Community Health Exam - Version A

1. The home health nurse is planning a visit with a client who has been discharged home after a hospitalization.
Which action should the nurse implement?

A. Avoid creating barriers by wearing a name tag in the home.

B. Schedule home visits that take place during the daylight hours.

C. Ensure HIPAA laws are observed by avoiding visits with other home care providers.

D. Use a duplicate copy of the client's record to provide concurrent services.

Answer: B
2. An occupational health nurse is reviewing a 20-year-old trend in the United States that has resulted in an
increase in certain medical conditions due to the rapid expansion of an urban industrial workforce. Which
medical conditions are specifically identified with this trend? (Select all that apply.)

A. Asthma.

B. Alcoholism.

C. Lung cancer.

D. Lead poisoning.

E. West Nile virus infection.

F. Hepatitis B virus infection.

Answer: A, C
3. A home health nurse knows that a 70-year-old male client who is convalescing at home following a hip
replacement, is at risk for developing decubitus ulcers. Which physical characteristic of aging contributes to
such a risk?

A. 16% increase in overall body fat.

B. Reduced melanin production.

C. Thinning of the skin with loss of elasticity.

D. Calcium loss in the bones.

Answer: C
4. The nurse is designing a bioterrorism plan for a community. Which agents are transmitted person to person via
respiratory or inhalation exposure? (Select all that apply.)

A. Ricin.

B. Pneumonic plague.

C. Anthrax.

D. Botulism.

E. Smallpox.

F. Brucellosis.
Answer: B, E
5. Which topic should the nurse include in planning a primary prevention class for
adolescents?

A. Risk factors for heart disease.

B. Dietary management of obesity.

C. Suicide risks and prevention.

D. Coping with stressful situations.

Answer: C
6. During an initial clinic visit, the nurse is taking the history for a client who wants to confirm her pregnancy.
The client's last child has a history of low-birth-weight (LBW). Which additional finding is most important for
the nurse to consider?

A. Cigarette smoking.

B. African-American ethnicity.

C. Poor nutritional status.

D. Limited maternal education.

Answer: B
7. A college student asks the nurse in the Campus Student Health Center about obtaining medication for motion
sickness before a scuba diving trip. What instruction should the nurse give the student regarding the use of
prescription-strength scopolamine (Transderm-V)?

A. Take the oral preparation 30 minutes before diving.

B. Apply the skin patch behind the ear 12 hours before your trip.

C. Use the medication at the first feeling of nausea on the boat.

D. Apply a new skin patch every 6 hours to the chest or abdomen.

Answer: B
8. What action is best for the community health nurse to take if the nurse suspects that an infant is being
physically abused?

A. Follow agency protocols to report suspected abuse.

B. Report suspicions to the local child abuse reporting hotline.

C. Educate the child's caregivers about growth and development issues.

D. Call the police department to have the child removed from the home.
Answer: A
9. A terrorist attack has occurred and several people have inhaled Ricin. Which intervention should the
emergency department nurse implement when caring for these clients?

A. Administer the antibiotic streptomycin, IV STAT.

B. Provide all clients with the Ricin antidote.

 C. Implement strict respiratory isolation immediately.

D. Provide supportive nursing care to the clients.

Answer: D
10. What is an example of a positive outcome for one of the Leading Health Indicators of Healthy People
2010?

A. A community has adopted a no smoking policy.

B. A rural community has a public transportation system.

C. The high school drop out rate has decreased by 15%.

D. A county has decreased their divorce rate by 10%.

Answer: A
11. The home health nurse is admitting a client with Parkinson's disease to the home healthcare service. In
planning care for this client, which nursing diagnosis has priority?

A. Impaired physical mobility related to muscle rigidity and weakness.

B. Ineffective coping related to depression and dysfunction due to disease progression.

C. Ineffective breathing pattern related to respiratory muscle weakness.

D. Fear related to constant possibility of experiencing seizures.

Answer: A
12. After accepting the position of school nurse in an public elementary school, what strategy is best for the
nurse to use to obtain an overview understanding of the student body?

A. Review all of the health records of the students presently registered for classes.

B. Talk with the current officers of the parent-teacher association.

C. Send home a survey form to parents of third grade students.

D. Conduct a windshield survey of the geographic areas served by the school.

Answer: D
13. Lillian Wald was a significant person in the history of American nursing. Which contributions can be attributed
to her? (Select all that apply.)

