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NUR 426 Exam 4: Questions & Answers
what is health protection in primary care? (Ans- clinical interventions such as immunization. what is risk reduction in primary care? (Ans- behavioral changes learned through health education. What are examples of health promotion at the individual and family level that would help people change their lifestyle to achieve health? (Ans- Free exercise programs in a community by public health offering classes or clubs for cycling, yoga, walking and Zumba to encourage residents to increase their physical activity. school nurses should consider all of these factors when implementing sex education in a school (Ans-
- parent's concerns
- cultural and environmental issues
- public health prevention concerns How can a PHN or primary care nurse advocate for their patients who have addictions? (Ans-
- assess for risk factors for medication miss-use
- determine and educate patient on expected/acceptable level of pain (some pain is okay)
- use non-opioid analgesics when possible
- scheduled pain management is better than prn for controlling pain
- use adjunctive pain management techniques
- avoid using extended release opioids
- limit supply to 3-5 days
- reduce supply of opioids in the home
- advocate for mental health care when appropriate what is collaboration in community health? (Ans- PHN works with key individuals, groups, coalitions, and organizations to change public health policies, programs, and community services to produce better health outcomes why would a community assessment be important for formulating primary prevention measures? (Ans- assessing a community's strengths and weaknesses can help to determine what resources are needed to prevent disease what level of care is the WHO focusing on currently? (Ans-
- primary health care now more than ever in crisis
- primary care: reduces mortality from cancer, heart disease, stroke, and all other causes of mortality.
- U.S. dealing with issue by use of advanced practice RNs what are some components of case management? (Ans- assess, plan, facilitate, and advocate for patients as soon as they enter their care to help plan discharge what are some benefits of case management? (Ans-
- improve patient outcomes
- improve patient care
- improve health of the community one patient at a time
- reduce duplication of care by preventing clients from getting the same type of service twice Older adults also have higher body burdens of chemicals that have been absorbed over their lifetimes. What is this called? (Ans- Bioaccumulation
what are some factors that increase health disparities in rural communities? (Ans- economic opportunities, educational systems, social and cultural factors, and geographic isolation what is cultural competency? (Ans-
- the attitudes, knowledge, and skills necessary for providing quality care to diverse populations
- includes cultural humility and an understanding that one person cannot possible know everything about all cultures what are some things that reduce access to healthcare in rural communities? (Ans-
- underfunded/understaffed facilities
- facilities shut down because of too few staff
- limited or no insurance
- frequently have to wait at least 30 minutes for EMS what is the role of a PHN in rural communities? (Ans-
- community diagnosis
- program planning
- interventions
- evaluation
- form partnerships what are characteristics of urban communities that influence health? (Ans-
- size, density, and economic status of cities
- environmental exposures (air quality, violence, crimes)
- socioeconomic status disparities
- psychological stress/ mental health
what are some ways a PHN can decrease disparities in rural areas? (Ans-
- Utilize the client-centered medical home (PCMH) model.
- Use telehealth services for clients that need medication refills and follow up visits.
- Address scope of practice barriers, especially for nurse practitioners.
- Improving the administration of electronic health records and reimbursement. what are five functions of a patient-centered medical home? (Ans-
- Patient-centered (partnership among practitioners, patients, and their families).
- Comprehensive care (team of care providers taking care of patient's physical and mental health-care needs, including prevention and wellness, acute care, and chronic care).
- Coordinated care (broader health-care system, including specialty care, hospitals, home health care, community services and supports).
- Accessibility (patients are able to access services with shorter waiting times, "after hours" care, 24/7 electronic or telephone access)
- Committed to quality and safety (quality improvement). What is community organization? (Ans- the process by which community groups are helped to identify common problems or change targets, mobilize resources, and develop and implement strategies for reaching their collective goals What is this an example of?: A PHN works with a community that determines they have a serious need for safe recreation spaces in an area. Together, they plan to work with city officials to plan a large new park in the area that includes safe playgrounds and a walking path with security cameras throughout. (Ans- community organization
American Nurses Association (ANA) principles for environmental health include? (Ans-
- aid in advocating for environmental health principles in nursing.
- assessing quality of environment they live & work in.
