Question 1

As a guest speaker for a group of community health nurses who are considering correctional nursing as a career, a correctional nurse provides an overview of the history of correctional nursing. Which aspect would the nurse describe as the historic view of correctional nursing?

Accepted Answer

Although the correctional system of prisons and jails has been around for a very long time, it historically provided minimal, if any, health care to inmates. Prison was a punishment, and the inmates were viewed as not deserving of care that was being paid for from public dollars. Communicable diseases were and continue to be a major health issue.

Question 2

A nurse is considering a career in public health nursing. The nurse determines the need to obtain which level of education for entry-level practice?

Accepted Answer

The American Nurses Association recommends that an entry-level PHN should have a bachelor's degree in nursing. Some states, such as California, require nurses to take additional classes and obtain certification beyond a bachelor's degree if the BSN program does not offer specific content (e.g., child abuse, public health didactic and practicum). PHNs working with specific populations, or in administration, should hold a master's degree. A PHN with a master's degree in community/public health nursing may take a national certification examination offered by the American Nurses Credentialing Center.

Question 3

A public health nurse is participating as a member of a job fair in a local community. One of the attendees asks the nurse how public health nursing differs from nursing in general. When describing the differences, which characteristics would the nurse include as reflecting public health nursing? Select all that apply.

Accepted Answer

Public health nurses focus on the greater good, seek out of clients in need, and are committed to the community. Public health nursing is grounded in social justice and focuses on health promotion and disease prevention. Public health nursing does not usually include acute care services or health restoration.

Question 4

A public health nurse is engaged in the public health function of assessment. Which activity would the nurse most likely be involved with?

Accepted Answer

The public health function of assessment is reflected when a public health nurse identifies the problems in a community and then prioritizes which issue to address first by deciding which issue impacts the most people and what interventions will help the population thrive. Evaluating for potential safety hazards and ensuring proper immunizations reflect the assurance function of public health. Working with officials to develop programs reflects the function of policy development.

Question 5

A public health nurse is conducting an orientation program for a group of new public health nurses. The nurse determines that the teaching was successful based on which statement by the group about public health nursing and other types of nursing?

Accepted Answer

In hospital nursing, nurses must address the issues that come to them. Whereas in public health nursing, it is necessary for the nurse to actively seek out and identify potential problems and situations. The priorities vary for both public health nursing and other types of nursing and certainly within different communities that a public health nurse practices. Nurses who work in public health must collaborate as must nurses who work in the hospital. However, the types of people and agencies that a public health nurse must collaborate with vary from the types of people and agencies that a hospital nurse must collaborate with. Nurses who work in public health use the nursing process as a foundation for their work, just as nurses who work in hospitals do. In public health nursing, the community is the client, but the nursing process may also be applied to individuals and families.

Question 6

A public health nurse is working with various officials to foster public health. The nurse would expect that the group would contact which organization as the primary federal agency involved with public health?

Accepted Answer

The main organization involved with public health is the Department of Health and Human Services (DHHS). Other federal agencies that also impact public health include the Environmental Protection Agency (EPA), the Department of Homeland Security, the Department of Agriculture, the Department of Education, and the Department of Veterans Affairs.

Question 7

A public health nurse is employed by the Indian Health Services. This nurse is working at which level?

Accepted Answer

The Indian Health Service is an agency headed by the Department of Health and Human Services, a federal agency. Thus, the nurse would be working at the federal level.

Question 8

A public health nurse asks another public health nurse who is a member of the U.S. Public Health Service Commissioned Corps about what is needed to qualify for a position. Which qualifications would the nurse most likely include in the response? Select all that apply.

Accepted Answer

To qualify as a nurse in the Commissioned Corps, one must be a U.S. citizen, <44 years old, able to pass a physical examination, possess a bachelor's or higher degree from an accredited nursing program, pass the National Council Licensure Examination (NCLEX), and hold a valid nursing license from 1 of the 50 states, the District of Columbia, Puerto Rico, Guam, or the U.S. Virgin Islands.

Question 9

A public health nurse is working with several communities to develop appropriate programs for health surveillance to improve client care and health research. Which agency would the nurse contact to obtain information on this topic?

Accepted Answer

The nurse would contact the Centers for Disease Control and Prevention that is responsible for health surveillance and the prevention of disease and bioterrorism. The National Institutes of Health provide medical research. The Agency for Health Care Research and Quality is responsible for research on health care quality and effectiveness. The Food and Drug Administration works to ensure the safety of food, medication, medical procedures, and equipment.

Question 10

A community health nurse is advocating for the development of school-based health clinics in the community high schools as a means to accomplish which outcome?

Accepted Answer

School-based health centers (SBHC) provide ready access to health care for large numbers of children and adolescents during school hours, reducing absences from school due to health care appointments. SBHCs provide a variety of services in a user-friendly manner at a convenient location. Many SBHCs do not provide contraceptive services on the school site due to school district policy or state law. These centers also are a cost-effective way to decrease visits to the emergency department.

Question 11

A nurse is attending a career day at the local college. One of the speakers is a school nurse who is describing the educational requirements for this position. Which level of education would the school nurse cite as a minimum requirement?

Accepted Answer

School nursing: Scope and standards of practice (ANA & NASN, 2011) indicates that school nurses should, at minimum, possess a bachelor's degree. As the needs of school-aged populations become increasingly complex, some states require even more specialized training for school nurses. In California, for instance, school nurses are expected to hold a school health services credential. This credential is obtained through a postbaccalaureate program that includes course work in audiology, guidance and counseling, exceptional children, school health principles and practice, a practicum in school nursing, child psychology, and health curriculum development, in addition to other courses. However, most California school nurse credential programs are now available only as part of a master's degree program. A national certification is available as well.

