Exam 3: NR 442/NR442 Community Health Nursing (NEW 2026–2027 Updated) | Comprehensive Questions & Answers | Accurate Verified Solutions – Chamberlain

…..DLDD Exam 3 NR 442/NR442 Community Health Nursing (NEW 2026–2027 Updated) | Comprehensive Questions & Answers | Accurate Verified Solutions – Chamberlain Q. When describing the global framework, which of the following would the community health nurse be least likely to include? A) Population B) Provider C) Procedure D) Physician ANSWERS D) Physician The global framework is bounded by a context and includes three parts, the three "Ps." These are the population, the provider, and the procedure. Physician would be included as a provider. Q. When applying the Universal Imperatives of Care, which of the following would be the priority? A) Mortality B) Daily functioning C) Decision making D) Cost ANSWERS A) Mortality The Universal Imperatives of Care include mortality, morbidity, daily functioning, decision making, and cost. This paradigm underscores the notion of first things first. That is, one must be alive and well before interventions focus on functioning or decision making. Q. A nursing student is considering a career in international community health nursing. Which of the following statements are accurate regarding the context of international community health nursing? Select all that apply. A) Global community health care is complex and is affected by multiple factors relating to geography, history, politics, culture, religion, and economy. B) The types of services that can be provided include a range from providing clinical services to policy making at an international level. C) People's conception of health, wellness, and illness are static from culture to culture. D) By looking through a computer window, the student is able to see almost anyplace, connect to about any person, and access information about almost any concept. E) The ways in which people view nurses and other health care providers are affected by their attitudes toward women, their culture, and belief systems. ANSWERS A) Global community health care is complex and is affected by multiple factors relating to geography, history, politics, culture, religion, and economy. B) The types of services that can be provided include a range from providing clinical services to policy making at an international level. D) By looking through a computer window, the student is able to see almost anyplace, connect to about any person, and access information about almost any concept. E) The ways in which people view nurses and other health care providers are affected by their attitudes toward women, their culture, and belief systems. The following statements are true: Global community health care is complex and is affected by multiple factors relating to geography, history, politics, culture, religion, and economy; The types of services that can be provided include a range from providing clinical services to policy making at an international level; By looking through a computer window, the student is able to see almost anyplace, connect to about any person, and access information about almost any concept; The ways in which people view nurses and other health care providers are affected by their attitudes toward women, their culture, and belief systems. The statement that people's conceptions of health are static from culture to culture is false. Indeed, people's conceptions of health, wellness, and illness vary from culture to culture. Q. A community health nurse is preparing a presentation for a community group about tuberculosis (TB) and its current epidemic status. Which of the following would the nurse include in the presentation about this disease? A) TB kills about 1.7 million people each year. B) All persons who are infected by the causative organism become ill and can spread the causative organism to others throughout the remainder of their lifetime. C) Three fourths of the world's population is thought to be currently infected by the causative organism. D) The highest number of deaths is in Eastern Europe. ANSWERS A) TB kills about 1.7 million people each year. TB kills approximately 1.7 million people each year. Only 5 to 10 of those infected become ill or can spread the causative organism to others within their lifetime. One third of the world's population is thought to be currently infected by the causative organism (tubercle bacillus). The highest number of deaths occur in Africa. Q. A community health nurse has identified noise as an environmental hazard. Using the Blumenthal classification, the nurse would identify this as which of the following class? A) Infectious agents B) Asphyxiates C) Poison D) Physical agents ANSWERS D) Physical agents The Blumenthal classification lists classes of environmental hazards. They include infectious agents (e.g., bacteria and viruses), respiratory fibrotic agents (e.g., coal dust), asphyxiates (e.g., carbon monoxide), poison (e.g., pesticides), physical agents (e.g., noise), psychological agents (stressful synergisms such as crowding combined with noise), mutagens (e.g., dioxin), teratogens (e.g., cadmium), and carcinogens (e.g., cigarette smoke) Q. Which one of the following factors has resulted in the Era of Chronic Long-Term Health Conditions? A) Decreased usage of tobacco by young populations B) Despite programs of control, many infectious diseases persist with many people surviving to experience chronic, long-term conditions secondary to the infectious disease. C) Shorter life expectancies due to chronic diseases D) Death from infectious diseases results in a decrease in degenerative diseases. ANSWERS B) Despite programs of control, many infectious diseases persist with many people surviving to experience chronic, long-term conditions secondary to the infectious disease. Despite the programs of control, many infectious diseases persist. However, populations now survive and also experience chronic, long-term conditions. These conditions affect mortality and morbidity, daily functioning, decision making, and cost. Thus, the longevity that has resulted from meeting the challenges of the Era of Infectious Diseases compounds the more recent emergence of chronic diseases in the many countries. The emergence of multidrug resistant diseases, continued persistence of infectious disease, and urbanization with deforestation have resulted in new and emerging infectious diseases and conditions. Q. When reviewing statistics about illnesses worldwide, which of the following would the nurse identify as the most common and a leading cause of mortality? A) Tuberculosis B) Smallpox C) Acute respiratory tract infection D) Infectious diarrheal disease ANSWERS C) Acute respiratory tract infection The most common illness in the world and a leading cause of mortality is acute respiratory tract infection (ARI). Three million deaths annually are attributed to ARI among children younger than 5 years of age, usually from pneumonia. Tuberculosis is considered epidemic today. Smallpox has been eradicated. Infectious diarrheal disease has been reduced due to oral rehydration therapy and improvements in water and sanitation. Q. Which of the following interventions would a community health nurse be involved with to help achieve a reduction in the number of measles deaths worldwide? A) Integrated Management of Childhood Illness (MCI) B) Global Alliance for Vaccine and Immunization C) Oral rehydration therapy D) Geographical information systems ANSWERS A) Integrated Management of Childhood Illness (MCI) The MCI is the intervention considered to have the greatest impact in reducing measles. It provides wide immunization coverage, rapid referral of serious cases, prompt recognition of secondary conditions, and improved nutrition and vitamin A supplementation. The Global Alliance for Vaccine and Immunization is an interagency initiative that seeks to protect every child against vaccine-preventable