West Coast University: NURS 340 Quiz 3 Quiz bank,100% CORRECT

West Coast University: NURS 340 Quiz 3 Quiz bank Chapter 06: Environmental Health 1. A nurse wants to have a better understanding of the physiological effects of selected chemicals. Which of the following individuals would provide the most useful information to the nurse? Toxicologist 2. A nurse wants to find information about environmental threats that are present in the community. Which of the following would be the best source of data for the nurse? National Library of Medicine 3. A nurse is assessing potential environmental health risks in the community. Which of the following would be the first step that the nurse should take? Perform a windshield survey 4. A community citizen reports to the public health nurse that the city water in one neighborhood has had an unusual taste for the past few months. Which of the following actions should the nurse take first? Check the most recent consumer confidence report. 5. A nurse who works at the local hospital asks a public health nurse what might be causing her hands to become very sore and sensitive. Which of the following statements would be the most appropriate response by the public health nurse? Check the material safety data sheet on any chemicals you have used recently. 6. Which of the following statements about children and environmental hazards is correct? Children are more susceptible to environmental toxins because of their smaller size. 7. Which of the following actions represents the use of secondary prevention to reduce environmental health risks? Collecting blood specimens from preschool children to check for lead levels 8. An occupational health nurse at a local factory is using primary prevention strategies to reduce the environmental health risks among the employees. Which of the following activities would the nurse most likely implement? Teaching new employees who will work outdoors about the signs and symptoms of heat- related illness 9. A nurse wants to help keep the community environment safe. Which of the following is the most appropriate action for the nurse to take? Reduce, reuse, and recycle. 10. Which of the following best describes the purpose of local health departments making unannounced inspections of local restaurants? To ensure compliance 11. A city has announced its plans to build a city dump near a community of poor and predominantly African-American citizens. Which of the following principles would the nurse be using when vocalizing opposition for this plan? Environmental justice 12. A nurse is completing a basic health assessment. Which of the following questions should be asked by an environmentally aware nurse? What jobs have you held longest? 13. A high school student considering a job in the restaurant industry after graduation asks a nurse about workplace safety issues. Which of the following acts would the nurse most likely discuss with the student? d. Occupational Safety and Health Act 14. The nurse is examining blood lead levels in school-age children 1 year after a community-wide education intervention. Which of the following phases of the nursing process is being implemented? d. Evaluation 15. A nurse practitioner has established a mobile clinic to vaccinate noninstitutionalized adults against influenza. Which of the following phases of the nursing process is being implemented? c. Intervention Giving immunizations is an intervention that will increase the number of people who will be vaccinated. Intervention includes coordinating medical, nursing, and public health actions to meet the clients needs. MULTIPLE RESPONSE 1. A public health nurse is assisting the community in dealing with the effects of lead paint poisoning. Which of the following activities would the nurse most likely complete? (Select all that apply.) c. Setting up a blood screening program with the local health department d. Encouraging local landlords to improve the condition of their housing 2. Which of the following are the major sources of air pollution in the United States? (Select all that apply.) a. Burning of fossil fuels b. Waste incineration d. Motor vehicles 3. A nurse wants to use the principles of risk and outrage to improve an environmental hazard in the community. To accomplish this, which of the following actions would be taken by the nurse? (Select all that apply.) b. Communicate the correct information in a timely fashion. d. Talk to those affected or those worried about the situation. 4. Which of the following strategies would a nurse expect to be implemented by a typical state environmental agency? (Select all that apply.) a. Acting, through unannounced inspections, to ensure compliance c. Monitoring hazardous substances to uphold established standards d. Obtaining and analyzing samples to confirm compliance 5. Which of the following actions would a nurse take when serving as an advocate for the community? (Select all that apply.) a. Asking questions related to health implications at policy meetings c. Serving as a source of information at public meetings d. Volunteering to serve on health-related committees Chapter 09: Epidemiological Applications Test Bank MULTIPLE CHOICE 1. A nurse is using analytic epidemiology when conducting a research project. Which of the following projects is the nurse most likely completing? b. Determining factors contributing to childhood obesity 2. A nurse is employed as a nurse epidemiologist. Which of the following activities would most likely be completed by the nurse? Evaluating the number of clients presenting with similar diseases 3. Which of the following actions by Florence Nightingale demonstrates her role as an epidemiologist? b. She demonstrated that a safer environment resulted in decreased mortality rate. 4. Which of the following statements describes how nursing in the community is more challenging than nursing in an acute care setting? It is more challenging to control the environment in the community. 5. Several small communities have applied for grant funding from the state department of health to help decrease their teenage pregnancy rate. Which of the following communities should the nurse suggest receiving funding first? d. Community Dwith 90 single teenage pregnancies in a city of 1500 The proportion of STIs to the total population was 100:1000. 7. The nursing staff has attempted to screen the entire African-American population in the community for diabetes. Which of the following would provide immediate verification of the success of the nursing staffs efforts? b. The incidence of diabetes will increase in the community. 8. In a particular community, several high school students were diagnosed with diabetes mellitus Type 2 during the annual high school health fair. Over the next few years, the nursing staff developed and implemented educational programs about the risk factors for diabetes mellitus Type 2 and proper nutrition. Which of the following would be most useful for the nurses to use to determine if they are having any impact? b. The incidence of diabetes is slowly decreasing during screening events. 