An advanced public health nurse investigates a cluster of cases of learning disabilities,

ANS: B
hearing impairment, and developmental delays in school-age children who live in an Lead used to be very common in gasoline and house paint in the U.S. Children living in cities with older
apartment complex that was built in 1971. The nurse suspects exposure to: houses are more likely to have high levels of lead. Houses painted before 1978. Even if the paint is not
A.carbon monoxide. peeling, it can be a problem. Lead paint is very dangerous when it is being stripped or sanded. These
B. lead. actions release fine lead dust into the air. Infants and children living in pre-1960's housing (when paint
often contained lead) have the highest risk of lead poisoning. Small children often swallow paint chips or
C. nitrogen dioxide.
dust from lead-based paint. Toys and furniture painted before 1976
D. radon.

A child is scheduled to receive inactivated polio vaccine (IPV), and a nurse preparing to ANS: C
administer the vaccine reviews the child's record. The nurse questions the administration of IPV contains neomycin. A history of anaphylactic reaction to neomycin is
IPV if which of the following is documented in the child's record?
considered a contraindication to IPV. The presence of a minor illness such as
A. Recent recovery from a cold
the common cold is not. IN addition, a history of frequent respiratory
B. A history of frequent respiratory infections
C. A history of an anaphylactic reaction to neomycin
infections is not a contraindication to receiving a vaccine. A local reaction to
D. A local reaction at the site of a previous IPV an immunization is not a contraindication to receiving a vaccine.

A clinic nurse is assessing a child who is scheduled to receive a live virus vaccine (immunization). Which of the
following are general contraindications associated with receiving a live virus vaccine? (Select all that apply)
A. The child has symptoms of a cold
B.The child had a previous anaphylactic reaction to the vaccine.
C. Mother reports that the child is having intermittent episodes of diarrhea.
D. Mother reports that the child has not had an appetite and has been fussy
E. The child has a disorder that caused a severely deficient immune system
F. Mother reports that the child has recently been exposed to an infectious disease.
ANS: B, E
The general contraindications for receiving live virus vaccines include a previous anaphylactic reaction to a
vaccine or a component of the vaccine. Additionally, live virus vaccines generally are not administered to
individuals with a severely deficient immune system, individuals with a severe sensitivity to gelatin, or
pregnant woman A vaccine is administered with caution to an individual with a moderate or severe acute
illness, with or without fever. Options 1,3,4 and 6 are not contraindications to receiving a live vaccine.

A clinic nurse is instructing the mother of a child with human immunodeficiency virus (HIV)
ANS: B
infection regarding immunizations. The nurse tells the mother that:
Immunizations against common childhood illnesses are recommended for all children
A. The hepatitis B vaccine will not be given to the child.
exposed to or infected with HIV. The inactivated influenza vaccine that is given IM will be
B. The inactivated influenza vaccine will be given yearly.
administered. The hepatitis B vaccine is administered according to the recommended
C. The varicella vaccine will be given before 6 months of age.
immunization schedule. Varicella-zoster immunoglobulin may be prescribed after
D. A western blot test needs to be performed and the results evaluated before
chickenpox exposure. Option 4 is unnecessary and inaccurate
immunizations.

Concerned with the care of school-children, the nurse does the

ANS: B
following.EXCEPT:
A. provides for a safe environment
B. detects, diagnose, and treats children with health problems
C. identifies and refers children with eye problems Not the role of the nurse
D. conducts health education classes

The gold standard of evidence gathering in evidence-based practice is:

A. Clinical knowledge and judgment
B. Expert opinions
C. Randomized clinical trials
ANS: C
D. Theories of practice

The health care model that utilizes Maslow's hierarchy as its base is the _____ ANS: C
The Basic Human Needs Model believes that the extent to which basic needs are met is a major factor in
Model. determining a person's level of health. Maslow's hierarchy of needs is a model that nurses use to
a. Health Belief understand the interrelationships of basic human needs. The Health Belief Model addresses the
b. Health Promotion relationship between a person's beliefs and behaviors. The Health Promotion Model notes that each
person has unique personal characteristics and experiences that affect subsequent actions. The Holistic
c. Basic Human Needs Health Model recognizes the natural healing abilities of the body and incorporates complementary and
d. Holistic Health alternative interventions such as music therapy.

