NR442 - Community Health Practice Exam A (50 Items), Exams of Nursing

Download NR442 - Community Health Practice Exam A (50 Items) and more Exams Nursing in PDF only on Docsity! NR442 - Community Health Practice Exam A (50 Items) 1. A community health nurse is planning a presentation for adults who have a family history of Alzheimer's disease. Which of the following behaviors should the nurse include as an early manifestation of Alzheimer's disease a. Withdrawal from social activities b. Forgetting the location of common object c. Experiencing incontinence d. Neglecting personal hygiene Rationale: Forgetting the location of common objects is an early manifestation of Alzheimer's disease. 2. A community health nurse identifies an increase in the occurrence of osteoporosis-related fractures in women experiencing menopause. Which of the following primary prevention strategies should the nurse implement? a. Advise the women to keep their immunizations updated. b. Encourage the women to participate in weight-bearing activities. c. Educate the women about the importance of limiting sun exposure. d. Instruct at-risk women to increase their intake of foods high in vitamin E. Rationale: Weight-bearing exercises, such as weight lifting, walking, and running, have been found to be beneficial in preventing osteoporosis. 3. A nurse is caring for a client who has terminal lung cancer and is receiving hospice care. Which of the following statements should the nurse identify as an indication that the client is in the denial stage of the grief process? a. "I'm looking forward to my daughter's wedding next year." b. "I don't deserve to die. This just isn't fair." c. "If I could just make it through this, I'd never smoke again." d. "I'm going to plan my memorial service next week." Rationale: During the denial stage of the grief process, the client rejects the reality of the impending loss. 4. A home care nurse is visiting an older adult and notes that unwashed dishes are piled up and newspapers cover the front steps. Which of the following questions should the nurse to ask the client to determine if he is socially isolated? a. "Why haven't you brought in your newspapers?" b. "Do you need help completing your housework?” c. "How often do you have visitors come to see you?" d. "Have you considered moving to an assisted living facility?" Rationale: "How often do you have visitors come to see you?" MY ANSWER The nurse should ask this question because it addresses the issue of social isolation by determining the frequency of contact between the client and others. 5. A community health nurse is discussing the role of a faith community nurse with a chaplain. Which of the following information should the nurse include in the discussion? a. The faith community nurse can provide pharmacologic pain management for clients who have a terminal illness. b. The faith community nurse can plan safety training for employees in a local factory. c. The faith community nurse can provide wound care for clients in their homes. d. The faith community nurse can facilitate substance abuse support groups. Rationale: This is one of the roles of a faith community nurse. 6. A community health nurse is conducting a needs assessment of a community. The nurse should identify that which of the following methods will yield direct data? a. Health surveys b. Medical records c. Informant interviews d. Morbidity/mortality statistics Rationale: The nurse should identify that informant interviews of the community's leaders will provide direct data. This information can help the nurse identify services needed by the community. 7. A nurse is providing education regarding lead exposure to a group of clients who live in a housing development built in 1968. Which of the following client statements indicates an understanding of the teaching? a. "I will use a dry-sanding technique when preparing to repaint my front door." b. "I will vacuum our wood floors every week." c. "I will increase the amount of red meat and milk in my child's diet." d. "I will use hot tap water to prepare my baby's formula." Rationale: Children should receive adequate amounts of iron and calcium in their diets to prevent lead absorption from their environment. 8. A community health nurse is participating in a quality improvement plan for a local health department. Which of the following techniques should the nurse use for process evaluation of the facility? (Select all that apply). a. Focus groups b. Written audits c. Satisfaction survey d. Interviews e. Values self-study 15. A public health nurse is conducting an education session about Lyme disease for a group of older adult clients at a senior center. Which of the following statements should the nurse identify as an indication that the client understands the teaching? a. "I should get an annual immunization to prevent Lyme disease." b. "I can take penicillin for 10 to 14 days to manage Lyme disease." c. "I can get Lyme disease from a mosquito bite." d. "I will have abdominal pain and diarrhea if I get Lyme disease." Rationale: A client who receives a diagnosis of Lyme disease in the early stages should respond to 10 to 14 days of penicillin or tetracycline therapy. The nurse should instruct the students to consume less than 300 mg/day of dietary cholesterol. High levels of dietary cholesterol in a diet can be a risk factor for cardiovascular disease. 