9. This year 600 of 8000 young women ages 17 to 20 years at a university health center tested positive for a sexually transmitted infection (STI). Which of the following terms best describes this data? c. Prevalence 10. A nursing staff has successfully screened for diabetes in the community. Which of the following might best persuade the health board to increase funding for diabetic clinics in this community? c. The prevalence of diabetes is now higher than previously recognized in the community. 11. A public health nurse found that out of the 70 people who ate the potato salad at a school picnic, 63 developed symptoms of food poisoning. Which of the following best describes the attack rate? c. 90% 12. A man is diagnosed with prostate cancer. Which of the following data should the nurse know to answer the man when he asks, What are the chances Ill survive this thing? b. Case fatality rate 13. Which of the following statistics is used by countries to compare the success of their health care systems? b. Infant mortality rate 14. A nurse is examining all of the various factors which can lead to disease. Which of the following models would the nurse most likely use? Epidemiologic triangle 15. A nurse is examining the various factors that lead to disease and suggests several areas where nurses could intervene to reduce future incidence of disease. Which of the following models would the nurse most likely use? Web of causality 16. Which of the following actions would a nurse take to reduce the high incidence of coronary artery disease (CAD) in a community? Distribution of handouts, including age-appropriate games, self-assessments, and education heart-healthy lifestyles; availability of community screenings for hyperlipidemia in persons a c. 35 and older; and walking programs for those affected with CAD 17. A school nurse wants to decrease the incidence of obesity in elementary school children. Which of the following describes a secondary prevention intervention that the nurse could implement? Weighing students to identify those who are overweight 18. A nurse advises a client with osteoporosis to have three servings of milk or dairy products daily. Which of the following levels of prevention is being used by the nurse? c. Tertiary prevention 19. A nurse has only a regular blood pressure cuff when conducting a health screening for all of the residents of a community. Which of the following may be lacking when obtaining blood pressure readings? d. Validity 20. A nurse is administering a tuberculosis skin test to a client who has AIDS. Which of the following results should the nurse anticipate when using this screening test? c. Decreased sensitivity 21. Persons in an auditorium may have been exposed to a disease. If they are infected, it is crucial that they receive immediate treatment and not take the disease home to their families. Which of the following characteristics would be most important to consider when selecting the screening test to be used? c. The sensitivity of the test 22. A woman is sitting in a corner of the clinical waiting room, crying audibly. The nurse asks, Whats wrong? Can I help? The woman responds, They just told me I have a positive mammogram and I need to see my doctor for follow-up tests. I know Im going to die of cancer. How can I tell my family? Which of the following information does the nurse need to know in order to help the woman cope with this finding? b. The positive predictive value of mammography 23. The administration at a local medical center examines the trends in health problems when developing long-range plans for staffing and space allocation. Which of the following sources of information would be most helpful? a. Local data drawn from a professional survey in the city 24. Statistics clearly demonstrate that there are significantly more cases of a disease in one particular neighborhood than in all the rest of the city. Assuming all else is the same, which of the following is the most likely explanation for a single neighborhood having such a different pattern of illness? a. A cultural or ethnic concentration in the neighborhood 25. Two women seem to agree on almost everything from favorite music to favorite media stars to the best way to prepare a meal. Which of the following best explains this similarity in the two women? a. They are both members of the same birth cohort. 26. A nurse reports that in comparison to all the children in a particular school, the children who are members of the Cub Scouts have 0.3 risk for obesity before entering the sixth grade. Which of the following recommendations would the nurse make to the new parents of two boys who had just moved into this schools neighborhood? c. Encourage the parents to enroll their sons in Cub Scouts. 27. A principal comments to the school nurse that it seems there are a lot more problems with asthma among the students than there were before the school was remodeled a couple of years ago. The nurse investigates the principals observation by reviewing all the school records to determine visits to the health office because of asthma by week and month for the past 5 years. Which of the following best describes the type of study the nurse is conducting? d. Retrospective cohort study 28. Which of the following types of study should the nurse researcher choose if the goal is to identify the long-term benefits and risks of a particular nursing intervention for senior citizens living in the community? c. Clinical trial The goal of a clinical trial is to evaluate the effectiveness of an intervention. Clinical trials are generally the best way to show causality. 29. A teacher recommends that surveys to obtain data on drug use be given to high school students when they meet for various school organizations. Which of the following best describes why the nurse would reject this suggestion? d. This method of data collection would result in selection bias. 30. A nurse is investigating a bacterial illness that has caused a health problem in the community. Only some of the people exposed to the bacteria have become ill. Which of the following factors best explains why this would have happened? Host factors The epidemiologic triangle includes the agent, host, and environment. The bacteria were the agent so chemical and physical agents are not relevant. The environment was apparently the same for everyone, since all were exposed to the bacteria. Therefore, only differences in host factors can explain why some became ill and some were able to fight off the bacterial infestation. MULTIPLE RESPONSE 1. Which of the following explains why contagious infections are becoming a central focus of public health? (Select all that apply.) a. Americans are fearful of terrorists using biological agents. c. Drug-resistant strains of old diseases have evolved. 