A. Development of public health nursing practice.

B. First nursing service for occupational health.

C. Campaigned for laws to require registration for nurses.

D. Established committee that was the forerunner of the NLN.

E. Instituted a sliding scale fee for service.

Answer: A, B, D, E
14. A male client is brought to the emergency department as the result of a motorcycle accident. He was not
wearing a helmet at the time of the accident, and states that he has no intention of ever wearing one. Within
 the framework of the Transtheoretical Model (TTM), which response should the nurse provide?

A. Wearing a helmet or not is certainly an individual decision.

B. You should seriously consider wearing a helmet.

C. Riding a motorcycle with a helmet increases your safety.

D. I really think you don't have the facts about helmet use.
Answer: A
15. A 12-year-old female is seen by the school nurse after recently experiencing increasing difficulty sitting still
and paying attention in class, and increasingly illegible handwriting. The nurse observes that the child has
protruding eyeballs and a staring expression. What action should the nurse take next?

A. Refer the child for psychologic evaluation due to attention deficit disorder.

B. Call the child's parents to schedule the child for an immediate medical exam.

C. Gather additional data by taking a health history and measuring vital signs.

D. Collaborate with the teacher to place the child on a behavior modification program.
Answer: C
16. The multidisciplinary home health care team is discussing a female client diagnosed with Parkinson's disease.
The home health care nurse reports the client is getting worse and her husband is no longer able to care for
her in the home. Which action should the home health nurse implement first?

A. Request a chaplain to counsel with the couple.

B. Assign a home health care aide to provide care daily.

C. Talk to the husband about placing his wife in a nursing home.

D. Contact the client's children to discuss the situation.

Answer: B
17. While discussing the science of nursing, the nurse identifies the domain of nursing theory. Which linkages
should the nurse provide to describe nursing's paradigm?

A. The person, the environment or situation, and health.

B. Stress reduction, self-care, and a systems model.

C. Curative care, restorative care, and terminal care.

D. Self-actualization, fundamental needs, and belonging.

Answer: A
18. During a home health visit, a male client reports to the nurse that he felt a solid testicular mass during self-
exam, but that it wasn't painful. What instruction should the nurse provide the client?

A. Continue to monitor the mass until the next scheduled annual medical exam.

B. Notify the healthcare provider if the mass becomes soft, painful, or starts to drain.

C. Schedule an appointment with the healthcare provider for prompt evaluation.

 D. Testicular nodules are of concern only if they feel matted or are not easily movable.
Answer: C
19. The nurse is planning a community-based project to reduce obesity in a school-aged population. Which
outcome statement best supports the goal for this population?

A. Increase in exercise will decrease obesity in children with a sedentary life style.

B. Students with a body mass index above the 95 percentile will decrease.

C. Within 2 years, students with a body mass index greater than 95% will be reduced by 50%.

D. In the target population, 30% of students will be below the 95 percentile in weight.
Answer: C
20. Attendance at a community health clinic is rising and clients have long waits for service. The charge nurse
believes that a computer system would be helpful in decreasing the time needed to conduct intake and exit
processing. What is the best way for the nurse to introduce the idea of obtaining a computer system for the
clinic?

Ask the medical director to talk to the Board of Directors about obtaining funds to implement a
A. computer system.

B. Send a signed letter to the editor of the local newspaper describing the benefits to the community.

C. Submit a written proposal to the Board of Directors about hardware and software improvement needs.
Meet informally with some Board members to enlist their support for the idea of implementing a
D. computer system.

Answer: C
21. Which presentation of an infectious disease is acquired through an indirect
transmission?

A. Syphilis contracted from a sexual partner.

B. Measles resulting from a daycare center outbreak.

C. Malaria following exposure in a mosquito-infested area.

D. Nosocomial influenza spreading rapidly in a long-term center.

Answer: C
22. Which topic should the nurse include in planning a secondary prevention project for the local retirement
community?

A. Safety measures in the home.

B. Adult immunization program.

C. Rehabilitation after surgery.

D. Vision and hearing screening.

Answer: D
23. The nursing education coordinator is creating employee orientation materials for staff nurses who plan to
work at a clinic that serves a lower socioeconomic neighborhood. What information should the educator
include regarding the clinic's client population? (Select all that apply.)
 A. Most of the clients are unemployed or disabled.

