Foundations of Nursing in the Community 4e by Marcia Stanhope-Test Bank

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Foundations of Nursing in the Community 4e by Marcia Stanhope-Test Bank

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WITH ANSWERS
Foundations of Nursing in the Community 4e by Marcia Stanhope-Test Bank

Chapter 02: The History of Public Health and Public and Community Health Nursing

Test Bank

 

MULTIPLE CHOICE

 

  1. A nurse is considering applying for a position as a public health nurse. Which of the following would be a reason this position would be appealing?
a. Its autonomy and independence
b. Its focus on acute care and immediately visible outcomes
c. Its collaboration with other health care professionals
d. Its flexibility and higher wages

 

 

ANS:  A

In-patient acute care nurses (not public health nurses) focus on acute care with outcomes known fairly quickly. Unlike in-patient nursing, in which there are other health care professionals and staff with whom to interact, public health nursing is known for its autonomy and independence.

 

DIF:    Cognitive Level: Apply (Application)                             REF:   p. 15

 

  1. The Elizabeth Poor Law of 1601 is similar to which current law?
a. Welfare
b. Food stamps
c. Medicaid
d. Medicare

 

 

ANS:  C

The Poor Law guaranteed medical care for poor, blind, and lame individuals, similar to Medicaid.

 

DIF:    Cognitive Level: Analyze (Analysis)                                         REF:    p. 15

 

  1. How did the Industrial Revolution result in previous caregiving approaches, such as care by families, friends, and neighbors, becoming inadequate?
a. Economic and political wars resulted in frequent death and injuries.
b. Incredible plagues consistently and constantly swept the European continent.
c. Migration and urbanization resulted in increased demand for care.
d. Caregivers could easily find other employment, so they demanded to be paid.

 

 

ANS:  C

Care became inadequate because of the social changes in Europe, with great advances in transportation, communication, and other technologies. The increased mobility led to migration and urbanization, which in turn led to increased need for care.

 

DIF:    Cognitive Level: Understand (Comprehension)               REF:   p. 15

 

  1. A colonist is working in the public health sector in early colonial America. Which of the following activities would have likely been completed?
a. Establishing schools of nursing
b. Developing vaccines to administer to large numbers of people
c. Collecting vital statistics and improving sanitation
d. Developing public housing and almshouses

 

 

ANS:  C

The other choices are events that happened after the colonial period.

 

DIF:    Cognitive Level: Apply (Application)                             REF:   p. 16

 

  1. Why did American citizens become interested in establishing government-controlled boards of health?
a. They were afraid of infectious diseases such as yellow fever.
b. The government could force the poverty-stricken to accept care.
c. Such boards could tax and thereby ensure adequate funds to pay for care.
d. Such a system would allow for accurate records of births and deaths.

 

 

ANS:  A

Threat of disease, especially yellow fever, led to public interest in establishing government-sponsored, or official, boards of health.

 

DIF:    Cognitive Level: Understand (Comprehension)               REF:   p. 16

 

  1. A nurse was employed by the Marine Hospital Service in 1800. Which of the following interventions would the nurse most likely have completed?
a. Setting policy on quarantine legislation for immigrants
b. Establishing hospital-based programs to care for the sick at home
c. Identifying and improving environmental conditions
d. Providing health care for merchant seamen

 

 

ANS:  D

Providing health care to seamen was an early effort by the federal government to improve public health. The purpose of the Marine Hospital Service was to secure its maritime trade and seacoast cities.

 

DIF:    Cognitive Level: Apply (Application)                             REF:   p. 16

 

  1. What was the outcome of the Shattuck Report?
a. Efforts to control alcohol and drug abuse, as well as tobacco use, were initiated.
b. Environmental sanitation efforts became an immediate priority.
c. Guidelines for modern public health organizations were eventually developed.
d. Local and state governments established boards of health after its publication.

 

 

ANS:  C

It took 19 years for the first of Shattucks recommendations to be implemented, but his report was the first effort to create a modern public health organization.

