Sample Chapter



Public Health Science And Nursing Practice By Christine Savage,Joan Kub – Test Bank


Chapter 1: Public Health and Nursing Practice




  1. The public health nurse (PHN) knows that he must approach a public health problem with an understanding of the related underlying risk factors in order to develop effective nursing interventions. He must also consider that these risk factors can be either ____ based or ____ based.
A. Disease; individual
B. Intervention; Government
C. Epidemic; population
D. Individual; population






  1. A nursing student is studying public health. She learns that, according to C.E.A. Winslow’s definition, some of the goals of public health are disease prevention, promoting health, control of communicable infections, and ____.
A. Risk assessment for disease
B. Birth control
C. Education on personal hygiene
D. Governmental safety regulations






  1. If the international medical community was working to contain several worldwide pandemics, they would look to the World Health Organization (WHO), which is
A. The public health arm of the United Nations
B. Working to improve health and well-being for the global population
C. Working with nurses to promote public health interventions
D. All of the above






  1. The Institute of Medicine (IOM) stated in their report, The Future of the Public’s Health, that there are three core functions that society carries out to collectively support the optimum conditions for public health. Which one of the following is not one of these functions?
A. Prevention
B. Assessment
C. Policy development
D. Assurance







  1. A nursing instructor is giving a lecture on public health and the importance of maintaining a population-focused perspective when administering care. Which of the following statements might a nursing student hear from the instructor?
A. Individual health occurs within the context of the population.
B. Individual health occurs within the context of the environment surrounding the individual.
C. Individuals achieve health at the individual level through individualistic actions.
D. Both 1 and 2







  1. With aging, there is an increase in noncommunicable (chronic) illness. The PHN recognizes that an example of a noncommunicable illness is
A. Heart disease
B. Human immunodeficiency virus (HIV)
C. Hepatitis
D. Severe acute respiratory syndrome (SARS)




  1. A PHN would like to use the Dahlgren-Whitehead model to help herself and other local practitioners understand health in populations. She understands that the Dahlgren-Whitehead ecological model assumes that
A. There are multiple determinants of health and thus, multiple strategies are needed.
B. A population and environmental approach is essential.
C. Linkages and relationships are crucial.
D. All of the above







  1. The obesity rate in a local neighborhood is the product of a poor quality grocery store and a lack of dedicated venues for exercise. This is an example of “upstream” determinants of public health determining the ecology of a community’s health “downstream.” The PHN understands that upstream determinants include social relations, neighborhoods and communities, institutions, and ____.
A. Social and economic policies
B. Availability of medicine
C. Nursing interventions
D. Government programs





  1. A nursing instructor is giving a lecture on community participation in an ecological public health system. She teaches that the benefits of this collaboration for participants in the community’s public health are that their efforts increase effectiveness and productivity, empower the participants, strengthen social engagement, and ____.
A. Decrease disease rates
B. Ensure accountability
C. Increase the number of medical facilities
D. Monitor childhood illnesses





  1. The PHN recognizes that which of the following scenarios is not an example of community collaboration?
A. A local service group working to organize disaster relief for tornado victims
B. A city council passing an ordinance to stop smoking in restaurants
C. An advocacy group working to improve health care for the mentally ill
D. A school working with the local health department to start a school clinic







  1. The PHN understands that which layer of government is responsible for issuing quarantines?
A. Federal
B. State
C. Local
D. All of the above








  1. The nursing student is taught correctly that local health departments do not oversee
A. The surveillance of disease
B. Investigation of disease outbreaks
C. Licensing of local hospitals
D. Public sanitation and water supply







  1. The PHN recognizes that environmental science, epidemiology, biostatistics, biomedical sciences, and ____ form the foundational subjects of public health.
A. Economics
B. The humanities
C. Social and behavioral sciences
D. Anthropology





  1. As defined by the World Health Organization (WHO), an example of a health promotion intervention is ____ whereas a health promotion, risk reduction is ____.
A. A health fair; funding a school health library
B. Giving a free exercise class; offering coupons at a restaurant for healthy food
C. A free antibiotic giveaway; a diet class for teenagers
D. A tour of a hospital; a relaxation technique class





  1. According to O’Donnell’s definition of health promotion, how could a public health nurse advise a company to encourage its employees to work toward good health?
A. Lower insurance premiums for good health habits
B. Have employee exercise classes or discounted health club memberships
C. Have incentives for healthy eating
D. All of the above





  1. According to Issel, when planning a health intervention in a diverse community concerning improving diet, the factor that must be evaluated (which includes shared geographic origin, language and dialect, religious faith, folklore, and food preferences) is termed ____.
A. Race
B. Culture
C. Ethnicity
D. Custom









  1. Globalization, which is a new challenge for public health, includes which of the following problems?

Select all that apply.

A. Greater disparities between rich and poor
B. Environmental degradation
C. Greater need for newer technology
D. Greater distribution of tobacco and alcohol
E. Emergence or re-emergence of communicable diseases





  1. Several nurses who work in the emergency room of an urban hospital notice that a sizable number of children in a certain ethnic population have come in with an illness, all presenting with similar symptoms. The nurses, who are not public health specialists, can intervene in the health of a community through their work with individuals by doing which of the following?

Select all that apply.

A. Increasing antibiotic therapy availability
B. Identifying characteristics of the disease
C. Grouping patients by diagnosis
D. Giving classes on how to avoid infections
E. Assessing the environment of the patients







  1. The regulatory activities of public health nursing include which of the following?

Select all that apply.

A. Interpreting public health laws, regulations, and policies
B. Monitoring regulated entities such as nursing homes
C. Writing new regulations for health care and legislating them
D. Taking part in health policy debates
E. Educating the public







  1. If a PHN had the capabilities required in the domains of the PHN Core Competencies, he or she would be able to do which of the following?

Select all that apply.

A. Develop policy for handling a local quarantine.
B. Understand the dietary restrictions of new immigrants.
C. Create a financial plan for a clinic and manage the budget.
D. Function as a medical doctor at a clinic if there is none.
E. Work with corporations to create an emergency response program to bioterrorism.




Chapter 2: Optimizing Population Health




  1. In 2011, the National Prevention Strategy released a plan to increase the number of Americans who are healthy at every stage of life. The National Prevention Strategy was authorized by the:
A. Department of Health and Human Services
B. Centers for Disease Control and Prevention
C. Affordable Care Act
D. American Medical Association





  1. A nursing student is studying the National Prevention Council Action Plan. The student correctly identifies which one of the following interventions as not reflecting the strategic directions in this plan?
A. Conducting bi-weekly visits to new mothers and newborn babies
B. Paying for insurance for low-income families
C. Providing nutrition classes which offer weekly fill-in guides for grocery shopping
D. Building a health and exercise center in a hospital near the physical and occupational therapy areas







  1. Based on the ecological model of health, a nurse would evaluate which of the following to understand why a community is having a large incidence of recurring respiratory infections?
A. Local health-care facilities
B. Community health-care programs
C. Medical tests results
D. Living and employment situations







  1. If a nurse is focusing on prevention and establishing a public health intervention for an illness by following the natural history of a disease, he or she is:
A. Making sure that everyone in a certain area receives treatment
B. Studying the biological components of the disease
C. Looking at medical trends of clients who have had the disease
D. Going to the autopsies of the patients who have died






  1. When a health-care provider offers nutritional health teaching on portions, patterns, and choices, he or she is using which type of approach?
A. Ecological
B. Downstream
C. Upstream
D. Health promotion






  1. A school cafeteria is planning menus for the school year. They must follow the 2012 national law that calls for school lunch programs to:
A. Have larger portions of fruits and vegetables, less sodium, and no trans fats
B. Have more protein and fewer carbohydrates
C. Offer 2% milk and low fat dairy products
D. Places a cap on lunch calories at 900, for all grades






  1. A nurse could encourage prevention for a patient with diabetes by
A. Having the patient try an experimental treatment
B. Asking them to share their experiences with other people
C. Having them take doses of the prescribed medicine on a PRN, or as needed, basis.
D. Helping him or her to slow the progression of the disease and prevent secondary illnesses related to the disease, such as blindness





  1. In order to assess the predominance of a disease in a population, a public health nurse (PHN) looks at a prevalence pot, which is
A. A way of estimating the amount of vaccine that needs to be produced
B. A way of estimating the past number of cases of a specific disease in a given area
C. A way of assessing the total number of cases of a disease that takes into account all of the stages of the disease
D. A method of calculating the potential number of various diseases in a given area





  1. A PHN notices the rising incidence of H1N1 (swine flu) in a geographic area. The nurse considers possible interventions, knowing that the preclinical phase of H1N1 lasts:
A. One to two days
B. Two to four days
C. Three to four days
D. Five to seven days





  1. In the traditional public health prevention framework, the level of prevention that includes early detection and initiation of treatment for disease, or screening, is referred to as the:
A. Clinical level
B. Primary level
C. Tertiary level
D. Secondary level





  1. Attributable risk is the proportion of cases or injuries that would be eliminated if a risk factor did not occur, but preventable fraction is:
A. The number of cases that actually occur
B. What could be achieved with a program implemented in a community setting within the at-risk population when community members actually participate in the program?
C. The number of cases that require intervention
D. What the estimated number of cases with high-risk factors are





  1. Population attributable risk (PAR) is based on the assumption that the risk factor is removed from the entire population being targeted. It also can be used to calculate the cost benefit and the ____ of a prevention program.
A. Cost effectiveness
B. Necessity
C. Population ecology
D. Percent of repeat participants






  1. The nursing student is studying learning theories. He learns that television commercials are an example of which learning theory?
A. Constructivism
B. Cognitivist
C. Bandura’s theory of social learning
D. Behaviorism





  1. A patient diagnosed with diabetes buys books, reads articles, talks with knowledgeable people, informs himself about what he can do to improve his health, and takes action. The PHN recognizes this method of adult learning as
A. Pedagogy
B. Andragogy
C. Constructivism
D. Humanism






  1. A nursing student is listening to a lecture on poor health outcomes. Based on research by the Institute of Medicine (IOM), the instructor says that less knowledge of chronic disease management, performance of fewer health promotion activities, low usage of the health-care system, and less use of preventative services are due to:
A. Low health literacy
B. Poor insurance
C. Limited access to medical services
D. Few prevention programs





  1. The PHN recognizes that which of these tests is not an indicator of health literacy?
A. The Test of Functional Health Literacy in Adults (TOFHLA)
B. Rapid Estimate of Adult Literacy in Medicine (REALM)
C. National Quality Forum (NQF)
D. Suitability Assessment of Material (SAM)







  1. If the total number of cases of a disease is 100, and the total number of persons in a population is 1,000, what would the prevalence be? ____________________



  1. In a hypertensive study, nurses took the blood pressure readings of 250 participants. In order to determine the accuracy of their readings, they wanted to test the sensitivity of their instruments. If the number of true positives is 40, and the total number of participants with disease (true positives plus false negatives) is 55, the sensitivity of the instrument is ____________________.





  1. A nursing student is studying preventable causes of death. In 2004, what were the three leading causes of preventable death?

Select all that apply.

A. Tobacco use
B. Drowning
C. Alcohol use
D. Falls
E. Improper diet and physical inactivity




  1. When screening for, monitoring, and diagnosing disease, a health-care provider always evaluates a measurement tool for which of the following attributes?

Select all that apply.

A. Reliability
B. Validity
C. Functionality
D. Sensitivity
E. Specificity




Chapter 3: Epidemiology and Nursing Practice




  1. John Snow, considered the founder of epidemiology, realized the source of the London’s cholera epidemic through:
A. A residential pattern of death
B. Mapping of the food supply
C. Interviewing the families of the sick
D. Performing autopsies





  1. The history and development of epidemiology has gone through several developmental phases. The public health nursing student learns that these phases came about in history in what order?
A. Risk factor phase, infectious disease phase, and sanitary phase
B. Infectious disease phase, risk factor phase, and sanitary phase
C. Sanitary phase, infectious disease phase, and risk factor phase
D. Agent phase, host phase, and environment phase






  1. A public health nurse (PHN) is asked by the hospital administration to find out why there are so many pediatric asthma patients coming to the ER for treatment and to develop a plan to reduce admissions by 10%. The nurse needs to untangle the multiple risk factors involved in order to determine what type of intervention should be developed, so he or she uses:
A. Descriptive data analysis
B. The ecological model
C. Demography
D. The web of causation





  1. If a nurse takes the number of new cases of a disease or illness among the contacts of initial (primary) cases and divides it by the number of people in the population at risk, he or she is calculating the:
A. Prevalence
B. Incidence
C. Secondary attack rate
D. Attack rate





  1. A public health official reports that the weekly influenza rate for a city in Oregon is 12.5%. This rate does not take into account smoking status, so it is a(n):
A. Independent rate
B. Mortality rate
C. Dependent rate
D. Morbidity rate





  1. When comparing the body mass index (BMI) of obese women in two cities, it would be an erroneous assumption for the nurse to think that, based on these averages, since the average BMI of City A was higher than that of City B, a woman in City A will have a higher BMI than a woman in City B. This assumption is referred to as:
A. An odds ratio
B. An ecological fallacy
C. A causality
D. Relative risk




  1. A nurse conducts a survey within several months to determine which children in a certain school have parents that smoke in order to study their risk for asthma. This type of study is called a(n):
A. Case-control study
B. Cross-sectional study
C. Cohort study
D. Outbreak investigation





  1. A control or “no disease” group is needed for study of oral cancer. The nurses conducting the study decide to use a group of patients with skin cancer because these patients are at the same facility, and the likelihood of developing oral cancer with skin cancer is low. However, this variable could still cause the disease being studied, as well as potential limitations in the study. This variable would be called a(n):
A. Confounder
B. Right censoring
C. Case-control
D. Odds ratio





  1. An epidemiologist uses the epidemiological triangle to explain the occurrence of disease by looking at the three main components of the model: the host, the environment, and the agent. The PHN understands that the agent could be one of many types except:
A. Biological and chemical
B. Nutritive
C. Physical
D. Ecological





  1. The public health nursing student is studying outbreak investigations and disease trends. The student learns that the disease that has seen an increase in the last 30 years after a decline in the 1970s is:
A. West Nile virus
B. H1N1 virus
C. Influenza
D. Pertussis






  1. A nurse is giving a lecture on communicable diseases and indicates that West Nile virus is spread by all of the following except:
A. Poor sanitation conditions
B. Insects
C. Poor hygiene
D. Tainted food






  1. The PHN understands that chronic diseases have replaced communicable diseases as the major disease classification for:
A. Larger third world countries
B. Low-income countries
C. High-income countries
D. Smaller, more primitive countries






  1. A PHN has a patient that has multiple medical issues that have developed over time. The nurse suspects that the issues are due to working in a chemical plant. The plant was monitored carefully, but a direct cause of his illness will be difficult to prove because:
A. Safety records of the plant do not pertain to the health records of the patient.
B. The patient has medical problems that could be caused by lifestyle decisions.
C. Toxic substances often have thresholds below which exposures do not present human health risks but above which can prove to have adverse and sometimes fatal consequences.
D. Some toxic substances are difficult to trace in medical tests.





  1. A family does preconception testing for early identification of cerebral palsy to make childbearing decisions by using genetic markers. The PHN recognizes that this area of study is called:
A. The Human Genome Project
B. Behavioral Risk Factor Surveillance System (BRFSS)
C. Ecological epidemiology
D. Genomics





  1. A PHN is looking into the high rate of diabetes in the community. The nurse knows that there are three categories of risk factors in the field of epidemiology to be considered in the investigation. These categories include all of the following except:
A. Prevalence
B. Behavioral
C. Environmental
D. Genetic





  1. A nursing instructor is giving a lecture on genetics and genetic testing. The instructor explains that there is a lot of controversy over testing for BRCA1 and BRCA2, the tumor suppressing genes that, if mutated, may indicate hereditary breast and ovarian cancer. The arguments against genetic testing for BRCA1 and BRCA2 include all of the following except:
A. The cost of the test is high.
B. The evidence to the effectiveness of the test is limited.
C. The test is difficult to perform.
D. Less than 10% of all breast cancers are genetically based.







  1. A local health department reports that there are 1,375 smokers in a town of 5,000. Of these smokers, 536 have reported that they have influenza. What percent of smokers have influenza? Round your answer to the nearest whole percent. ____________________



  1. A PHN is studying the rate of H1N1 in the community. If there are five cases of H1N1 in the community of 1,000 people, what is the prevalence rate? ____________________






  1. A PHN recognizes that which of the following are types of cohort studies?

Select all that apply.

A. Prospective
B. Retrospective
C. Historical
D. Longitudinal
E. Statistical




  1. A nursing student learns that an outbreak investigation could be used in which of the following situations?

Select all that apply.

A. High numbers of hip injuries at a local nursing home
B. Gastroenteritis illness investigations at a community daycare
C. Food borne illnesses resulting from salmonella at a restaurant
D. Employees with elevated levels of asbestosis
E. A community with an unexpectedly high number of infants with elevated blood lead levels





Chapter 4: Introduction to Community Assessment




  1. A public health nurse (PHN) conducts a community health assessment to identify the needs of a population. For example, the PHN might gather data to provide the rationale for a pediatric clinic in a low income area. He or she would take into account the sociodemographics of the community, as well as the:
A. Preventive health concerns
B. Need for medical facilities
C. Collaboration of the community
D. Lifestyle concerns





  1. A PHN is assigned to an area to do a community assessment. The demographic data the nurse collects includes:
A. Insurance company preference
B. Religious affiliation
C. Educational levels
D. Medical results





  1. A nursing instructor explains to a nursing student that information about a community’s health services and resources includes all of the following factors except:
A. Service use patterns
B. Treatment data
C. Insurance costs
D. Provider/client ratios





  1. A nursing instructor describes one approach to conducting an assessment as a collection of data about the populations living within the community; an assessment of the assets within the community, such as the local health department capacity; and the identification of problems and issues in the community, such as unmet needs and health disparities, and opportunities for action. The instructor explains that this type of approach is called a:
A. Rapid needs assessment
B. Comprehensive community assessment
C. Population-focused assessment
D. Health impact assessment





  1. A PHN is looking for a tool to help conduct a community assessment. The nurse can get such a tool from the:
A. National Institute of Occupational Safety and Health (NIOSH)
B. Affordable Care Act (ACA)
C. Institute of Medicine (IOM)’s report The Future of Public Health
D. Community Health Assessment aNd Group Evaluation (CHANGE)





  1. A PHN goes to a factory to find out why employees are missing so many work days. What type of assessment would be the most appropriate in this case?
A. Setting-specific assessment
B. Health impact assessment
C. Problem or health issue-based assessment
D. Population-focused assessment





  1. In order to develop maintenance and survival strategies for a community in the event of an emergency, a PHN looks for useful places, persons, and systems. This part of the assessment is called:
A. Capacity building
B. Needs assessment
C. Participatory research
D. Asset mapping






  1. A PHN uses the Mobilizing for Actions through Planning and Partnerships (MAPP) strategic model because of its distinct use for assessing what particular aspect of a public health situation?
A. Financial
B. Mortality
C. Intervention
D. Geographic






  1. A PHN is using the MAPP model to conduct an assessment within the community and has reached Phase 3, the four assessments. The nurse understands that analysis of the legislation, technology, and other external positive and negative influences that have an impact on the promotion and protection of the public’s health is called a:
A. Community themes and strengths assessment
B. Forces of change assessment
C. Community health status assessment
D. Local Public Health System Assessment (LPHSA)





  1. A PHN was asked to come to a town that was having some noticeable health problems. Driving through town, the nurse noted that there were many for-sale signs, as well as very little green space and some trash in the street. This preassessment phase is called a:
A. Community themes and strengths assessment
B. Community Health Assessment aNd Group Evaluation (CHANGE)
C. Community health status assessment
D. Windshield survey





  1. A relatively permanent statistical subdivision of a county that averages between 2,500 and 8,000 inhabitants is called a:
A. Census block
B. Secondary data
C. Census tract
D. Health-care sector






  1. According to the CHANGE model, the aspect of a community that includes community-wide efforts that have an effect on the social and built environments such as improving food access, walkability or bike-ability, tobacco use or exposure, or personal safety is called the:
A. Community institution or organization sector
B. Health-care sector
C. Community-at-large sector
D. Preventative sector





  1. A nursing student is learning about a type of sampling in which a list of the possible participants is present and the number needed for the sample is divided into the total population. From that point, n, every nth person is chosen for the sample. The student learns that this type of sampling is called:
A. Quota sampling
B. Convenience sampling
C. Simple random sampling
D. Systematic sampling





  1. A community assessment team found that the problem with their surveys of older adults was that there was not enough information on the health-related quality of life (HRQoL) for those over the age of 65 who were not living in a health-care facility. The best approach to assess this population is to do surveys:
A. By personal interview
B. By mail
C. By telephone
D. Online





  1. A nursing student is listening to a lecture in which the instructor explains that a population pyramid is a way to visually compare a population for a certain demographic such as age. If a pyramid has a broad base and a small top, it represents:
A. Slow growth
B. Rapid growth
C. Equal growth
D. Mostly older people, with no growth





  1. Using the Kinship/Economics/Education/Political/Religious/Associations (KEEPRA) model for observing formal institutions in a community, the PHN recognizes that which of the following categories assesses the number or availability of recreational centers?
A. Education
B. Kinship
C. Associations
D. Economic







  1. A nursing student is listening to a lecture on community assessment tools. The nursing instructor explains that PHNs have found that some of the best uses of the Geographic Information Systems (GIS) include which of the following?


