C228 – WGU

promote the health and welfare of clients across the lifespan and from diverse populations.

›› the relationship between an individual's environment and health ›› Depicts health as a continuum ›› Emphasizes preventive care

›› to predict or explain health behaviors ›› preventive health behaviors are taken primarily for the purpose of avoiding disease ›› Emphasizes change at the individual level ›› Describes the likelihood of taking an action to avoid disease based on: »»Perceived susceptibility, seriousness, and threat of a disease »»Modifying factors (e.g., demographics, knowledge level) »»Cues to action (e.g., media campaigns, disease impact on family/friends, recommendations from health care professionals) »»Perceived benefits minus perceived barriers to taking action

›› Complements the health belief model ›› Emphasizes change at the community level ›› Identifies relationship between health deficits and availability of health‑promoting resources ›› Theorizes that behavior changes within a large number of people can ultimately lead to social change

a group of people and institutions that share geographic, civic, and/or social parameters.

*mortality rates, disease prevalence, levels of physical activity, obesity, tobacco use, substance use *used to describe the health status of a community and serve as targets for the improvement of a community's health.

Assessing to determine needs and intervening to protect and promote health, and preventing disease within a specific population

Focus of Care: Individuals & Families Nursing Activities: Illness care: where individuals, families, and groups live, work, and "attend" (schools, camps, prisons)

Focus of Care: At-risk individuals, families, groups, & Community Nursing Activities: Health care: Determining health needs to improve the collective health of the community

Nursing Activities: Promote, preserve, and maintain the health of populations by the delivery of health services to individuals, families, and groups in order to impact "community health."

Nursing Activities: Promote, preserve, and maintain the health of populations through disease and disability prevention and health protection of the community as a whole.

ex: Respecting a client's right to self‑determination (making a decision not to pursue chemotherapy)

ex: Developing plans of care that include a system for monitoring and evaluating outcomes

ex: Assessing risks and benefits when planning interventions

Determining eligibility for health care services based on income and fiscal resources

*study of health-related trends in populations for the purposes of disease prevention, health maintenance, and health protection. *relies on statistical evidence to determine the rate of spread of disease and the proportion of people affected. *used to evaluate the effectiveness of disease prevention and health promotion and to determine which goals have been met.

study of the relationships among an agent, a host, and an environment

increases or decreases the risk for disease

*animate or inanimate object that causes the disease *Chemical *Physical *Infectious

the living being that is affected by the agent.

*the setting or surrounding that sustains the host. *Physical *Social

Use of reinforcement methods to change learners' behaviors.

Use of sensory input and repetition to change learners' patterns of thought, thereby changing behaviors.

Age Gender Genetics Ethicity Immunological Status Physiological State Occupation

Use of ongoing discussion and inquiry to increase learners' depth of knowledge, thereby changing thinking and behaviors.

Drugs Toxins

Use of techniques specific to learners' developmental stages to determine readiness to learn, and to impart knowledge.

Noise Temp.

Assists learners to grow by emphasizing emotions and relationships and believing that free choice will prompt actions that are in their own best interest.

Viruses Bacteria

Links information to beliefs and values to change or shift the learners' expectations.

Geography Water/ Food Supply Presence of Reservoirs/ Vectors

Access to HC High-Risk working conditions Poverty

the practice of protecting and promoting the health of populations using knowledge from nursing, social, and public health sciences

organized community efforts designed to prevent disease and promote health.

U.S. Department of Health and Human Services.

It includes a comprehensive range of services including public health; prevention; and diagnostic, therapeutic, and rehabilitative services. PHC is essential care made universally accessible to individuals and families in a community. PHC encourages self-care and self-management in health and the social welfare of daily life. PHC does not provide a focus on incidence of disease, pathophysiology of disease, or individual orders for care.

personal health care that provides first-contact and continuous, comprehensive, and coordinated care.

*personal behavior (or lifestyle) - have the greatest effect *environmental factors (including physical, social, and economic environments) *human biology **environment and biology accounting for the greatest effect on the development of all illnesses *the health care system—medical services are said to have the least effect.

