NUR 257 / NUR257 Exam 4 V1 – Concepts of Aging and Chronic Illness in Nursing Review (Latest 2026/2027 Update) | Galen | Complete Study Guide | Verified Questions & Answers | 100% Correct Solutions | Grade A

NUR 257 / NUR257 Exam 4 V1 – Concepts of Aging and Chronic Illness in Nursing Review (Latest 2026/2027 Update) | Galen | Complete Study Guide | Verified Questions & Answers | 100% Correct Solutions | Grade A Q: Your patient has been diagnosed with squamous cell carcinoma. What type of lesion would you expect to see on this patient? Answer Firm, irregular, flashy, pink nodule Q: You just finished a continuing education session about rapid eye movement. Sleep behavior disorder. You hear your coworkers discussing the content. Which of the following statements indicates correct understand understanding. Answer This is most likely to occur in men over 60 Q: You are orienting a new nurse and reviewing her plan of care for the day to prevent pressure injury for her patients. Which of the following would you re-educate her about? Answer She should not position a paraplegic patient for comfort so that they can rest for the day Q: You just received your patient assignment for the day. They are all day postop hip replacements. Which of the following patients would you assess first? Answer The patient that has not had a bowel movement since surgery Q: You are working at a rehab facility and admitted a client he has had difficulty sleeping since admission. Which of the following actions should you implement first? Answer Ask the patient what time they typically go to bed at home and implement into the plan of care. Another answer choice: cluster care Q: Your patient reports they have been experiencing insomnia for several weeks. What is the best intervention for you to educate them about? Answer Use dim lighting in the bedroom and put earplugs in before falling asleep. Q: You're educating a patient about management of restless leg syndrome. Which of the following is a recommendation intervention? Answer Implementing a stretching routine before bed Q: You were educating your silver sneakers group about sleeping patterns in the older adult. Which of the following when stated by members of the group indicates correct understanding? Answer Chronic illnesses can affect the quality of my sleep Q: You just completed you're continuing education about sleep disturbances in the older adult. Which of the following indicates correct understanding? Answer REM sleep decreases with age Q: Your UAP reported a fall with injury on one of your patients. Which of the following requires immediate follow up when stated by the UAP Answer "He fell while trying to get back in bed after using the bathroom." Another answer choice: "The client was trying to reach their wheelchair after using their bedside commode" Q: You see your UAP put four rails app on a patient who will not stay in bed. You educate the UAP that the appropriate number of side rails is not to be considered a restraint is. Answer 2 half length rails Q: Care for client high risk for falling, won't stay in bed, PCP puts order in for side rail restraints only. What should the nurse use? Answer Two full length rails Q: Which of the following has the highest risk for falls? Answer A patient with a shuffling gate Q: You are working on the palliative care unit. It is appropriate to decrease the amount of pain medication when a patient.? Answer Request a smaller dose so they can be awake for family visits Q: You are orienting a new nurse and you have a patient with a morphine PCA. Which of the following would require education if done by this new nurse Answer Giving amitriptyline as an adjuvant medication...this is wrong Q: You have a patient who is deaf in one ear. Which action would be best for the Nurse to take Answer Face the patient, keep hands away from the face when speaking Q: You were educating a client who just had cataract removal. Which of the following events would you instruct the patient to call the provider immediately? Severe pain-Call the doctor Answer Common in postop patients: itchy, eyes, clear, teary, discharge, and blurry vision Q: You're assessing a patient and they state it feels like a curtain is being lowered over their vision field. Which diagnosis is consistent with this complaint? Answer Retinal detachment. Patient can also complain of floaters. Q: You're assessing your patient with the history of arthritis. You notice an elevation and heart rate and blood pressure when you take the vital signs. Which of the following is most appropriate action to take? Answer Ask the patient if they are in pain Q: You are assessing a client in a clinic setting who has been managing their gout. However, they are in the clinic because of a flareup. Which of the following would you associate with this