A. To locate medical facilities
B. To identify spatial data
C. To display environmental risk factors and health risks
D. To display demographic data
E. To display socioeconomic data




  1. A PHN wants to conduct an assessment in the community and intends to start by collecting data through the use of a survey. The PHN recognizes that the advantages of a health indicator survey that measures health-related quality of life (HRQoL) include which of the following?


A. HRQoL is a multidimensional construct that relates to a person’s perception of the impact their physical and emotional health has on their quality of life.
B. HRQoL is an indicator of how much health insurance will pay if you are in the hospital.
C. Including HRQoL items on a survey will provide information on the health of the community that the secondary data does not provide.
D. HRQoL ascertains if an intervention is needed.
E. HRQoL contains information that is quantitative rather than qualitative in nature.






  1. A public health team wanted to track the changes in a population within their town, particularly a shift in the Hispanic population. Currently, the town’s population is 60% Hispanic, whereas five years ago, it was 39%. The percentage change is ____________________.






  1. A PHN wants to calculate the age-adjusted crude death rate of a community. If the total number of expected deaths is 365 and the total standard population is 60,000, then the death rate would be ____________________.



Chapter 5: Health Program Planning




  1. A community’s public health nurses (PHNs) are working on building community capacity, which includes all of the following except:
A. Organizing assets and resources to improve the health of a community
B. Assessing how many people the community clinic will contain at one time
C. Working in partnerships and supporting decision making
D. Identifying root causes of health problems and working on interventions and outcomes






  1. Due to health concerns for high-risk populations, Healthy People 2020 includes as one of its main goals:
A. To provide better insurance programs
B. To have collaboration among governmental agencies
C. To provide access to preventive health-care services
D. To improve assessment of services





  1. A public health nursing instructor educates a class that the Predisposing, Reinforcing and Enabling factors, and Causes in Educational Diagnosis and Evaluation (PRECEDE) component of the PRECEDE-PROCEED begins with:
A. An examination of administrative and organizational issues
B. A comprehensive community assessment
C. Preventative programs
D. The implementation of behavior change





  1. In general, nurses using the program planning model would begin by:
A. Assessing the community
B. Clarifying the health problem
C. Understanding the underlying factors that contribute to the problem
D. Developing an intervention





  1. A group of public health officials want to use the logic model for program design. In this model, when a program’s intended outcome is achieved, this is referred to as successful:
A. Input
B. Output
C. Outcome
D. Impact





  1. The logic model can provide an analytical structure for better outcome development and program management and evaluation. This was applied to programs aimed at families at risk for homelessness. Researchers found that the main advantage to this model was that
A. They were able to acquire government aid.
B. They were able to more clearly define their goals to determine more immediate outcomes.
C. They were able to get more material resources.
D. They were able to build houses for those at risk.





  1. If the logic model is used for its linear reasoning in program design, the implementer will read the model like a map, from left to right, whereas stakeholders will read the steps:
A. From left to right
B. All at once
C. From right to left
D. By scanning





  1. If a PHN is working for the cause of social justice within a community, he or she will distribute a vaccine
A. Only to children
B. Only to the elderly
C. Only to those who have insurance
D. To everyone equally, according to the resources available





  1. Keeping in mind distal social determinants when helping a community, a nurse uses the resources available to:
A. Build a better playground.
B. Build a better clinic.
C. Build a better school.
D. Build a better community grocery store.






  1. A PHN is studying a geriatric population in a high-rise building. As part of the community diagnosis, there are several factors to be examined, including the factor that is particularly significant to designing the program since it alters the outcome. This factor is called the:
A. Causal factor
B. Mediating factor
C. Moderating factor
D. Antecedent factor





  1. When a PHN is working on a community diagnosis for an industrial town with a high incidence of a normally water-borne illness, the nurse researches the characteristics of the problem. This part of a community diagnosis looks at
A. What the problem is related to
B. The assessment
C. The population
D. How the problem is demonstrated






  1. A nurse wants to use evidence-based practice (EBP) to develop a program aimed at preventing social isolation in older adults. The first step the nurse should take is to
A. Do an assessment.
B. Develop a community diagnosis.
C. Consult the literature to create a rationale for intervention.
D. Begin community organizing.






  1. A nurse is planning for the community acceptance of a program, estimating resources, developing specific plans for activities, and establishing program management. The nurse is currently working on
A. Project management
B. Program evaluation
C. Program implementation
D. Program planning





  1. A nurse is working on a type of evaluation that examines how a program actually works and whether any outside environmental events might have an impact on the program. This type of evaluation is called a
A. Formative evaluation
B. Process evaluation
C. Summative evaluation
D. Program evaluation






  1. A PHN is gathering evaluation information on a program to be used for several purposes, except
A. To share with the media for public relations
B. To make improvements on the program
C. To redefine the population being served
D. To share with funding agencies





  1. Pressure to slant or misuse the findings of an evaluation from the stakeholders would be what kind of problem?
A. Moral
B. Management
C. Confidentiality
D. Ethical







  1. A PHN is evaluating the effectiveness of a health intervention program for children by looking at the program characteristics. According to Lisbeth Scherer’s criteria, the nurse will be looking for which of the following?


A. Whether the program is meeting all the needs of the children
B. Whether the program continues to reach out to the families in neighborhoods
C. Whether the program stays true to its goals
D. Whether the staff and managers are able to support the mission of the program
E. Whether the program is able to attract grant money





  1. When analyzing evidence-based practice (EBP) literature to see if the information should be used in planning a program, a nurse should look at which of the following?


A. Quantitative and qualitative data from studies
B. Analysis to see if the program is thriving
C. Economic indicators to see if the program is financially stable
D. Indicators of real outcomes and behavior change
E. Indicators of outside factors that might change the program




  1. In community organizing, the PHN recognizes that her role is that of a:


A. Stakeholder
B. Leader
C. Listener
D. Facilitator
E. Developer of skills





  1. When considering the outcomes of a planned intervention, a nurse should measure which of the following types of outcomes?


A. Short-term
B. Medium-term
C. Changes in knowledge, skills, or behavior
D. Long-term
E. Unexpected or unintended outcomes





Chapter 6: Environmental Health Nursing




  1. After the oil spill of 2010 in the Gulf of Mexico, which occurred following a hurricane in that same area four years previously, public health officials became particularly concerned about the economic health of the area. What caused this economic concern?
A. Illnesses due to the quality of the air
B. Illnesses due to the quality of the water
C. The habitats of the fishing industry being destroyed
D. The closing of the recreational industry





  1. The health effects of the 2010 oil spill in the Gulf of Mexico on the workers and residents, the food supply, and the fishing industry demonstrates the relationship between environmental health and personal health. According to the World Health Organization (WHO), the factors that are addressed in environmental health are:
A. Water, air, and waste
B. Economics and governmental structure
C. Areas that we live, work, and play
D. Physical, chemical, and biological





  1. A public health nurse (PHN) uses the epidemiological triangle to understand
A. The environment that brings an agent and host together
B. The role environment plays in the health of individuals, families, and communities
C. The role of water, air, and waste in environmental health
D. Both 1 and 2





  1. A PHN is evaluating a community’s pollution, accessible transportation, and outside activities and the maintenance of its neighborhood buildings. The nurse is evaluating the:
A. Environmental stability
B. Built environment
C. Ecological approach
D. Environmental health




  1. The PHN realizes that the mere presence of an agent, even if it is known to have toxic properties, does not necessarily mean there is a risk to health. However, the three routes of entry for chemical exposure include all of the following, except:
A. Ingestion
B. Inhalation
C. Dermal absorption





  1. A hospital admits a patient who is having breathing problems after mixing household cleaning products. The nurse recognizes that this patient is suffering from exposure to which type of environmental hazard?
A. Biological
B. Mixed
C. Physical
D. Chemical





  1. A family survived a dangerous weather event, but now they are suffering through another part of environmental risk: stress, pain, and anxiety. The nurse recognizes that this is the:
A. Physical agent
B. Mixed exposure
C. Psychosocial factor
D. Biological agent






  1. A PHN is learning about exposure risk assessments, which are used by policy makers and other regulators to evaluate the health effects from an environmental exposure. In these assessments, the final step in the process involves making a judgment about the risk of the health problems to those who are exposed. The nurse learns that this is referred to as a:
A. Dose-response assessment
B. Risk characterization
C. Hazard identification
D. Exposure assessment






  1. Older adults have higher body burdens of chemicals that have been absorbed over their lifetimes, and these chemicals collect in the adipose tissue or bone, and can later result in poor health outcomes, such as cancer or organ damage. The PHN recognizes that this substance collection is called:
A. Half-life
B. Bioaccumulation
C. Latency period
D. Environmental exposure




  1. A PHN notices that the Air Quality Index measures 120 for an area. The PHN knows that this means that:
A. The air quality is good.
B. The air quality is  unhealthy.
C. The air quality is hazardous.
D. The air quality is moderate affecting the most sensitive individuals.




PTS:   1                    CON:  Oxygenation | Safety


  1. A nursing instructor is holding a lecture on environmental health and explains that gene environment interaction:
A. Can directly cause diabetes, pulmonary disease, and breast cancer
B. Can change the expression of a genetic trait and alter physical aspects
C. Can have either a protective influence or increase risk for many diseases
D. Does not demonstrate any noticeable effect from the environment






PTS:   1                    CON:  Family | Nursing Roles | Safety


  1. A PHN is helping to manage a chemical spill crisis in a nearby community. In order to find out the community’s chemical response plan, the nurse consults which of the following?
A. The Emergency Planning and Community Right to Know Act (EPCRA)
B. The Centers for Disease Control and Prevention (CDC)
C. Healthy People 2020
D. The World Health Organization (WHO)






PTS:   1                    CON:  Trauma | Critical Thinking | Safety


  1. A PHN knows that the ambient air standard, which is the highest level of a pollutant in a specific place over a specific period of time that is not hazardous for humans, is most influenced by:
A. Wind
B. Weather
C. Population
D. The surrounding built environment






PTS:   1                    CON:  Oxygenation | Safety


  1. Many outdoor air contaminants originate from various sources. The PHN recognizes that sources such as gas stations, dry cleaners, commercial building heating and cooling systems, and waste disposal facilities are referred to as:
A. Criteria air pollutants
B. Area sources
C. Mobile sources
D. Point sources





  1. Particulate matter varies in size, and the size determines the site of the deposition in the respiratory system. The nursing student is taught that this means that:
A. The larger the particulate, the more hazardous
B. The smaller the particulate, the more hazardous
C. The size of the particulate is not important
D. The lungs and dust masks can take care of the particulates






  1. According to the WHO, it is estimated that a large number of people worldwide do not have access to safe drinking water. In a lecture on water quality, a PHN learns that the main barriers to the provision of clean drinking water include all of the following except
A. Financial capacity
B. Too many facilities for the sanitary disposal of excrement
C. Sustainability of the water supply
D. Sanitation and hygiene behaviors







  1. A nursing instructor is giving a lecture on environmental sustainability. The instructor explains that this is a critical issue to the global environment and an important emerging public health issue. Some of the issues addressed within environmental sustainability include which of the following?

Select all that apply.

A. Preventing environmental exposure
B. Maintaining the funding for research and development for alternative energy
C. The rates in which renewable resources are harvested
D. The rates of depletion of nonrenewable resources
E. The creation of pollution that can continue for an indefinite period of time



5 This is correct. Environmental sustainability must include the monitoring and regulation of pollution to insure water and air quality.



PTS:   1                    CON:  Nursing Roles | Safety


  1. The PHN understands that the toxicity of chemicals in children is more severe than that in older populations because of which of the following reasons?

Select all that apply.

A. Children play in outdoor soil, which can be contaminated.
B. Children may ingest substances from unlabeled, repurposed food containers.
C. Children have faster rates of absorption of toxic substances.
D. Parental oversight is minimal.
E. Children have less developed immune systems.




  1. To aid a lower income family who is struggling with a pest problem in their home, a PHN recommends a program known as integrated pest management, which offers methods to deter pests. Some of these methods include which of the following?

Select all that apply.

A. Caulking and sealing cracks and holes in the home
B. Eating in one place
C. Getting rid of clutter
D. Storing food in sealed containers
E. Making sure the family is vaccinated




  1. The public health nursing student learns that the need for environmental justice extends to disadvantaged populations, who, as a result of low income, age, health status, race, or other social indices of susceptibility, are at greatest risk of exposure to environmental hazards because of which of the following problems?

Select all that apply.

A. Substandard housing
B. Lack of access to health care
C. Lack of nutritious food
D. Lack of safe places to play
E. Employment in risky jobs




Chapter 7: Health Disparities




  1. A nurse is studying the increased infant mortality rate at a local hospital in a largely African American community. The nurse notes that there are very few options for prenatal care in the community and recognizes that this is an example of:
A. Health disparity
B. Health inequity
C. Health injustice
D. Social determinant of health





  1. Which of the following is the definition of health disparity?
A. A difference in health outcomes
B. An unequal and unjust difference in health outcomes
C. A social factor that impacts health outcomes and contributes to disparity
D. Access to health care for everyone without financial hardship





  1. In many countries, which factors decrease infant mortality rate?
A. Income
B. Education level
C. Neither 1 nor 2
D. Both 1 and 2





  1. In a study performed by the Center for Economic and Political Studies, researchers found that between 2003 and 2006 the cost of health inequalities in the United States was approximately:
A. $1 million
B. $100 million
C. $1 billion
D. $1 trillion





  1. Which of the following programs has been designed to work toward optimal health for all Americans?
A. Racial and Ethnic Approaches to Health (REACH)
B. Universal Health Care
C. Healthy People
D. EURO Health for All





  1. Which of the following statements about Healthy People is correct?
A. Healthy People 2010 was successful in reaching its goal of ending health disparities.
B. Healthy People 2010 focused on climate change as one of the key factors contributing to health inequities.
C. The goal of Healthy People 2020 was expanded to include improving the health of all ages and groups, and to eliminate all health disparities and inequities.
D. The goal of Healthy People 2010 was to reduce health disparities and inequity.






  1. A nurse manager has been working in a community health center for many years. In the recent months, the nurse manager has noticed a dramatic increase in the number of Hispanic clients coming in to the center with uncontrolled diabetes. Which of the following is the best way to address the situation?
A. Speak with local providers about decreasing the length of time between follow-up visits.
B. Involve pharmacists in counseling newly diagnosed patients about their insulin regimen.
C. Perform a community assessment to determine why community members aren’t properly caring for themselves.
D. Develop several educational handouts about managing diabetes and have them translated into Spanish.






  1. A nurse educator is preparing a lesson on the issues surrounding the Affordable Care Act and universal health care. In 2005, which organization passed a resolution that states that every person should be able to access health-care services regardless of economic status?
A. The Supreme Court
B. The World Health Organization
C. The United Nations
D. The World Health Assembly





  1. Researchers have found that investment in which of the following would have had a greater effect on health disparities than the investment in new medical technology?
A. Improving quality of health care
B. Increasing access to education for everyone
C. Implementing universal health care
D. Decreasing crime rate





  1. A nurse is teaching an in-service for new nurses on the importance of cultural sensitivity when caring for patients. Which of the following statements is incorrect?
A. Ethnic diversity of health-care staff plays little role in the reduction of health-care inequalities.
B. Translators should always be used when a patient does not speak English as a primary language.
C. Nurses and other health-care workers may often display discriminatory behavior without realizing it.
D. Nurses must always work as patient advocates to make sure that the patient is receiving culturally sensitive care.






  1. A nurse is working in a community center and notices a high rate of obesity in its members. The nurse suspects that poor access to fresh fruits and vegetables may be partially responsible. What should the nurse do first when formulating a plan?
A. Assess the social determinants in the community.
B. Implement a plan to increase access to fresh produce.
C. Outline the steps needed to address the disparity.
D. Formulate a community diagnosis.





  1. A nurse is performing an assessment of a very economically diverse community and realizes that while comparing income to health outcomes, the nurse must be careful to:
A. Compare only the outcomes of the richest community members to the outcomes of the poorest community members.
B. Recognize that income and outcomes exist on a scale, and look across the entire spectrum.
C. Evaluate only the poorest health outcomes and where they land on the income spectrum.
D. Evaluate only the poorest community members and their health outcomes.





  1. A nurse is looking at reasons why members of a community are more likely to die from heart disease. The nurse finds several studies that suggest that social factors, such as ____, are more important than behavioral choices.
A. Smoking
B. High-fat or high-sugar diets
C. Poverty
D. Lack of exercise






  1. A research nurse is looking for funding to study health disparities in a community—an ethnically and economically diverse inner city neighborhood. The nurse is trying to apply evidence from controlled studies to see how they correlate in the real world. What type of study is the nurse designing?
A. Translational
B. Causation
C. Correlation
D. Observational






  1. During a lecture on health disparities, a student asks the instructor how communities with great access to health care can still have poor health outcomes. How should the instructor respond?
A. Social determinants of health determine how people respond to health threats and how they access preventative care.
B. The student is incorrect. Communities with good access to care have good health outcomes.
C. This phenomenon only occurs in communities where the quality of health care is poor.
D. Members of these communities only have access to primary-care providers, which reduces the quality of care they receive.





  1. A nurse is counseling a young man with obesity and diabetes. The nurse explains that in addition to direct medical costs, indirect costs will likely include:
A. Costs of medication
B. Lost wages and loss of employment productivity
C. Decreased lifespan
D. Increased costs of health insurance








  1. A nurse is organizing a round table presentation at a conference. The nurse asks the other participants for suggestions on actions that nurses can take to reduce national health disparities. Which of the following suggestions are known to be effective measures for the reduction of health disparities?

Select all that apply.

A. Volunteer with an international organization that supports building infrastructure in underdeveloped areas.
B. Support initiatives that increase physical education classes and healthy school meals.
C. Design and create research studies that address inequities and support vulnerable populations.
D. Discuss social and health disparity information with coworkers to promote awareness.
E. Act as advocates for patients, families, and communities in reducing inequities.




  1. A nurse administrator is teaching staff about populations at risk for poor health outcomes in an attempt to decrease health inequities in the hospital. Which of the following groups does the nurse administrator mention are at higher risk for poor health outcomes related to health disparities?

Select all that apply.

A. People who carry private health insurance
B. Families receiving public assistance
C. African Americans
D. Native Americans
E. The middle class





  1. A public health nurse (PHN) is performing a community assessment in order to reduce the childhood obesity rate in a community. What social determinants of health should the PHN examine?

Select all that apply.

