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Community Health Nursing NCLEX
Questions and answers correctly solved.
The nurse is preparing a smoking cessation class and is amazed at how many people still smoke even with the information on lung cancer so readily available. She believes that her class will convert many smokers to nonsmokers once they get all the latest information. The nurse is a believer in which of the following health care models? a. Health Belief Model b. Health Promotion Model c. Basic Human Needs Model d. Holistic Health Model - correct answers.ANS: A The Health Belief Model addresses the relationship between a person's beliefs and behaviors. The Health Promotion Model is more complex than the Health Belief Model in that it notes that each person has unique personal characteristics and experiences that affect subsequent actions. The Basic Human Needs Model is based on the theory that all people share basic human needs, and the extent to which basic needs are met is a major factor in determining a person's level of health. The Holistic Health Model recognizes the natural healing abilities of the body and incorporates complementary and alternative interventions such as music therapy. Education is important but is not the sole determinant of change. The health care model that utilizes Maslow's hierarchy as its base is the _____ Model. a. Health Belief b. Health Promotion c. Basic Human Needs d. Holistic Health - correct answers.ANS: C The Basic Human Needs Model believes that the extent to which basic needs are met is a major factor in determining a person's level of health. Maslow's hierarchy of needs is a model that nurses use to understand the interrelationships of basic human needs. The Health Belief Model addresses the relationship between a person's beliefs and behaviors. The Health Promotion Model notes that each person has unique personal characteristics and experiences that affect subsequent actions. The Holistic Health
Model recognizes the natural healing abilities of the body and incorporates complementary and alternative interventions such as music therapy. The patient is describing moderate incisional pain that was not relieved by the last dose of hydromorphone (Dilaudid) given 90 minutes earlier. The patient is not due for another dose of medication for another 2 1/2 hours. The nurse repositions the patient, asks what type of music she likes, and puts on the music channel on the television, setting it to play that type of music. The nurse is attempting to utilize which health care model? a. Health Belief Model b. Health Promotion Model c. Basic Human Needs Model d. Holistic Health Model - correct answers.ANS: D The Holistic Health Model recognizes the natural healing abilities of the body and incorporates complementary and alternative interventions such as music therapy. The Health Belief Model addresses the relationship between a person's beliefs and behaviors. The Health Promotion Model notes that each person has unique personal characteristics and experiences that affect subsequent actions. The Basic Human Needs Model believes that the extent to which basic needs are met is a major factor in determining a person's level of health. Maslow's hierarchy of needs is a model that nurses use to understand the interrelationships of basic human needs. Many variables influence a patient's health beliefs and practices. Internal and external variables influence how a person thinks and acts. An example of an internal variable would be a. Perception of functioning. b. Family practices. c. Socioeconomic factors. d. Cultural background. - correct answers.ANS: A Internal variables include a person's developmental stage, intellectual background, perception of functioning, and emotional and spiritual factors. External variables influencing a person's health beliefs and practices include family practices, socioeconomic factors, and cultural background. The nurse is admitting a patient with uncontrolled diabetes mellitus. It is the fourth time the patient is being admitted in the last 6 months for high blood sugars. During the admission process, the nurse asks the patient about her employment status and displays a nonjudgmental attitude. Why does the nurse do this? a. Noncompliant patients thrive on the disapproval of authority figures. b. External variables have little effect on compliance. c. A person's compliance is affected by economic status. d. Employment status is an internal variable that impacts compliance. - correct answers.ANS: C A person's compliance with treatment is affected by economic status. A person tends to give a higher priority to food and shelter than to costly drugs or treatments. A person generally seeks approval and support from social networks, and this desire for approval affects health beliefs and practices. Internal and external variables influence how a
immunizations, and physical and nutritional fitness activities. Tertiary prevention occurs when a defect or disability is permanent and irreversible. It involves minimizing the effects of long-term disease or disability through interventions directed at preventing complications and deterioration. Just as health and health behavior are affected by internal and external variables, so are illness and illness behavior. Which external variables can affect illness and behavior? (Select all that apply.) a. Perception of the seriousness of the illness b. Patient's coping skills c. Cultural background d. Social support e. Socioeconomic status - correct answers.ANS: C, D, E External variables influencing a patient's illness behavior include the visibility of symptoms, social group, cultural background, economic variables, accessibility of the health care system, and social support. Internal variables include the patient's perceptions of symptoms and the nature of the illness, as well as the patient's coping skills and locus of control. A patient is admitted to a rehabilitation facility following a stroke. The patient has right- sided paralysis and is unable to speak. The patient will be receiving physical therapy and speech therapy. What are these examples of? a. Primary prevention b. Secondary prevention c. Tertiary prevention d. Health promotion - correct answers.ANS: C Tertiary prevention occurs when a defect or disability is permanent and irreversible. It involves minimizing the effects of long-term disease or disability through interventions directed at preventing complications and deterioration. Secondary prevention focuses on individuals who are experiencing health problems or illnesses, and who are at risk for developing complications or worsening conditions. Activities are directed at diagnosis and prompt intervention. Primary prevention precedes disease or dysfunction and is applied to people considered physically and emotionally healthy. Health promotion includes health education programs, immunizations, and physical and nutritional fitness activities. Risk factors can be placed in the following interrelated categories: genetic and physiological factors, age, physical environment, and lifestyle. The presence of any of these risk factors means that a. A person with the risk factor will get the disease. b. The chances of getting the disease are increased. c. The disease is guaranteed not to develop if the risk factor is controlled. d. Risk modification will have no effect on disease prevention. - correct answers.ANS: B The presence of risk factors does not mean that a disease will develop, but risk factors increase the chances that the individual will experience a particular disease or dysfunction. Control of risk factors does not guarantee that a disease will not develop.