2. A nurse is concerned about the high incidence of STDs in the community college population and sets up a special STD screening. Which of the following groups of students would be encouraged to attend? (Select all that apply.) b. Sexually active students who had been screened the previous year c. Students who claimed to not be sexually active and do not plan to become sexually active d. Students who are sexually active but never go all the way 3. A nurse is planning to host a health screening at a large urban mall. Which of the following variables will help the nurse determine which screenings should be included? (Select all that apply.) b. Health problems for which the specific population is at risk d. Whether health care providers are available to follow up on any positive screening results 4. A nurse believes a new mouth care procedure (MCP) is causing more mouth problems than it is helping to avoid. Which of the following must be present for the nurse to go to administration with confidence that the new mouth care procedure (MCP) is causing problems? (Select all that apply.) a. A plausible explanation of how the new MCP could cause harm c. Consistently seeing mouth inflammation in many of the patients who have received the MCP Documentation from patient records that mouth inflammation in clients did not occur until aft d. the new procedure was implemented Chapter 26: Infectious Disease Prevention and Control Test Bank MULTIPLE CHOICE 1. Which of the following is the number one cause of death worldwide? b. Infectious diseases 2. Which of the following places best describes where the incidence of Vancomycin- resistant Staphylococcus aureus (VRSA) and methicillin-resistant S. aureus (MRSA) is currently rising? a. Areas where people share dressing or bathing facilities 3. During an outbreak of hepatitis A, nurses are giving injections of hepatitis A immunoglobulin to selected susceptible persons. Which of the following best describes the type of immunity that will follow the administration of these injections? d. Passive immunity 4. A man loudly protests his increased property tax bill right after the public health department has made a plea for more funds. Why, he asks, should my tax dollars be used to pay for their children to be immunized? Which of the following would be the best response by the nurse? c. Only by making sure most kids are immunized can we stop epidemics that might hurt all of u 5. Which of the following components of the epidemiologic triangle contributes most to a female client developing a vaginal infection caused by fungi after successful treatment of her strep throat with antibiotics? Environment 6. Which of the following best represents an example of infectious disease spreading via a vector? a. Being bitten by an infected mosquito 7. A nurses Mantoux test is positive for exposure to tuberculosis. Which of the following conclusions should be drawn by the nurse? The nurse has been exposed to tuberculosis. The test results wont be reliable so soon after exposure. 9. Which of the following data would most likely be collected in a syndromic surveillance system? c. Incidence of school absenteeism 10. A community is experiencing an epidemic of the measles. The nurse is trying to determine if this problem is happening in other communities as well. Which of the following resources should the nurse use to answer this question? c. Morbidity and Mortality Weekly Report 11. There is great concern in the nurses community over three local cases of West Nile virus. Which of the following actions should the nurse take to get the community involved in addressing this problem? d. Have an educational campaign to remove any containers of standing water 12. Which of the following is the most probable cause of the increase in new emerging infectious diseases? a. Activities or behavior of humans, including changes in the environment 13. Which of the following best describes the current goal in relation to communicable diseases? b. To exterminate specific infectious agents one by one The goal of prevention and control programs is to reduce the prevalence of a disease to a level at which it no longer poses a major public health problem. In some cases, diseases may even be eliminated or eradicated. 14. Which of the following biological warfare agents poses the greatest bioterrorism threat to a community? a. Anthrax 15. Which of the following public health actions has been particularly instrumental in reducing childhood infectious diseases in the United States? c. No shots, no school legislation, which legally requires children be immunized before school Vaccines are one of the most effective methods of preventing and controlling communicable diseases. 16. A student comes to the college health clinic with typical cold symptoms of fever, sneezing, and coughing, but the nurse also notes small white spots on the inside of the students cheeks. Which of the following actions should be taken by the college health nurse? b. Inform all students, staff, and faculty of a possible measles epidemic Measles is an acute, highly contagious disease that, although considered a childhood illness, is often seen in the United States in adolescents and young adults. Symptoms include fever, sneezing, coughing, conjunctivitis, small white spots on the inside of the cheek (Koplik spots), and a red, blotchy rash beginning several days after the respiratory signs. 17. An instructor is reviewing Salmonella infections with her class. Which of the following comments indicates that the student needs further review on how Salmonella is spread? c. Salmonella may be spread by spores that form once contaminated blood is exposed to the air. Meat, poultry, and eggs are the foods most often associated with salmonellosis outbreaks. 18. Which of the following is the most common vector-borne disease in the United States? c. Lyme disease Lyme disease became a nationally notifiable disease in 1991 and is now the most common vector- borne disease in the United States. 19. A student complains to the college health nurse that her academic work has been going downhill because of lack of sleep. My 3-year-old probably misses her babysitter since she has started going to the big daycare center. She hasnt been sleeping well and keeps scratching her bottom. Hopefully, shell adapt to daycare soon. Which of the following information should the nurse provide to the student? b. Your daughter may have pinworms; let me teach you how to check for this. Enterobiasis (pinworm infection) is the most common helminthic infection in the United States with about 42 million cases a year. This infection is seen most often among children in institutional settings. Pinworms cause itching, especially around the anus, which can result in a lack of sleep for both child and caregiver. 20. Which of the following is the most common vector-borne disease worldwide? b. Malaria 21. At a town meeting with public health officials to discuss a communicable disease outbreak, a nurse is asked to explain what is meant by the phrase a virulent organism. The nurse explains that this means the organism causing the disease is able to do which of the following? d. Produce very severe physical reactions Virulence is the ability to produce a severe pathological reaction. 22. A client is using a primary prevention strategy to prevent infectious disease. Which of the following actions is the client most likely taking? a. A client receives a tetanus booster every 10 years. Tetanus boosters given before exposure are a measure of primary prevention because exposure has not yet occurred. If given after exposure (i.e., the client may be infected but disease has not developed), they are considered secondary prevention. 