevent the spread of a fire, and to help people escape from a fire. The presence of two regular doors next to a revolving door prevents the revolving door from being jammed if a lot of people are trying to exit the building. Brightly lit exit signs guide people through the dark smoke toward the exit. Finally, the absence of decorations on the walls keeps a fire from spreading along flammable materials.
C The correct answer is none of the above. Fire code regulations are very strict and aim to help prevent the spread of a fire, and to help people escape from a fire. The presence of two regular doors next to a revolving door prevents the revolving door from being jammed if a lot of people are trying to exit the building. Brightly lit exit signs guide people through the dark smoke toward the exit. Finally, the absence of decorations on the walls keeps a fire from spreading along flammable materials.
D This is correct. Fire code regulations are very strict and aim to help prevent the spread of a fire, and to help people escape from a fire. The presence of two regular doors next to a revolving door prevents the revolving door from being jammed if a lot of people are trying to exit the building. Brightly lit exit signs guide people through the dark smoke toward the exit. Finally, the absence of decorations on the walls keeps a fire from spreading along flammable materials.

 

 

PTS:   1                    CON:  Assessment | Safety | Legal

 

  1. A nurse is looking to implement new preventative measures to address the rate of drowning in young children in the community. All of the following policies are examples of primary prevention, except:
A. Swimming instruction for every child
B. Mandatory installation of locked child-safety fences around all community and private pools
C. Community-wide CPR instruction
D. Mandatory use of life jackets for all children on boats

 

 

ANS:  C

Objective: 4. Understand the role of policy in injury and violence prevention.

  1. 276

Heading: Epidemiology of Unintentional Injury: Drowning > Prevention of Drowning

Integrated Processes: Nursing Process

Client Need: Safe and Effective Care Environment: Safety and Infection Control

Cognitive Level: Application [Applying]

Concept: Safety

Difficulty: Moderate

  Feedback
A This is incorrect. Use of life jackets, installation of child-safety fences around all community and private pools, and swimming instruction for every child are all examples of primary prevention because they aim to prevent drowning in the first place.
B This is incorrect. Use of life jackets, installation of child-safety fences around all community and private pools, and swimming instruction for every child are all examples of primary prevention because they aim to prevent drowning in the first place.
C This is correct. Use of life jackets, installation of child-safety fences around all community and private pools, and swimming instruction for every child are all examples of primary prevention because they aim to prevent drowning in the first place. Secondary prevention includes treating the medical issues associated with drowning, such as with CPR.
D This is incorrect. Use of life jackets, installation of child-safety fences around all community and private pools, and swimming instruction for every child are all examples of primary prevention because they aim to prevent drowning in the first place.

 

 

PTS:   1                    CON:  Safety

 

COMPLETION

 

  1. A nurse decides to use a Haddon Matrix to evaluate factors that may contribute to patient falls on the medical units of the hospital. What is the minimum number of boxes that should be drawn on the grid to be filled out? ____________________

 

ANS:

12

Feedback: A Haddon Matrix has a minimum of 12 boxes in three rows and four columns. The designated rows refer to the time associated with the event: pre-event, event, and post-event. The columns relate to the constructs included in the Epidemiological Triangle and on preventative measures, and include the host, agent, environment, and levels of prevention.

 

Objective: 3. Utilize appropriate frameworks in the assessment of injury and violence.

  1. 268-270

Heading: Determining the Risk for Injury or Violence > The Haddon Matrix

Integrated Processes: Nursing Process

Client Need: Safe and Effective Care Environment: Safety and Infection Control

Cognitive Level: Application [Applying]

Concept: Safety; Critical Thinking

Difficulty: Moderate

 

PTS:   1                    CON:  Safety | Critical Thinking

 

  1. A nurse is working in an emergency room and caring for a young woman who was admitted to the hospital after a motor vehicle accident. The policeman who accompanied the nurse requests a blood alcohol level and toxicology screen. The nurse knows that what minimum blood alcohol level is considered to be driving while impaired? ____________________

 

ANS:

0.08

Feedback: Driving with a blood alcohol level of 0.08 or above is considered to be driving while impaired. This is illegal and the young woman will likely be arrested and charged if her blood level comes back above that level.

 

Objective: 2. Define the burden of disease related to injury and violence using current epidemiological frameworks.

  1. 271-272

Heading: Epidemiology of Unintentional Injury: Motor Vehicle Crashes > Risk Factors for Motor Vehicle Crashes

Integrated Processes: Nursing Process

Client Need: Safe and Effective Care Environment: Safety and Infection Control

Cognitive Level: Application [Applying]

Concept: Violence; Safety; Legal; Addiction

Difficulty: Moderate

 

PTS:   1                    CON:  Violence | Safety | Legal | Addiction

 

MULTIPLE RESPONSE

 

  1. A nurse is working with parents and community members to develop a chemical and medication safety class in their community. Techniques that they should discuss include which of the following?

Select all that apply.

