Question 1

A 45-year-old woman presents to the emergency department complaining of chest pain and feeling anxious.She asks to have an electrocardiogram (EKG)but is told that "heart disease is a man's disease" and is given a prescription for lorazepam (Ativan).What can the nurse conclude?

Accepted Answer

A stereotype is a mental image that portrays members of a specific group with the same attributes.Believing that heart disease is a "man's disease" is an example of a stereotype.Because the practitioner held this view,the woman's health care was compromised.The other statements cannot be justified from this example.

Question 2

The jail nurse is interviewing a woman who has been brought to the clinic for prenatal care.Which of the following are appropriate actions for the nurse to perform? (Select all that apply.)

Accepted Answer

A nurse who is able to deliver culturally competent care to incarcerated women quickly becomes cognizant of the challenges of caring for this population.These women tend to have many health problems,including substance abuse and dependency.They frequently have not had access to health-related knowledge.Because nearly 1.3 million children of incarcerated women have no mother figure in their lives,women in prison or jail are often deeply concerned about their welfare.This demonstrates caring and can often be the motivation for making changes.The nurse needs to complete a thorough obstetrical history,including determining risk factors for high-risk pregnancy.The nurse does not need to know about the woman's criminal history.

Question 3

The clinic nurse is interviewing a woman and her daughter who describe their address as"temporary." The mother appears thin,pale,and tired.Her blood work confirms anemia and pregnancy.What actions by the nurse would be most helpful? (Select all that apply.)

Accepted Answer

A priority for this family is to provide information regarding shelters,to facilitate follow-up clinic visits for the mother to address her pregnancy and anemia,and to determine if the family is currently in a safe place or if the family is vulnerable to violence.Nutrition in pregnancy should be discussed,but it is not the priority intervention at this point.There is no reason to call the Department of Children and Family Services unless abuse is suspected.

Question 4

A nurse working in the community uses the public health intervention model to combat diabetes mellitus type 2.Using this model,which interventions are appropriate? (Select all that apply.)

Accepted Answer

The public health intervention model,also known as the Intervention Wheel,is a framework that contains three levels for health-care interventions,from the micro-level of the individual to the macro-level of the environment.Interventions are aimed at individuals/families,communities,and larger institutional and social systems.Lobbying to build walking/biking trails and assisting with community gardens are examples of community-level interventions.Encouraging high-risk individuals to have glucose screening is at the individual/family level,as is education about the benefits of daily exercise.An example of an institutional or societal intervention would be lobbying Congress to pass laws requiring insurance companies to provide incentives for health promotion activities.

Question 5

A nurse considers beneficence as the guiding ethical principle for nursing practice.Working within that framework,which action by the nurse best demonstrates that concept?

Accepted Answer

Beneficence means acting for the patient's benefit,or doing good.Giving a pain medication before a therapy session helps the patient fully participate,improving his or her recovery.Allowing the patient to make informed choices demonstrates autonomy.Returning when promised is an example of fidelity.Turning patients,even though it causes temporary discomfort,is non-maleficence.

Question 6

What does the nursing student understand about health disparities in the United States? (Select all that apply.)

Accepted Answer

African American babies have a significantly higher infant mortality rate compared to European Americans. Health resources in the U.S. are not evenly distributed, contributing to disparities. Sudden infant death syndrome is more prevalent among American Indian and Alaska Native babies.

Question 7

The community health nurse knows that the public health intervention model is focused on which of the following intervention levels? (Select all that apply.)

Accepted Answer

The public health intervention model is an inclusive framework that encompasses three levels at which interventions can be initiated,from the micro-level of the individual to the macro-level environment.Interventions are targeted toward individuals/families,communities,and larger institutional and societal systems.Government and hospitals are not one of the three levels.

Question 8

A nurse is working with a patient determined to have low health literacy and has taught the patient vital self-care measures for a chronic illness.How will the nurse best determine if the patient has understood the information? (Select all that apply.)

Accepted Answer

Communicating with people who have low health literacy can be challenging.Some strategies the nurse can employ are: specific training,asking open-ended questions,asking patients to restate information or provide a return demonstration of skills,using plain and culturally sensitive language,and developing health information tailored to specific populations.To assess for cultural congruency,the nurse can ask the patient to explain how the self-care measures fit into the patient's life.Simply giving the patient brochures does not guarantee that the patient understands or will use them,or even whether the patient can read.Giving a quiz might be seen as intimidating.

Question 9

The clinic nurse explains to a student that an appropriate nursing action is screening all children for child abuse.What other information does the nurse give the student about child abuse? (Select all that apply.)

Accepted Answer

The National Child Abuse and Neglect Data System reports that three children die of child abuse in the home each day.Children are most commonly abused by someone they know,and in 79% of cases,the perpetrator is a parent.Child abuse can set up a perpetuating cycle of suffering and more violence later in life,potentially reaching to future generations.Neglect is the most common form of child abuse.One out of every four girls will be sexually abused by the time she reaches 18.

Question 10

A nurse working in a women's health clinic has several patients who are from a minority culture,live in the inner city,lack employment that offers benefits,have large families,and often lack transportation to health care.Which of these factors are considered broad determinants of health? (Select all that apply.)

Accepted Answer

Broad determinants of health care are personal,community,and societal systems and include environment,employment,insurance,class,race,social support,access to health services,genetic endowment,and personal histories.Family size itself is not a broad determinant of health care;however,it could be included in the larger category of personal history.