*a provider arrangement whereby comprehensive care is provided to plan members for a fixed, "per member per month" fee. *Use of designated providers

*provider arrangement in which predetermined rates are established for services to be delivered to members.

identifying educational needs establishing educational goals and objectives selecting appropriate educational methods implementing the educational plan and evaluating the educational process and product

emphasizes how individual characteristics and experiences impact health promotion. Each person has personal characteristics, including biological, physical and psychological, and experiences that influence health choices and behaviors. These characteristics can be influenced by the nurse to achieve healthy outcomes.

describes the individual's perception of the threat of illness. The perception of benefits that any action might bring to the individual or barriers or problems to taking action. Population-based nurses can learn an individual's beliefs and perceptions of illness to to modify health behaviors and choices.

describes the individual's attitude toward a behavior reflects the individual's expected consequences of that behavior. According to this model, actions are influenced by people around the individual and the individual's perception of the ability to control the behavior.

emphasizes the importance of educational and motivational changes at the community level through utilizing community resources, such as a lay health advisor, peer education, or social networks. In this model, the nurse utilizes a natural helper—a member of the community or social network trained to provide information and social support. The person or group can facilitate attitude and healthy behavior changes. Peer education is a type of natural helper intervention.

emphasizes the importance of interaction between personal factors, behavior, and the environment. According to the theory, people learn within a social context through concepts such as modeling and observational learning. Applying this theory to health behavior, the nurse knows that learning takes place primarily by observing and imitating the actions of others. The behavior is also influenced by being rewarded and/or punished for these actions.

Model of Spiritual Care - the foundation of Parish nursing

*dominant theory of ethical decision making *comprised of respect for autonomy, nonmaleficence, beneficence, & distributive justice

*collaborating with community agencies to improve services *ensuring competence of health care workforce

*holistic care of populations *personal health counseling *health ed *liaison *facilitate support groups, change, train volunteers *ID spiritual strengths for coping

1) Provider control 2)Predictable routine 3) Maintenance of hospital policy 4) Resource availability 5) Collegial collaboration and consultation 6) Controlled patient compliance 7) Standardization of care

why treat people...w/o changing what makes them sick?

- Greater awareness of the reality of client lives and situations than may be true in other areas of nursing. ie: u see roaches in apt

1) Impressing 2) Behaving 3) Swapping 4) Belonging 5) Chilling out

Risk of (specific problem or health risk ) Among (specific group or population affected by the problem/risk) Related to (strengths and weaknesses in the community that influence the specific problem or health risk in the community)

to ID and understand the causal factors and mechanisms of disease, disability, and injuries so that effective interventions can be implemented to prevent the occurrence of these adverse processes before they begin or before they progress.

- Discuss a low-fat diet and the need for regular physical exercise with clients. - when a nurse provides health education and training for daycare workers about issues of health and hygiene, such as proper hand hygiene, diapering, and food preparation and storage - Immunizations, importance of wearing seatbelts, taking folic acid supplementation at preconception to prevent neural tube defects, fluoridation of water supplies to prevent dental caries, and actions taken to reduce human exposure to agents that may cause cancer - Implement a community level program like walking for exercise to assist citizens in improving health behaviors related to lifestyle. - Use the Code of Ethics for Nurses to guide your nursing practice - Use the information exchange process to increase the client's understanding of how to use the health care system and the health promotion strategies that will maintain health. - Complete a family genogram and assess health risks with the family to contract for family health activities to prevent diseases from developing