A. Proper labeling of all household chemicals and medications
B. Keeping household chemicals outside
C. Storing all cleaning materials and medications out of the reach of children
D. Encouraging disposal of medications into the toilet
E. Informing parents not to share any medications with anyone whom the medication is not prescribed

 

 

ANS:  A, C, E

Objective: 5. Apply current evidence based population interventions to the prevention of injury and violence.

  1. 278

Heading: Epidemiology of Unintentional Injury: Poisonings > Prevention of Unintentional Poisoning

Integrated Processes: Teaching/Learning

Client Need: Safe and Effective Care Environment: Safety and Infection Control

Cognitive Level: Analysis [Analyzing]

Concept: Safety; Trauma; Nursing Roles; Medication

Difficulty: Moderate

 

  Feedback
1 This is correct. There are several measures that parents can take to prevent accidental poisonings in their children or other household members. These include proper labeling of all household chemicals and medications, storing all cleaning materials and other chemicals out of the reach of children and how the manufacturer intends, encouraging the proper disposal of medications (e.g., not into the toilet due to environmental hazards) and other chemicals, and not sharing any medications with other people.
2 This is incorrect. There are several measures that parents can take to prevent accidental poisonings in their children or other household members. These include proper labeling of all household chemicals and medications, storing all cleaning materials and other chemicals out of the reach of children and how the manufacturer intends, encouraging the proper disposal of medications (e.g., not into the toilet due to environmental hazards) and other chemicals, and not sharing any medications with other people.
3 This is correct. There are several measures that parents can take to prevent accidental poisonings in their children or other household members. These include proper labeling of all household chemicals and medications, storing all cleaning materials and other chemicals out of the reach of children and how the manufacturer intends, encouraging the proper disposal of medications (e.g., not into the toilet due to environmental hazards) and other chemicals, and not sharing any medications with other people.
4 This is incorrect. There are several measures that parents can take to prevent accidental poisonings in their children or other household members. These include proper labeling of all household chemicals and medications, storing all cleaning materials and other chemicals out of the reach of children and how the manufacturer intends, encouraging the proper disposal of medications (e.g., not into the toilet due to environmental hazards) and other chemicals, and not sharing any medications with other people.
5 This is correct. There are several measures that parents can take to prevent accidental poisonings in their children or other household members. These include proper labeling of all household chemicals and medications, storing all cleaning materials and other chemicals out of the reach of children and how the manufacturer intends, encouraging the proper disposal of medications (e.g., not into the toilet due to environmental hazards) and other chemicals, and not sharing any medications with other people.

 

 

PTS:   1                    CON:  Safety | Trauma | Nursing Roles | Medication

 

  1. A nurse is teaching a class about emergency preparedness and violence. Which of the following factors is associated with an increased risk of being the victim of violence or intentional harm?

Select all that apply.

A. Age between 15 and 44
B. Poor mental health
C. Substance abuse
D. Male gender
E. Low socioeconomic status

 

 

ANS:  A, B, C

Objective: 1. Describe the impact of injury and violence on the health of a population.

  1. 267

Heading: Introduction > Overview of Violence

Integrated Processes: Teaching/Learning

Client Need: Safe and Effective Care Environment: Safety and Infection Control

Cognitive Level: Application [Applying]

Concept: Trauma; Violence; Safety; Nursing Roles

Difficulty: Moderate

 

  Feedback
1 This is correct. Increased risk for violence is associated with people between the ages of 15 and 44, poor mental health, and substance abuse. It is a community-wide issue and affects people of both genders and all socioeconomic status equally.
2 This is correct. Increased risk for violence is associated with people between the ages of 15 and 44, poor mental health, and substance abuse. It is a community-wide issue and affects people of both genders and all socioeconomic status equally.
3 This is correct. Increased risk for violence is associated with people between the ages of 15 and 44, poor mental health, and substance abuse. It is a community-wide issue and affects people of both genders and all socioeconomic status equally.
4 This is incorrect. Increased risk for violence is associated with people between the ages of 15 and 44, poor mental health, and substance abuse. It is a community-wide issue and affects people of both genders and all socioeconomic status equally.
5 This is incorrect. Increased risk for violence is associated with people between the ages of 15 and 44, poor mental health, and substance abuse. It is a community-wide issue and affects people of both genders and all socioeconomic status equally.

 

 

PTS:   1                    CON:  Trauma | Violence | Safety | Nursing Roles

 

 

Chapter 24: Vulnerable Populations

 

MULTIPLE CHOICE

 

  1. A nurse is working with a group of refugees who recently arrived in the United States after suffering terrible violence in their country. The nurse knows that they should be assessed for:
A. Communicable diseases
B. Injuries related to torture or sexual assault
C. Mental illness such as PTSD
D. All of the above

 

 

ANS:  D

Objective: 2. Distinguish groups in our society who are traditionally considered vulnerable.