Question 11

A nurse ensures that a patient does not have questions regarding the upcoming surgical procedure and verifies that the signature on the consent form is the patient's signature.Which ethical principle is this nurse demonstrating?

Accepted Answer

Autonomy is the right to make decisions and to have the information necessary to make such decisions.Beneficence is doing good.Fidelity is keeping promises.Justice is treating everyone fairly.

Question 12

Which childhood illnesses are the subject of a Healthy People initiative regarding vaccinations? (Select all that apply.)

Accepted Answer

One goal of the Healthy People initiative is to reduce vaccine-preventable illnesses such as measles,mumps,and rubella to zero cases and to reduce pertussis in children under 7 to no more than 2,000 cases/year.Asthma and meningitis are not included in this goal.

Question 13

One goal of the Healthy People 2020 initiative is to increase the number of people who have some form of health insurance.What percentage of the population is the target?

Accepted Answer

Healthy People 2020 has the ambitious goal of increasing the proportion of people with health insurance to 100%.

Question 14

A nurse has heard of the "digital divide" between people who have access to technology and those who don't.The nurse asks a mentor how this can affect health care.What response by the mentor is most accurate?

Accepted Answer

The explosion in information makes digital access to health-care resources vital.There are even applications for smart phones that have a health-care function.Not all clinics and physician offices have online appointment scheduling.Most people surveyed would like to connect with their physicians via email but not on social networking sites.

Question 15

The community health nurse is aware that the goals of Healthy People 2020 include which of the following? (Select all that apply.)

Accepted Answer

Goals of the Healthy People 2020 document include the following: (1)To attain high-quality,longer lives free of preventable disease,disability,injury,and premature death;(2)to achieve health equity,eliminate disparities,and improve the health of all groups;(3)to create social and physical environments that promote good health for all;and (4)to promote quality of life,healthy development,and healthy behaviors across all life stages.The blueprint does not call for developing healthy behaviors only in children and teens,nor does it call for simply increasing the average life span.

Question 16

The public health nurse explains to students that diversity is an increasing phenomenon in this country.What facts about this phenomenon does the nurse share with the students? (Select all that apply.)

Accepted Answer

The population of ethnic minorities is expected to reach 50% by the year 2050,which increases the need for culturally competent health care.One in five people will be over the age of 65 by 2030,increasing the impact of chronic illnesses.Hispanics,blacks,Asians,and Native Americans are the historically designated minority groups.There is no biologic basis for race;racial and ethnic categories are socially created.

Question 17

A nurse is working with a woman who is 4 months pregnant.The woman has had a series of temporary housing,has no job,and is wearing clothing that is obviously way too big for her.What action can the nurse take to most improve the health of this woman and child?

Accepted Answer

WIC,or the Women,Infants,and Children Program,targets pregnant women,infants,and children up to age 5 who are nutritionally at risk.WIC provides supplemental nutritious foods and nutrition counseling.Forty-five percent of infants born in this country participate in the WIC program.Helping with transportation needs and facilitating return appointments is helpful too,but not to the degree that improving this woman's nutrition will be.The woman might be eligible for Medicaid,but not Medicare,which is for the elderly.

Question 18

A nurse has helped organize and staff a free vaccination clinic for underserved populations in a central location of the city.The nurse is unhappy that so few people came to the clinic.In evaluating this outcome,what factors does the nurse recognize as potentially leading to the problem? (Select all that apply.)

Accepted Answer

Underserved,typically poor,populations face multiple obstacles to obtaining health care that need to be considered when organizing events.If the clinic hours were during the day,parents might be reluctant to pull children out of school for fear of being labeled as truant.Parents participating in "welfare to work" programs or who have low-skill,low-wage jobs might not be able to miss work,or would forfeit pay by doing so.Participants need transportation to the clinic,which is located in one area of town.Language barriers could lead to confusion or misunderstanding or lack of awareness of the clinic.The lack of insurance shouldn't be a concern because the vaccinations are free,but it is possible this was a point that some misunderstood.

Question 19

Which of the following activities should the perinatal nurse encourage women who come for preconceptional counseling to consider? (Select all that apply.)

Accepted Answer

Folic acid supplementation helps to prevent certain birth defects.A fetus's exposure to harm could potentially be prevented if a woman were counseled prior to pregnancy about the adverse effects of alcohol,tobacco,toxoplasmosis,and other teratogens in her home or workplace.During the preconception period,it is too early for the woman to take iron supplements (unless she is anemic),and debating infant feeding methods is not the priority at this time.

Question 20

A mother brings her 6-month-old infant and 18-month-old child to the health clinic for a routine visit.The nurse counsels the mother about lead exposure testing.Which information should the nurse include? (Select all that apply.)

Accepted Answer

The American Academy of Pediatrics recommends that all children between the ages of 1 and 2 years receive testing for lead exposure,as 25% of homes presently occupied by children under the age of 6 have known lead contamination.Lead exposure has been linked to a number of medical and developmental problems,including anemia,seizures,and mental retardation.

Quiz 2: Contemporary Issues in Womens, Families, and Childrens Health Care

A 45-year-old woman presents to the emergency department complaining of chest pain and feeling anxious.She asks to have an electrocardiogram (EKG) but is told that "heart disease is a man's disease" and is given a prescription for lorazepam (Ativan) .What can the nurse conclude?