 

DIF:    Cognitive Level: Understand (Comprehension)               REF:   p. 16

 

  1. Which of the following nurses is famous for creating public health nursing in the United States?
a. Florence Nightingale
b. Frances Root
c. Lillian Wald
d. Mrs. Solomon Loeb

 

 

ANS:  C

Lillian Wald established the Henry Street Settlement and later emerged as the established leader of public health nursing during its early decades.

 

DIF:    Cognitive Level: Remember (Knowledge)                                 REF:    p. 18

 

  1. Which of the following would have been the focus of a school nurse in the early 20th century?
a. Investigating causes of absenteeism
b. Teaching school as well as being a nurse
c. Promoting nursing as an autonomous practice
d. Providing medical treatment to enable children to return to school

 

 

ANS:  A

Early school nursing focused on investigating causes of absenteeism, not providing medical treatment. That was the responsibility of physicians.

 

DIF:    Cognitive Level: Apply (Application)                             REF:   pp. 18-19

 

  1. A nurse is reviewing the original work of the National Organization for Public Health Nursing. Which of the following accomplishments of today was started within this organization?
a. Requiring that public health nurses have a baccalaureate degree in nursing
b. Standardizing public health nursing education
c. Developing nursing cooperatives
d. Opening the Henry Street Settlement

 

 

ANS:  B

The National Organization for Public Health Nursing sought to standardize public health nursing. The Henry Street Settlement was already in existence. The baccalaureate degree in nursing was not developed yet.

 

DIF:    Cognitive Level: Apply (Application)                             REF:   pp. 19-20

 

  1. Why were nurses so unprepared for public health nursing in the early twentieth century?
a. Community health nursing had not yet been created as a field.
b. No one would teach the nurses how to engage in public health activities.
c. Nightingales textbook did not include content on public health nursing.
d. Nurses were educated in diploma schools, which focused on hospital nursing.

 

 

ANS:  D

Nursing school courses taught in diploma schools of nursing emphasized hospital care of patients; thus, nurses were unprepared for home visiting.

 

DIF:    Cognitive Level: Understand (Comprehension)               REF:   p. 20

 

  1. A nurse is considering joining the American Public Health Association. What information about this organization should be considered when making this decision?
a. APHA focuses on the public health concerns of the medical profession.
b. APHA represents concerns of nursing specialty practices.
c. APHA provides a forum for nurses to discuss their public health concerns.
d. APHA focuses on providing health promotion education to the public.

 

 

ANS:  C

APHA was formed to facilitate interprofessional efforts and promote the practical application of public hygiene. The Public Health Section within APHA provides nurses with a forum to discuss their concerns and strategies. It also serves as a focus of leadership and policy development for community/public health nursing.

 

DIF:    Cognitive Level: Apply (Application)                             REF:   p. 20

 

  1. Why did the Metropolitan Life Insurance Company establish and retain for several years the first community nursing health program for policyholders?
a. Creating such a service was the morally correct thing to do.
b. Employing nurses directly was less expensive than paying taxes to the city for the same purpose.
c. Having the companys nurses make home visits increased worker morale.
d. Having public health nurses visit policyholders and their families led to a decline in policyholder deaths, thus lowering costs for the insurance company.

 

 

ANS:  D

Metropolitan Life saw an average decline of 7% in the mortality rate of policyholders and almost a 20% decline in the deaths of children. The insurance company attributed this improvement and the associated reduced costs to the visiting nurses.

 

DIF:    Cognitive Level: Understand (Comprehension)               REF:   p. 21

 

  1. Which client would have been most likely to receive care from the Frontier Nursing Service?
a. An injured soldier
b. A homebound, elderly male
c. A woman in labor
d. A child with measles

 

 

ANS:  C

The Frontier Nursing Service nurses were trained in nursing public health and midwifery and provided care to rural and inaccessible areas, which led to reduced mortality.

 

DIF:    Cognitive Level: Apply (Application)                             REF:   pp. 21-22

 

  1. A public health nurse is determining what type of programming should be developed for the community. Which of the following is the most crucial factor that will influence program development?
a. Comprehensive assessment and planning done in the community
b. Documented needs of the local community
c. Federal funding for priority diseases or groups
d. Nursing staffs expertise and skills

 

 

ANS:  C

Programs are designed to fit funding priorities; thus, the areas supported by Congress determine the categories in which most effort is focused locally.