23. Which of the following infectious disease interventions best represents the use of secondary prevention? d. Health care workers are required to have a tuberculosis skin test or chest x-ray. Tuberculosis screening for health care workers is an example of secondary prevention. MULTIPLE RESPONSE 1. Six students order meals at a local restaurant. Which of the following students are at highest risk for illness? (Select all that apply.) b. The second student asks for a hamburger, very rare. d. The fourth student orders a breakfast meal with two very soft-poached eggs and toast. 2. Which of the following symptoms suggests smallpox as opposed to the more common and much less dangerous chickenpox? (Select all that apply.) c. Rash lesions are most abundant on the face and extremities, not on the trunk. d. Rash occurs 2 to 4 days after sudden onset of fever rather than with the fever. Symptoms of smallpox include rash lesions on face and extremities, rash that occurs 2 to 4 days after onset of fever, and vesicles that are deep seated. 3. The advanced practice nurse explains that the client has an upper respiratory infection (URI) and suggests several measures that might make the client more comfortable. Which of the following best describes why the nurse doesnt just prescribe antibiotics as the client repeatedly requests? (Select all that apply.) b. Viral diseases are not affected by antibiotics. d. The more antibiotics are prescribed, the more infectious agents develop resistance to such dru Antibiotics are not effective against viral diseases, a fact found unacceptable to many clients looking for relief from the misery of a cold or flu. The inappropriate prescribing of antibiotics contributes to the growing problem of infectious agents that have developed resistance to once- powerful antibiotics. Chapter 27: HIV Infection, Hepatitis, Tuberculosis, and Sexually Transmitted Diseases Test Bank MULTIPLE CHOICE 1. Which of the following sexually transmitted diseases can be prevented through immunization? c. Hepatitis B 2. Which of the following provides the best explanation as to why people do not immediately seek medical treatment when they first become ill with HIV? c. They dont recognize their symptoms as possibly being due to HIV. When HIV enters the body, it can cause a flu-like syndrome referred to as a primary infection or acute retroviral syndrome. panicked. Which of the following would be most important to emphasize to the client immediately? The test would not cover any recent infection, so if the client has had recent unprotected sex the test should be repeated in 3 months. 4. A student asks the nurse at the student health clinic how AIDS is diagnosed. Which of the following statements would be the best response by the nurse? A diagnosis of AIDS is made when CD4 T lymphocytes drop to less than 200/ml. 5. The correctional health nurse is doing a quick assessment on a newly admitted inmate who is HIV positive. Which of the following diseases should the inmate receive screening for immediately? Tuberculosis 6. A school nurse asks a class about the ways HIV can be transmitted. Which of the following comments by a student indicates a need for additional teaching? a. I wouldnt sit next to someone with HIV. 7. In the United States, which demographic group has the highest risk for HIV infection? c. White homosexual men 8. Which of the following best explains why some health clinics allow clients to be tested for HIV anonymously with no record of the clients name, address, or contact information? b. Client may be engaged in illegal activities (drug use). 9. A nurse is providing education to a client about the use of PrEP. Which of the following statements would the nurse include as part of this teaching? c. The effectiveness of PrEP will depend on your adherence to the medication regimen. 10. A male client visits the clinic office complaining of a yellow, green discharge from his penis. Which of the following STDs has the client most likely contracted? Gonorrhea 11. A client is being treated for secondary syphilis. Which of the following signs and symptoms would the nurse anticipate the client would exhibit? d. Skin rash without itching Secondary syphilis occurs when the organism enters the lymph system and spreads throughout the body. Signs include skin rash on one or more areas of the body and do not cause itching. 12. Which of the following best explains why chlamydia is a major focus of public health efforts? b. It can cause problems in infants born to infected mothers 13. Which of the following statements best explains why HSV-2 infection is more challenging for a client than gonorrhea infection? a. HSV-2 is a viral infection that is both chronic and incurable. 14. When a nurse discovers that a woman has been treated for cervical cancer, the nurse asks the woman whether she has ever been tested for HIV or other STDs. The woman is offended and asks why the nurse would ask her such a thing. Which of the following statements would be the best response from the nurse? Cervical cancer usually is caused by HPV, and often the presence of one STD is accompanied by b. other STDs. 15. Which of the following best describes the characteristic appearance of lesions of human papillomavirus (HPV)? Elevated growths with a cauliflower appearance 16. A client who is very upset says to the nurse, But we always used a condom! How could I have genital warts? Which of the following would be the best response by the nurse? d. Skin to skin contact to a wart may have occurred outside the area that the condom covers. 17. Which of the following statements best explains why many health care providers are more afraid of getting hepatitis B than HIV? d. There is no treatment for HBV, which can be a very serious illness. 18. A nurse explained to a new mother that because she had tested positive for the hepatitis B virus, her newborn son would need the hepatitis B vaccine immediately and then also an immune globulin injection. Wait, said the new mother. Why is my son getting two shots? Which of the following statements would be the best response by the nurse? a. One injection protects your son, while the other encourages his body to build up immunity. This therapy is recommended to make sure that you receive the treatment you need and the infection doesnt become resistant to the drugs. 20. A nurse is concerned about the prevalence of tuberculosis among migrant farmworkers. Which of the following activities would be best to use when implementing tertiary prevention? b. Initiate directly observed therapy (DOT) for tuberculosis treatment. Tertiary prevention is carried out among persons already infected with the disease. 21. A mother felt very guilty that her baby was born HIV positive. When the nurse suggested the usual DPT and MMR immunizations, the mother was extremely upset. Dont you know HIV children are immunosuppressed? she exclaimed. Which of the following would be the nurses best response? Being HIV positive, your child is more likely to catch an infection and be very ill if not b. immunized. 