NR 442 Community Health Practice Exam_A (50 Items) | NR442 Community Health Practice Exam_A {100% CORRECT}

NR 442 Community Health Practice Exam A (50 Items) 1. A community health nurse is planning a presentation for adults who have a family history of Alzheimer's disease. Which of the following behaviors should the nurse include as an early manifestation of Alzheimer's disease a. Withdrawal from social activities b. Forgetting the location of common object c. Experiencing incontinence d. Neglecting personal hygiene Rationale: Forgetting the location of common objects is an early manifestation of Alzheimer's disease. 2. A community health nurse identifies an increase in the occurrence of osteoporosis-related fractures in women experiencing menopause. Which of the following primary prevention strategies should the nurse implement? a. Advise the women to keep their immunizations updated. b. Encourage the women to participate in weight-bearing activities. c. Educate the women about the importance of limiting sun exposure. d. Instruct at-risk women to increase their intake of foods high in vitamin E. Rationale: Weight-bearing exercises, such as weight lifting, walking, and running, have been found to be beneficial in preventing osteoporosis. 3. A nurse is caring for a client who has terminal lung cancer and is receiving hospice care. Which of the following statements should the nurse identify as an indication that the client is in the denial stage of the grief process? a. "I'm looking forward to my daughter's wedding next year." b. "I don't deserve to die. This just isn't fair." c. "If I could just make it through this, I'd never smoke again." d. "I'm going to plan my memorial service next week." Rationale: During the denial stage of the grief process, the client rejects the reality of the impending loss. 4. A home care nurse is visiting an older adult and notes that unwashed dishes are piled up and newspapers cover the front steps. Which of the following questions should the nurse to ask the client to determine if he is socially isolated? a. "Why haven't you brought in your newspapers?" b. "Do you need help completing your housework?” c. "How often do you have visitors come to see you?" d. "Have you considered moving to an assisted living facility?" Rationale: "How often do you have visitors come to see you?" MY ANSWER The nurse should ask this question because it addresses the issue of social isolation by determining the frequency of contact between the client and others. 5. A community health nurse is discussing the role of a faith community nurse with a chaplain. Which of the following information should the nurse include in the discussion? a. The faith community nurse can provide pharmacologic pain management for clients who have a terminal illness. b. The faith community nurse can plan safety training for employees in a local factory. c. The faith community nurse can provide wound care for clients in their homes. d. The faith community nurse can facilitate substance abuse support groups. Rationale: This is one of the roles of a faith community nurse. 6. A community health nurse is conducting a needs assessment of a community. The nurse should identify that which of the following methods will yield direct data? a. Health surveys b. Medical records c. Informant interviews d. Morbidity/mortality statistics Rationale: The nurse should identify that informant interviews of the community's leaders will provide direct data. This information can help the nurse identify services needed by the community. 7. A nurse is providing education regarding lead exposure to a group of clients who live in a housing development built in 1968. Which of the following client statements indicates an understanding of the teaching? a. "I will use a dry-sanding technique when preparing to repaint my front door." b. "I will vacuum our wood floors every week." c. "I will increase the amount of red meat and milk in my child's diet." d. "I will use hot tap water to prepare my baby's formula." Rationale: Children should receive adequate amounts of iron and calcium in their diets to prevent lead absorption from their environment. 8. A community health nurse is participating in a quality improvement plan for a local health department. Which of the following techniques should the nurse use for process evaluation of the facility? (Select all that apply). a. Focus groups b. Written audits c. Satisfaction survey d. Interviews e. Values self-study Rationale: Focus groups is correct. The nurse should include focus groups, which are small groups of individuals who use the health department services, for process evaluation of the facility. This information allows for review of the facility's strengths and weaknesses in the quality of client care delivery. Written audits is correct. The nurse should include written audits, which are written evaluations of the quality of care provided by the health department, for process evaluation of the facility. This information allows for review of the facility's strengths and weaknesses in the quality of client care delivery. Satisfaction survey is correct. The nurse should include satisfaction surveys, which are assessments of clients' perception of their care made via telephone or written questionnaires, for process evaluation of the facility. Interviews is correct. The nurse should include interviews of clients who use the health department's services for process evaluation of the facility. Values self-study is incorrect. A values self-study is performed as the first step in quality assurance when the health department determines the needs of the community, the services to offer, and develops a philosophy and overall objectives for the facility. 9. A community health nurse is planning an in-service about STIs for a group of adolescents. Which of the following clinical findings should the nurse include as a manifestation of primary syphilis? a. Malaise b. Maculopapular rash on palms c. Chancre d. Lymphadenopathy Rationale: Chancre is a clinical manifestation of primary syphilis. All the others are symptoms are clinical manifestations of secondary syphilis. 