NUR4636
COMMUNITY NURSING
EXAM Q & A
2024
1. A community nurse is conducting a home visit for a 65-year-old man with
chronic obstructive pulmonary disease (COPD). The nurse observes that the patient
has difficulty breathing, cyanosis, and a productive cough with yellowish sputum.
The nurse also notes that the patient smokes half a pack of cigarettes per day and
lives alone in a poorly ventilated apartment. What is the most appropriate nursing
diagnosis for this patient?
a) Ineffective airway clearance related to increased mucus production and smoking
b) Impaired gas exchange related to ventilation-perfusion imbalance and hypoxia
c) Activity intolerance related to decreased oxygen delivery and fatigue
d) Risk for infection related to impaired ciliary function and chronic inflammation
*Answer: b) Impaired gas exchange related to ventilation-perfusion imbalance and
hypoxia
Rationale: Impaired gas exchange is the most appropriate nursing diagnosis for this
patient because it reflects the underlying pathophysiology of COPD, which is a
chronic condition that causes airflow obstruction, alveolar damage, and
hypoxemia. Ineffective airway clearance, activity intolerance, and risk for infection
are also relevant nursing diagnoses for this patient, but they are not as specific or as
urgent as impaired gas exchange.
2. A community nurse is planning a health promotion program for a group of low-
income pregnant women who live in a rural area. The nurse identifies that one of
the main health problems affecting this population is iron-deficiency anemia. What
is the best strategy for the nurse to implement to prevent and treat iron-deficiency
anemia in this group?
a) Provide iron supplements and educate the women on the importance of taking
them regularly
1
,b) Screen the women for hemoglobin levels and refer them to a hematologist if
needed
c) Encourage the women to consume foods rich in iron and vitamin C and avoid
foods that inhibit iron absorption
d) Collaborate with local food banks and community organizations to ensure food
security and access to nutritious foods
*Answer: d) Collaborate with local food banks and community organizations to
ensure food security and access to nutritious foods
Rationale: Collaborating with local food banks and community organizations is the
best strategy for the nurse to implement because it addresses the root cause of iron-
deficiency anemia in this population, which is poverty and lack of access to
adequate nutrition. Providing iron supplements, screening for hemoglobin levels,
and educating on dietary choices are also important interventions, but they are not
as effective or sustainable as ensuring food security and access.
3. A community nurse is evaluating the outcomes of a smoking cessation program
that was implemented in a high school. The program consisted of educational
sessions, peer support groups, and nicotine replacement therapy. The nurse collects
data from the students who participated in the program using surveys, interviews,
and saliva tests. What is the most appropriate method for the nurse to analyze the
data and measure the effectiveness of the program?
a) Descriptive statistics
b) Inferential statistics
c) Qualitative analysis
d) Mixed methods analysis
*Answer: d) Mixed methods analysis
Rationale: Mixed methods analysis is the most appropriate method for the nurse to
analyze the data and measure the effectiveness of the program because it combines
both quantitative and qualitative approaches, which are suitable for different types
of data. Descriptive statistics can be used to summarize numerical data, such as the
number of students who quit smoking or reduced their cigarette consumption.
Inferential statistics can be used to test hypotheses and draw conclusions about the
relationships between variables, such as the association between smoking cessation
and academic performance or self-esteem. Qualitative analysis can be used to
interpret textual data, such as the students' perceptions, experiences, and opinions
about the program. Mixed methods analysis can integrate all these types of data
and provide a comprehensive and holistic evaluation of the program.
2
, A client with tuberculosis sneezes in the waiting room and infects several other
clients who are sitting on the other side of the room. Which mechanism of
transmission is involved in this case?
A) Airborne
B) Droplet
C) Direct contact
D) Indirect contact
6. Thestudent-nurse discusses transmission that involves contact of a
susceptible host with a vehicle. Based on the chain of infection links, which
exemplifies a vehicle?
A) Animals
B) Insects
C) Reptiles
D) Water
7. Chloroquine-resistant malaria occurs in most of Africa, the Middle East, and
Asia and all of the South Pacific islands. This type of disease occurrence is
known as:
A) Endemic
B) Epidemic
C) Pandemic
D) Outbreak
8. Person,place, and time characterize the description of an epidemiologic
problem. Using knowledge of outbreak investigations, which occurs with
propagated outbreaks?
A) Same person or vehicle as the reservoir or means of transmission
B) Infection transmitted from person to person over a short period of time
C) Generating secondary infections with intervals between peaks
that approximate the usual incubation period for the infection
D) Generating tertiary infections following exposure to a primary case
9. Several levels of public health surveillance are necessary to protect the nation's
health. At what level are healthcare providers and health facilities required to
report certain infectious diseases?