However, risk factor identification assists patients in visualizing those areas in life that can be modified or even eliminated to promote wellness and prevent illness. Models of health offer a perspective by which to understand the relationships between the concepts of health, wellness, and illness. Nurses are in a unique position to assist patients in achieving and maintaining optimal levels of health because nurses (Select all that apply.) a. Understand the challenges of today's health care system. b. Identify actual and potential risk factors. c. Have coined the term "illness behavior." d. Can minimize the effects of illness and assist to the return of optimal health - correct answers.ANS: A, B, D Nurses are in a unique position to assist patients in achieving and maintaining optimal levels of health. Nurses understand the challenges of today's health care system and embrace the opportunity to use wellness activities to promote health and wellness and to prevent illness. Nurses can identify actual and potential risk factors that predispose a person or group to illness. Nurses who understand how patients react to illness can minimize the effects of illness and assist patients and their families in maintaining or returning to the highest level of functioning. Medical sociologists call the reaction to illness "illness behavior." The nurse is caring for a patient who has been trying to quit smoking. She has been smoke free for 2 weeks but had two cigarettes last night and at least two this morning. What should the nurse anticipate? a. The patient does not want to and never will quit smoking. b. The patient will return to the contemplation or precontemplation phase. c. The patient will need to adopt a new lifestyle for change to be effective. d. The patient must pick up her attempt right where she left off. - correct answers.ANS: B When relapse occurs, the person will return to the contemplation or precontemplation stage before attempting the change again. The patient cannot pick up her attempt where she left off. It is believed that change involves movement through a series of stages. These stages range from no intention to change (precontemplation), to making small changes (preparation), to actively engaging in strategies to change behavior (action), to maintenance. The action phase indicates a desire to change and a potential to do so. Changes will be maintained over time only if they are integrated into an individual's overall lifestyle. The nurse is working in a drug rehabilitation clinic and is in the process of admitting a patient who says that she wants to be "detoxified." It is important for the nurse to a. Identify the patient's stage of change. b. Realize that the patient is ready to change. c. Instruct the patient that she will have to change her lifestyle. d. Instruct the patient that relapses are not tolerated. - correct answers.ANS: A
A tornado strikes a mobile home community in a small rural town. Approximately 10 families are left without food and shelter. Which reaction demonstrates the community's viability? A. Community leaders activate the community disaster plan. B. Community leaders contact the federal government about disaster relief. C. Relief workers run out of bottled water and bedding supplies. D. Tornado victims are sent to a boarding home in the nearest urban area. - correct answers.ANS: A Mortality rates from two communities can best be compared after calculating: A. the age-adjusted rates. B. the crude rates. C. the gender-specific rates. D. the prevalence rates. - correct answers.ANS: A The age-adjusted rates are rates that would have existed if the population under study had the same age distribution as the "standard" population. Therefore, they are summary measures adjusted for differences in age distributions. For example, a county having a higher percentage of elderly people may have a higher rate of death or hospitalization than a county with a younger population, merely because the elderly are more likely to die or be hospitalized. (The same distortion can happen when comparing races, genders, or time periods.) Age adjustment can make the different groups more comparable. An advanced public health nurse investigates a cluster of cases of learning disabilities, hearing impairment, and developmental delays in school-age children who live in an apartment complex that was built in 1971. The nurse suspects exposure to: A.carbon monoxide. B. lead. C. nitrogen dioxide. D. radon. - correct answers.ANS: B Lead used to be very common in gasoline and house paint in the U.S. Children living in cities with older houses are more likely to have high levels of lead. Houses painted before 1978. Even if the paint is not peeling, it can be a problem. Lead paint is very dangerous when it is being stripped or sanded. These actions release fine lead dust into the air. Infants and children living in pre-1960's housing (when paint often contained lead) have the highest risk of lead poisoning. Small children often swallow paint chips or dust from lead-based paint. Toys and furniture painted before 1976 What is the vision of the Department of Health A. Responsible for the formulation, planning, implemented, and coordination of policies and programs in the field of health B. Regulates health goods and services C. Health as Right. Health for all Filipinos by the year 2000 and Health in the hands of the People bythe year 2020 D. All of the above - correct answers.ANS: C