B. Access to mass transit may be an issue.

C. Clients will need reminders to bring insurance cards.

D. Basic physiologic needs of this population are often unmet.

E. Clients who are homebound will qualify for Medicaid.

F. Nonadherence to healthcare recommendations is likely.

Answer: A, B, D
24. The nurse is working in a community clinic that serves a population comprised mainly of migrant families. In
planning the use of resources for secondary prevention, which activity should be the priority?

A. Skin testing for tuberculosis.

B. Glucose monitoring for diabetes.

C. Blood work for cardiovascular disease.

D. Height and weight for altered nutrition.

Answer: A
25. The nurse is teaching a community group about risks of cardiovascular disease. Several clients ask the nurse
to determine their risk. Which client should the nurse identify as having the greatest risk for cardiovascular
disease?

A. A male with a serum cholesterol level of 199 mg/dl.

B. A female with a serum cholesterol level of 201 mg/dl.

C. A male with a low-density lipoprotein (LDL) level of 200 mg/dl.

D. A female with a low-density-lipoprotein (LDL) level of 160 mg/dl.

Answer: C
26. The nurse administers a booster dose of DTaP (diphtheria, tetanus, and pertussis) vaccine to an infant.
Which level of prevention is the nurse implementing?

A. Primary prevention.

B. Tertiary prevention.

C. Secondary prevention.

D. Primary nursing.
Answer: A
27. The nurse is assessing a Vietnamese child during a home health visit and identifies round swellings on the
child's back. The child's mother says she rubbed the edge of a coin on her child's oiled skin. The nurse should
recognize that this behavior is prompted by which cultural belief?

A. The child's behavior was not acceptable.

B. The purpose is to rid the body of disease.

 C. This method is commonly used for discipline.

D. Temper tantrums are commonly managed using this method.

Answer: B
28. The nurse is developing a plan to provide quality health care for a certain community. Data obtained from
which resources should be helpful to the nurse in developing a community healthcare plan for this
community? (Select all that apply.)

A. Census data.

B. Risk management data.

C. Budgeting process information.

D. Available workforce in the community.

E. Client-satisfaction surveys.

F. Changes in the community's demographic data.

Answer: A, B, C, E, F
29. A nurse organizes a community action group to help resolve health problems in a low income neighborhood
with a large population of recent immigrants from Africa. What problem should the nurse address first?

A. High rate of unemployment.

B. Low immunization rate of children.

C. Provision of substandard health care.

D. Access to bilingual care providers.

Answer: B
30. When asked to help develop interventions to combat obesity among children, the community health nurse
should stress the importance of implementing which activity?

A. Set goals that are focused on developing healthier lifestyles.

B. Develop strict diet plans for school-aged children.

C. Provide diet classes for the obese children during school hours.

D. Require all children to participate in organized team sports.

Answer: A
31. A young woman tells the public health nurse that a friend was recently diagnosed with Hepatitis B and she is
concerned about getting the disease. During the assessment interview, which question is most important for
the nurse to ask this woman?

A. Did you drink after or use any utensils that your friend used?

B. Have you noticed any yellowish tinge to the whites of your eyes?

C. Have you shared any needles or had sex with your friend?

D. How long ago was your friend diagnosed with Hepatitis B?

Answer: C
32. The nurse is preparing to discharge an elderly, recently widowed female client following a mild stroke. At this
time she is able to walk with the aid of a walker. As part of the discharge planning, what referral is most
important for the nurse to make?

A. Pastoral care.

B. Meals-on-Wheels.

C. Grief support group.

D. Physical therapy.
Answer: B
33. A nurse working in a community health setting is performing primary health screenings. Which individual is at
highest risk for contracting an HIV infection?

A. A 17-year-old who is sexually active with numerous partners.

B. A 45-year-old lesbian who has been sexually active with two partners in the past year.

C. A 30-year-old cocaine user who inhales the drug and works in a topless bar.

D. A 34-year-old male homosexual who is in a monogamous relationship.

Answer: A
34. Which intervention should the public health nurse implement when attempting to address one of the leading
health indicators of Healthy People 2010?

A. Lead a weekly water aerobics class for the elderly at a community center.

B. Teach a class on cultural awareness to nursing students at the university.

C. Design and implement a no smoking campaign at the local high school.

D. Write a grant to help provide glucometers to individuals who cannot afford one.
Answer: C