Community Exam 3
Healthy People 2020is a guidepost for nurses and interdisciplinary teams in community
and public health. Which new focal areas will the nurse discover has been added to the
2020 goals? (Select all that apply.)
The nurse has determined the specific indicators and focal areas that are needed to
establish immunization and well-child clinics in a low-income neighborhood. What actions
should the nurse prioritize to meet the health outcomes of the project?
Absenteeism due to illness has increased recently in the local middle school. The increase is noted to be related to exacerbation of asthma symptoms in the student population.
Which would be the most effective approach in decreasing absenteeism among this
population?
The local clinic is dedicated to the well adult and child. It has evening hours and offers
varied programs for the community. The programs include immunizations and classes on
fire safety, health education, and car safety, to name a few. How would the nurse best
explain the level of prevention used in this setting to your colleagues?
The nurse works in a facility that provides hospice care for clients with cancer diagnoses.
The nurse recognizes that the care provided in this facility is tertiary in nature. When developing the care plan for these individuals, which functions should the nurse prioritize? (Select all that apply.
The nurse decided to use a learning model based on Skinner with a client with diabetes to improve compliance with dietary and blood glucose assessment requirements. Which
would be the bestway to implement this program?
Positive reinforcement- give rewards for low blood sugars and eating healthy
The nurse decides to use the health belief model for a wellness walking program for older adults. The walk is to begin each day at 8 PM. Each day a different participant is to start a chain of phone calls to other participants to remind all to attend. The nurse informs the
clients in the clinic that walking will improve their overall health and well-being. Two older
adults show up the first night and none the second. Which information should the nurse
gather to explain the failure of the program? (Select all that apply.)
A 47-year-old client and three members of his neighborhood have had their homes robbed and belongings scattered. The client contacts the police and, with their assistance, develops a neighborhood watch. The watch is organized, and 24 families have been recruited to participate. The watch will be active throughout vacation months and as needed. Which
model will this organization be mostutilizing in this process?
1The nurse is analyzing an epidemiologic study conducted on the occurrence of Zika virus
cases in his state. While evaluating the information, which option is the best interpretation
of “rate”?
In researching cases of West Nile virus in the community, the nurse explores how the
interactions among people infected with this virus, mosquitoes, and the environment they
share contribute to outbreaks of this disease. Which epidemiologic model is the nurse
prioritizing in this case?
3The nurse explores all of the possible factors that contribute to coronary artery disease in
the community as links in multiple interrelated chains. Which epidemiologic models is the
nurse utilizing in this case?
The nurse is appraising new epidemiologic research concerning the reported cases of
measles over the past 5 years. Which is the best explanation for the nurse to apply to
“risk factor” when analyzing this research?
The nurse has been requested to investigate the outbreak of H1N1 in the community. In
documenting the outbreak, which should the nurse prioritize in its description? Select all
that apply.
In researching an outbreak of malaria in the developing nation where the nurse currently
works, the nurse decides not to focus on the role of mosquitoes in transmitting the disease
but on how the physical environment of the community, biologic aspects of the
community, and social customs interact to affect the prevalence of this disease. Which
epidemiologic model is the nurse utilizing?
A public health nurse is curious if there has been an increase in the need for hospitalization among reported influenza cases. Which factor should the nurse prioritize for researching to answer this query?
A nurse is concerned there has been an increase in the number of influenza cases in the
county over the past year when compared with last year. Which rate will best provide the
answer to this nurse?
A nursing student is examining an epidemiologic report for a class project. Which
explanation should the student conclude will best define sensitivity?
Ability of a test to correctly identify people who have a health problem or probability of the test being positive and the person having the disease
The nurse wishes to calculate the probability of persons in the county developing chronic obstructive pulmonary disease over the course of a year. Which measure will be best for
the nurse to utilize?
The nurse is maintaining a graph which depicts the distribution of influenza cases by the
time of onset of influenza
Spatial map
Incidence rate
Sensitivity
Prevalence
Attack rate
The nurse works with a female client who recently developed an infection of
Staphylococcus aureuswhile in the hospital. The nurse would determine that S. aureusis
which component in the chain of infection?
Agent
A student nurse asks if an infectious disease is the same thing as a communicable disease. The nurse explains that an infectious disease is not necessarily a communicable disease.
Which factor could the nurse point out that a communicable disease must have that an
infectious disease would not have to have? (Select all that apply.)
The school nurse is concerned when a student presents to the office with chickenpox. The nurse determines that some of this student's classmates are most likely in which part of
the infectious cycle?
Incubation period
The nurse notes a client arrives for an appointment who appears to have a severe upper
respiratory infection. Which mechanism of transmission is the nurse most likely
attempting to prevent by requesting this client to wear a mask while sitting in the waiting
room?
Several levels of public health surveillance are necessary to protect the nation's health. At what level are healthcare providers and health facilities required to report certain infectious
diseases?