diseases. This initiative addresses all of these types of diseases. Oral rehydration therapy has been used to reduce mortality associated with diarrheal diseases. Geographical information systems is not a program but a means to monitor diseases. Q. Which one of the following statements about poliomyelitis is the most accurate? A) Polio is not endemic in any countries at present. B) Polio has been eliminated worldwide. C) Rotary International has contributed no funds but many hours of manpower to eradicate polio. D) Polio has been eliminated from the Western hemisphere. ANSWERS D) Polio has been eliminated from the Western hemisphere. Polio has been eliminated from the Western Hemisphere. It is now almost eliminated worldwide. Polio is endemic in Afghanistan, India, Pakistan, and Nigeria. Rotary International has contributed over $900 million dollars to help eradicate this disease. Q. A community health nurse is reading a journal article about global health and communicable diseases. The article states that elimination is the goal. The nurse interprets this to mean which of the following? A) There are no further cases of the disease anywhere. B) No further preventive efforts are necessary. C) The disease is no longer a public health threat. D) The disease has been interrupted in a geographic area. ANSWERS D) The disease has been interrupted in a geographic area. The term elimination is used when a disease has been interrupted in a defined geographic area. In 1991, WHO defined elimination as a reduction of prevalence to less than one case per 1 million population in a given area. Eradication means interruption of person-to-person transmission and limitation of the reservoir of infection so that no further preventive efforts are required; it indicates a status whereby no further cases of a disease occur anywhere. The term control indicates that a specific disease has ceased to be a public health threat. A community health nurse instructs a local community group on how to prepare homemade oral rehydration solution. Which of the following ingredients would the nurse include? A) Sea water B) Table salt C) Baking soda D) Crushed bananas ANSWERS B) Table salt Oral rehydration solution consists of 1 L of safe water to which is added half small teaspoon of salt, and four large spoons of sugar. In addition, bananas or green coconut water are encouraged to compensate for the loss of potassium. Communicable disease is a global health concern with a primary goal of eradicating communicable diseases worldwide. Achievement of this goal would involve: A) interrupting disease in a limited, defined geographic area. B) reducing the incidence and/or prevalence of communicable diseases. C) establishing primary health care services for all people on the globe. D) interrupting transmission and reservoir of infection to prevent further cases. D) interrupting transmission and reservoir of infection to prevent further cases. Eradication is an ambitious and expensive goal and has occurred with smallpox in 1977 and is under way with other diseases such as poliomyelitis, guinea worm, leprosy, and measles so that many diseases can be eradicated early in the 21st century. One major means of eradicating communicable diseases is to interrupt the transmission and reservoir, thereby preventing the development of new cases. Interrupting disease in a limited area may be a starting point, but more widespread involvement is needed. Reducing the incidence or prevalence would provide indications about the effects of attempting to eradicate the disease. Establishing primary health care services is the goal of Alma-Ata "health for all." Which one of the following statements about immunization is true? A) The World Health Organization estimates that a billion more lives could be saved each year with immunizations. B) Vaccines are one of the most cost-effective interventions found in public health. C) Half of the world's children are being reached with essential vaccines. D) In the United States, toddlers are thoroughly vaccinated. B) Vaccines are one of the most cost-effective interventions found in public health. Vaccines are one of the most cost-effective interventions found in public health. The World Health Organization estimates that 3 million more lives could be saved each year with immunizations. Three fourths of the world's children are being reached with essential vaccines. In the United States, only 10% of toddlers are protected against measles, mumps, and rubella via vaccinations. A community health nurse is working with an international agency in Australia. The nurse would most likely encounter which type of health care system? A) Entrepreneurial B) Welfare-oriented C) Comprehensive D) Socialist B) Welfare-oriented Australia subscribes to a welfare-oriented health care system in which statutory programs drive these systems to support the cost of health care for all, or almost all, of the population through their "national health insurance." An Entrepreneurial Health Care System, found in the United States, is one in which the country's health care system is based, in part, on its political economy. A Comprehensive Health Care System is a step away from the welfare-oriented type in that substantial modifications exist in delivery and financing that result in universal entitlements. These systems are found in Scandinavian countries, Great Britain, and New Zealand. Socialist Health Care Systems came about through social revolutions that abolished free-market economies and replaced them with socialism where the health care system is also socialized. They are found in countries such as Russia, Eastern Europe, Albania, Bulgaria, Czechoslovakia, East Germany, Hungary, Poland, Romania, Yugoslavia, and China. Which of the following are factors that influence populations' perceptions of health and health status and their receptivity to community health nursing programs? Select all that apply. A) Their perceptions of healthy food B) Their attitudes toward women C) Their culture D) Their belief systems E) Their geographic location B) Their attitudes toward women C) Their culture D) Their belief systems The factors that influence populations' perceptions of health and health status and their receptivity to community health nursing programs include their attitudes toward women, their culture, and their belief systems. Their perceptions of healthy food or their geographic location would not have a direct bearing on their perception of health and health status or receptivity to community health nursing programs. A community health nurse is preparing to work in a country in which women are viewed as weak and ineffectual. Which of the following would the nurse need to do first? A) Determine his or her own position and beliefs about this view B) Develop a basic plan to change the view of women C) Become aware of possible areas that might impact care D) Avoid situations involving the care of women A) Determine his or her own position and beliefs about this view Community health nurses first, need to determine their own position on this issue and come to terms with it, realizing that it may impact their care. Once aware, the nurses can then prepare appropriately for situations in which their care may be affected. It would be inappropriate and probably impossible to attempt to change the view or avoid situations involving the care of women. Which of the following statements about the personal and professional perceptions that nurses bring to providing community health nursing interventions within an international context is most accurate? A) Community health nurses are not susceptible to preconceived perceptions and biases. B) It is not necessary for community health nurses to face their own beliefs. C) Community health nurses are universally opposed to female circumcision, the use of nonlicensed personnel to carry out medical treatments, and the use of Western interventions used