- Implement blood pressure and cholesterol screening; give a treadmill stress test. - Health screenings - teach an asthmatic client to recognize and avoid exposure to asthma triggers and assist the family to implement specific protection strategies such as replacing carpets, keeping air systems clean and free of mold, staying inside when the pollution level is high, and avoiding pets. - mammography to detect breast cancer, Papanicolaou (Pap) smears to detect cervical cancer, colonoscopy for early detection of colon cancer, prenatal screening of pregnant women to screen for gestational diabetes - Provide mental health interventions after stressful events. - The public health nurse provides toxin screenings for migrant workers who may be exposed to pesticides. - Implement a family-planning program to prevent unintended pregnancies for young couples who attend the local community health center. - Encourage clients who are pregnant to participate in prenatal care and Special Supplemental Nutrition Program for Women, Infants and Children to increase the number of healthy babies and reduce the costs related to preterm baby care. - Use case finding to identify existing health problems in your caseload and the population served by your agency. Timely, holistic assessments and interventions can slow disease trajectories and promote healing and health. - Assess disaster victims and triage for care. - Investigate an outbreak of flulike illness in a local school. - Provide programs in child development and behavior management for families who have not yet abused their children but whose children are brought to the attention of social authorities for aggressive behavior problems. - Develop a way for homeless individuals to read their TB skin test, if necessary, and to transfer the results back to the facility at which the skin test was administered. - To prevent the spread of disease - Notify partners and trace contacts (HIV)

- enhance rehabilitation from disease, injury, or disability - Provide cardiac rehabilitation, medication, and surgery. - medical treatment - physical and occupational therapy, and rehabilitation - Monitor the use of prescription medications and adherence to treatment to reduce risk for illness complications - Provide health promotion activities to persons with serious and persistent mental illness. - Promote support group participation for those with mental health disabilities. - The public health nurse provides a diabetes clinic for a defined population of adults in a low-income housing unit of the community. - If blood pressure cannot be controlled by diet, refer the client to a physician or nurse practitioner for medication; advise the client to engage in a cardiac program that will oversee diet and exercise. - Participate in home visits to mothers who are at risk for neglecting babies, to reduce the costs related to abuse - Provide health care and treatment for those infected by H1N1 or the new strains of the virus. - Evaluate the incidence or prevalence of obesity among school children after the implementation of the program and provide programs to reduce complications from the condition. - A review of the public health report card indicated that community incidence of complications from vaccine-preventable diseases have declined over a 2-year period after the implementation of the parent education program. - Provide family therapy for abusive families; remove children from the home. - Develop a contract with the family to change nutritional patterns to reduce further complications from the specified health problem. - Provide directly observed medication therapy for people with active TB. - Develop programs to help people reduce or end substance abuse - Regular inspection of hands and feet, as well as using protective footwear and gloves to avoid trauma and infection for leprosy clients who have lost sensation in those areas- developing an individual education plan (IEP) for students with long-term health needs - developing an individual education plan (IEP) for students with long-term health needs

1. Valid (accurate): A high probability of correct classification of persons tested 2. Reliable (precise): Results are consistent from place to place, time to time, and person to person 3. Capable of large group administration: A) Fast in both the administration of the test and the obtaining of results. B) Inexpensive in both personnel required and the materials and procedures used. 4. Innocuous: Few if any side effects, and the test is minimally invasive 5. High yield: Able to detect enough new cases to warrant the effort and expense (yield defined as the amount of previously unrecognized disease that is diagnosed and treated as a result of screening)

- the interrelationships among the agent, host, and environment (the epidemiologic triangle) - the interactions of factors, exposures, and characteristics in a causal web affecting the risk for disease - and the levels of prevention corresponding to stages in the natural history of disease.

the meeting of collective needs through identifying problems and managing interactions within the community itself and between the community and the larger society

1. informant interviews 2. participant observation 3. secondary analysis of existing data 4. surveys 5. windshield surveys

makes sure that essential community-wide health services are available. This may include providing essential personal health services for those who would otherwise not receive them.

a collection of individuals who share one or more personal or environmental characteristics

a systematic process of assessment, planning, service coordination, referral, monitoring, and evaluation that meets the multiple service needs of clients.

Communicates facts, ideas, and skills that change knowledge, attitudes, values, beliefs, behaviors, and practices of individuals, families, systems, and/or communities.

selecting and carrying out a series of actions to achieve a stated goal.

the methods used to determine if a service is needed and will be used, whether a program to meet that need is carried out as planned, and whether the service actually helps the people it is intended to help.