How is a disaster the same as or different from an emergency? ANS: B

a. A disaster is personal, whereas an emergency is community-wide.
b. An emergency is personal, whereas a disaster is community-wide.
c. Both emergencies and disasters are devastating.
d. Both emergencies and disasters are failures resulting in extensive
insurance claims.
A disaster is any event that causes a level of destruction, death, or injury that affects the abilities of the
community to respond to the incident using available resources. Emergencies differ from disasters in
that the agency, community, family, or individual can manage an emergency using their own resources.
However, a disaster event may be beyond the ability of the community to respond to and recover from
the incident using its own resources. Disasters frequently require assistance from outside the immediate
community.

John, a 86 year old male, is currently enrolled in the Medicaid program in Texas. Which of
the following services is John guaranteed by Medicaid?
a. Food stamp
b. Eyeglasses
c. Blood test
c. Blood test
d. Nonprescription drug
e. Transportation support

Just as health and health behavior are affected by internal and external variables, so are illness and illness ANS: C, D, E
behavior. Which external variables can affect illness and behavior? (Select all that apply.) External variables influencing a patient's illness behavior include the visibility
a. Perception of the seriousness of the illness of symptoms, social group, cultural background, economic variables,
b. Patient's coping skills
c. Cultural background accessibility of the health care system, and social support. Internal variables
d. Social support include the patient's perceptions of symptoms and the nature of the illness,
e. Socioeconomic status as well as the patient's coping skills and locus of control.
Many variables influence a patient's health beliefs and practices. Internal and external
variables influence how a person thinks and acts. An example of an internal variable ANS: A
would be Internal variables include a person's developmental stage, intellectual
a. Perception of functioning. background, perception of functioning, and emotional and spiritual factors.
b. Family practices. External variables influencing a person's health beliefs and practices include
c. Socioeconomic factors. family practices, socioeconomic factors, and cultural background.
d. Cultural background.

Medicare part A covers:

A. Doctors visits ANS: B
B. Hospital care Medicare Part A is hospital insurance. Most people
C. Nursing home care aren't charged a premium for Medicare Part A.
D. Prescription drugs

Medicare part B covers: (Select all that apply)

ANS: A, C
A. Doctor's visits
Medicare Part B helps cover medical services such as doctors' services,
B. Nursing home care
outpatient care and some medical equipment. Part B also covers some
C. Flu Shot
preventive services, such as flu shots and screenings for diabetes and certain
D. Prescription drugs
cancers. Medicare does not cover long-term care or routine vision care.
E. Routine vision

ANS: A, B, D
Models of health offer a perspective by which to understand the relationships between the concepts of
Nurses are in a unique position to assist patients in achieving and maintaining optimal levels of health.
health, wellness, and illness. Nurses are in a unique position to assist patients in achieving and maintaining
Nurses understand the challenges of today's health care system and embrace the opportunity to use
optimal levels of health because nurses (Select all that apply.)
wellness activities to promote health and wellness and to prevent illness. Nurses can identify actual and
a. Understand the challenges of today's health care system.
potential risk factors that predispose a person or group to illness. Nurses who understand how patients
b. Identify actual and potential risk factors.
react to illness can minimize the effects of illness and assist patients and their families in maintaining or
c. Have coined the term "illness behavior."
returning to the highest level of functioning. Medical sociologists call the reaction to illness "illness
d. Can minimize the effects of illness and assist to the return of optimal health
behavior."

Mortality rates from two communities can best be compared after ANS: A
calculating: The age-adjusted rates are rates that would have existed if the population under study had the same age
distribution as the "standard" population. Therefore, they are summary measures adjusted for
A. the age-adjusted rates.
differences in age distributions. For example, a county having a higher percentage of elderly people may
B. the crude rates. have a higher rate of death or hospitalization than a county with a younger population, merely because the
C. the gender-specific rates. elderly are more likely to die or be hospitalized. (The same distortion can happen when comparing races,
D. the prevalence rates. genders, or time periods.) Age adjustment can make the different groups more comparable.

