NUR 426 Exam 4 | Questions and Answers (Complete Solutions)

NUR 426 Exam 4 | Questions and Answers (Complete Solutions) When providing care within the context of primary health care, the most important person is/are: 1. The individual/family 2. The population 3. The primary-care physician 4. The medical specialist A nurse is looking to reduce the number of adolescents in her community that are using tobacco. The nurse implements a community-wide program to raise awareness about the dangers of nicotine use and creates a support group specifically aimed at teens looking to quit smoking. This is an example of: 1. Health protection. 2. Health promotion. 3. Risk reduction. 4. Tertiary prevention. The nurse at a community-based primary care organization is educating newly hired nurses about the process used at the clinic for developing public health programs aimed at benefiting community members whether they attend the clinic or not. The nurse explains that even though the primary care offered at the clinic focuses on caring for an individual, the health promotion activities that they are developing for the community are focused on: 1. The family. 2. The health-care provider. 3. The health-care organization. 4. The population. A young woman presents to her primary care provider. Her mother has just been diagnosed with Huntington's disease, and several other members of her family have been diagnosed with the condition as well. She wants to know her options regarding testing to see if she is a genetic carrier. From an ethical perspective, what issue would be most important to discuss with the patient? 1. The cost of Huntington's disease screening 2. Whether the test is available at the local lab 3. What will happen when her insurance finds out the results 4. The fact that there is no known treatment that can alter the progression of the disease A nurse is working with a community center that primarily serves a nearby Native American tribe. The nurse knows that many of the tribe members suffer from type 2 diabetes. which of the following interventions is an example of tertiary prevention? 1. Teaching school-aged children healthy exercise. 2. Conducting a blood glucose screening for program for the adults in the community. 3. Actively encouraging patients diagnosed with type 2 diabetes to have foot, eye, and hemoglobin A1C screening tests every 3 months. 4. Publishing a culturally grounded guide about preventing diabetes using input from the tribal leaders and distributing it to all persons who come to the clinic. A nurse is speaking with her accountant about opening a free clinic as a 501(c)(3) organization. The accountant advises the nurse: 1. To charge patients his or her regular fees. 2. To waive her professional fees but charge for testing and more advanced care. 3. To charge a nominal fee if the patient can afford to pay but provide services regardless. 4. To charge a small fee, usually around 25% of the service value. The public health department (PHD) is concerned about an outbreak of measles that has occurred in a country adjacent to theirs. Although there are currently no reported cases, as one of their actions the PHD reaches out to all the primary care providers to encourage all of their unvaccinated patients to get vaccinated and to encourage the parents of unvaccinated children to get their vaccinations up to date. Such a public health initiative is an example of: 1. A secondary prevention approach related to screening. 2. A primary prevention approach focused on health protection. 3. A primary prevention approach focused on health promotion. 4. A primary prevention approach focused on screening. A nurse working in an inner-city community health clinic is concerned that her patient education efforts related to achieving a healthy lifestyle are not resulting in any substantial changes in her patients. When she discussed this with one mother whose children are struggling with obesity, the mother explained that she is unable to find fresh fruits and vegetables in their neighborhood and resorts to the use of fast food. This information makes the nurse wonder if this is true for other families. What should she do next? 1. Ask families she sees to keep a food journal to see what food substitutions could be made. 2. Perform a problem- or health-issue-based assessment beginning with an assessment of sources of healthy foods such as supermarkets and farmers markets available in the community. 3. Arrange for free bussing from the community center to the closest supermarket. 4. Refer them to the local supplemental nutrition assistance program (SNAP) office to help them obtain benefits. A new strain of flu has emerged, and the CDC has released a new vaccine that is for use in high-risk populations. which population is most apt to be high-risk? 1. Pregnant women 2. Older adults 3. Children 4. All of the above A nurse has worked at a community health center for many years. Over the last several months, the nurse has noticed a significant decline in community members using the resources available at the clinic. What is the first thing the nurse should do? 1. Begin offering day care services and free transportation to the clinic to make it more convenient. 2. Reach out to former patients to determine why they are no longer returning to the clinic. 3. Perform a community assessment. 4. Begin offering a new patient reduced fee rate. A nurse is meeting with a patient with no history of IV drug use after he has spoken with the doctor and received a diagnosis of hepatitis B and E/ The patient expresses concern that someone will find out about his diagnosis. How does the nurse respond? "I can understand that you are concerned about this.." 1. "You do not need to worry because this patient information is protected by HIPAA, and I am not allowed to provide this information to anyone who is not responsible for your clinical care." 2. "However, it is your responsibility to inform all of your previous sexual partners." 3. "However, this is a reportable disease in this state. This means the public health department will ask you for all your possible contacts that might requiring counseling and/or post-exposure prophylaxis." 