22. A nurse was reading PPD tests 24 hours after another nurse had administered them. Which of the following findings would cause the nurse to interpret the test as positive? 10 mm of swelling and increased firmness in a client recently released from a correctional d. facility 23. A high school student is planning to volunteer at the hospital after school, so she needs to have a Mantoux test before beginning. Which of the following information should the nurse provide to the new volunteer? d. You will need to return in 2 to 3 days to have any reaction interpreted. The Mantoux test is a TB skin test that involves a 0.1-ml injection containing 5 tuberculin units of PPD tuberculin (not tines as in the TB tine test). MULTIPLE RESPONSE 1. In which of the following cases would the school nurse be correct to advise the parents of an HIV-infected child to keep the child home from school? (Select all that apply.) b. The child persists in biting behavior or is unable to control body secretions. d. There is an outbreak of chickenpox in the school. 2. A woman and man who have come to the health clinic begin to argue loudly. You gave me an STD! the man yells. The woman screams back, Not me. I dont have an STD! Which of the following statements would be most appropriate for the nurse to say to them? (Select all that apply.) Actually, youre very fortunate to have been tested so you and your partner can begin treatmen a. before more serious damage is done. Some STDs may not have any symptoms, so you need to be tested for other conditions and b. treated if necessary. c. Sometimes the test is inaccurate, so before getting too upset, you should ask to be tested again 3. The public health nurse comes to the hospital to see a client just diagnosed with hepatitis A. The nurse says, Im sorry to bother you when youre not feeling well, but I need to ask you a few questions. Which of the following questions would be most appropriate for the nurse to ask the client? (Select all that apply.) b. Who lives with you? c. Where are you employed? Chapter 03: The U.S. Health and Public Health Care Systems Test Bank MULTIPLE CHOICE 1. A public health agency is planning to implement the electronic health record. Which of the following is a benefit of this choice? a. Facilitation of interprofessional care 2. A community health nurse is trying to increase enrollment in SCHIP. Which of the following interventions would be most effective? Handing out SCHIP applications to uninsured children seen in local hospital emergency b. departments 3. A nurse is explaining the health care system in the United States to a group of physicians visiting from South America. How would the nurse best describe the current health care system? c. It is divided primarily into two components: private health care and public health care. Health care in the United States consists of a personal care system and a public health system, with overlap between the two. 4. Which of the following best describes ideal primary health care? b. Essential care available to all community members, which encourages self-management Primary health care is generally defined as essential care made universally accessible to individuals and families in a community with their full participation and at a cost that the community can afford. 5. How does managed care attempt to control costs of care? By requiring families to choose a care provider from the MC network and not allowing access t b. other services without their providers permission 6. An 80-year-old woman comes to the community health care facility with a large bag of medications. She tells the nurse she can no longer afford these medications because her only income is Social Security. Which statement is the best response by the nurse? Lets see if we can get some help from Medicare to help you pay for these medications. This elderly patient probably is eligible for benefits through Medicare Part D. Medicare Part D has been added to Medicare to help cover the cost of prescriptions. 7. A nurse is determining which health care services must be offered at a local public health clinic. Which of the following factors is most important for the nurse to consider? d. Services mandated by the state government 8. A nurse is planning to conduct research on patient care outcomes. Which of the following agencies would the nurse use as a resource? a. Agency for Health Care Research and Quality 9. How does the Department of Agriculture promote the health of U.S. citizens? c. By collaborating with others to provide food or food stamps to needy persons 10. Which of the following best describes why local, state, and federal governmental agencies have started to cooperate and collaborate more closely in the last few years? b. Increased focus on emergency preparedness and response 11. Which of the following principles has been used by the American Nurses Association (ANA) when encouraging health care reform? d. Universal access to essential health services should be available for all citizens. 12. African-American females have a higher mortality rate from breast cancer than White females. This is an example of: Disparity MULTIPLE RESPONSE 1. What do demographic figures suggest about the ways in which the population of the United States is changing? (Select all that apply.) a. Approximately 12% of the U.S. population was born in a different country. b. Hispanics are the largest minority group population. d. Mortality for both genders in all age groups declined. 2. Which of the following statements are accurate descriptions of current social and economic trends in the United States? (Select all that apply.) a. Citizens are appreciating the quality of life enjoyed in the United States. c. Many families are seeing decreases in family income. d. Massive and unexpected social and economic changes have occurred. 3. Which of the following provides evidence that the U.S. health care system is in crisis? (Select all that apply.) a. Full-time employees may not have health insurance as a benefit. c. Long work hours and provider fatigue are a major factor in medical errors. 4. A nurse is working at a state health department. Which of the following duties would most likely be completed in this setting? (Select all that apply.) a. Administering the Medicaid program b. Assessing the health needs of the states citizens Chapter 05: Cultural Influences in Nursing in Community Health Test Bank MULTIPLE CHOICE 1. Which of the following best describes most Americans attitude toward immigrants? a. Ambivalence because there are no clear solutions about how to address their needs 2. A nurse is about to despair. Earlier in the week, she carefully taught a patient from a different culture exactly how much medication to take and emphasized the importance of taking the correct amount. However, the patient is back in the hospital today with symptoms of an overdose, although the patient denies taking more than the label indicated. Which of the following is the most likely explanation? The patient was also taking folk medicines that had many of the same effects and perhaps some of the same ingredients as the prescribed medication. 