The nurse is admitting a patient with uncontrolled diabetes mellitus. It is the fourth time the patient is
being admitted in the last 6 months for high blood sugars. During the admission process, the nurse asks
the patient about her employment status and displays a nonjudgmental attitude. Why does the nurse do
this?
a. Noncompliant patients thrive on the disapproval of authority figures.
b. External variables have little effect on compliance.
c. A person's compliance is affected by economic status.
d. Employment status is an internal variable that impacts compliance.
ANS: C
A person's compliance with treatment is affected by economic status. A person tends to
give a higher priority to food and shelter than to costly drugs or treatments. A person
generally seeks approval and support from social networks, and this desire for approval
affects health beliefs and practices. Internal and external variables influence how a person
thinks and acts toward health care. Employment status is an external variable, not an
internal variable.

The nurse is caring for a patient who has been trying to quit smoking. She has been smoke
free for 2 weeks but had two cigarettes last night and at least two this morning. What
should the nurse anticipate?
a. The patient does not want to and never will quit smoking.
b. The patient will return to the contemplation or precontemplation phase.
c. The patient will need to adopt a new lifestyle for change to be effective.
d. The patient must pick up her attempt right where she left off.
ANS: B
When relapse occurs, the person will return to the contemplation or precontemplation stage before
attempting the change again. The patient cannot pick up her attempt where she left off.
It is believed that change involves movement through a series of stages. These stages range from no
intention to change (precontemplation), to making small changes (preparation), to actively engaging in
strategies to change behavior (action), to maintenance. The action phase indicates a desire to change and
a potential to do so. Changes will be maintained over time only if they are integrated into an individual's
overall lifestyle.

The nurse is preparing a smoking cessation class and is amazed at how many people still smoke even ANS: A
with the information on lung cancer so readily available. She believes that her class will convert many The Health Belief Model addresses the relationship between a person's beliefs and behaviors. The
smokers to nonsmokers once they get all the latest information. The nurse is a believer in which of the Health Promotion Model is more complex than the Health Belief Model in that it notes that each person
following health care models? has unique personal characteristics and experiences that affect subsequent actions. The Basic Human
a. Health Belief Model Needs Model is based on the theory that all people share basic human needs, and the extent to which
b. Health Promotion Model basic needs are met is a major factor in determining a person's level of health. The Holistic Health Model
c. Basic Human Needs Model recognizes the natural healing abilities of the body and incorporates complementary and alternative
d. Holistic Health Model interventions such as music therapy. Education is important but is not the sole determinant of change.

The nurse is working in a clinic that is designed to provide health education ANS: A
Primary prevention precedes disease or dysfunction and is applied to people considered physically and
and immunizations. As such, this clinic is designed to provide emotionally healthy. Health promotion includes health education programs, immunizations, and physical
a. Primary prevention. and nutritional fitness activities. Secondary prevention focuses on individuals who are experiencing health
b. Secondary prevention. problems or illnesses and who are at risk for developing complications or worsening conditions.
Activities are directed at diagnosis and prompt intervention. Tertiary prevention occurs when a defect or
c. Tertiary prevention. disability is permanent and irreversible. It involves minimizing the effects of long-term disease or
d. Diagnosis and prompt intervention. disability through interventions directed at preventing complications and deterioration.

ANS: A
The nurse is working in a drug rehabilitation clinic and is in the process of admitting a
Processes of change, or nursing interventions, should be appropriately chosen to match
patient who says that she wants to be "detoxified." It is important for the nurse to
the stage of change. Most behavior change programs are designed for those people who
a. Identify the patient's stage of change.
are ready to take action regarding their health behavior problems. Only a minority of
b. Realize that the patient is ready to change.
people are actually in this action stage. Changes will be maintained over time only if they
c. Instruct the patient that she will have to change her lifestyle.
are integrated into an individual's overall lifestyle. As individuals attempt a change in
d. Instruct the patient that relapses are not tolerated.
behavior, relapse followed by recycling through the stages occurs frequently.
The nurse is working on a committee to evaluate the need for increasing the levels of ANS: D
fluoride in the drinking water of the community. In doing so, the nurse is fostering the Fluoridation of municipal drinking water and fortification of homogenized milk with vitamin
concept of D are examples of passive health promotion strategies. With active strategies of health
a. Illness prevention. promotion, individuals are motivated to adopt specific health programs such as weight
b. Active health promotion. reduction and smoking cessation programs. Illness prevention activities such as
c. Wellness education. immunization programs protect patients from actual or potential threats to health.
d. Passive health promotion. Wellness education teaches people how to care for themselves in a healthy way.