Ethical theory that bases moral obligation on duty and claims that actions are obligatory irrespective of the good or bad consequences that they produce. Because humans are rational, they have absolute value. Therefore, persons should always be treated as ends in themselves and never only as means.

Ethical theory based on the weighing of morally significant outcomes or consequences regarding the overall maximizing of good and minimizing of harm for the greatest number of people.

Approach to problem solving in bioethics that uses the principles of respect for autonomy, beneficence, nonmaleficence, and justice as the basis for organization and analysis

A. CORRECT: This is an example of community-based nursing, which involves management of acute and chronic conditions in a community setting. B. INCORRECT: This is an example of community-oriented nursing, which involves health care of individuals, families and groups to improve the collective health of the community. C. CORRECT: This is an example of community-based nursing, which involves management of acute and chronic conditions in a community setting. D. INCORRECT: This is an example of community-oriented nursing, which involves health care of individuals, families and groups to improve the collective health of the community. E. INCORRECT: This is an example of community-oriented nursing, which involves health care of individuals, families and groups to improve the collective health of the community.

A. CORRECT: The nurse is advocating for the leaders to uphold the ethical principle of distributive justice, which is the fair distribution of benefits and burden in society. B. INCORRECT: The nurse is not advocating for the leaders to uphold the ethical principle of fidelity, which involves keeping commitments and following through with promises. C. INCORRECT: The nurse is not advocating for the leaders to uphold the ethical principle of respect for autonomy, which is supporting the rights of individuals to determine and pursue personal health care goals. D. INCORRECT: The nurse is not advocating for the leaders to uphold the ethical principle of veracity, which is the concept of telling the truth.

C. CORRECT D. CORRECT

A. INCORRECT: Showing informational videos is an appropriate learning strategy for clients who are visual learners. B. INCORRECT: Providing equipment to practice hands-on skills is an appropriate learning strategy for clients who are tactile-kinesthetic learners. C. INCORRECT: Supplying outlines for note-taking is an appropriate learning strategy for clients who are visual learners. D. CORRECT: Facilitating small group discussions is an appropriate learning strategy for clients who are auditory learners.

A. INCORRECT: The nurse is using secondary prevention when performing a home safety check at a client's home. B. INCORRECT: The nurse is using tertiary prevention when teaching healthy nutrition to clients who have hypertension. C. CORRECT: The nurse is using primary prevention when providing influenza immunizations to employees at a local preschool. D. INCORRECT: The nurse is using secondary prevention when implementing a program to notify individuals exposed to a communicable disease.

●● Primary Prevention Activities ◯◯ Teaching healthy heart curriculum (nutrition, exercise, not smoking) ◯◯ Educating about dental health ◯◯ Discussing safety (seat belts, bicycle helmets, stranger safety) ◯◯ Administering immunizations ◯◯ Teaching about communicable disease transmission ◯◯ Sex education ◯◯ Advocating for safe playground equipment ◯◯ Substance use prevention education

●● Secondary Prevention Activities ◯◯ Performing tuberculin skin tests ◯◯ Performing routine checks for pediculosis ◯◯ Taking measures to control communicable disease outbreaks ◯◯ Screening for lead exposure ◯◯ Implementing scoliosis screenings ◯◯ Identifying students at risk for suicide or self-harm ◯◯ Performing vision and hearing screenings ◯◯ Checking heights and weights ◯◯ Identifying child abuse or neglect

●● Tertiary Prevention Activities ◯◯ Teaching about allergic triggers for students with asthma ◯◯ Administering medications to treat chronic conditions (asthma, diabetes, seizure disorders) ◯◯ Monitoring glucose levels and administering insulin to students who have diabetes ◯◯ Discussing and planning for nutritional needs of students who have diabetes ◯◯ Developing communication methods for students with autism