A. Location of primary health providers
B. Nutrition and physical education classes in the public schools
C. Housing security
D. Presence of sidewalks within the community
E. Access to fresh produce








  1. A PHN is looking at creating a plan to address the high rate of uncontrolled hypertension in a community. List the following steps in the order in which the nurse should perform them (1–4).

_____ 1. Evaluate the community to see what social determinants of health need to be addressed and what is lacking within the community.

_____ 2. Review the program outcomes with evaluations from participants and local care providers to determine the effectiveness of the program.

_____ 3. Start planning a community wide health fair with representatives from local primary-care providers, fitness centers, and local produce vendors.

_____ 4. Have printed material and educational information available for community participants to take home and use after the fair.



Chapter 8: Surveillance and Communicable Diseases




  1. A nurse working in a community clinic noticed an unusually large number of patients with a specific type of influenza. The nurse knew that the disease was running rampant in other parts of the country, making it ____.
A. A pandemic
B. An endemic
C. An epidemic
D. Both 1 and 2





  1. A nurse who treated a patient with a severe respiratory infection incorporates which of the following preventive measures to ensure the disease will not spread to others?
A. Use personal protection equipment (PPE)
B. Wash hands frequently
C. Proper cleaning of patient areas
D. All of the above




  1. When a patient shows symptoms of pneumonia, the nurse knows to first understand three key factors about the disease, including:
A. The infectious agents that cause disease
B. The environment relevant to the transmission of disease from one person to another
C. Who is at risk for becoming infected
D. All of the above





  1. A nurse starting a new job in a pediatric clinic is reviewing a list of infectious diseases he or she might encounter in her patients. Which of these are included on her list?
A. Chickenpox
B. Tuberculosis (TB)
C. Group A streptococcus
D. Both 1 and 3




  1. Each fall, a public health nurse (PHN) working with the elderly understands that influenza peaks in ____ and ____, so the PHN checks the Centers for Disease Control and Prevention’s flu report that tracks trends across the country.
A. December, February
B. October, March
C. December, April
D. September, February





  1. A PHN working in an Idaho clinic suspects that a patient—a 30-year-old Hispanic man who was a substance abuser—has HIV/AIDS. Which of the following might have suggested that conclusion?
A. He is in the 25 to 44 age group where rates are the highest.
B. He is Hispanic and a substance abuser.
C. He lives in Idaho, a state with a high percentage of HIV/AIDS patients.
D. Both 1 and 2






  1. A nurse volunteering in an African clinic notices many patients have diarrheal disease, which the nurse recognizes is spread by which of the following?
A. Water
B. Food
C. Person-to-person contact
D. All of the above






  1. Although many communicable diseases have been eradicated, new ones are appearing or old ones are morphing into new forms. Which of the following fall into the category of those not yet eradicated?
A. Multiple drug resistant tuberculosis (MDRTB)
B. Smallpox
C. West Nile Virus
D. Both 1 and 3





  1. A patient showing signs of pneumonia is admitted to a hospital, where tests indicate he has highly infectious M tuberculosis, and he has had contact with many patients, employees, and family members despite isolation. An investigation team, including a PHN, should take which of the following steps to find out what went wrong?
A. Identify the index case, the first case identified in a particular outbreak.
B. Identify secondary cases, those patients who were diagnosed with active TB and who had contact with the index patient.
C. Identify all contacts.
D. All of the above






  1. When treating patients that may be infectious, nurses are required to institute appropriate isolation procedures based on the known or suspected agent. These procedures are public health interventions aimed at preventing the spread of disease in:
A. Employees
B. Community members
C. Other patients
D. All of the above





  1. PHNs are involved in protecting the population at large from the spread of infectious agents. They must be able to identify elements of the infection cycle in their patients, including
A. Agent of infection characteristics
B. Mode of transmission
C. Lifecycle of an agent of infection
D. All of the above





  1. Infection control nurses in two hospitals located in the same county notice an increase in positive labs for Escherichia coli (E. coli) 0157:H7 infections in their patients. They then join the investigative team and conduct which of the following steps to prevent the spread of the outbreak?
A. Determine if there is an epidemic.
B. Find a common source.
C. Identify the pathogen.
D. All of the above




  1. A Baltimore City nurse is aware that from 2003 to 2004 the prevalence of syphilis in the city increased by 40%. As part of the investigative team, the nurse and colleagues assessed the data related to the new syphilis cases and were able to define it as an epidemic using which of the following steps?
A. Determine if the prevalence reached epidemic threshold.
B. Determine the type of epidemic.
C. Review demographic cases.
D. All of the above





  1. A nurse working in the emergency department is aware that the flesh-eating bug can be caused by:
A. Staphylococcus aureus
B. Clostridium perfringens
C. Bacteroides fragilis
D. All of the above





  1. While studying communicable diseases, a PHN learns that the main objective is to control the spread of disease by
A. Changing the environment
B. Activating the agent
C. Increasing host resistance
D. Both 1 and 3






  1. Nurses give vaccinations to help increase host resistance to other diseases. Among the vaccines commonly administered are
A. Pneumonia
B. Influenza
C. Smallpox
D. Both 1 and 2





  1. Several factors influence the decisions of public health agencies to make vaccines mandatory. These include
A. Effectiveness of the vaccine
B. Where the highest risk exists
C. Where the lowest risk exists
D. Both 1 and 2





  1. Communicable diseases that a nurse might expect to commonly encounter in patients include:
A. Chickenpox
C. Influenza
D. Both 1 and 3





  1. Categories of infectious agents an infectious disease nurse might expect to encounter in patients include:
A. Bacteria
B. Mycoses
C. Viruses
D. All of the above





  1. A nurse treats a patient with Lyme disease and notes that ____ act as vectors and transmit the agent from its reservoir to its host.
A. Hookworms
B. Anthropods
C. Protozoa
D. None of the above




Chapter 9: Noncommunicable Diseases




  1. Nurses working with diabetes patients know that this noncommunicable chronic disease (NCD) has which of the following characteristics?

Select all that apply.

A. It cannot be prevented by a vaccination.
B. It cannot be cured by a medication.
C. It requires long-term management.
D. It is not affected by weight.
E. It does not require lifestyle changes such as regular exercise.




  1. In caring for their chronic disease patients, nurses must do which of the following?

Select all that apply.

A. Know others who have or have had the disease.
B. Know the pathophysiology of the disease.
C. Understand the disease from a public health perspective.
D. Help patients understand self-management techniques.
E. Work in a hospital setting.




  1. Nurses working with chronic disease patients consider it important to know about the burden of disease associated with a specific disease because it does which of the following?

Select all that apply.

A. Takes into account what impact the disease will have on the community as a whole
B. Provides an overview of the disease’s social and economic impact
C. Helps determine promotion and prevention efforts targeting most common chronic diseases
D. Does not impact treatment cost
E. Does not affect risk of injury





  1. Nurses working with chronic disease patients assess them based on which of the following risk factors?
A. Nutrition
B. Both 1 and 3
C. Alcohol and tobacco use
D. Height





  1. A nurse working with chronic disease patients readily recognizes that the common forms of diabetes include:
A. Type 1
B. Type 3
C. Both 1 and 4
D. Type 2




  1. When a nurse treats a heart disease patient, he or she evaluates which of the patient’s risk factors to determine how modification might help bring about improvement?
A. Tobacco use
B. Both 1 and 3
C. Amount of exercise
D. Height





  1. Cardiovascular nurses know that over a third of adults have two or more risk factors for heart disease and stroke, which may include
A. High blood pressure
B. An inactive lifestyle
C. Both 1 and 2
D. Normal body weight






  1. A public health nurse (PHN) can employ which of the following to help determine what leads to the development of disease?
A. Case control study
B. Cohort study
C. Epidemiological survey
D. All of the above






  1. A nurse working in a hospital oncology unit notices that the number of lung cancer admissions has increased in a particular zip code. What steps should the nurse take to determine what is causing the increase?
A. Notify the nurse manager.
B. Both 1 and 4
C. Disregard admissions records for similar cases.
D. Present the findings to the public health department for their review.




  1. A PHN evaluating an increase in lung cancer cases in a certain area would take which of the following steps to determine what was causing the increase?
A. Conduct a retrospective case control study.
B. Both 1 and 3
C. Ask family members of lung cancer patients for additional information.
D. Not survey town residents





  1. A nurse working with diabetes patients noted that most of them are obese and that this is a risk factor affecting their disease. The nurse knows that in 2009 and 2010 approximately ____ of U.S adults and ____ of children were obese, meaning they had a body mass index greater than or equal to 30.
A. 35.7 %, 16.7%
B. 22.5%, 17.9%
C. 40%, 15%
D. 25.5%, 35.5%





  1. A cardiovascular nurse is treating a smoker with a high risk for cardiovascular disease. Which of the following should the nurse discuss with the patient?
A. Outline the health risks associated with smoking.
B. Share statistics about adverse health outcomes related to smoking.
C. Both 1 and 2
D. Recommend smoking more.




  1. A PHN concerned about the increase in NCDs in a community screens patients for which of the following?
A. Socioeconomic risk
B. Genetic predispositions
C. Behavioral factors
D. All of the above




  1. A nurse working in a community clinic understands that morbidity and mortality related to NCD is affected by access to health care, so the nurse makes sure the patients:
A. Have access to preventive screenings
B. Ignore follow-up appointments
C. Both 1 and 4
D. Get resources to help them manage care






  1. A nurse who treats diabetic patients encourages the patient to follow which of these recommendations to manage their disease diagnosis over time?
A. Monitor blood sugar.
B. Adhere to medication treatment.
C. Both 1 and 2
D. Avoid regular checkups with a health-care provider.





  1. Nurses working with persons at high risk for NCDs encourage their patients to prevent disease development by:
A. Incorporating healthy eating habits
B. Leading a sedentary lifestyle
C. Getting regular preventive screenings
D. Both 1 and 3





  1. An important part of a nurse’s role is to make sure patients understand the importance of ____ in treating their chronic disease.
A. Adhering to medication regimens
B. Both 1 and 3
C. Practicing CDSM
D. Eating anything they want





  1. To educate their patients about the risks of developing NCDs, nurses might share which of the following facts?
A. The five leading causes of death in the United States are NCDs .
B. Risk for NCD is not affected by individual behaviors, the environment, and socioeconomic factors.
C. Prevention occurs across the continuum starting with primary prevention during the perinatal period through tertiary prevention measures such as CDSM programs.
D. Both 1 and 3




  1. A pediatric nurse in Florida reviewed a report for the state’s schools and found which of the following statistics?
A. Twenty-one percent of schools required students to take two or more health education courses.
B. Seventy-six percent taught 14 key nutrition and dietary behavior topics in a required course.
C. Both 1 and 2
D. Ten percent taught a required physical education (P.E.) course in all grades in the school.





  1. When screening a patient for NCD risk, a nurse reviews the social determinants of health, including which of the following?
A. The social gradient
B. Early life
C. Work life
D. All of the above




Chapter 10: Mental Health




  1. According to Healthy People 2020, which of the following are characteristics of mental health?

Select all that apply.

A. Engaging in productive activities
B. Having fulfilling relationships
C. Experiencing alterations in thinking
D. Adapting to change
E. Coping with challenges






  1. In 2010, approximately how many people in the United States reported experiencing mental disorders in the previous year?
A. 15%
B. 50%
C. 30%
D. 25%





  1. A student nurse is studying stress and mental health. The student nurse learns that ____ is based on an individual’s ability to access protective factors that exist at different levels in order to withstand chronic stress or recover from traumatic life events.
A. Intervention
B. Support
C. Resilience
D. Therapy





  1. ____ addresses specific subgroups at highest risk for development of a mental disorder or those that are showing early signs of a mental disorder.
A. Indicated prevention
B. Selective prevention
C. Universal prevention
D. Both 1 and 2





  1. The public health nurse (PHN) recognizes that which of the following are used as screening tools for depression?
A. Patient Health Questionnaire 2
B. Center for Epidemiological Studies Depression Scale (CESD-10)
C. Brief Symptom Checklist-18 of the My Mood Monitor (M-3)
D. Both 1 and 2






  1. During a course on mental disorders, a PHN learns that the term serious mental illness (SMI) refers to diagnosable mental disorders that may disrupt a person’s ability to function and may qualify that person for support services. The PHN also notes that the mental disorders that can lead to SMI include:
A. Mild depression
B. Panic disorder
C. Schizophrenia
D. Both 2 and 3





  1. While studying the prevalence of mental health disorders worldwide, a PHN learns about the World Mental Health Survey, which is used to determine estimates of human capital costs and prevalence of mental disorders in a wide range of countries. The survey was developed by
A. The Centers for Disease Control and Prevention (CDC)
B. The World Health Organization (WHO)
C. The Institute of Medicine (IOM)
D. The World Health Assembly





  1. Which ethnic group has the highest 12-month prevalence of a mental disorder?
A. Hispanics
B. African Americans
C. Asian Americans
D. Non-Hispanic whites





  1. A PHN learns in a behavioral health class that the relationship between physiology and mental health plays an important role in mental disorders. Which of the following physiological factors may contribute to the development of mental disorders?
A. Conditions that affect brain chemistry, such as medication side effects or toxins
B. Physical trauma
C. 1 and 2
D. Unstable family life






  1. Which of the following community environment factors play a role in the development of mental disorders?
A. Living in high crime areas
B. Poverty
C. Both 1 and 2
D. Family instability





  1. ____ is a combination of personal attributes and societal stereotypes related to human characteristics viewed as unacceptable.
A. Indicated prevention
B. Stigma
C. Risk factors
D. Transinstitutionalization





  1. A nurse interested in working with persons with mental disorders who live in poverty understands that the most effective treatment involves multiple sectors of society, such as government agencies, grass roots groups, nonprofits, and businesses, working in tandem. This interrelationship is called:
A. Indicated prevention
B. Intersectoral strategies
C. Health-Related Quality of Life
D. Institute of Medicine Model of Prevention





  1. A recent graduate nurse working in an urban labor and delivery unit had a patient who experienced a difficult labor. The mother, suffering from postpartum depression (PPD), committed suicide a year after giving birth. Although the nurse knew the basics about PPD, the nurse immediately studied the condition in depth and learned that PPD:
A. Can be triggered by a massive hormone drop following delivery
B. Can intensify to cause delusions
C. Occurs soon after delivery
D. All of the above





  1. A nurse working in labor and delivery requested permission from the nurse manager to conduct a quality improvement project to screen patients that might be susceptible to PPD. After completing the project, which of the following screening guidelines did the unit incorporate?
A. All patients will be screened for PPD when they are admitted to the labor and delivery unit.
B. Patients at high risk are referred to the attending obstetrician.
C. Before being discharged, all new mothers will complete a questionnaire specific to PPD symptoms.
D. All of the above




  1. A PHN treats a patient who may be depressed. To verify suspicions, the PHN checks ____, the definitive clinical guide for diagnosing mental disorders and providing consistency and accuracy in the screening for mental disorders.
A. The Diagnostic and Statistical Manual of Mental Disorders (DSM-5)
B. The Center for Epidemiological Studies Depression Scale (CESD-10)
C. Patient Health Questionnaire 2
D. Brief System Checklist-18 of the My Mood Monitor





  1. About 6.7% of the U.S. population is affected by ____ each year. It is the leading cause of disability for people ages 15 to 44 and is more prevalent in women than men.
A. Postpartum depression (PPD)
B. Schizophrenia
C. Major Depressive Disorder (MDD)
D. Posttraumatic Stress Disorder (PTSD)





  1. During the past decade, the morbidity and mortality rate of SMI has increased, showing that persons diagnosed with an SMI die ____ years earlier than those in the general population.
A. 5
B. 25
C. 20
D. 10





  1. A PHN considering a career in mental health nursing learns that the ____ mandates that group health plans of 50 or more persons, which cover mental health and substance use disorders, must provide benefits equivalent to or better than those benefits provided for medical or surgical benefits.
A. Mental Health Parity Act
B. Community Mental Health Centers Act
C. Affordable Care Act
D. None of the above





  1. Nurses working for the Indian Health Services at a reservation health clinic note a high rate of suicide among adolescents living on the reservation. In order to reduce the odds, the nurses decide to take which of the following steps?
A. Determine what stakeholders should be involved to design a community level intervention.
B. Review the national statistics on teen suicide among Native Americans.
C. Complete a draft plan of action.
D. All of the above






  1. A nurse working with mental health outpatients notes that which of the following risk factors are common in the patients?
A. Social isolation
B. Substance use
C. Traumatic life events
D. All of the above




Chapter 11: Substance Use and the Health of Communities




  1. When a nurse at a community clinic is checking a patient for the effects of psychoactive substances, he or she looks for which of the following signs?
A. Altered mood
B. Both 1 and 3
C. Level of consciousness
D. None of the above




  1. A student nurse studying substance use learns that in addition to stimulants, inhalants, depressants, and cannabis, psychoactive substances include which of the following?
A. Dissociative anesthetics
B. Both 1 and 3
C. Hallucinogens
D. Non-narcotics





  1. A public health nurse (PHN) researching risk factors for mortality found that ____ and ____ are among the top ten.
A. Alcohol and tobacco
B. Inhalants and stimulants
C. Cannabis and caffeine
D. None of the above





  1. To find out how much alcohol a patient uses, a nurse asks about which of the following?
A. Quantity of alcohol consumed
B. Frequency of alcoholic beverage consumption
C. Duration of use
D. All of the above




  1. A nurse whose teenage patient is showing signs of alcohol abuse reviews which of the following first to help the patient?
A. Universal level of prevention
B. Selective level of prevention
C. Indicated level of prevention
D. None of the above




PTS:   1                    CON:  Promoting Health | Addiction


  1. A nurse studying substance use disorders learns that alcohol is a causal factor in ____ types of diseases and injuries.
A. 60
B. 80
C. 20
D. 10





  1. Nurses at a local trauma center were involved in evaluating their hospital’s screening program for alcohol substance abuse. Which of the following steps were part of their plan?
A. Review files on patients admitted with a possible alcohol-related injury.
B. Evaluate the current screening system in use on their unit.
C. Review current screening techniques used in other hospitals.
D. All of the above




  1. Nurses in a student health clinic used a program called Brief Alcohol Screening and Intervention for College Students (BASICS) to help students make better alcohol use decisions. The BASICS program consists of:
A. Two one-hour interviews
B. Both 1 and 3
C. A feedback profile
D. An alcohol breathalyzer test





  1. When a community health nurse explains the consequences of tobacco use to a patient who smokes, the nurse mentions which of the following adverse health consequences experienced by tobacco users?
A. Damage to the oral cavity and teeth
B. Chronic obstructive pulmonary disorders
C. Cancer
D. All of the above





  1. A nurse working on a maternity unit became concerned when one of the pregnant patients admitted to smoking. Which of the following adverse effects might eventually affect her unborn child?
A. Low birth weight
B. Increased risk for Sudden Infant Death Syndrome (SIDS)
C. Both 1 and 2
D. Lower rates of asthma




  1. A nurse treating a new patient learns that he was a smoker. Which of the following questions will help determine if he still smokes and how much he smokes?
A. Do you now use tobacco?
B. Have you ever used tobacco?
C. Are you interested in quitting tobacco use?
D. All of the above





  1. A nurse researching illicit drug use for a new job at a community clinic learns that the number one illicit drug in the United States as of 2010 is:
A. Cocaine
B. Hallucinogens
C. Marijuana
D. Inhalants





  1. A 20-year-old man brought to the emergency room with hallucinations appeared euphoric, tremulous, and anorexic and had dilated pupils. The nurse who examined him found that the culprit was ____ use.
A. Methamphetamine
B. Cocaine
C. Alcohol
D. None of the above





  1. A nurse suspects one of the emergency room patients is an illicit drug user. Which screening methods should the nurse use to verify this conclusion?
A. A clinician’s guide
B. Both 1 and 3
C. National Institute on Drug Abuse (NIDA) ASSIST tool
D. Diagnostic and Statistical Manual of Mental Disorders (DSM-5)





  1. A PHN preparing a report on substance abuse would find that which of the following are true?
A. Substance use, especially use of tobacco and alcohol, is a serious public health issue, and policy initiatives exist at the global, national, state, and local levels aimed at reducing the harm associated with at-risk substance use.
B. Both 1 and 3
C. The cultural context for substance use has shifted overtime, but stigma continues to be a barrier for entrance into treatment for the person with at-risk use or a substance use disorder.
D. At-risk substance use does not affect the overall health of the individual, the family, or the community.