A nurse provides home care instructions to the parents of a child hospitalized with
pertussis. The child is in the convalescent stage and is being prepared for discharge. ANS: D
Which statement by a parent indicates a need for instructions? Pertussis is transmitted by direct contact or respiratory droplets from
A. We need to encourage our child to drink fluids coughing. The communicable period occurs primarily during the catarrhal
B. Coughing spells may be triggered by dust or smoke stage. Respiratory precautions are not required during the convalescent
C. Vomiting may occur when our child has coughing episodes phase. Options 1,2,3 are accurate components of home care instructions.
D. We need to maintain droplet precautions and a quiet environment for at least 2 weeks

A patient is admitted to a rehabilitation facility following a stroke. The patient has right- ANS: C
sided paralysis and is unable to speak. The patient will be receiving physical therapy and Tertiary prevention occurs when a defect or disability is permanent and irreversible. It involves
speech therapy. What are these examples of? minimizing the effects of long-term disease or disability through interventions directed at preventing
complications and deterioration. Secondary prevention focuses on individuals who are experiencing
a. Primary prevention health problems or illnesses, and who are at risk for developing complications or worsening conditions.
b. Secondary prevention Activities are directed at diagnosis and prompt intervention. Primary prevention precedes disease or
c. Tertiary prevention dysfunction and is applied to people considered physically and emotionally healthy. Health promotion
d. Health promotion includes health education programs, immunizations, and physical and nutritional fitness activities.

The patient is admitted to the emergency department of the local hospital from home with reports of ANS: B
chest discomfort and shortness of breath. She is placed on oxygen, has labs and blood gases drawn, and Secondary prevention focuses on individuals who are experiencing health problems or illnesses and who
is given an electrocardiogram and breathing treatments. What level of preventive care is this patient are at risk for developing complications or worsening conditions. Activities are directed at diagnosis and
receiving? prompt intervention. Primary prevention precedes disease or dysfunction and is applied to people
a. Primary prevention considered physically and emotionally healthy. Health promotion includes health education programs,
b. Secondary prevention immunizations, and physical and nutritional fitness activities. Tertiary prevention occurs when a defect or
c. Tertiary prevention disability is permanent and irreversible. It involves minimizing the effects of long-term disease or
d. Health promotion disability through interventions directed at preventing complications and deterioration.

ANS: D
The patient is describing moderate incisional pain that was not relieved by the last dose of hydromorphone (Dilaudid)
The Holistic Health Model recognizes the natural healing abilities of the body and incorporates
given 90 minutes earlier. The patient is not due for another dose of medication for another 2 1/2 hours. The nurse
repositions the patient, asks what type of music she likes, and puts on the music channel on the television, setting it to complementary and alternative interventions such as music therapy. The Health Belief Model addresses
play that type of music. The nurse is attempting to utilize which health care model? the relationship between a person's beliefs and behaviors. The Health Promotion Model notes that each
a. Health Belief Model person has unique personal characteristics and experiences that affect subsequent actions. The Basic
b. Health Promotion Model
Human Needs Model believes that the extent to which basic needs are met is a major factor in
c. Basic Human Needs Model
d. Holistic Health Model determining a person's level of health. Maslow's hierarchy of needs is a model that nurses use to
understand the interrelationships of basic human needs.

Risk factors can be placed in the following interrelated categories: genetic and
ANS: B
physiological factors, age, physical environment, and lifestyle. The presence of any of
The presence of risk factors does not mean that a disease will develop, but risk factors
these risk factors means that
increase the chances that the individual will experience a particular disease or dysfunction.
a. A person with the risk factor will get the disease.
Control of risk factors does not guarantee that a disease will not develop. However, risk
b. The chances of getting the disease are increased.
factor identification assists patients in visualizing those areas in life that can be modified or
c. The disease is guaranteed not to develop if the risk factor is controlled.
even eliminated to promote wellness and prevent illness.
d. Risk modification will have no effect on disease prevention.