3. A nurse wishes to develop cultural competence. Which of the following actions should the nurse take first? Consider how the nurses own personal beliefs and decisions are reflective of his or her culture. 4. A nurse is caring for a client of another culture. Which of the following actions would be most appropriate for the nurse to take? Alter personal nonverbal behaviors to reflect the cultural norms of the client. 5. A male nurse had a habit of sitting with the lower part of one leg resting over the knee of his opposite leg when collecting a clients history. He stopped doing this around Muslim clients after being told that Muslims were offended when he exposed the sole of his foot (shoe) to their face. Which of the following was exhibited by the nurse when he changed his behavior? d. Cultural skill 6. The nurse practitioner (NP) discovered that an immigrant client is not taking the penicillin prescribed because his illness is hot and he believes that penicillin, a hot medicine, will not provide balance. Which of the following terms best describes the action taken by the NP when the clients prescription is changed to a different yet equally effective antibiotic? d. Cultural skill 7. Mexican immigrants who take metamizole (Mexican aspirin) for pain may experience life- threatening agranulocytosis. Which of the following actions would be taken by a nurse who employs cultural repatterning? c. Explain the harmful effects of metamizole and recommend an alternative medication for pain. 8. A health care worker tells a nurse, It does no good to try to teach those Medicaid clients about nutrition because they will just eat what they want to no matter how much we teach them. Which of the following is being demonstrated by this statement? Stereotyping 9. A nurse says, I’m not going to change the way I practice nursing based on where the client is from, because research shows that Western health care technology and research is best. Which of the following is being demonstrated by the nurse’s statement? a. Ethnocentrism Ethnocentrism, a type of cultural prejudice at the cultural population level, is the belief that ones own group determines the standards for behavior by which all other groups are to be judged. For example, some American nurses and providers may think, The way we do it is the only right way to provide this care. 10. A nurse states, The best way to treat a client from another country is to care for them the same way we would want to be cared for. After all, we are all humans with the same wants and needs. What does this statement reflect in relation to culture? b. Blindness 11. A family from Mexico comes to the public health department. No one in the family speaks English, and nobody at the health department speaks Spanish. Which of the following actions should be taken by the nurse? Obtain an interpreter to translate. 12. A nurse who is explaining to a client why it is important to take medication states, The medication takes a couple of weeks to be effective, but then you should feel better. When the client is next seen, no medication has been purchased. Which of the following is the most likely explanation? The nurse emphasized that eventually the client would feel better, but the client needed to feel better immediately so didn’t bother with the drug. 13. A client is crying softly and saying, What did I do to deserve this punishment, Lord? Which of the following responses by the nurse would be the most appropriate? c. What can I do to be helpful to you right now? 14. A Buddhist patient enters the hospital for diagnostic testing just before lunch time. The nurse tells the aide to give a meal tray to the new patient, because no tests will be done until later that evening. The aide gives the patient a meal of Salisbury steak, bread, green beans, and potatoes with brown gravy. The patient eats nothing but a slice of bread and the green beans. Which of the following considerations was omitted by the nurse? b. The patients Buddhist faith probably requires a vegetarian diet. Most Buddhists are vegetarians and dont eat meat. 15. At a local hospital, postpartum care policy requires that nurses observe the mother during infant care to assess the mothers ability to care for the new baby and to promote bonding. A new mother expresses concern that in her country, all infant care is provided by other family members so that the mother can rest and recover. Which of the following actions would be taken by a culturally competent nurse? Allow family members to provide the newborns care and assess the mothers knowledge of chil a. care through discussion. 16. For a bedridden Muslim patient, the nurse rearranges the room and moves the bed so that it faces toward Mecca for the patients daily prayers. Which of the following is the nurse demonstrating through these actions? a. Accommodation Cultural accommodation involves including aspects of the patients religious beliefs and/or folk practices in the traditional health care system to implement essential treatment plans. 17. A nurse gives detailed information on how to apply for Medicaid to a new mother who moved to the United States from Russia about 10 years ago. The nurses next client is an African-American mother of newborn twins who worked until the children were born. The nurse knows the woman is eligible to maintain her insurance after her employment was lost and does not discuss insurance options at all. Which of the following errors is being made by the nurse? c. Overt intentional prejudice 18. A 40-year-old Bosnian, Muslim woman who does not speak English presents to a community health center in obvious pain. She requests a female health care provider. Through physical gestures, the woman indicates that the pain is originating in either the pelvic or genital region. Which of the following interpreters would be the most appropriate in this situation? c. A female who does not know the client 19. When teaching a nutrition class to a student group with a large Hispanic population, the school nurse incorporates foods such as salsa and other healthy dishes familiar to Hispanic students into the presentation. Which of the following best describes the action taken by the nurse? a. Primary prevention Primary prevention involves activities such as health teaching to prevent a problem from occurring. MULTIPLE RESPONSE 1. An undocumented immigrant comes to a physicians office to receive care. Which of the following services can the client receive? (Select all that apply.) a. Treatment for tuberculosis c. Immunization for polio They are eligible only for emergency medical services, immunizations, treatment for the symptoms of communicable diseases, and access to school lunches. 