exasperation? Answer I got engaged last weekend and we went to Broadway to celebrate Q: Which of the following are indications of hearing loss? Answer A)Frequently misunderstanding others B) ringing in the ears with dizziness C) accusing others of mumbling Q: You are teaching your client about oste-o-arthritis and how to slow down the progression of the disease. Which of the following indicates correct understanding when stated by the patient. Answer I will start doing water aerobics Q: You have a patient that you suspect is undiagnosed rheumatoid arthritis. Which of the following clinical manifestations would you assess for? Answer Low-grade fever, fatigue, anorexia, joint pain Q: You were taking care of a patient with primary open angle glaucoma. Which of the following would you expect to find during your assessment? Answer Eye ache, headache, fixed, and dilated pupil and complaints of tired eyes Q: You have a patient with rheumatoid arthritis who is prescribed prednisone daily. Which of the following would be important to include in your education to this patient? Answer Take a bone density scan every two years Q: What is diabetic retinopathy? Answer damage to the blood vessels in the retina; it can occur in both type one and type two diabetes patients. Q: This is a pain assessment in advanced dementia scale Answer PAINAD The thickening of the center of the retina, most common cause a visual loss attributed by diabetes Answer Diabetic macular edema A group of diseases that can damage the optic nerve. It is the second leading cause of blindness in the US. Answer Glaucoma; this is optic nerve damage with pressure A chronic, systematic, inflammatory joint disorder. Considered an autoimmune disorder. Rheumatoid arthritis Answer Never use heat. Can use cold packs, regular exercise, like walking and swimming meds NSAIDs and DMARDS. Patient had their first gout attack. What medication would you expect to provide teaching on? Answer Colchinine Patient with osteoarthritis, what would you instruct them how to slow the progression of their disease down? Answer Start swimming twice per week. And walking Who would be at most risk with osteopenia for osteoporosis? Answer Small framed man who smokes and take steroids for five years A patient who was newly diagnosed with osteoporosis, what would you teach this patient about safety in their home? Answer Remove rags from the floor Patient discharge for cataracts, if they experience_______they should immediately contact their Moderate or severe eye pain Patient with painful arthritic joints, what non-farm intervention can be done. Tens unit Client has been taking 20 mg prednisone daily for their rheumatoid arthritis, what precaution should the nurse advise the client about taking this medication? They will need to get a bone density test every two years Patient with long history of arthritis pain, present presents to the ED pulse 115, blood pressure 170/80, what intervention should be implemented 1st Assess the patient for pain Which of the following should the nurse include for exercises for people with osteoporosis? A brisk walk Giving pain meds to a client with left hip replacement surgery the nurse needs to remember Administer pain meds, but it's the lowest dose to prevent side effects. Administer opiates and titrate slowly. Attending an older client with impaired vision, which statement by the client requires further teaching I use a razor to shave my face in the morning Talking to a client with suspected hearing loss, what action by the client would reinforce this suspicion on discharge Speaking loud to the nurse, reports, dizziness, or ringing of the ears, turns her ear towards the person that is talking and complains that multiple people are mumbling when speaking Patient with primary open ankle glaucoma, what findings would you observe? Mild eye itching, aching with a headache, increase sensitivity to glare, progressive, deterioration of peripheral fields, fixed, dilated pupils, complains of tired eyes. Remember with open glaucoma, the side vision goes first comes down like a curtain. Client has neuropathic pain to lower extremities, what medication would be prescribed for this patient? Gabapentin Discharge instructions for laser surgery to remove cataracts, what statement indicates correct teaching I will avoid tying my own tennis shoes for several weeks following surgery. I will wear a slip on shoes. Working in long term care facility with multiple clients, highest priority client is The client who has not had a bowel movement in three days. Would need to perform a focus assessment. Implementing measures of preventing pressure ulcers, what action requires intervention if the nurse does this Client head of bed in semi Fowlers for comfort during the day is not correct Client might have rheumatoid