simultaneously with other methods of treatment. D) It is critical for community health nurses to face their own beliefs when confronting female circumcision, the use of nonlicensed personnel to carry out medical treatments, and the use of Western interventions used simultaneously with other methods of treatment. D) It is critical for community health nurses to face their own beliefs when confronting female circumcision, the use of nonlicensed personnel to carry out medical treatments, and the use of Western interventions used simultaneously with other methods of treatment. It is critical for community health nurses to face their own beliefs when confronting female circumcision, the use of nonlicensed personnel to carry out medical treatments, and the use of Western interventions used simultaneously with other methods of treatment. Community health nurses are as susceptible as any other group of people to preconceived perceptions and biases. Community health nurses may not be universally opposed to female circumcision, the use of nonlicensed personnel to carry out medical treatments, and the use of Western interventions used simultaneously with other methods of treatment. Community health nurses need to be knowledgeable about the World Health Organization because its mission reflects which of the following? A) Collaboration in health development to free the world from poverty B) Service as an independent agency providing economic and humanitarian assistance overseas C) Representation of the global interests and concerns of the nursing profession D) Global health promotion by supporting development efforts of governments, organizations, and universities throughout the world D) Global health promotion by supporting development efforts of governments, organizations, and universities throughout the world WHO's mission reflects global health promotion by supporting development efforts of governments, organizations, and universities throughout the world. Collaboration to free the world from poverty reflects the mission of the World Bank. Service as an independent agency for economic and humanitarian assistance describes the mission of the United States Agency for International Development (USAID). Representation of global interests and concerns of nurses describes the mission of the International Council of Nurses (ICN). An instructor in community health nursing teaches a group of students about the role of the World Health Organization and global health, reviewing the importance of the Declaration of Alma-Ata. The instructor determines that the students have grasped the importance when they describe it as which of the following? A) The beginning of the Carter Center's work in disease prevention and agriculture B) A formal document written by 134 nations in 1978 to achieve "health for all" C) Participatory development activities, working in partnership with voluntary organizations D) Alliance building and communicating best practices for global health development B) A formal document written by 134 nations in 1978 to achieve "health for all" The declaration represents the work of 134 nations during a WHO/UNICEF conference in 1978 to achieve primary health care for all. The Carter Center was founded in 1986 and is not related to the work at Alma-Ata. Participatory development activities describe the work of the United States Agency for International Development (USAID). Alliance building and communicating best practices describe the Global Health Council, which is a leading private, voluntary, American nongovernmental organization. Which of the following statements about the International Council of Nurses (ICN) are accurate? Select all that apply. A) ICN represents the global interests and concerns of the nursing profession. B) The mission of ICN is to maintain the role of nursing in health care through its global voice. C) ICN has, as members, nursing organizations from 130 countries representing 13 million nurses. D) ICN is a governmental organization. E) ICN employs Regional Nursing Advisors. A) ICN represents the global interests and concerns of the nursing profession. B) The mission of ICN is to maintain the role of nursing in health care through its global voice. C) ICN has, as members, nursing organizations from 130 countries representing 13 million nurses. The following statements about ICN are accurate: ICN represents the global interests and concerns of the nursing profession; the mission of ICN is to maintain the role of nursing in health care through its global voice; and ICN has, as members, nursing organizations from 130 countries representing 13 million nurses. ICN is a nongovernmental organization. Regional Nursing Advisors are employed at the international level of the World Health Organization. After teaching a class of community health nursing students about the World Health Organization, the instructor determines that the teaching was successful when the class identifies which of the following as the highest governing body? A) World Health Assembly B) WHO Collaborating Centers C) The European Union D) U.S. Agency for International Development A) World Health Assembly The World Health Assembly is the highest governing body within WHO. WHO Collaborating Centers are networks of centers focusing on specific areas of expertise and carry out the work of the member countries in these areas. The European Union is an organization that provides funding for many projects including health. The U.S. Agency for International Development is an independent bilateral agency of the executive branch that works to enhance long-term and equitable economic growth. A group of students are reviewing for an examination on nongovernmental organizations that provide global interventions. The students demonstrate the need for additional study when they identify which of the following as an example? A) Global Health Council B) CARE C) Carter Center D) World Bank D) World Bank The World Bank is an agency that focuses on economic development. It partners with countries, WHO, and other organizations. It is not a nongovernmental organization. Examples of nongovernmental organizations include Global Health Council, The Center for International Health and Cooperation, CARE, and the Carter Center. Which organization would be most appropriate for the community health nurse to contact for assistance when dealing with countries shattered by war and ethnic violence? A) Center for International Humanitarian Cooperation B) CARE C) Global Health Council D) International Council of Nurses A) Center for International Humanitarian Cooperation The Center for International Humanitarian Cooperation (CIHC), founded in 1992, promotes healing and peace in countries shattered by war, regional conflicts, and ethnic violence. CARE intervenes by responding to famines and disasters worldwide with emergency food, supplies, and rehabilitative efforts. The GHC advocates for needed policies and resources, builds networks and alliances among those working to improve health, and shares innovative ideas, knowledge, and best practices in health. The ICN represents the global interests and concerns of the nursing profession. Which of the following statements about the World Health Organization is accurate? A) The World Health Organization does not provide technical support for interventions or provide assistance developing nursing knowledge and skills. B) The World Health Organization can help a member state determine the drugs that are essential and will assist in developing health policy, project plans, and programs. C) The World Health Organization provides medicines and other tangible resources to its member states. D) The World Health Organization focuses on professional issues to support the development of particular health-related practitioners, such as nurses. B) The World Health Organization can help a member state determine the drugs that are essential and will