A. CORRECT: Culture is the beliefs, values, attitudes, and behaviors shared by a group of people and transmitted from generation to generation. Nutritional practices are influenced by an individual's culture. B. CORRECT: Culture is the beliefs, values, attitudes, and behaviors shared by a group of people and transmitted from generation to generation. Family structure is influenced by an individual's culture. C. CORRECT: Culture is the beliefs, values, attitudes, and behaviors shared by a group of people and transmitted from generation to generation. Health care interactions are influenced by an individual's culture. D. INCORRECT: Biological variations are physical, biological and physiological differences between races, and are not influenced by the beliefs, values, and attitudes of an individual. E. CORRECT: Culture is the beliefs, values, attitudes, and behaviors shared by a group of people and transmitted from generation to generation. Views about illness are influenced by an individual's culture.

A. INCORRECT: It is important for the nurse to determine the client's perception of his current health status. However, when conducting a cultural assessment, the nurse should perform a different action first. B. CORRECT: The nurse's first action when beginning a cultural assessment is to collect self-identifying data about the client, including specific information about how the client's cultural beliefs influence family structure, food patterns, religious preferences, and health practices. C. INCORRECT: While it is important for the nurse to determine how the client's culture may impact the effectiveness of nursing actions, the nurse must gather other information first. D. INCORRECT: It is important for the nurse to gather information about previous client interactions with the health care system. However, when conducting a cultural assessment, the nurse should perform a different action first.

A. CORRECT: This is an appropriate question for the nurse to ask when assessing for "A," which represents activities in the mnemonic. B. INCORRECT: This is not an appropriate question for the nurse to ask when assessing for "A" in the mnemonic. This question is appropriate to assess the first "R," which represents residence in the mnemonic. C. INCORRECT: This is not an appropriate question for the nurse to ask when assessing for "A" in the mnemonic. This question is appropriate to assess the second "P," which represents past work in the mnemonic. D. INCORRECT: This is not an appropriate question for the nurse to ask when assessing for "A" in the mnemonic. This question is appropriate to assess the first "E," which represents environmental concerns in the mnemonic.

A. INCORRECT: The availability of a family member to provide transportation for a client in the morning is not a barrier to accessing health care. The follow-up appointment should be scheduled during this time frame. B. CORRECT: Inconvenient hours make scheduling a follow-up appointment challenging, and indicates a barrier to accessing health care for this client. C. INCORRECT: A single provider in the local community that is approved by the client's health maintenance organization does not indicate a barrier to accessing health care. The follow-up appointment should be scheduled with this provider. D. INCORRECT: A provider who is bilingual does not indicate a barrier to accessing health care. This increases accessibility for clients who may speak a different language.

A. INCORRECT: Managing the Women, Infants, and Children program is a responsibility of state departments of health, not local health departments. B. CORRECT: Providing education to achieve community health goals is a component of identifying and intervening to meet health needs of the local community, which is a responsibility of local health departments. C. CORRECT: Funding for local health departments come from local, state and federal monies, therefore; local health departments are responsible for coordinating directives issued from the state level. D. INCORRECT: Reporting communicable diseases to the CDC is a responsibility of state departments of health, not local health departments. Local health department report communicable diseases to the state department of health. E. INCORRECT: Licensing of registered nurses is incorrect. Licensing of registered nurses is a responsibility of state boards of nursing, not local health departments.

◯◯ I = Investigate potential exposures ◯◯ P = Present work (exposures, use of personal protective equipment, location of material safety data sheets [MSDS], taking home exposures, trends) ◯◯ R = Residence (age of home, heating, recent remodeling, chemical storage, water) ◯◯ E = Environmental concerns (air, water, soil, industries in neighborhood, waste site or landfill nearby) ◯◯ P = Past work (exposures, farm work, military, volunteer, seasonal, length of work) ◯◯ A = Activities (hobbies, activities, gardening, fishing, hunting, soldering, melting, burning, eating, pesticides, alternative healing/medicines) ◯◯ R = Referrals and resources (Environmental Protection Agency, Agency for Toxic Substances & Disease Registry, Association of Occupational and Environmental Clinics, MSDS, OSHA, local health department, environmental agency, poison control) ◯◯ E = Educate (risk reduction, prevention, follow-up)

