Homework Lance
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
2. 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
3. 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
4. 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 vehicle–related 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
5. 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 vehicle–related 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
6. 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
7. 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
8. 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
9. 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.
Women’s 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
10. 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 grandparent’s 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
11. 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
12. 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 nurse’s second focus.
DIF: Cognitive Level: Apply (Application) REF: p. 359
13. 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 can’t believe I didn’t get that promotion. I thought I was the best candidate.”
b.
“I can’t believe they didn’t admit me to that graduate program with my good undergraduate grades!”
c.
“I can’t believe how lonely it is around the house since my spouse died.”
d.
“I can’t 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) REF: p. 360
14. A community health nurse is planning to implement an intervention to reduce the prevalence of sexually transmitted diseases in the community. Which of the following actions would most likely be taken by the nurse?
a.
Establish immunization clinics to prevent STDs.
b.
Educate people with HIV about the mode of transmission.
c.
Explain to women that HIV is transmitted to women usually by IV drug abuse.
d.
Develop a STD clinic to increase community access to services.
ANS: A
The goal of Healthy People 2020 is to promote responsible sexual behaviors, strengthen community capacity, and increase access to quality services to prevent sexually transmitted diseases and their complications. Nursing activities should align with these goals.
DIF: Cognitive Level: Analyze (Analysis) REF: p. 361
15. Which statement about eating disorders is correct?
a.
Individuals with anorexia frequently complain about weight loss.
b.
Purging is associated with anorexia.
c.
Most women with bulimia are concerned with the shape and weight of their body.
d.
Bulimia is considered to have more medical complications than anorexia.
ANS: C
Those with bulimia are usually concerned with the shape and weight of their body. Those with anorexia view themselves as normal or overweight, purging is associated with bulimia, and anorexia is considered to have more complications than bulimia.
DIF: Cognitive Level: Understand (Comprehension) REF: p. 361
16. A nurse is providing contraceptive counseling to a female client. Which of the following is the most appropriate outcome of this counseling?
a.
Encourage the individual to choose abstinence.
b.
Ensure the individual is educated to make an informed choice about reproduction.
c.
Advocate for increased funding for reproductive services.
d.
Reduce the health risks of the individual.
ANS: B
The goal of contraceptive counseling is to ensure that women have appropriate instruction to make informed choices about reproduction. The nurse should provide a nonjudgmental approach during counseling and allow the woman to choose the appropriate contraceptive method. Nurses do advocate for reproductive services for women, but that is not a goal of contraceptive counseling. Reduction in the health risks of the individual is a goal of pre-conceptual counseling.
DIF: Cognitive Level: Analyze (Analysis) REF: p. 362
17. A nurse is providing pre-conceptual counseling to a young woman. Which of the following supplements would the nurse most likely recommend?
a.
Iron
b.
Calcium
c.
Folic acid
d.
Vitamin C
ANS: C
Research has shown that intake of folic acid can significantly reduce the occurrence of serious and often fatal neural tube defects by 50% to 70%. A recommendation was made that women capable of or planning a pregnancy take 0.4 to 0.8 mg of folic acid daily (USPSTF, 2009).
DIF: Cognitive Level: Apply (Application) REF: p. 362
18. Which of the following best describes the current research findings related to the use of hormone replacement therapy (HRT)?
a.
HRT does not prevent heart disease.
b.
Use of HRT is recommended to prevent osteoporosis.
c.
When used with complementary therapies, HRT is most effective.
d.
HRT is a contributing cause of breast cancer.
ANS: A
HRT does not prevent heart disease. To prevent heart disease women should avoid smoking, reduce fat and cholesterol intake, limit salt and alcohol, maintain a healthy weight, and be physically active.
DIF: Cognitive Level: Understand (Comprehension) REF: p. 362
19. Which of the following best describes where health care dollars in the United States be focused to improve breast cancer cure rates?
a.
Education for women about breast cancer
b.
Early detection programs with referral to ongoing access to a care provider
c.
Primary prevention programs
d.