arthritis. What should you assess for? Low-grade fever, fatigue, anorexia with weight loss Client has suspected retinal attachment when the client states this I have the sensation of a curtain being pulled over my vision Nurse is conducting an initial assessment on a client suspected of having sleep apnea which findings below confirm Sleeping with three pillows, daytime, sleepiness, reports of choking when waking from sleep. Frequent morning, headaches, complaints of insomnia, and daytime sleepiness Attending a conference as a nurse on sleep disturbances for the older adult, which statement is correct Time spent in bed increases, but time spent sleep decreases Sleep decreases with age Caring for older client, acute care, setting having difficulty sleeping at the facility and at home, you understand, which of the following regarding sleep patterns of the older adult population Chronic pain experienced by the client can interfere with quality and quantity of sleep as well as chronic illnesses Older client diagnosed with scabies, what should the nurse assess the client for? Curved or linear ridges of the skin, burrows, keeps patient up at night because he's scratching Older client admitted to rehab develops, alteration, and sleep pattern, what action is best promote sleep Have the client go to bed at the same time as he did at home? Firm, red, irregular Skelly spot on chest of client, nurse expects what Squamous cell carcinoma. This is the second most common cancer lesions began as firm, irregular, then turned fleshing pink. Most common and slow to grow. Triggered by extensive sun, exposure, chronic irritation, and ulcerations of skin. Basal cell Assessing elder client who frequently changes positions and wakes up during the night, which of the following factors does the nurse contribute to this issue? Osteoarthritis to both hips Client with reddened area over Coccyx, what values should the nurse monitor? Pre-albumin and lymphocytes Assessing a client diagnosed with herpes disaster, what would you find in this client? Painful vesicles with clear fluids and is very contagious Assessing paraplegic client from spinal cord injury, reddened area over hips and sacrum. What should the nurse do? Monitor hydration status and reposition every two hours Caring for older client suffering with mobility issues, which statement is correct regarding the use of assistive device devices Smart Caes provide feedback to the client and can detect when a fall has occurred Charge nurse reviewing incident with new nurse in which older client was injured by fall, which statement by the new nurse requires immediate follow up The client was trying to reach their wheelchair after using their bedside commode Client with osteoarthritis recently repaired hip fracture, what would be your priority nursing diagnosis? Decrease my ability due to surgical procedure Assessing older male client that has been determined high risk for falls, what intervention is important to implement first Provide journal at bedside along with call light to call for assistance A client with painful joints due to rheumatoid arthritis, which non-pharmacological therapy would you recommend Rheumatoid arthritis joints are warm and tender. Patients are stiff in the morning and last longer than 30 minutes. Treatment cold packs... Never heat! Regular exercise, walking, swimming. Educating a patient on macular degenerate disease. Which would you correlate with this disease? Smoking, genetic disposition A patient just returned from surgery. How would you ask them to rate their pain level? On a scale 1 to 10 You are treating patients with pain, which patient would be treated in adequately The patient with aphasia. Because they cannot tell you that they are in pain. You were in a clinic attending to a patient who was diagnosed with osteoarthritis. They have a low-grade fever and joint pain. What action should the nurse take next? Prepare the patient for labs Teaching a patient with hypertension, which teaching correlates with an understanding of an unmanaged diagnosis of hypertension Notify their PCP if they notice any changes in their vision Why should you have your elderly patients bring in all medications that they take? (OTC, herbal, etc.) To assess for possible drug interactions Fall RF Include: incontinence, burns, poor vision, sensory deficits, age, meds, weakness, environmental hazards, footwear, and some diseases/disorders. What meds can increase fall risk? BP meds and sedation Education for a pt on BP meds: change positions slowly (orthostatic hypotension) Example of environmental hazards that can increase the fall risk: -loose rugs -inadequate lighting Ways to decrease environmental hazards in the home of a patient at high fall risk? - add night lights - install handrails - remove loose rugs - clean