  1. A team of nurses for a medical surgical unit have been assigned to develop a Screening and Brief Intervention (SBI) alcohol program for their department. Which of the following steps should they take?
A. Review current alcohol SBI recommendations from the Joint Commission on Accreditation.
B. Develop a plan to train health-personnel on the use of the alcohol SBI.
C. Both 1 and 2
D. Choose not to prepare an evaluation plan.






  1. During a class lecture, a nursing student learned that which of the following are considered psychoactive substances?
A. Depressants
B. Stimulants
C. Both 1 and 2
D. Antidepressants





  1. A PHN follows which of these guiding principles on harm reduction when helping patients who are substance users?
A. Clients are responsive to culturally competent, non-judgmental services delivered in a manner that demonstrates respect for individual dignity, personal strength, and self-determination.
B. Service providers are responsible to the wider community for delivering interventions which attempt to reduce the economic, social, and physical consequences of drug- and alcohol-related harm and harms associated with other behaviors or practices that put individuals at risk.
C. Because those engaged in unsafe health practices are often difficult to reach through traditional service venues, the service continuum must seek creative opportunities and develop new strategies to engage, motivate, and intervene with potential clients.
D. All of the above





  1. To help smoking patients improve their health, a nurse uses which of the following smoking cessation strategies?
A. Advise all tobacco users to quit.
B. Assist tobacco users with a quit plan.
C. Both 1 and 2
D. None of the above





  1. A nurse working in the emergency department is treating a substance use disorder patient with accelerated heart rate and blood pressure. The nurse determines that which of the following substances is the culprit?
A. Stimulants
B. Narcotics
C. Depressants
D. Hallucinogens




Chapter 12: Injury and Violence




  1. A nurse is educating new staff in the emergency department about the types of injuries and illness they might be treating. The nurse mentions that which population is at greatest risk for unintentional injuries?
A. Women under the age of 45
B. Women over the age of 45
C. Men under the age of 45
D. Men over the age of 45





  1. A nurse has volunteered with an organization treating women who were the victims of rape as a weapon of war in the Congo. This violence is considered:
A. Community violence
B. Collective violence
C. Stranger violence
D. Interpersonal violence





  1. A nurse is reviewing car accident data to see how a city’s statistics compare with state and national data. Which of the following would provide the most comprehensive database of information?
A. National Violent Death Reporting System
B. Vital Statistics
C. Department of Motor Vehicles
D. Department of Transportation






  1. A nurse has seen an increase in infant injuries during motor vehicle accidents due to poor car seat installation. The nurse wants to consider upstream policies at the population level to address this issue but doesn’t have the time to take on the project. How should the nurse proceed?
A. Reconsider the project at a different time when the workload at his or her primary job lightens.
B. Delegate some of the project tasks to an unlicensed assistive personnel (UAP).
C. Quit the job to dedicate all of his or her time to the project.
D. Consider a collaborative relationship with the public health department and fire and police departments.






  1. A nurse is providing fire prevention education to families in the community. Which of the following groups in the United States is not at a higher risk for suffering burns from a fire at home?
A. Men
B. Women
C. Children
D. Older adults






  1. A nurse is teaching water safety at the local community pool and mentions that which of the following is the most significant risk factor for drowning?
A. Gender
B. Income
C. Education
D. Age




PTS:   1                    CON:  Safety | Nursing Roles


  1. A nurse is performing a home visit for a young mother that lives in the projects in Brooklyn, New York. There is a young child who is three years old living in the apartment as well. The nurse notices that the window guards on the bedroom window are hanging off the building. How does the nurse proceed?
A. Encourage the woman to call the landlord after the nurse leaves.
B. Call Child Protective Services to report an unsafe living situation.
C. Call the landlord directly to ensure the timely repair of the window guards and encourage the woman to keep the windows closed in the meantime.
D. Call the city to report a bad landlord.






  1. A nurse is working at a high school when a young woman comes down to the nursing office concerned about her boyfriend whom she states is making suicidal comments. How does the nurse proceed?
A. Counsel the young woman about relationship issues.
B. Call the young woman’s parents about her concerns.
C. Inform the school psychologist immediately and notify the boyfriend’s parents.
D. Call the young man down to the nurse’s office for a mental health evaluation.




  1. A nurse is working at a suicide prevention hotline and is training new staff members. He or she informs the new nurses that the most important questions to ask callers include:
A. Whether they have a means or a plan to commit suicide, including whether they have access to a weapon, such as a gun
B. If they have been diagnosed with a mental illness
C. If they suffer from addiction
D. None of the above






  1. A group of nurses is looking to design a home visitation program for parents who are at high risk for child maltreatment. What factors should the nurses focus on?
A. Parenting skills and access to educational support
B. Promoting family relationships and increasing child monitoring
C. Increasing access to nutrition and wellness programs
D. Assisting with parental education and financial assistance programs as needed





  1. A nurse is caring for a young woman in a same sex relationship. The woman frequently presents to the ER with vague injuries and the nurse is beginning to suspect that the woman is being physically abused by her partner. How should the nurse proceed?
A. Inform the physician.
B. Give her a pamphlet about escaping domestic violence.
C. Notify the police.
D. Refer her to a social worker and engage her in discussion about creating a safety plan.





  1. A young woman presents to a community clinic. She states that she is having severe anxiety and insomnia after suffering an acquaintance rape at school last year. She is unable to go back to college and her grades are suffering as a result. What does the nurse suspect that this young woman is suffering from?
A. Post-traumatic stress disorder
B. Generalized anxiety disorder
C. Major depression
D. Personality Disorder






  1. A nurse is performing a community assessment of an inner city neighborhood. The nurse is looking for physical risk factors in the community to determine if they might be contributing to the high level of violence and drug abuse in the neighborhood. Which of the following factors should be evaluated?
A. Youth activity
B. Dwelling types
C. Physical layout of the community
D. All of the above





  1. A nurse is presenting a lecture about providing nursing and medical care during wars and in conflict areas. The nurse is discussing how war has changed in the last few decades. Which of the following statements is correct?
A. There are more wars currently than in the past.
B. War-related deaths have increased in the past decade.
C. Fewer countries have weapons of mass destruction due to increased world condemnation of such weapons.
D. Reporting of wars and war crimes has increased.





  1. A nurse is reviewing the safety procedures and protections in place at the community center where he or she works. Which of the following should he or she be most concerned about?
A. Presence of two regular doors next to the revolving door in the front of the center
B. Brightly lit exit signs
C. Absence of decorations on the walls
D. None of the above




  1. A nurse is looking to implement new preventative measures to address the rate of drowning in young children in the community. All of the following policies are examples of primary prevention, except:
A. Swimming instruction for every child
B. Mandatory installation of locked child-safety fences around all community and private pools
C. Community-wide CPR instruction
D. Mandatory use of life jackets for all children on boats






  1. A nurse decides to use a Haddon Matrix to evaluate factors that may contribute to patient falls on the medical units of the hospital. What is the minimum number of boxes that should be drawn on the grid to be filled out? ____________________



  1. A nurse is working in an emergency room and caring for a young woman who was admitted to the hospital after a motor vehicle accident. The policeman who accompanied the nurse requests a blood alcohol level and toxicology screen. The nurse knows that what minimum blood alcohol level is considered to be driving while impaired? ____________________






  1. A nurse is working with parents and community members to develop a chemical and medication safety class in their community. Techniques that they should discuss include which of the following?

Select all that apply.

A. Proper labeling of all household chemicals and medications
B. Keeping household chemicals outside
C. Storing all cleaning materials and medications out of the reach of children
D. Encouraging disposal of medications into the toilet
E. Informing parents not to share any medications with anyone whom the medication is not prescribed




  1. A nurse is teaching a class about emergency preparedness and violence. Which of the following factors is associated with an increased risk of being the victim of violence or intentional harm?

Select all that apply.

A. Age between 15 and 44
B. Poor mental health
C. Substance abuse
D. Male gender
E. Low socioeconomic status




Chapter 13: Nursing and Global Health




  1. A nurse is presenting a lecture about global health and life expectancy and states that in America, the biggest reason for the increase in life expectancy is:
A. Better public health practices
B. Increased education
C. Decrease in crime
D. Improved housing





  1. A nurse is preparing to volunteer with a charity organization working in India that provides medical care to underserved communities. The nurse is performing a cultural and community assessment and determines that their per capita income is $2,973. This classifies the country as:
A. Low-income
B. Low-middle-income
C. Upper-middle-income
D. High-income






  1. A nurse is teaching a class about global health issues when a student asks why the health of other countries is relevant to the United States. The nurse replies:
A. “Because of the global world we live in, the health of one country can profoundly affect the health, economy, and security of the rest of the world.”
B. “It doesn’t, but being aware of health issues in other countries allows nurses who are interested to volunteer their services internationally.”
C. “Being aware of health issues in other countries gives us information about what not to do as public health nurses.”
D. “Looking at global health issues gives us information about how to treat medical emergencies here.”





  1. A nurse is teaching a class about international health policy. In that class, what does primary health care refer to?
A. The first point of contact within the health-care system
B. The bare minimum and essential care needed for health, both in individuals and within the community
C. The acute care setting
D. The coordinator of more specialized care





  1. A nurse is volunteering in a LIC by assisting medical staff in setting up clinics throughout several communities. The nurse remembers reading about a set of goals that were developed within the international community and that seek to address poverty, education, environmental sustainability, and human rights. The nurse wishes to use these goals as a framework for one of the clinics under his or her responsibility. To gather more information, the nurse should research:
A. Healthy People 2020
B. Millennium Development Goals
C. Health for All
D. Euro Health





  1. A nurse is working with an organization that has established objectives to assist LICs within their purview to achieve the MDGs. They need additional funding, though, to help them reach their policy goals. Which organization might they contact for help?
C. World Bank





  1. A nurse has been contacted to consult with the coordinating health organization of the U.N.  This means that the nurse will be working with:
B. Global Health Center
C. World Bank





  1. A nurse is looking for international volunteer opportunities working with women with a focus on reproductive health. Which organization is a good place to contact?
A. Catholic Relief Service





  1. A nurse is presenting a lecture to a nursing class about the Millennium Development Goals and our progress in meeting them. Which of the following statements is correct?
A. The goal is to achieve them by 2020.
B. The selected outcomes are used to measure progress in each country.
C. Each goal and its outcome criteria is independent of the other objectives within the MDGs.
D. There has been significant progress in meeting some of the goals, but there is still a lot of work that needs to happen in other goals.





  1. A nurse is teaching a class about the global health issues that face the world’s population. Many of the students express frustration at the lack of progress and ask what they can do. The nursing instructor responds that which of the following may be the most effective, long-term solution?
A. Regular volunteer work
B. Financial contributions to organizations providing health services
C. Promoting health literacy and increasing education
D. Increasing the number of nursing education programs





  1. A nurse is working with a local community group in a LIC with a serious problem with a lack of adequate nursing staff. How can nurses be encouraged to stay within the community?
A. Recruit more nurses from the local, rural community.
B. Institute continuing education programs for nurses to continue their learning.
C. Provide education for nurses working in these areas about issues related to working with the limited resources they have available.
D. All of the above






  1. A nurse is evaluating the global issues surrounding nutrition and accessibility of health food options. One unintended health consequence of the globalization and industrialization of food production has been a(n):
A. Increase in noncommunicable diseases such as diabetes and heart disease in LICs
B. Decrease in maternal and child health issues in LICs
C. Shift in the distribution of deaths from older populations to younger populations in LICs
D. Decline in noncommunicable diseases, especially in areas where communicable disease is rampant





  1. A nurse is working in a community clinic in Bangladesh treating many members of the medically-indigent population. A young man comes into the clinic with a large ulcerated lump on the back of his legs. He reports having noticed a fly bite at that spot a few days ago. What does the nurse suspect?
A. Leishmaniasis
B. Malaria
C. Dengue Fever





  1. An experienced emergency room nurse is beginning a volunteer experience at a large rural hospital in sub-Saharan Africa. Before beginning work the next week, what should the nurse do first?
A. Visit the hospital to figure out the layout, supply situation, and the patient care model used.
B. Begin studying the language.
C. Review ACLS and BLS protocols.
D. Perform a cultural assessment of the community in which he or she will be working.





  1. A nurse is caring for a young man in the emergency room. He presents with severe headache, a rash, joint pain, and a fever of 103.5° F. He reports having traveled to India recently. What does the nurse suspect?
A. Leishmaniasis
B. Dengue fever
C. Severe acute respiratory syndrome
D. Malaria





  1. A nurse is working at a very crowded hospital in Southeast Asia. There are not enough staff or supplies for the nurse to properly care for many of the patients. How can the nurse handle the immediate situation?
A. Post ads to recruit new medical staff.
B. Close the hospital to further patients until the staffing situation improves.
C. Delegate routine care and hygiene tasks to family members who are staying with their loved ones.
D. Develop continuing education programs about caring for culturally diverse populations for the nurses to complete in their spare time.








  1. A nurse is educating emergency room nurses about the symptoms of Avian Influenza, as there is some evidence of infection overseas. The nurse wants the staff to be aware of the symptoms so they can closely monitor for the virus. Which of the following symptoms should be included?

Select all that apply.

A. Eye infections
B. Pneumonia
C. Fever
D. Muscle weakness and paralysis
E. Cough




  1. A nurse is assisting a primary health clinic in a rural South American country in establishing a quality and inclusive primary care program. The nurse consults the WHO components to primary health care for guidance. Which of the following elements is included in the WHO guide?

Select all that apply.

A. Diminish social disparities in health.
B. Improve maternal and child health care.
C. Better organize health care around the needs of the community.
D. Improve funding for primary-care programs.
E. Increase collaborative relationships for and stakeholder participation in public policy development.




  1. A nurse working in a clinic in South America suspects that a patient, a young woman, has Chagas. What contraindications should the nurse screen for before initiating treatment?

Select all that apply.

A. Liver disease
B. Renal disease
C. Bleeding abnormalities
D. Pulmonary disease
E. Pregnancy





  1. Two nurses are establishing a primary health care clinic in a rural part of Africa. Their goal is to include as many of the essential components of primary health care, as defined during a WHO conference in Alma Alta. Which of the following functions would likely be included in their model of care?

Select all that apply.

A. Patient education about health problems
B. Maternal and child health care
C. Principles of proper nutrition
D. Adequate supply of safe water and healthy foods
E. Treatment and prevention of local infectious diseases




Chapter 14: Health Planning for Local Public Health Departments




  1. A nurse is beginning employment at a local health department and reviewing the job description and the functions that fall under the purview of the health department. Which of the following is not one of the six minimum functions as named by the American Public Health Association (APHA)?
A. Vital statistics
B. Public health education
C. Promotion of elder health and safety
D. Environmental sanitation





  1. A nurse wishes to involve the local health department in planning a community-wide intervention. The nurse calls the reception area to determine how best to involve the health department and learns that it is run by the local government in conjunction with the local board of health, also known as a ____ system.
A. Centralized
B. Mixed
C. Decentralized
D. Shared





  1. A nurse is teaching a class about public health nursing. A student asks about the daily responsibilities and core functions of a public health nurse (PHN) working within the health department. Which of the following is not one of the core public health functions the nurse would list?
A. Decrease health disparities within the community
B. Assessment of the population
C. Creation of public health policies to enhance community health
D. Ensure that the public health system runs smoothly





  1. A PHN is working in the public health department in San Diego County. After a recent storm, the department begins to conduct water testing to ensure that the ocean water is safe to swim in. Testing results reveal that the level of bacteria is 10 times the acceptable limit. How does the nurse proceed?
A. Issue a public health statement informing residents of the risk of swimming.
B. Close the beaches until the levels return to normal.
C. Treat the water with anti-microbial agents.
D. Issue a boil water alert.





  1. A nurse is working with a public health department (PHD). They have set a goal to expand their role into direct, individualized patient care. The PHD has little to no funding available for this project. Which of the following is a way that the nurse can still help the PHD reach their goal?
A. Fundraise with local politicians and key business owners.
B. Provide their services on a voluntary basis in one area of the PHD building.
C. Open a federally qualified health center (FQHC).
D. Adjust their budget in other areas to open funds for the project.





  1. A nurse working at a PHD received a phone call from a coworker who works on the labor and delivery floor at the local hospital. The coworker reports that they are seeing many more women and their children coming into the hospital with inadequate nutrition. They wish to partner with the PHD on a project that addresses this issue. Where should they begin?
A. Perform a community and cultural assessment to understand the community in which they are working.
B. Send a questionnaire to all of these women to see why they aren’t utilizing Women, Infants, and Children (WIC) and other governmental services.
C. Place flyers for the WIC program in local physician’s office and the lobby of the hospital.
D. Sign up all women who deliver at the hospital for home visits after discharge from the hospital so their home nutrition habits can be assessed.





  1. A nurse is looking to improve communication about emergency situations with the younger population. Which of the following methods is likely to be most effective for young adults?
A. Radio alerts
B. Television alerts
C. Email alerts
D. Text messages





  1. A nurse working in a primary care office is caring for a young woman with a new diagnosis of Syphilis. The young woman is horrified and asks the nurse if she has to tell anyone about the diagnosis. How should the nurse respond?
A. “Absolutely not. This is your protected health information and I can’t release any information unless you give me permission.”
B. “I’ll need to contact the local health department and they will likely contact your prior sexual partners to be screened as well.”
C. “You should call your previous partners, but I can’t force you to call anyone.”
D. None of the above





  1. A major wildfire has struck a town in California. The firefighters have finally put the fire out, but there are large sections of several communities that have been destroyed. How should the nurse intervene during the immediate recovery phase?
A. Revise the emergency preparedness plans to reflect the problems that have emerged.
B. Go into the community to assess the needs of the displaced residents.
C. Allow the first responders to take control of the situation.
D. None of the above





  1. A PHN is working with coworkers to track an outbreak of a new virus. They need additional help in visualizing the location and density of the victims. What tool should they consider using?
C. Public Health Systems
D. A map





  1. A nurse has been hired by the PHD to perform family planning services. The position was formed as the result of categorical funds obtained from a federal grant. This means that the nurse will need to:
A. Practice according to the guidelines of the federal government.
B. Track time spent in each function to ensure that it meets the grants requirements.
C. Invoice the grant at the end of the position.
D. Apply for approval from the state and local governments.





  1. A PHN has accepted a new position with the local PHD. While reviewing the records the PHN notices that the last community health assessment was completed 4 years ago. What should the PHN do?
A. Nothing; the last assessment was only 4 years ago.
B. Perform a brief assessment to become familiar with the community.
C. Perform a full community health assessment, as per protocol.
D. Report the nurses’ negligence for failing to keep up with assessments.





  1. A nurse is evaluating the lack of prenatal care in many of the women in the community. The nurse is looking to obtain information about the rate of certain risk factors in the county. What resource should the nurse check?
C. Healthy People 2020





  1. A PHN is presenting a lecture to a group of nursing students about the need for public health nurses. Which of the following statements is correct?
A. Public health workers must be specially credentialed.
B. Compensation is high compared with private sector employment.
C. There are severe shortages in PHN faculty members.
D. Increased funding from the federal government has incentivized recruitment for inner city and rural PHDs.





  1. An occupational nurse has a worker complaining of flu-like symptoms. The CDC had recently released an alert regarding a new strain of influenza that has been at pandemic levels in their city. How does the nurse proceed?
A. Send him home to recover.
B. Send him to his primary care provider (PCP) for diagnosis and let the PCP handle reporting the case to the public health department.
C. Notify the PHD and begin epidemiological screening of his coworkers.
D. None of the above





  1. A nurse is counseling a young man with a new diagnosis of tuberculosis. Which of the following statements about what to expect during his treatment is incorrect?
A. He will be taking several antibiotics for several weeks.
B. He will need to stay in the hospital and in isolation until he has 2 to 3 negative sputum tests.
C. He will need to be observed taking his medication each day.
D. He will need to be on activity restrictions until he is feeling completely recovered.