2. A nurse recognizes that although a patient speaks English, the patient is from a culture with which the nurse is unfamiliar. Therefore, a cultural assessment should be attempted. Which of the following questions should the nurse ask? (Select all that apply.) a. Can you tell me where your family is from? b. Do you practice a particular religious faith? Chapter 04: Ethics in Community Health Nursing Practice Test Bank MULTIPLE CHOICE 1. When and by whom was nursings first code of ethics written? a. 1893, by Lystra Gretter 2. A nurse didnt know what to do when faced with a particular ethical dilemma because an option that would have a good outcome didnt seem possible. The nurse decided to talk to the agency supervisor and decide what action to take. Which of the following best describes the nurses actions? Justified, because this provides an opportunity to discuss the issue but the nurse maintains c. responsibility for the decision 3. Which of the following is the first and most crucial step in the ethical decision-making process? c. Identify the ethical concerns. The first step in the ethical decision-making framework is to carefully identify the ethical issue or dilemma. Interviewing the family concerning their perspective of the threat to the family’s well-being 5. The nurse learns that a family has decided not to accept medical intervention for a health care problem because paying for the care would drastically reduce the family’s resources and ability to meet the needs of other family members. Ethically, which of the following actions should be taken by the nurse? Appreciate that the family has made the decision that it feels is best and take no further acti if it is clear the family has made an informed choice. 6. Some nurses are debating about the appropriate action to take in relation to a particular family. The father is ill, and the other family members have chosen to continue working rather than take time off to care for the ill family member. One nurse states, It is a wifes responsibility to care for an ill husband. Which of the following ethical approaches is being used by this nurse? c. Deontological ethics The nurse is focusing on duty, which is a deontological approach based on the moral obligation to engage in certain actions. 7. Some nurses are debating about the appropriate action to take in relation to a particular family. One member of the family is ill, and the other family members have chosen to continue working rather than take time off to care for the ill family member. One nurse states, The whole family is being affected and will fall apart if they dont focus on their familys needs first before anything else. Which of the following ethical approaches is being used by this nurse? d. Utilitarianism By focusing on the whole family, not individual members, and the consequences or outcomes for the whole family during this time of stress, the nurse is taking a utilitarian approach. 8. Some nurses are debating about the appropriate action to take in relation to a particular family. One member of the family is ill, and the other family members have chosen to continue working rather than take time off to care for the ill family member. One nurse states, But it doesnt have to be an either/or situation. Perhaps each family member could take a turn calling in sick just 2 or 3 days. That way they could all take a turn at helping and yet not upset their employers. Wouldnt that be fair? Which of the following ethical approaches is being used by this nurse? c. Principlism The nurse is focusing on ethical principlesin this case, beneficence (do good for the ill family member), nonmaleficence (do no harm, even to the employer), and justice (everyone takes a turn and shares equally). 9. Some nurses are debating about the appropriate action to take in relation to a particular family. One member of the family is ill, and the other family members have chosen to continue working rather than take time off to care for the ill family member. One nurse states, Its not up to us; its the familys decision. They know what is best for them. Which of the following ethical approaches is being used by this nurse? c. Principlism The nurse is using an ethical principle, namely autonomy, in which each person or group can choose those actions that fulfill its values and goals. 10. Which of the following is the dominant issue in ethical debate around an issue such as continuing or withdrawing treatment in acute health care? d. Upholding ethical principles 11. The staff cannot reach an agreement on what is the right thing to do in relation to a specific patient. Which of the following approaches should the nurse use in personally deciding what is right? c. Do whatever the nurse would recommend to anyone in a similar situation One of the rules in deontological decision making is to determine whether the proposed actions can be generalized so that all persons in similar situations are treated similarly. 12. A man entered the emergency department bleeding profusely and screaming, Ive got to see a doctor right now! Ive got a right to see a doctor! Im hurt. You have to take care of me! Which of the following premises would ethically justify such a demand for immediate attention? Our society believes that all persons should be treated equally and that basic needs, such as no c. dying if death can be avoided, should be met. The ethical theory of egalitarianism suggests that everyone is entitled to equal rights, equal treatment, and an equal share of the goods of societyand that the governments role is to ensure this happens, at least on a basic level. 13. From an ethical standpoint, what is the problem with the belief that everyone should receive his or her fair share, that life should always be fair, and that everyone should make his or her own decisions? a. With this belief, the needs of society as a whole are ignored. 14. A physician refuses to order pain medication for a drug addict who has been severely injured in a car accident. When reminded by nurses that pain medication has not been ordered, the physician using (or misusing)? Virtue ethics Virtue ethics emphasizes practical reasoning applied to character development. 15. Which of the following is considered the most important goal in nursing today? Demonstrating caring as the basis of nursing practice 16. With which of the following ethical approaches are Gilligan and Noddings associated? b. Feminine ethic Gilligan and Noddings are associated with the approach known as the feminine ethic, which focuses on the morality of responsibility in relationships that emphasize connection and caring as a moral imperative. 17. How are ethics and public policies similar? Both strive for the public good. 18. A new nurse states to a nursing colleague, But why do I have to be involved in politics? I just want to be the very best clinical nurse I can. Which of the following would be the best response from the nursing colleague? b. Political action is the way you try to fulfill your ethical responsibilities to clients. To be a good clinical nurse, the nurse needs resources and supportive policies that can be obtained only through political action to ensure those very resources and policies. 19. Which of the following would confirm that the nurses advocacy has been truly successful or effective? d. Systematic social changes are made to improve quality of life. Advocacy is the application of information and resources to effect systematic changes that shape the way people in a community live to reduce death and disability and improve quality of life in the community. Although all of these options could be seen as beneficial, only when systematic social changes are made to improve quality of life can advocacy be considered truly effective. 