The three essential elements of informed consent are: ANS: D

A.accountability, beneficence, and paternalism. Informed consent is a process for getting permission before conducting a
healthcare intervention on a person. A health care provider may ask a
B. confidentiality, truthfulness, and advocacy. patient to consent to receive therapy before providing it, or a clinical
C. financial risk, rule of utility, and protection of privacy. researcher may ask a research participant before enrolling that person into a
D. information, comprehension, and freedom from coercion. clinical trial.

A tornado strikes a mobile home community in a small rural town. Approximately 10

families are left without food and shelter. Which reaction demonstrates the community's
viability?
A. Community leaders activate the community disaster plan.
B. Community leaders contact the federal government about disaster relief.
ANS: A
C. Relief workers run out of bottled water and bedding supplies.
D. Tornado victims are sent to a boarding home in the nearest urban area.

What is the vision of the Department of Health

A. Responsible for the formulation, planning, implemented, and coordination of policies
and programs in the field of health
B. Regulates health goods and services
C. Health as Right. Health for all Filipinos by the year 2000 and Health in the hands of the
ANS: C
People bythe year 2020
D. All of the above

When acting as a mediator, the nurse advocate would:

A. Choose a new health plan for a client with limited funds
B. Assist new parents in communicating with their health plan regarding well-baby
coverage
C. Provide health education to teens who need knowledge about sexually transmitted
ANS: B
diseases
D. Set up a doctor's appointment for an illiterate adult
When assessing a community's health care needs, an advanced public health nurse ANS: A
interviews a first-grade teacher and the editor of the weekly news bulletin. The nurse is Key informant interviews are qualitative in-depth interviews with people who
using which data collection method?
know what is going on in the community. The purpose of key informant
A.Key informant
interviews is to collect information from a wide range of people—including
B. Nominal group
C. Participant observer
community leaders, professionals, or residents—who have first hand
D. Social survey knowledge about the community.

Which is the primary goal of community health nursing?A. To support and supplement the efforts of the
medical profession in the promotion of health and prevention of illness Answer: (B) To enhance the capacity of
B. To enhance the capacity of individuals, families and communities to cope with their health needs
C. To increase the productivity of the people by providing them with services that will increase their
level of health
individuals, families and communities to
cope with their health needs
D. To contribute to national development through promotion of family welfare, focusing particularly on
mothers and children.

Which of the following categories would make a person eligible for Medicaid
a) Family of 4 with an income of $200,000
b) Pregnant women and children under 6 in a low income household b) Pregnant women and children under
6 in a low income household
c) Only Employed single men
d) Only pharmacy students
e) Only college athletes

Which of the following people would be eligible for Medicare Part A?

a. Jane age 63 who is a citizen
b. John age 65 who has come to the United States on a Visa
c. James age 64 who is a resident of the United States
e. Jared age 64 with End-Stage Renal
d. Jan age 64 with a spouse that has worked for at least 5 years in Medicare-covered
employment
Disease (ESRD)
e. Jared age 64 with End-Stage Renal Disease (ESRD)

Which program is an example of secondary prevention?A. A community-

wide nutrition program at fast-food establishments
B. A program to immunize persons exposed to infectious disease with
immunoglobulin G within two weeks of exposure ANS: B
C. Alcoholics Anonymous
D. An exercise program for persons who have had a stroke

Which U.S. agency is responsible for overseeing the actions of protecting against, ANS: E
responding to, recovering from, and preventing the effects of disaster? Because of the recognition of the need to be prepared, programs have been created to
a. American Red Cross address the national, state, and local management of disasters. President G. W. Bush
b. Department of National Security established the National Incident Management System (NIMS) in 2004. The NIMS provides
c. Federal Emergency Management Agency a systematic, proactive approach for all levels of government and nongovernmental
d. The National Disaster Relief Agency agencies to work seamlessly to prevent, protect against, respond to, recover from, and
e. The National Incident Management System prevent the effects of disasters (Federal Emergency Management Agency, 2009).