assist in developing health policy, project plans, and programs. The World Health Organization can help a member state determine the drugs that are essential and will assist in developing health policy, project plans, and programs. The World Health Organization does focus on providing technical support related to the interventions and provides assistance developing nursing knowledge and skills. The World Health Organization does not provide medicines and other tangible resources to its member states but does help member states determine the drugs that are essential and assist in developing health policy, project plans, and programs. Which of the following statements regarding WHO Collaborating Centers is most accurate? A) One or two Regional Nursing Advisors carry out the work of a region that might be the home to thousands of nursing personnel. B) The World Health Organization Collaborating Centers in Nursing and other fields focus on specific areas of expertise and carry out the work of the member countries in these areas. C) It is referred to a philosophy, a movement, a way of thinking, a setting for health services, or a set of principles. D) It focuses on professional issues to support the development of particular health-related practitioners. B) The World Health Organization Collaborating Centers in Nursing and other fields focus on specific areas of expertise and carry out the work of the member countries in these areas. The World Health Organization Collaborating Centers in Nursing and other fields focus on specific areas of expertise and carry out the work of the member countries in these areas. Regional Nursing Advisors work in collaboration with WHO Collaborating Centers to accomplish the work within each region. Primary Health Care is referred to a philosophy, a movement, a way of thinking, a setting for health services, or a set of principles. A community health nurse is working with people who experienced a tornado and have been forced to leave their homes to escape the effects of a disaster. The nurse would identify these people as which of the following? A) Indirect victims B) Refugees C) Displaced persons D) Casualties C) Displaced persons Displaced persons are those who have been forced to leave their homes to escape the effects of a disaster. Indirect victims are the relatives and friends of direct victims. Refugees are direct victims who are forced to leave their homeland, usually due to war, religious persecution, or political turmoil. A casualty is a human being who is injured or killed by or as a direct result of an accident. A community health nurse working as a part of a disaster response team is told that the disaster is classified as a multiple-casualty incident. The nurse would interpret this to mean which of the following? A) There is more than 1 but less than 10 casualties. B) The number of casualties is between 2 and 100. C) Casualties number over 100. D) There are too many casualties to count. B) The number of casualties is between 2 and 100. If casualties number more than two people but fewer than 100, the disaster is characterized as a multiple-casualty incident. A mass-casualty incident involves 100 or more casualties. A community health nurse is part of a disaster response team that is first to respond to an earthquake. The team evaluates the level of destruction and devastation, identifying this as which of the following? A) Intensity B) Scope C) Casualty D) Range of effect A) Intensity The intensity of a disaster is the level of destruction and devastation it causes. The scope of a disaster is the range of its effect, either geographically or in terms of the number of victims. Casualty refers to the human being(s) injured or killed by or as a direct result of an accident. Which of the following examples of disasters are natural disasters? Select all that apply. A) The Earthquake and tsunami in Japan in 2011 B) The 2008 shootings at Virginia Tech C) The terrorist attacks on the United States on September 11, 2001 D) Wildfires that affected California in October 2007 E) The oil spill in the gulf coast in 2010 that threatened hundreds of species of wildlife A) The Earthquake and tsunami in Japan in 2011 D) Wildfires that affected California in October 2007 Examples of natural disasters include the earthquake and tsunami in Japan in 2011 and wildfires that affected California in October 2007. The following disasters are man-made: the 2008 shootings at Virginia Tech; the terrorist attacks on the United States on September 11, 2001; and the oil spill in the gulf coast in 2010 that threatened hundreds of species of wildlife. After teaching a class about the factors that contribute to disasters, the instructor determines that the teaching was successful when the students identify which of the following as the agent? A) Population's age B) Radiation C) Level of preparedness D) Flood-prone location B) Radiation The agent is the natural or technologic element that causes the disaster. For example, the high winds of a hurricane and the lava of an erupting volcano are agents, as are radiation, industrial chemicals, biologic agents, and bombs. The population's age is an example of host factor. The level of preparedness and flood-prone location are examples of environmental factors. Which of the following federal agencies would a community health nurse expect to be contacted to assist with a disaster in the United States? A) American Red Cross B) Federal Emergency Management Agency (FEMA) C) WHO's Emergency Relief Operations D) Pan American Health Organization B) Federal Emergency Management Agency (FEMA) The Federal Emergency Management Agency (FEMA) is the federal agency responsible for assessing and responding to disaster events in the United States. The American Red Cross is authorized to provide disaster assistance free of charge across the country through its more than 1 million volunteers. It is not supported by the federal government. The World Health Organization's Emergency Relief Operations provide disaster assistance internationally, and the Pan American Health Organization works to coordinate relief efforts in Latin America and the Caribbean. The nurse is using the epidemiological triad to explain the factors contributing the disaster. Which one of the following statements about the environment factors that contribute to disasters is most accurate? A) The environment is the natural or technologic element that causes the disaster. B) The environment is the human being who experiences the disaster. C) Factors that could potentially contribute to or mitigate a disaster are environmental. D) Examples of environmental factors that cause a disaster are high winds of a hurricane and the lava of an erupting volcano. C) Factors that could potentially contribute to or mitigate a disaster are environmental. Factors that could potentially contribute to or mitigate a disaster are environmental. The agent factor is the natural or technologic element that causes the disaster, for example the high winds of a hurricane and the lava of an erupting volcano. The host is the human being who experiences the disaster. A community health nurse is working with a community that is involved with identifying risk factors for program development in case of a disaster. This community is in which phase of disaster management? A) Prevention B) Preparedness C) Response D) Recovery A) Prevention During the prevention phase, no disaster is expected or anticipated. The task during this phase is to identify community risk factors and to develop and implement programs to prevent disasters from occurring. Disaster preparedness involves improving community and individual reaction and responses so that the effects of a disaster are minimized. The response phase begins immediately after the onset of the disastrous event. During the recovery phase, the community takes actions to repair, rebuild, or relocate damaged homes and