 

DIF:    Cognitive Level: Apply (Application)                             REF:   p. 23

 

  1. A nursing student during World War II would likely join which group?
a. The Public Health Service of New York City
b. The Marine Nurse Corps
c. The Frontier Nursing Service
d. The Cadet Nurse Corps

 

 

ANS:  D

The Bolton Act of 1943 established the Cadet Nurse Corps during World War II, which increased enrollment in schools of nursing at undergraduate and graduate levels.

 

DIF:    Cognitive Level: Analyze (Analysis)                                         REF:    p. 23

 

  1. A public health nurse is compiling information about how to promote early detection of breast cancer in women. Which document would most likely provide useful information about this topic?
a. The Future of Public Health
b. Healthy People 2020
c. Patient Protection and Affordable Care Act
d. Scope and Standards of Public Health Nursing Practice

 

 

ANS:  B

The Healthy People documents propose a national strategy to improve significantly the health of Americans by preventing or delaying the onset of major chronic illnesses, injuries, and infectious diseases.

 

DIF:    Cognitive Level: Analyze (Analysis)                                         REF:    p. 26

 

  1. A public health nurse is involved in health care reform. Which of the following best explains why the nurse is involved in these efforts?
a. To promote the nursing profession
b. To increase funding for public health nursing
c. To address the concerns of nurses
d. To help improve health care access

 

 

ANS:  D

Public health nurses have been involved in health care reform for several years. An emphasis of reform is that health promotion and disease prevention appear to yield reduction in costs and illness/injury incidence while increasing years of healthy life.

 

DIF:    Cognitive Level: Apply (Application)                             REF:   p. 26

 

MULTIPLE RESPONSE

 

  1. How did Florence Nightingale help bring about community health nursing? (Select all that apply.)
a. She convinced socially prominent wealthy women to volunteer to give care.
b. She focused on all soldiers and their environment.
c. She interacted with each individual person, assessing his or her needs and acting to meet those needs.
d. She kept careful records on what was done and what were the results.

 

 

ANS:  B, D

Nightingale progressively improved the soldiers health using a population-based approach that improved both environmental conditions and nursing care. Using simple epidemiology measures, she documented a decreased mortality rate to demonstrate the outcomes.

 

DIF:    Cognitive Level: Remember (Knowledge)                                 REF:    pp. 17, 26-27

 

  1. A nurse working with Mary Breckinridge would have likely assisted with: (Select all that apply.)
a. Establishing the Henry Street Settlement
b. Developing health programs geared toward improving the health care of the rural populations
c. Blazing a nursing trail through the Rockies, providing nursing care to miners and their families
d. Ensuring positive outcomes for pregnancies among women in the Appalachian region

 

 

ANS:  B, D

Mary Breckinridge developed health programs geared toward improving the health care of the rural and often inaccessible populations in the Appalachian regions of southern Kentucky. Breckinridge introduced the first nurse-midwives into the United States when she deployed FNS nurses trained in nursing, public health, and midwifery. Their efforts led to reduced pregnancy complications and maternal mortality, and to one-third fewer stillbirths and infant deaths in an area of 700 square miles. Lillian Wald established the Henry Street Settlement.

 

DIF:    Cognitive Level: Apply (Application)                             REF:   p. 22

 

  1. How did nursing education change in the 1950s? (Select all that apply.)
a. Baccalaureate nursing programs typically included public health nursing concepts.
b. Diploma schools of nursing continued to expand their student numbers.
c. Junior and community colleges began offering nursing programs.
d. Nurses were strongly encouraged to have a scientific basis for their practice.

 

 

ANS:  A, C

In the 1950s public health nursing became a required part of most baccalaureate nursing education programs. In 1952 nursing education programs began in junior and community colleges.