Tertiary care through long-term follow-up
ANS: B
Early detection can promote a cure, whereas late detection typically ensures a poor prognosis. The differences in the outcomes between women of color and white women point to issues associated with early detection, access to health care, and follow-up by a regular care provider.
DIF: Cognitive Level: Understand (Comprehension) REF: p. 362
20. Which of the following behaviors results in men being less healthy than women?
a.
Concentration on sports, hunting, and other dangerous recreational choices
b.
Employment in stressful positions more so than women
c.
Preference to spend money on priorities other than health care
d.
Reluctance to visit physicians
ANS: D
A major obstacle to improving men’s health is their apparent reluctance to consult their primary care provider. Men are not well connected to the health care system. Men do not participate in health care at the same level as women, apparently because of the traditional masculine gender role learned through socialization (Bonhomme, 2007). Only 57% of U.S. men see a doctor, nurse practitioner, or physician assistant compared with 74% of women (AHRQ, 2010).
DIF: Cognitive Level: Understand (Comprehension) REF: p. 363
21. Which of the following characteristics indicates a man is at a higher risk for developing prostate cancer?
a.
Being of Caucasian descent
b.
Has not had a PSA test
c.
Has a father or brother who has had prostate cancer
d.
Has benign prostatic hypertrophy (BPH)
ANS: C
Having a father or brother who has had prostate cancer places a man at higher risk for developing prostate cancer.
DIF: Cognitive Level: Understand (Comprehension) REF: p. 364
22. Which of the following factors has the largest impact on health disparities among all populations?
a.
Ethnicity
b.
Education level
c.
Lifestyle choices
d.
Poverty
ANS: D
Poverty is a strong and underlying current factor that affects all special groups.
DIF: Cognitive Level: Understand (Comprehension) REF: pp. 364-365
23. A nurse is working with incarcerated adults who are being released from prison. Which of the following nursing interventions would be most appropriate for the nurse to implement?
a.
Connect offenders with community-based mental health programs.
b.
Provide community supervision for mentally ill offenders.
c.
Advocate for increased prison time to decrease recidivism rates.
d.
Educate about available state resources.
ANS: A
Connecting offenders with community-based mental health programs at the time of release from prison can decrease recidivism rates, because many incarcerated adults experience major psychiatric disorders. It would be impossible for the nurse to supervise all mentally ill offenders in the community. Increased prison time is not shown to decrease recidivism rates and education about available state resources is not the most important nursing intervention to provide for this population.
DIF: Cognitive Level: Analyze (Analysis) REF: p. 365
24. Which of the following will provide the highest benefit to an older adult’s well-being?
a.
Eligibility for Medicare and Social Security
b.
Higher socioeconomic status, income, and education
c.
Senior citizen privileges such as senior citizen centers and senior citizen discounts
d.
Social networks that give support and meaning to life
ANS: D
Medicare, Social Security, senior privileges, and high socioeconomic status, income, and education are all extremely helpful to older adults. However, social networks that give support and meaning to life are a major factor that can contribute to ongoing health and vitality. One of the biggest dangers is social isolation.
DIF: Cognitive Level: Understand (Comprehension) REF: p. 367
25. A nurse is implementing Wagner’s Chronic Care Model. Which of the following actions would the nurse most likely take?
a.
Educate a community group about hypertension control.
b.
Create a budget for chronic disease management.
c.
Administer immunizations to community members.
d.
Conduct depression screenings in the community.
ANS: A
Use of electronic health records, provider reminders for key evidence-based care components, interprofessional teams communicating regularly and community health classes to educate people with chronic diseases are various ways the CCM is being implemented. Creating a budget is not a way to use CCM. Administration of immunizations and conducting depression screenings do not address the management of the most common and costly chronic diseases: heart disease, diabetes, stroke, cancer, and arthritis.
DIF: Cognitive Level: Apply (Application) REF: p. 367
26. Toward whom is the TLC model targeted?
a.
Caregivers of older persons with health problems
b.
Community organizations that offer services for the elderly
c.
Elderly clients with health problems
d.