businesses and restore health and economic vitality to the community. A community health nurse is working with a community that is involved with improving community and individual reaction and responses, so that the effects of a disaster are minimized. This community is in which phase of disaster management? A) Prevention B) Preparedness C) Response D) Recovery B) Preparedness Disaster preparedness involves improving community and individual reaction and responses so that the effects of a disaster are minimized. During the prevention phase, no disaster is expected or anticipated. The task during this phase is to identify community risk factors and to develop and implement programs to prevent disasters from occurring. The response phase begins immediately after the onset of the disastrous event. During the recovery phase, the community takes actions to repair, rebuild, or relocate damaged homes and businesses and restore health and economic vitality to the community. When would the nurse expect the response phase of a disaster to occur? A) When no disaster is expected or anticipated B) Immediately after the onset of the disastrous event C) Long-term phase occurring after the disastrous event D) Prior to the disastrous event B) Immediately after the onset of the disastrous event The response phase of disaster occurs immediately after the onset of the disastrous event. During the prevention phase no disaster is expected or anticipated. Long-term phase occurring after the disastrous event is the recovery phase. Prior to the disastrous event is the preparedness phase. Which of the following statements about disaster planning is most accurate? A) Disaster planning is essential for a community, business, or hospital. B) A disaster plan must be lengthy and detailed. C) A disaster plan should be created by the person responsible for the emergency management of the community. D) It is assumed that all professionals have addressed their personal preparation. A) Disaster planning is essential for a community, business, or hospital. Disaster planning is essential for a community, business, or hospital. A disaster plan need not be lengthy. A disaster plan should be created by all involved, including community leaders, health and safety professionals, and lay people. All nurses should address their own personal preparedness to respond in a disaster, but this may not be assumed. Which of the following are necessary components of a nurse's personal preparedness? Select all that apply. A) Workplace and community disaster plans have been reviewed by the nurse. B) An individual disaster plan for the nurse's own family has been developed. C) The nurse participated in disaster drills at the workplace and had a family disaster drill to practice what actions to take in the event of a disaster. D) It is not necessary for the nurse to bring copies of their nursing license and driver's license. E) In the case of an actual disaster, the nurse will be able to use equipment made available to them. A) Workplace and community disaster plans have been reviewed by the nurse. B) An individual disaster plan for the nurse's own family has been developed. C) The nurse participated in disaster drills at the workplace and had a family disaster drill to practice what actions to take in the event of a disaster. To be personally prepared, a nurse should have read and understood workplace and community disaster plans, should have developed a disaster plan for his or her own family, and should have participated in disaster drills. Nurses preparing to work in disaster areas should bring copies of their nursing license and driver's license and bring basic equipment. As part of secondary prevention, the community health nurse engages in crisis intervention to achieve which of the following? A) Reestablish equilibrium to the lives of those involved B) Prevent the crisis altogether C) Involve as many people as possible in the resolution D) Triage clients during the recovery phase of the crisis A) Reestablish equilibrium to the lives of those involved The stated goal of crisis intervention is to reestablish equilibrium. Prevention is the best approach, but some crises, such as natural disasters, cannot be prevented. They can, however, be prepared for to decrease the negative effects of the crisis as much as possible. It is important to have an adequate number of people needed to come to resolution. However, too many people involved in resolution may cause additional confusion, chaos, and unnecessary delays. Triage decisions need to be made during the response phase of the disaster or crisis and not deferred until the recovery phase. Triage is an ongoing process throughout the response phase. A community health nurse is engaged in primary prevention activities related to disasters. Which of the following would be examples of appropriate activities? Select all that apply. A) Providing anticipatory guidance B) Practicing an escape plan C) Providing emergency assistance D) Planning disaster drills E) Providing immediate response F) Reducing the degree of disability A) Providing anticipatory guidance B) Practicing an escape plan D) Planning disaster drills Anticipatory guidance, practicing escape plans, and planning disaster drills all constitute primary prevention activities. Providing emergency assistance and immediate response reflect secondary prevention activities. Reducing the degree of disability or damage resulting from the disaster reflects tertiary level prevention activities. When describing primary prevention activities that would occur in the preparedness phase of a terrorist attack involving biologic weapons like smallpox or anthrax to a local community group, which of the following would the nurse include? A) Investigating outbreaks to determine source B) Administering vaccines C) Screening suspected cases D) Treating persons who have been infected B) Administering vaccines Primary prevention activities that would occur in the preparedness phase of a terrorist attack involving biologic weapons like smallpox or anthrax would include administering vaccines. Investigating outbreaks to determine the source, screening suspected cases, and treating persons who have been infected would be secondary prevention activities. A community health nurse is assisting the local community in preparing a disaster plan. Which of the following would the nurse expect to be addressed? Select all that apply. A) Chain of command B) Routes for transportation C) Triage D) Basic equipment E) Copies of licenses A) Chain of command B) Routes for transportation C) Triage A disaster plan should address the chain of command, routes and modes of transportation, and triage methods. Basic equipment and licenses are items that a nurse should bring along when preparing to work in a disaster area. A community health nurse is responding to a disaster. Which of the following would most likely be the least appropriate area for the nurse to be located? A) The disaster site B) Triage C) Victim treatment area D) Local hospitals A) The disaster site Usually, the immediate disaster site is not the best place for the disaster nurse, who can be far more effective in triage and treatment of victims. One of the lessons of the World Trade Center bombing was that the greatest need for medical professionals was at the local hospitals, not at the disaster site. When performing triage during a disaster, which color would indicate that the victim is in urgent need of care? A) Red B) Yellow C) Green D) Black A) Red During triage, red indicates that the victim has injuries or medical problems that will likely lead to death if no treated immediately. Yellow indicates that the person has injuries that require medical attention but time to treatment is not yet critical. Green indicates that the victim has minor injuries or are presenting with minimal signs of illness. Black indicates that the victim is dead or has suffered