 

DIF:    Cognitive Level: Remember (Knowledge)                                 REF:    p. 25

 

  1. How did health care and its delivery change during the 1980s? (Select all that apply.)
a. Funding to public health increased as funding for acute hospital care decreased.
b. Laws began to be passed that discouraged the use of alcohol, drugs, and tobacco.
c. Nurse practitioners were increasingly used to provide care.
d. Public health programs suffered reduced political support, financing, and effectiveness.

 

 

ANS:  B, C, D

During the 1980s funding began to shift to meet the costs of acute hospital care, medical procedures, and institutional long-term care. The use of health maintenance organizations was encouraged, and the use of nurse practitioners increased. Consumer and professional advocacy groups urged the passage of laws to prohibit unhealthy practices such as smoking and driving under the influence of alcohol. By the late 1980s, public health had declined in political support, financing, and effectiveness.

 

DIF:    Cognitive Level: Remember (Knowledge)                                 REF:    p. 25

Chapter 10: Evidence-Based Practice

Test Bank

 

MULTIPLE CHOICE

 

  1. A nurse executive is implementing evidence-based practice at a community nursing center that serves a large Cuban immigrant population. Which of the following actions would be the most helpful for the nurse?
a. Review clinical policies with cultural competency experts from the local university.
b. Conduct weekly staff meetings to discuss which methods work best when helping immigrants.
c. Invite Cuban immigrants from the community to serve on the centers advisory board.
d. Send personnel to conferences and seminars that focus on treating Hispanic immigrants.

 

 

ANS:  C

Although all of these options are good, to determine whether practice is serving the needs of the population, the nurse will need to consult the population served. This means that evidence should be applied with input from the community. For example, decisions related to the services to be offered in a nurse-managed clinic should be made with input from the clinics advisory board, which should include community leaders and consumers of the clinics services. Cuban immigrant needs may not be the same as those of Hispanic immigrants from other places such as Mexico or Spain.

 

DIF:    Cognitive Level: Apply (Application)                             REF:   p. 176

 

  1. A community health nurse is determining the best way to address an outbreak of a new infectious disease using evidence-based practice. Which of the following actions would the nurse most likely take?
a. Review policies and procedures
b. Review outcomes of clinical trials
c. Review several nursing textbooks
d. Review reputable sites on the Internet

 

 

ANS:  B

Research findings, knowledge from basic science, clinical knowledge, and expert opinion should be considered sources of evidence for EBP. The problem with nursing textbooks is that many are not grounded in evidence-based practice, because the concept is relatively new to the United States (as mentioned in the section of the chapter on historical perspectives of EBP). Scanning the Internet for ideas is helpful only if evidence-based practice sites are accessed, and most Internet sites are not EBP sites.

 

DIF:    Cognitive Level: Apply (Application)                             REF:   p. 176, 181

 

  1. A nursing administrator wants to develop a work environment conducive to the implementation of evidence-based practice (EBP). Which of the following actions would best achieve this goal?
a. Conducting market research to determine customer satisfaction with EBP
b. Eliciting opinions from nurses on how EBP will affect workload
c. Purchasing computers and Internet access for use by employees
d. Sending staff to conferences related to incorporation of EBP into practice

 

 

ANS:  C

A lack of computers and Internet access can create a barrier to implementation of EBP in community-based nursing agencies. If these are provided, nurses can quickly access current evidence-based findings and recommendations.

 

DIF:    Cognitive Level: Analyze (Analysis)                                         REF:    p. 178

 

  1. A busy school health nurse concerned over the rising incidence of obesity wants to implement evidence-based practice (EBP) but faces barriers because of time constraints. Which of the following actions should the nurse take first?
a. Identify students who are obese so that they may be closely monitored for weight control success or failure.
b. Evaluate best practices to determine those that have the highest success rates for weight control in children.
c. Schedule physician appointments for obese children.
d. Develop an obesity management program for children whose body mass index exceeds normal.

 

 

ANS:  B

The first step of the seven-step EBP process is step zero, which involves a curiosity about the interventions that are being applied; this is not described in any of the topic descriptors. Step one requires asking questions in a PICOT format; this is not described in any of the topic descriptors. Step two involves searching for the best evidence to answer the question. This is done through evaluating best practices.