Nurses who care for older clients
ANS: A
The TLC model is focused toward caregivers (primarily families) in an effort to relieve caregiver burden. Components are T = training in care techniques, safe medication use, recognition of abnormalities, available resources; L = leaving the care situation periodically to obtain respite and relaxation and maintain their normal living needs; and C = care for themselves (the caregiver) through adequate sleep, rest, exercise, nutrition, socialization, solitude, support, financial aid, and health management.
DIF: Cognitive Level: Understand (Comprehension) REF: p. 367
27. A client explains to the nurse that it is just impossible for her and her husband to continue to have his mother in the home alone during the day while they work because the woman becomes confused and has fallen twice. Which of the following community resources should the nurse recommend?
a.
Adult day health
b.
Home health
c.
Long-term care
d.
Senior center
ANS: A
Adult day health is for individuals whose mental and/or physical function requires additional health care and supervision. It serves as more of a medical model than the senior center, and individuals typically return home to their caregivers at night. Long-term care would take the client out of the home. Home health would leave the patient for periods of unsupervised time in which the patient could have problems and help would not be available.
DIF: Cognitive Level: Apply (Application) REF: p. 368
28. An elderly person is in the last stages of dying. Which type of care would be the best for him?
a.
Home health
b.
Assisted living
c.
Nursing home
d.
Hospice
ANS: D
Hospice would be the best form of care for a person in the last stages of dying.
DIF: Cognitive Level: Apply (Application) REF: pp. 349, 368
29. Which of the following is the best way to ensure good nutrition in infants?
a.
Breastfeeding only
b.
Feed them only brand-name baby foods
c.
Feed them only brand-name cereals
d.
Feed them only brand-name formulas
ANS: A
Breastfeeding is the preferred method of infant feeding. Breast milk provides appropriate nutrients and antibodies for the infant. Breastfed infants have fewer illnesses and allergies. Breastfeeding is associated with a lower risk in developing childhood obesity.
DIF: Cognitive Level: Understand (Comprehension) REF: p. 349
30. A nurse is implementing a tertiary prevention program to promote health among middle-aged women with diabetes. Which of the following best describes the intervention being implemented by the nurse?
a.
Developing lifestyle improvement programs for women at risk for diabetes
b.
Presenting lifestyle management presentations at women’s conferences
c.
Monitoring blood glucose levels closely and modifying diet accordingly
d.
Screening glucose levels of women at risk for development of diabetes
ANS: C
Tertiary prevention includes activities that are aimed to reduce the complications of the disease process. Only monitoring blood glucose levels is directed toward preventing problems in women who already are diagnosed with diabetes.
DIF: Cognitive Level: Analyze (Analysis) REF: p. 360
31. A nurse advises a client who has HIV not to donate blood, plasma, or organs. Which of the following levels of prevention is being used?
a.
Primary prevention
b.
Secondary prevention
c.
Tertiary prevention
d.
Health promotion
ANS: C
Tertiary prevention includes those interventions aimed at disability limitations and rehabilitation from disease, injury, or disability.
DIF: Cognitive Level: Analyze (Analysis) REF: p. 360
32. A nurse wants to promote improved health for obese children in the community. Which of the following best describes a tertiary prevention measure that the nurse would implement?
a.
Establish lifestyle improvement programs through local youth organizations.
b.
Evaluate the food intake of a group of children for a 48-hour period.
c.
Provide education programs to overweight expectant parents.
d.
Evaluate the body mass index of children at regularly scheduled well-child exams.
ANS: A
Tertiary prevention includes activities aimed to reduce the complications of the disease process. Only lifestyle improvement programs are directed toward preventing problems in children who are already obese. Evaluating food intake and evaluating BMI are types of screening programs (secondary prevention). Providing education programs to overweight expectant parents does not involve children.
DIF: Cognitive Level: Analyze (Analysis) REF: p. 360
MULTIPLE RESPONSE
1. Which of the following adolescent(s) would receive care from the advanced practice nurse without parental consent? (Select all that apply.)
a.