mortal wounds. A community health nurse responding to a disaster is involved with caring for the bodies of the casualties who have died. Which of the following would be an appropriate method for documentation? A) Making a note on the triage tag B) Using a toe tag for identification C) Placing the name on a casualty list D) Recording the name on the victim's body B) Using a toe tag for identification Toe tags make documentation visible and accessible and are the most appropriate means for documentation. Making a note on the triage tag, placing the name on a casualty list and recording the name on the victim's body are inappropriate. Which time after the disaster would be the ideal time for this to occur? A) Within 18 hours B) 1 to 3 days C) 4 to 6 days D) 7 to 10 days B) 1 to 3 days The ideal time for CISD is between 24 and 72 hours after the disaster event. When providing secondary prevention activities for individuals experiencing psychological consequences of a disaster, which of the following would the nurse do as a generic approach? A) Providing situational support for stress relief B) Conveying warmth and concern for the client C) Teaching about expected emotional reactions D) Reunifying family members who were separated C) Teaching about expected emotional reactions The generic approach is designed to reach high-risk individuals and large groups who have experienced the same disaster, teaching them about the expected emotional reactions to the type of disaster they have experienced and promoting adaptive responses. Environmental manipulation results in the change of a person's physical or interpersonal situation, providing situational support to relieve stress. An example of environmental manipulation is when a community health nurse coordinates the reunification of family members separated by the disaster. General support is defined as the caring, warmth, and concern the community health nurse conveys to the client as she or he delivers services. A community health nurse suspects that a client who was a victim of a disaster 3 months ago is experiencing post-traumatic stress disorder. Which of the following would the nurse expect to find? Select all that apply. A) Diminished startle response B) Hypervigilance C) Feelings of detachment D) Flashbacks E) Full range of affect B) Hypervigilance C) Feelings of detachment D) Flashbacks Signs and symptoms of post-traumatic stress disorder include increased startle response, hypervigilance, feelings of detachment, flashbacks, and restricted affect. A group of ten people from the commune in the hills come into town dressed in robes and have their faces covered. They have weapons hidden in their clothing and begin entering the three banks in town to rob them. These actions can be classified as which of the following? A) Natural disaster B) Terrorism C) Casualty D) Adventitious crisis B) Terrorism The actions resemble terrorism, the unlawful use of force and violence against persons or property to intimidate or coerce a government, the civilian population or any segment thereof in furtherance of political or social objectives. The actions are not a natural disaster. Casualty refers to the person who is injured or killed by or as a direct result of an accident. An adventitious crisis is an event that is out of the ordinary in magnitude and personal experience. After teaching a group of students about agents associated with chemical warfare, the instructor determines that additional teaching is needed when the students identify which as an example? A) Explosives B) Nerve agents C) Anthrax D) Jet fuel C) Anthrax Anthrax is considered a bioweapon. Explosives, nerve agents, and jet fuel are considered agents of chemical warfare. Which of the following would be most appropriate for community health nurses to encourage when helping communities cope with the anxiety associated with terrorism? A) Maintaining high levels of alertness and fear B) Spending time with children and young people C) Spending more time indoors D) Keeping a fear journal B) Spending time with children and young people Most young people carry a charge of positive energy that is infectious. Maintaining high levels of alertness and fear are not healthy. Instead individuals should be a little afraid because a certain level of fear is healthy if the person learns to use it as positive energy. Spending more time outdoors is helpful remedy. Individuals should keep a courage journal; fear immobilizes and courage takes action. A community health nurse is preparing a presentation for a community group about possible agents of terrorism. Which of the following would the nurse include as an example of a bioweapon? Select all that apply. A) Mustard gas B) Sarin C) VX gas D) Nerve agents E) Bombs A) Mustard gas B) Sarin C) VX gas Bioweapons include mustard gas, sarin, VX gas, and anthrax. Nerve agents and bombs are examples of chemical warfare agents. A community health nurse is working with other professionals to develop preventive programs to address the leading cause of death in men and women. Which of the following would be appropriate? A) Risk reduction for heart disease B) Cancer screening C) Safety education D) Flu vaccine immunization A) Risk reduction for heart disease The leading cause of death for men and women is heart disease. Therefore, risk reduction for heart disease would be most appropriate. Cancer screening, safety education, and flu vaccine immunization would be appropriate for cancer, the second leading cause of death; unintentional injuries, the third leading cause of death in men; and influenza and pneumonia, the eighth leading cause of death in men and women respectively. Which of the following would the community health nurse identify as a key aspect for this community's ability to follow through with the teaching? A) Life expectancy B) Health disparity C) Health literacy D) Financial ability C) Health literacy Health literacy is a critical aspect of managing health problems and a key to being able to read and understand health information so that individuals can follow through and make appropriate health decisions. Low health literacy also contributes to health disparities, a difference in health status due to sex, race, or ethnicity. Life expectancy is the average number of years an individual member is projected to live. It is a standard measurement unrelated to the ability to follow through with teaching. Financial ability may impact a person's ability to obtain needed services, but it is not a key aspect. When assessing a population for health disparities, which of the following would the nurse least likely evaluate? A) Race B) Education C) Age D) Sexual orientation C) Age A health disparity is defined as a difference in health status that occurs by sex, race or ethnicity, education or income, disability, geographic location, or sexual orientation. Age would not be used to assess health disparity. Which one of the following statements about life expectancy is most accurate? A) The life expectancy for White women is 4 years greater than for Black women. B) The life expectancy for Black men is 6 years greater than for White men. C) In the United States, life expectancy continues to decline. D) There is a gap in life expectancy between women and men of more than 6 years. A) The life expectancy for White women is 4 years greater than for Black women. The life expectancy for White women is 4 years greater than for Black women. The life expectancy for White men is 6 years greater than for Black men. In the United States, life expectancy continues to increase consistently over time. The gap in life expectancy between women and men was 5.0 years in 2007. A community health nurse is working with a grant funded project to address stroke prevention nationwide. After reviewing statistics related to stroke, which would the nurse identify as having the greatest need for this type of program? A) North central