16. A school nurse is educating a group of high school student about recommended dietary guidelines. Which of the following statements by a student indicates an understanding of the teaching? a. "I can consume up to 25 percent of my daily calories from saturated fatty acids." b. "I should consume less than 300 milligrams per day of dietary cholesterol." c. "I can increase my daily consumption of foods that contain refined grains." d. "I should consume 800 milligrams per day of dietary calcium." Rationale: "I should consume less than 300 milligrams per day of dietary cholesterol." The nurse should instruct the students to consume less than 300 mg/day of dietary cholesterol. High levels of dietary cholesterol in a diet can be a risk factor for cardiovascular disease. 17. A community health nurse is creating a program to reduce domestic violence in the community. Which of the following interventions should the nurse identify as secondary prevention? a. Creating a public service announcement about the warning signs of intimate partner abuse b. Recognizing and reporting suspected abuse to the appropriate protective services c. Collaborating with support agencies to ensure the ongoing treatment for abuse e. Educating individuals and groups about preventing domestic and community abuse Rationale: Secondary prevention is an intervention that focuses on early detection of a health problem to facilitate early diagnosis and treatment. Recognizing and reporting suspected abuse facilitates diagnosis and intervention, helping to prevent further abuse. 18. A nurse in a clinic is planning teaching for a client who was newly diagnosed with hepatitis C. Which of the following instructions should the nurse include in the teaching? a. Consume a low-carbohydrate diet until symptoms resolve. b. Schedule an appointment for an immunoglobulin injection. c. Abstain from sexual intercourse until antibody tests are negative. d. Wear a mask in public places while receiving treatment. Rationale: Hepatitis C is transmitted through sexual intercourse. Therefore, the nurse should instruct the client to abstain from sexual intercourse until antibody tests are negative. 19. A nurse at a county health department is caring for a client who is at 28 weeks of gestation. The nurse should identify which of the following characteristics as a risk for potential future abuse of the newborn? a. The client recently married the father of her unborn baby. b. The client works part-time at a local restaurant. c. The client has changed providers three times during her pregnancy. d. The client has recurring nightmares about her unborn baby. Rationale: Frequently changing health care providers is a warning sign for potential future child abuse because it can indicate that the client is in an abusive relationship and is attempting to hide it from her provider. Clients who experience abuse are at a higher risk for abusing their own children. 20. A public health nurse is planning an educational program for a group of nurses at a community health department about pertussis infection. which of the following information should the nurse include? a. Individuals should receive an annual influenza vaccine to minimize the risk of infection with pertussis. b. Newborns should receive the first dose of the diphtheria, tetanus, and acellular pertussis (DTaP) vaccine prior to discharge from the hospital. c. Individuals who have had pertussis do not require immunization. d. Individuals transmit the pertussis bacteria through airborne droplets. Rationale: Transmission occurs when an individual who has an infection with Bordetella pertussis coughs and expels droplets smaller than 5 microns 21. A clinic nurse is caring for a client who reports taking ginkgo biloba for several weeks since seeing a naturopathic healer. The nurse should instruct the client that ginkgo biloba may alter the effects of which of the following medications? a. Warfarin b. Metoprolol c. Digoxin d. Diltiazem Rationale: Ginkgo biloba can hinder coagulation. Therefore, the nurse should instruct the client that ginkgo biloba may alter the effects of warfarin. 22. A home health care nurse is teaching a client's family about preventing the transmission of Clostridium difficile. Which of the following transmission-based precautions should the nurse include in the teaching? a. "You will be able to access my mother's hospital medical records for us to review." b. "You will be able to give my mother's pain medication." c. "You can submit invoices to Medicare to reimburse you for your services." d. "You will coordinate with volunteers who will come to help my mother." Rationale: A faith community nurse can assist with receiving services from various volunteers within the client's spiritual community to provide additional support and comfort to the client during the dying process. 23. A home health care nurse is teaching a client's family about preventing the transmission of Clostridium difficile. Which of the following transmission-based precautions should the nurse include in the teaching? a. Contact precautions b. Droplet precautions c. Airborne precautions d. Protective environment Rationale: Contact precautions. The nurse should instruct the family to implement contact precautions while providing care for a client who has C. difficile. Contact precautions eliminate the exposure to contaminated body fluids and items. Droplet precautions. The nurse should implement droplet precautions when providing care for a client who has diphtheria or mumps. Droplet precautions require the use of appropriate hand hygiene, the wearing of a surgical mask when within 3 feet of the client, and the use of dedicated care equipment. Airborne precautions. The nurse should implement airborne precautions when providing care for a client who has varicella, pulmonary tuberculosis, or measles. This type of precaution requires a negative airflow room and the wearing of an N95 mask. Protective environment. The nurse should implement protective environment precautions for clients who are highly susceptible to infections, such as clients who have severe dermatitis, major burns, leukemia, or who are undergoing chemotherapy. 