  1. A PHN is reviewing the birth data collection forms for birth certificates. The PHN is checking that the forms contain at least which of the following pieces of information?

Select all that apply.

A. Number of prenatal visits
B. Parental income
C. Type of delivery
D. Congenital defects
E. Parental education





  1. A PHN is reviewing immunization rates for the students in the county. The PHN observes that the rate is significantly lower for incoming kindergartners than it has been in years past. After performing a community assessment, the PHN finds that many of the unvaccinated children have parents who have low education and are part of the lower socioeconomic class in the community. Which of the following interventions may be successful at boosting immunization rates in the county?

Select all that apply.

A. Mandate that all students be vaccinated before starting public school.
B. Provide a list of places where the students can obtain low-cost immunizations.
C. Prepare a parent handout in simple to understand information in a variety of languages.
D. Send home copies of the CDC immunization requirements for the parents to review.
E. Offer a free vaccination clinic at the school for one week.




  1. A nurse has just accepted a job with the local public health department. The nurse will be responsible for monitoring and managing the vital statistics. What data will be tracked?

Select all that apply.

A. Communicable diseases
B. Births
C. Marriages
D. Divorces
E. Deaths





  1. A PHN has decided to use the MAPP tool to address the issue of domestic violence in the community. As the PHD has never used this tool before, the PHN obtains specialized training for which of the following assessment tools?

Select all that apply.

A. Community Themes and Strengths Assessment
B. Local Public Health System Assessment
C. Forces of Change Assessment
D. Community Health Status Assessment
E. Cultural Health Assessment



Chapter 15: Health Planning for Acute Care Settings




  1. A nurse is teaching a class about the role of acute care in the nursing process. A student asks what type of prevention, if any, acute care mainly provides. The nurse replies:
A. Primary
B. Secondary
C. Tertiary
D. Quaternary






  1. A nurse is planning specific interventions that aim to reduce the rate of complications due to uncontrolled blood sugar levels in the diabetes population. The word population is being used in the ____ context.
A. Public health
B. Hospital setting
C. Cultural
D. None of the above






  1. A labor and delivery nurse is evaluating the hospital’s C-section rate and wants to see how it compares with national statistics. Which resource should the nurse check?
A. Healthcare Cost and Utilization Project
B. Healthy People 2020
C. Agency for Healthcare Research and Quality
D. Institutional Review Board





  1. As part of a capstone project, a student nurse is reviewing hospital admissions and discharge data. The student nurse decides to use which group of data to track hospital admissions and review groups of related diagnoses?
A. ICD9 codes
B. Major Diagnostic Categories (MDCs)
C. Recidivism rates
D. ALOS statistics





  1. A nurse is partnering with a local television station to create a public service announcement discussing heart disease in women. The nurse explains that women often experience the symptoms of a heart attack differently than men. These symptoms can include:
A. Abdominal pain
B. Nausea
C. Difficulty breathing
D. All of the above





  1. A nurse is looking to improve the care of women presenting to the ED with atypical symptoms of a heart attack. The nurse finds that the average door-to-balloon rate in their hospital is 64 minutes. How does the nurse proceed?
A. No need to address this—the door-to-balloon rate is well within the desired guidelines.
B. Perform a hospital and ED assessment to see where these patients are being held up.
C. Mandate EKGs for every patient who comes into the emergency room.
D. Create a separate wing of the emergency room especially for suspected cardiac patients.





  1. A nurse is creating a study within the hospital that would require obtaining patient records for regular chart reviews. How should the nurse proceed?
A. Obtain the records from the EMR, or the medical records department as required by the hospital.
B. Inform the physician and patient about why the nurse needs to review the records and get copies per hospital policy.
C. Create a proposal to present to the Institutional Review Board for review.
D. The nurse is not able to use the records because it is a violation of HIPAA.





  1. A nurse is reviewing the Healthy People 2020 objectives related to heart disease and stroke and decides to develop interventions to reduce hospitalizations of older people with heart failure. Which of the following is an example of an intervention at the level of secondary prevention?
A. Admission of patients with a history of cardiac failure into an outpatient cardiac rehab facility
B. Education about the danger of smoking and alcohol use in schools
C. Having patients at high-risk take a daily, low-dose aspirin
D. Promotion of good nutrition and exercise habits




  1. A nurse is teaching new nurses how to optimize post-hospital discharge outcomes for patients. Which of the following actions should the nurses take?
A. Perform a discharge assessment before patients leave the hospital.
B. Perform a home health visit before the patient is discharged to assess if it is a safe environment to return to.
C. Order mandatory home health visits for all patients who have been hospitalized.
D. Have standardized discharge instructions for patients to follow when they return home.





  1. A nurse is looking to develop a new policy to address the rising rate of central line infections in their medical ICU. The nurse speaks with the nurse manager about utilizing the Plan-Do-Study-Act (PDSA) approach, instead of simply developing new ICU protocols. Which of the following is not a benefit of using this system?
A. New protocols can be tested before implementing them throughout the hospital ICUs.
B. The staff can work with manufacturers of the medical equipment to determine how the central line trays can be arranged more efficiently.
C. They can figure out what works on the large scale fairly quickly.
D. The nurses can figure out what other processes need to be addressed with the new policy changes.





  1. A nurse is admitting a new patient through the emergency room after collapsing at home. The patient’s girlfriend states that he has been really sick the last few days and complained of feeling dizzy just before losing consciousness. The nurse takes the following vital signs: temperature of 38.7°C, pulse of 121 beats per minute, blood pressure of 87/52, and respiratory rate of 32 breaths per minute. The nurse observes that he is diaphoretic. After running a CBC, the white blood cell count is 14,532. After stabilizing him, the nurse calls the ICU to prepare them to treat which of the following?
A. Shock
B. Sepsis
D. Heart failure





  1. A nurse is caring for a young child who is suspected of having meningitis. A spinal tap culture is pending. If it comes back positive for N. meningitidis, the nurse will need to:
A. Discharge him from the hospital; it is appropriate for his family to care for him at home.
B. Inform the child’s daycare and other caregivers so they can monitor for symptoms of the infection.
C. Promptly admit the child to the ICU.
D. Double the dose of antibiotics.






  1. A nurse is caring for a patient in the emergency room. The physician orders hyperbaric oxygen therapy, antibiotics, and surgical debridement in the morning. The nurse knows that the doctor suspects:
A. Cellulitis
B. Necrotizing fasciitis
C. Toxic shock syndrome
D. Sepsis





  1. A nurse is presenting a lecture about pneumonia to a group of senior citizens in a community center. The nurse explains that people with which of the following risk factors are at a higher risk of developing the infection?
A. Cigarette smoking, alcoholism, and heart failure
B. Immunosuppression and hypertension
C. Diabetes and gastritis
D. Hypertension, diabetes, and heart failure





  1. A nurse manager is presenting an in-service to the rest of the nurses on the floor. They are discussing the recent spread of Vancomycin-Resistant Enterococci (VRE) within the hospital and how to prevent transmission on their floor. The nurse manager mentions that the most effective method of reducing transmission of this infection is:
A. Isolation precautions for every infectious patient on the floor
B. Improved patient admission protocols
C. Increased use of personal protective equipment
D. Increased hand washing for all health-care workers





  1. A nurse is answering telephone calls from a triage line. A call comes in from a 62-year-old woman who has complaints of unusual fatigue, abdominal pain, and nausea. She denies eating anything unusual that day. What should the nurse advise her to do?
A. Rest and take an antacid.
B. Call her physician in the morning.
C. Go to the nearest emergency room.
D. Schedule an appointment with a cardiologist next week.







  1. A nurse is reviewing the hospital’s statistics in comparison with the IHI “100,000 Lives Campaign” to see what the facility could do to improve safety within the organization. What statistics should the nurse look at?

Select all that apply.

A. Use of rapid response teams
B. Central line infections
C. Ventilator assisted pneumonia
D. Pressure wounds
E. Number of falls






  1. A nurse is teaching a CPR course for non-medical professionals. Place the following steps for performing CPR on an adult in the order in which they should be performed (1-4):

_____ 1. Chest compressions

_____ 2. Assess the patient

_____ 3. Clear the airway

_____ 4. Administer breaths






  1. A group of nurses is looking to reduce the number of cases of ventilator-associated pneumonia in their hospital. The nurses decide to use the IHI model as their guiding process. Place the following steps in the order in which they should be performed (1-4):

_____ 1. Study the process from start to finish.

_____ 2. Develop a goal statement and determine what will be measured during this process.

_____ 3. Proceed with ventilator care process using standard hospital protocols.

_____ 4. Make changes to the processes as determined by results of the study.





  1. A nurse is evaluating the survival rate for victims of Motor Vehicle Accidents (MVAs) who had used seat belts. The following data was reviewed: The total number of MVAs was 548, the total number of deaths was 232, the total number of people wearing seatbelts during their MVA was 476, and the total number of deaths in people wearing seatbelts was 117. What is the survival rate in people wearing seatbelts? Round your answer to the nearest whole number. ____________________


Chapter 16: Health Planning for Primary Care Settings




  1. A nurse is teaching a class about different models of care. The nurse explains that ____ is the most important person in the primary health-care model.
A. The individual/family
B. The population
C. The primary-care physician
D. Medical specialists





  1. A nurse is looking to reduce the number of teen smokers in her community. The nurse implements a community-wide program to raise awareness about the dangers of nicotine use and creates a support group specifically aimed at teens looking to quit smoking. This is an example of:
A. Health protection
B. Health promotion
C. Risk reduction
D. Tertiary Prevention





  1. A community health nurse is training new nurses about the development of public health programs to benefit community members. The nurse explains that even though primary care focuses on caring for an individual, health promotion activities need to focus on:
A. The family
B. Each individual patient
C. Good medical care
D. The community





  1. A nurse is volunteering a community-wide health fair. The nurse is performing blood pressure and blood glucose screenings for everyone who stops by the booth. After performing the screening tests, the most important thing that the nurse must give to all of the participants is:
A. A prescription for blood pressure or diabetes medication as needed
B. An appointment for follow-up appointment with a specialist
C. A specific and individualized action plan with their next steps
D. The normal values for blood pressure and blood glucose levels so they know how to interpret their own levels





  1. A young woman presents to her primary care provider. Her mother has just been diagnosed with Huntington’s disease and several other members of her family have been diagnosed with the condition as well. She wants to know her options regarding testing to see if she is a genetic carrier. The nurse discusses with her the need to consider which of the following?
A. The cost of Huntington’s disease screening
B. Whether the test is available at the local lab
C. What will happen when her insurance finds out the results
D. Ethical issues and their impact on her and her family





  1. A nurse is working with a community center that primarily serves a nearby Native American tribe. The nurse knows that many of the tribe members suffer from type 2 diabetes. Which of the following interventions is an example of a tertiary prevention?
A. Reviewing blood glucose testing techniques
B. Routine blood glucose screening for everyone who comes into the clinic
C. Actively encouraging diabetic patients to have foot, eye, and hemoglobin A1C screening tests every three months
D. Publishing a guide about preventing diabetes and distributing it to people who are unaffected





  1. A nurse working in a primary health setting is reviewing the patient education materials they keep in the office. How should the nurse consider updating the forms?
A. Review for medical accuracy and update as needed.
B. Perform a cultural assessment to see how the population has changed since the forms were created.
C. Translate into the languages of cultural groups who frequently use the community center.
D. All of the above





  1. A nurse is speaking with her accountant about opening a free clinic as a 501(c)(3) organization. The accountant advises the nurse:
A. To charge patients his or her regular fees
B. To waive her professional fees, but charge for testing and more advanced care
C. To charge a nominal fee if the patient can afford to pay, but provide services regardless
D. To charge a small fee, usually around 25% of the service value






  1. A nurse is doing a presentation for a group of community members who are concerned about the passage of the Affordable Care Act and how it will affect their community. They are an economically disadvantaged community with very few local physicians. How does the nurse respond?
A. “We’ve received a large federal grant to help increase your access to affordable primary care services.”
B. “Taxes will need to be increased in order to open new community health centers.”
C. “There will be a large multispecialty medical group opening in the nearest city.”
D. “You will all be required to purchase costly health insurance.”





  1. A nurse is working in a community health clinic in an inner city. The nurse has been caring for a particular family for many years, helping them to reduce their weight. At their last visit, the mother expresses frustration at being unable to find fresh fruits and vegetables in their neighborhood. How should the nurse proceed?
A. Have them keep track of their intake in a food journal to see what substitutions could be made.
B. Perform a community assessment to determine what stores and food sources are available in the community.
C. Arrange for free bussing from the community center to the closest supermarket.
D. Refer them to the local SNAP office to help them obtain benefits.





  1. A new strain of flu has emerged, and the CDC has released a new vaccine that is for use in high-risk populations. A primary care nurse should offer the vaccine to which patient population?
A. Pregnant women
B. Elderly men and women
C. Everyone who visits the office
D. The nurse should wait for direction from the CDC





  1. A student nurse is interviewing a primary care nurse about her role in the community. The student asks about the most important part of the nurse’s job, outside of patient care. The nurse cites:
A. The need to network and build strong relationships in the community
B. Continuous learning through continuing nursing education
C. Strong assessment skills
D. The ability to focus on the big picture





  1. A nurse has worked at a community health center for many years. Over the last several months, the nurse has noticed a significant decline in community members using the resources available at the clinic. What is the first thing the nurse should do?
A. Begin offering daycare services and free transportation to the clinic to make it more convenient.
B. Reach out to former patients to determine why they are no longer returning to the clinic.
C. Perform a community assessment.
D. Begin offering a new patient reduced fee rate.





  1. A nurse is reviewing lab results from a routine health screening for one of her patients. The nurse notes a new diagnosis of Hepatitis B. The nurse sits with the patient after he has spoken with the doctor and the patient expresses concern that someone will find out about his diagnosis. How does the nurse respond?
A. “Don’t worry; no one will find out.”
B. “You will need to inform all of your previous sexual partners.”
C. “I will need to inform the local health department about your diagnosis.”
D. None of the above






  1. A primary health nurse has observed an increase in the rate of patients being treated for pertussis in her community. The nurse has seen multiple news reports on the issue and knows that this isn’t an isolated problem. The nurse decides to brainstorm strategies to reduce the pertussis rate in her community. First, the nurse should:
A. Consult with local pediatricians about increasing vaccination rates in children.
B. Begin creating patient education materials to distribute in the waiting room.
C. Perform a health and cultural evaluation of her community.
D. Begin offering vaccinations free of charge.






  1. A primary care nurse works with many Native Americans on the local reservation. Knowing that they are at high risk for developing diabetes, the nurse puts together a comprehensive prevention plan. Which of the following interventions is an example of a primary intervention?
A. Regular foot and eye care
B. Encouraging a healthy diet and weight loss if appropriate
C. Tight blood sugar control with every meal
D. Yearly blood glucose screening







  1. A hospital nurse is admitting a new patient and asks if the patient has a primary care provider. The patient asks about the benefit of having a primary care provider and the nurse replies with which of the following?

Select all that apply.

A. Increased access to health care
B. Decreased health-care costs
C. Focus on a curative model of care
D. Increased patient education and advocacy
E. Physician focused treatment




  1. A nurse is working with a primary care physician who has made the decision to move to a Patient-Centered Medical Home (PCMH) model of care after reviewing research presented in the latest issue of a prominent medical journal. The nurse is preparing some educational materials to present to the patients and mentions that the benefits of moving to this model of care include which of the following?

Select all that apply.

A. Care focusing on the whole individual
B. Integrated care
C. Use of highly specialized PCMH physicians
D. Increased access to care
E. Access to private insurance, meaning the patient can move away from Medicaid




  1. A public health nurse (PHN) has seen an increase in the number of patient’s being seen with bed bug bites. After speaking with several colleagues who also work at primary health facilities in the community, the nurse discovers that this is not an isolated issue. They decide to create a public service announcement educating the public about bed bugs. What information should be included?

Select all that apply.

A. Physical description of what they look like
B. Lifespan of the bed bug
C. Bed bugs in popular culture
D. How to get rid of them
E. How to find them in the home







  1. A nurse is putting together a public service announcement in conjunction with the local health department in an effort to get more men screened for colorectal cancer. In the absence of other factors, at what age should average, low risk men have their first colonoscopy? ____________________



Chapter 17: Health Planning with Rural and Urban Communities




  1. A public health nurse (PHN) is creating a team of professionals to address the rising teen pregnancy rate in the community. Which of the following characteristics of successful partnerships is not suggested by the U.S. Department of Education in the Regional Education Network?
A. There will be new partners as the partnership progresses.
B. The partners have committed to the process and the goals.
C. All of the partners must be equally committed financially.
D. Make sure the members of the partnership are equally representative of the community-at-large in terms of culture, race, and perspective.





  1. A nurse is moving to a rural area and beginning work at a health clinic there. The nurse is performing a basic community assessment to prepare for treating this new community. The nurse knows that which of the following is not characteristic of the needs of the rural population?
A. More likely to smoke tobacco and drink alcohol
B. Have less education and higher rate of poverty
C. Increased dental problems
D. Have a higher life expectancy





  1. A nurse is reviewing goals from the Rural Health People 2010 program in anticipation of setting goals for the next decade. Which of the following is not one of the goals identified in Rural Healthy People 2010?
A. Increasing access to health care
B. Reducing rates of diabetes
C. Increasing oral health
D. Reducing cancer rates





  1. A nurse is working in a community health center in a very rural community and is training a new nurse who will be working part-time. The nurse explains that the biggest health problem facing their community is:
A. Inability to access health care
B. Poor nutrition
C. Lack of health education
D. Farming accidents






  1. A nurse has been volunteering at a community center in a very rural area twice a month for several years. Over the last few months, the nurse has noticed that the patient load has increased substantially as the population of this community has aged. It is not feasible for the nurse to spend more time at this center. How can the nurse continue to serve the needs of the community?
A. Try to hire another nurse to help fill in.
B. Set up a tele-health arrangement so the nurse can answer simple questions from home or while on the road.
C. Set up a scheduling and triage system so the nurse only sees the neediest patients.
D. Consider closing the free clinic and opening a fee-for-service center.





  1. A nurse is working with several community members in an inner-city environment to help address the broken windows and damaged buildings in their community. They’ve had several residents volunteer to repair the damages overnight to keep the community looking well cared for. This is an example of:
A. Community organization
B. Community empowerment
C. Community partnerships
D. None of the above.





  1. A nurse is looking to address teen gang violence in a nearby community using the principles of community organizing. The nurse has spent a great deal of time in the community performing a community assessment and getting to know residents and key stakeholders. What is the next step?
A. Identify core leaders to organize the community around.
B. Identify clear goals that relate to the over-arching goal of reducing teen gang violence.
C. Identify available resources.
D. Create a plan to evaluate their actions.






  1. A nurse is working in a family planning clinic that provides treatment for sexually transmitted infections (STIs). The nurse has noticed a significantly increased number of infections in young women who come to the clinic and wonders if this is a community-wide problem. Which of the following techniques would be helpful in answering that question?
A. Building a coalition and positive relationships with other health care providers in the area
B. Performing a community assessment
C. Interviewing several key stakeholders in the community
D. Creating a Federally Qualified Health Centers (FQHCs)






  1. A nurse is working on his or her first Community-Based Participatory Research (CBPR) project. One factor the nurse should be extremely careful of is:
A. The ethical protection of the human participants
B. Making sure that community members aren’t directly involved in the research
C. Ensuring that the research is ethical and is protective of the community
D. To choose a topic that is neutral to the community





  1. A nurse is considering entering the specialty of parish nursing. Nurses working in this field perform which of the following roles, in addition to standard nursing jobs?
A. Advocate for individuals within the parish.
B. Improve spiritual health through practices such as grief counseling.
C. Provide health education.
D. Perform health screenings of parish members.