Question 12

A public health nurse is reading an article about the impact of the Supreme Court decision regarding Estelle v. Gamble. The nurse would identify which impact as related to this decision?

Accepted Answer

The Supreme Court ruled that not providing medical services inflicted pain and denied inmates of their Eighth Amendment rights. This decision led to major reforms in the corrections health system. Medical providers were hired, and inmates' rights were established. The decision did not address facilities or use of managed care organizations. Treatment in a timely fashion was not part of this decision. However, later lawsuits involved this issue.

Question 13

A nurse working in a correctional setting provides care to inmates with various health conditions. Based on research, which health conditions would the nurse most likely address as most prevalent? Select all that apply.

Accepted Answer

Communicable diseases such as tuberculosis and hepatitis C are of great concern in the correctional community. In addition, drug abuse by inmates is very high. Heart disease and asthma rates vary.

Question 14

A school nurse functions to promote a healthy school environment. Which activity would be most appropriate for the nurse to do?

Accepted Answer

Promotion of healthful school living emphasizes planning a daily schedule for monitoring healthful classroom experiences, extracurricular activities, school breakfasts and lunches, emotional climate, discipline programs, and teaching methods. It also includes screening, observing, and assessing to identify needs early and report illegal drug use, suspected child abuse, and violations of environmental health standards. Health promotion involves the nurse in supporting the physical, mental, and emotional health of school personnel by being an accessible resource to teachers and staff regarding their own health and safety. Providing asthma care and developing individualized health plans are examples of providing health services. Engaging in incidental teaching reflects the function of health education.

Question 15

A school nurse who is not a nurse practitioner works in an elementary school (K-4) with 1,200 students. Which activities would be most appropriate for the nurse to engage in with this group? Select all that apply

Accepted Answer

Vision and hearing screening, teaching basic health practices, and monitoring chronic illnesses are appropriate school nurse activities for children in this age group. Scoliosis screening would be more appropriate for children in their early adolescent growth spurt years, not at this age. A school nurse would not order medications. A school nurse practitioner would provide primary care and, if allowed by the state, prescribe medications.

Question 16

A school nurse is describing the responsibilities associated with this specialty to a group of nurses at a job fair. One of the nurses asks, "What is your primary responsibility?" Which response would be most appropriate?

Accepted Answer

The primary responsibilities of the school nurse are to prevent illness and to promote and maintain the health of the school community. The school nurse serves not only individuals, families, and groups within the context of school health but also the school as an organization and its membership (students and staff) as aggregates. Caring for children with special health needs, performing health screenings, and assessing acute health problems are aspects associated with the primary responsibilities of preventing illness and promoting and maintaining the health of the school community.

Question 17

A school nurse is reviewing the population of school-age children for chronic conditions. Which conditions would the school nurse expect to find most often? Select all that apply.

Accepted Answer

The five chronic conditions most often seen in school-age children are asthma, diabetes, seizures, severe food allergies, and attention deficit/behavioral disorders. Rheumatoid arthritis is not common. HIV/AIDS and tuberculosis are more commonly seen in correctional settings.

Question 18

A school nurse is providing care to a group of children with severe food allergies. Which intervention would be most important for the nurse to include in the child's plan of care?

Accepted Answer

Severe food allergies can lead to anaphylactic shock. School nurses coordinate and work with students and their families, along with school personnel to raise awareness and enlist caution. They also work with families and health care providers to ensure that epinephrine via an autoinjector is available for the child in case of emergencies. School nurses also work with teachers and lunch room personnel to alert them of the allergy, explain what can happen in a case of anaphylaxis, and provide training on how to use the autoinjector or other needed medication. Calling the child's parents in case of a reaction would be important but prompt treatment with epinephrine is the priority. Responsible adults, not other children, should know how to administer the epinephrine. Daily medication usually is not required for children with food allergies, however, avoidance of the allergen is.

Question 19

A correctional nurse is working to develop programs for inmates and reviews the demographics of this population to determine potential issues. When comparing this population to the general population, which finding would the nurse expect?

Accepted Answer

Demographically, inmates differ from the general population. First, inmates have all committed some type of crime, and 97% of those in state and federal prisons are serving more than 1 year and over half (53.2%) are serving time for violent crimes. Thirteen percent of males and 11% of females in state prisons have been convicted of murder. Half of federal prison inmates are serving time for drug offenses. National statistics indicate a larger portion of Black (37%) and White (32%) than Hispanic (22%) male inmates in state and federal prisons. For female prisoners, Whites more than double the total number of Black prisoners and almost triple the number of Hispanic prisoners. The imprisonment rate for males is 890 per 100,000 U.S. residents, but for females, it is only 65. In addition, the inmate population is drawn disproportionately from lower socioeconomic backgrounds when compared with the general public. This increases their chances of having a long trajectory of poorer access to health care and treatment. Statistics show a greater disproportion of inmates who are chronically ill and have infectious diseases than the nonincarcerated population (Carson, 2015).

Question 20

A correctional nurse is proactively working with the institution to develop programs for the facility to address problems and the trends for the future. Which type of program would be most appropriate for the nurse to recommend?

Accepted Answer

Typically, inmates are older, sicker, and remain in prison longer than in previous years. Therefore, the nurse would need to develop programs to address older inmates with more chronic illnesses and longer incarcerations.

Quiz 28: Public Settings