- participating in researching best practices that promote a safe and healthy environment. The probability that someone will be adversely affected by a hazardous substance depends on what three major factors? (Ans-
- substance toxicity
- whether it enters the body and reaches susceptible organs
- the amount that is present what are some interventions for if a child is found to have a high blood lead level? (Ans-
- home visit and environmental assessment to determine source of lead exposure
- ensure child is getting enough iron and other micronutrients in food What is a nursing intervention a PHN can do on a home visit for a child with a high blood lead level that lives in a home built before 1970's? (Ans- Conduct a home assessment and refer the family to a lead poisoning prevention program. which age groups is at a higher risk for developing diseases due to high consumption of possibly contaminated substances such as air, water, or food? (Ans- children *infants have double the RR of adults so they are particularly susceptible to disease from contaminated air
what factors does environmental health include? (Ans- physical, chemical, external biological factors, and factors that impact behavior. Does not include mental health issues or fair distribution of environmental burdens. which age group is at a higher risk for developing complications of pre- existing disease as a result to environmental exposure? (Ans- older adults *older age means less ability for the body to compensate which increases risk for complications related to heart disease, stroke, lung diseases, and diabetes what is the air quality index? (Ans- a measure the degree of air pollution and what it means for health. what are some examples on indoor air pollutents? (Ans- mold, pesticides, metals, gram negative bacteria, chemicals, poor air circulation what is ambient air quality? What diseases are associated with poor ambient air quality? (Ans- pollutant levels that surround a place and travel with the wind. Higher chance of developing pulmonary and cardiovascular disease. What is point source pollution? (Ans- pollution from a single source that can be identified ex: the train that derailed causing toxic gas to release into the air what are examples of mobile/nonpoint pollution sources? (Ans- cars and trucks that emit toxin into the air while driving what is environmental health? (Ans- - aspects of human health, disease, and injury that are determined or influenced by factors in the environment.
- doesn't include behaviors related to social environments, cultural environments, or genetics
- heat exhaustion and heat stroke from heat waves
- exacerbated cardiovascular and pulmonary diseases from atmospheric weather changes what are the four steps of an exposure risk assessment? (Ans- 1 - hazard identification 2 - dose response assessment (higher dose=more harm) 3 - exposure assessment (level, time, and extent of exposure) 4 - risk characterization (is the person acutely ill from the exposure or do they have an increased risk for developing illness later?) what are the types of exposures? (Ans- - chemical agents: carbon monoxide, metals, pesticides
- biological agents: microbes, plant/animal contact, allergens (dust mites and cockroaches)
- physical agents: heat, cold, radiation, noise, vibration, falls, vehicle crashes, crush injuries, violence
- psychosocial factors: living with abusive individuals
- real or perceived threats: stress, panic, and anxiety at such a constant level that it threatens health, safety, and wellbeing
- mixed exposures: more than one threat from combined agents (ex: exposure to noise and chemicals together can result in ototoxicity) what are some conditions that increase older adults risk for disease related to environmental exposure? (Ans- vision loss, hearing loss, respiratory disease, skin fragility, decreased metabolic rate, osteoporosis, bioaccumulation (higher burden of absorbed chemicals) what are some weather conditions that older adults are at a higher risk for developing health concerns from? (Ans- heat waves, cold conditions, space heaters that run on kerosene, fires, houses not being up to code what is health promotion in primary care? (Ans- helping people gain control over their health by focusing on individual behaviors, social factors, and environmental factors.
What is primary prevention an occupational health nurse can implement in a workplace environment? (Ans- The use of PPE for employees what is urban agglomeration? (Ans- Urbanized core region that consists of several adjacent cities or megacities and their surrounding developed suburbs; possibly including several municipalities and may cross international boarders what are some of the benefits of increasing use of tele-health in rural communities? (Ans- - good for areas with distance between patient and provider
- improves use of nurses
- fewer hospital visits
- improved management of noncommunicable diseases what are the components of collaboration? (Ans- respect, equity, synergy (working together), clear roles, responsibilities, shared vision for outcome and process, open and frequent communication, improved use of resources what is the six-step guide for partnership? (Ans- 1 - assess needs 2 - state problems 3 - identify key players 4 - establish relationship 5 - establish mutual goals 6 - implement plan what is the importance of partnerships? (Ans- - improved access to needed programs
- promotion of referrals
- increased knowledge of how the partnered agencies work
- provide realistic expectations on how the agencies should work together
3 - intervene when necessary 4 - serve as advocates 5 - promote self management (especially with older kids) what are the factors that determine the content of sex education in schools? (Ans- - culture in the community (religious areas vs nonreligious areas)
- environmental issues specific to the area (high STD/STI rates, high teen pregnancy rates) What are some examples of federal laws and regulations pertaining to school nursing? (Ans- elementary and second education act child abuse prevention and treatment act children health insurance program healthy hunger free kids act what are some examples of state laws and regulations pertaining to school nursing? (Ans- nurse practice acts and codes immunization and screening regulations how do school nurses play a role in addressing cyberbullying? (Ans- - understand what cyberbullying is, help to educate students and teachers on how to identify cyberbullying