environment with a clear path. What diseases/disorders could increase a pt's fall risk? Neurological and cardiovascular disorders. Those at risk for social isolation: those in frail health. primary prevention definition: maximizing health through strategies that are set in place before an illness or injury occur. Primary Prevent Examples: - immunizations - sunscreen - safety classes Secondary Prevention Definition: maximizing health through strategies that are set in place at the early stages of illness and injury. Secondary Prevention Examples: - ANY screening - BP screening, mass screening, etc. Houses built before 1978 used... lead-based paint Tertiary Prevention Definition: maximizing health and wellness through long-term management and treatment of persons with chronic conditions; QOL is maintained. Tertiary Prevention Examples: - support groups - palliative care - rehabilitation programs. Ethics: moral principles that govern a person's behavior or activities; Based on a well-founded standard of right and wrong. Autonomy: the right of an individual to make decisions for themselves Beneficence: do what is in the best interest of the pt Nonmaleficence: Do no harm. Justice: the fair distribution of rights and resources Veracity/Virtues: compassion, trustworthiness, integrity; commitment to tell the truth. Fidelity: keep faithful to ethical principles and the ANA code of ethics for nurses. Accountability: being held responsible for one's actions. Confidentiality: maintaining the client's privacy by not disclosing personal/health information. Definition of Neglect (Elderly): An intentional or negligent act that causes physical or emotional harm or leads to a serious risk of harm to a person over 60 years. Why do many elder abuse cases go unreported? the elderly may be afraid of further violence. Who are the MC abusers of the elderly? caregivers and family members. Who are particularly at risk for abuse? elderly with chronic illness and depletion of financial resources who are dependent on children and grandchildren. What are the 6 areas of abuse? - Neglect (willful and passive) - Physical - Sexual - Psychological - Financial - Abandonment Epidemiology: study of disease, causes, and health outcomes in a. population. What is the most important part of epidemiology? how to control a disease. Goal of Epidemiology: to prevent or limit the consequences of illness and disability in humans, as well as to maximize their state of health. Epidemiological Process: - A: data gathered; nature, extent, and scope of problem are defined; described by person, place, and time. - D: tentative hypothesis; data analyzed to test it. - P: plan are made to control and prevent. -I: actions are initiated to implement the plan. - E: actions are evaluated and report is made; further research if necessary. Incidence Rate: the rate of NEW CASES of a disease occurring in a population over a period of time. Prevalence Rate: measures the proportion of cases (OLD AND NEW) in a population over a period of time. Point Prevalence: proportion of a population that has the problem at a specific point in time. Period Prevalence: proportion of population that had the problem during a given time frame ("last 12 months") Outbreak: sudden increase of cases in a certain period of time, in a certain place; more limited geographically (school, city, etc.) Epidemic: unexpected increase of cases at a certain time, caused by a NEW infectious agent, in a population. Endemic: constant prevalence (predictable) of cases in a population or area (Flu season, Malaria to South America, etc.); unspecified time. Infectious Agent: germs, bacteria, viruses, and parasites. Reservoir: where the germ resides. Portal of Exit: where the germs leave the reservoir (mouth, cuts, stool) Transmission: how the germ gets around (airborne, droplet, etc) Portal of Entry: how the germ gets in (mouth, cuts, eyes) Susceptible Host: any person with weakened immunity (elder, babies, etc) Carrier: a PERSON or animal who harbors the infectious organism and transmits it, but shows no symptoms. Colonization: the PRESENCE of a microorganism in a host. Multiples but does not interact with the host (NO S/SX) Incubation Period: Time period between the initial contact with the agent and the appearance of s/sx. What is Cultural Competence? considering cultural aspects of health, illness, and treatment for each client or community. First Goal of Cultural Competence: know your own bias. Special Needs of Rural Population: Transportation needs. (Some hospitals have drivers) What can a RN NOT delegate to another healthcare personnel? their own assessment, education, charting, etc. Living Will: legal document that tells doctors how you want to be treated if you cannot make your own decisions about emergency treatment in the future. Durable