  1. 604-605

Heading: Migrant Workers, Immigrants, Refugees, and Asylees > Refugees and Asylees

Integrated Processes: Nursing Process

Client Need: Psychosocial Integrity

Cognitive Level: Application [Applying]

Concept: Infection; Diversity; Violence; Assessment

Difficulty: Easy

  Feedback
A The correct answer is all of the above. Refugees arriving in the United States have likely faced violence or rape in their refugee camps or on the journey to this country. There is also a significantly increased risk of contracting infectious diseases or developing mental illness secondary to the trauma they survived.
B The correct answer is all of the above. Refugees arriving in the United States have likely faced violence or rape in their refugee camps or on the journey to this country. There is also a significantly increased risk of contracting infectious diseases or developing mental illness secondary to the trauma they survived.
C The correct answer is all of the above. Refugees arriving in the United States have likely faced violence or rape in their refugee camps or on the journey to this country. There is also a significantly increased risk of contracting infectious diseases or developing mental illness secondary to the trauma they survived.
D This is correct. Refugees arriving in the United States have likely faced violence or rape in their refugee camps or on the journey to this country. There is also a significantly increased risk of contracting infectious diseases or developing mental illness secondary to the trauma they survived.

 

 

PTS:   1                    CON:  Infection | Diversity | Violence | Assessment

 

  1. A nurse has finished an initial assessment of a community with a high rate of obesity. The nurse has observed that socioeconomic status seems to be linked with poor outcomes in this community. What is the next step?
A. Set goals to reduce obesity rate by 5 percent in the next 3 years.
B. Set up a community fair to begin educating people in the community about healthy food choices.
C. Involve key members of the community in the goal setting and plan formation phase of the nursing process.
D. Perform a cultural assessment to see what other factors may be involved in this community.

 

 

ANS:  D

Objective: 6. Differentiate the various roles and responsibilities of the nurse when caring for vulnerable populations.

  1. 590

Heading: Risk Factors Related to Vulnerability > Multiple Determinants of Vulnerability

Integrated Processes: Nursing Process

Client Need: Health Promotion and Maintenance

Cognitive Level: Application [Applying]

Concept: Diversity; Nutrition; Promoting Health

Difficulty: Moderate

  Feedback
A Before setting goals, the nurse needs to complete a cultural assessment and look for other variables.
B Before creating a plan to address the obesity rate, the nurse needs to complete a cultural assessment and look for other variables.
C Before creating a plan to address the obesity rate, the nurse needs to complete a cultural assessment and look for other variables.
D Before setting goals or creating a plan to address the obesity rate, the nurse needs to complete a cultural assessment and look for other variables.

 

 

PTS:   1                    CON:  Diversity | Nutrition | Promoting Health

 

  1. A nurse is assessing a young woman who recently lost her job. She has no way to support her family and has found herself living on the streets because she doesn’t have any other family in the area. Which of the following is the best way to proceed?
A. Look at the broader picture and see if there are any opportunities for policy change.
B. Refer her to a shelter and document.
C. Offer her a job-training program.
D. Ask her to come back in 6 months for a reevaluation.

 

 

ANS:  A

Objective: 5. Develop strategies for reducing vulnerability among various groups.

  1. 583-586

Heading: Introduction

Integrated Processes: Nursing Process

Client Need: Health Promotion and Maintenance

Cognitive Level: Analysis [Analyzing]

Concept: Promoting Health; Critical Thinking; Legal

Difficulty: Moderate

  Feedback
A This is correct. There is great opportunity to help more people than this one young woman through policy change. Many people suffered during the recent economic down turn and are in need of assistance as well.
B This is incorrect. Simply referring her to a shelter does not address the larger problem. There is great opportunity to help more people than this one young woman through policy change. Many people suffered during the recent economic down turn and are in need of assistance as well.
C This is incorrect. Simply referring her to a job-training program does not address the larger problem. There is great opportunity to help more people than this one young woman through policy change. Many people suffered during the recent economic down turn and are in need of assistance as well.
D This is incorrect. Simply having her come back in six months does not address the larger problem. There is great opportunity to help more people than this one young woman through policy change. Many people suffered during the recent economic down turn and are in need of assistance as well.

 

 

PTS:   1                    CON:  Promoting Health | Critical Thinking | Legal

 

  1. A nurse is working in a prison health center with many of the older prisoners. The nurse is anticipating having to manage which of the following conditions that tends to be more prevalent in the aging prison population?
A. Cognitive disorders
B. Cancer
C. Dental problems
D. Mental disorders

 

 

ANS:  A

Objective: 6. Differentiate the various roles and responsibilities of the nurse when caring for vulnerable populations.