A. Correct: The nurse should identify the ethnicity of the people visible in the community as a component a windshield survey. B. Incorrect: Individuals who hold power are identified through formal and informal observations of community activities, as a participant observer. C. Correct: The nurse should identify natural community boundaries as a component a windshield survey. D. Incorrect: Prevalence of disease is incorrect. Disease prevalence is a component of secondary data and is identified through morbidity rates of the community. E. Correct: The nurse should identify the presence of public protection, such as police, fire, and animal control, as a component a windshield survey.

A. Incorrect: This is not the first action the nurse should take. In order to determine health patterns within collected data the nurse must take another action first. B. Correct: This is the first action the nurse should take. In order to adequately and appropriately analyze collected data the nurse must first compile collected data into a database. C. Incorrect: This is not the first action the nurse should take. In order to ensure data collection is complete the nurse must take another action first. D. Incorrect: This is not the first action the nurse should take. In order to identify health needs of the local community the nurse must take another action first.

A. Incorrect: The nurse should not include determining availability of resources to initiate the program as part of the evaluation plan; this should be done during the assessment phase. However, when evaluating sustainability of the program, the nurse should determine whether resources are available for continuing the program. B. Incorrect: The nurse should not include gaining approval for the program from local leaders as part of the evaluation plan. This approval should take place as part of the preplanning phase because plans for the program should not move forward without adequate community support. C. Incorrect: The nurse should not include establishing a timeline for implementation of interventions as part of the evaluation plan. Timeline development should occur after determining and selecting the best strategies for meeting the program's goals and objectives. D. Correct: The nurse should include comparing program impact to similar programs as part of the evaluation plan. This comparison assists with determining the efficiency of the program.

A. Correct: Informant interviews are direct conversations with individual community members for the purpose of obtaining ideas and opinions. B. Incorrect: Participant observation is observing formal or informal community activities and does not involve direct conversations with individual community members. C. Incorrect: Focus groups are directed talks with a representative sample of a community, and do not involve direct conversations with individual community members. D. Incorrect: Surveys are specific questions asked in a written format and do not involve direct conversations with individual community members.

A. Correct: Birth statistics are an example of secondary data the nurse should review. B. Correct: Previous health survey results are an example of secondary data the nurse should review. C. Incorrect: Windshield surveys are a method of collecting direct data. D. Incorrect: Community forums are a method of collecting direct data. E. Correct: Health records are an example of secondary data the nurse should review.

A. INCORRECT: Clients who require skilled nursing care at home qualify for home health. B. INCORRECT: Home health may provide teaching to clients about life-sustaining measures, but this is not a function of hospice. C. INCORRECT: Home health assists clients to develop the skills needed to care for themselves independently. D. CORRECT: Controlling the client's symptoms is a component of hospice care.

A. CORRECT: The nurse manager should include noise as a physical agent when discussing work‑related illness and injury. B. INCORRECT: The nurse manager should include age as a host factor when discussing work-related illness and injury. C. CORRECT: The nurse manager should include lighting as a physical agent when discussing work‑related illness and injury. D. INCORRECT: The nurse manager should include viruses as a biological agent when discussing work-related illness and injury. E. INCORRECT: The nurse manager should include stress as an outcome of psychological agents when discussing work-related illness and injury.

A. CORRECT: The nurse should determine the work practices of employees when conducting a work site survey. B. INCORRECT: The nurse should determine past exposure to specific agents when conducting an occupational health history on individual workers, not a work site survey. C. INCORRECT: The nurse should determine past jobs of individual employees when conducting an occupational health history on individual workers, not a work site survey. D. INCORRECT: The nurse should determine the length of time working in current role when conducting an occupational health history on individual workers, not a work site survey.