4. None of the above. A primary Health nurse has observed an increase in the rate of patients being treated for pertussis in her community. The nurse has seen multiple news reports on the issue and knows that this isn't an isolated problem. The nurse decides to brainstorm strategies to reduce the pertussis rate in her community. First, the nurse should: 1. Consult with local pediatricians about increasing vaccination rates in children. 2. Begin creating patient education materials to distribute in the waiting room. 3. Perform a health and cultural evaluation of her community. 4. Begin offering vaccinations free of charge. A primary care nurse works at the Native American Health Center, a nonprofit organization serving the California Bay Area Native Population. The center has asked her to put together a comprehensive prevention plan related to type 2 diabetes. Which of the following interventions is an example of primary intervention? 1. Regular foot and eye care 2. Encouraging a healthy diet and weight loss if appropriate 3. Tight blood sugar control with every meal 4. Screening blood glucose yearly In response to the increase in opioid overdoses within their community, a primary care clinic could implement which of the following with patients who are experiencing chronic pain? 1. Screen appropriately. 2. Prescribe appropriately. 3. Use a statewide automated reporting system. 4. Help patients recognize potential problems. 5. All of the above. A primary care nurse is volunteering at lead screening clinic for children living in an inner city community. After performing the screening tests, what is the most important thing for the nurse to do for the children with a positive screen? 1. Conduct a home visit. 2. Refer them to a pediatric specialist for further screening and possible treatment. 3. Offer parents educational materials related to reducing lead exposure in children. 4. Conduct a community-wide environmental assessment to determine the source of the lead exposure. A nurse is working in a primary health care setting that has had a recent influx of persons immigrating from a West African country. She wants to incorporate cultural components to the care of patients from this country. What are possible aspects of the culture that she should learn more about? 1. Kinship 2. Source of income 3. Gender roles 4. Value of children A primary care clinic has decided to hire a nurse to serve as the clinics case manager. The essence of case management is the incorporation for the client, the family, and the community into meeting the needs of the patient. Based on current evidence related to this approach, it is primarily hoped that this will lead to: 1. Cost containment. 2. Increased patient satisfaction. 3. Improved patient outcomes. 4. Reduced time needed for each patient to spend with his or her primary health care provider. A hospital nurse is admitting a new patient and asks him if he has a primary care provider. He asks the nurse about the benefit of having a primary care provider, and the nurse replies with which of the following? 1. Increased access to health care 2. Decreased health-care costs 3. Focused on care of disease during the acute phase 4. Increased patient education and advocacy 5. Physician-focused treatment A nurse is working with a primary care physician who has made the decision to move to a patient-centered medical home (PCMH) model of care after reviewing research presented in the latest issue of a prominent medical journal. The nurse is preparing some education materials to present to the patients and mentions that the benefits of moving to this model of care include which of the following? 1. Care focusing on the whole individual 2. Integrated care 3. Use of highly specialized PCMH physicians 4. Increased access to care 5. Access to private insurance, meaning the patient can move away from Medicaid A public health nurse (PHN) has been tasked with addressing the rise in teen pregnancies in her communities. She wishes to create linkages among agencies that provide care to teens and/or obstetrical care generally. Which would be her first step based on the six-step guide created by The Center on Education and Training for Employment at The Ohio State University? 1. State the key challenges, articulate why they are better addressed by multiple agencies, and name potential key players. 2. Create a harmonious planning environment among agencies. 3. Assess the need to work in partnership with other agencies. 4. Make sure the members of the partnership are equally representative of the community-at-large in terms of culture, race, and perspective. A nurse is moving to a rural area and beginning work at a health clinic there. The nurse is performing a basic community assessment to prepare for working with this new community. The nurse knows that which of the following is not characteristic of the needs of the rural population? 1. More likely to smoke tobacco and drink alcohol 2. Have less education and higher rate of poverty 3. More likely to have increased dental problems 4. More likely to have a higher life expectancy A nurse is reviewing top 10 priorities from Rural Healthy People 2020 National Survey. Which of the following is not one of the top 10 priorities? 1. Access to quality health services 2. Diabetes 3. Mental health and mental disorders 4. Cancer A nurse has been volunteering at a free clinic located at a community center in a rural area twice a month for several years. Over the last few months, the nurse has noticed that the patient load has increased substantially as the population of this community has aged. It is not feasible for the nurse to spend more time at this center. What might be the most feasible action she could take to continue to serve the needs of the community? 1. Try to hire a nurse to work at the free clinic. 2. Set up a telehealth arrangement so the nurse can answer simple questions from home or while on the road. 3. Set up a scheduling and triage system so the nurse only sees the neediest patients. 4. Consider closing the free clinic and opening a fee-for-service center. A nurse is working with several community members in an inner-city environment to help address broken windows and damaged buildings in their community. They've had several residents volunteer to form a group that will repair the damages and keep the community looking well cared for. This is an example of: 1. Community organization. 