  1. 606

Heading: Incarceration and Vulnerability > Impact on Health

Integrated Processes: Nursing Process

Client Need: Psychosocial Integrity

Cognitive Level: Application [Applying]

Concept: Cognition; Promoting Health

Difficulty: Moderate

  Feedback
A This is correct. Aging prisoners are more likely to face cognitive disorders such as Alzheimer’s and dementia.
B This is incorrect. Aging prisoners are more likely to face cognitive disorders such as Alzheimer’s and dementia.
C While the rate of dental problems is higher in the prison population, the aging prisoners are more likely to face cognitive disorders such as Alzheimer’s and dementia.
D While the rate of mental disease is higher in the prison population, the aging prisoners are more likely to face cognitive disorders such as Alzheimer’s and dementia.

 

 

PTS:   1                    CON:  Cognition | Promoting Health

 

  1. A nurse is teaching a class about vulnerable populations. He instructs that vulnerable populations have been divided into three groups. Which of the following is not one of the three groups that research has identified?
A. People suffering as a result of their behavior (for example, drug addicts)
B. Children of parents who made bad decisions (for example, illegal immigrants)
C. People who became vulnerable through no fault of their own (for example, from cancer)
D. Adults that are born into vulnerable populations because of their ethnicity or race

 

 

ANS:  D

Objective: 2. Distinguish groups in our society who are traditionally considered vulnerable.

  1. 586-587

Heading: Ethics: Concepts Related to Vulnerability

Integrated Processes: Teaching/Learning

Client Need: Health Promotion and Maintenance

Cognitive Level: Application [Applying]

Concept: Promoting Health; Nursing Roles

Difficulty: Moderate

  Feedback
A The three groups of vulnerable populations include people suffering as a result of their behavior, children of parents who made bad decisions, and people who became vulnerable through no fault of their own.
B The three groups of vulnerable populations as divided by the community include people suffering as a result of their behavior, children of parents who made bad decisions, and people who became vulnerable through no fault of their own.
C The three groups of vulnerable populations as divided by the community include people suffering as a result of their behavior, children of parents who made bad decisions, and people who became vulnerable through no fault of their own.
D The three groups of vulnerable populations as divided by the community include people suffering as a result of their behavior, children of parents who made bad decisions, and people who became vulnerable through no fault of their own.

 

 

PTS:   1                    CON:  Promoting Health | Nursing Roles

 

  1. A school nurse has observed an increase in bully behavior in her school. The nurse has noticed that a lot of it seems to be directed toward two gay students and wonders if a school policy change is required to change this behavior. How should the school nurse proceed?
A. Institute a zero tolerance policy for any bully behavior.
B. Set goals for zero incidents of bullying next year.
C. Perform a community assessment to see why the bully behavior has increased.
D. Get the teachers involved in teaching anti-bully behavior in the classroom.

 

 

ANS:  C

Objective: 5. Develop strategies for reducing vulnerability among various groups.

  1. 607-608

Heading: Lesbian, Gay, Bisexual, and Transgender Population > Interventions and Policy

Integrated Processes: Nursing Process

Client Need: Psychosocial Integrity

Cognitive Level: Analysis [Analyzing]

Concept: Violence; Assessment; Critical Thinking

Difficulty: Moderate

  Feedback
A This is likely a good intervention to establish within the school. However, the nurse should assess the school population first to see what is causing the increase in bully behavior. The results of that assessment will guide the plan.
B This is a good goal for the school to set. However, the nurse should assess the school population first to see what is causing the increase in bully behavior. The results of that assessment will guide the plan.
C The nurse should assess the school population first to see what is causing the increase in bully behavior. The results of that assessment will guide the plan.
D This is likely a good intervention to establish within the school. However, the nurse should assess the school population first to see what is causing the increase in bully behavior. The results of that assessment will guide the plan.

 

 

PTS:   1                    CON:  Violence | Assessment | Critical Thinking

 

  1. A nurse is sitting in a community clinic and chatting with a South American patient. He reports that other members of the community are rude to him and his family and act as if he and his family are not part of the community. He mentions that this is a common experience among the South American population living in town. The nurse knows that:
A. This likely plays no role in his health or health status.
B. This family is being stigmatized.
C. The family needs to focus on bonding with their South American community.
D. Marginalization can lead to increased vulnerability and health disparities.

 

 

ANS:  D

Objective: 2. Distinguish groups in our society who are traditionally considered vulnerable.

  1. 587

Heading: Ethics: Concepts Related to Vulnerability > Marginalization

Integrated Processes: Nursing Process

Client Need: Psychosocial Integrity

Cognitive Level: Application [Applying]

Concept: Diversity

Difficulty: Moderate

  Feedback
A This family and the rest of the South American community in this town is being marginalized, which can lead to increased vulnerability and health disparities.
B This family and the rest of the South American community in this town is being marginalized, not stigmatized, which can lead to increased vulnerability and health disparities.
C Bonding with the rest of the South American community in town can be beneficial for the family, but does not negate the harm done by the rest of the community.
D This family and the rest of the South American community in this town is being marginalized, which can lead to increased vulnerability and health disparities.