State
Chain of infection
Defense mechanisms (kinds of immunity) Active
live or dead exposure to a pathogen, takes longer to build but last
Defense mechanisms (kinds of immunity) Passive
Defense mechanisms (kinds of immunity)Acquired
- defense built with exposure
Defense mechanisms (kinds of immunity) Natural
develops on own
Defense mechanisms (kinds of immunity) Herd
SC reportable diseases (immediate list)
Endemic
Epidemic
Outbreak
Pandemic
Modes of transmission- Airborne
Modes of transmission- Droplet
Modes of transmission- direct contact
Modes of transmission- indirect contact
involves an inanimate object or vector
Vector
transmission occurs through carrier
Portal of entry and exit
A man who lives in a homeless shelter is diagnosed with active tuberculosis (TB). The
shelter keeps a list of those who are assigned beds, and the majority of those sleeping there
are regulars. Which finding would indicate a positive tuberculin skin test result using a
two-step process?
6mm induration
A 16-year-old client visits the community health clinic with concerns that she may have a STI. She asks whether STIs are treatable. Which STIs should the nurse point out are easily treated and curable? (Select all that apply.)
The school nurse is preparing for a health class discussion covering the basics of sexually transmitted infections (STIs). Which factors should the nurse point out will place an
individual at high risk for acquiring a STI? (Select all that apply.)
What are the clinical manifestations of TB?
What are the clinical manifestations of Syphilis?
What are the clinical manifestations of Chlamydia?
Intermenstrual bleeding, cervical discharge, rectal discharge, cervical tenderness, dysuria
What are the clinical manifestations of Gonorrhea?
What are the clinical manifestations of HPV?
warts
What are the clinical manifestations of HSV?
Identify the kinds of abuse (select all that apply)
What are the strategies to reduce societal violence: primary, secondary, tertiary (select all that apply)
The nurse is evaluating a young mother who believes she may be pregnant again. Which relationship factor discovered by the nurse should raise suspicions that this family is at
risk for intimate partner violence?
Preventing intimate partner violence (IPV) and recurrence of violence requires targeting efforts at all three levels of prevention:
Pediatric providers face special issues in screening for intimate partner violence (IPV) in a caregiver who is accompanying a child. Which strategies should the healthcare providers
prioritize for addressing this screening issue? (Select all that apply.)
Preventing intimate partner violence (IPV) and recurrence of violence requires targeting efforts at all three levels of prevention: primary, secondary, and tertiary. Which is an
appropriate tertiary prevention strategy?
The public health nurse is conducting a routine well-child visit. Which statements should raise concern with the nurse in regards for the safety of children? (Select all that apply.)
The nurse is completing a screening of a suspected case of child abuse. Which instance would the nurse considered child abuse and neglect and report? Select all that apply
1 The nurse works with a 16-year-old client who has an alcohol use disorder. Which mental disorder, highly correlated to substance use disorder, should the nurse also assess for in
this client? (Select all that apply.)
A client arrives at the clinic shaky and requesting a refill on a prescription for alprazolam. The nurse suspects that the client might be experiencing substance withdrawal. Which comment by the client would mosttend to confirm the nurse's suspicion?
The community health nurse is concerned with the prevalence of new HIV infections in
the community and understands the strong correlation between substance use disorders
and HIV. Which interventions should the nurse promote in the community health clinic to
bestaddress this problem? (Select all that apply.)
The nurse works in the ER when a client arrives with respiratory depression associated
with a heroin overdose. Which medication should the nurse predict to be ordered for this
client?
The public health nurse is evaluating the community in the effort to determine the
underserved members with the goal of decreasing their risk for health problems. Which
factors should the nurse evaluate to determine who belongs to this group? (Select all that
apply.)
Dependence
Denial
Comorbidities and associated or coexisting health problems
General physical appearance of substance use
Strategies to reduce substance disorders
A nurse is assessing a client who was recently released from prison. Which crime would the nurse mostsuspect that the client may have committed?
The nurse works at a clinic in Arizona that provides bilingual (English and Spanish) care to low-income immigrant workers from Mexico. Which designation mostaccurately describes the area or the population this nurse serves?
Medically underserved area
Medically underserved population
Vulnerability-
Underserved-
What are the common health problems for migrant workers?
Migrant workers- prevention
What are the common health problems for veterans?
Veteran prevention
What are the common health problems for Refugees?
Refugee prevention
What are the common health problems for pregnant adolescents?
Pregnant adolescence prevention
What are the common health problems for prison population?
Prison population prevention
What are the common health problems for LGBTQQA?
LGBTQQA prevention
Ebola
Symptoms- hemorrhage, NVD, shock, fever, headache, muscle ache
PPE- contact and droplet isolation
Biological agents-plague
Symptoms- fever, chills, weakness, tender lymphnodes
PPE- droplet and contact
Tularemia
Symptoms- sudden fever, chills, headache, diarrhea, muscle aches, progressive weakness, septic infection and pneumonia
Smallpox
Symptoms- high fever, fatigue, rash begins on face and tongue but quickly speads to trunk, arms, legs, hands and feet, then turn to pus filled lescions
Onset- rash appears 2-4 days after fever
PPE- contact and airborne
Botulism
Symptoms- double blurred vision, slurred speech, difficulty swallowing, progressive muscle weakness, difficulty breathing
inhalation anthrax
Symptoms- headache, fever, chills, muscle aches, chest discomfort, dyspnea, shock
PPE- airborne
Early 20th century leading cause of death
Respiratory diseases (TB)
Leading cause of death in children and second leading cause of death overall
Infectious diseases