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

…..DLDD NR 442/NR442 Exam 3 (NEW 2026–2027 Updated) |Community Health Nursing | Comprehensive Questions & Answers | Accurate Verified Solutions – Chamberlain Q. The nurse is working with a group of clients to increase their physical activity levels. The group has developed a plan to meet three times a week at a local walking trail. The clients are in which phase of making change? A) Preparation B) Motivation C) Maintenance D) Action E) Contemplation Answers Preparation Q. The nurse is caring for a client whose mother has type 2 diabetes. Which recommendations should the nurse make? SATA Answers -Use a fitness tracker to track steps -Review nutritional information when dining out -Take the stairs instead of the elevator -Keep fresh fruit and vegetables available -Schedule walking dates with friends ALL OF THE ABOVE Q. Which are examples of programs or activities to promote health equity? SATA Answers -Adapting work policies to include culturally appropriate materials -Conducting assessments of kindergartner's readiness for school -Collaboration of local businesses, organizations, and government to improve recreational areas -A free health care clinic with evening hours -A community garden built to supply fresh produce ALL OF THE ABOVE Q. A client with an increased risk of heart disease decides to stop smoking to reduce their risk. When the client is in which phase are they most likely successful at smoking cessation? A) Contemplation B) Action C) Maintenance D) Preparation E) Precontemplation Answers Maintenance Q. The nurse is caring for a client diagnosed with type 2 diabetes mellitus five years ago. The client has a family history of type 2 diabetes mellitus, is Hispanic, is overweight, had gestational diabetes 10 years ago, and developed high blood pressure last year. Which type 2 diabetes risk factors increased this client's risk? SATA Answers -Hispanic -Family history -History of gestational diabetes -Weight -Hypertension ALL but hypertension Q. Which categories of social determinants of health? SATA Answers -Social and community context -Economic stability -Healthcare access and quality -Neighborhood and built environment -Education access and quality ALL OF THE ABOVE Q. Which are examples of issues related to social determinants of health? SATA Answers -Adequate food supply -Exposure to air pollution -Lack of handicapped accessible sidewalks -Racism -Poor health literacy ALL OF THE ABOVE Q. Which objectives are examples of social determinants related to healthcare access and quality? SATA Answers -Increase the proportion of people with a usual primary care provider -Increase the proportion of adults with broadband access to the internet -Increase the proportion of people with dental insurance -Increase the proportion of students who graduate with a regular diploma 4 years after starting 9th grade -Increase employment in working-age people Increase the proportion of people with a usual primary care provider + increase the proportion of people with dental insurance Q. Which questions should the nurse ask a client when assessing economic stability? SATA Answers -"Are you able to eat three healthy meals a day?" -"In the last 12 months, has your electric, gas, oil, or water company threatened to shut off services?" -"How often do you feel you do not have enough money to pay your bills?" -"How often does anyone threaten to harm you?" ALL, except "How often does anyone threaten to harm you?" Q. A nurse is caring for a client who has adequate health insurance. Which assessment findings contribute to the client having inadequate health? SATA Answers -Only seeing a physician for health problems -Low health literacy -Only seeing the dentist when in pain -Limited transportation ALL OF THE ABOVE Q. The nurse is caring for a client in a primary care facility. Which assessment findings reported by the client are related to social determinants of health? SATA Answers -A great amount of smog in their community -Discrimination in the workplace -Not taking prescribed hypertension medication -Occasionally running out of food -Difficulty making rent payments ALL except Not taking prescribed hypertension medication Q. Which aspects of social determinants of health are positively impacted by a person having a high-paying job with health insurance? SATA Answers -Food security -Choice of location of their home -Ability to own a home -Access to healthcare -No access to preventative health services ALL except No access to preventative health services Q. The nurse is caring for a client with a low income who reports that they have missed work because they share a vehicle that is not always available. Which actions should the nurse take? SATA Answers -Assess access to public transportation -Provide a bus schedule -Recommend purchasing another vehicle -Explore other transportation options -Refer to social services for a bus pass ALL except Recommend purchasing another vehicle Q. Which assessment findings indicate the family is at risk for poor health and well-being? SATA Answers -School suspensions -Incarcerated parent -Employment status -Income -Exposure to violence ALL OF THE ABOVE Q. Private Healthcare Subsytem Answers -Nonprofit agencies -Profit agencies -Voluntary agencies Q. Public Healthcare Subsytem Answers -Federal programs -State programs -Local programs The public health nurse us