- provide treatment to those victims of cyberbullying. What are the psychosocial consequences on alcohol use in teens? (Ans- - increased risk for dating violence
- increased risk for incidents involving risky behaviors screening high school students for dating violence would be what form of prevention? (Ans- secondary prevention what are some ways the school nurse can promote vaccination administration? (Ans- - school located vaccination programs and vaccination compliance surveillance
- educate parents on which vaccines are recommended for their children's age group and what the attendance consequences will be if they choose not to vaccinate the children (may have to miss important events or long periods of school)
- outreach to immigrant populations What should we look for when screening a teen for dating violence? (Ans- - increased risk behaviors such as alcohol and drug use
- social and emotional responses
- look for potential injuries that are unexplained what are some examples of the services that school nurses can provide to students and their families? (Ans- - access to health insurance
- care coordination with provider and family
- educate on available services
- creating individualized health plan to address chronic illness needs. What are some ways a school nurse can prepare for emergencies? (Ans- - develop emergency management procedures
- educate teachers and students on what to do in case of an emergency
- identify issues
- coordinate CPR training for staff members
- evaluate training exercises for first aid and emergency care What are some ways a school nurse meets the needs of a disabled student? (Ans- - case manage
- individuals with disabilities act
- help to integrate children into the "normal" classrooms
- least restrictive environment
- individualized educational programs (IEPs)
- individualized healthcare plans (504 plan)
- enable disabled students to attend school
- medication administration
- health teaching/counseling
- emergency care plan
What are examples of criteria that qualify employees as having a disability? (Ans- - physical or mental impairment that limits one or more major life activities
- a record of impairment
- the disability would affect the person's ability to perform a job without accommodation. What questions should a OEHN ask an employer to assess for disaster preparedness? (Ans- "How will communication between on site and off site employees proceed?" "Do you have any employees who are disabled and what are their needs in an emergency?" "What types of emergency supplies are needed and when?" "What is the evacuation procedure?" "If everyone must lockdown, what supplies are necessary?" "Are the fire plans up to date?" "Are the emergency plans coordinated with other business and community members in the area?" Why are migrant workers at a higher risk for skin cancer compared to other laborers? (Ans- - exposure to pesticides, cleaning agents, farm animals, infectious diseases, and extreme weather **largest risk is sun exposure, screen for skin cancer What are some examples of primary, secondary, and tertiary prevention in relation to occupational health? (Ans- - primary: engineering controls (emergency shut off), PPE (hard hats)
- secondary: screening and monitoring for common work related illnesses and injuries
- tertiary: diagnosing occupational illnesses and alter the work assignments as necessary (worker develops asthma from working with chemicals so he should be moved to a different area with less of that chemical exposure)
Who does OSHA protect? (Ans- workers, family members, employers, customers, suppliers, nearby communities, and other members of the public affected by the work environment What questions does the OEHN need to ask when assessing for risks in a facility? (Ans- - What are the hazardous exposures
- How are the workers exposed (inhaled/ingested/touch)
- Which physical and chemical exposures should be evaluated on walkthrough
- what are the anticipated injuries/illness and causes
- is there a hierarchy of control
- what PPE is appropriate
- how bad are the fall hazards (wet/cluttered floors)
- do the employees receive safety/hazard avoidance training and then actually demonstrate that they understand the safety practices? what are the benefits of health promotion in the workplace? (Ans- - reduced absences
- increased productivity
- increases wellbeing, self-actualization, and personal fulfillment
- improves image of management by helping employees to view them as proactive and actually invested in their employees What are examples of health promotion in the workplace? (Ans- physical exercise, meditation, relaxation **NOT job sharing: increases stress of another person What are the 5 levels of control? Which one is the most effective and why? (Ans- 1 - elimination or substitution 2 - engineering controls 3 - warning 4 - administrative controls 5 - PPE
What is the purpose of disaster planning? (Ans- - To be prepared
- Be able to manage the disaster
- How are we going to respond
- Prevent mortalities and morbidities as aftereffects of the disaster What is disaster preparedness? (Ans- planning to avoid and reduce negative effects of risks and hazards from a disaster What is disaster surveillance? (Ans- identifies risk factors, tracks trends, determines appropriate actions and interventions how do you describe Hazard Communication Standard? (Ans- It does not deal with emergency preparedness, it is a policy requiring both employees and employers to be knowledgeable about hazards in the workplace and to protect themselves from illness or injury. What are some injuries that can occur as a result of extreme heat? (Ans- hyperthermia, dehydration, heat stroke, and heat exhaustion What are risks that arise with extreme cold? (Ans- stranded without heat or electricity can result in frostbite and hypothermia What are the 3 C's of disaster response? (Ans- - communication
- coordination
- collaboration What is preparedness? (Ans- - plan proactively
- look out for vulnerabilities
- look out for indicators of emergency such as location, timing, and magnitude What is mitigation? (Ans- - reduces harmful effects
- preventative actions (prevent emergency from occurring)
- occurs before an incident
What is response? (Ans- actually putting the plan in action; usually focuses on emergency relief such as first aid and basic care to keep victims alive What is recovery? (Ans- stabilizes community after a disaster and rehabilitates the community What is evaluation? (Ans- evaluates for:
- necessary revisions to correct issues
- what interventions worked and didn't
- determine which challenges surface
- quality assurance