A. INCORRECT: The nurse is not functioning in the role of direct caregiver. As a direct caregiver, a nurse provides illness or injury care to children at school. B. INCORRECT: The nurse is not functioning in the role of consultant. As a consultant, a nurse provides information to families, administrators, teachers, and parent-teacher groups to encourage decisions that promote the health of the students. C. CORRECT: The nurse is functioning in the role of case manager. As a case manager, the nurse coordinates comprehensive services for students with complex health needs. D. INCORRECT: The nurse is not functioning in the role of counselor. As a counselor, a nurse develops a trusting relationship with students and provides support on issues affecting their lives.

A. INCORRECT: Placing posters with images of appropriate hand hygiene near restrooms is a primary prevention strategy. B. CORRECT: Routinely checking students for pediculosis throughout the school year is a secondary prevention strategy. C. INCORRECT: Implementing age-appropriate injury prevention programs for each grade level is a primary prevention activity. D. INCORRECT: Working with the dietitian to determine carbohydrate counts for students with diabetes is a tertiary prevention activity.

●● Family characteristics ◯◯ Members communicate well and listen to each other. ◯◯ There is affirmation and support for all members. ◯◯ Members teach respect for others. ◯◯ There is a sense of trust. ◯◯ Members play and share humor together. ◯◯ Members interact with one another. ◯◯ There is a shared sense of responsibility. ◯◯ There are traditions and rituals. ◯◯ Members seek help for their problems.

●● Times of transition ◯◯ Birth of a child ◯◯ Adoption of a child ◯◯ Death of a family member ◯◯ Child moving from the home ◯◯ Child getting married ◯◯ Major illness of a family member ◯◯ Divorce of a family member ◯◯ Loss of the main source of family income

●● Reductions in ◯◯ Barriers to access ◯◯ Allergic content within the home ◯◯ Families that are unable to have a child or maintain a pregnancy ◯◯ Exposure to secondhand smoke ◯◯ Household hunger ●●Increases in ◯◯ Health education provided by an agency ◯◯ Home testing for radon ◯◯ Health insurance coverage ◯◯ Individuals with a usual primary care provider

A. CORRECT: An underweight child is a manifestation of child neglect. B. INCORRECT: A healing spiral fracture is a manifestation of physical abuse. C. INCORRECT: Genital irritation is a manifestation of sexual abuse. D. INCORRECT: Burns on the palms of the hands are a manifestation of physical abuse. E. CORRECT: Poor hygiene is manifestation of child neglect.

A. INCORRECT: Increased, not decreased, blood pressure is a manifestation of alcohol withdrawal. B. CORRECT: Diaphoresis is a manifestation of alcohol withdrawal. C. INCORRECT: Dilated, not pin-point, pupils are a manifestation of alcohol withdrawal. D. INCORRECT: Tachycardia, not bradycardia, is a manifestation of alcohol withdrawal.

A. INCORRECT: Smoking is the first-most, not fifth-most, preventable cause of death in the United States. B. INCORRECT: Nicotine is a central nervous system stimulant, not depressant. C. INCORRECT: Withdrawal effects from smoking are substantial, not minimal, and increase physical dependence. D. CORRECT: Tolerance to nicotine does develop quickly.

A. INCORRECT: Providing support programs for new parents is a primary prevention strategy. B. INCORRECT: Screening a client whose spouse recently died for suicide risk is a secondary prevention strategy. C. CORRECT: Teaching a client who has schizophrenia about medication interactions is a tertiary prevention strategy. D. INCORRECT: Discussing stress reduction techniques with employees at an industrial site is a primary prevention strategy.

A. CORRECT

●● Violence ●● Substance use disorders ●● Homelessness ●● Mental health issues ●● Poverty ●● Chronic stress ●● Poor self-esteem ●● Access to health care services

A. Incorrect: Cholera is waterborne illness. B. Incorrect: Malaria is a vector-borne illness. C. Correct: When discussing modes transmission, the nurse should include influenza as an airborne illness. D. Incorrect: Salmonellosis is a foodborne illness.