 

 

PTS:   1                    CON:  Diversity

 

  1. A public health nurse (PHN) is starting a study of different populations in the community to see which groups have face marginalization, and to what degree. The PHN is looking for evidence that:
A. A group has been discriminated against based on their race or ethnicity.
B. A group has been treated as if they are not important or of little consequence to the rest of society.
C. A group has been labeled by society as possessing a particular characteristic that is not valued, leading to a loss of status.
D. A group has been assigned a negative or positive belief that is believed to apply to the entire group.

 

 

ANS:  B

Objective: 1. Describe the concept of vulnerability from a population perspective.

  1. 587

Heading: Ethics: Concepts Related to Vulnerability > Marginalization

Integrated Processes: Nursing Process

Client Need: Psychosocial Integrity

Cognitive Level: Application [Applying]

Concept: Diversity; Assessment

Difficulty: Moderate

  Feedback
A Being discriminated against based on race or ethnicity is called racism or discrimination.
B This is correct. Being treated as if they are of little consequence or not important is called marginalization.
C Having been labeled by society as possessing a particular characteristic that is not valued, leading to a loss of status is called stigmatization, not marginalization.
D Assigning a negative or positive belief that is believed to apply to the entire group is called stereotyping, not marginalization.

 

 

PTS:   1                    CON:  Diversity | Assessment

 

  1. A nurse is working with the local government to determine where best to spend money obtained from a new funding program. The nurse is looking for particularly vulnerable communities. Which of the following communities might be best served by the increased funding?
A. A primarily Hispanic community that is rich in culture and community
B. A low socioeconomic Caucasian community that is facing abnormally high levels of lung cancer
C. A middle class African American community with an obesity rate of 15 percent
D. An upper class community where there is an outbreak of Hand, Foot, and Mouth Disease

 

 

ANS:  B

Objective: 3. Demonstrate an understanding of the individual and social determinants of health and their contribution to population vulnerability.

  1. 583-586

Heading: Introduction

Integrated Processes: Nursing Process

Client Need: Health Promotion and Maintenance

Cognitive Level: Analysis [Analyzing]

Concept: Cellular Regulation; Promoting Health; Critical Thinking; Economics; Legal

Difficulty: Difficult

  Feedback
A Having a strong tie to community and culture decreases a population’s risk for medical vulnerability.
B This community is the most medically vulnerable. Having low Socioeconomic status SES and facing a serious medical conditions makes them more at risk for poor outcomes.
C Middle class communities may face some vulnerabilities, but residents are generally able to afford adequate health care. Ethnicity does play a role and in fact, the primarily African American population does face a higher risk of health vulnerability. An obesity rate of 15 percent is under the national average.
D An upper class community does not usually face health disparities, since residents are more able to afford health care. Hand, Foot, and Mouth Disease is a very common childhood disease that does not need special intervention.

 

 

PTS:   1

CON:  Cellular Regulation | Promoting Health | Critical Thinking | Economics | Legal

 

  1. A nurse is teaching a class about the effect of socioeconomic status on health outcomes. The nurse explains that socioeconomic status is related to:
A. Income
B. Occupation
C. Education
D. All of the above

 

 

ANS:  D

Objective: 3. Demonstrate an understanding of the individual and social determinants of health and their contribution to population vulnerability.

  1. 588-590

Heading: Risk Factors Related to Vulnerability > Social Determinants of Health and Vulnerability

Integrated Processes: Teaching/Learning

Client Need: Health Promotion and Maintenance

Cognitive Level: Application [Applying]

Concept: Economics; Promoting Health; Nursing Roles

Difficulty: Moderate

  Feedback
A The correct answer is “All of the above.” Socioeconomic status is a reflection of three factors: income, occupation and education. As education increases, so does job stability and income. People with lower levels of education tend to have less stable work with poorer pay.
B The correct answer is “All of the above.” Socioeconomic status is a reflection of three factors: income, occupation and education. As education increases, so does job stability and income. People with lower levels of education tend to have less stable work with poorer pay.
C The correct answer is “All of the above.” Socioeconomic status is a reflection of three factors: income, occupation and education. As education increases, so does job stability and income. People with lower levels of education tend to have less stable work with poorer pay.
D This is the correct answer. Socioeconomic status is a reflection of three factors: income, occupation and education. As education increases, so does job stability and income. People with lower levels of education tend to have less stable work with poorer pay.

 

 

PTS:   1                    CON:  Economics | Promoting Health | Nursing Roles

 

  1. A nurse is caring for a young homeless man on the medical floor of the local hospital. He was admitted several days ago to safely detox from alcohol. He reports having nowhere to go once he is discharged. Who should be involved in his discharge planning?
A. Social worker
B. Addiction specialist
C. Psychiatrist
D. All of the above

 

 

ANS:  D

Objective: 6. Differentiate the various roles and responsibilities of the nurse when caring for vulnerable populations.