2. Community empowerment. 3. Community partnerships. 4. None of the above. A nurse is looking to address teen gang violence in a nearby community using the principles of community organizing. The nurse has spent a great deal of time in the community performing a community assessment and getting to know residents and key stakeholders. What is the next step? 1. Identify core leaders to organize the community around the main issue. 2. Identify clear goals that relate to the overarching goal of reducing teen gang violence. 3. Identify available resources. 4. Create a plan to evaluate their actions. A nurse is working in a family planning clinic that provides treatment for sexually transmitted infections (STIs). The nurse has noticed a significant increase in the incidence rate of STIs in the young women being seen at the clinic and wonders if this is a community-wide problem. Which of the following techniques would be a helpful first step in answering her question? 1. Develop collaborative relationships with other health-care providers in the area concerned with STIs. 2. Perform a comprehensive community assessment. 3. Interview several key stakeholders in the community. 4. Create a federally qualified health center (FQHC). A nurse is working on his or her first community-based participatory research (CBPR) study. An essential factor specific to CBPR research that the nurse should be careful to address is: 1. The ethical protection of human participants. 2. Making sure that community members aren't directly involved in the research. 3. Ensuring there is a benefit to the community related to the study. 4. Choosing a topic that is neutral to the community. A nurse is considering entering the specialty of parish nursing. Nurses working in this field perform which of the following activities specific to that of a parish nurse? 1. Advocating for individuals within the parish. 2. Improving spiritual health through practices such as grief counseling. 3. Providing health education. 4. Performing health screenings of parish members as needed. A young college student in a rural community has called the health department to get a recommendation for a health center where she could be seen for a chronic health problem. She is uninsured and can't afford the private clinic in town. The PHN recommends that the student: 1. Visit the local health department for management and treatment of her care. 2. Proceed to the local emergency department. 3. Visit the community health center run by an advanced practice registered nurse (APRN). 4. None of the above. A nursing professor is looking to give students clinical experience in relation to health program planning with a focus on implementation. The professor proposes which of the following projects to the curriculum committee? 1. A community assessment of three different neighborhoods 2. A mock community assessment and health policy development for a hypothetical community 3. A requirement that each student complete a paper about the history of health policy in the United States 4. Placement of students in a local community center that has requested the school partner with them on population-level health interventions they would like to put in place A nurse is performing an assessment of a community where the population totals 55,542 persons and has a population density of 1,000 persons per square mile. How does the nurse classify the area? 1. Rural 2. Suburban 3. Urban cluster 4. Urbanized area A student nurse is reviewing important global communities for ideas about a final research project. The student nurse discovers a movement in Europe that focuses on reducing health disparities and involving the local community in program design and implementation. What program does this describe? 1. Healthy Cities 2. Healthy People 3. Medical Homes 4. Racial and Ethnic Approaches to Community Health Jacob has worked as a PHN in urban areas and has just now moved to a rural area and taken a job in the public health department in charge of county outreach programs. Based on data he recently reviewed from the Federal Office of Rural Health Policy, the following might be programs he should consider except: 1. An oral health program. 2. A chronic disease self-management program. 3. An internet-based health education program. 4. A mobile pharmacy program. The state public health department in a large northern state has convened a task force to help optimize the health of the populations living in the state's rural communities by addressing major barriers to promoting optimal health in those rural communities. Which of the following is a major barrier? (Select all that apply.) 1. Decreased access health care 2. Lack of funding for safety net programs 3. Difficulty recruiting physicians, physician assistants, and nurse practitioners 4. Migration of people from other areas For the PHN working in a large urban public health department, what are possible health issues facing the population as a whole? (Select all that apply.) 1. Higher crime rates 2. Higher levels of air pollution 3. Lower socioeconomic status 4. Higher incidence of sexually transmitted infections A nurse is looking to develop a coalition of women's health providers and experts in the community. Which of the following strategies would be effective in helping to build a coalition? (Select all that apply.) 1. Create detailed objectives and activities 2. Address diversity among the membership 3. Map assets 4. Convene the coalition prior to drafting a mission statement and structure 5. Maintain and evaluate the vitality of the coalition A nurse is speaking with members of a community center about using community organization as a process for change. The nurse explains that there are several specific principles for creating change within the community. Which of the following are examples of these principles? (Select all that apply.) 1. Use nonviolence as a tool. 2. Apply downstream assessment principles. 3. The nurse will provide solutions for the community to follow.