A 16-year-old who is living on his own (not with his parents)
b.
A pregnant adolescent
c.
An adolescent in an emergency situation
d.
An adolescent whose diagnosis has a serious prognosis
ANS: A, B, C
Most states have enacted laws allowing health care providers to treat adolescents in certain situations without parental consent. These situations include emergency care, substance abuse, pregnancy, and birth control. All 50 states recognize the “mature minors doctrine.” This allows youths 15 years of age and older to give informed medical consent if it is apparent that they are capable of understanding the risks and benefits and if the procedure is medically indicated.
DIF: Cognitive Level: Apply (Application) REF: pp. 351-352
2. Which of the following interventions would the nurse most likely implement when addressing the problem of asthma among school-aged children? (Select all that apply.)
a.
Assess schools and day care centers for environmental “friendliness.”
b.
Share nutritional information with all students in the school.
c.
Develop home and environmental assessment guides.
d.
Teach all school personnel how to use rescue inhalers.
ANS: A, C
Population-focused strategies for asthma management include education programs for families of children and adolescents who have asthma, development of home and environmental assessment guides to identify triggers, education and outreach efforts in high-risk populations to aid in case finding (e.g., in areas with low income, high unemployment, and substandard housing, where there is exposure to secondhand smoke), development of community clean air policies (e.g., no burning of leaves, use of smoke-free zones), improved access to care for asthmatic patients (e.g., developing clinic services with consistent health care providers to decrease emergency department use), and assessment of schools and day-care centers for lack of asthma triggers.
DIF: Cognitive Level: Apply (Application) REF: p. 354
3. A health care provider is working with elderly clients who have ongoing chronic disease. Which of the following strategies can best assist them with healing? (Select all that apply.)
a.
Advocating for increased support for elderly persons
b.
Eliminating signs and symptoms of disease
c.
Managing any chronic diseases to prevent complications and delay deterioration
d.
Maximizing self-care capacity
ANS: C, D
With chronic illness, the focus is on healing (a unique process resulting in a shift in the body/mind/spirit system) rather than curing (elimination of the signs and symptoms of disease). Appropriate goals include maximizing self-care capacity, managing chronic diseases effectively, preventing complications, delaying deterioration and decline, and achieving the highest possible quality of life before dying with comfort, peace, and dignity.
DIF: Cognitive Level: Analyze (Analysis) REF: pp. 357-358
4. After seeing a public education program on the need for screening colonoscopy and the dangers of colorectal cancer, an older friend asks the nurse, “I’m really scared of getting cancer. What can I do to avoid that kind of cancer?” Which of the following recommendations should be made by the nurse? (Select all that apply.)
a.
Avoid smoking or much alcohol.
b.
Choose poultry or fish rather than red or processed meat.
c.
Eat lots of fruits, vegetables, and fiber each day.
d.
Try to get at least 8 hours of sleep a night.
ANS: A, B, C
Obesity, physical inactivity, smoking, heavy alcohol consumption, a diet high in red or processed meats, and insufficient intake of fruits and vegetables are risk factors for colorectal cancer.
DIF: Cognitive Level: Apply (Application) REF: p. 361
5. A nurse’s mother leans forward and says, “My best friend fell the other day and now she’s in the hospital. I’m really worried about getting osteoporosis. What do you think I should do?” What should the nurse recommend? (Select all that apply.)
a.
Ask your doctor for hormone replacement therapy.
b.
Continue to abstain from alcohol and not use tobacco.
c.
Eat foods high in calcium such as fortified skim milk.
d.
Eat lots of green leafy vegetables.
ANS: B, C
It is estimated that one of every two American women older than 50 years will experience an osteoporosis-related fracture in her lifetime. Primary prevention activities include a diet rich in calcium and vitamin D; exposure to sunlight for 20 minutes a day; exercise, especially weight-bearing activities such as walking, running, stair climbing, and weight lifting, to improve bone density; limiting alcohol consumption; and avoiding smoking.
DIF: Cognitive Level: Apply (Application) REF: p. 365
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