evaluating nutrition services provided by a local health department. Which components should the nurse examine to evaluate the quality of the care services? SATA -Equity -Safety -Effectiveness -Timeliness -Client-centered -Efficiency ALL OF THE ABOVE The nurse is caring for a low-income family who needs assistance with healthcare insurance. Which insurance programs are available for clients who qualify? SATA -Supplemental Nutrition Assistance Program (SNAP) -Medicare -Nutrition Program for Women, Infants, and Children (WIC) -Children's Health Insurance Program (CHIP) -Medicaid Children's Health Insurance Program (CHIP) + Medicaid Health services considered Private Healthcare Subsytem -Healthcare provided by St. Jude for a child with cancer -Healthcare provided in a cardiology office Health services considered Public Healthcare Subsytem -Healthcare provided at a Veteran's Affairs outpatient clinic -Healthcare provided at a correctional facility Health services provided from local level -Follow up on reports of communicable disease outbreaks -Inspect restaurants for food safety Health services provided from state level -Manage licensing of nurses Health services provided from federal level -Collaborate with the World Health Organization -Manage healthcare services for veterans A nurse is conducting a blood pressure screening at a health fair and identifies several clients who require referral to a provider. Which client statement indicates a barrier to accessing healthcare? A)"My insurance will only pay for one healthcare provider in my town" B)"I do not drive, and my son is only available to take me places in the morning" C)"I work during the day and the local after-hours clinic is no longer in operation" D)"I schedule appointments with the local healthcare provider who speaks Spanish and English" C)"I work during the day and the local after-hours clinic is no longer in operation" A public health nurse is reviewing the outcomes of an education class about diabetes. The class was held at three different locations, each near public transportation. Which aspect of quality does this finding most support? -Effectiveness -Timeliness -Client-centered -Equity -Safety -Efficiency EQUITY Which components should the nurse consider when assessing environmental health? SATA -Water quality -Outdoor air quality -Work-related exposures -Waste management -Healthy homes -Natural environment -Food safety ALL except Natural environment In which situation does the nurse use the mnemonic, "I PREPARE?" A) Identifying disaster resources B) Creating environmental disaster plans C) Assessing for environmental exposure D)Monitoring air and water pollution exposure People should avoid outdoor activities when the air quality index is high because it indicates less healthy air quality and can cause negative health effects. Poor outdoor air quality negatively impacts the ____ system and can cause _______. Respiratory Airway inflammation The public health nurse received several phone calls from clients experiencing sudden symptoms of abdominal pain, diarrhea, and fever after eating at a local restaurant. Which actions by the restaurant cooking staff could have contributed to the illnesses? SATA -Using the same knife to cut raw meat and cheese -Storing food at recommended temperatures -Storing raw meat with raw vegetables -Washing hands after handling raw meat -Tawing meat at room temperature USING THE SAME KNIFE TO CUT RAW MEAT AND CHEESE, STORING RAW MEAT WITH RAW VEGETABLES, THAWING MEAT AT ROOM TEMPERATURE The nurse at a health department receives a call that a family has become ill with diarrhea and vomiting after swimming in a local lake. What actions should the nurse take? SATA -Notify the beach manager to close the beach -Notify the state health department -Inform the client that the contamination is from recent rain -Recommend supportive care for vomiting and diarrhea -Assure the client that the water is tested daily NOTIFY THE STATE HEALTH DEPARTMENT, AND RECOMMEND SUPPORTIVE CARE FOR VOMITING AND DIARRHEA The nurse is assessing a client's potential exposure to environmental hazards. The client works as a radiology tech. Which assessment questions should the nurse ask? SATA -"Where does your drinking water come from?" "Do you wear a lead shield at work?" -"What year was your home built?" -"Is there a history of heart disease in your family?" -"Where do you live?" ALL EXCEPT "Is there a history of heart disease in your family" A public health nurse assessed the following factors. Which factors place the family at risk of exposure to environmental hazards? SATA -Living near a plastic and rubber manufacturer -Living in an old, overcrowded apartment building -The highest level of education is 9th grade -Working in a low paying manufacturing job -Food supply supplemented by food bank ALL EXCEPT The highest level of education is 9th grade Place the policy process steps in order from first to last 1) Problem identification 2) policy analysis 3) Strategy and policy development 4) Policy enactment 5) Policy implementation Which are ways that nurses can influence health policy? SATA -Severe on a health department advisory board -Conduct health policy research -Avoid conversations about controversial health policy -Write letters to legislators about healthcare issues -Vote for candidates who support needed healthy policy ALL EXCEPT Avoid conversation about