POA: legal document that names your health care proxy. Health Care Proxy: A person who can make health care decisions for the pt. This person should be familiar with your values and wishes. S/Sx When Death is Imminent: - secretions - dyspnea - dehydration - anorexia - impaired skin integrity - delirium (irreversible) - N/V Nonpharmacological Care When Death is Imminent: - warm milk to promote sleep - back rub - change positions - music - meeting spiritual needs RESPECT PT CULTURE. Pharmacological Care When Death is Imminent: - administer pain meds routinely (around the clock); NOT PRN - Long-acting pain meds are ideal Underserved Population: homeless, povery/crime, people with disabilities. Common Chronic Diseases of the Underserved Population: heart disease, diabetes, HTN. What Method Should You Use for Patient Teaching? the teach-back method. Signs that the Pt is Not Understanding: laughing, blank staring, and not asking questions. Individual Health Assessment: Individualized care as needed. (playground injuries, sickness, bullying) Population-Based Assessment: In a school, these are typically periodic assessments done regularly throughout the school year. (immunizations, physicals, vision/hearing tests). Analysis of Vulnerability: identify unmet needs; relocation of at-risk people; sensor monitoring. A community lacing tornado sirens that lives in an area that experiences tornados (what is observation?) analysis of vulnerability. Assessment of Risk: After potential hazards are ID... the extent of damages and threats are estimated. Identification of Hazards: unique to a community; may involve propensity for natural disasters, chemical or radioactive spills, transportation accidents, etc. (incorporates historical data). Source of Contamination where the contaminants are from and what they are. Environmental Media & Transport Mechanisms: the environmental medium that the contaminant is in helps determine who is exposed and how they are exposed (water, lakes, plants, animals) Point of Exposure: the place where people come in contact with the contaminated medium. Route of Exposure: how the contaminant enters the body (eating, drinking, breathing, and touching). Focus of Caring for an Exposed Pt: - ID current/past exposures - try to mitigate or reduce adverse effects - eliminate exposures. Environmental Justice: the belief that no group of people should bear a disproportionate share of negative environmental health consequences, regardless of RACE, CULTURE, AND INCOME. When is Environmental Justice Important to Consider? when looking at the impact of the environment on a community. Natural Disaster: the result of a natural occurrence that impact the environment (earthquakes, floods, tornadoes, etc.) Accidental Disaster: those that happen as a result of circumstantial factors; usually are not deliberate; broadly defined. (human error, road conditions, etc) Terrorism: criminal acts, including against civilians, committed with the intent to cause death or serious bodily injury, or with intent of provoking a state of terror. (mass destruction, hostages, assassination). Preimpact Examples: - ice storm predicted with widespread electrical outages. -- establishing living quarters for those without heat. Impact Example: roads being salted; snow being shoveled so residents can get to temporary shelters. Postimpact Example: Ensuring the community has access to safe food and water after power outage for several days. 1/Red Tag: Unstable; injured and requiring immediate transfer. -Critical 2/Yellow Tag: Stable; injured and can wait to be transferred. -Urgent 3/Green Tag: injured with minor/less urgent needs. -Delayed 0/Black Tag: those who have died. -Expectant POD (Point of Distribution)/Emergency Dispensing Site centralized location where the public picks up emergency supplies, including food, water, and meds, following a disaster. When an ethical problem arises, which is the most important nursing responsibility? analyzing the ethical principles. When a germ enters the body, multiplies, and cause a reaction. infection Can a CNA provide postmortem care? YES In a low income country, what intervention is the most effective to decrease the incidence of diarrheal illnesses? provide sanitized drinking water. The Triad Model Includes... agent, host, and environment. The most common RF among underserved populations are...? social determinants of health What is the priority of a nurse during a chemical disaster? Don PPE Why should you have your elderly patients bring in all medications that they take? (OTC, herbal, etc.) To assess for possible drug interactions Fall RF Include: incontinence, burns, poor vision, sensory deficits, age, meds, weakness, environmental hazards, footwear, and some diseases/disorders. What meds can increase fall risk? BP meds