24. A nurse is performing a home visit for a client who has tuberculosis (TB). As the nurse is leaving the client's house, a neighbor asks, "Is it true that my neighbor has TB?" Which of the following responses should the nurse make? a. "You should ask the public health department." b. "Do you have questions about tuberculosis?" c. "Have you ever been tested for tuberculosis?" d. "You should take precautions against this infection." Rationale: This response addresses the neighbor's concerns while protecting the client's confidentiality. 25. A nurse is developing a genogram for a client to determine education needs. Which of the following health risk information should the nurse expect to obtain with this tool? a. Biological b. Behavioral c. Social d. Economic make the hospice referral for the client. 34. A nurse is preparing a community education program about health care needs during pregnancy. The nurse should include which of the following vaccines is safe to administer to a client who is pregnant? a. Herpes zoster b. Tetanus, diphtheria, pertussis (Tdap) c. Varicella d. Measles, mumps, rubella Rationale: The nurse should include that a client who is pregnant should receive the Tdap vaccine between 27 and 36 weeks of gestation. 35. A community health nurse is providing care to a client who has stopped taking his prescribed blood pressure medication. Which of the following actions should the nurse take first? a. Inform the provider of the client's decision b. Determine the client's reason for discontinuing the medication c. Discuss the consequences of discontinuing the medication with the client d. Provide the client with an educational pamphlet about the medication Rationale: When using the nursing process, the first step the nurse should take is to assess the client. By determining the client's reason for discontinuing the medication, the nurse can promote adherence to treatment. 36. Community leaders have requested a meeting with a community health nurse to discuss creating a mobile meals program. Which of the following should the community health nurse assess first? a.The leadership support of the community b. The availability of volunteers c. The availability of volunteers d. The need for the program Rationale: Using the urgent vs. nonurgent approach to client care, the nurse should first assess the need for the mobile meals program. This action allows the nurse to collect data on the client, which is the community, and meets the first step of program planning. The needs of the community will determine all other steps of the planning process. 37. A nurse is preparing to administer medication to a client who has active tuberculosis. Which of the following precautionary measures should the nurse take? a. Wear gloves. b. Wear a gown. c. Use disposable equipment. d. Use an N95 respirator. Rationale: A client who has active TB require airborne precautions to prevent the spread of droplet nuclei smaller than 5 microns. The nurse should wear an N95 respiratory when administering medication to prevent transmission of the infection. 38. A community health nurse is reviewing plans for a health education program. The nurse should identify that which of the following components of the plan needs to be changed? a. Program content is organized topically. b. Pamphlets are written at a 12th-grade level. c. The presentation is delivered via a computer slide presentation. d. Attendance at the program is voluntary Rationale: The nurse should identify that the pamphlets written at a 12th-grade reading level requires a change. The American Medical Association and the National Institutes of Health recommend written materials are written at a 6th-grade level or lower. 39. A nurse is planning a health promotion activity for the local community. Which of the following activities should the nurse include as an? a. Teaching foot care to adults who have diabetes mellitus b. Testing school-age children for lead exposure c. Providing tuberculosis screenings for day care providers d. Teaching meal planning classes to older adults Rationale: This is an example of primary prevention. 40. A home health nurse is providing nutritional instructions to a client who has COPD and is malnourished. Which of the following instructions should the nurse include? a. Drink at least 480 mL (16 oz) of liquid with each meal. b. Avoid foods that contain eggs c. Lie flat for 15 to 30 mins after eating d. Use milk instead of water when making canned soup Rationale: The client should use milk when preparing canned soup to increase his intake of protein and calories. 41. A nurse in a pediatric clinic is providing care to several clients. The nurse should recognize that which of the following conditions is included on the Nationally Notifiable Infectious Conditions list? a. Varicella b. Erythema infectiosum c. Scarlet fever d. Molluscum contagiosum Rationale: The nurse should recognize that varicella is included on the Nationally Notifiable Infectious Conditions list. States voluntarily conduct surveillance and report instances of certain diseases to the Centers for Disease Control and Prevention so the data can be compiled and released each year. 42. A nurse is caring for a client who has recently emigrated from another country and states, "The health care system in my country was better and should be used everywhere." The nurse should recognize that the client is demonstrating which of the following behaviors? a. Social organization