  1. 592

Heading: Strategies for Reducing Vulnerability > Nursing Care of Vulnerable Populations–Roles of the Nurse

Integrated Processes: Nursing Process

Client Need: Psychosocial Integrity

Cognitive Level: Analysis [Analyzing]

Concept: Addiction; Collaboration

Difficulty: Difficult

  Feedback
A Social workers should be involved in his discharge planning. The social worker can help him find rehab programs to help him stay off of alcohol. In addition, the nurse can help him find assistance programs that he might qualify for. Addiction specialists and psychiatrists should also be involved in his care to give him long-term solutions for staying sober.
B Social workers should be involved in his discharge planning. The social worker can help him find rehab programs to help him stay off of alcohol. In addition, the nurse can help him find assistance programs that he might qualify for. Addiction specialists and psychiatrists should also be involved in his care to give him long-term solutions for staying sober.
C Social workers should be involved in his discharge planning. The social worker can help him find rehab programs to help him stay off of alcohol. In addition, the nurse can help him find assistance programs that he might qualify for. Addiction specialists and psychiatrists should also be involved in his care to give him long-term solutions for staying sober.
D Social workers should be involved in his discharge planning. The social worker can help him find rehab programs to help him stay off of alcohol. In addition, the nurse can help him find assistance programs that he might qualify for. Addiction specialists and psychiatrists should also be involved in his care to give him long-term solutions for staying sober.

 

 

PTS:   1                    CON:  Addiction | Collaboration

 

  1. A nurse is caring for a young man who is squatting in an old factory a mile away. The nurse documents that he is experiencing what type of homelessness?
A. Primary
B. Secondary
C. Tertiary
D. He is not homeless because he has an indoor shelter in which to sleep.

 

 

ANS:  A

Objective: 3. Demonstrate an understanding of the individual and social determinants of health and their contribution to population vulnerability.

  1. 593

Heading: Homelessness and Vulnerability

Integrated Processes: Communication and Documentation

Client Need: Psychosocial Integrity

Cognitive Level: Application [Applying]

Concept: Communication

Difficulty: Moderate

  Feedback
A This young man is experiencing primary homelessness because he is living in an abandoned building, which is not suitable for living.
B This is incorrect. Secondary homelessness is when someone is staying in a temporary housing situation, such as in a shelter or with a family member or friend.
C This is incorrect. Tertiary homelessness is when someone is renting a single room without the security of a fixed place to live.
D This young man is homeless because he doesn’t have a safe and reliable place to stay. He is experiencing primary homelessness because he is living in an abandoned building, which is not suitable for living.

 

 

PTS:   1                    CON:  Communication

 

  1. A nurse received funding to start a mobile health unit to serve the needs of the homeless population. In addition to a general nurse staffing the unit, what other type of nurse should be hired to assist?
A. Cardiac
B. Surgical
C. Psychiatric
D. Nutrition

 

 

ANS:  C

Objective: 5. Develop strategies for reducing vulnerability among various groups.

  1. 597-598

Heading: Homelessness and Vulnerability > Interventions and Services for Persons Experiencing Homeless

Integrated Processes: Nursing Process

Client Need: Psychosocial Integrity

Cognitive Level: Analysis [Analyzing]

Concept: Promoting Health; Critical Thinking; Nursing

Difficulty: Difficult

  Feedback
A Members of the homeless population are significantly more likely to suffer from mental disorders and drug addiction. It would be helpful to have a psychiatrist or mental health specialist available when working with the homeless population.
B Members of the homeless population are significantly more likely to suffer from mental disorders and drug addiction. It would be helpful to have a psychiatrist or mental health specialist available when working with the homeless population.
C Members of the homeless population are significantly more likely to suffer from mental disorders and drug addiction. It would be helpful to have a psychiatrist or mental health specialist available when working with the homeless population.
D Members of the homeless population are significantly more likely to suffer from mental disorders and drug addiction. It would be helpful to have a psychiatrist or mental health specialist available when working with the homeless population.

 

 

PTS:   1                    CON:  Promoting Health | Critical Thinking | Nursing

 

  1. A nurse is performing a pelvic exam on a woman in her mid-twenties. The nurse asks the woman what type of birth control she uses and the woman laughs, saying that she doesn’t need birth control because she is a lesbian. How should the nurse respond?
A. “That’s correct, you do not need contraception.”
B. “You should consider contraception anyway, just in case you ever decide to be intimate with a man.”
C. “You still need to use a barrier contraceptive because of the risk of sexually transmitted infections.”
D. “Hormonal contraceptives might be a good option for you.”

 

 

ANS:  C

Objective: 6. Differentiate the various roles and responsibilities of the nurse when caring for vulnerable populations.