A. Incorrect: Respiratory secretions are a portal of exit. B. Correct: Skin is a portal of entry the nurse should discuss. C. Correct: The genitourinary tract is a portal of entry the nurse should discuss. D. Incorrect: Saliva is a portal of exit. E. Correct: Mucous membranes are a portal of entry the nurse should discuss.

A. Incorrect: Outlining specific roles of community agencies is a component of disaster preparedness. B. Correct: Identifying community vulnerabilities is a component of disaster prevention. C. Incorrect: Prioritizing care of individuals is a component of disaster response. D. Incorrect: Providing stress counseling is a component of disaster recovery.

A. Incorrect: Hantavirus is a Category C biological agent. B. Incorrect: Typhus is a Category B biological agent. C. Correct: Plague is a Category A biological agent. D. Correct: Tularemia is a Category A biological agent. E. Correct: Botulism is a Category A biological agent.

A. Incorrect: Metronidazole is used to treat trichomoniasis, skin infections, and septicemia. B. Correct: Community members exposed to anthrax will need access to ciprofloxacin. This medication is used for the prophylactic treatment of anthrax. C. Incorrect: Zanamivir is used to treat influenza. D. Incorrect: Fluconazole is used to treat candidiasis.

smallpox (variola), botulism toxin, anthrax, tularemia, hemorrhagic viral fevers, and plague.

typhus and cholera

hantavirus

›› IV ciprofloxacin (Cipro) prophylactically for exposure or high risk of exposure ›› Antibiotics do not stop disease progression.

›› Headache ›› Fever ››Muscle aches ›› Chest discomfort ›› Severe dyspnea ›› Shock

›› High fever ›› Fatigue ›› Severe headache ›› Rash (begins on face and tongue, quickly spreading to the trunk, arms, and legs, then hands and feet) that turns to pus‑filled lesions ›› Vomiting

A. INCORRECT: Shared power must exist for a partnership to be successful. B. CORRECT: Flexibility must exist for a partnership to be successful. C. CORRECT: Integrity must exist for a partnership to be successful. D. INCORRECT: Shared goals must exist for a partnership to be successful. E. CORRECT: Negotiation must exist for a partnership to be successful.

A. INCORRECT: This is an example of a nurse functioning as a change agent. B. CORRECT: This is an example of a nurse functioning as a consultant. Community health nurses serve as a consultant regarding the health care needs of individuals, families, and groups within the community served. C. INCORRECT: This is an example of a nurse functioning as a case manager. D. INCORRECT: This is an example of a nurse functioning as a caregiver.

A. INCORRECT: Monitoring the client's satisfaction with the referral is an appropriate action by the nurse. However, another action must occur first in the referral process. B. INCORRECT: Once the client agrees, providing client information to referral agencies is an appropriate action by the nurse. However, another action must occur first in the referral process. C. INCORRECT: Reviewing available resources with the client is an appropriate action by the nurse. However, another action must occur first in the referral process. D. CORRECT: Identifying referrals that the client needs is the first action the nurse should take in the referral process. Identifying the client's needs then allows the nurse and client to focus on specific needs while moving forward in the referral process.

A. CORRECT: Costs associated with services are an example of a resource barrier to community referrals. B. INCORRECT: Decreased motivation is an example of a client barrier to community referrals. C. INCORRECT: Inadequate knowledge of resources is an example of a client barrier to community referrals. D. INCORRECT: Lack of transportation is an example of a client barrier to community referrals.

A. CORRECT: Coordinating services to meet the client's needs is an appropriate action by the nurse in the implementation phase of the case management process. B. INCORRECT: Comparing outcomes with original goals is an appropriate action by the nurse in the evaluation phase of the case management process. C. INCORRECT: Determining the client's financial constraints is an appropriate action by the nurse in the assessment phase of the case management process. D. INCORRECT: Clarifying roles of interprofessional team members is an appropriate action by the nurse in the planning phase of the case management process.