B) Southeast C) Southwest D) Pacific northwest B) Southeast The nurse would identify the southeast as the area of greatest need because here. Known as the stroke belt, stroke death rates for both Blacks and Whites are higher than in anyother part of the country. The nurse educator is aware that the nursing student has a grasp of the major health problems of adults when the nursing student makes which one of the following statements? A) "Morbidity and mortality among adults does not vary much by age, gender, and race/ ethnicity." B) "The six leading causes of death in adults include suicide, Alzheimer's disease, and homicide." C) "Diseases of the heart and cerebrovascular diseases are the first and third causes of death in adults." D) "Malignant neoplasms, chronic lower respiratory diseases, unintentional injuries, and diabetes mellitus are not among the sixleading causes of death in adults." C) "Diseases of the heart and cerebrovascular diseases are the first and third causes of death in adults." The following statement is true: "Diseases of the heart and cerebrovascular diseases are the first and third causes of death in adults." Morbidity and mortality among adults varies substantially by age, gender, and race/ ethnicity. Malignant neoplasms, chronic lower respiratory diseases, unintentional injuries, and diabetes mellitus are among the six leading causes of death in adults. Causes of death in adults that are not among the six leading causes of death include suicide,Alzheimer's disease, and homicide. The following is a list of the top five causes of unintentional injuries accounting for the majority of adults deaths due to injury. Order these in their proper sequence from first to fifth. A) Fire arms B) Suffocation C) Motor vehicle crashes D) Poisoning E) Falls C) Motor vehicle crashes A) Fire arms D) Poisoning E) Falls B) Suffocation The top five causes of unintentional injuries include motor vehicle crashes, fire arms, poisoning, falls, and suffocation. Together, these causes account for approximately 80%of all injury deaths. A community health nurse is preparing a presentation about drug use and abuse for a group of adults. Which of the following would the nurse include as the one of the fastest growing forms of drug abuse? A) Cocaine B) Alcohol C) Prescription drugs D) Heroin C) Prescription drugs Illegal use of prescription drugs is one of the fastest growing forms of drug abuse, and it is becoming a major public health concern. The primary illicit drugs used in the United States, such as cocaine and heroin, have and continue to be a public health problem. Alcohol abuse also is a public health problem and is considered the third leading lifestyle-related cause of death for people living in the United States. After teaching a group of students about the major types of cancer affecting men and women, the instructor determines that the teaching was successful when the students identify which of the following as the number one cause of cancer deaths among adults? A) Colon B) Pancreatic C) Esophageal D) Lung D) Lung Lung and bronchus cancers are the number one cause of cancer deaths among adults. Colon and rectal cancers are the third most common cancers in adults. Pancreatic and esophageal cancers are less common causes of cancer death. A patient comes to the community health clinic with complaints of changes in urination. Which of the following would lead the community health nurse to suspect that the patient has benign prostatic hypertrophy (BPH)? A) Nighttime frequency B) Dysuria C) Hematuria D) Flank pain A) Nighttime frequency The symptoms of BPH vary, but the most common ones involve changes or problems with urination, such as hesitant, interrupted, or weak urinary stream; urgency or leaking of urine; and more frequent urination, especially at night. Dysuria may indicate a urinary tract infection. Hematuria could suggest a variety of problems, such as infection calculi, or cancer. Flank pain may indicate conditions such as pyelonephritis or renal calculi. When developing community health programs target to adult men, which of the following would the nurse need to integrate into the plan? A) Improved quality of education programs available for men B) Increased access of health services by men as compared to women C) Limited male-gender specific research D) Increased awareness of men's health issues C) Limited male-gender specific research The current state of men's health involves a lack of quality health education programs for men, health care services that are only accessed half as much by men when compared to women, and a lack of male gender-specific research. In addition, awareness of men's health issues is lacking. Currently, there is no Office on Men's Health in the U.S. Department of Health and Human Services; legislation to establish such an office has been introduced; however, the bill did not progress out of the congressional subcommittee on health and has not been reintroduced. A community health nurse is reviewing research related to women's health. Which of the following would the nurse use to obtain information about postmenopausal women's health? A) The Women's Health Study B) The Women's Health Initiative C) The Nurses' Health Study I D) The Nurses' Health Study II B) The Women's Health Initiative The nurse would use The Women's Health Initiative. This study was a major 15-year research program addressing the most common causes of death, disability, and poor quality of life in postmenopausal women— CVD, cancer, and osteoporosis. The Women's Health Study evaluated the effects of vitamin E and low-dose aspirin therapy in primary prevention of CVD and cancer in apparently healthy women. The Nurses' Health Study I investigated the potential long-term consequences of the use of oral contraceptives. The Nurses' Health Study II studied oral contraceptives, diet, and lifestyle risk factors in a population younger than the original Nurses' Health Study cohort. While working in a community health clinic, a community health nurse interviews a 24-year-old client. Which of the following would lead the nurse to suspect that the client is binge eating? A) Significant weight loss from dieting last year B) Participation in excessive exercise C) Exaggerated concern about body shape D) Severe emaciation A) Significant weight loss from dieting last year Binge eating is an eating disorder that is characterized by repeated episodes of uncontrolled eating. It usually starts following significant weight loss from dieting. Typically, individuals with this disorder eat quickly, eat until they are uncomfortably full, eat when they are not hungry, eat large amounts of food alone, have difficulty expressing their feelings, have difficulty controlling impulses and stress, and feel depressed about overeating. Participation in excessive exercise and an exaggerated concern about body shape is usually associated with bulimia. Severe emaciation is associated with anorexia. Which of the following statements by a women's group indicates that they have understood the teaching about heart disease and women? A) "More women die of breast cancer than heart disease." B) "Women experience similar symptoms as men." C) "Hormone replacement therapy protects the heart." D) "Heart disease is the number one killer of women." D) "Heart disease is the number one killer of women." Heart disease is the number one killer of women. One in 2.6 female deaths is from cardiovascular disease, compared to 1 in 30 from breast cancer. Women have atypical symptoms or less acute chest pain than men, often leading them to delay care. Hormone therapy does not reduce coronary events. Which one of the following statements about coronary heart disease and stroke are most accurate? A) Cardiovascular disease kills more women than men. B) Stroke kills more men than women. C) White persons are more likely to have their first stroke earlier than Black persons. D) Risk factors