  1. A young college student in a rural community has called the health department to get a recommendation to a health center where she could be seen for some chronic health problems. She is uninsured and can’t afford the private clinic in town. The PHN recommends that the student:
A. Visit the local health department for her care.
B. Proceed to the local emergency room.
C. Visit the community health center run by an advanced practice registered nurse (APRN).
D. None of the above






  1. A nursing professor is looking to give students a knowledge of and experience in community organization and health program planning and implementation. The professor proposes which of the following projects to the school board?
A. A community assessment of three different neighborhoods
B. A mock community assessment and health policy development for a made-up community
C. A paper about the history of health policy in the United States
D. Having the University partner with a local community center where the students can participate in programs and program development





  1. A nurse is performing an assessment of a community where the population is 32,971. How does the nurse classify the area?
A. Rural
B. Suburban
C. Urban cluster
D. Urbanized area





  1. A student nurse is reviewing important global communities for ideas for a final research project. The student nurse discovers a movement in Europe that focuses on reducing health disparities and involving the local community in program design and implementation. What program does this describe?
A. Healthy Cities
B. Healthy People
C. Medical Homes
D. Racial and Ethnic Approaches to Community Health





  1. A nurse has been counseling a young woman who was diagnosed with terminal cancer several months ago. The nurse is anticipating that the young woman is moving toward the second phase of spiritual care. This means that she:
A. Will be able to find a new place with God and the church community
B. Will be able to reorient her thought process around her illness
C. Will be able to find a safe place to talk about her diagnosis
D. Will be able to change her self-perception to include the illness





  1. A public health department is looking to attract health-care providers to open a clinic in their rural community, where there is desperate need for primary care providers. Which of the following benefits should be listed in the job posting?
A. Brand new housing
B. Description of community events and culture
C. Guarantee of employment for family members
D. All of the above







  1. A nurse is looking to develop a coalition of women’s health providers and experts in the community. Which of the following strategies would be effective in helping to build a coalition?

Select all that apply.

A. Contributing financially to the projects endorsed by the coalition
B. Creating a well-organized message
C. Creating a personal brand identity
D. Taking credit for coalition successes
E. Establishing relationships with key members of the coalition



  1. A nurse is speaking with members of a community center about using community organization as a process for change. The nurse explains that there are several specific principles for creating change within the community. Which of the following are examples of these principles?

Select all that apply.

A. Use violence as needed.
B. Apply downstream assessment principles.
C. The nurse will provide solutions for the community to follow.
D. Increase the community’s decision-making ability.
E. Aim to minimize social and economic disparities.




  1. A group of student nurses is evaluating the health needs of an urban environment for their capstone project. Which of the following health needs exist especially in an urban city?

Select all that apply.

A. Decreased mental illnesses
B. Increased stress
C. Increased respiratory illnesses
D. Decreased drug addiction
E. Decreased rates of sexually transmitted infections






  1. A group of nurses wants to develop a collaborative effort that works to reduce the obesity rate in their community. Place the following steps in the order in which they should be performed (1-4):

_____ 1. Describe the major problems and issues and determine how a partnership would benefit their goals.

_____ 2. Identify the key stakeholders within the community and beneficial collaborators.

_____ 3. Determine if there is a need to collaborate with other agencies or individuals.

_____ 4. Establish mutual goals and a plan that addresses those goals.




Chapter 18: Health Planning for Maternal-Infant and Child Health Settings




  1. A nurse wants to address the rate of infant mortality in underdeveloped countries. The nurse knows that addressing which of the following risk factors would be most effective in reducing the infant mortality rate?
A. Maternal health
B. Poor breastfeeding habits
C. Socioeconomic status
D. Vaccine preventable infections






  1. A nurse is evaluating global maternal mortality rate to look for patterns. Overall, the nurse notices that MMR is declining, except in
A. The United States
B. Switzerland
C. Spain
D. Sudan





  1. A group of nurses is visiting a community where they want to address the rate of tobacco use in pregnant women, but they only have a short amount of time to prepare for their trip. What is their first step?
A. Create a fish bone diagram.
B. Assess the community for social and demographic data.
C. Create objective, easy to assess goals.
D. Identify populations more likely to smoke.





  1. A couple is undergoing in vitro fertilization, and they are having a discussion with their doctor about how many embryos to transfer into the wife’s uterus. The female partner is 31 and both are in good health. They have an excellent prognosis for pregnancy. How many embryos would the nurse expect the doctor to recommend that they transfer?
A. 1
B. 2
C. 3
D. 4






  1. A nurse who works on the labor and delivery floor of the hospital has observed that the rate of cesarean sections on the floor is close to 35%. The nurse and colleagues have agreed that this needs to be addressed. How should they proceed?
A. Begin teaching natural childbirth classes.
B. Speak with the physicians about the current statistics and the need to address it.
C. Perform a community assessment to determine what factors are contributing to the elevated C-section rate.
D. Set a hospital goal to lower the C-section rate to under 30% within five years.






  1. A nurse is volunteering in a third-world community to improve maternal and child health in the community. To get a basic idea of the health of the population, the nurse should evaluate
A. Under-five mortality rate
B. Maternal mortality rate
C. Infant mortality rate
D. Preterm birth rate






  1. A nurse is working with a small community in rural Africa. There is funding in place to provide low-cost and free contraceptives to women, but the unplanned pregnancy rate has not changed, despite the program being in effect for two years. How should the nurse proceed?
A. Withdraw funding from the community, since it does not seem to be effective.
B. Provide printed materials on how to properly use condoms and spermicide gels.
C. Host a small community focus group with several key women to discuss reasons why the program isn’t effective.
D. Begin looking for grants to increase funding so they can establish a women’s health and family planning center in the community.





  1. A pediatric nurse is putting together a series of educational handouts to give to moms when they come in for well-baby visits. What is the most important piece of information to include on the handout about healthy sleep habits?
A. Dress the baby in lightweight, loose fitting clothes.
B. Put the baby to sleep on his or her back.
C. Don’t begin strict sleep training until the baby is at least 3 to 4 months old.
D. Use a lightweight, small blanket if the room is cold.






  1. A nurse is teaching a class about national and international initiatives to improve the health and well-being of women, infants, and children. Which of the following statements is incorrect?
A. Safer pregnancy and birth is a priority of the Millennium Development Goals.
B. One of the objectives of Healthy People 2020 is to reduce low birth weight and very low birth weight by 10%.
C. Two of the Millennium Development Goals directly address the health of women, infants, and children.
D. The goals for lowering low birth weight and very low birth weight in Healthy People 2010 were met.





  1. As a part of a community policy using upstream approaches to improve pregnancy outcomes, a nurse would be looking to establish which of the following changes?
A. Hiring doulas to assist women during delivery
B. Scheduling phone calls to women two weeks after bringing their baby home from the hospital
C. Increasing offerings of childbirth classes
D. Conducting preconception and nutrition consultations






  1. Which of the following health problems would be the priority for a nurse planning for new policy initiatives?
A. Rising C-section rates
B. New influenza strain targeting young children
C. Rising rates of obesity in pregnancy
D. High rate of accidents in children under five





  1. A public health nursing student is starting to do research for a dissertation. The student is specifically looking for C-section rates and low birth weight statistics. All of the following are appropriate sources to use except
A. PeriStats
B. Office of Minority Health
D. PubMed





  1. A nurse is beginning to work with a local community to address rising obesity rates in pregnant women. Which of the following statements about setting goals during the planning process is correct?
A. Both long- and short-term goals must be identified.
B. Only short-term goals should be identified initially.
C. Goals should be formed first to help guide the community assessment.
D. The goals should address negative health outcomes.





  1. A nurse is working with a local pregnancy organization to promote nutrition in young pregnant women. The organization serves a diverse population, as it is situated in a middle-income neighborhood in a very populated city. What must the nurses remember during their assessment?
A. To complete a cultural community assessment
B. The unique nutritional needs of pregnancy
C. Dietary and allergy restrictions
D. The availability of fresh foods in the neighborhood




  1. A nurse is working on the postpartum unit of the hospital. The nurse is caring for a young woman who is three days after delivery and is about to be discharged with her young son. The nurse notices that the young woman seems hesitant to be involved in the baby’s care and frequently sends him back to the nursery once her family goes home. How does the nurse respond?
A. Refuse to discharge the baby with his mother.
B. Refer the family to a homecare agency so they can receive home visits.
C. File a report with child protective services.
D. Request a psych consult for the mother.







  1. A nurse is working with the community council and several representatives from the school district to find ways to address health disparities related to pregnancy in the community. They decide to use the nominal group process as a means to expedite their planning. Place the following steps in the order in which they should be followed (1–4):

_____1. The group votes to rank the different categories in order of importance.

_____2. Each member brainstorms as many issues related to health disparities in pregnancy as possible and writes their ideas on small pieces of paper.

_____3. Make sure everyone is in agreement that they will support or agree with whatever decisions the group makes.

_____4. The group facilitator arranges and sorts the group ideas into different categories, usually onto a large board in the front of the room.





  1. A nurse is working at an in vitro fertilization (IVF) center. Recently, the nurse and physician have started evaluating outcomes and discovered a rise in pregnancy complications, especially in their overweight and obese patients. After performing their community assessment, the staff sets a goal to reduce complications in their pregnant patients by 15 percent in three years. Which of the following are likely to be the most effective interventions?

Select all that apply.

A. Establish an office policy that any patient undergoing IVF have a BMI under 30.
B. Place patient education materials about weight and pregnancy in the reception area.
C. Include a weight and blood pressure assessment as part of the initial visit and subsequent visits as appropriate.
D. Partner with a nutritionist who specializes in the care and management of overweight women.
E. Hold weekly seminars and weight loss support groups.





  1. A nurse is looking to lower the high teen pregnancy rate at the local high school. The nurse has performed an assessment and begun work on developing goals to address the pregnancy rate. Which of the following concerns should be considered when working with and educating this population?

Select all that apply.

A. It is illegal in some communities to provide sexual education to teens
B. Does the teen need parental permission to participate?
C. Teens are not interested in sexuality education.
D. Teens do not usually respond to school programs.
E. Educational content and programs are often regulated by school policy.







  1. A nurse is examining the maternal and infant health in the community. A total of 696 women delivered babies last year. Of those, 12 women delivered stillborn babies. Six women died during childbirth. What is the maternal mortality rate expressed per 100,000 live births? Round to the nearest whole number. ____________________



  1. A nurse is looking to calculate the teen pregnancy birth rate for a city. There are 62,578 young women between the ages of 15 and 19 in the city. There were 1,019 live births reported among this age group last year. What is the teen pregnancy birth rate expressed per 1,000 teen girls? Express your answer to the nearest whole number. ____________________



Chapter 19: Health Planning for School Settings




  1. A nurse is assessing the health education program at the elementary school (grades K–5). Which of the following is not a criteria of a quality health education program?
A. A specially-trained health teacher teaches the program.
B. The program is run for kids in second through fifth grade.
C. The health education program includes information about substance use and abuse.
D. The health education curricula addresses the physical, emotional, social, and mental health of its students and families.






  1. A school nurse recently accepted a position with a Title I school. In addition to the regular role as the school nurse, the position will also include:
A. Sexually transmitted infection (STI) testing
B. Treatment of some communicable diseases
C. Management and evaluation of some chronic health conditions
D. Early pregnancy care






  1. A school nurse is reviewing the vaccination records of the students. Several kids are missing one or more vaccinations. How should the nurse proceed?
A. Call the parents and inform them that their child is missing some vaccinations and explain the importance of staying current with the vaccination schedules.
B. Inform the principal and have the students removed from class the next day.
C. Do nothing; the parents have the right to refuse vaccinations for their child.
D. Order the vaccine and start administering vaccines as needed during the school day.




  1. A parent has called the school nursing office to inquire about which vaccinations are recommended by the school for her preteen daughter. The nurse responds with:
A. Influenza
B. Pneumococcal and dTAP
C. Meningococcal, Varicella, and influenza
D. Meningococcal, dTAP, and HPV





  1. A new school nurse is reviewing the procedures put in place by the prior nurse, a woman with over 30 years of experience. The nurse notices that a school-wide scoliosis screening occurs every fall. How does the new nurse proceed?
A. Continue performing the scoliosis screenings each year.
B. Only continue scoliosis screening on students who are symptomatic.
C. Eliminate scoliosis screenings altogether.
D. Check state screening guidelines to see what is required for school nurses in the state.





  1. A nurse is performing a quarterly inspection of the equipment in the school. The nurse’s priority is to make sure which piece of equipment is present and working properly?
A. Code Cart
B. Automated external defibrillator (AED)
C. Otoscope
D. Flowmeter






  1. A school nurse is preparing a presentation for the rest of the teaching staff about severe allergic reactions and anaphylaxis. Which of the following statements is correct?
A. The most common food allergens are soy, chocolate, and strawberries.
B. The EpiPen Act of 2013 improves management of anaphylaxis in the school setting.
C. Most anaphylactic reactions occur at home.
D. Reported food allergies are decreasing among children.





  1. A school nurse is speaking with one of the teachers in the elementary school. The teacher is discussing one of the students who has become very disruptive in the classroom. The student’s grades are suffering and the teacher notices that the student is frequently out of his chair and not paying attention to what the rest of the class is doing. How should the nurse handle the situation?
A. Call the student’s physician on file and speak with him about prescribing ADHD medication.
B. Inform the student’s parents about the situation and let them decide how to proceed.
C. Instruct the teacher and the student’s parents to complete a Connors Rating Scale. The nurse should also observe the student in the classroom.
D. Suggest methods of age-appropriate discipline for the teacher to try with the student.





  1. A school nurse has recently noticed a dramatic increase in the number of students suffering from asthma attacks while in the school building. The nurse knows that the school, though cleaned frequently, is in a very old building. How should the nurse proceed?
A. Review student health records and obtain statistics on the number of students being diagnosed with asthma and having asthma attacks while in school over the last ten years.
B. Instruct the custodial staff to replace the ventilation and furnace systems.
C. Obtain a copy of the EPA Indoor Air Quality Tools for School Action Kit and work with the principal to implement the goals outlined in the guide.
D. Send letters home to the parents of affected kids requesting follow-up with their pediatricians.






  1. A parent has called the school nurse’s office to discuss her daughter’s new diagnosis of type 2 diabetes. The parent is inquiring about what role the nurse will play in managing her care while the girl is in school. How does the nurse respond?
A. “As a nurse, I can help her if she becomes ill in class, but I can’t help her manage her diabetes.”
B. “I can help her adjust her insulin dosing as needed to ensure that she stays at a proper blood glucose level.”
C. “I will help regulate her diet so that she doesn’t consume too much sugar.”
D. “I can help administer the prescribed insulin dose, perform blood glucose testing, and manage symptoms of hypoglycemia.”





  1. A school nurse has observed a slight increase in teacher absenteeism due to illness and decides to implement several new programs to boost employee wellness. What is the nurse’s first step?
A. Send out questionnaires to all of the staff members to see what type of programs they would be interested in.
B. Set a goal to reduce absenteeism by 5 percent within the next year.
C. Start a yearly health fair to set goals for the following year.
D. Implement a staff-wide weight loss competition.





  1. A nurse has observed that a particular fifth grade student visits the office two to three times each week with stomachaches, headaches, and vague complaints of not feeling well. This has been continuing for several months. What is the most appropriate action for the nurse to take?
A. Refuse to see the child anymore.
B. Call his parents to discuss his symptoms and the need to be evaluated by his pediatrician.
C. Send the child home until he obtains medical clearance to return.
D. Refer him to the school psychiatrist for mental evaluation.





  1. An elementary school nurse is caring for many students in the office. The school nurse has an assistant who is not a registered nurse. Which of the following tasks should the nurse delegate to the assistant?
A. Giving a young girl with type 2 diabetes and a blood glucose of 62 a cup of orange juice
B. Supervising a 12-year-old girl in administration of her injectable insulin
C. Giving an 8-year-old boy his ADHD medication
D. Performing a vision assessment on a 10-year-old boy





  1. A new high school nurse is reviewing the sex education materials and finds them completely outdated, without any mention of contraception or sexually transmitted infections. How should the nurse proceed?
A. Revise the materials and begin implementing the new program.
B. Look into state and local regulations that might impact the development of a new program.
C. Leave the materials as is, but create a new presentation that includes the omitted topics.
D. Schedule a meeting with parent representatives to discuss changing the program.






  1. A nurse is working in a middle school health center. The nurse has noticed that a new student has been in the office, almost daily, with vague complaints. The nurse has also heard the teachers talking about how he’s had some difficulty adjusting to his new school. How should the nurse proceed?
A. Send the child back to class without seeing him.
B. Call his parents and let them know that he needs to stop using the health center if he is not sick.
C. Pull him aside and talk to him about how he is adjusting to school.
D. Implement a school-wide anti-bully campaign.




  1. A school nurse is beginning work at a brand new elementary charter school. As the nurse is developing screening policies for the students in the school, which of the following must be included?
A. Scoliosis screening
B. Hearing and vision screening
C. Both scoliosis and hearing and vision screening
D. It depends on what the state mandates.








  1. A school nurse working in a private school is training a new school nurse. Which of the following federal laws influence their practice?

Select all that apply.

A. Elementary and Secondary Education Act
B. Children’s Health Insurance Program (CHIP)
C. Family Educational Rights and Privacy Act
D. Child Abuse Prevention and Treatment Act
E. The School Nurse Act




  1. A high school nurse recently received information about the development of Healthy People 2020. As a result of reading through the literature, the nurse puts together a proposal to develop several new programs for the school over the coming years. Which of the following are in alignment with the goals of Healthy People 2020?

Select all that apply.

A. Increase the presence of security guards on campus during school hours and make sure that all doors are locked at all times.
B. Start a mandatory anti-drug program.
C. Improve the quality of the school lunch program.
D. Start a school breakfast program.
E. Increase the number of and participation in after school activities.






  1. A nurse wants to help lower the rate of absenteeism among school-age children in his community. Place the following steps of the nursing process in the order in which the nurse should carry them out (1–4):

_____1. Implementation

_____2. Evaluation

_____3. Assessment

_____4. Planning






  1. A high school nurse is reviewing their physical education program. Currently, students are in physical education classes for only 30 minutes three times a week. If they don’t get any other physical activity, by how many minutes do they fall short of most recommendations? ____________________


Chapter 20: Health Planning for Older Adults




  1. A nurse is teaching a class about caring for the aging population and the increase in lifespan. Which of the following statements is correct?
A. Super centenarians are people who have lived to be over 100 years old.
B. Lifespan marks the average age of the population until death.
C. Aging is a product of both chronological age and biological age.
D. Globally, people over the age of 65 are considered old.






  1. A nurse is giving a lecture to a group of new nurses who have started working in a Skilled Nursing Facility about caring for the aging population. The nurse stresses the need to include which of the following in addition to a standard health assessment for a new patient?
A. Mental health assessment
B. Cultural assessment
C. Financial assessment and evaluation
D. Family assessment





  1. A nurse is presenting a lecture about the theories of aging and how to potentially treat the elderly according to the various theories. A student mentions hearing that enzyme CoQ10 could be effective in delaying the signs of aging. What theory does this address?
A. Free-radical theory
B. Cross-linkage theory
C. Protein synthesis errors
D. Genetic theories





  1. A nurse is training new staff at a senior’s residential community about ways to help the residents age well. According to the nurse, the most important thing that volunteers and staff can do is
A. Assist them with their activities of daily living.
B. Provide ample time to rest and relax.
C. Keep them socially engaged and active.
D. Minimize stress and responsibilities.