 

DIF:    Cognitive Level: Analyze (Analysis)                                         REF:    p. 179

 

  1. The nurse has been reading everything she can find on a particular clinical problem, using both the closest medical library and the Internet. Which of the following would be the most helpful source?
a. A journal with a whole issue devoted to research on that clinical problem
b. A randomized controlled clinical trial related to that clinical problem
c. A researcher who has built a career on studying that clinical problem
d. A systematic review related to the clinical problem

 

 

ANS:  D

A systematic review is an approach to identifying, appraising, and synthesizing research evidence to evaluate and interpret all available research that is relevant to a particular research question. Systematic reviews can be accessed from most databases. Systematic reviews require more rigor and contain less opinion of the author than typical reviews of the literature.

 

DIF:    Cognitive Level: Apply (Application)                             REF:   p. 179

 

  1. A school health nurse plans to use evidence-based practice (EBP) to guide the development of health education programs most likely to increase retention of learning in elementary schoolchildren. Which of the following would be the best way to use EBP in this situation?
a. Ask other school health nurses what they included in their own education programs.
b. Compare and contrast randomized clinical trials related to learning in elementary schoolchildren.
c. Develop a series of games to accompany the programs developed to promote health.
d. Seek out and examine health education programs for elementary school children on the Internet.

 

 

ANS:  B

Randomized clinical trials are the gold standard of evidence gathering in EBP.

 

DIF:    Cognitive Level: Apply (Application)                             REF:   p. 182

 

  1. After finding several studies related to the clinical problem, a nurse knows the studies must be evaluated. Which of the following characteristics should be present in the literature?
a. Federally supported multiagency clinical studies
b. Multiple high-quality studies with large sample sizes and consistent findings
c. Research studies done by multidisciplinary teams in multiple settings
d. Controlled clinical trials

 

 

ANS:  B

The Agency for Healthcare Research and Quality (AHRQ) reviewed 40 systems used to evaluate the quality of studies and strength of evidence. The report identified three domains for evaluating systems that grade the strength of evidence: quality, quantity, and consistency. The quality of a study refers to the extent to which bias is minimized. Quantity refers to the number of studies, the magnitude of the effect, and the sample size. Consistency refers to studies that have similar findings, using similar and different study designs.

 

DIF:    Cognitive Level: Apply (Application)                             REF:   p. 181

 

  1. A nurse is familiar with evidence-based practice (EBP) and wants to implement it into the care of clients. Which of the following would present the biggest challenge?
a. Assessing ones current practice and accessing evidence-based resources
b. Convincing administration that EBP is beneficial
c. Distinguishing EBP from practice based on old standards
d. Showing clients that EBP will improve their health outcomes

 

 

ANS:  A

The first step toward implementing evidence-based practice in nursing is recognizing the current status of ones own practice and believing that care based on the best evidence will lead to improved client outcomes. The challenge for the clinician is how to access the evidence and integrate it into practice, thus moving beyond practice based solely on experience, tradition, or ritual.

 

DIF:    Cognitive Level: Apply (Application)                             REF:   p. 182

 

  1. Which of the following groups is pressuring clinicians the most to use evidence-based practice (EBP)?
a. Administrators
b. Insurance companies
c. Nurses
d. Physicians

 

 

ANS:  B

Much of the pressure to use evidence-based practice comes from third-party payers and is a response to the need to contain costs and reduce legal liability.

 

DIF:    Cognitive Level: Understand (Comprehension)               REF:   p. 183

 

  1. A nurse implements an education program that incorporates computer games to reinforce learning for a group of older adults. Although the research demonstrates evidence of improved retention of this information, the nurse experiences exactly the opposite with this group. Which of the following is the most likely cause of such poor outcomes?
a. Failure to consider client and setting differences
b. Inadequate incorporation of evidence into practice
c. Inferior quality of the available research evidence
d. Lack of skills when evaluating the evidence

 

 

ANS:  A

EBP cannot be applied as a universal remedy without attention to client differences. When EBP is applied at the community level, best evidence may point to a solution that is not sensitive to cultural issues and distinctions and thus may not be acceptable to the community. For example, computer games may be excellent for younger groups but are often poorly suited for older Americans who may face challenges with learning new technology.