and sedation Education for a pt on BP meds: change positions slowly (orthostatic hypotension) Example of environmental hazards that can increase the fall risk: -loose rugs -inadequate lighting Ways to decrease environmental hazards in the home of a patient at high fall risk? - add night lights - install handrails - remove loose rugs - clean environment with a clear path. What diseases/disorders could increase a pt's fall risk? Neurological and cardiovascular disorders. Those at risk for social isolation: those in frail health. primary prevention definition: maximizing health through strategies that are set in place before an illness or injury occur. Primary Prevent Examples: - immunizations - sunscreen - safety classes Secondary Prevention Definition: maximizing health through strategies that are set in place at the early stages of illness and injury. Secondary Prevention Examples: - ANY screening - BP screening, mass screening, etc. Houses built before 1978 used... lead-based paint Tertiary Prevention Definition: maximizing health and wellness through long-term management and treatment of persons with chronic conditions; QOL is maintained. Tertiary Prevention Examples: - support groups - palliative care - rehabilitation programs. Ethics: moral principles that govern a person's behavior or activities; Based on a well-founded standard of right and wrong. Autonomy: the right of an individual to make decisions for themselves Beneficence: do what is in the best interest of the pt Nonmaleficence: Do no harm. Justice: the fair distribution of rights and resources Veracity/Virtues: compassion, trustworthiness, integrity; commitment to tell the truth. Fidelity: keep faithful to ethical principles and the ANA code of ethics for nurses. Accountability: being held responsible for one's actions. Confidentiality: maintaining the client's privacy by not disclosing personal/health information. Definition of Neglect (Elderly): An intentional or negligent act that causes physical or emotional harm or leads to a serious risk of harm to a person over 60 years. Why do many elder abuse cases go unreported? the elderly may be afraid of further violence. Who are the MC abusers of the elderly? caregivers and family members. Who are particularly at risk for abuse? elderly with chronic illness and depletion of financial resources who are dependent on children and grandchildren. What are the 6 areas of abuse? - Neglect (willful and passive) - Physical - Sexual - Psychological - Financial - Abandonment Epidemiology: study of disease, causes, and health outcomes in a. population. What is the most important part of epidemiology? how to control a disease. Goal of Epidemiology: to prevent or limit the consequences of illness and disability in humans, as well as to maximize their state of health. Epidemiological Process: - A: data gathered; nature, extent, and scope of problem are defined; described by person, place, and time. - D: tentative hypothesis; data analyzed to test it. - P: plan are made to control and prevent. -I: actions are initiated to implement the plan. - E: actions are evaluated and report is made; further research if necessary. Incidence Rate: the rate of NEW CASES of a disease occurring in a population over a period of time. Prevalence Rate: measures the proportion of cases (OLD AND NEW) in a population over a period of time. Point Prevalence: proportion of a population that has the problem at a specific point in time. Period Prevalence: proportion of population that had the problem during a given time frame ("last 12 months") Outbreak: sudden increase of cases in a certain period of time, in a certain place; more limited geographically (school, city, etc.) Epidemic: unexpected increase of cases at a certain time, caused by a NEW infectious agent, in a population. Endemic: constant prevalence (predictable) of cases in a population or area (Flu season, Malaria to South America, etc.); unspecified time. Infectious Agent: germs, bacteria, viruses, and parasites. Reservoir: where the germ resides. Portal of Exit: where the germs leave the reservoir (mouth, cuts, stool) Transmission: how the germ gets around (airborne, droplet, etc) Portal of Entry: how the germ gets in (mouth, cuts, eyes) Susceptible Host: any person with weakened immunity (elder, babies, etc) Carrier: a PERSON or animal who harbors the infectious organism and transmits it, but shows no symptoms. Colonization: the PRESENCE of a microorganism in a host. Multiples but does not interact with the host (NO S/SX) Incubation Period: Time period between the initial contact with the agent and the appearance of s/sx. What is Cultural Competence? considering cultural aspects of health, illness, and treatment for each client or community. First Goal of Cultural Competence: know your own bias. Special