controversial health policy The Affordable Care Act, also known as the Health Care Reform Act, made significant changes to _____ and helped shift the focus of health care from _____ to _______. Health care insurance Treatment of illness Health promotion and wellness The nurse recognizes that there is a significant number of children in the state with special health needs. Which actions by the nurse reflect the essential public health services? SATA -Educate others about the lack of health services available for children with special health needs -Develop partnerships to help identify solutions to increase access to support services -Develop policies and plans that support children with special health needs -Advise on a policy-making board to assure the needs of children with special health needs are met -Evaluate the effects of implementing programs to support children with special health needs ALL OF THE ABOVE What are barriers to health policy development and implementation? SATA -Political barriers to getting a public health issue on the health board agenda -Lack of dedicated funding for public health programs -Policies developed that promote equitable distribution of services -Public's lack of understanding about a policy issue -Policies based on health service research ALL EXCEPT Policies developed that promote equitable distribution of services & Policies based on health service research Lobbying A nurse presents to legislature about the opioid epidemic and treating dependency Political Action Committee A group supporting financially and work to elect nurse champions to public office Campaigning A nurse sending out letters in support of electing someone to office Change Agent A nurse serving on a state board of health immunization advisory committee Title VIII Nursing Workforce Reauthorization Act supports which aspects of nursing workforce development? SATA -Increase the number of associate and baccalaureate degree nurses -Increase the number of nurses trained to care for older adults Increase the number of nursing faculty -Increase diversity of the nursing workforce -Increase the number of colleges of nursing ALL except Increase the number of colleges of nursing A nurse supporting legislation to provide health care through Medicaid to undocumented children promotes ____. A nurse supporting legislation to allow advanced practice nurses to practice at the full extent of their licensure promotes ____. Health equity Health care access A health care facility experienced an increase in medication errors involving clients after transfer of care. Place the action in the order they should be performed. 1) The workgroup identified there was no standard process for medication reconciliation 2) An evidence-based medication reconciliation toolkit was identified by the workgroup 3) A medication reconciliation policy was drafted with input from unit councils and information technology regarding integration with the electronic health record 4) The medication reconciliation policy was approved through shared governance 5) Nursing staff utilized the medication reconciliation process during transition of care and charts were monitored for compliance Which actions by the public health nurse are considered advocacy on behalf of families living in poverty? SATA -Collaborating with local agencies to promote resources available to those in poverty -Initiating public discussion of the impact of poverty on health -Supporting local anti-poverty groups -Building a solid evidence-base of data related to poverty to support the need for change -Presenting the issue of family poverty at professional organization meetings ALL OF THE ABOVE How would you describe the quality of water in our country today More than million Americans drink dirty water daily , Once underground water is contaminated it cannot be cleaned, Can be contaminated with pesticides, construction Who can receive medicare benefits Permanently disabled, Renal, ALS, Federal employees, 65 or older, Eligible for social security Example of modifiable risk factor for HTN Diet, Exercise, More water, Less salt, Decrease high fat foods, Smoking/vaping Umbrella - which federal agency administers most health care related activities HHS - US department of health and services You are giving a presentation to seniors about preventing artheroscolisis. What are modifiable risk factors Smoking, Activity, Diet, Obesity - HTN and high cholesterol What are some pollutants in air in urban areas Carbon monoxide, Nitrogen, Sulfur dioxide What kind of symptoms would you see in a pt that's having asthma attack Labored breathing, Accessory muscle use, Wheezing, Chest feels tight, Tachycardia, Nasal flaring When working with pts with HIV, what are some disease that they could develop due to immune status Pneumonia, TB If you have a asthma pt having an attack at home, what is the go to drug Albuterol Working in correctional facility and there are several different pts with illnesses, would you worry about a 15 year old being quite in adult facility Yes, suicidal ideation, bullying What kind of assessment or screening does a school nurse do Vision and hearing, Scoliosis, Blood pressure, Height and weight If a hospice pt wants to continue to receive curative care, can they stay on hospice No Environment for a community, food or food production, what are some issues that might concern you Pesticides, Preservatives, Urban