 

DIF:    Cognitive Level: Apply (Application)                             REF:   p. 183

 

  1. A health care provider is concerned about the high number of clients with type 2 diabetes mellitus who have poor glucose control. What would be the best reference for the provider to implement evidence-based practice (EBP) in the management of this problem?
a. Published protocols
b. Current research findings
c. Opinions of colleagues
d. Nursing journals

 

 

ANS:  B

EBP in community-oriented nursing challenges nurses to integrate outcomes of the best evidence into their clinical practice. Current research findings will explicate evidence of most successful interventions. (Randomized clinical trials are the gold standard of research for EBP.) Protocols and opinions often reflect tradition rather than the most current scientific evidence. Although many nursing journals are peer reviewed, many are not and, even if peer reviewed, many are not research based or focused on scientific evidence. Similarly, information from the Internet may or may not be reliable, because the goal of many websites is to sell products rather than to serve as an unbiased source. Determining when the website was last updated would also be helpful in evaluating the sites usefulness.

 

DIF:    Cognitive Level: Apply (Application)                             REF:   p. 183

 

  1. Staff members have agreed to implement evidence-based practice; they have chosen a specific problem and searched the literature. The group has selected the interventions that seem the easiest to implement. Which of the following actions would the staff take next?
a. Assess the quality of the evidence in the literature.
b. Decide how best to orient the staff and community to the proposed changes.
c. Eliminate all nursing interventions that are not evidence based.
d. Choose another specific problem for the next literature search.

 

 

ANS:  A

After the group has chosen the topic and evaluated the literature for approaches that seem feasible, specific interventions are chosen. The quality of the evidence must be assessed before recommending specific changes or writing a protocol to resolve the problem. Grading the strength of evidence or determining the quality, quantity, and consistency of research studies must be done before making recommendations for practice.

 

DIF:    Cognitive Level: Apply (Application)                             REF:   p. 179

 

  1. A school nurse is developing a primary prevention strategy for school-aged children. Which of the following interventions would the nurse most likely implement?
a. Developing individualized exercise programs for overweight children
b. Drafting policy for increases in noncompetitive physical activity programs
c. Monitoring body mass index in children to identify elevations before they become difficult to manage
d. Notifying parents and/or guardians of their childs height-weight scale in comparison with national norms

 

 

ANS:  B

At the primary prevention level, campaigns to support regular exercise, greater emphasis on school-based physical education programs, and environmental and policy initiatives to create or enhance places for physical activity in communities can make significant contributions to improving the lifestyle of sedentary children. Exercise programs are an example of tertiary prevention. Monitoring BMI in children is an example of secondary prevention. Notifying parents of their childrens height-weight scale increases family awareness but does not meet the definition of a preventive measure.

 

DIF:    Cognitive Level: Apply (Application)                             REF:   p. 183

 

  1. Which of the following is the best way to increase the number of persons who come to their screening test appointments?
a. Reminding clients via telephone, e-mail, or mail
b. Emphasizing long life and happy family when conditions are caught early and treated successfully
c. Pointing out how inexpensive and convenient screening tests are
d. Stressing the dangerousness of the condition if not caught early

 

 

ANS:  A

Client reminders and recalls via mail, telephone, or e-mailor a combination of these strategiesare effective in increasing compliance with screening activities such as those for colorectal and breast cancer.

 

DIF:    Cognitive Level: Understand (Comprehension)               REF:   p. 183

 

  1. A nurse manager wants to facilitate incorporation of evidence-based practice (EBP) in the clinical setting. Which of the following would be the best strategy to accomplish this goal?
a. Eliminate all protocols and standards that are not evidence based
b. Encourage group reflection on the ideals and expectations of nursing care
c. Refer agency nurses to Internet sources of research findings
d. Support nurses using practice-oriented research findings in decision making

 

 

ANS:  D

EBP demands changes. It requires incorporating more practice-oriented research and more collaboration between clinicians and researchers. Emphasis should be on decision making using the varied sources of evidence. The environment and climate must be supportive in order to implement EBP.