  1. 607

Heading: Lesbian, Gay, Bisexual, and Transgender Population > Impact on Health

Integrated Processes: Teaching/Learning

Client Need: Health Promotion and Maintenance

Cognitive Level: Application [Applying]

Concept: Sexuality; Promoting Health; Nursing Roles

Difficulty: Moderate

  Feedback
A Even though a lesbian may not need contraceptives to prevent pregnancy, it is still important to use barrier contraception to prevent the transmission of sexually transmitted infections.
B This is insensitive to the woman’s sexual preferences and is not an appropriate thing to say. The woman should still use barrier contraceptives to prevent the transmission of sexually transmitted infections.
C Even though a lesbian may not need contraceptives to prevent pregnancy, it is still important to use barrier contraception to prevent the transmission of sexually transmitted infections.
D Hormonal contraceptives are not effective against sexually transmitted infections and only prevent pregnancy. The woman should be using barrier contraceptives.

 

 

PTS:   1                    CON:  Sexuality | Promoting Health | Nursing Roles

 

  1. A nurse is working within a community clinic on the Mexican-Californian border. The nurse frequently takes care of refugee families when they first arrive in the United States. When meeting with a new family, the nurse makes sure to inform them that they are eligible for which of the following services?
A. Medicaid eligibility
B. Free health insurance for 1 year
C. Housing and food support
D. Free English classes

 

 

ANS:  C

Objective: 6. Differentiate the various roles and responsibilities of the nurse when caring for vulnerable populations.

  1. 604-605

Heading: Migrant Workers, Immigrants, Refugees, and Asylees > Refugees and Asylees

Integrated Processes: Teaching/Learning

Client Need: Health Promotion and Maintenance

Cognitive Level: Application [Applying]

Concept: Promoting Health; Diversity; Nursing Roles

Difficulty: Moderate

  Feedback
A This is incorrect. When refugees first arrive in the United States, they are given food and housing support, health insurance for the first 8 months and employment training or job placement assistance. They are encouraged to apply for Medicaid at the end of the 8 months, but they would still need to apply and qualify.
B This is incorrect. Refugees are given health insurance for 8 months when they first arrive. They are encouraged to apply for Medicaid at the end of the 8 months, but they still need to apply and qualify.
C This is correct. When refugees first arrive in the United States, they are given food and housing support, health insurance for the first 8 months and employment training or job placement assistance.
D This is incorrect. When refugees first arrive in the United States, they are given food and housing support, health insurance for the first 8 months and employment training or job placement assistance.

 

 

PTS:   1                    CON:  Promoting Health | Diversity | Nursing Roles

 

  1. A nurse encounters a young woman with her child in the community. They do not speak English, but the nurse is fluent in Spanish and is able to communicate with them in their native language. The woman is very frightened and states that she can’t go back to her country because the local government will harm her and her child if she does not convert to Catholicism. The nurse takes the woman to the local immigration office to apply for what status?
A. Asylee
B. Refugee
C. Immigrant
D. Permanent Resident

 

 

ANS:  A

Objective: 2. Distinguish groups in our society who are traditionally considered vulnerable.

  1. 604-605

Heading: Migrant Workers, Immigrants, Refugees, and Asylees > Refugees and Asylees

Integrated Processes: Nursing Process

Client Need: Psychosocial Integrity

Cognitive Level: Application [Applying]

Concept: Diversity; Violence; Legal

Difficulty: Moderate

  Feedback
A An asylee is a person who is looking to escape an oppressive situation in her own country, but who has already made it to the United States. A refugee is someone who is looking to escape their country but who still is living in their home country.
B A refugee is someone who is looking to escape their country but who still is living in their home country. This woman is an asylee because she has already made it to the United States.
C She should be applying for asylee status. An asylee is a person who is looking to escape an oppressive situation in her own country, but who has already made it to the United States.
D She should be applying for asylee status. An asylee is a person who is looking to escape an oppressive situation in her own country, but who has already made it to the United States.

 

 

PTS:   1                    CON:  Diversity | Violence | Legal

 

MULTIPLE RESPONSE

 

  1. A nurse is speaking with politicians about the need to modify the poverty threshold to be fairer to people living in poverty and people living just over the poverty line. Which of the following are potential ways that the poverty threshold could be amended to be more accurate or fair?

Select all that apply.

A. Amend it to reflect increased spending on health care and transportation.
B. Amend it to reflect increased housing costs.
C. Amend it to reflect increased need and cost of childcare.
D. Amend it to reflect increased spending on food.
E. Amend it to reflect regional cost of living.

 

 

ANS:  A, B, C, E

Objective: 5. Develop strategies for reducing vulnerability among various groups.

  1. 588-590

Heading: Risk Factors Related to Vulnerability > Social Determinants of Health and Vulnerability

Integrated Processes: Nursing Process

Client Need: Health Promotion and Maintenance

Cognitive Level: Analysis [Analyzing]

Concept: Promoting Health; Nursing Roles; Legal

Difficulty: Difficult

 

  Feedback
1 This is correct. The old poverty threshold calculations do not reflect recent increases in spending on health care and transportation. Adjusting for these expenses would make the poverty threshold fairer.
2 This is correct. The old poverty threshold calculations do not reflect recent increases in spending on housing (rentals and purchases). Adjusting for these expenses would make the poverty threshold fairer.
3 This is correct. The old poverty threshold calculations do not reflect the increased need for and increased cost of childcare. Adjusting for these expenses would make the poverty threshold fairer.
4 This is incorrect. Food spending has actually decreased in recent years.
5 This is correct. The old poverty threshold calculations do not reflect regional differences in cost of living.