  1. A nurse is describing aging according to the Rowe and Kahn Model of Successful Aging to a class of new nursing students. Which of the following is not one of their key components of successful aging?
A. Low likelihood of disease and disability
B. Actively engaged with life
C. Minimal stress and loss
D. High functioning ability, both cognitive and physical






  1. A nurse is looking to create health policies in the community to promote healthy aging. Which of the following would likely be successful?
A. Programs that promote nutritious eating choices and maintaining a healthy weight in young children
B. Increasing access to alternative medications and treatments for common diseases in the elderly
C. Free or reduced public transportation costs for people over the age of 65
D. Increased access to education






  1. A nurse has noticed an increase in the number of older patients in the community coming down with pneumonia from influenza each winter. In addition to increasing access to the influenza vaccine each winter, which intervention would likely be effective for this particular age group?
A. Increasing hand washing
B. Improving nutrition by increasing access to healthy foods and prepared meals.
C. Getting more restorative sleep
D. Increasing exercise through community programs





  1. A nurse has set up a workshop in the senior community center to teach the residents who are newly diagnosed with diabetes how to manage their disease and inject insulin. The nurse documents this on the paperwork to the nursing manager as which type of intervention?
A. Primary prevention
B. Secondary prevention
C. Tertiary prevention
D. Quaternary prevention





  1. A nurse is working at a specialized clinic for patients with chronic obstructive pulmonary disease (COPD). Each year, the nurse recommends that patients get the influenza vaccine from their primary care provider, but notices that there are a lot of older women who do not get the vaccine, despite the recommendations. What should the nurse do first?
A. Print educational materials about the importance of yearly flu shots.
B. Set up low-cost transportation to local primary care providers for the women.
C. Start offering the flu shot at the COPD clinic.
D. Perform a focused community assessment to determine why these women aren’t getting the flu shot.





  1. Two nurses are talking about the number of patients that are admitted to the hospital each week due to falls in the home. They decide to partner up with the local senior center to design a community program aimed at reducing falls in the senior population. Which of the following interventions would likely be most effective?
A. Create printed material that the seniors can take home and use to assess their home.
B. Train volunteers to go into the homes of seniors at high risk for falls to assess their homes and help improve the home environment.
C. Provide an exercise program in the community center to increase agility and balance.
D. Pair up seniors at high risk with a volunteer caretaker who can help with chores and running errands.




| Safety


  1. A nurse is working in the emergency room and brings an elderly woman into triage. The woman’s daughter, with whom she lives, accompanies her. She came to the emergency room for shortness of breath, but on closer inspection, is covered with scabies and bed bug bites. After admitting her for evaluation, what should the nurse do?
A. Arrange for dermatology consult.
B. Review proper skin care and hygiene with the daughter.
C. Suggest an infectious disease specialist for the woman to see after being discharged from the hospital.
D. Report suspected elder neglect to the appropriate authorities.




  1. A woman is consulting with a nurse about the different housing options available for her parents, both in their 70’s and still very active. They wish to move into a situation where they could live for the rest of their lives. They currently rent an apartment and have a significant amount of liquid cash due to the sale of their home 6 months ago. What does the nurse recommend as the best option?
A. Skilled nursing facility
B. Aging in place
C. Naturally occurring retirement community
D. Continuing care retirement community






  1. A nurse is performing an admissions assessment on a 93-year-old woman with abdominal pain. The woman is unable to remember certain facts about her medical history or current medications. How should the nurse proceed?
A. Document her as slightly forgetful, consistent with age.
B. Inform the physician about her declining mental status.
C. Speak with the woman’s family about whether this is normal for her.
D. Speak with the physician about ordering medication for dementia.





  1. A home health nurse is visiting with patients for the day. Most of the patients are elderly people, being cared for in their home by family members. As part of a cultural assessment, the nurse must also discuss:
A. Caregiver stress and burnout
B. Financial responsibilities
C. Mental status changes
D. Expected needs over the coming year




  1. A nurse is beginning a new position with a home-care agency that provides hospice care. The nurse learns that the primary role of the nurse providing hospice care is to
A. Provide for the patient’s medical needs at the end of life.
B. Help the patient stay active until their death.
C. Assist the patient and family through the dying process and toward a good death.
D. Provide hygiene and personal care when the family is unable to.





  1. A nurse is admitting a new patient into the hospice program. Before planning end-of-life care and decisions, the nurse must consider which of the following?
A. The culture and heritage of the patient
B. Mental status and competence
C. Patient’s physical health status
D. Health-care benefits







  1. A nurse is counseling a 62-year-old woman in good health about her alcohol use. The woman asks how many drinks she should limit herself to each week. The nurse replies that she should have no more than ____________________ drinks per week.




  1. A nurse is examining population data in the community and wants to determine the aged dependency ratio in order to figure out the relationship between community workers who are still in the workforce and those who are not. The total population of the community is 15,703. There are 3,625 children s 0 to 14 years old, 7,201 people aged 15 to 64, and 4,877 people aged 65 and over. What is the aged dependency ratio? Round to the nearest whole number. ____________________





  1. A nursing director has instituted mandatory alcohol and illegal drug screening and history for all new admissions, including elderly patients. The director knows that long-term use of alcohol can put patients at risk for which of the following?

Select all that apply.

A. Cardiomyopathy
B. Pancreatitis
C. Gall bladder dysfunction
D. Hypertension
E. Throat cancer





  1. A nurse educator is having a discussion with students about the aging of the U.S. population. Which of the following are possible reasons for why our lifespan is increasing?

Select all that apply.

A. Decreased education
B. Better access to quality health-care
C. Increased average income
D. Improved physical environment
E. Increased urbanization




Chapter 21: Health Planning for Occupational Health




  1. A nurse is starting a new job as an occupational and environmental health nurse (OEHN) for a large corporation. The nurse wants to ensure that the company’s health and safety practices align with his or her standards of practice. What organization should the nurse check with?






  1. An occupational nurse is starting a new position with a company with 35 employees. The nurse asks to see the OSHA 300 form, but is told that the company is not required to use that form. How does the nurse reply?
A. You’re right. The OSHA 300 logs are voluntary.
B. You’re right. The OSHA 300 logs should be kept when a company has 50 employees.
C. That’s incorrect. The OSHA 300 logs should be kept when a company has at least 10 employees.
D. Each employee is required to keep their own logs and report injuries as applicable.





  1. A nursing student is doing a project using the OSH program to evaluate a local workplace. What is the first step?
A. Evaluate the workplace, looking for hazards.
B. Perform a community and workplace cultural assessment.
C. Perform medical screening on all employees.
D. Collect routine health data on all employees





  1. A nurse is describing the prevention measures available to the rest of the hospital staff. The nurse explains that the use of personal protective equipment is an example of:
A. Primary prevention
B. Secondary prevention
C. Tertiary prevention
D. Quaternary prevention





  1. A nurse is preparing a lecture about caring for the needs of the American workforce. Which of the following statements is incorrect?
A. The American workforce is becoming more knowledge based.
B. Most Americans are employed at their first job at 18 years of age.
C. The predominant health issue affecting the workforce is diseases associated with a sedentary lifestyle.
D. The American workplace is becoming more diverse.





  1. A public health nurse (PHN) is volunteering at a clinic that provides care to migrant workers who work in the fields in their community. In addition to routine health assessments, what should the nurse screen for?
A. Hearing loss
B. Skin cancer
C. Diabetes
D. Heart failure




  1. A worker has been exposed to a chemical that he is not used to working with. How should the OEHN proceed with treatment?
A. Quickly use water to rinse the chemical off and perform an assessment of the exposed skin.
B. Consult the material safety data sheet (MSDS) for more information on how to treat the exposure.
C. Call an ambulance and have a coworker bring a sample of the chemical with the victim to the hospital.
D. Encourage self-care and have the worker come back if he experiences any other symptoms.





  1. A PHN is working as an occupational nurse for a mining company. Which of the following is an example of a secondary prevention policy that the nurses can implement to address the high risk of pulmonary disorders found in miners?
A. Use of respirators for everyone working in the mine
B. Routine lung cancer and pulmonary disease screening
C. Job transfers for workers with pulmonary changes from the mine to an administrative position
D. Installation of a high-powered air filtration system in the mine





  1. A nurse is beginning a new position on the medical floor of a hospital. A patient is being admitted with symptoms consistent with tuberculosis. What personal protective equipment does the nurse need when caring for the patient?
A. Gloves
B. Gloves and mask
C. Gloves, mask, and gown
D. Gloves, gown, and respirator





  1. A nurse is working as an occupational nurse with a coal mining company. The nurse frequently observes workers sitting next to the entrance of the mine and eating lunch. The nurse knows that this poses a serious health risk. How should the nurse proceed?
A. Speak with several workers to see why they are eating next to the entrance of the mine.
B. Have management install hand-washing stations next to the entrance so workers can wash their hands before eating.
C. Establish a break room in a portable trailer so that workers have a place to go eat lunch.
D. Host a wellness seminar so that the nurse can provide information to the workers.






  1. A nurse is preparing to perform physical exams for a group of new employees. What information is the most crucial to the proper evaluation of the new employees’ health?
A. Medical records
B. Job description
C. Latest blood test results
D. Vaccination records





  1. A nurse has noticed that the average age of the workers in a factory is starting to increase. In anticipation of the needs of this population of workers, which program would likely be effective in keeping these workers safe?
A. Beginning a fitness program for workers to build muscle, flexibility, and balance
B. Reducing hours
C. Decreasing lighting and frightening noises
D. Implementing an early retirement program





  1. An OEHN is speaking with an employee who was injured on the job several weeks ago. It may be several more weeks before he is able to return to work. The nurse refers him to ____ to discuss payment during his time off.
A. Long-term disability
B. Workers’ compensation
C. Social security
D. A no-fault attorney




  1. A nurse is working in a private practice. Most of the staff members work at their desks and there are always baked goods from patients in the break room. The nurse wishes to implement positive healthy changes for the staff members. What is the best way to encourage these changes?
A. Start a running team and sponsor employees in running races together.
B. Host an employee wellness fair.
C. Mandate yearly screenings for hypertension and diabetes.
D. Sponsor a voluntary weight loss competition.





  1. An OEHN at a large electronics factory wishes to implement new programs to improve employee health and well-being. The OEHN decides to screen employees yearly to determine who requires additional interventions. What is the most effective way to accomplish this?
A. Workplace assessment
B. Physical exam
C. Health risk appraisal (HRA)
D. Occupational and environmental history





  1. An OEHN is reviewing the disaster preparedness plan. The OEHN doesn’t see any mention of how to handle a catastrophic leak of a dangerous chemical, commonly used in the plan, into the community. After working with the managers, in what part of the preparedness plan should this information be included?
A. Preparedness
B. Evaluation
C. Mitigation
D. Recovery







  1. A nurse is starting a position with a large agricultural farm in the Central California valley, where most of the migrant workers are recent immigrants to the area. This farm has never before employed an OEHN, and so the nurse wants to establish a training program especially for these newly immigrated workers. What information and assistance is particularly helpful for this population?

Select all that apply.

A. Safe work practices
B. Assistance in locating shelter and food
C. Financial assistance for education
D. Complaint policies
E. Immigration assistance




  1. An OEHN is performing an employee health evaluation for a new female worker who will be working on a construction site. What information is particularly relevant to the assessment?

Select all that apply.

A. Fit of PPE
B. Hearing and vision assessment
C. Family situation
D. Previous medical records
E. Job description



  1. An occupational nurse is asked to perform a walk-through assessment of the factory where he or she works. What type of information should the nurse include in the assessment?

Select all that apply.

A. Obvious dangers or hazards
B. The presence or absence of safe walkways
C. Observations of noise levels
D. The use of personal protective equipment
E. The physical activity of the workers




  1. A nurse is working on an oncology floor and explaining to the new nurses the safety measures required when handling chemotherapy. The nurse describes multiple levels of control, including which of the following?

Select all that apply.

A. Elimination
B. Engineering controls
C. Warning
D. Administrative controls
E. Personal protective equipment




Chapter 22: Public Health Policy and Finance




  1. A nurse is working with local government officials and political lobbyists to prompt a vote to improve the school lunch program. The nurse knows that this is an example of:
A. Advocacy
B. Public health policy
C. Equity
D. Public health economics






  1. A nurse is preparing to teach a class on public health policy and its impact on nursing practice. Which of the following statements is incorrect and should be excluded from the lecture?
A. Nursing scope of practice as determined by state nurse practice acts are included in public health policy.
B. Nurses are affected by public health policy both professionally and personally.
C. Changing health policy does not fall within the scope of nursing practice.
D. Some federal and payroll tax exemptions are an example of public health policy.





  1. A nurse is caring for a young man who is complaining about the state of the health-care system. He argues that health care should be left to the free market economy. To explain why relying on the free market is not practical, the nurse responds,
A. “There are too many health-care providers to support the health-care system in a free market economy.”
B. “A free market system is difficult to implement because during emergencies, patients and their families are unable to properly research local emergency care options.”
C. “The American health-care system is already based on a free market system.”
D. “A free market economy is based on the sale of goods, and does not apply to the health-care system.




  1. A nurse is working at a local community health center. The nurse is speaking with an elderly Native American man who lives on a nearby reservation. He reports that many members of his tribe are unable to afford health care and are suffering from alcoholism and diabetes. What program should the nurse suggest that the gentleman contact?
A. Indian Health Services
B. Medicaid
C. Medicare
D. Alcoholics Anonymous





  1. A nurse is looking to create policies that would reduce the rate of tobacco use by teenagers in the local community. Who would be the most important group to consult with when performing a community assessment?
A. Physicians and educators
B. Local teenagers
C. Public health and tobacco experts
D. Local shop owners and community council members





  1. A school nurse is evaluating the lunch program in the district after a student had a serious anaphylactic reaction to peanuts. The school is located in a lower socioeconomic area of the city. What new policy would make the most sense in this school?
A. Mandate that all students purchase their food on campus and not bring any food into the building.
B. Obtain funding to provide free school lunches for everyone.
C. Make the school a completely peanut-free campus.
D. Ensure that every classroom has access to an EpiPen in case of future reactions.





  1. A nurse is giving a lecture about public policy and policy changes. A student asks about what impact culture has on public health policy. How should the nurse respond?
A. People have a right to their cultural identity and that should be prioritized over the public health policy.
B. A person’s culture has little to do with health behaviors.
C. Policy makers should prioritize the health and well-being of the entire community, regardless of local cultural values.
D. Culture not only refers to ethnicity or race, but also to various communities and groups of people.





  1. A nurse is working with the local representative to pass a law raising the legal age for purchasing tobacco to 21 years old. It has been passed into the committee phase of the legislative process. How should the nurse prepare for the next step?
A. Contact all of the local legislators to lobby for passing of the bill.
B. Encourage local citizens to vote on the bill.
C. Prepare evidence-based research and current clinical studies to support their position and educate committee members about the medicine behind nicotine addiction in youths.
D. Inform local store owners about the impending change in the law.





  1. An occupational nurse is speaking with union representatives about a long-standing problem with insufficient safety equipment at a local surgical center. Where does the nurse suggest they report the problem?
C. City Council
D. The medical director





  1. A nursing student studying public health has asked the instructor where to find good sources of evidence-based practice to help formulate policy changes as part of a thesis project. Which resource would be most helpful for the student?
A. The New England Journal of Medicine
B. Medscape
C. The CDC
D. The Community Guide





  1. A nurse is looking at federal funding for the school lunch program and childhood obesity data for the kids in  school. The nurse found that despite the highest rate of federal funding for any local school in their district and increased nutrition standards to improve the quality of food, kids in the school also have the highest obesity rate. What conclusion can you draw from this information?
A. Even more funding is required to have an effect on the obesity rate.
B. The nutritional standards aren’t sufficient and the school should revert back to the original ones.
C. Some policies aren’t enough to change behavior, as many kids are still bringing unhealthy lunches in from home.
D. The school should begin a school breakfast program as well so that kids have increased access to healthy foods.





  1. A nursing student is writing a grant for a class project to obtain funding to open a clinic. The clinic is to be used for community residents to be tested and treated for sexually transmitted infections (STI). The instructor advises the nursing student to include a discussion of how increased funding in this clinic would decrease the rate of STI transmission. This discussion includes:
A. Public health economics
B. Public health finance
C. Market economy
D. Health Funding





  1. A nurse is counseling a young woman with a new diagnosis of Gonorrhea. What should be included in the discharge instructions?
A. The nurse will need to contact all of the woman’s prior sexual partners to inform them of her diagnosis.
B. Filing a report with the health department is mandated and is a way for them to track infection rates.
C. All of the above
D. None of the above




  1. A nurse is having a discussion with a patient about who should be responsible for overseeing the public health system and the health of American citizens. The patient states that each person should be responsible for his or her own health. The nurse replies that the American Constitution gives this power to:
A. Federal government
B. State governments
C. Local governments
D. Private insurance companies





  1. A nurse is caring for a young child with a severe ear infection in a hospital emergency room. The nurse asks the mother why it took so long for the child to get care and the mother stated that she couldn’t afford medical bills and that they didn’t qualify for Medicaid. Once the child has received medical attention, what program does the nurse recommend to the mother?
C. Medicare





  1. A nurse is having a discussion with a coworker about frustration at the slow rate of positive health policy change. The nurse has attempted to contact the local policy-maker about the need to expand public transportation availability for community members struggling to get to work but has not received a response. What might the coworker suggest?
A. Visiting the representative’s local office
B. Trying again after the next election
C. Getting a group of nurses and local residents to work together to make their needs known
D. Write a formal letter of complaint








  1. A nurse has noticed an increase in drug and alcohol abuse in the young adult population in the community. The nurse has teamed up with another nurse to formulate policies to address this health concern. Place the following steps in the order in which they should be performed (1–4):

_____ 1. Brainstorm a list of possible policy interventions.

_____ 2. Perform an assessment of the community, looking at social information, the available resources, and needs of the community.

_____ 3. Examine the efficiency, effectiveness, and equity of policy alternatives.

_____ 4. Establish goals, working with a representative of the teens living in the community.





  1. A nurse is looking to reduce the childhood obesity rate in the school district. After assessing the budget, available resources, and the needs of the students, the nurse has decided to focus on increasing the physical activity of the students. What factors should the nurse consider when evaluating the different alternatives?

Select all that apply.

A. Current evidence-based practice
B. The effectiveness of each policy
C. The feasibility of each policy
D. The efficiency of each policy goal in relation to the cost of enforcing the policy
E. The fairness of each policy’s costs and benefits





  1. A nurse is teaching a class on the basic principles of health insurance. The nurse asks the class about benefits of the Affordable Care Act to American citizens. What are some possible responses?

Select all that apply.

A. Expansion of Medicaid to include more people
B. Coverage of young people under the age of 26 on their parents’ health insurance policy
C. Universal health coverage for all citizens
D. Mandatory employer-paid coverage for all employees
E. Expansion of access to and coverage of preventative care





  1. A nurse has called the state nursing board to discuss being an advocate for health policy change. The state BON representative gives which of the following as examples of appropriate ways for a nurse to advocate for policy change?

Select all that apply.

A. Reporting a newly diagnosed case of Listeria to the public health department
B. Informing staff about the signs and symptoms of a new virus infecting local residents
C. Random inspections of the nursing and clinical staff by the nursing director of a skilled nursing facility
D. Regularly using personal protective equipment
E. Working with the school board to include nutrition classes in the middle school curriculum





Chapter 23: Culture and Public Health Nursing




  1. A nurse is developing new policies in the unit to increase cultural competence and sensitivity. The nurse decides to reference the core competencies developed by the Quad Council, and explain how the first skill, ____, is crucial to all nursing practice.
A. Acting in a sensitive manner with people of diverse backgrounds
B. Identifying the role that social determinants of health play in health care
C. Recognizing the importance of diversity in health care
D. Understanding factors contributing to diversity






  1. A public health nurse (PHN) is moving from his or her hometown in the Northeastern United States to a new position in Southern California. When beginning the local community assessments, what might the PHN notice about how the environment affects regional culture?
A. People living in the colder Northeast climate are more likely to socialize around outdoor experiences.
B. Clothing styles are very similar.
C. Food choices in Southern California tend to be lighter and revolve around fresh produce.
D. None of the above





  1. A nurse is speaking with a new group of student nurses about the importance of developing cultural humility, not just cultural competence. How does the nurse suggest that the students begin to develop cultural humility?
A. Study as much as they can about other cultures
B. Nothing–it will become second nature as they progress in their career.
C. Perform cultural self-assessments regularly.
D. Perform cultural assessments on every patient they encounter.