A) Local
B) State
C) Federal
3
COMMUNITY NURSING
EXAM Q & A
2024
1. A community nurse is conducting a home visit for a 65-year-old man with
chronic obstructive pulmonary disease (COPD). The nurse observes that the patient
has difficulty breathing, cyanosis, and a productive cough with yellowish sputum.
The nurse also notes that the patient smokes half a pack of cigarettes per day and
lives alone in a poorly ventilated apartment. What is the most appropriate nursing
diagnosis for this patient?
a) Ineffective airway clearance related to increased mucus production and smoking
b) Impaired gas exchange related to ventilation-perfusion imbalance and hypoxia
c) Activity intolerance related to decreased oxygen delivery and fatigue
d) Risk for infection related to impaired ciliary function and chronic inflammation
*Answer: b) Impaired gas exchange related to ventilation-perfusion imbalance and
hypoxia
Rationale: Impaired gas exchange is the most appropriate nursing diagnosis for this
patient because it reflects the underlying pathophysiology of COPD, which is a
chronic condition that causes airflow obstruction, alveolar damage, and
hypoxemia. Ineffective airway clearance, activity intolerance, and risk for infection
are also relevant nursing diagnoses for this patient, but they are not as specific or as
urgent as impaired gas exchange.
2. A community nurse is planning a health promotion program for a group of low-
income pregnant women who live in a rural area. The nurse identifies that one of
the main health problems affecting this population is iron-deficiency anemia. What
is the best strategy for the nurse to implement to prevent and treat iron-deficiency
anemia in this group?
a) Provide iron supplements and educate the women on the importance of taking
them regularly
1
,b) Screen the women for hemoglobin levels and refer them to a hematologist if
needed
c) Encourage the women to consume foods rich in iron and vitamin C and avoid
foods that inhibit iron absorption
d) Collaborate with local food banks and community organizations to ensure food
security and access to nutritious foods
*Answer: d) Collaborate with local food banks and community organizations to
ensure food security and access to nutritious foods
Rationale: Collaborating with local food banks and community organizations is the
best strategy for the nurse to implement because it addresses the root cause of iron-
deficiency anemia in this population, which is poverty and lack of access to
adequate nutrition. Providing iron supplements, screening for hemoglobin levels,
and educating on dietary choices are also important interventions, but they are not
as effective or sustainable as ensuring food security and access.
3. A community nurse is evaluating the outcomes of a smoking cessation program
that was implemented in a high school. The program consisted of educational
sessions, peer support groups, and nicotine replacement therapy. The nurse collects
data from the students who participated in the program using surveys, interviews,
and saliva tests. What is the most appropriate method for the nurse to analyze the
data and measure the effectiveness of the program?
a) Descriptive statistics
b) Inferential statistics
c) Qualitative analysis
d) Mixed methods analysis
*Answer: d) Mixed methods analysis
Rationale: Mixed methods analysis is the most appropriate method for the nurse to
analyze the data and measure the effectiveness of the program because it combines
both quantitative and qualitative approaches, which are suitable for different types
of data. Descriptive statistics can be used to summarize numerical data, such as the
number of students who quit smoking or reduced their cigarette consumption.
Inferential statistics can be used to test hypotheses and draw conclusions about the
relationships between variables, such as the association between smoking cessation
and academic performance or self-esteem. Qualitative analysis can be used to
interpret textual data, such as the students' perceptions, experiences, and opinions
about the program. Mixed methods analysis can integrate all these types of data
and provide a comprehensive and holistic evaluation of the program.
2
, A client with tuberculosis sneezes in the waiting room and infects several other
clients who are sitting on the other side of the room. Which mechanism of
transmission is involved in this case?
A) Airborne
B) Droplet
C) Direct contact
D) Indirect contact
6. Thestudent-nurse discusses transmission that involves contact of a
susceptible host with a vehicle. Based on the chain of infection links, which
exemplifies a vehicle?
A) Animals
B) Insects
C) Reptiles
D) Water
7. Chloroquine-resistant malaria occurs in most of Africa, the Middle East, and
Asia and all of the South Pacific islands. This type of disease occurrence is
known as:
A) Endemic
B) Epidemic
C) Pandemic
D) Outbreak
8. Person,place, and time characterize the description of an epidemiologic
problem. Using knowledge of outbreak investigations, which occurs with
propagated outbreaks?
A) Same person or vehicle as the reservoir or means of transmission
B) Infection transmitted from person to person over a short period of time
C) Generating secondary infections with intervals between peaks
that approximate the usual incubation period for the infection
D) Generating tertiary infections following exposure to a primary case
9. Several levels of public health surveillance are necessary to protect the nation's
health. At what level are healthcare providers and health facilities required to
report certain infectious diseases?
A) Local
B) State
C) Federal
3