 

 

PTS:   1                    CON:  Promoting Health | Nursing Roles | Legal

 

  1. A nurse is training for a new job at a community clinic after moving to Central California, an area rich in agriculture and migrant workers. The nurse asks about specific social and health issues that the migrant worker population faces and the nurse supervisor replies:

Select all that apply.

A. They have difficulty establishing residency in a single location, making them ineligible for government benefits.
B. Most of them lack access to workers compensation or disability insurance.
C. Frequent travel and location changes make it difficult for them to establish continuity of care with a single provider.
D. Illegal immigration status is often a problem.
E. Language is often a barrier.

 

 

ANS:  A, B, C, E

Objective: 3. Demonstrate an understanding of the individual and social determinants of health and their contribution to population vulnerability.

  1. 599-603

Heading: Migrant Workers, Immigrants, Refugees, and Asylees > Migrant Workers

Integrated Processes: Teaching/Learning

Client Need: Health Promotion and Maintenance

Cognitive Level: Application [Applying]

Concept: Diversity; Promoting Health; Nursing Roles; Health-Care System; Communication

Difficulty: Moderate

 

  Feedback
1 This answer is correct. Migrant workers tend to “follow the job,” meaning that they travel around the country looking for work, which is usually agriculturally based. This can make establishing a residency, and accessing government benefits, difficult.
2 This is correct. Migrant workers usually work long hours and don’t have access to disability insurance or workers compensation.
3 This is correct. When traveling around the country for work, it becomes difficult to establish continuity of care with a single provider.
4 Some migrant workers may be illegal immigrants, but most are legal citizens or residents.
5 Many migrant workers do not speak English or speak English as a second language. This can lead to difficulties in obtaining culturally appropriate health care.

 

 

PTS:   1

CON:  Diversity | Promoting Health | Nursing Roles | Health-Care System | Communication

 

  1. A nurse is preparing a class on caring for the homeless population. The nurse asks the class to brainstorm some risk factors for becoming homeless. Which of the following should the class list as known risk factors for homelessness?

Select all that apply.

A. Young families
B. Caucasians
C. Single men
D. African Americans
E. Having mental illness

 

 

ANS:  C, D, E

Objective: 4. Apply the multiple determinants of vulnerability approach in determining levels of vulnerability of a particular population.

  1. 593-594

Heading: Homelessness and Vulnerability > Prevalence of Homelessness

Integrated Processes: Teaching/Learning

Client Need: Psychosocial Integrity

Cognitive Level: Application [Applying]

Concept: Diversity; Family; Promoting Health; Nursing Roles

Difficulty: Moderate

 

  Feedback
1 This is incorrect. Single people are significantly more likely to become homeless than families. This may be in part because of the number of safety nets in place to help families and children.
2 Hispanics and African Americans are much more likely to become homeless than Caucasians.
3 This is correct. Single men are much more likely to become homeless than single women or families.
4 Hispanics and African Americans are much more likely to become homeless than Caucasians.
5 Having mental illness is a major risk factor for becoming homeless. In fact, the rate of homelessness is significantly higher in people with mental health issues.

 

 

PTS:   1                    CON:  Diversity | Family | Promoting Health | Nursing Roles

 

  1. It is the first day of class for new graduate public health nursing students. The professor explains that as PHNs, they will need to fill many roles, including which of the following?

Select all that apply.

A. Educator
B. Advocate
C. Administrator
D. Researcher
E. Social worker

 

 

ANS:  A, B, D

Objective: 6. Differentiate the various roles and responsibilities of the nurse when caring for vulnerable populations.

  1. 592-593

Heading: Strategies for Reducing Vulnerability > Nursing Care of Vulnerable Populations–Roles of the Nurse

Integrated Processes: Teaching/Learning

Client Need: Health Promotion and Maintenance

Cognitive Level: Application [Applying]

Concept: Evidence-Based Practice; Nursing Roles; Promoting Health

Difficulty: Moderate

 

  Feedback
1 PHNs must fill many roles, including that of educator. They are responsible for educating patients, their families, and other health-care workers about public health issues.
2 PHNs are expected to work as advocates for their patients and their communities.
3 Some public health workers may begin working in administrative capacities, but that is not a typical part of being a PHN.
4 PHNs must be proficient researchers. Their research skills are needed during community assessments as they thoroughly research the community in which they are working.
5 Social workers are specially trained case managers. PHNs are not social workers, nor do they act like them professionally.

 

 

PTS:   1                    CON:  Evidence-Based Practice | Nursing Roles | Promoting Health

 

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