10. A community health nurse is caring for an adolescent who is seeking help for unplanned pregnancy. Which of the following actions should the nurse take first? a. Recommend that the adolescent meet with the school guidance counselor to discuss educational options. b. Request permission to interview the father of the child to obtain a medical history c. Help the client obtain a provider for prenatal care d. Provide information on parenting classes so the client can learn about caring for a newborn Rationale: The client is an adolescent and experiencing an unplanned pregnancy, which are factors that place the client at risk for complications. Therefore, the first action the nurse should take is to assist the client in obtaining prenatal care. 11. 1. A community health nurse is planning to establish a community garden to address the lack of nutritious food options in the area. Which of the following actions should the nurse take first to initiate the plan? a. Identify community members who demonstrate an interest in the project. b. Hold a community information session to inform the residents of the plan c. Select residents to take on leadership roles in the project d. Monitor the progress of the project to keep the project on course Rationale: Identify community members who demonstrate an interest in the project. The first action the nurse should take when using the nursing process is to assess the community. By identifying those community members who demonstrate an interest in the project, the nurse can establish a local support group who will assist in engaging other community residents with establishing the garden. 12. A nurse is conducting a home visit for an older adult client. The nurse should identify which of the following findings as an indicator of possible neglect? a. Lives alone b. Taking outdated prescriptions c. Has a BMI of 25 d. Presence of alcohol in the home Rationale: Taking outdated prescriptions is an example of inadequate medical care and is an indicator of possible neglect. The client taking outdated prescriptions is an example of inadequate medical care and is an indicator of possible neglect. 13. A nurse is caring for a 16-year-old client who has a new diagnosis of human papillomavirus. Which of the following actions should the nurse take? a. Report the infection to the state health department b. Instruct the client to return for a blood test in 1 month. c. Administer ceftriaxone 250mg IM. d. Teach the client how to apply imiquimod 5% cream to the lesions. Rationale: The client can self-treat the lesions using topical imiquimod 5% cream to the lesions at bedtime for up to 16 weeks. 14. A school nurse is reviewing the records of four students who are returning to school after being diagnosed with methicillin-resistant staphylococcus aureus (MRSA). Which of the following actions should the nurse take? a. Coordinate an immunization clinic at the school b. Recommend prophylactic treatment for classmates c. Report the cases of MRSA to child protective services d. Provide education about MRSA throughout the school system Rationale: Appropriate hand hygiene and self-care will help prevent the spread of MRSA 15. A public health nurse is conducting an education session about Lyme disease for a group of older adult clients at a senior center. Which of the following statements should the nurse identify as an indication that the client understands the teaching? a. "I should get an annual immunization to prevent Lyme disease." b. "I can take penicillin for 10 to 14 days to manage Lyme disease." c. "I can get Lyme disease from a mosquito bite." d. "I will have abdominal pain and diarrhea if I get Lyme disease." Rationale: A client who receives a diagnosis of Lyme disease in the early stages should respond to 10 to 14 days of penicillin or tetracycline therapy. The nurse should instruct the students to consume less than 300 mg/day of dietary cholesterol. High levels of dietary cholesterol in a diet can be a risk factor for cardiovascular disease. 16. A school nurse is educating a group of high school student about recommended dietary guidelines. Which of the following statements by a student indicates an understanding of the teaching? a. "I can consume up to 25 percent of my daily calories from saturated fatty acids." b. "I should consume less than 300 milligrams per day of dietary cholesterol." c. "I can increase my daily consumption of foods that contain refined grains." d. "I should consume 800 milligrams per day of dietary calcium." Rationale: "I should consume less than 300 milligrams per day of dietary cholesterol." The nurse should instruct the students to consume less than 300 mg/day of dietary cholesterol. High levels of dietary cholesterol in a diet can be a risk factor for cardiovascular disease. 17. A community health nurse is creating a program to reduce domestic violence in the community. Which of the following interventions should the nurse identify as secondary prevention? a. Creating a public service announcement about the warning signs of intimate partner abuse b. Recognizing and reporting suspected abuse to the appropriate protective services c. Collaborating with support agencies to ensure the ongoing treatment for abuse e. Educating individuals and groups about preventing domestic and community abuse Rationale: Secondary prevention is an intervention that focuses on early detection of a health problem to facilitate early diagnosis and treatment. Recognizing and reporting suspected abuse facilitates diagnosis and intervention, helping to prevent further abuse. 18. A nurse in a clinic is planning teaching for a client who was newly diagnosed with hepatitis C. Which of the following instructions should the nurse include in the teaching? a. Consume a low-carbohydrate diet until symptoms resolve. b. Schedule an appointment for an immunoglobulin injection. c. Abstain from sexual intercourse until antibody tests are negative. d. Wear a mask in public places while receiving treatment. Rationale: Hepatitis C is transmitted through sexual intercourse. Therefore, the nurse should instruct the client to abstain from sexual intercourse until antibody tests are negative.