 

DIF:    Cognitive Level: Analyze (Analysis)                                         REF:    p. 184

 

MULTIPLE RESPONSE

 

  1. A nurse has decided to increase the evidence base of current nursing practice in an agency. Which of the following describes a barrier that could be encountered by the nurse? (Select all that apply.)
a. Colleagues who dont know how to search the literature or critique research
b. Dedication to the history and tradition of the agency
c. Little or no research published in the clinical area of concern
d. Several meta-analyses in the literature with inconsistent results

 

 

ANS:  A, C

Barriers to evidence-based practice exist when the following are limited or lacking: time, access to journal articles, search skills, critical appraisal skills, and an understanding of research terminology. Other barriers include miscommunication about the process; inferior or unavailable research or other evidence; unwillingness of organizations to fund research or make decisions based on evidence; and concern that evidence-based practice will decrease emphasis on individual client needs or the nurses clinical decisions.

 

DIF:    Cognitive Level: Apply (Application)                             REF:   p. 178

Chapter 20: Health Risks Across the Life Span

Test Bank

 

MULTIPLE CHOICE

 

  1. A school nurse wants to decrease the rate of obesity among children. Which of the following actions in the community would be most effective?
a. Lobby legislators to enact stronger legislation regarding school lunches and snack machines in schools.
b. Increase nutrition programs in schools that teach children to make healthy food choices.
c. Involve the entire family in the planning and managing of nutrition, especially when a child in the family is obese.
d. Provide after-school and summer camps that focus on diet and exercise.

 

 

ANS:  C

Interventions need to be based on goals of lifestyle changes for the entire family. The goal is to modify the way the family eats, exercises, and plans daily activities. Although it is important to teach nutrition, exercise, and proper food choice, if the family does not, for example, prepare the proper foods from which they can choose, the knowledge of the child is insignificant.

 

DIF:    Cognitive Level: Analyze (Analysis)                                         REF:    pp. 349, 355

 

  1. A nurse wants to establish a program to decrease the death rate among children. Which of the following health problems should be the target of this program?
a. Accidents and injuries
b. AIDS
c. Childhood obesity
d. Vaccine-preventable diseases

 

 

ANS:  A

Injuries are the number one cause of death for children (and young adults up to age 21 years) in the United States. Injuries and accidents are the most important causes of preventable disease, disability, and death among children. Most are preventable. Obesity, although a significant problem, is not a common cause of death in children.

 

DIF:    Cognitive Level: Apply (Application)                             REF:   p. 350

 

  1. A nurse wants to establish a program to decrease the death rate among adolescents. Which of the following programs should be developed?
a. Anti-alcohol program
b. Anti-smoking program
c. Careful driving program
d. Safe sex program

 

 

ANS:  C

Motor vehicle accidents are the leading cause of death among children and teenagers.

 

DIF:    Cognitive Level: Apply (Application)                             REF:   p. 351

 

  1. Which of the following is of the greatest concern for the nurse who works with high school students?
a. Alcohol use
b. Motor vehicle accidents
c. Sports-related injuries
d. Unprotected sex

 

 

ANS:  B

Motor vehiclerelated injuries and violence are the leading causes of morbidity and mortality for adolescents. Thus, this would be the greatest concern for the nurse working with high school students.

 

DIF:    Cognitive Level: Understand (Comprehension)               REF:   p. 351

 

  1. A mother says, My son wants me to let him buy a car. I must admit, I certainly get tired of driving him around to all his sports and other activities. Do you think I should let him have a car? Which of the following statements would be the best response by the nurse?
a. Absolutely, it will help him recognize the cost of gas and maintenance.
b. Certainly. Most young men want their own car, and peer pressure can be painful.
c. It depends on whether you trust your son to drive safely.
d. No, adolescent males cannot be trusted with an automobile.

 

 

ANS:  C

Motor vehiclerelated injuries and violence are the leading causes of morbidity and mortality for adolescents. Males are more likely to take risks, and injury death rates for boys are twice as high as those for girls. Thus, the response by the nurse should take these factors into consideration in response and encourage the mother to individualize her decision for her son.