  1. A nurse is looking to educate women in the community about women’s health issues. After performing a community assessment, the nurse decides to target young women by holding informal and fun seminars for small groups. Where should the nurse consider holding these seminars?
A. The local library
B. Nail and hair salons
C. The town community center
D. Local parks





  1. A nurse is performing a community assessment in a small town several hundred miles away. The nurse only has a few days in town before heading back to analyze the assessment. What is the best way to get as much information as possible?
A. Perform demographic research from public records.
B. Drive around town and observe local residents.
C. Interview key stakeholders in the community about life in town.
D. Attend a city council meeting to observe local policy makers.






  1. A nurse is wrapping up a community cultural assessment but needs to clarify some of the information learned and ask some additional questions. What is the best way to do this?
A. Internet research
B. Reading old newspapers and community magazines
C. Questionnaires mailed to community residents
D. Hosting a focus group with several key members of the community





  1. A nurse is teaching a class about government policies and their effect on health care. Which of the following programs made it a central goal to eliminate health disparities?
B. Social Security Insurance
C. Healthy People 2020
D. None of the above





  1. A nurse has completed an in-depth community assessment on a local town to address rising levels of obesity and hypertension. What is the best next step?
A. Meet with local community members to establish realistic, culturally appropriate goals for the community.
B. Hold a town hall meeting for everyone in the community to discuss the findings.
C. Start planning a community fair so residents can start to get more information about healthy eating and exercise habits.
D. Host a focus group to clarify information learned during the assessment.





  1. A nurse manager is reviewing terms associated with appropriate cultural care with the staff. The nurse is discussing the goal of creating an environment where patients feel respected for their cultural differences. What is this called?
A. Cultural safety
B. Cultural competence
C. Cultural humility
D. Cultural conflict





  1. A PHN is presenting a guest lecture to an undergraduate ethics class. The PHN is describing the ethical question of whether providing culturally inappropriate care violates the principle that nurses should only act in his or her patient’s best interests. This is also known as:
A. Autonomy
B. Justice
C. Beneficence
D. Maleficence




  1. A nurse is meeting with community stakeholders to review a cultural community assessment. The nurse has been sent to this town to address rising tobacco use and to help the community find ways to encourage quitting. The community is a very small town without primary caregivers and other support systems in place. Which of the following is the best intervention for this town?
A. Provide free bussing into the nearest town so community members can attend tobacco cessation support groups.
B. Train local community members about running smoking cessation support groups and individual support services.
C. Host a community fair to disseminate information about the dangers of smoking.
D. Pass a law forbidding smoking in public places.






  1. A nurse is performing the very beginning of a community assessment. The nurse is evaluating the community’s language and family structure and traditions. This is known as
A. Race
B. Ethnicity
C. Culture
D. Ethnocentrism






  1. A nurse in a hospital is assigned a new patient who only speaks Italian. The nurse knows that language is a big part of a person’s identity, but it also contributes to their:
A. Culture
B. Ethnicity
C. All of the above
D. None of the above




  1. A nurse is talking with a colleague about an IV solution he or she has been ordered to set up. The nurse is confused by the calculations for the drip rate. A friend jokingly tells the nurse to ask a third colleague, who happens to be Korean, saying, “Aren’t all Asians good at math?” This is an example of what type of behavior?
A. Racism
B. Ethnocentrism
C. Positive stereotyping
D. Negative stereotyping




  1. A nurse has been called to visit a community specifically for older adults (aged 55 and over) where there has been a dramatic rise in gonorrhea infections. What is the first step?
A. Establish a display in the community center with educational materials about safe sex and free condoms.
B. Speak with the individuals involved and determine the source of the infection.
C. Organize a community wide meeting to discuss why safe sex practices are important even though pregnancy is no longer a concern.
D. Perform a community assessment to see what interventions might be needed in the community.





  1. A nurse is caring for a Buddhist patient who has mentioned that his daily periods of meditation are very important to him. How should the nurse respond?
A. Get more information from him about what this means: When does he meditate and for how long, and does he need anything specific to facilitate his practice?
B. Tell him you’ll need to speak with the physician to see if the hospital would be able to accommodate his meditation time.
C. Smile and tell him that’s fine.
D. Apologize that the medical staff needs to be able to have access to him at all times and that you couldn’t guarantee private time to meditate.







  1. A nurse is planning to do a community cultural assessment. Place the following steps in the order in which they should be performed (1–4):

_____ 1. Explore the community in more detail through newspapers, magazines, and other evidence-based sources.

_____ 2. Sponsor a focus group to clarify information and ask additional questions.

_____ 3. Review demographics of the community.

_____ 4. Perform interviews with several key members of the community.





  1. A nurse is preparing to do his or her first community cultural assessment on a nearby town. What should the nurse include in the assessment?

Select all that apply.

A. Average level of education
B. Religion
C. Socioeconomic breakdown
D. Language
E. Health beliefs, practices, and traditions




  1. A nurse is creating a questionnaire to help students begin their cultural self-assessment. What questions should  be included in the questionnaire?

Select all that apply.

A. What are my religious beliefs?
B. What are my personal beliefs and values?
C. Where did I grow up and how did that affect my values?
D. Who in my life do I consider to be most influential in helping me establish my belief system?
E. What does good health mean to me? What does bad health mean to me?




  1. A nurse is discussing changing population patterns and diversity with a class. The nurse mentions that the percentage of Caucasians within the American population is decreasing in comparison with other minority populations. The nurse asks the class why, despite the increase in diversity, the Caucasian population is still considered to be the majority group. How can students in the class respond?

Select all that apply.

A. Caucasians still remain the largest percentage of the population.
B. Other ethnicities tend to experience a pattern of inequality and disadvantage.
C. Minority groups are more self-conscious about their role in society.
D. America is historically a Caucasian country.
E. Caucasians tend to have more social power and influence.





Chapter 24: Vulnerable Populations




  1. A nurse is working with a group of refugees who recently arrived in the United States after suffering terrible violence in their country. The nurse knows that they should be assessed for:
A. Communicable diseases
B. Injuries related to torture or sexual assault
C. Mental illness such as PTSD
D. All of the above




  1. A nurse has finished an initial assessment of a community with a high rate of obesity. The nurse has observed that socioeconomic status seems to be linked with poor outcomes in this community. What is the next step?
A. Set goals to reduce obesity rate by 5 percent in the next 3 years.
B. Set up a community fair to begin educating people in the community about healthy food choices.
C. Involve key members of the community in the goal setting and plan formation phase of the nursing process.
D. Perform a cultural assessment to see what other factors may be involved in this community.






  1. A nurse is assessing a young woman who recently lost her job. She has no way to support her family and has found herself living on the streets because she doesn’t have any other family in the area. Which of the following is the best way to proceed?
A. Look at the broader picture and see if there are any opportunities for policy change.
B. Refer her to a shelter and document.
C. Offer her a job-training program.
D. Ask her to come back in 6 months for a reevaluation.






  1. A nurse is working in a prison health center with many of the older prisoners. The nurse is anticipating having to manage which of the following conditions that tends to be more prevalent in the aging prison population?
A. Cognitive disorders
B. Cancer
C. Dental problems
D. Mental disorders





  1. A nurse is teaching a class about vulnerable populations. He instructs that vulnerable populations have been divided into three groups. Which of the following is not one of the three groups that research has identified?
A. People suffering as a result of their behavior (for example, drug addicts)
B. Children of parents who made bad decisions (for example, illegal immigrants)
C. People who became vulnerable through no fault of their own (for example, from cancer)
D. Adults that are born into vulnerable populations because of their ethnicity or race




  1. A school nurse has observed an increase in bully behavior in her school. The nurse has noticed that a lot of it seems to be directed toward two gay students and wonders if a school policy change is required to change this behavior. How should the school nurse proceed?
A. Institute a zero tolerance policy for any bully behavior.
B. Set goals for zero incidents of bullying next year.
C. Perform a community assessment to see why the bully behavior has increased.
D. Get the teachers involved in teaching anti-bully behavior in the classroom.





  1. A nurse is sitting in a community clinic and chatting with a South American patient. He reports that other members of the community are rude to him and his family and act as if he and his family are not part of the community. He mentions that this is a common experience among the South American population living in town. The nurse knows that:
A. This likely plays no role in his health or health status.
B. This family is being stigmatized.
C. The family needs to focus on bonding with their South American community.
D. Marginalization can lead to increased vulnerability and health disparities.





  1. A public health nurse (PHN) is starting a study of different populations in the community to see which groups have face marginalization, and to what degree. The PHN is looking for evidence that:
A. A group has been discriminated against based on their race or ethnicity.
B. A group has been treated as if they are not important or of little consequence to the rest of society.
C. A group has been labeled by society as possessing a particular characteristic that is not valued, leading to a loss of status.
D. A group has been assigned a negative or positive belief that is believed to apply to the entire group.





  1. A nurse is working with the local government to determine where best to spend money obtained from a new funding program. The nurse is looking for particularly vulnerable communities. Which of the following communities might be best served by the increased funding?
A. A primarily Hispanic community that is rich in culture and community
B. A low socioeconomic Caucasian community that is facing abnormally high levels of lung cancer
C. A middle class African American community with an obesity rate of 15 percent
D. An upper class community where there is an outbreak of Hand, Foot, and Mouth Disease






  1. A nurse is teaching a class about the effect of socioeconomic status on health outcomes. The nurse explains that socioeconomic status is related to:
A. Income
B. Occupation
C. Education
D. All of the above





  1. A nurse is caring for a young homeless man on the medical floor of the local hospital. He was admitted several days ago to safely detox from alcohol. He reports having nowhere to go once he is discharged. Who should be involved in his discharge planning?
A. Social worker
B. Addiction specialist
C. Psychiatrist
D. All of the above





  1. A nurse is caring for a young man who is squatting in an old factory a mile away. The nurse documents that he is experiencing what type of homelessness?
A. Primary
B. Secondary
C. Tertiary
D. He is not homeless because he has an indoor shelter in which to sleep.





  1. A nurse received funding to start a mobile health unit to serve the needs of the homeless population. In addition to a general nurse staffing the unit, what other type of nurse should be hired to assist?
A. Cardiac
B. Surgical
C. Psychiatric
D. Nutrition





  1. A nurse is performing a pelvic exam on a woman in her mid-twenties. The nurse asks the woman what type of birth control she uses and the woman laughs, saying that she doesn’t need birth control because she is a lesbian. How should the nurse respond?
A. “That’s correct, you do not need contraception.”
B. “You should consider contraception anyway, just in case you ever decide to be intimate with a man.”
C. “You still need to use a barrier contraceptive because of the risk of sexually transmitted infections.”
D. “Hormonal contraceptives might be a good option for you.”





  1. A nurse is working within a community clinic on the Mexican-Californian border. The nurse frequently takes care of refugee families when they first arrive in the United States. When meeting with a new family, the nurse makes sure to inform them that they are eligible for which of the following services?
A. Medicaid eligibility
B. Free health insurance for 1 year
C. Housing and food support
D. Free English classes





  1. A nurse encounters a young woman with her child in the community. They do not speak English, but the nurse is fluent in Spanish and is able to communicate with them in their native language. The woman is very frightened and states that she can’t go back to her country because the local government will harm her and her child if she does not convert to Catholicism. The nurse takes the woman to the local immigration office to apply for what status?
A. Asylee
B. Refugee
C. Immigrant
D. Permanent Resident







  1. A nurse is speaking with politicians about the need to modify the poverty threshold to be fairer to people living in poverty and people living just over the poverty line. Which of the following are potential ways that the poverty threshold could be amended to be more accurate or fair?

Select all that apply.

A. Amend it to reflect increased spending on health care and transportation.
B. Amend it to reflect increased housing costs.
C. Amend it to reflect increased need and cost of childcare.
D. Amend it to reflect increased spending on food.
E. Amend it to reflect regional cost of living.





  1. A nurse is training for a new job at a community clinic after moving to Central California, an area rich in agriculture and migrant workers. The nurse asks about specific social and health issues that the migrant worker population faces and the nurse supervisor replies:

Select all that apply.

A. They have difficulty establishing residency in a single location, making them ineligible for government benefits.
B. Most of them lack access to workers compensation or disability insurance.
C. Frequent travel and location changes make it difficult for them to establish continuity of care with a single provider.
D. Illegal immigration status is often a problem.
E. Language is often a barrier.





  1. A nurse is preparing a class on caring for the homeless population. The nurse asks the class to brainstorm some risk factors for becoming homeless. Which of the following should the class list as known risk factors for homelessness?

Select all that apply.

A. Young families
B. Caucasians
C. Single men
D. African Americans
E. Having mental illness




  1. It is the first day of class for new graduate public health nursing students. The professor explains that as PHNs, they will need to fill many roles, including which of the following?

Select all that apply.

A. Educator
B. Advocate
C. Administrator
D. Researcher
E. Social worker




Chapter 25: Disaster Management and Public Health Emergency Preparedness




  1. A nurse is attending a training session on disaster management and is surprised to learn that:
A. True emergency preparedness and disaster management is a continuous cycle and has no beginning or end.
B. There are four major phases of a disaster life cycle.
C. There are three stages of the disaster preparedness framework.
D. Emergency preparedness and disaster management must only occur at the local level.





  1. A nurse is reviewing the disaster and emergency plans for the hospital before updating them. What characteristic needs to be addressed, as it is not helpful in a disaster preparedness plan?
A. The plan is broad in scope and able to address multiple types of disasters.
B. The plan is comprehensive and contains plans for advanced preparation, disaster management and post-disaster evaluation.
C. The plan stresses autonomy and independence from nearby organizations.
D. The plan includes information about long-term management of the after effects of the disaster.






  1. A nurse is working at a high school that is serving as a community shelter during a hurricane. In the surge after the storm, the basement starts filling with floodwaters and then the power shuts off. As a result, the nurse contacts the local coast guard to assist in relocating people in the shelter to an unaffected elementary school across town. This is an example of:
A. Mitigation
B. Preparedness
C. Triage
D. Recovery





  1. A public health nurse (PHN) is working with a community after a major wildfire. The fire has been completely contained and will be put out shortly. How does the nurse proceed?
A. Return home and allow the local firefighters to finish putting the fire out.
B. Contact the Federal Government to ask for assistance in managing the wildfire.
C. Wait another day or two until the fire is confirmed to be out and then return home.
D. Begin surveillance and assess for incidences of respiratory disease related to the fires.





  1. A nurse is speaking at a city council meeting in a coastal town on the northeastern coast of the United States. The nurse is explaining that in order to protect the rest of the town, the city council needs to restrict people from building homes along the immediate coastline. A resident stands up, angry, and demands to know why he can’t purchase property there. The nurse replies:
A. “People living along the coastline are at greater risk for property damage from seawater.”
B. “Deforestation along the coast can increase risk and severity of strong storm surges during hurricanes or coastal storms.”
C. “Remote areas can be more difficult to evacuate in case of an emergency.”
D. “All community members need to be able to access the coastline in case of an emergency evacuation.”





  1. A nurse has been dispatched to communities along the New Madrid fault in Missouri because the area has seen a recent increase in seismic activity. The nurse is attempting to put policies in place that mitigate the potential damages from future earthquakes. Which of the following is an example of an effective policy change?
A. Require a post-earthquake meeting to discuss the town’s response.
B. Create an emergency preparedness plan.
C. Update building ordinances to be more resistant to seismic activity.
D. Make the Director of the City Health Department in charge of all emergency response needs.





  1. A nurse is at the beach with friends when one of them begins to complain about dizziness and fatigue. It is a particularly hot day in the middle of a heat wave. How should the nurse react?
A. Call an ambulance.
B. Tell her to close her eyes and rest.
C. Give her some cool water.
D. Leave the beach with the friend and have her sit in an air-conditioned car while drinking an electrolyte replacement drink.





  1. A nurse is working with a local television station to work on a public service announcement meant to educate residents on how to prepare for tornados. What advice does the nurse give in the event that a tornado is imminent?
A. Watch for the coming storm at the windows.
B. Immediately take shelter in a basement away from any windows.
C. Take shelter in a large room under a blanket.
D. As soon as the alarm goes off, gather your emergency supplies and head to the nearest community shelter.





  1. A nurse is working at a hospital in Hawaii. A neighboring island has been evacuated due to a volcanic eruption. The hospital has been put on alert that they will be receiving injured people from the evacuated island. What types of injuries or illnesses should the nurse and other staff be prepared for?
A. Burns
B. Respiratory disease
C. Severe lacerations or other traumatic injuries
D. All of the above





  1. A nurse is volunteering with the local fire department and is sitting in on a class about dealing with wildfires. The instructor is talking about strategies for fighting a fire that is burning below the forest floor in the humus layer of the soil. This is known as what type of fire?
A. Wildfire
B. Ground fire
C. Surface fire
D. Crown fire






  1. A nurse is taking care of a several patients who were injured as a result of a pipe bomb explosion. The current patient has ruptured eardrums and traumatic injuries to his lower extremities due to flying debris. How does the nurse document these injuries?
A. Primary
B. Secondary
C. Tertiary
D. Primary and secondary






  1. A nurse is assisting paramedics at the site of a large accident with many injured people. During the initial response, it is especially important to:
A. Notify the media so they can assist in informing the community of what happened.
B. Triage victims according to the severity of their injuries.
C. Interview victims and witnesses to determine what happened.
D. Notify clergy and mental health professionals to assist survivors at the site.





  1. A nurse is responding to the scene of a small plane crash in the community. First responders are on the scene treating victims, but they have asked the nurse to notify the appropriate federal authorities. The nurse informs:
A. The FBI
B. The FAA
D. The Department of Homeland Security





  1. A nurse is working very closely with a community after a small plane crashed into an apartment complex and killed many of its residents. Now that the crash site has been cleaned and the community is starting to return to normal, what is the priority for this community?
A. Screen for and manage depression, anxiety, and post-traumatic stress disorder.
B. Establishing an emergency management plan.
C. Hold a community debriefing about what happened.
D. Encourage residents to get back to their regular routines as soon as possible.






  1. A nurse is working with the state department of health. Weather forecasters are anticipating that several communities will be impacted by a severe hurricane that will likely decimate the coastline of their community. They order a voluntary evacuation for several communities, in particular those that are likely to be most severely impacted. Which of the following statements is incorrect?
A. Use of the Emergency Alert System by broadcasters during an emergency is voluntary.
B. They should consider mandatory evacuations if residents chose to not evacuate as suggested.
C. There should be a legal plan in place to deal with residents who are not complying with instructions.
D. A shelter should be established to help vulnerable residents and people who are not able to find somewhere to stay.





  1. A prison nurse has received notification that there is a powerful storm system approaching the prison that is likely to cause tornados in the area, putting the prison and prisoners at risk. The nurse is reviewing the emergency response plan, which should include:
A. Plans for the safety of first responders
B. Plans for the protection and safety of prisoners and staff
C. Plans for the safety of the general public
D. All of the above






  1. A nurse is organizing a disaster drill for the hospital. Which factors should the nurse consider while organizing the drill?

Select all that apply.

A. They should be scheduled twice a year.
B. The materials should be specific to the expected surge at that facility during a disaster.
C. They should only involve a few key staff members.
D. They should practice the organizational structure of the facility.
E. In addition to the actual drill, the entire staff and volunteers should undergo a continuing education in-service.




  1. A PHN has been sent to the site of a nuclear accident to assist in setting up long-term surveillance. The PHN will want to monitor cases of which of the following diseases?

Select all that apply.

A. Heart disease
B. Leukemia
C. Mental illness
D. Thyroid disease
E. Diabetes





  1. A nurse has just been promoted to serve on the disaster preparedness committee of the hospital. The nurse’s role during a disaster is to collect emergency information and distribute it to public health officials as required. What information should the nurse collect?

Select all that apply.

A. Staffing needs
B. Supply inventory and shortages
C. Name, social security number, and phone number of every employee responding to the disaster
D. Budget needs of the hospital
E. The number of patients who have already been treated and who still need care







  1. A nurse is reviewing the disaster preparedness cycle with other nurses in the hospital. The nurse explains that the following steps must occur. Place them in the correct order (1–4):

_____ 1. Recovery

_____ 2. Preparedness

_____ 3. Mitigation

_____ 4. Response