areas - food desert - not enough grocery stores, GMO's - no idea what they will do Vaping better than smoking? No What are examples of modifiable behaviors for adults Smoking cessation, Diet and exercise, Drinking, Vaccines Medicaid is primarily for people who meet which of the following requirements? a. low income b. disabled c. children d. elderly a. low income a deductible is: a. A set proportion of the medical cost that the insured must pay out of pocket b. The amount the insured must pay each year before the plans begin to pay c. Always the same amount for all insurance plans d. A flat amount an insured must pay each time health services are used b. The amount the insured must pay each year before the plans begin to pay during the orientation of new nurses to an acute care facility, diagnosis-related groups (DRGs) are discussed. which statement by one of the nurses orientees indicates an accurate understanding of DRGs? a. "DRGs are a predetermined amount that will be paid for a client with a specific diagnosis." b. "DRG rates are fixed, regardless of the occurrence of major uncontrollable events." c. "DRG rates are grouped by client age, with a predetermined rate of pay determined by client age." d. "DRG rates are revised quarterly to reflect the constant changes that occur in the healthcare system." a. "DRGs are a predetermined amount that will be paid for a client with a specific diagnosis." What is the common practice of employers requiring employees to pay a portion of the health cost of health insurance premiums referred to as? a. prospective payments b. fee for service c. bundle pricing d. cost-sharing d. cost-sharing The nurse is caring for a patient in the acute care hospital. She notices in the chart that patient has Medicare listed as the primary insurance. Which part of the Medicare plan will cover the cost of this inpatient stay? a. Part A b. Part B c. Part C d. Part D a. Part A MCO stands for: a. managed care organization b. managed clinical office c. managed clinical organization d. managed care office a. managed care organization Patient with insurance tend to use more health care which results in greater utilization of services. This is called _________________________________. a. cost sharing b. moral hazard c. economics d. risk b. moral hazard Medicare is primarily for people who meet the following eligibility requirement. a. low-income b. elderly c. children d. disabled b. elderly Which type of health insurance plan requires the participant to select a primary care provider? a. preferred-provider organization (PPO) b. health maintenance organization (HMO) c. children's health insurance program (CHIP) d. high deductible health plan b. health maintenance organization (HMO) I.H.S. provides health care services to which of the following groups? a. American Indian and Alaska Natives b. International citizens born outside of the Unites States c. active duty and retired armed forces individuals d. Any individual on an income based sliding scale a. American Indian and Alaska Natives what is a civil wrong committed against an individual? a. tort b. crime c. misdemeanor d. arson a. tort what is a 'reasonable person'? a. The patient in a patient-provider relationship b. an individual in society that exercises average care, skill, and judgment c. An employer that is also names with a nurse in a lawsuit d. a person who lost the ability to work due to injury b. an individual in society that exercises average care, skill, and judgment what is a "respondeat superior"? a. "unjustifiable detention" b. "The thing speaks for itself" c. "The right to privacy" d. "Let the Master answer" d. "Let the Master answer" what is a 'breach of duty"? a. a nurse should reasonably anticipate that damage would result from acts or omissions b. An injury was a direct result from a professional not following the standard of care c. a deviation from the standard of care d. an obligation to adhere to a specific standard of care c. a deviation from the standard of care which of the following is not considered an invasion of privacy? a. Touching a patient's belongings without asking b. using a patients' picture without their consent c. Sharing patient information with authorization to a healthcare provider d. entering a patient's room without knocking c. Sharing patient information with authorization to a healthcare provider what is the term used to describe conduct that deviates from the standard of practice? a. malpractice b. negligence c. assault d. law a. malpractice how is the standard of care defined at an agency where a nurse works? a. based on physician's orders b. with nursing education textbooks c. with policies and procedures d. with trust that the nurse knows what to do c. with policies and procedures forcing a patient to ambulate against their will is an example of: a. false imprisonment b. battery c. negligence d. assault b. battery a nurse has been found in possession of illegal controlled drugs that were stolen from a patient. what category of law is this? a. criminal law b. statutory law c. constitutional law d. contract law a. criminal law what are statutory laws? a. Defines conduct that is harmful to another individual b. policies and procedures c. laws made by the legislative branch of the government d. Laws that deal with the rights and duties of citizens c. laws made by the legislative branch of the government