 

DIF:    Cognitive Level: Analyze (Analysis)                                         REF:    p. 351

 

  1. Which of the following children is most at risk for being abused?
a. A 1-year-old
b. A 6-year-old
c. A 9-year-old
d. A teenager

 

 

ANS:  A

Children under the age of 4 years and children with special needs are at highest risk for abuse.

 

DIF:    Cognitive Level: Apply (Application)                             REF:   p. 353

 

  1. If underlying causes were listed on autopsy reports, which of the following would be the most common cause of unnecessary death in the United States?
a. Alcohol
b. Guns
c. Tobacco
d. Unprotected sex

 

 

ANS:  C

Smoking has been identified as the most important preventable cause of morbidity and mortality in the United States.

 

DIF:    Cognitive Level: Understand (Comprehension)               REF:   p. 355

 

  1. A client has designated someone else to make health care decisions when he or she is unable to do so. Which of the following methods is the client using to make health care decisions?
a. An advance directive
b. A living will
c. A durable medical power of attorney
d. The Patient Self-Determination Act

 

 

ANS:  C

Durable medical power of attorney is the legal way for a client to designate someone else to make health care decisions when he or she is unable to do so.

 

DIF:    Cognitive Level: Apply (Application)                             REF:   p. 357

 

  1. A woman needs to take some time off from work to care for her invalid mother. Which of the following health policies allows her to take an extended leave from work to care for a family member?
a. Personal Responsibility and Work Opportunity Reconciliation Act
b. Womens Health Equity Act (WHEA)
c. Temporary Assistance for Needy Families (TANF)
d. Family and Medical Leave Act (FMLA)

 

 

ANS:  D

The FMLA provides job protection and continuous health benefits where applicable for eligible employees who need extended leave for their own illness or to care for a family member.

 

DIF:    Cognitive Level: Apply (Application)                             REF:   p. 357

 

  1. Which of the following situations would most likely indicate elder abuse?
a. A daughter refuses to visit her mother due to work commitments.
b. A child runs around a grandparents house breaking items.
c. A young man repeatedly steals money from his grandmother.
d. An elderly person demands that the family come for dinner.

 

 

ANS:  C

Theft or mismanagement of money or resources is an element of abuse.

 

DIF:    Cognitive Level: Apply (Application)                             REF:   p. 358

 

  1. A nurse would like to learn more about the overall health of a population. Which of the following indicators would the nurse most likely use?
a. Life expectancy
b. Mortality rate
c. Morbidity rate
d. Health status

 

 

ANS:  A

Life expectancy is a measure that is often used to gauge the overall health of a population.

 

DIF:    Cognitive Level: Apply (Application)                             REF:   p. 358

 

  1. A nurse is new to the community but wants to begin planning immediately for health promotion programs. Even though the nurse does not yet know the community, which of the following programs would be good to plan first?
a. Alcohol and tobacco cessation programs
b. Cancer screening programs
c. Cardiac health education programs
d. Exercise for life programs

 

 

ANS:  C

Heart disease is one of the most significant public health problems in the United States, responsible for premature mortality and disability. Cardiovascular disease is the leading cause of death in the United States. Good nutrition and exercise programs, while both good health promotion programs, are too narrow in focus to represent the greatest need in the community. Cancer is the second leading cause of death so may be the nurses second focus.

 

DIF:    Cognitive Level: Apply (Application)                             REF:   p. 359

 

  1. A nurse is performing a health assessment on a young adult female. Which of the following comments by the client would cause the nurse to be concerned?
a. I cant believe I didnt get that promotion. I thought I was the best candidate.
b. I cant believe they didnt admit me to that graduate program with my good undergraduate grades!
c. I cant believe how lonely it is around the house since my spouse died.
d. I cant believe how little I care about anything anymore since that diagnosis.

 

 

ANS:  D

A number of factors contribute to depression, including being female, having a family history of depression, unemployment, and chronic disease. All the options represent a loss, either potential or actual, but the statement about not caring about anything represents an actual symptom of depression.

 

DIF:    Cognitive Level: Apply (Application)            

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