Needs of Rural Population: Transportation needs. (Some hospitals have drivers) What can a RN NOT delegate to another healthcare personnel? their own assessment, education, charting, etc. Living Will: legal document that tells doctors how you want to be treated if you cannot make your own decisions about emergency treatment in the future. Durable POA: legal document that names your health care proxy. Health Care Proxy: A person who can make health care decisions for the pt. This person should be familiar with your values and wishes. S/Sx When Death is Imminent: - secretions - dyspnea - dehydration - anorexia - impaired skin integrity - delirium (irreversible) - N/V Nonpharmacological Care When Death is Imminent: - warm milk to promote sleep - back rub - change positions - music - meeting spiritual needs RESPECT PT CULTURE. Pharmacological Care When Death is Imminent: - administer pain meds routinely (around the clock); NOT PRN - Long-acting pain meds are ideal Underserved Population: homeless, povery/crime, people with disabilities. Common Chronic Diseases of the Underserved Population: heart disease, diabetes, HTN. What Method Should You Use for Patient Teaching? the teach-back method. Signs that the Pt is Not Understanding: laughing, blank staring, and not asking questions. Individual Health Assessment: Individualized care as needed. (playground injuries, sickness, bullying) Population-Based Assessment: In a school, these are typically periodic assessments done regularly throughout the school year. (immunizations, physicals, vision/hearing tests). Analysis of Vulnerability: identify unmet needs; relocation of at-risk people; sensor monitoring. A community lacing tornado sirens that lives in an area that experiences tornados (what is observation?) analysis of vulnerability. Assessment of Risk: After potential hazards are ID... the extent of damages and threats are estimated. Identification of Hazards: unique to a community; may involve propensity for natural disasters, chemical or radioactive spills, transportation accidents, etc. (incorporates historical data). Source of Contamination where the contaminants are from and what they are. Environmental Media & Transport Mechanisms: the environmental medium that the contaminant is in helps determine who is exposed and how they are exposed (water, lakes, plants, animals) Point of Exposure: the place where people come in contact with the contaminated medium. Route of Exposure: how the contaminant enters the body (eating, drinking, breathing, and touching). Focus of Caring for an Exposed Pt: - ID current/past exposures - try to mitigate or reduce adverse effects - eliminate exposures. Environmental Justice: the belief that no group of people should bear a disproportionate share of negative environmental health consequences, regardless of RACE, CULTURE, AND INCOME. When is Environmental Justice Important to Consider? when looking at the impact of the environment on a community. Natural Disaster: the result of a natural occurrence that impact the environment (earthquakes, floods, tornadoes, etc.) Accidental Disaster: those that happen as a result of circumstantial factors; usually are not deliberate; broadly defined. (human error, road conditions, etc) Terrorism: criminal acts, including against civilians, committed with the intent to cause death or serious bodily injury, or with intent of provoking a state of terror. (mass destruction, hostages, assassination). Preimpact Examples: - ice storm predicted with widespread electrical outages. -- establishing living quarters for those without heat. Impact Example: roads being salted; snow being shoveled so residents can get to temporary shelters. Postimpact Example: Ensuring the community has access to safe food and water after power outage for several days. 1/Red Tag: Unstable; injured and requiring immediate transfer. -Critical 2/Yellow Tag: Stable; injured and can wait to be transferred. -Urgent 3/Green Tag: injured with minor/less urgent needs. -Delayed 0/Black Tag: those who have died. -Expectant POD (Point of Distribution)/Emergency Dispensing Site centralized location where the public picks up emergency supplies, including food, water, and meds, following a disaster. When an ethical problem arises, which is the most important nursing responsibility? analyzing the ethical principles. When a germ enters the body, multiplies, and cause a reaction. infection Can a CNA provide postmortem care? YES In a low income country, what intervention is the most effective to decrease the incidence of diarrheal illnesses? provide sanitized drinking water. The Triad Model Includes... agent, host, and environment. The most common RF among underserved populations are...? social determinants of health What is the priority of a nurse during a chemical disaster? Don PPE