20. How can nurses know whether they have been effective in assessing the community and planning and implementing appropriate interventions? b. Examine the morbidity and mortality rate of the community. 21. What is the relationship between ethics and a community health nursing practice? c. Ethics is constantly involved in nurses clinical decisions. Ethical problems in public health nursing include inequities in power, unacceptable practices, inequitable resource allocation, conflict between ethics and law, and inadequate systems support for nursing. MULTIPLE RESPONSE 1. Three nurses disagree over the appropriate treatment for a woman who is an excellent candidate for hospice care. The first nurse believes that deciding on care rather than cure is the womans decision and no one else can decide for her. The second nurse says that it is the responsibility of the health care team to do good for the woman, and if the physician thinks there is still a possibility of cure, then the nurses should do everything they can to implement the treatment plan. The third nurse states that it isnt fair for the family members to expend all their resources on the woman, who is probably going to die anyway. Which of the following conclusions can be drawn from this dispute? (Select all that apply.) a. Ethical principles can conflict with one another. d. There is no single accepted approach for resolving such disagreements. Chapter 07: Government, the Law, and Policy Activism Test Bank MULTIPLE CHOICE 1. Which of the following best defines the word politics? a. A neutral term meaning influence Politics is a neutral term meaning the art of influencing others to accept a specific course of action. 2. Which of the following activities is completed by the executive branch of the federal government? a. Administration of policy Legislative branch of government 4. Which of the following statements best describes why the federal government has become involved in health care? The Constitution gives the federal government the power to promote the general welfare. 5. A client states to the nurse, I have heard the Affordable Care Act is supposed to help improve the health care I receive, but so far I have seen no benefits from this legislation. Which of the following statements would be the best reply by the nurse? Maybe you have not directly seen the changes; however, several things have changed in health a. care because of this bill. 6. What was the significance of the 1979 Surgeon Generals report? d. It created national goals for promoting health and preventing disease. The 1979 Surgeon Generals report began a focus on preventing disease and promoting health for all Americans. 7. A nurse is advocating for the public health department to increase the number of public health nurses that it employs. Which of the following factors should the nurse emphasize? d. Providing salaries commensurate with responsibilities 8. A nurse is determining whether a hospital has the right to require infected patients to be isolated against their will. To which type of law will the nurse refer? Constitutional law 9. Who is responsible for determining the scope of practice for registered nurses? State legislators 10. Which of the following statements by a client indicates a lack of understanding regarding an appropriate reason to sue for malpractice? c. My daughter wasnt given a call light, and for a whole shift no one checked on her condition. 11. Which of the following statements best describes the law in relation to clinical practice by nursing students? b. Students are expected to meet the same standard of care as the professional nurse. 12. A nurse wishes to see a bill passed to support funding for the use of interpreters for clients with limited English proficiency. Which of the following would be the best time for the nurse to request support from the local senator, who is not on the committee that is reviewing this bill? c. When the bill moves out of committee to be heard by the entire Senate 13. The state board of nursing has written new regulations to clarify in a more concrete manner what the nurse practice act allows and requires. Which of the following effects will this change have on nurses in this state? d. Major, because these rules and regulations have the effect of law and must be obeyed 14. A bill with the potential to decrease health care services is passed by Congress. Which of the following actions should the nurse take to influence the bills implications? b. Contact the regulatory agency and participate in public hearings 15. Which of the following agencies has the most influence on the health and welfare of U.S. citizens? U.S. Department of Health and Human Services (USDHHS) 16. Which of the following laws established programs for provision of health services for women and children and supported community-oriented nursing practice? c. Sheppard-Towner Act The Sheppard-Towner Act of 1921 played an important role in the development of public health policy, public health nursing, and social welfare policy. MULTIPLE RESPONSE 1. Which of the following describes the significance of the passage of The Public Health Threats and Emergencies Act? (Select all that apply.) b. It led to improved water quality and food safety guidelines. c. It included funding for public health activities. 2. Which of the following best describes the importance of the World Health Organization (WHO) to the United States? (Select all that apply.) a. Provides daily information on disease occurrences b. Establishes international standards for antibiotics and vaccines 3. Which of the following activities are the responsibility of the Centers for Disease Control and Prevention? (Select all that apply.) a. Conduct research to enhance disease prevention b. Detect and investigate infectious disease problems c. Develop and advocate public health policies 4. A nurse is visiting a state legislator to encourage the legislator to vote for a particular health bill that the state nurses association has endorsed. Which of the following actions would be most important for the nurse to complete? (Select all that apply.) a. Allow the legislator or staff to ask questions. d. Have a handout that summarizes all the major points in support of the bill. 5. A nurse would like to become involved in political action. Which of the following actions would be most appropriate for the nurse to accomplish this goal? (Select all that apply.) a. Become a member of the state nurses association. b. Be friendly with everyone, whether supportive or not of your ideas. 6. A nurse is testifying at a committee meeting about a health bill. Which of the following actions should be taken by the nurse? (Select all that apply.) a. Briefly describe personal education, experience, and expertise in the area. b. Discuss how the bill affects more than just nurses. c. Include factual data and, if possible, statistical information in visual form.