FINAL EXAM NSG420 COMMUNITY NURSING

FINAL EXAM NSG420 COMMUNITY NURSING CH 1 1. A community is concerned about the threat of bioterrorism. Which of the following best describes the basis for this concern? a. Bioterrorism has the potential to dissolve community-based programs. b. This threat could cause the health care system to collapse. c. The threat of bioterrorism may divert funds from other public safety health care programs. d. Fear of bioterrorism will increase the need for shelters. ANS: C Bioterrorism may have an impact on the availability of resources for public safety health care programs. Because funds are diverted it is possible that community-based programs would be eliminated, the health care system could experience changes, and that there would be an increase in the need for shelter. However, all of these things would happen because of the diversion of funds. DIF: Cognitive level: Analyzing REF: p. 5 TOP: Nursing process: Diagnosis MSC: NCLEX: Psychosocial Integrity 2. A nurse provides for the availability of essential personal health services for people who would otherwise not receive health care. Which of the public health core functions is being used? a. Assessment b. Prevention c. Assurance d. Policy development ANS: C Assurance deals with the availability of health services. Prevention is not a core function, assessment refers to systematic data collection, and policy development refers to the need to provide leadership in developing health policies. DIF: Cognitive level: Applying REF: p. 6 TOP: Nursing process: Assessment MSC: NCLEX: Health Promotion and Maintenance Revised 02/2019 1 3. The nurse is investigating environmental health problems caused by contaminated ground water. Which of the following types of nursing practice is being used? a. Community-oriented b. Community-based c. Policy development d. Tertiary care ANS: A Community-oriented nursing emphasizes the prevention of disease and disability. Communitybased nursing practice is a setting-specific practice whereby care is provided for clients and families where they live, work, and attend school. Policy development seeks to build constituencies that can help bring about change in public policy. Tertiary care focuses on highly specialized medical care. DIF: Cognitive level: Analyzing REF: p. 16 (Box 1-5) TOP: Nursing process: Implementation MSC: NCLEX: Health Promotion and Maintenance END CH 1 CH 4 4. A nurse is examining the income levels and social networks of individuals in a community. Which of the following is the nurse investigating? a. Culture b. Development c. Community d. Determinants ANS: D Determinants are conditions and factors that are important considerations in population health. Culture refers to the beliefs and customs of a certain group. Development refers to something that is being created. Community is a group of people living in the same geographic location. DIF: Cognitive level: Applying REF: p. 66 TOP: Nursing process: Assessment MSC: NCLEX: Safe and Effective Care Environment: Management of Care Revised 02/2019 2 5. A nurse is assessing a refugee who fled the genocide in Darfur. Which of the following disease/disorder should the nurse anticipate finding? a. TB b. Post-traumatic stress disorder (PTSD) c. Chronic obstructive pulmonary disorder (COPD) d. Malnutrition ANS: B The biopsychological changes seen following genocide include physical stress reactions (cardiovascular, neurological) and mental stress responses, especially PTSD and depression. The biopsychosocial changes are the major concern over any physical illnesses that may be present. DIF: Cognitive level: Analyzing REF: p. 87 TOP: Nursing process: Assessment MSC: NCLEX: Safe and Effective Care Environment: Safety and Infection Control End CH 4 CH 6 6. A nurse has used the steps of the ethical decision-making process when making a decision. Which of the following is most similar to this process? a. Healthy People 2010 b. Deontology c. The nursing process d. Advocacy ANS: C The steps of the ethical decision-making framework are to first identify the ethical issues and dilemmas, then place them within a meaningful context, obtain all relevant facts, reformulate ethical issues and dilemmas if needed, consider appropriate approaches to actions or options, make decisions and take action, and evaluate decisions and action. The nursing process involves the same basic steps: assessment, diagnosis, planning, implementation, and evaluation. Healthy People 2010, deontology, and advocacy do not involve these multiple steps described by the ethical decision-making framework and the nursing process. DIF: Cognitive level: Analyzing REF: p. 124 (Table 6-1) TOP: Nursing process: Implementation MSC: NCLEX: Safe and Effective Care Environment: Management of Care Revised 02/2019 3 7. A nurse is applying the ethical principle of non-maleficence. Which of the following describes the action that the nurse is taking? a. Administering medications using the “five rights” b. Allowing clients to be active participants in their care c. Providing patient privacy when delivering care d. Referring a client to a physical therapist ANS: A Non-maleficence requires that one do no harm. It requires that health care professionals act according to the standards of due care, always seeking to produce the least amount of harm possible. Providing privacy when delivering care demonstrates the client’s right to privacy. Allowing clients to be active participants in their care refers to the ethical principle of the right to autonomy. Referring a client to a physical therapist demonstrates the nursing role of referral agent. DIF: Cognitive level: Analyzing REF: p. 126 (Box 6-2) TOP: Nursing process: Implementation MSC: NCLEX: Safe and Effective Care Environment: Management of Care 8. A nurse refers to the Code of Ethics for Nurses or the Public Health Code of Ethics. Which of the following describes why the nurse has referred to this document? a. To provide answers for ethical dilemmas b. To guide professional practice related to ethics c. To increase moral leadership in ethics d. To find a framework for ethical decision making ANS: B These codes provide general ethical principles and guide personnel in thinking about the underlying ethics of the profession. They do not provide answers for ethical dilemmas, only serve as a guide. They do not increase moral leadership, nor do they provide a framework for ethical decision making. DIF: Cognitive level: Applying REF: p. 132 TOP: Nursing process: Planning MSC: NCLEX: Safe and Effective Care Environment: Management of Care END CH 6 Revised 02/2019 4 CH 7 9. A nurse is working with an immigrant population. Which of the following should be the first action taken by the nurse? a. Be aware of one’s own culture b. Become familiar with traditional practices of the immigrants c. Try to see things from the immigrant’s viewpoint d. Learn to speak the language of the immigrant population ANS: A Cultural competence is one of the core attributes of public health nurses. Nurses come from a variety of cultural backgrounds and have their own cultural traditions. Nurses also bring their biomedical beliefs and values to the practice environment that may differ from the client’s own beliefs and values. Because nurses recognize their own culture, they are better able to understand that there are differences among cultures. Being aware of one’s own culture should be done before completing the other tasks of increasing familiarity with traditional practices, trying to see things from the other’s point of view, or learning to speak the language. DIF: Cognitive level: Applying REF: p. 152 TOP: Nursing process: Implementation MSC: NCLEX: Health Promotion and Maintenance 10. A nurse implements nursing interventions considering the uniqueness of the person’s culture. Which of the following best describes this action? a. Cultural diversity b. Cultural knowledge c. Cultural competence d. Cultural awareness ANS: C Providing care based on the uniqueness of the client’s cultural norms and values is one of the three guiding principles of culturally competent nursing care. Cultural diversity refers to the degrees of variation represented among populations based on lifestyle, ethnicity, race, interest, across place, and place of origin across time. Cultural knowledge refers to the process of searching for and obtaining a sound educational understanding about culturally diverse groups. Cultural awareness refers to the self-examination and in-depth exploration of one’s own biases, stereotypes, and prejudices as they influence behavior toward other cultural groups. DIF: Cognitive level: Applying REF: pp. 151-152 TOP: Nursing process: Implementation MSC: NCLEX: Safe and Effective Care Environment: Management of Care