for cardiovascular disease are not known. A) Cardiovascular disease kills more women than men. Cardiovascular disease kills more women than men. Stroke kills more women than men. Black persons are more likely to have their first stroke earlier than White persons. Risk factors for cardiovascular disease are known. Some are controllable such as lifestyle, and some are uncontrollable such as heredity. A community health nurse working in a local women's health clinic is planning a teaching session for a group of women about menopause. Which of the following would the nurse include in the session? A) Menopause involves very noticeable and characteristic symptoms. B) The symptoms are usually temporary lasting for a month or two. C) It can occur as early as age 30 but more commonly ages 45 to 55 years. D) Going 6 months without a period signals menopause. C) It can occur as early as age 30 but more commonly ages 45 to 55 years. Menopause is a time that marks the permanent cessation of menstrual activity. It usually occurs between the ages of 45 and 55 years. However, it can occur as early as age30. Symptoms of menopause vary among women and last from months to years. They range from hardly noticeable in some women to very severe in others. Natural menopause is when a woman has not had a period in 12months (no other apparent causes). During a home visit to a family, a community health nurse encourages the mother, aged 42, and grandmother, aged 67, to have a clinical breast exam at which frequency? A) Monthly B) Yearly C) Every 2 years D) Every 3 years B) Yearly Clinical breast exams, performed by a health care provider should be done every year for each of these women. They should also perform breast self-exam every month. The mother at her current age should have a physical examination every 2 years. Both the mother and grandmother should have a pelvic exam and Pap smear done every 3 years after three consecutive negative Pap smears. As part of a health screening program, a community health nurse determines that a client is infected with the human papilloma virus (HPV). The community health nurse encourages the client to do which of the following? A) Get a mammogram immediately B) Have her blood glucose level checked C) Undergo testing for a breast cancer gene D) Have a pelvic examination and Pap smear D) Have a pelvic examination and Pap smear Infection with certain types of human papilloma virus is associated with an increase risk for developing cervical cancer. Pap smears have improved early detection and prevention of cervical cancer dramatically. HPV infection is not associated with breast cancer, so there is no need for a mammography or testing for a breast cancer gene. HPV is not associated with diabetes so blood glucose testing is not indicated. A nurse is instructing the adult male members of a family on how to perform testicular self examination. Which of the following would the nurse include? A) Performing the examination every 3 months B) Completing the exam right after a hot shower C) Examining both testicles at the same time D) Reporting a slight difference in size of one testicle B) Completing the exam right after a hot shower A testicular self-examination should be performed monthly right after a hot shower or bath. One testicle is examined at a time. One testicle, usually the right one, is normally slightly larger than the other. Which one of the following statements best describes the role of the community health nurse in promoting the health of adult men 35to 65 years of age? A) Anticipatory guidance to men approaching each stage and help them with ways to manage life more effectively. B) Men of this age do not need to enhance their self-care skills. C) A positive attitude toward aging is not helpful to men at this time in their lives. D) Men of this age should exercise sporadically. A) Anticipatory guidance to men approaching each stage and help them with ways to manage life more effectively. The community health nurse can provide anticipatory guidance to men approaching this stage and help them with ways to manage life more successfully. Successful navigating this stage of life can be fulfilling but may require a man to enhance his self-care skills. This includes having a positive attitude toward aging, one that examines the benefits of maturity, finds a balance between work and home, and maintains a healthy lifestyle by eating balanced meals and obtaining regular exercise. When developing a plan of care for a group of male patients experiencing erectile dysfunction, which of the following would the nurse expect to institute first? A) Lifestyle changes B) Adjustments to current medications C) Psychotherapy D) Behavior modification A) Lifestyle changes Treatment for ED usually proceeds from least to most invasive. For some men, making a few healthy lifestyle changes may solve the problem. Smoking cessation, weight loss, and increased physical activity may help some men regain sexual function. Cutting back on any drugs with harmful side effects is considered next. For example, drugs for high blood pressure work in different ways. If a particular drug is causing problems with erection, a different class of blood pressure medicine might work just as well. Medications, psychotherapy and behavior modifications would follow. Which of the following would a community health nurse recommend adult men and women over the age of 50 receive yearly? A) Electrocardiogram B) Tetanus booster C) Flexible endoscopy D) Hemoccult stool testing D) Hemoccult stool testing Men and women over the age of 50 should receive yearly physical exams and hemoccult stool testing, electrocardiograms every 3 years, tetanus booster every 10 years, and flexible endoscopy every 3 to 4 years. A community health nurse, who is working with a program to foster early detection of prostate cancer, recommends prostate-specific antigen testing and a digital rectal exam for men with average risk starting at which age? A) 40 years B) 45 years C) 50 years D) 55 years C) 50 years The American Cancer Society recommends that screening of men who are at average risk should begin at age 50 years and should include a blood test to assess PSA levels and a digital rectal examination. When describing the changes occurring in the older adult population globally, which of the following would be most accurate? A) The over-80 years age group is the fastest growing segment of the group. B) Males have a longer projected life expectancy when compared with females. C) Most countries have adequate numbers of social programs for older adults. D) Adults over age 65 are expected to account for about 25% of the population by 2050. A) The over-80 years age group is the fastest growing segment of the group. In most of the world, the population of those over 80 years of age is growing faster than any other population age group. A higher life expectancy at birth for females compared with males is almost universal. Many countries have few or no social programs available for older adults. By the year 2050, one tenth of the population is expected to be over the age of 65 years. A community health nurse is working with an older adult population ranging in age from 75 to 85 years. The nurse correctly classifies this group as which of the following? A) Young-old B) Old-old C) Oldest-old D) Elite-old B) Old-old Those between the ages of 65 and 75 are classified as "young-old," while those between 75 and 85 are labeled "old-old." The number of people living into "older" old age (75 years and older) is increasing. Forty percent of elderly people in the United States are among the "oldest-old" (85 to 100 years), while more than 200,000 are among the elite- old, or centenarians. While working with another group of community health nurses, a nurse overhears one of the nurses saying, "That older man should just retire. He's 70 years old. How productive can he be?" The nurse interprets this statem