Concerned with the care of school-children, the nurse does the following.EXCEPT: A. provides for a safe environment B. detects, diagnose, and treats children with health problems C. identifies and refers children with eye problems D. conducts health education classes - correct answers.ANS: B Not the role of the nurse A nurse provides home care instructions to the parents of a child hospitalized with pertussis. The child is in the convalescent stage and is being prepared for discharge. Which statement by a parent indicates a need for instructions? A. We need to encourage our child to drink fluids B. Coughing spells may be triggered by dust or smoke C. Vomiting may occur when our child has coughing episodes D. We need to maintain droplet precautions and a quiet environment for at least 2 weeks - correct answers.ANS: D Pertussis is transmitted by direct contact or respiratory droplets from coughing. The communicable period occurs primarily during the catarrhal stage. Respiratory precautions are not required during the convalescent phase. Options 1,2,3 are accurate components of home care instructions. A clinic nurse is assessing a child who is scheduled to receive a live virus vaccine (immunization). Which of the following are general contraindications associated with receiving a live virus vaccine? (Select all that apply) A. The child has symptoms of a cold B.The child had a previous anaphylactic reaction to the vaccine. C. Mother reports that the child is having intermittent episodes of diarrhea. D. Mother reports that the child has not had an appetite and has been fussy E. The child has a disorder that caused a severely deficient immune system F. Mother reports that the child has recently been exposed to an infectious disease. - correct answers.ANS: B, E The general contraindications for receiving live virus vaccines include a previous anaphylactic reaction to a vaccine or a component of the vaccine. Additionally, live virus vaccines generally are not administered to individuals with a severely deficient immune system, individuals with a severe sensitivity to gelatin, or pregnant woman A vaccine is administered with caution to an individual with a moderate or severe acute illness, with or without fever. Options 1,3,4 and 6 are not contraindications to receiving a live vaccine. A child is scheduled to receive inactivated polio vaccine (IPV), and a nurse preparing to administer the vaccine reviews the child's record. The nurse questions the administration of IPV if which of the following is documented in the child's record? A. Recent recovery from a cold B. A history of frequent respiratory infections C. A history of an anaphylactic reaction to neomycin D. A local reaction at the site of a previous IPV - correct answers.ANS: C
B. Assist new parents in communicating with their health plan regarding well-baby coverage C. Provide health education to teens who need knowledge about sexually transmitted diseases D. Set up a doctor's appointment for an illiterate adult - correct answers.ANS: B Which U.S. agency is responsible for overseeing the actions of protecting against, responding to, recovering from, and preventing the effects of disaster? a. American Red Cross b. Department of National Security c. Federal Emergency Management Agency d. The National Disaster Relief Agency e. The National Incident Management System - correct answers.ANS: E Because of the recognition of the need to be prepared, programs have been created to address the national, state, and local management of disasters. President G. W. Bush established the National Incident Management System (NIMS) in 2004. The NIMS provides a systematic, proactive approach for all levels of government and nongovernmental agencies to work seamlessly to prevent, protect against, respond to, recover from, and prevent the effects of disasters (Federal Emergency Management Agency, 2009). How is a disaster the same as or different from an emergency? a. A disaster is personal, whereas an emergency is community-wide. b. An emergency is personal, whereas a disaster is community-wide. c. Both emergencies and disasters are devastating. d. Both emergencies and disasters are failures resulting in extensive insurance claims. - correct answers.ANS: B A disaster is any event that causes a level of destruction, death, or injury that affects the abilities of the community to respond to the incident using available resources. Emergencies differ from disasters in that the agency, community, family, or individual can manage an emergency using their own resources. However, a disaster event may be beyond the ability of the community to respond to and recover from the incident using its own resources. Disasters frequently require assistance from outside the immediate community. Which of the following people would be eligible for Medicare Part A? a. Jane age 63 who is a citizen b. John age 65 who has come to the United States on a Visa c. James age 64 who is a resident of the United States d. Jan age 64 with a spouse that has worked for at least 5 years in Medicare-covered employment e. Jared age 64 with End-Stage Renal Disease (ESRD) - correct answers.e. Jared age 64 with End-Stage Renal Disease (ESRD) Which of the following categories would make a person eligible for Medicaid a) Family of 4 with an income of $200,
b) Pregnant women and children under 6 in a low income household c) Only Employed single men d) Only pharmacy students e) Only college athletes - correct answers.b) Pregnant women and children under 6 in a low income household John, a 86 year old male, is currently enrolled in the Medicaid program in Texas. Which of the following services is John guaranteed by Medicaid? a. Food stamp b. Eyeglasses c. Blood test d. Nonprescription drug e. Transportation support - correct answers.c. Blood test
